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Category: Qualification of dietary advice
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Subcategory 1: Qualification of dietary advice when handling common pregnancy signs and symptoms:
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| Example: |
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“… food is the biggest challenge. Because when she arrives to start prenatal care at the unit, what is her main complaint? Nausea, vomiting, difficulty in eating… these are the advice that I use to not focus on. We do use to focus on other things and forget about it a little… I myself have a hard time saying: oh, what food items can you avoid? You talk a little about coffee. Which I found amazing. And that was something I didn't even talk to them about, which I now intend to start talking about. And…but which food items can they avoid that will cause less nausea? Which food items cause flatulence the most, right? They have a lot of questions about it. And we used to approach it in a very generic way: 'Ah, avoid sweets, you know, avoid saturated fats that are deep-fried foods. Avoid excess salt. These foods that are processed, right…” |
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Subcategory 2: Qualification of dietary advice by other categories of health professionals (in addition to nutritionists):
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| Example: |
| “… so, here in my job, for the pregnant woman to get to an individual appointment with the nutritionist, usually faces some changes already… [such as] excessive weight gain, some pathology, or a high-risk prenatal care. In addition, we make group approaches and who will provide this service are the doctors, nurses, and nursing technicians. In addition, we make group approaches and who will provide this service are the doctors, nurses, and nursing technicians. And many times, … in my practice, with the rush, diet goes a little unnoticed.” |
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Subcategory 3: Qualification of dietary advice for pregnant women based on scientific evidence and the food culture of Brazilian people:
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| Example: |
| “… you talked in the leaflet a little, you know, about social classes, right, and about consumption, you know, that white women, white pregnant women usually consume a little more… not a little, right… more healthy foods. The mulatto and black women, yes, consume more industrialized foods, right, processed. And for me, this is essential. Very important. So yeah, I wish I had material on that, because I can't find it, I can't get it. It is not accessible. Most of the women that I start prenatal care today, in my region, right, I work in the south region, extreme south, are mostly black and mulatto women. So, this woman is the woman who consumes more ultraprocessed foods… but for me it is essential that I look at this data that exists about black and mulatto women, who consume more ultraprocessed foods, and that I can advise them in an accessible way, the foods that are also available in other ways and that are healthier for them during this time…” |
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Subcategory 4: Qualification of dietary advice for pregnant women based on the recommendations of the Dietary Guidelines for the Brazilian Population:
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| Example: |
| “… going back to the case of pregnant women, I usually use the Guideline very little, because it has been very comprehensive. And maybe, it is, to think of a protocol, in specific guidelines, for pregnant women. For me, it's very interesting.” |
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Category: Promoting the trust of professionals
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| Example: |
| “So, yeah, for me, yes, it gives me a lot more confidence. I realize that, over time, as we are in a very dynamic job, there is a lot going on, right, no one was expecting, for example, this pandemic, and there are guidelines all the time, every day we receive something new; then I feel that, during my practice, many things end up fading into oblivion, or we end up losing a little, right. So, I want material that makes me think always, yes, that doesn't let me fade into oblivion, right, that makes me confident so that I can always offer this protocol, right, and that is always relevant. Of course, things are changing all the time, but with the material that I can, that I can offer that and I think it's going to offer me a lot more confidence, for sure.” |
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Topic: Applicability
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Category: Challenges and spaces for using the protocol in prenatal appointments
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Subcategory 1: Challenges linked to the health work process that influence the applicability of the protocol:
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| Example: |
| “… yes, what I think will be a great challenge, J., at least in my job, is that I still see professionals who are not nutritionists, with difficulty, … the routine of fitting in the filling of the food consumption marker, which is the starting point for the protocol. The protocol, it will be based on you filling in the marker and from the marker responses, you should guide that. Yeah, and then I think that, I don't know, it's up to us to think of strategies to encourage this filling, if not in all appointments or for everybody, yes, the entire population served, but focused, at least in this period, to be able to provide advice for pregnant women. So, kind of, first, it would be important for us to understand food as a health determinant and that it belongs to all of us and how important it is to be addressed. And the marker is a kickoff. So, I think this is a big initial challenge.” |
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Subcategory 2: Pregnancy as an opportune phase for changes in diet and subsequent application of the protocol.
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Example:
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| “… and especially the pregnant women, right, which are a group that I see like that, in my job, that is looking for care, self-care, is looking for more information. It's a group that's more interested, mainly, in nutritional information, right, in nutrient information, vitamins, and everything else, and then, I think the more knowledge we have, the simpler, both for us to learn and to pass on to these pregnant women, I think it will flow much better and it is very helpful. Because we have a lot of extensive material, a lot of long stuff and we can't stop to read it. And we end up losing super useful knowledge, but that we can't read. You can't stop to acquire that knowledge.” |
