Person-centred care in interventions to limit weight gain in pregnant women with obesity - a systematic review

Olander, E. K., Berg, M., McCourt, C., Carlstroem, E. & Dencker, A. (2015). Person-centred care in interventions to limit weight gain in pregnant women with obesity - a systematic review. BMC Pregnancy and Childbirth, 15, p. 50. doi: 10.1186/s12884-015-0463-x

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Abstract

Background
Person-centred care, asserting that individuals are partners in their care, has been associated with care satisfaction but the value of using it to support women with obesity during pregnancy is unknown. Excessive gestational weight gain is associated with increased risks for both mother and baby and weight gain therefore is an important intervention target. The aims of this review was to 1) explore to what extent and in what manner interventions assessing weight in pregnant women with obesity use person-centred care and 2) assess if interventions including aspects of person-centred care are more effective at limiting weight gain than interventions not employing person-centred care.

Methods
Ten databases were systematically searched in January 2014. Studies had to report an intervention offered to pregnant women with obesity and measure gestational weight gain to be included. All included studies were independently double coded to identify to what extent they included three defined aspects of person-centred care: 1) “initiate a partnership” including identifying the person’s circumstances and motivation; 2) “working the partnership” through sharing the decision-making regarding the planned action and 3) “safeguarding the partnership through documentation” of care preferences. Information on gestational weight gain, study quality and characteristics were also extracted.

Results
Ten studies were included in the review, of which five were randomised controlled trials (RCT), and the remaining observational studies. Four interventions included aspects of person-centred care; two observational studies included both “initiating the partnership”, and “working the partnership”. One observational study included “initiating the partnership” and one RCT included “working the partnership”. No interventions included “safeguarding the partnership through documentation”. Whilst all studies with person-centred care aspects showed promising findings regarding limiting gestational weight gain, so did the interventions not including person-centred care aspects.

Conclusions
The use of an identified person-centred care approach is presently limited in interventions targeting gestational weight gain in pregnant women with obesity. Hence to what extent person-centred care may improve health outcomes and care satisfaction in this population is currently unknown and more research is needed. That said, our findings suggest that use of routines incorporating person-centredness are feasible to include within these interventions.

Item Type: Article
Uncontrolled Keywords: Person-centred care, Maternal obesity, Gestational weight gain, Intervention, Systematic review
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: School of Health Sciences > Department of Child Health & Children's Nursing
URI: http://openaccess.city.ac.uk/id/eprint/11983

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