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产科医疗服务提供者对向超重/肥胖孕妇传达孕期体重增加建议的看法。

Obstetric healthcare providers' perceptions of communicating gestational weight gain recommendations to overweight/obese pregnant women.

作者信息

Grohmann Barbara, Brazeau-Gravelle Pauline, Momoli Franco, Moreau Katherine, Zhang Tinghua, J Keely Erin

机构信息

The Ottawa Hospital Dietetic Internship Program.

The Ottawa Hospital.

出版信息

Obstet Med. 2012 Dec;5(4):161-165. doi: 10.1258/om.2012.120003. Epub 2012 Sep 17.

Abstract

BACKGROUND

Gestational weight gain (GWG) is a major risk factor of poor pregnancy outcomes. Obese pregnant women frequently report bias and discrimination when dealing with healthcare providers (HCPs). Effective communication of GWG recommendations may impact risks. Study objectives were to identify perceptions of HCPs in communicating GWG recommendations and to identify potential gaps/opportunities that could be addressed in the development of appropriate materials/programmes.

METHODS

A survey tool was created using the Theory of Planned Behaviour to capture HCPs' attitudes, behaviours and intentions, using four-point Likert questions. Surveys were distributed to obstetricians/gynaecologists, family physicians, obstetric residents/ fellows, midwives, registered/public health nurses and registered dietitians.

RESULTS

Results from 96 surveys show that HCPs agreed discussing GWG was important (100%), beneficial for patient-provider rapport (86%) and best practice (100%); however, most found it unpleasant (68%). Providers have confidence in their skills to provide nutrition advice (71%) and believe they have sufficient training (56%); yet, 31% acknowledged making derogatory comments and indicated that they could improve their communication of GWG (92%).

CONCLUSIONS

HCPs believe they are providing GWG recommendations in an effective and empathetic manner. While an underlying current of bias/discrimination remains, there is recognition of the importance of more training and access to appropriate tools.

摘要

背景

孕期体重增加(GWG)是不良妊娠结局的主要风险因素。肥胖孕妇在与医疗服务提供者(HCPs)打交道时经常报告受到偏见和歧视。有效传达GWG建议可能会影响风险。研究目标是确定HCPs在传达GWG建议方面的看法,并确定在制定适当的材料/计划时可以解决的潜在差距/机会。

方法

使用计划行为理论创建了一个调查工具,通过四点李克特问题来捕捉HCPs的态度、行为和意图。调查对象包括产科医生/妇科医生、家庭医生、产科住院医师/研究员、助产士、注册/公共卫生护士和注册营养师。

结果

96份调查结果显示,HCPs一致认为讨论GWG很重要(100%),有利于医患关系(86%)且是最佳实践(100%);然而,大多数人认为讨论起来不愉快(68%)。医疗服务提供者对自己提供营养建议的技能有信心(71%),并认为自己接受了足够的培训(56%);然而,31%的人承认发表过贬损性言论,并表示他们可以改进GWG的沟通(92%)。

结论

HCPs认为他们以有效且富有同情心的方式提供GWG建议。虽然潜在的偏见/歧视仍然存在,但人们认识到更多培训和获取适当工具的重要性。

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