Scott Jodie, Oxlad Melissa, Dodd Jodie, Szabo Claudia, Deussen Andrea, Turnbull Deborah
School of Psychology, The University of Adelaide, Adelaide 5005, Australia.
Robinson Institute and School of Paediatrics and Reproductive Health, Department of Perinatal Medicine, Women's and Babies Division, Women's & Children's Hospital, The University of Adelaide, Adelaide 5005, Australia.
J Clin Med. 2020 Oct 19;9(10):3351. doi: 10.3390/jcm9103351.
Worldwide, half of women begin a pregnancy with overweight or obesity, which increases the risk of pregnancy and birth complications and adversely affects the lifelong health of the offspring. In order for metabolic changes to influence the gestational environment, research suggests that weight loss should take place before conception. This study aimed to understand women's emotional and social contexts, knowledge, motivations, skills and self-efficacy in making healthy change. Semi-structured interviews conducted with twenty-three women with overweight or obesity, informed by the Information-Motivation-Behavioural Skills (IMB) model, were analysed using reflexive thematic analysis. Information-related themes identified included poor health risk knowledge, healthy food decisions and health versus convenience. The Motivation themes comprised taking responsibility, flexible options, social expectations, interpersonal challenges and accountability. Behavioural Skills entailed themes such as the mental battle, time management, self-care and inspiration. An environmental factor was identified in affordability-limiting access to healthier alternatives. Women wanted simple, flexible options that considered family commitments, time and budgetary constraints. Unprompted, several mentioned the importance of psychological support in managing setbacks, stress and maintaining motivation. Strategies for enhancing self-efficacy and motivational support are required to enable longstanding health behaviour change. Findings will inform intervention mapping development of an eHealth solution for women preconception.
在全球范围内，有一半的女性在怀孕时体重超重或肥胖，这增加了怀孕和分娩并发症的风险，并对后代的终身健康产生不利影响。为了使代谢变化影响妊娠环境，研究表明应该在怀孕前进行体重减轻。本研究旨在了解女性在做出健康改变时的情感和社会背景、知识、动机、技能和自我效能感。以信息-动机-行为技能（IMB）模型为依据，对23名超重或肥胖女性进行了半结构化访谈，并使用反思性主题分析法进行了分析。确定的与信息相关的主题包括健康风险知识匮乏、健康食品决策以及健康与便利性。动机主题包括承担责任、灵活选择、社会期望、人际挑战和问责制。行为技能涉及心理斗争、时间管理、自我护理和激励等主题。确定了一个环境因素，即可承受性限制了获得更健康选择的机会。女性希望有简单、灵活的选择，同时考虑到家庭责任、时间和预算限制。在没有提示的情况下，有几位提到了心理支持在应对挫折、压力和维持动力方面的重要性。需要提高自我效能感和动机支持的策略，以实现长期的健康行为改变。研究结果将为孕前女性电子健康解决方案的干预映射开发提供信息。
