School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
Institute for Applied Health Research, University of Birmingham, Birmingham, Edgbaston, B15 2TT, UK.
BMC Pregnancy Childbirth. 2021 Jun 29;21(1):462. doi: 10.1186/s12884-021-03905-3.
After childbirth, most women do not lose the extra weight gained during pregnancy. This is important because postnatal weight retention contributes to the development of obesity in later life. Research shows that postnatal women living with overweight would prefer to weigh less, are interested in implementing weight loss strategies, and would like support. Without evidence for the benefit of weight management interventions during pregnancy, postnatal interventions are increasingly important. Research has focused on intensive weight loss programmes, which cannot be offered to all postnatal women. Instead, we investigated the feasibility of a brief intervention delivered to postnatal women at child immunisation appointments. This qualitative study explored the views of women who received the intervention and healthcare professionals who delivered it.
The intervention was delivered within the context of the national child immunisation programme. The intervention group were offered brief support encouraging self-management of weight when attending general practices to have their child immunised at two, three and four months of age. The intervention involved motivation and support from practice nurses to encourage women to make healthier lifestyle choices through self-monitoring of weight and signposting to an online weight management programme. Nurses provided external accountability for weight loss. Women were asked to weigh themselves weekly and record this on a weight record card. Nested within this trial, semi-structured interviews explored the experiences of postnatal women who received the intervention and nurses who delivered it.
The intervention was generally acceptable to participants and child immunisation appointments considered a suitable intervention setting. Nurses were hesitant to discuss maternal weight, viewing the postnatal period as a vulnerable time. Whilst some caveats to implementation were discussed by nurses, they felt the intervention was easy to deliver and would motivate postnatal women to lose weight.
Participants were keen to lose weight after childbirth. Overall, they reported that the intervention was acceptable, convenient, and, appreciated support to lose weight after childbirth. Although nurses, expressed concerns about raising the topic of weight in the early postnatal period, they felt the intervention was easy to deliver and would help to motivate women to lose weight.
产后,大多数女性无法减掉怀孕期间增加的额外体重。这很重要,因为产后体重滞留会导致日后肥胖的发生。研究表明,超重的产后女性更希望体重减轻,对实施减肥策略感兴趣,并希望得到支持。由于没有证据表明在怀孕期间进行体重管理干预有益,因此产后干预变得越来越重要。研究集中在强化减肥方案上,但不能将其提供给所有产后女性。相反,我们研究了在儿童免疫接种预约时向产后女性提供简短干预的可行性。这项定性研究探讨了接受干预的女性和提供干预的医疗保健专业人员的观点。
该干预措施是在国家儿童免疫计划的背景下实施的。干预组在其孩子两个月、三个月和四个月大时到常规医疗诊所进行免疫接种时,会获得简短的支持,鼓励他们在管理自己体重方面进行自我管理。该干预措施涉及到从护士那里获得动机和支持,鼓励女性通过自我监测体重并引导他们使用在线体重管理计划来选择更健康的生活方式。护士会为体重减轻提供外部监督。女性被要求每周称重并将其记录在体重记录卡上。在这项试验中嵌套了半结构化访谈,以探讨接受干预的产后女性和提供干预的护士的经验。
该干预措施普遍被参与者接受,儿童免疫接种预约被认为是合适的干预环境。护士对讨论产妇体重犹豫不决,认为产后期间是一个脆弱的时期。虽然护士们讨论了实施的一些注意事项,但他们认为该干预措施易于实施,可以激励产后女性减轻体重。
参与者产后非常渴望减肥。总体而言,他们报告称,该干预措施是可以接受的,方便的,并且他们很欣赏这种在产后为他们提供的减肥支持。尽管护士们对在产后早期阶段提出体重问题表示担忧,但他们认为该干预措施易于实施,可以帮助激励女性减肥。