Dencker Anna, Premberg Åsa, Olander Ellinor K, McCourt Christine, Haby Karin, Dencker Sofie, Glantz Anna, Berg Marie
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
BMC Pregnancy Childbirth. 2016 Jul 30;16(1):201. doi: 10.1186/s12884-016-0969-x.
Obesity during pregnancy is increasing and is related to life-threatening and ill-health conditions in both mother and child. Initiating and maintaining a healthy lifestyle when pregnant with body mass index (BMI) ≥ 30 kg/m(2) can improve health and decrease risks during pregnancy and of long-term illness for the mother and the child. To minimise gestational weight gain women with BMI ≥ 30 kg/m(2) in early pregnancy were invited to a lifestyle intervention including advice and support on diet and physical activity in Gothenburg, Sweden. The aim of this study was to explore the experiences of women with BMI ≥ 30 kg/m(2) regarding minimising their gestational weight gain, and to assess how health professionals' care approaches are reflected in the women's narratives.
Semi-structured interviews were conducted with 17 women who had participated in a lifestyle intervention for women with BMI ≥ 30 kg/m(2) during pregnancy 3 years earlier. The interviews were digitally recorded and transcribed in full. Thematic analysis was used.
The meaning of changing lifestyle for minimising weight gain and of the professional's care approaches is described in four themes: the child as the main motivation for making healthy changes; a need to be seen and supported on own terms to establish healthy routines; being able to manage healthy activities and own weight; and need for additional support to maintain a healthy lifestyle.
To support women with BMI ≥ 30 kg/m(2) to make healthy lifestyle changes and limit weight gain during pregnancy antenatal health care providers should 1) address women's weight in a non-judgmental way using BMI, and provide accurate and appropriate information about the benefits of limited gestational weight gain; 2) support the woman on her own terms in a collaborative relationship with the midwife; 3) work in partnership to give the woman the tools to self-manage healthy activities and 4) give continued personal support and monitoring to maintain healthy eating and regular physical activity habits after childbirth involving also the partner and family.
孕期肥胖现象日益增多，且与母婴的生命威胁及健康问题相关。怀孕时体重指数（BMI）≥30kg/m²的女性开始并维持健康的生活方式，可改善健康状况，降低孕期风险以及母婴患长期疾病的风险。为尽量减少孕期体重增加，瑞典哥德堡邀请怀孕初期BMI≥30kg/m²的女性参加生活方式干预，内容包括饮食和体育活动方面的建议与支持。本研究的目的是探究BMI≥30kg/m²的女性在尽量减少孕期体重增加方面的经历，并评估健康专业人员的护理方法在女性叙述中的体现。
对17名三年前在孕期参加过针对BMI≥30kg/m²女性的生活方式干预的女性进行了半结构式访谈。访谈进行了数字录音并全文转录。采用了主题分析法。
改变生活方式以尽量减少体重增加的意义以及专业人员的护理方法在四个主题中得到描述：孩子是做出健康改变的主要动力；需要按照自己的方式被关注和支持以建立健康的生活习惯；能够管理健康活动和自身体重；以及需要额外支持以维持健康的生活方式。
为支持BMI≥30kg/m²的女性做出健康的生活方式改变并限制孕期体重增加，产前保健提供者应：1）以非评判的方式使用BMI来关注女性的体重，并提供关于有限孕期体重增加益处的准确适当信息；2）在与助产士的合作关系中按照女性自己的方式提供支持；3）合作帮助女性获得自我管理健康活动的工具；4）在产后持续提供个人支持和监测，以维持健康的饮食习惯和规律的体育活动习惯，这也涉及伴侣和家人。
