Criss Shaniece, Oken Emily, Guthrie Lauren, Hivert Marie-France
Department of Health Sciences, Furman University, 3300 Poinsett Hwy, Greenville, SC, 29613, USA.
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive Suite 401E, Boston, MA, USA, 02215.
BMC Pregnancy Childbirth. 2016 Oct 20;16(1):317. doi: 10.1186/s12884-016-1118-2.
Gestational weight gain (GWG) is an important predictor of short and long-term pregnancy outcomes for both mother and child, and women who set a GWG goal are more likely to gain within recommended ranges. Little information is available regarding potentially modifiable factors that underlie a woman's GWG goals. Our aims were to explore women's perceptions regarding factors that affect GWG, their understanding of appropriate GWG, their goal-setting experiences including patient-health care provider (HCP) conversations, and supportive interventions they would most like to help them achieve the recommended GWG.
We conducted nine in-depth interviews and seven focus groups with a total of 33 Boston, Massachusetts (MA) area women who were pregnant and had delivered within the prior 6 months. We recorded and transcribed all interviews. Two investigators independently coded resulting transcripts. We managed data using MAXQDA2 and conducted a content analysis.
Perceived factors that contributed to GWG goal-setting included the mother's weight control behaviors concerning exercise and diet-including a "new way of eating for two" and "semblance of control", experiences during prior pregnancies, conversations with HCPs, and influence from various information sources. Women focused on behaviors with consistent messaging across multiple sources of information, but mainly trusted their HCP, valued one-to-one conversations with them about GWG, preferred that the HCP initiate the conversation about GWG goals, and would be open to have the conversation started based on visual aid based on their own GWG progression.
Pregnant women highly value discussions with their HCP to set GWG goals. Pregnant women view their clinicians as the most reliable source of information and believe that clinicians should open weight-related discussions throughout pregnancy.
孕期体重增加(GWG)是母婴短期和长期妊娠结局的重要预测指标,设定GWG目标的女性更有可能在推荐范围内增加体重。关于影响女性GWG目标的潜在可改变因素的信息很少。我们的目的是探讨女性对影响GWG的因素的看法、她们对适当GWG的理解、她们设定目标的经历(包括患者与医疗保健提供者(HCP)的对话)以及她们最希望帮助自己实现推荐GWG的支持性干预措施。
我们对马萨诸塞州波士顿地区33名在过去6个月内怀孕并分娩的女性进行了9次深入访谈和7次焦点小组讨论。我们记录并转录了所有访谈内容。两名研究人员独立对所得转录本进行编码。我们使用MAXQDA2管理数据并进行了内容分析。
导致设定GWG目标的感知因素包括母亲在运动和饮食方面的体重控制行为——包括“两人的新饮食方式”和“控制感”、既往妊娠经历、与HCP的对话以及来自各种信息来源的影响。女性关注多个信息来源中传递一致信息的行为,但主要信任她们的HCP,重视与HCP就GWG进行一对一的对话,希望HCP发起关于GWG目标的对话,并且愿意基于自己GWG进展的视觉辅助工具展开对话。
孕妇高度重视与HCP讨论以设定GWG目标。孕妇将她们的临床医生视为最可靠的信息来源,并认为临床医生应在整个孕期开启与体重相关的讨论。