Weight Changes and Body Image in Pregnant Women: A Challenge for Health Care Professionals

Identifying and Mapping Canadian Registered Dietitians' Perceptions and Knowledge of and Experiences with Weight-Related Evidence: A Scoping Review

In this scoping review, "weight-related evidence" is an umbrella for various terms, phrases, and ways in which weight, body size, fatness, and/or obesity present in research and dietetic practice. Canadian Registered Dietitians' perceptions of, experiences with, and/or knowledge of weight-related evidence in nutrition care was identified and mapped. Implementing JBI scoping review methodology, four databases were searched: (i) CINAHL (EBSCO); (ii) Medline (Ovid); (iii) Embase (Elsevier); and (iv) Scopus (Elsevier). Google and Bing were searched for grey literature. Three JBI-trained independent reviewers completed screening to extraction. Community consultation was conducted using the Delphi Method. Of 2217 results, 67 were included in the review (29 peer-reviewed; 38 grey). Identified frequencies were 67 examples of perception, 54 of experience, and 51 of knowledge. This review identified diverse definitions/perspectives of weight-related evidence, highlighting the benefits of continuing to discuss and explore this topic within and beyond dietetics. Weight-related evidence was identified in nutrition care in various settings, representing nutrition assessment, diagnoses, interventions, monitoring, and evaluation. Focused on dietetic research and practice, this work provides a foundation for future evaluation of dietitian-led intervention fidelity, utility, and effectiveness, using systematic review or other research designs. These Canadian findings can serve as a foundation for a global/international review.

Body image perception and social support as predictors of psychological distress among third trimester pregnant women in Nigeria

BACKGROUND

Body image perception and social support during pregnancy can impact the psychological distress levels experienced by pregnant women. As a result, the purpose of this study was to examine the relationship between various components of social support and body image perception on psychological distress levels among pregnant women in their third trimester in Nigeria.

METHOD

A cross-sectional study was conducted among 246 pregnant women who were in the third trimester and attending selected health care facilities in Ogbomoso, a semiurban city in Oyo State, Nigeria. Body image perception, social support, and psychological distress scales were used to collect the data. Data were analyzed and summarized using descriptive and inferential statistics (ANOVA and multiple regression), with significance set at p < 0.05.

RESULTS

Regression analysis showed that 44% of the variation in psychological distress among pregnant women was explained by the background variables, marital status, body image perception, appraisal support, tangible support, belonging support, interaction between body image perception and appraisal support, belong support and tangible support.

CONCLUSION

Intervention programs focusing on bolstering tangible support, belonging support and appraisal support are recommended at reducing the psychological distress due to body image perception among pregnant women at third trimester.

Exploring body dissatisfaction in pregnancy and the association with gestational weight gain, obesity, and weight stigma

OBJECTIVE

Body dissatisfaction in pregnancy has been associated with negative psychological maternal outcomes, including increased risk of postpartum depression. This study aimed to explore weight-related factors that influence body dissatisfaction in pregnancy, including gestational weight gain (GWG), weight stigma, obesity, and weight loss attempts before pregnancy.

DESIGN

Secondary analysis of a larger cross-sectional study.

SETTING

Online survey administered via Qualtrics.

PARTICIPANTS

≥12 weeks pregnant, ≥18 years of age, having a singleton pregnancy and residing in Canada.

MEASUREMENTS AND FINDINGS

A battery of questionnaires were completed, including the Body Image in Pregnancy Scale (BIPS) sub-scale. The BIPS scores were compared based on experiences of weight stigma in pregnancy, perception towards their GWG, weight loss attempts before pregnancy, obesity, and GWG category classified as excessive or not referring to Institute of Medicine (2009) guidelines. Significant differences were entered into a linear regression model with BIPS scores as the dependent variable. Significance was accepted as p<0.05. A total of 182 participants completed the survey. There were no differences in BIPS scores based on GWG category (p = 0.160), or obesity (p = 0.230). Poorer BIPS scores were reported by those who felt they had gained 'too much' pregnancy weight than 'appropriate' (p<0.001), and among those who were trying to lose weight before pregnancy compared to those who were not (p = 0.002). Poorer BIPS scores were also reported by individuals who indicated they had experienced weight stigma during pregnancy compared to those who had not (p<0.001). Regression results showed that significant variables were perceptions towards GWG (p = 0.003) and experiencing weight stigma in pregnancy (p = 0.011).

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Perceptions towards GWG and experiencing weight stigma can influence body dissatisfaction in pregnancy. Given the detrimental physical and psychological consequences of body dissatisfaction, effective strategies to reduce prenatal weight stigma are needed, such as training maternal healthcare providers to offer sensitive preconception and prenatal weight counselling.

Body perception in pregnant women: a qualitative study

BACKGROUND

Dramatic body changes in pregnancy cause severe concerns among pregnant women about their appearance. Therefore, this study aimed to explore body perception in pregnant women.

MATERIALS AND METHODS

The qualitative study, using the conventional content analysis approach, was conducted on Iranian pregnant women who were in their second or third trimester of pregnancy. Participants were selected through purposeful sampling method. In-depth and semi-structured interviews were held with 18 pregnant women aged 22 to 36 years, using open-ended questions. Sampling was performed until data saturation was reached.

RESULTS

Three main categories were extracted from 18 interviews: (1) "symbols," with two subcategories, including 'motherhood' and 'vulnerability,' (2) "feelings toward body changes," with five subcategories, including 'negative feelings toward skin changes,' 'feeling unfit,' 'attention-drawing body shape,' 'the ridiculous body shape' and 'obesity,' and (3) "attraction and beauty," with two subcategories, including 'sexual attraction' and 'facial beauty.'

CONCLUSION

The results showed that pregnant women's body perception could be described as maternal feelings and feminine attitudes toward changes during pregnancy compared to mental ideals of facial and body beauty. It is recommended that Iranian women's body perception during pregnancy be evaluated using this study results and that counseling interventions be implemented for women with negative body perceptions.

The psychometric properties and validity of the Turkish version of the Body Image in Pregnancy Scale (BIPS-Turkish)

In our study, we aimed to assess the validity and reliability of the Turkish version of the Body Image in Pregnancy Scale (BIPS). A total of 220 pregnant women participated in the study. The content validity of the scale was evaluated by the content validity index (CVI) and its construct validity was evaluated by confirmatory factor analysis (CFA). The reliability of the scale was assessed with internal consistency analysis, item analysis, test-retest reliability, and parallel forms reliability. After the modification, the t values, factor loadings and fit indices of the scale items were at a good and acceptable level (χ2 = 1114.57, df = 505, χ2/df = 2.20, RMSEA = 0.07, SRMR = 0.07, CFI = 0.95, GFI = 0.90). Hence, a 34-item, 7-factor construct was confirmed for the Turkish version of the BIPS. Cronbach's alpha internal consistency coefficient of the overall scale was 0.90 and Cronbach's alpha internal consistency coefficients of the subscales were within the range of 0.65-0.94. Test-retest and parallel forms reliability of the scale were at a sufficient level. In conclusion, it was determined that BIPS can be used as a valid and reliable measurement tool to evaluate body image perceptions of Turkish pregnant women.

Nursing staff's experience of appearance issues in various nursing situations

Background

Health care professionals frequently interact with unknown patients in a process involving appearance-based judgements and priority-setting, all of which has an effect on health care equality. The healthcare provider–patient interaction is also highly relevant for the awareness and support of patients’ appearance concerns, with an associated possibility for improving patients’ satisfaction with their appearance and health. The aim was therefore to explore nursing staff’s experience of patients’ appearance issues in various nursing situations, with the purpose to facilitate awareness raising and knowledge development.

Method

A qualitative research approach with focus group interviews was chosen due to the exploratory aim of the study. Five semi-structured focus group interviews were conducted with 24 nursing staff in total (19 women and five men). The participants’ ages varied (20 to 45 years) as did their professional nursing experience. The interviews lasted approximately one hour, were digitally recorded, transcribed verbatim and analysed through thematic analysis.

Results

The thematic analysis resulted in the two themes Patient perspective and Professional nursing role, with associated subthemes. The findings showed the importance and impact of appearance issues in nursing situations and how these are linked to the health of the patients. Some groups of patients were identified as more vulnerable than others, which was associated with health care inequalities and health disparities. Value-based strategies along with knowledge, and skills for holistic person-centred care were identified as important resources for the development of appearance-related awareness and support in various nursing situations.

Conclusion

Strategies for improvement can be realised through the educational system for nursing staff, but mainly by using collective reflective learning forums in different workplaces. An empowerment approach is considered a useful framework for the implementation of holistic person-centred care, functioning as a resource for appearance-related awareness and support in various nursing situations. However, more research is needed on the complex and challenging phenomenon of appearance issues in nursing situations. Knowledge development related to successful person-centred strategies for appearance-related awareness and support is important, especially strategies with a salutogenic perspective.