Associate Professor of Family Medicine at Dalhousie University in Halifax, NS, and a doctoral candidate in family medicine at Western University in London, Ont.
Can Fam Physician. 2017 Jul;63(7):e341-e349.
To compare prenatal care providers' perceived self-efficacy in starting discussions about gestational weight gain with pregnant women under a variety of conditions of gradated difficulty, when weight gain has been in excess of current guidelines.
A 42-item online questionnaire related to the known barriers to and facilitators of having discussions about gestational weight gain.
Canada.
Prenatal care providers were contacted through the Family Medicine Maternity Care list server of the College of Family Physicians of Canada.
The 42 items were clustered into categories representing patient factors, interpersonal factors, and system factors. Participants scored their self-efficacy on a scale from 0 ("cannot do at all") to 5 ("moderately certain can do") to 10 ("highly certain can do"). The significance level was set at α = .05.
Overall, clinicians rated their self-efficacy to be high, ranging from a low mean (SD) score of 5.14 (3.24) if the clinic was running late, to a high mean score of 8.97 (1.34) if the clinician could externalize the reason for undertaking the discussion. There were significant differences in self-efficacy scores within categories depending on the degree of difficulty proposed by the items in those categories.
The results were inconsistent with previous studies that have demonstrated that prenatal care providers do not frequently raise the subject of excess gestational weight gain. On the one hand providers rate their self-efficacy in having these discussions to be high, but on the other hand they do not undertake the behaviour, at least according to their patients. Future research should explore this discrepancy with a view to informing interventions to help providers and patients in their efforts to address excess gestational weight gain, which is increasingly an important contributor to the obesity epidemic.
比较产前保健提供者在各种困难条件下，当体重增加超过当前指南时，开始与孕妇讨论妊娠体重增加的自我效能。
一项与阻碍和促进讨论妊娠体重增加的已知因素相关的 42 项在线问卷。
加拿大。
通过加拿大家庭医生学院的家庭医学产科护理名单服务器联系产前保健提供者。
这 42 项被分为代表患者因素、人际因素和系统因素的类别。参与者根据 0（“完全不能”）到 5（“中等确定可以”）到 10（“非常确定可以”）的量表对自我效能进行评分。显著性水平设定为α=0.05。
总体而言，临床医生对自己的效能评价较高，评分范围从诊所延迟时的低平均（SD）分数 5.14（3.24）到临床医生可以外化讨论原因时的高平均分数 8.97（1.34）。根据这些类别中的项目提出的困难程度，自我效能评分在类别内存在显著差异。
结果与先前表明产前保健提供者不经常提出妊娠体重增加过多的研究不一致。一方面，提供者对他们进行这些讨论的自我效能评价较高，但另一方面，根据他们的患者，他们并没有采取这种行为。未来的研究应该探索这种差异，以便为帮助提供者和患者努力解决妊娠体重增加过多的干预措施提供信息，这越来越成为肥胖流行的一个重要因素。
