Healthcare providers’ gestational weight gain counselling practises and the influence of knowledge and attitudes: a cross-sectional mixed methods study

Abstract

ObjectiveTo understand current gestational weight gain (GWG) counselling practices of healthcare providers, and the relationships between practices, knowledge and attitudes.DesignConcurrent mixed methods with data integration: cross-sectional survey and semistructured interviews.ParticipantsPrenatal healthcare providers in Canada: general practitioners, obstetricians, midwives, nurse practitioners and registered nurses in primary care settings.ResultsTypically, GWG information was provided early in pregnancy, but not discussed again unless there was a concern. Few routinely provided women with individualised GWG advice (21%), rate of GWG (16%) or discussed the risks of inappropriate GWG to mother and baby (20% and 19%). More routinely discussed physical activity (46%) and food requirements (28%); midwives did these two activities more frequently than all other disciplines (P<0.001). Midwives interviewed noted a focus on overall wellness instead of weight, and had longer appointment times which allowed them to provide more in-depth counselling. Regression results identified that the higher priority level that healthcare providers place on GWG, the more likely they were to report providing GWG advice and discussing risks of GWG outside recommendations (β=0.71, P<0.001) and discussing physical activity and food requirements (β=0.341, P<0.001). Interview data linked the priority level of GWG to length of appointments, financial compensation methods for healthcare providers and the midwifery versus medical model of care.ConclusionsInterventions for healthcare providers to enhance GWG counselling practices should consider the range of factors that influence the priority level healthcare providers place on GWG counselling.

Prevalência de aconselhamento para atividade física na Atenção Básica à Saúde: uma revisão sistemática

“…Dos artigos incluídos, 21 avaliaram a prevalência de aconselhamento para AF oferecido por profissionais da ABS (Tabela 1). A maior parte dos artigos reportou a realização de aconselhamento por médico (n = 10; 47,6%) [27][28]31,[36][37][38]41,[44][45][46] e por equipe multidisciplinar incluindo o médico (n = 6; 28,6%) [32][33]35,39,40,42 ; seguido por enfermeiro (n = 3; 14,3%) 29,30,34 e por agente comunitário de saúde (também denominado em alguns países como visitante de saúde) (n = 2; 9,5%) 15,43 . A prevalência de aconselhamento para AF referida pelos profissionais de saúde apresentou uma média de 60,2 ± 22,7% (Figura 2).…”

“…Os poucos estudos que avaliaram a realização de aconselhamento entre várias profissões encontraram que enfermeiro 42 , enfermeiro e ACS 32 , médico 33 , parteira 39 foram os profissionais que mais aconselhavam.…”

Comparison and Characterization of Prenatal Nutrition Counseling among Large-for-Gestational Age Deliveries by Pre-Pregnancy BMI

“…However, due to lack of reimbursement for these services and priority given to high-risk pregnancies, the registered dietician seldom provides PNC to otherwise healthy pregnant women [9]. Therefore, the delivery of PNC becomes the responsibility of the healthcare team, which varies by healthcare provider [10,11], with 19% and 26% of obstetricians and general practitioners, respectively, providing counseling [11]. Other studies report that~69% of women received PNC from their healthcare provider [12,13] and that there was no difference in PNC by pre-pregnancy body mass index (BMI) [13].…”

“…Other studies report that~69% of women received PNC from their healthcare provider [12,13] and that there was no difference in PNC by pre-pregnancy body mass index (BMI) [13]. Despite this, providers who are more knowledgeable about gestational weight gain (GWG) recommendations are more inclined to provide PNC [11]. Receipt of PNC has generally focused on vitamins and foods to avoid (i.e., lunch meat, high-mercury fish, etc.)…”

Oncology nurses’ knowledge and awareness on metabolic syndrome in cancer survivors and the perceived barriers to the provision of related care: A mixed‐method study

“…Therefore, semi-structured interviews are needed to identify the in-depth information nurses need in order to provide MetS-related care to cancer survivors and to identify the perceived barriers to care despite the recognised importance of MetS-related care. Providing a more effective support for healthcare providers, including nurses, to improve MetS-related care interactions with cancer survivors requires a detailed understanding of the current state and the factors affecting these practices (Morris et al, 2017). Quantitative research or qualitative research alone is insufficient for understanding MetS in cancer survivors.…”