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一项混合方法研究评估了将妊娠增重图表纳入产前保健的情况。

A mixed method study evaluating the integration of pregnancy weight gain charts into antenatal care.

机构信息

Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.

出版信息

Matern Child Nutr. 2019 Jul;15(3):e12750. doi: 10.1111/mcn.12750. Epub 2018 Dec 13.

Abstract

Monitoring pregnancy weight can reduce excess gestational weight gain (GWG), and is recommended in clinical practice guidelines as part of routine care. This study aimed to evaluate the implementation of routine weight monitoring using a pregnancy weight gain chart (PWGC), and assess health care professionals (HCPs) and pregnant women's attitudes and practices around its use. A semiquantitative survey was conducted with a consecutive sample of antenatal women at 16 and 36 weeks gestation. Women were weighed, and a PWGC audit done at 36 weeks gestation to assess adherence to chart use and GWG. A cross-sectional survey of antenatal HCPs at the Australian facility assessed staff attitudes and practices relating to weight monitoring and PWGC use. Of the 291 women surveyed, 68% reported being given a PWGC. Of the audited PWGCs (n = 258), 54% had less than three weights recorded, 36% had errors, and 3% were unused. All HCPs surveyed (n = 42) were aware of the PWGC, 63% reported using it to track GWG regularly and 26% believed it to be only the woman's responsibility (i.e., not the midwife's role) to complete it. Seventy-six percent reported they needed more training in counselling pregnant women, and insufficient time was a main barrier to weighing and conversing with women. It is feasible to implement a PWGC into routine antenatal care. Clarity over women's and HCPs responsibility for monitoring GWG and completion of the PWGC is needed. Training on correct PWGC use and counselling and workforce engagement are required to overcome barriers and support healthy GWG.

摘要

监测妊娠体重可以减少妊娠期间体重过度增加(GWG),并作为常规护理的一部分在临床实践指南中得到推荐。本研究旨在评估使用妊娠体重增长图表(PWGC)进行常规体重监测的实施情况,并评估医疗保健专业人员(HCPs)和孕妇对其使用的态度和做法。对 16 周和 36 周妊娠的连续产前妇女进行了半定量调查。在 36 周妊娠时对妇女进行称重,并对 PWGC 进行审核,以评估对图表使用和 GWG 的依从性。对澳大利亚设施的产前 HCPs 进行了横断面调查,评估了与体重监测和 PWGC 使用相关的工作人员态度和做法。在所调查的 291 名妇女中,68%的人报告说收到了 PWGC。在审核的 PWGC 中(n=258),有 54%的记录少于三次体重,36%有错误,3%未使用。所有接受调查的 HCP(n=42)都知道 PWGC,63%的人报告说定期使用它来跟踪 GWG,26%的人认为这是妇女自己的责任(即不是助产士的角色)来完成。76%的人报告说他们需要更多的孕妇咨询培训,时间不足是称重和与妇女交谈的主要障碍。将 PWGC 纳入常规产前护理是可行的。需要明确妇女和 HCP 监测 GWG 和完成 PWGC 的责任。需要进行关于正确使用 PWGC 和咨询以及劳动力参与的培训,以克服障碍并支持健康的 GWG。

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