孕妇既往减肥手术后的营养护理体会

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-02-10 DOI:10.1016/j.midw.2025.104333

Taylor M. Guthrie , Lauren Kearney , Kahlee Snape , Linda Sweet , Vidanka Vasilevski , Susan de Jersey

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引用次数: 0

摘要

问题减肥手术后的怀孕率在全球范围内正在上升，这与健康益处有关，但也增加了微量营养素缺乏、早产和胎龄小的风险。减肥手术可能会限制女性满足孕期营养需求的能力，因此需要个性化的营养治疗。然而，对于女性在减肥手术后怀孕期间对营养相关护理的经历和偏好知之甚少。目的描述女性在减肥手术后的怀孕经历，重点是营养相关护理。方法：本定性研究访问了澳大利亚各地有任何减肥手术史的妇女。半结构化的电话访谈在怀孕36周后和分娩前进行。数据分析采用反身性主题分析。13名年龄在26-37岁之间的女性参与了研究。产生了三个主题：导航医疗保健，减肥手术后怀孕的个人代价，以及女性代理。尽管妇女强烈希望获得专门的营养护理，但她们在获得这种护理方面遇到了一些障碍。即使提供护理，由于保健专业人员对减肥手术后怀孕所面临的营养挑战的了解有限，护理往往不能满足妇女的需求。这迫使妇女在产科护理团队之外寻求信息，并在护理期间为自己辩护。讨论这些发现强调需要解决减肥手术后孕妇获得营养护理的障碍。提高对妊娠和术后症状的了解可以加强以妇女为中心的护理。结论需要提高所有产科护理专业人员对减肥手术的认识，以提高与孕妇知情，共同决策的机会。

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Pregnant women's experiences of nutrition care after previous bariatric surgery

Problem

The rate of pregnancy following bariatric surgery is rising globally and is associated with health benefits but also increased risk of micronutrient deficiency, preterm birth and small for gestational age offspring. Bariatric surgery may limit women's ability to meet the nutrient demands of pregnancy, necessitating individualised nutrition therapy. However, little is known about women's experiences of, and preferences for nutrition-related care during pregnancy after bariatric surgery.

Aim

To describe women's experiences of pregnancy after bariatric surgery, focussing on nutrition-related care.

Methods

This qualitative study interviewed women across Australia with a history of any bariatric surgery. Semi-structured telephone interviews were conducted after 36-weeks gestation and before childbirth. Data were analysed using reflexive thematic analysis.

Findings

Thirteen women aged 26–37 participated. Three themes were generated: navigating healthcare, the personal toll of pregnancy after bariatric surgery, and women's agency. Despite a strong desire for specialised nutrition care, women encountered several barriers to accessing this. When care was available, it often did not meet women's needs due to healthcare professionals’ limited understanding of the nutrition challenges faced in pregnancies following bariatric surgery. This compelled women to seek information outside their maternity care team and advocate for themselves during care.

Discussion

These findings highlight the need to address barriers to accessing nutrition care for pregnant women following bariatric surgery. Improved understanding of pregnancy and post-operative symptoms may enable enhanced woman-centred care.

Conclusion

Greater awareness of bariatric surgery among all maternity care professionals is needed to improve opportunities for informed, shared decision-making with pregnant women.

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.