대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지
DOI QR코드

DOI QR Code

과체중 및 비만임부를 위한 생활습관중재 프로그램의 효과

Effect of Lifestyle Intervention Program for Overweight and Obesity Pregnant Women

  • 최혜경 (전북대학교 간호대학) ;
  • 김현옥 (전북대학교 간호대학.전북대학교 간호과학연구소)
  • Choi, Hye Kyung (College of Nursing, Jeonbuk National University) ;
  • Kim, Hyeon Ok (College of Nursing.Research Institute of Nursing Science, Jeonbuk National University)
  • 투고 : 2019.10.29
  • 심사 : 2020.04.29
  • 발행 : 2020.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study was conducted to identify the effects of a lifestyle intervention program on weight gain, dietary habits, fatigue and pregnancy stress, blood pressure, and neonatal birth weight, using Cox's interaction model of client health behavior for overweight and obese women. Methods: This was a quasi-experimental research with a non-equivalent control group pre-post test design. A total of 52 patients who met the selection criteria, including 25 in the experimental group and 27 in the control group, were the subjects of the study; they comprised overweight and obese pregnant women who were receiving prenatal care at A and B women's hospital in J province. The lifestyle intervention program ran for 12 weeks in total and consisted of interactions involving affective support, health information, and professional/technical competencies. The data collection period was from February 1, 2017 to August 31, 2017. Results: This study showed differences in the appropriate weight gain rate (χ2=6.17, p=.013), suppression of an increase in fatigue (t=-2.32, p=.012), and an increase in pregnancy stress (t=-1.87, p=.034). Yet, no differences in physical activity, dietary habits change, blood pressure, and neonatal birth weight (p>.05) were found. Conclusion: The study findings indicate that this program could be an effective intervention for the control of appropriate weight gain, fatigue, and pregnancy stress. Therefore, a lifestyle intervention program based on Cox's interaction model of client health behavior could be an efficient strategy for a positive health outcome of overweight and obesity pregnant women.

키워드

참고문헌

  1. American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 548: Weight gain during pregnancy. Obstetrics & Gynecology. 2013;121(1):210-212. https://doi.org/10.1097/01.AOG.0000425668.87506.4c
  2. Institue of Medicine, National Research Council. Weight gain during pregnancy: Reexamining the guidelines [Internet]. Washington, D.C.: The National Academies Press; c2009 [cited 2018 Feb 19]. Available from: https://www.cbsnews.com/htdocs/pdf/052809_pregnancy.pdf.
  3. Ha JY, Kim HJ, Kang CS, Park SC. An association of gestational weight gain and prepregnancy body mass index with perinatal outcomes. Korean Journal of Obstetrics and Gynecology. 2011;54(10):575-581. https://doi.org/10.5468/KJOG.2011.54.10.575
  4. Chasan-Taber L, Silveira M, Waring ME, Pekow P, Braun B, Manson JE, et al. Gestational weight gain, body mass index, and risk of hypertensive disorders of pregnancy in a predominantly Puerto Rican population. Maternal and Child Health Journal. 2016;20(9):1804-1813. https://doi.org/10.1007/s10995-016-1983-3
  5. Huang A, Ji Z, Zhao W, Hu H, Yang Q, Chen D. Rate of gestational weight gain and preterm birth in relation to prepregnancy body mass indices and trimester: A follow-up study in China. Reproductive Health. 2016;13:93. https://doi.org/10.1186/s12978-016-0204-2
  6. Cosson E, Cussac-Pillegand C, Benbara A, Pharisien I, Nguyen MT, Chiheb S, et al. Pregnancy adverse outcomes related to pregravid body mass index and gestational weight gain, according to the presence or not of gestational diabetes mellitus: A retrospective observational study. Diabetes & Metabolism. 2016;42(1):38-46. https://doi.org/10.1016/j.diabet.2015.06.001
  7. Nazik E, Eryilmaz G. Incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women. Journal of Clinical Nursing. 2014;23(11-12):1736-1750. https://doi.org/10.1111/jocn.12323
  8. Egger G, Binns A, Rossner S. Lifestyle medicine: Managing diseases of lifestyle in the 21st century. 2nd ed. North Ryde (NSW): McGraw-Hill; 2011. p. 95-168.
  9. Luoto R, Kinnunen TI, Aittasalo M, Kolu P, Raitanen J, Ojala K, et al. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: A cluster-randomized controlled trial. PLoS Medicine. 2011;8(5):e1001036. https://doi.org/10.1371/journal.pmed.1001036
  10. Mottola MF, Giroux I, Gratton R, Hammond JA, Hanley A, Harris S, et al. Nutrition and exercise prevent excess weight gain in overweight pregnant women. Medicine & Science in Sports & Exercise. 2010;42(2):265-272. https://doi.org/10.1249/MSS.0b013e3181b5419a
  11. Quinlivan JA, Lam LT, Fisher J. A randomised trial of a fourstep multidisciplinary approach to the antenatal care of obese pregnant women. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2011;51(2):141-146. https://doi.org/10.1111/j.1479-828X.2010.01268.x
  12. Shirazian T, Monteith S, Friedman F, Rebarber A. Lifestyle modification program decreases pregnancy weight gain in obese women. American Journal of Perinatology. 2010;27(5):411-414. https://doi.org/10.1055/s-0029-1243368
  13. Poston L, Bell R, Croker H, Flynn AC, Godfrey KM, Goff L, et al. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): A multicentre, randomised controlled trial. The Lancet Diabetes & Endocrinology. 2015;3(10):767-777. https://doi.org/10.1016/S2213-8587(15)00227-2
  14. Daley AJ, Jolly K, Jebb SA, Roalfe AK, Mackillop L, Lewis AL, et al. Effectiveness of regular weighing, weight target setting and feedback by community midwives within routine antenatal care in preventing excessive gestational weight gain: Randomised controlled trial. BMC Obesity. 2016;3:7. https://doi.org/10.1186/s40608-016-0086-4
  15. Kwon HS, Cheong KJ. Effect of pregnant woman yoga on psychology of first childbirth mother. Journal of Holistic Mind Body Therapy. 2016;3(3):1-22. https://doi.org/10.22588/hatajat/2016.3.3.1
  16. Ji ES, Cho KJ, Kwon HJ. Effects of yoga during pregnancy on weight gain, delivery experience and infant's birth weight. Korean Journal of Women Health Nursing. 2009;15(2):121-129. https://doi.org/10.4069/kjwhn.2009.15.2.121
  17. Lim SA, Jeong KJ. Regular yoga practice and mental training beneficially affects physical and mental status of primipara. The Journal of Korea Society for Wellness. 2015;10(1):271-281.
  18. Cox CL. An interaction model of client health behavior: Theoretical prescription for nursing. Advances in Nursing Science. 1982;5(1):41-56. https://doi.org/10.1097/00012272-198210000-00007
  19. Voldner N, Froslie KF, Haakstad LAH, Bo K, Henriksen T. Birth complications, overweight, and physical inactivity. Acta Obstetricia et Gynecologica Scandinavica. 2009;88(5):550-555. https://doi.org/10.1080/00016340902818162
  20. Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. International Journal of Obesity. 2008;32(3):495-501. https://doi.org/10.1038/sj.ijo.0803710
  21. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Reports. 1985;100(2):126-131.
  22. Centers for Disease Control and Prevention. Healthy pregnant or postpartum women [Internet]. Atlanta: CDC; c2011 [cited 2016 Sep 13]. Available from: https://www.cdc.gov/physicalactivity/basics/pregnancy/index.htm.
  23. Kim WY, Cho MS, Lee HS. Development and validation of mini dietary assessment index for Koreans. Journal of Nutrition and Health. 2003;36(1):83-92.
  24. Lee KA, Hicks G, Nino-Murcia G. Validity and reliability of a scale to assess fatigue. Psychiatry Research. 1991;36(3):291-298. https://doi.org/10.1016/0165-1781(91)90027-m
  25. Kim Y, Chung CW. Development of the Korean pregnancy stress scale. Japan Journal of Nursing Science. 2018;15(2):113-124. https://doi.org/10.1111/jjns.12175
  26. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P. The hypertensive disorders of pregnancy (29.3). Best Practice and Research Clinical Obstetrics and Gynaecology. 2015;29(5):643-657. https://doi.org/10.1016/j.bpobgyn.2015.04.001
  27. Lee JJ, Kim MH, Ko KO, Kim KA, Kim SM, Kim ER, et al. The study of growth measurements at different gestatioal ages of Korean newborn the survey and statistics. Journal of the Korean Society of Neonatology. 2006;13(1):47-57.
  28. Shim CS, Lee YS. Effects of a yoga-focused prenatal program on stress, anxiety, self confidence and labor pain in pregnant women with in vitro fertilization treatment. Journal of Korean Academy of Nursing. 2012;42(3):369-376. https://doi.org/10.4040/jkan.2012.42.3.369
  29. Choi HK. Effect of lifestyle intervention program for overweight and obesity pregnant women [dissertation]. Jeonju: Jeonbuk National University; 2018. p. 1-109.
  30. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39(2):175-191. https://doi.org/10.3758/bf03193146
  31. Hickey CA. Sociocultural and behavioral influences on weight gain during pregnancy. The American Journal of Clinical Nutrition. 2000;71(5 Suppl):1364S-1370S. https://doi.org/10.1093/ajcn/71.5.1364s
  32. Kim M, Kim HJ, Shin G. Exercise patterns and factors affecting exercise duration in pregnant women. Journal of Korean Biological Nursing Science. 2017;19(4):258-265. https://doi.org/10.7586/jkbns.2017.19.4.258
  33. Moon HS. Literature review on psychological and physiological effects of exercise in pregnant women. Journal of Korean Association Physical Education and Sport for Girls and Women. 2017;31(3):181-197. https://doi.org/10.16915/jkapesgw.2017.09.31.3.181
  34. Guelinckx I, Devlieger R, Mullie P, Vansant G. Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: A randomized controlled trial. The American Journal of Clinical Nutrition. 2010;91(2):373-380. https://doi.org/10.3945/ajcn.2009.28166
  35. Oh JS, Cho MS. Comparison of eating habits based on weight gain during pregnancy: Centered on recommended standards of the Institute of Medicine. Journal of the Korean Dietetic Association. 2011;17(2):99-117. https://doi.org/10.14373/JKDA.2011.17.2.099
  36. Knapp TR. Focus on psychometrics. Coefficient alpha: Conceptualizations and anomalies. Research in Nursing & Health. 1991;14(6):457-460. https://doi.org/10.1002/nur.4770140610
  37. Moon H. The effect of the yoga exercise on fatigue, anxiety and labor process in expectant mothers [dissertation]. Gwangju: Chonnam National University; 2003. p. 1-74.
  38. Chasan-Taber L, Silveira M, Waring ME, Pekow P, Braun B, Manson JE, et al. Gestational weight gain, body mass index, and risk of hypertensive disorders of pregnancy in a predominantly Puerto Rican population. Maternal and Child Health Journal. 2016;20(9):1804-1813. https://doi.org/10.1007/s10995-016-1983-3
  39. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988. p. 40.
  40. Borglin G, Richards DA. Bias in experimental nursing research: Strategies to improve the quality and explanatory power of nursing science. International Journal of Nursing Studies. 2010;47(1):123-128. https://doi.org/10.1016/j.ijnurstu.2009.06.016