Saarikko Johanna, Niela-Vilén Hannakaisa, Rahmani Amir M, Axelin Anna
Department of Nursing Science, University of Turku, Turku, Finland.
Department of Obstetrics and Gynaecology, Turku University Hospital and Faculty of Medicine, University of Turku, Turku, Finland.
BMC Pregnancy Childbirth. 2021 Mar 11;21(1):200. doi: 10.1186/s12884-021-03689-6.
Maternal overweight is increasing, and it is associated with several risk factors for both the mother and child. Healthy lifestyle behaviors adopted during pregnancy are likely to impact women's health positively after pregnancy. The study's aim was to identify and describe weight management behaviors in terms of the Capability, Opportunity and Motivation Behaviour (COM-B) -model to target weight management interventions from both the perspectives of women who are overweight and maternity care professionals.
This qualitative, descriptive study was conducted between 2019 and 2020. Individual interviews with pregnant and postpartum women who were overweight (n = 11) and focus group interviews with public health nurses (n = 5) were undertaken in two public maternity clinics in Southwest Finland. The data were analyzed using deductive content analysis consistent with the COM-B model.
In the capability category, the women and the public health nurses thought that there was a need to find consistent ways to approach overweight, as it had often become a feature of the women's identities. The use of health technology was considered to be an element of antenatal care that could be used to approach the subject of weight and weight management. Smart wearables could also support an evaluation of the women's lifestyles. The opportunity category highlighted the lack of resources for support during perinatal care, especially after birth. Both groups felt that support from the family was the most important facilitating factor besides motivation. The women also expressed a conflict between pregnancy as an excuse to engage in unhealthy habits and pregnancy as a motivational period for a change of lifestyle. Furthermore, the women wanted to be offered a more robust stance on weight management and discreet counseling.
Our findings offer a theoretical basis on which future research can define intervention and implementation strategies. Such interventions may offer clear advice and non-judgmental support during pregnancy and after delivery by targeting women's capabilities, opportunities, and motivation. Health technology could be a valuable component of intervention, as well as an implementation strategy, as they provide ways during maternity care to approach this topic and support women.
孕妇超重现象日益普遍，且与母婴的多种风险因素相关。孕期采取的健康生活方式行为可能会对产后女性健康产生积极影响。本研究旨在根据能力、机会和动机行为（COM-B）模型识别并描述体重管理行为，以便从超重女性和产科护理专业人员两个角度确定体重管理干预措施。
本定性描述性研究于2019年至2020年期间进行。在芬兰西南部的两家公立产科诊所，对超重的孕妇和产后女性（n = 11）进行了个体访谈，并对公共卫生护士（n = 5）进行了焦点小组访谈。使用与COM-B模型一致的演绎性内容分析法对数据进行分析。
在能力方面，女性和公共卫生护士认为有必要找到持续一致的方法来应对超重问题，因为超重往往已成为这些女性身份特征的一部分。健康技术的使用被视为产前护理的一个要素，可用于探讨体重及体重管理话题。智能可穿戴设备也有助于评估女性的生活方式。机会方面突出了围产期护理期间，尤其是产后缺乏支持资源的问题。两组人员都认为，除动机外，家人的支持是最重要的促进因素。女性还表达了一种矛盾心理，即一方面将怀孕作为养成不健康习惯的借口，另一方面又将怀孕视为改变生活方式的动力期。此外，女性希望在体重管理方面能得到更坚定的立场和谨慎的咨询服务。
我们的研究结果为未来研究确定干预和实施策略提供了理论基础。此类干预措施可通过针对女性的能力、机会和动机，在孕期和产后提供明确的建议和无偏见的支持。健康技术可以成为干预措施以及实施策略的重要组成部分，因为它们在产科护理过程中提供了探讨该话题和支持女性的方式。
