Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Australia.
BMC Pregnancy Childbirth. 2012 Sep 27;12:102. doi: 10.1186/1471-2393-12-102.
Excess gestational weight gain (GWG) can affect the immediate and long term health outcomes of mother and infant. Understanding health providers' views, attitudes and practices around GWG is crucial to assist in the development of practical, time efficient and cost effective ways of supporting health providers to promote healthy GWGs. This study aimed to explore midwives' views, attitudes and approaches to the assessment, management and promotion of healthy GWG and to investigate their views on optimal interventions.
Midwives working in antenatal care were recruited from one rural and one urban Australian maternity hospital employing purposive sampling strategies to assess a range of practice areas. Face-to-face interviews were conducted with 15 experienced midwives using an interview guide and all interviews were digitally recorded, transcribed verbatim and analysed thematically.
Midwives interviewed exhibited a range of views, attitudes and practices related to GWG. Three dominant themes emerged. Overall GWG was given low priority for midwives working in the antenatal care service in both hospitals. In addition, the midwives were deeply concerned for the physical and psychological health of pregnant women and worried about perceived negative impacts of discussion about weight and related interventions with women. Finally, the midwives saw themselves as central in providing lifestyle behaviour education to pregnant women and identified opportunities for support to promote healthy GWG.
The findings indicate that planning and implementation of healthy GWG interventions are likely to be challenging because the factors impacting on midwives' engagement in the GWG arena are varied and complex. This study provides insights for guideline and intervention development for the promotion of healthy GWG.
妊娠体重过度增加（GWG）会影响母婴的近期和长期健康结果。了解卫生保健提供者对 GWG 的看法、态度和做法对于帮助制定实用、高效和具有成本效益的方法来支持卫生保健提供者促进健康的 GWG 至关重要。本研究旨在探讨助产士对 GWG 的评估、管理和促进的看法、态度和方法，并调查他们对最佳干预措施的看法。
从一家农村和一家城市澳大利亚产科医院招募了从事产前保健的助产士，采用目的抽样策略评估了一系列实践领域。采用访谈指南对 15 名经验丰富的助产士进行了面对面访谈，所有访谈均进行了数字记录、逐字转录和主题分析。
接受访谈的助产士表现出与 GWG 相关的一系列看法、态度和做法。出现了三个主要主题。在这两家医院的产前保健服务中，GWG 总体上被低优先级对待。此外，助产士非常关注孕妇的身心健康，并担心与女性讨论体重和相关干预措施可能带来的负面影响。最后，助产士认为自己是为孕妇提供生活方式行为教育的核心，并确定了支持促进健康 GWG 的机会。
研究结果表明，由于影响助产士参与 GWG 领域的因素多种多样且复杂，因此规划和实施健康 GWG 干预措施可能具有挑战性。本研究为促进健康 GWG 的指南和干预措施的制定提供了见解。
