Nagpal Taniya S, Liu Rebecca H, Gaudet Laura, Cook Jocelynn L, Adamo Kristi B
Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada.
Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Women's College Hospital, Institute for Health System Solutions & Virtual Care, Toronto, Ontario, Canada.
Patient Educ Couns. 2020 Nov;103(11):2214-2223. doi: 10.1016/j.pec.2020.06.017. Epub 2020 Jul 2.
As the prevalence of obesity increases, more women are at risk of potentially experiencing weight stigma in prenatal health care settings. The objective of this scoping review was to summarize the primary literature assessing potential causes of weight stigma in prenatal health care settings and synthesize recommendations for health care providers to improve clinical practice.
A search strategy was developed combining the terms pregnancy, weight stigma, obesity, and prenatal care. A systematic search was completed in the following databases: Medline, EMBASE, PsycInfo, CINAHL, Opengrey, and Proquest.
Eighteen resources were included in this review, of which 17 were qualitative, and one was a mixed-methods study design. Weight stigma occurred in prenatal health care settings when providers: avoided weight-related discussions, assumed lifestyle behaviors, and had poor communication when discussing risks associated with obesity. Recommendations to prevent weight stigma included: offering sensitivity training to discuss obesity during pregnancy, implementing a patient-centred approach, including evaluating individual health behaviors, and providing educational resources to patients explaining potential risks and referrals.
This review summarizes recommendations to eliminate weight stigma in prenatal health care settings.
These recommendations can be implemented in clinical practice and can improve the delivery of prenatal care.
随着肥胖患病率的上升,越来越多的女性在产前保健环境中面临遭受体重歧视的风险。本范围综述的目的是总结评估产前保健环境中体重歧视潜在原因的主要文献,并综合为医疗保健提供者提出的改善临床实践的建议。
制定了一个搜索策略,将妊娠、体重歧视、肥胖和产前护理等术语结合起来。在以下数据库中完成了系统搜索:医学文献数据库(Medline)、荷兰医学文摘数据库(EMBASE)、心理学文摘数据库(PsycInfo)、护理学与健康领域数据库(CINAHL)、开放灰色文献数据库(Opengrey)和Proquest数据库。
本综述纳入了18篇文献,其中17篇为定性研究,1篇为混合方法研究设计。当医疗服务提供者在产前保健环境中出现体重歧视时,表现为:避免与体重相关的讨论、假定生活方式行为,以及在讨论肥胖相关风险时沟通不良。预防体重歧视的建议包括:提供敏感性培训以讨论孕期肥胖问题、采用以患者为中心的方法,包括评估个体健康行为,并向患者提供解释潜在风险和转诊的教育资源。
本综述总结了消除产前保健环境中体重歧视的建议。
这些建议可在临床实践中实施,可改善产前护理服务。