Page 136 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

134 | Part 3 Lifestyle intervention
was combined with brief counseling248; this integrated two-component intervention induced positive changes in knowledge and awareness of intake levels of fruit and vegetables among schoolchildren.
In addition to individual counseling, our results seem to indicate that group counseling might be suitable for these women as well. However, this needs to be further examined. During the focus group meetings, women reported that they would like to share their experiences with fellow sufferers. Their preference for a location where they could meet fellow sufferers, and their preference for a forum to get in touch with fellow sufferers, reflects this desire. This is also demonstrated by the fact that, after the focus group interviews, participants exchanged their e-mail addresses. In their social environment, women generally seem to lack the company of women who have experienced the same pregnancy complication(s), probably because of lack of knowledge and lack of understanding about the complication and its consequences. Due to this lack of social support, during participation in lifestyle counseling they would like contact with other women who have experienced the same pregnancy complication(s).
Some methodological considerations of the present study need to be addressed. Some selection bias may have occurred since only patients who gave birth in the Erasmus University Medical Center (a tertiary referral hospital) were invited to participate; despite efforts to prevent bias (e.g., by having random, consecutive participant selection), a volunteer bias might have occurred. In addition, an investigator bias may have arisen; although using more than one analyst might have improved the consistency or reliability of the analyses, the appropriateness of the interrater reliability concept in qualitative research is still debated249.