Application Of Integrated Theory Of Health Behavior Change On Weight Management Of Pregnant Women

ObjectivesTo understand the current status of women’s weight gain during pregnancy and its influencing factors;to explore the effect of the integrated theory of healthy behavior change on weight management of pregnant women,and to provide a reference for obstetric clinical nursing clinics to innovate new models of weight management during pregnancy Methods(1)A total of 378 pregnant women who met the inclusion criteria in obstetric outpatient clinics in three tertiary A hospitals in Changsha City,Hunan Province from June to December 2018,adopted the general information questionnaire for pregnant women and weight management during pregnancy The strategy scale,the maternal exercise self-efficacy scale,and the health promotion lifestyle-Ⅱ scale were used for questionnaire surveys to observe the maternal and infant pregnancy outcome after delivery,understanding the current status of women’s gestational weight gain and analyze its influencing factors.(2)The pregnant women undergoing prenatal examinations were selected as the research subjects.108 pregnant women who met the inclusion criteria were numbered according to the order of their visits and randomly divided into control group and intervention group Group,There were 54 people in each group;the control group carried out weight management in accordance with conventional health education;the intervention group used the integrated theory of healthy behavior change for weight management in addition to conventional health education.After the intervention,the two groups of pregnant women’s weight management strategy scores during pregnancy,pregnancy exercise selfefficacy scores,health promotion lifestyle scores,weight gain during pregnancy,pregnancy outcome and other aspects were compared.Results1.Analysis of current status of gestational weight gain and its influencing factors.(1)Current status of gestational weight gain: The average gestational weight gain of women in this region was(14.58±3.24)kg;96 cases(25.4%)had excessive gestational weight gain;34 cases(8.99%)had underweight gain during pregnancy.(2)Pregnancy outcome: The average gestational week of pregnancy for women in this region was(39.57±2.05)weeks;132 cases(34.92%)of cesarean section women;48 cases(12.7%)of pregnancy complicated with diabetes;32cases(8.47%)of pregnancy had complicated with hypertension;4 cases(1.06%)were born prematurely;15 cases(3.97%)were born with low birth weight;33cases(8.73%)were born with giant babies.(3)Scale scores: The average score of pregnancy weight management strategy scale for pregnant women was [(69.92±10.86)points].And the average score of pregnant women’s exercise self-efficacy was [(28.52±2.44)points],the average score of health promotion lifestyle was [(85.77±18.52)points].(4)Influencing factors of women’s gestational weight gain: from largest to smallest,they were weight management strategies during pregnancy,pregnant women’s exercise self-efficacy,pregnancy times,education level,health promotion lifestyle,pre-pregnancy BMI,age,parity,and residence.2.Research on the application of integrated theory of healthy behavior change in weight management of pregnant women.(1)Before the intervention,the two groups had no statistically significant differences in general data,weight management strategies during pregnancy,pregnant women’s exercise self-efficacy,and health promotion lifestyle scores(P>0.05).(2)After the intervention,the average total score of weight management strategy during pregnancy in the control group [(68.73±12.66)points] was significantly lower than that of the intervention group [(101.79±8.62)points],and the difference was statistically significant(P<0.05).The scores of exercise management,family support,diet management,stimulation strategies,self-monitoring,and management goals in the intervention group were higher than those in the control group,and the difference was statistically significant(P<0.05).(3)After the intervention,the average score of exercise self-efficacy of pregnant women in the control group [(28.99±2.63)points] was significantly lower than that of the intervention group [(39.43±2.77)points],and the difference was statistically significant(P<0.05).(4)After the intervention,the health promotion lifestyle score of the intervention group [(124.27±2.28)points] was significantly higher than the total score of the control group [(89.92±2.53)points].Except for interpersonal relationship,the other 5 dimensions of the intervention group were higher than those of the control group,and the differences were statistically significant(P<0.05).(5)The mean women’s gestational weight gain in the control group was(15.82±4.23)kg,and the mean women’s gestational weight gain in the intervention group was(13.66±3.15)kg,the difference was statistically significant(P<0.05).(6)The average gestational week of the pregnant women in the control group was(39.18±1.25)weeks,and the average gestational week of the pregnant women in the intervention group was(38.75±1.78)weeks,the difference was not statistically significant(P>0.05).(7)In the control group,21 cases(38.89%)of cesarean section,8 cases of gestational diabetes(14.81%),5 cases(9.26%)of gestational hypertension.in the intervention group,5 cases(9.26%)of cesarean section,and 2 cases(3.7%)of gestational diabetes,2 cases(3.7%)of pregnancy-induced hypertension;the difference was statistically significant(P<0.05).(8)The average birth weight of newborns in the control group was(3566.72±480.25)g.The average birth weight of newborns in the intervention group was(3201.58±395.17)g.The difference between the two groups was not statistically significant(P>0.05).The control group was born with giant babies there were 8 cases(14.81%),5 cases(9.26%)of low birth weight infants,2cases(3.7%)of giant infants and 1 case(1.85%)of low birth weight infants in the intervention group.The difference between the two groups was statistically significant(P< 0.05).Conclusions(1)Improper weight gain of pregnant women in this region is still at a high level,especially the incidence of EGWG is still at a high level.(2)The cesarean section rate in this region exceeds the WHO warning line and is at a high level.(3)Pregnancy weight management strategies,pregnant women’s exercise self-efficacy,and health-promoting lifestyle II of pregnant women in this region are in the lower middle level.(4)Weight gain during pregnancy is affected by age,pre-pregnancy BMI,education level,place of residence,times of pregnancy,parity,weight management strategies during pregnancy,and exercise self-efficacy of pregnant women.(5)Pregnancy women through ITHBC’s weight management program can increase the rate of achieving reasonable weight gain during pregnancy,reduce the risk of neonatal large and low birth weight infants,and reduce the incidence of cesarean section.To provide a reference for the new model of weight management during pregnancy in the obstetric clinical nursing clinic.