The impact of general health and social support on health promoting lifestyle in the first year postpartum

The structural equation modelling

Authors

  • Roya Sadeghi Ph.D. of Health Education, Associate Professor, Department of Health Education and Health Promotion, School ofPublic Health, Tehran University of Medical Sciences, Tehran, Iran

Keywords:

Postpartum Period, Life Style, Social Support

Abstract

Background and aim: Postpartum is a critical period for mothers which often leads to neglect of their own health. Mothers’ new responsibilities may affect their health promoting lifestyle (HPL). The aim of this study was to determine the impact of both general health and social support on health-promoting lifestyle.  Methods: A cross-sectional survey was conducted on 310 women who gave birth over a one-year period in Zanjan (Iran), 2016. A proportionate stratified random sampling technique was used to select respondents from each stratum. Health-promoting lifestyle was assessed using the health-promoting lifestyle profile II (HPLP II) scale. A structure equation model (SEM) was used to determine the relationship between observed and latent variables. Data were analysed using SPSS version 22 and LISREL 8.5 software. Results: The age of 42.6% of the participants was more than 30 years and 40.3% of them had an academic education. The mean score of the health-promoting lifestyle was 131.28 (15.37). The structural equation model fitted well with RMSEA =0.07, CFI=0.92, and GFI=0.94. Among the latent factors, general health, with a factor load of -0.68, had greater impact on health-promoting lifestyle than social support. Moreover, there was a significant correlation (-0.63) between general health and perceived social support in the postpartum period.  Conclusion: health-promoting lifestyle was not at appropriate levels among women in the first year after delivery. These findings suggest that strengthening general health and social support would improve a health-promoting lifestyle in Iranian postpartum women.

References

Matteson P. Women's health during the childbearing years: a community-based approach: Mosby; 2001.2)Dodou HD, Rodrigues DP, Costa ACMAC, Oriá MOB, Castro RCMB, Queiroz ABA, etal. Self-care andempowerment in postpartum: social representations of puerperae. International Archives of Medicine.2016; 9(1). doi: 10.3823/2041.3)Mercer RT. Becoming a mother versus maternal role attainment. Journal of nursing scholarship. 2004;36(3):226-32. doi: 10.1111/j.1547-5069.2004.04042.x. PMID: 15495491.4)Walker LO, Wilging S. Rediscovering the “M” in “MCH”: Maternal health promotion after childbirth. JObstet Gynecol Neonatal Nurs. 2000; 29(3): 229-36. PMID: 10839571.5)Hammoudeh W, Mataria A, Wick L, Giacaman R. In search of health: quality of life among postpartumPalestinian women. Expert review of pharmacoeconomics & outcomes research. 2009; 9(2): 123-32.PMID: 19402799.6)O'Toole ML, Sawicki MA, Artal R. Structured diet and physical activity prevent postpartum weightretention. Journal of Women's Health. 2003; 12(10): 991-8. doi: 10.1089/154099903322643910. PMID:14709187.7)Troy NW. Is the significance of postpartum fatigue being overlooked in the lives of women? MCN Am JMatern Child Nurs. 2003;28(4): 252-7. PMID: 12840692.8)Barkin JL, Bloch JR, Hawkins KC, Thomas TS. Barriers to optimal social support in the postpartum period.J Obstet Gynecol Neonatal Nurs. 2014; 43(4): 445-54. PMID: 24946850.9)Chen CM, Kuo SF, Chou YH, Chen HC. Postpartum Taiwanese women: their postpartum depression,social supportand health‐promoting lifestyle profiles. Journal of Clinical Nursing. 2007; 16(8): 1550-60.PMID: 17655544.10)Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, et al. Perinatal depression:Prevalence, screening accuracy, and screeningoutcomes. Evid Rep Technol Assess (Summ). 2005; (119):1-8. PMID: 15760246, PMCID: PMC4780910.11)Veisani Y, Delpisheh A, Sayehmiri K, Rezaeian S. Trends of postpartum depression in iran: a systematicreview and meta-analysis. Depress Res Treat. 2013; 2013:291029. doi: 10.1155/2013/291029. PMID:23936640.12)Bruwer B, Emsley R, Kidd M, Lochner C, Seedat S. Psychometric properties of the MultidimensionalScale of Perceived Social Support in youth. Comprehensive psychiatry. 2008; 49(2): 195-201. doi:10.1016/j.comppsych.2007.09.002. PMID: 18243894.13)Phang KN, Koh SSL, Chen Hc. Postpartum social support of women in Singapore: A pilot study.International Journal of Nursing Practice. 2015; 21(S2): 99-107. doi: 10.1111/ijn.12340. PMID: 26125577.14)Leahy‐Warren P, McCarthy G, Corcoran P. First‐time mothers: social support, maternal parental self‐efficacy and postnatal depression. Journal of clinical nursing. 2012; 21(3‐4): 388-97. doi: 10.1111/j.1365-2702.2011.03701.x. PMID: 21435059.15)Hung CH, Chung HH. The effects of postpartum stress and social support on postpartum women’s healthstatus. Journal of advanced nursing. 2001; 36(5): 676-84. doi: 10.1046/j.1365-2648.2001.02032.x. PMID:11737500.16)Mirghafourvand M, Baheiraei A, Nedjat S, Mohammadi E, Charandabi SM, Majdzadeh R. A population-based study of health-promoting behaviors and their predictors in Iranian women of reproductive age.Health Promot Int. 2015; 30(3): 586-94. doi: 10.1093/heapro/dat086. PMID: 24395956.17)Montgomery KS, Bushee TD, Phillips JD, Kirkpatrick T, Catledge C, Braveboy K, et al. Women’schallenges with postpartum weight loss. Maternal and child health journal. 2011; 15(8): 1176-84. doi:10.1007/s10995-010-0681-9. PMID: 20844941.18)Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice:John Wiley & Sons; 2008.

Kline RB. Principles and Practice of Structural Equation Modeling, (Methodology In The Social Sciences).2004.20)Zeidi I, Hajiagha A, Zeidi B. Reliability and validity of Persian version of the health-promoting lifestyleprofile. JMUMS. 2012; 22: S103.21)Montazeri A, Harirchi AM, Shariati M, Garmaroudi G, Ebadi M, Fateh A. The 12-item General HealthQuestionnaire (GHQ-12): translation and validation study of the Iranian version. Health and quality of lifeoutcomes. 2003; 1(1): 1. PMID: 14614778.22)Bagherian-Sararoudi R, Hajian A, Ehsan HB, Sarafraz MR, Zimet GD. Psychometric properties of thePersian version of the multidimensional scale of perceived social support in Iran. Int J Prev Med. 2013;4(11): 1277-81.PMID: 24404362, PMCID: PMC3883252.23)Janghorbani M, Amini M, Willett WC, Gouya MM, Delavari A, Alikhani S, et al. First nationwide surveyof prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity. 2007; 15(11):2797-808. PMID: 18070771.24)Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd edn. Hillsdale: Earlbaum; 1988.25)Cheng CY, Pickler RH. Effects of stress and social support on postpartum health of Chinese mothers in theUnited States. Research in nursing &health. 2009; 32(6): 582-91. PMID: 19877163.26)Panzarine S, Slater E, Sharps P. Coping, social support, and depressive symptoms in adolescent mothers.Journal of Adolescent Health. 1995; 17(2): 113-9. PMID: 7495822.27)Chenary R, Noroozi A, Tavafian SS, Firoozabadi MS. Effective Factors on Health-Promoting LifestyleAmong Iranian Chemical Veterans in 2014 Based on Health Promotion Model: A Path Analysis. Iran RedCrescent Med J. 2016; 18(8): e33467. doi: 10.5812/ircmj.33467. PMID: 27781120, PMCID: PMC5065710.28)Cotter KA. No Strain, No Gain: An Application of Social Cognitive Theory to Physical Activity Across theLifespan: ProQuest; 2008.29)Emmanuel E, St John W, Sun J. Relationship between social support and quality of life in childbearingwomen during the perinatal period. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2012; 41(6):E62-70. PMID: 22861382.30)Ohashi Y, Asano M. Transition to early parenthood, and family functioning relationships in Japan: alongitudinal study. Nursing & health sciences. 2012;14(2): 140-7. doi: 10.1111/j.1442-2018.2011.00669.x.PMID: 22316497.31)Muhlenkamp AF, Sayles JA. Self-esteem, social support, and positive health practices. Nursing Research.1986; 35(6): 334-8. doi: 10.1097/00006199-198611000-00007. PMID: 3640349.32)Negron R,Martin A, Almog M, Balbierz A, Howell EA. Social support during the postpartum period:mothers’ views on needs, expectations, andmobilization of support. Maternal and child health journal.2013; 17(4): 616-23. doi: 10.1007/s10995-012-1037-4. PMID: 22581378, PMCID: PMC3518627.33)Fowles ER, Cheng HR, Mills S. Postpartum health promotion interventions: A systematic review. Nursingresearch. 2012; 61(4): 269-82. doi: 10.1097/NNR.0b013e3182556d29. PMID: 22592390.34)Groth SW, David T. New mothers’ views of weight and exercise. MCN The American journal of maternalchild nursing. 2008; 33(6): 364. doi: 10.1097/01.NMC.0000341257.26169.30. PMID:18997572, PMCID:PMC2712877.35)Gokyildiz S, Alan S, Elmas E, Bostanci A, Kucuk E. Health‐promoting lifestyle behaviours in pregnantwomen in Turkey. International journal of nursing practice. 2014; 20(4): 390-7. doi: 10.1111/ijn.12187.PMID: 24118372.36)JesseDE, Reed PG. Effects of spirituality and psychosocial well‐being on health risk behaviors inAppalachian pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2004; 33(6): 739-47. doi: 10.1177/0884217504270669. PMID: 15561662.37)Grace SL, Williams A, Stewart DE, Franche RL. Health-promoting behaviors through pregnancy,maternity leave, and return to work: effects of role spillover and other correlates. Women & Health. 2006;43(2): 51-72. doi: 10.1300/J013v43n02_04. PMID: 17000611.38)Callister LC, Khalaf I. Spirituality in childbearing women. The Journal of perinatal education. 2010; 19(2):16-24. PMID: 20498751.39)Baheiraei A, Mirghafourvand M, Charandabi SM, Mohammadi E, Nedjat S. Health-promoting behaviorsand social support in Iranian women ofreproductive age: a sequential explanatory mixed methods study.International journal of public health. 2014; 59(3): 465-73. PMID: 24042269.40)Bahadoran P, Tirkesh F, Oreizi HR. Association between physical activity 3-12 months after delivery andpostpartumwell-being. Iran J Nurs Midwifery Res. 2014; 19(1): 82. PMID: 24554965.

Published

2021-12-24