How can midwives utilise the teachable moment in pregnancy for women: A focus on the role of language

怀孕期间与医疗保健专业人员的互动可以在女性中产生高水平的动机，从而导致健康行为的改变，被称为“教育时刻”（Lawson & flok, 2009）。保健服务在怀孕期间有明确的护理途径，这意味着一些妇女与保健专业人员接触和初次互动的频率增加。行为的改变可以看到采取健康的行为，如体育活动，也可以减少危险行为。因此，怀孕提供了对母亲和婴儿的身心健康产生短期和长期影响的机会。医疗保健专业人员使用的语言是关系的核心，必须尊重并使妇女能够舒适地分享她们的精神和身体健康经验和担忧。研究表明，医疗保健专业人员的培训应包括沟通（Vermeir等人，2015年）。英国皇家助产士学院最近启动了一个项目，研究助产士在实践中使用的语言，重点关注“正常分娩”等术语的使用（https://www.rcm.org.uk/what-is-the-rebirth-project/）。健康心理学提供基于证据的理论和技术，为良好实践提供信息，并且发现学生助产士可以接受健康心理学理论和技术（例如，行为改变技术）（Hart等人，2018）。该博士工作方案将采用健康心理学和助产学的跨学科方法，目的是按照医学研究委员会的指导方针设计和测试一种干预措施（医学研究委员会，2006年）。本博士论文建立在导师和往届博士生现有工作的基础上。干预将针对助产士，并将重点放在语言的使用上。在干预之后，助产士将能够积极发现和诊断需要改变的健康行为，以支持妇女/产妇的短期和长期身心健康。这项工作将从系统回顾开始，采用混合方法，采用定性方法来发展理论和调查干预的可接受性，并采用定量技术来调查疗效。该方案将涉及关键利益攸关方的投入，并计划举行几次公众参与活动，以告知工作方案并传播调查结果。

Interactions with healthcare professionals in pregnancy can create high levels of motivation in women which can lead to changes to health behaviours, labelled a 'teachable moment' (Lawson & Flocke, 2009). Healthcare services have clear care pathways during pregnancy meaning an increase in frequency of contact and first interactions with healthcare professionals for some women. Changes to behaviour can see the adoption of healthy behaviours such as physical activity and also the reduction in risk behaviours. Thus, pregnancy offers an opportunity to have short and long term impact on the physical and mental health of mother and baby. Language used by healthcare professionals is central to the relationship and must be respectful and enable women to feel comfortable to share their mental and physical health experiences and concerns. Research has suggested that healthcare professionals training should include communication (Vermeir, et al., 2015). The Royal College of Midwives have recently launched a project looking at language used by midwives in practice, with a focus on the use of terms such as 'normal birth' (https://www.rcm.org.uk/what-is-the-rebirth-project/). Health Psychology provides evidence-based theories and techniques to inform good practice and the inclusion of health psychology theory and techniques (e.g., behaviour change techniques) has been found to be acceptable to student midwives (Hart et al., 2018).This programme of PhD work will take an interdisciplinary approach from health psychology and midwifery with the aim of designing and testing an intervention following the Medical Research Council guidelines (MRC, 2006). This PhD builds on the existing work of the supervisors and previous PhD students. The intervention will be for midwives and will focus on the use of language. Following the intervention, midwives will be able to actively detect and diagnose health behaviours that require change to support women/birthing peoples' short and long term mental and physical health. The work will start with a systematic review and take a mixed method approach employing qualitative methods to develop theory and investigate acceptability of the intervention, and quantitative techniques to investigate efficacy. The programme will involve key stakeholder input throughout with several public engagement events planned to inform the programme of work and disseminate findings.