坐月子期間產婦之健康促進生活方式及其影響因素之探討

Factors Related to Health-Promoting Lifestyle Behaviors among Postpartum Women during their Doing the Month Period

王淑諒(Shu-Liang Wang)

指導教授 ： 陳靜敏

臺北醫學大學/護理學院/護理學研究所/碩士(2002年)

摘要

本研究旨在瞭解坐月子期間產婦的基本屬性、產後社會支持、產後關注、採行健康促進生活方式的現況及相關性，並預測健康促進生活方式的重要影響變項。應用橫斷性、相關性研究設計，以方便取樣選取在台中縣市某四家醫療院所生產且產後期滿30天的280位產婦為研究對象。 研究工具係自擬而成，包括基本資料、產後關注量表、產後社會支持量表與健康促進生活方式量表等，具合宜之專家效度（CVI >.86）及 信度（Cronbach’s α=.87~.90），共回收有效問卷240份（回收率為85.7%）。 主要研究結果顯示：(1)坐月子期間以遵從「不與丈夫有性關係」禁忌者為最多；且愈遵從者對此關注程度愈高，尤以遵從「不洗頭」禁忌者對此最為關注。(2)產後關注量表共四層面，其關注程度以「生理變化」為最高，「心理困擾」最低。(3)健康促進生活方式量表包含六層面，其平均得分以「人際支持」以及「健康責任」最佳，以「運動」最差。(4)產後社會支持量表分為三層面，以感受到「情緒支持」的支持程度最多，「訊息支持」最少。(5)基本屬性中產婦丈夫的社經地位、胎次、產後體重增加量、新生兒性別以及餵奶方式與產後關注的部分層面有顯著相關。(6)與健康促進生活方式有顯著相關的基本屬性有：產婦及其丈夫的教育程度、以及產婦的年齡、工作狀態、生產方式、產後體重增加量、餵奶方式。(7)「整體性」健康促進生活方式與「生理變化」的關注程度達顯著正相關；對「生理變化」與「遵從坐月子禁忌」的關注程度愈高者，其愈會執行健康促進生活方式中的「健康責任」；在「運動」層面的健康促進生活方式則與「整體性」、「生理變化」、「心理困擾」及「育嬰問題」等層面的產後關注程度呈現正相關；但是對「育嬰問題」的關注程度愈高，則「壓力處理」、「自我實現」及「人際支持」等層面的健康促進生活方式愈差；對「心理困擾」愈關注，在「自我實現」與「人際支持」兩層面的健康促進生活方式就愈不好。(8)除了「運動」外，健康促進生活方式的其他層面與產後社會支持呈現顯著正相關。(9) 產後體重增加量大於13.6公斤、生理變化關注程度及產後社會支持程度顯著預測產婦於坐月子期間的健康促進生活方式，共解釋14.6%的變異量。本研究發現產後社會支持及產後關注程度對產婦落實健康促進生活方式之重要性，進而提供護理人員於推展婦幼健康促進活動之參考依據。

關鍵字

坐月子產婦 ； 健康促進生活方式 ； 產後關注 ； 產後社會支持

並列摘要

The purpose of this study was to examine the current status of health-promoting lifestyle behaviors and its associated factors on social demographic variables, postpartum social support, and postpartum concerns, and further to explore its predicting factors among postpartum women. This study used cross-sectional, correlational design. A total of 280 postpartum women were recruited by convenience sampling. Four research instruments were self-developed to collect data with acceptable content validity(CVI>.86) and reliability(Cronbach’s α=.87~.90). The questionnaire was mailed to subjects 30 days after their delivery. A total of 240 effective questionnaires returned (response rate = 85.7%). The main results revealed: (1)During the doing the month period, the taboo of no sexual behavior was complied by the majority of postpartum women. Women who complied more on the related taboo had higher postpartum concern level, especially for those who complied the taboo of no hairwashing. (2)Among 4 domains, women concerned most on physiological changes and the least on the mental distress. (3)Among 6 domains, women had highest score on both of interpersonal support and health responsibility, and lowest on that of exercise. (4)Women perceived highest on emotional support, and the least on informational support for postpartum social support. (5) Socio- economic status of postpartum women''s husbands, para, maternal weight gain, neonatal gender, and feeding pattern influenced some domains of post- partum concerns. (6)The significant social demographic variables correlated to health-promoting lifestyle were women and their husbands’ educational level, and women''s age, work status, delivery method, maternal weight gain, and feeding pattern. (7)The health-promoting lifestyle profile in general was positively associated with women’s concern on physiological changes. Postpartum women had higher concern on physiological changes and compliance of taboo would implement the health responsibility of health-promoting lifestyle more frequently. The exercise health-promoting behavior was positively related to postpartum concern of physiological change, mental distress, parenting and total scale. Those who with higher concern on parenting performed worse on stress management, self-actualization, and interpersonal support. Those who concerned more on mental distress would execute less health-promoting lifestyle of domains of self-actualization and interpersonal support. (8)Except the exercise behavior, the other health-promoting lifestyle domains were positively associated with postpartum social support. (9)Gaining more than 13.6 Kg maternal weight, more concern on physiological changes, and received more postpartum social support were significant predictors of health-promoting lifestyle of postpartum women during the doing the month. A total of 14.6% variance was explained by these 3 variables.

並列關鍵字

doing the month women ； health-promoting lifestyle ； postpartum concerns ； postpartum social support

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