本文關(guān)鍵詞：跨理論模型在孕婦體重管理行為干預(yù)中的應(yīng)用　出處：《重慶醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 跨理論模型 孕婦 體重管理 變化過(guò)程 助產(chǎn)士

【摘要】：目的：以跨理論模型(The Transtheoretical Model, TTM)為理論基礎(chǔ)，對(duì)孕期婦女體重增長(zhǎng)的相關(guān)行為按其所處的行為階段，，制定并采取針對(duì)性行為干預(yù)策略，同時(shí)評(píng)估干預(yù)效果，探討一種基于TTM的孕期體重管理行為干預(yù)方法，提高臨床上對(duì)孕婦體重管理的質(zhì)量。 方法：門診收集60例肥胖孕婦，按收集時(shí)先后順序依次編號(hào)1～60，單號(hào)自動(dòng)進(jìn)入干預(yù)組，雙號(hào)自動(dòng)進(jìn)入對(duì)照組�；�評(píng)估后，干預(yù)組由門診助產(chǎn)士采取階段性行為干預(yù)策略對(duì)其實(shí)施體重管理；對(duì)照組僅接受助產(chǎn)士常規(guī)健康教育。分別在孕12-14周(T0)、孕18-20周（T1）孕22-24周(T2)與孕26周（T3）對(duì)兩組孕婦的體重管理行為變化階段、變化過(guò)程進(jìn)行評(píng)估與分析，比較其差異性；同時(shí)在孕26周比較兩組孕婦孕期與助產(chǎn)士溝通次數(shù)的差異性。 結(jié)果： 1.干預(yù)前兩組孕婦所處行為階段分析顯示:60例孕婦中,體重管理行為處于前意向或意向或準(zhǔn)備階段的孕婦共56例(93%),處于行動(dòng)或保持階段的孕婦所占比例極少。 2.干預(yù)后資料分析：對(duì)兩組孕婦在不同干預(yù)時(shí)點(diǎn)的體重管理行為變化的指標(biāo)進(jìn)行組間比較,結(jié)果顯示:基線TO時(shí),兩組孕婦在行為變化階段、變化過(guò)程方面差異均無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)；干預(yù)后在孕22-24周(T2)、孕26周（T3）,兩組孕婦在變化階段、變化過(guò)程方面差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)；干預(yù)后T1時(shí)兩組孕婦在變化階段存在統(tǒng)計(jì)學(xué)差異(P0.05)，而在變化過(guò)程方面不存在統(tǒng)計(jì)學(xué)差異(P＞0.05)。 3.孕26周時(shí)，兩組孕婦在與助產(chǎn)士的溝通次數(shù)上存在顯著統(tǒng)計(jì)學(xué)差異(P0.01)。 結(jié)論： 1.基于跨理論模型制定的行為干預(yù)策略使孕婦體重管理行為所處變化階段向前推進(jìn)；同時(shí)促使變化過(guò)程向有益于體重控制的方向改善。 2.TTM對(duì)孕婦孕期體重指數(shù)（BMI）、胎兒出生體重等的干預(yù)效果有待進(jìn)一步研究。 3.基于TTM的階段性行為干預(yù)策略，促進(jìn)了孕婦孕期與助產(chǎn)士的溝通，進(jìn)而一定程度上提高了助產(chǎn)士對(duì)孕婦孕期照護(hù)的連續(xù)性。
[Abstract]:Objective: to take the Transtheoretical Model (TTM) as the theoretical basis. The behavior related to weight gain of pregnant women was designed and adopted targeted behavioral intervention strategies according to their behavior stage, and the intervention effect was evaluated at the same time. To explore a method of intervention of pregnant weight management based on TTM to improve the quality of pregnant women's weight management. Methods: 60 obese pregnant women were collected from outpatient clinic, numbered 160 in order of collection, single number automatically entered the intervention group, double number automatically entered the control group, and after baseline evaluation. In the intervention group, the outpatient midwives carried out the weight management by the phased behavioral intervention strategy. The control group only received midwife routine health education in 12-14 weeks of gestation (T0). The changes of body weight management behavior in the two groups were evaluated and analyzed, and the differences were compared between 18 and 20 weeks of gestation (22-24 weeks) and 26 weeks of gestation (P < 0.05). At the same time, the differences of communication times between pregnant women and midwives were compared between the two groups at 26 weeks of gestation. Results: 1. The behavioral stage analysis of the two groups of pregnant women before intervention showed that 56 of 60 pregnant women with weight management behavior were in the former intention or intention or preparation stage. The proportion of pregnant women in the active or maintenance phase is very low. 2. Analysis of post-intervention data: the changes of weight management behavior of pregnant women in two groups were compared at different intervention time points. The results showed that: at baseline to, the two groups of pregnant women were in the stage of behavior change. There was no significant difference in the process of change (P > 0.05). After intervention, there were significant differences between the two groups in the phase of change and the process of change (P 0.05) at 22-24 weeks of gestation and 26 weeks of gestation. There was a statistical difference between the two groups at T1 after intervention in the stage of change, but there was no statistical difference in the process of change (P > 0.05). 3. At the 26th week of gestation, there was a significant difference between the two groups in the frequency of communication with the midwife (P 0.01). Conclusion: 1.Behavioral intervention strategies based on cross-theoretical model can push forward the changing stage of pregnant women's weight management behavior and improve the change process towards the direction beneficial to weight control. 2. The intervention effect of TTM on pregnancy body mass index (BMI) and fetal birth weight (FBW) of pregnant women needs further study. 3. The phased behavioral intervention strategy based on TTM promotes the communication between pregnant women and midwives, and to some extent improves the continuity of midwives' care during pregnancy.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R473.71

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