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Midwives' strategies in challenging dietary and weight counselling situations
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. (Arcum)
2014 (Engelska)Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 3, s. 107-112Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: By enhancing maternal nutritional status, midwives can help women lower the risks of pregnancy complications and adverse birth outcomes as well as improve maternal health during pregnancy and in the long run. Dietary counselling is, on the other hand, not reported to be effective. Poor communication and conflicting messages are identified as possible barriers to adherence with recommendations. Midwives' experiences of providing dietary advice and counselling during pregnancy are sparsely reported. The aim of this study was therefore to explore midwives' strategies when faced with challenging dietary counselling situations. Methods: Seventeen midwives from different parts of Sweden and working within antenatal health care were interviewed by telephone. The interviews were analysed using qualitative content analysis. Results: Challenges were commonly experienced when counselling women who were overweight, obese, had eating disorders or were from different cultures. The midwives talked in terms of "the problematic women" when addressing counselling problems. Strategies used in challenging counselling situations were Getting acquainted; Trying to support and motivate; Pressure to choose "correttly"; Controlling and mastering; and Resigning responsibility. Conclusions: The results indicate that Swedish midwives' counselling strategies are quite ambiguous and need to be questioned and that counselling of vulnerable groups of women should be highlighted. We could identify a need for education of practicing midwives to develop person-centred counselling skills.

Ort, förlag, år, upplaga, sidor
2014. Vol. 5, nr 3, s. 107-112
Nyckelord [en]
Dietary counselling, Pregnancy, Midwives, Qualitative, Non-adherence, Empowerment
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Arbetsmedicin och miljömedicin
Identifikatorer
URN: urn:nbn:se:umu:diva-95871DOI: 10.1016/j.srhc.2014.07.001ISI: 000342889200004OAI: oai:DiVA.org:umu-95871DiVA, id: diva2:768397
Tillgänglig från: 2014-12-03 Skapad: 2014-11-06 Senast uppdaterad: 2018-01-11Bibliografiskt granskad
Ingår i avhandling
1. Pregnant women and midwives are not in tune with each other about dietary counseling: studies in Swedish antenatal care
Öppna denna publikation i ny flik eller fönster >>Pregnant women and midwives are not in tune with each other about dietary counseling: studies in Swedish antenatal care
2015 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background During pregnancy, a healthy diet is beneficial for the expecting mother and her fetus. Midwives in antenatal care have an ideal position for promoting a healthy diet and thereby help women to not only lower the risks of pregnancy complications and adverse birth outcomes, but improve maternal health. The overall aim of this thesis was to describe diet and dietary changes during pregnancy from the women’s and the midwives’ perspectives with a focus on dietary counseling. The thesis comprises four studies. The specific aims in the respective studies were to: I) Describe pregnant women’s attitudes to and experiences of dietary information and advice, as well as dietary management during pregnancy. II) Explore midwives’ strategies in challenging dietary counseling situations. III) Describe how midwives’ perceive their role and their significance in dietary counseling of pregnant women.  IV) Describe women’s food habits during pregnancy and up to six months postpartum.

Methods Studies I-III were qualitative. Study I included focus group interviews with 23 pregnant women. Study II included telephone interviews with 17 experienced midwives working in Swedish antenatal health care. Study III included the same 17 interviews from study II and supplemented them with four face-to-face-interviews. Qualitative content analysis was performed in all three studies. Study IV was a longitudinal study including a quantitative analysis of a questionnaire, which was given to women at five occasions during and after pregnancy. It concerned their food habits and it was answered by 163 women. The quantitative data was analyzed using comparative and descriptive statistics.

Results The overall findings of the thesis were summarized as the main theme “Pregnant women and midwives are not in tune with each other about dietary counseling”. The main theme included the two themes ‘Pregnant women are concerned about risks for their child but fail to change to healthier dietary habits over time’, and ‘Midwives view themselves as authorities, though questioned ones’. In subthemes it was highlighted that pregnant women are well informed and interested in risk reduction for their child’s best and that they try to do their best to improve their diet during pregnancy. However, their diet did not reach levels of healthy eating recommendations and became even unhealthier after pregnancy. It was also highlighted that midwives experienced insufficient knowledge in dietary issues and related risks and that they had difficulties to give dietary support to pregnant women. Midwives were found to mainly focus on giving information and they lacked sufficient competence for challenging counseling.

Conclusion Pregnant women, on the one hand, experience a lack of support from the midwives when dealing with dietary changes. The midwives, on the other hand, feel exposed and express a need for both further education in dietary issues and training in counseling. Women’s food habits during, but in particular after pregnancy need improvement, and dietary counseling could be more focused on healthy eating in a long-term perspective.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2015. s. 114
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1745
Nyckelord
Pregnancy, food habits, dietary counseling, counseling strategies, woman-centred care, antenatal care, qualitative methods, longitudinal studies, food frequency questionnaire.
Nationell ämneskategori
Allmänmedicin
Forskningsämne
allmänmedicin
Identifikatorer
urn:nbn:se:umu:diva-107691 (URN)978-91-7601-294-9 (ISBN)
Disputation
2015-09-18, Aulan, Vårdvetarhuset, Umeå, 13:00 (Svenska)
Opponent
Handledare
Anmärkning

Felaktigt ISSN angivet i avhandlingen och på spikbladet.

Tillgänglig från: 2015-08-28 Skapad: 2015-08-27 Senast uppdaterad: 2018-01-11Bibliografiskt granskad

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Av författaren/redaktören
Wennberg, Anna LenaHamberg, KatarinaHörnsten, Åsa
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Institutionen för folkhälsa och klinisk medicinInstitutionen för omvårdnad
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Sexual & Reproductive HealthCare
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologiArbetsmedicin och miljömedicin

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