How should midwives discuss smoking behaviour in pregnancy with women of low educational attainment?
How should midwives discuss smoking behaviour in pregnancy with women of low educational attainment?
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DOI：
10.1016/s0266-6138(97)80008-3
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发表时间：
1997-12-01
期刊：
影响因子：
2.7
通讯作者：
Nyberg, K
中科院分区：
文献类型：
--
作者：
Arborelius, E;Nyberg, K
目的：了解低学历妇女如何看待她们在怀孕期间吸烟的事实，以便能够构建合适的咨询方案。设计：使用录音访谈的定性研究。设置：瑞典斯德哥尔摩北部的诊所。参与者：13名在前几个月分娩并在怀孕期间吸烟的妇女。结果：所有妇女都知道吸烟对胎儿有危险。有几个人自己经历过吸烟对胎儿的有害影响。然而，许多人谈到了其他吸烟的妇女，她们仍然生下了健康的婴儿。尽管如此，大多数人还是因为吸烟而感到内疚，部分原因是吸烟让他们觉得自己是“坏人”，部分原因是出于对婴儿的关心。大多数妇女说，警告和说教助产士并没有让他们减少吸烟，相反，许多人吸烟多。结论和实践的影响：没有一个妇女达到了他们感到有动力戒烟的阶段。实际上，只有少数人能够在怀孕期间改变吸烟习惯。然而，访谈显示了以客户/病人为中心的方法的重要性，这种方法以客户/病人的前景和社会状况为基础。一个潜在的成功战略可能是协调以客户/病人为中心的方法与认知行为方案。另一项重要任务是确认和加强这些妇女作为准母亲的作用，并介绍吸烟问题，使妇女根据自己的能力和社会状况选择尽可能减少吸烟。这些妇女可能会受益于被确认为母亲的角色，尽管她们吸烟。考虑到社会规范的影响，小组讨论也很重要，因为他们可以在小组讨论中“仔细考虑”。
Objective: to understand how women with low educational attainment perceived the fact of their smoking during pregnancy in order to be able to construct suitable counselling programmes.Design: qualitative study using tape-recorded interviews.Setting: clinic north of Stockholm, Sweden.Participants: thirteen women who had given birth during the previous months and who had smoked during pregnancy.Findings: all of the women were aware that smoking presented risks to the fetus. Several had themselves experienced the damaging effects of smoking on the fetus. However, many talked about other women who had smoked and still given birth to healthy babies. Nevertheless, the majority felt guilty because they smoked, partly because it made them feel as though they were 'bad people' and partly out of concern for the baby. Most of the women stated that warnings and moralising from midwives did not make them cut down their smoking; on the contrary, many smoked more.Conclusions and implications for practice: none of the women had reached the stage where they felt motivated to stop smoking. Realistically speaking, probably only a few of them would be able to change their smoking habits during pregnancy. The Interviews, however, showed the significance of a client/patient-centred methodology, based on the client's/patient's outlook and social situation. A potentially successful strategy could be to co-ordinate client/patient-centred methodology with cognitive behavioural programmes. An important task is also to confirm and strengthen these women in their roles as mothers-to-be and to introduce the subject of smoking in such a way that the women choose to reduce their smoking as much as possible, given the individual's own ability and social situation. These women might benefit from being confirmed in their maternal role despite the fact that they smoke. Group discussions, where they could 'think it over', would also be of significance, considering the influence of social norms.