Basu Andrea, Kennedy Lynne, Tocque Karen, Jones Sharn
Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, UK.
BMC Pregnancy Childbirth. 2014 Jul 4;14:218. doi: 10.1186/1471-2393-14-218.
Women in Wales are more likely to be obese in pregnancy than in any other United Kingdom (UK) country. Midwives are ideally placed to explore nutrition, physical activity and weight management concerns however qualitative studies indicate they lack confidence in raising the sensitive issue of weight. Acknowledging this and the reality of finite time and resources, this study aimed to deliver compact training on nutrition, physical activity and weight management during pregnancy to increase the knowledge and confidence of midwives in this subject.
A compact training package for midwives was developed comprising of evidence based nutrition, physical activity and weight management guidance for pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Descriptive statistics were applied and 95% confidence intervals were calculated.
43 midwives registered for training, 32 (74%) attended and completed the questionnaires. Although, pre training knowledge and confidence varied between participants, statistically significant improvements in self-reported knowledge and confidence were observed post training. 97% indicated knowledge of pregnancy specific food and nutrition messages as 'better' (95% CI 85 to 100), as opposed to 3% stating 'stayed the same'--60% stated 'much better'. 83% indicated confidence to explain the risks of raised BMI in pregnancy was either 'much' or 'somewhat better' (95% CI 66 to 93), as opposed to 17% stating 'stayed the same'. 89% indicated confidence to discuss eating habits and physical activity was 'much' or 'somewhat better' (95% CI 73 to 97) as opposed to 11% stating 'stayed the same'. Emergent themes highlighted that training was positively received and relevant to midwifery practice.
This study provides early indications that a compact nutrition, physical activity and weight management training package improves midwives self-reported knowledge and confidence. Cascading training across the midwifery service in the Health Board and conducting further studies to elicit longer term impact on midwifery practice and patient outcomes are recommended.
威尔士的女性在孕期比英国其他任何地区的女性更易肥胖。助产士在探讨营养、身体活动及体重管理问题方面具有理想的条件,然而定性研究表明,她们在提出敏感的体重问题时缺乏信心。认识到这一点以及时间和资源有限的现实情况,本研究旨在提供关于孕期营养、身体活动及体重管理的紧凑培训,以增强助产士在该主题方面的知识和信心。
为助产士开发了一个紧凑的培训包,其中包含基于证据的孕期营养、身体活动及体重管理指南。通过助产士负责人推广培训,并在卫生委员会内部进行。基于国家公共卫生指南中的陈述设计问卷,以评估培训前后自我报告的知识和信心的变化。应用描述性统计并计算95%置信区间。
43名助产士报名参加培训,32名(74%)参加并完成了问卷。尽管培训前参与者的知识和信心各不相同,但培训后自我报告的知识和信心有统计学上的显著提高。97%的人表示对孕期特定食物和营养信息的了解“更好”(95%置信区间85至100),而3%的人表示“保持不变”——60%的人表示“好多了”。83%的人表示解释孕期BMI升高风险的信心“大大”或“有所”提高(95%置信区间66至93),而17%的人表示“保持不变”。89%的人表示讨论饮食习惯和身体活动的信心“大大”或“有所”提高(95%置信区间73至97),而11%的人表示“保持不变”。新出现的主题突出表明,培训受到积极欢迎且与助产实践相关。
本研究提供了早期迹象,表明一个紧凑的营养、身体活动及体重管理培训包可提高助产士自我报告的知识和信心。建议在卫生委员会的助产服务中推广培训,并开展进一步研究以了解对助产实践和患者结局的长期影响。