Prenatal care experiences among pregnant women with obesity in Wisconsin, United States: a qualitative quality improvement assessment.
Prenatal care experiences among pregnant women with obesity in Wisconsin, United States: a qualitative quality improvement assessment.
复制标题
DOI：
10.1186/s12884-021-03629-4
复制
发表时间：
2021-02-15
影响因子：
3.1
通讯作者：
Antony KM
中科院分区：
文献类型：
--
作者：
Hurst DJ;Schmuhl NB;Voils CI;Antony KM
在产前护理期间经历的耻辱和偏见会影响护理质量，并最终影响肥胖孕妇及其婴儿的健康。我们试图1）更好地了解BMI ≥40 kg/m2的妇女在接受产前护理时所经历的偏见和耻辱，2）衡量妇女对肥胖妇女团体产前教育的兴趣，3）收集有关其首选体重相关术语的反馈。我们对30名在美国中西部地区一所大学附属教学医院接受产前护理的BMI ≥40 kg/m2的妇女进行了半结构化访谈，并进行了主题内容分析。所有妇女都回顾了她们在围产期护理期间的积极经历，在此期间，她们感到得到了提供者的倾听和尊重。然而，许多人也描述了对与体重有关的偏见的恐惧或回忆起基于体重的歧视。妇女们对一项针对肥胖孕妇的小组产前护理方案反应良好，该方案侧重于营养、体育活动和体重管理。女性认为“体重”和“BMI”是描述体重最理想的术语，而“大尺寸”和“肥胖”则被评为最不理想。许多BMI ≥40 kg/m2的孕妇在产前护理环境中存在偏倚。减轻对体重的偏见的潜在步骤包括提高提供者对这一人群的经验和观点的认识，扩大针对高BMI妇女的产前护理选择，包括集体护理，以及使用患者偏好的体重相关术语。在本手稿的其余部分，尽可能使用术语“高BMI”代替术语“肥胖”来描述BMI ≥ 30 kg/m2的女性，以尊重我们采访的女性的首选术语。在线版本包含补充材料，可通过10.1186/s12884-021-03629-4获得。
Stigma and bias experienced during prenatal care can affect quality of care and, ultimately, the health of pregnant women with obesity and their infants. We sought to 1) better understand the bias and stigma that women with BMIs ≥40 kg/m2 experience while receiving prenatal care, 2) gauge women’s interest in group prenatal education for women with obesity, and 3) gather feedback about their preferred weight-related terminology. We conducted and thematically content-analyzed 30 semi-structured interviews of women with BMIs ≥40 kg/m2 who received prenatal care at a university-affiliated teaching hospital in the Midwest region of the United States. All women recalled positive experiences during their perinatal care during which they felt listened to and respected by providers. However, many also described a fear of weight-related bias or recalled weight-based discrimination. Women reacted favorably to a proposed group prenatal care option for pregnant women with obesity that focused on nutrition, physical activity, and weight management. Women rated “weight” and “BMI” as the most desirable terms for describing weight, while “large size” and “obesity” were rated least desirable. Many pregnant women with BMIs ≥40 kg/m2 experience bias in the prenatal care setting. Potential steps to mitigate bias towards weight include improving provider awareness of the experiences and perspectives of this population, expanding prenatal care options targeted towards women with high BMIs, including group care, and using patient-preferred weight-related terminology. Through the remainder of this manuscript, wherever possible, the term “high BMI” will be used in place of the term “obesity” to describe women with BMI ≥ 30 kg/m2 in order to respect the preferred terminology of the women we interviewed. The online version contains supplementary material available at 10.1186/s12884-021-03629-4.
登录
查看更多内容
影响因子：
2.7
作者：
Faucher, Mary Ann;Mirabito, Ann M.
通讯作者：
Mirabito, Ann M.
影响因子：
8.9
作者：
Phelan, S. M.;Burgess, D. J.;van Ryn, M.
通讯作者：
van Ryn, M.
影响因子：
3.8
作者：
Merrill, Emily;Grassley, Jane
通讯作者：
Grassley, Jane
影响因子：
4.2
作者：
Houghton, Catherine;Murphy, Kathy;Casey, Dympna
通讯作者：
Casey, Dympna
影响因子：
12.7
作者：
Puhl, Rebecca M.;Heuer, Chelsea A.
通讯作者：
Heuer, Chelsea A.