بررسی تأثیر مدل 5آ بر تغییر رفتار فعالیت فیزیکی در زنان باردار با اضافه وزن

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مشاوره در مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

2 استادیار گروه مامایی، مرکز تحقیقات چاقی مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

3 دانشجوی دکتری تغذیه، مرکز تحقیقات چاقی مادر و کودک، مجتمع مراکز تحقیقاتی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

4 دانشیار گروه آمار زیستی، مرکز تحقیقات ایمنی بیمار، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

چکیده

مقدمه: اضافه وزن و چاقی، یک چالش قابل توجه برای مراقبت دوران بارداری می‌باشد. حدود 50% از زنان با شاخص توده بدنی بالای 25 کیلوگرم بر متر مربع باردار می‌شوند که می‌تواند با افزایش خطر بارداری همراه باشد. مطالعه حاضر با هدف تعیین تأثیر مدل 5آ بر تغییر رفتار فعالیت فیزیکی در زنان باردار دارای اضافه وزن انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 95-1394 بر روی 120 زن باردار با اضافه وزن مراجعه کننده به مراکز بهداشتی درمانی ارومیه انجام شد. گروه کنترل مراقبت‌های معمول را دریافت و گروه مداخله آموزش چهره به چهره فعالیت فیزیکی بر اساس مدل خودمدیریتی 5آ را دریافت کرد. این مطالعه طی 3 ماه در قالب 5 مرحله سؤال، ارزیابی، راهنمایی، توافق، کمک و پیگیری به اجرا درآمد. گردآوری داده‌ها با استفاده از پرسشنامه فعالیت فیزیکی در بارداری انجام گرفت. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماریSPSS (نسخه 21) و آزمون‌های تی‌مستقل، کای دو و آنالیز کواریانس انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: متوسط سطح کل فعالیت فیزیکی در گروه کنترل در شروع و پایان مداخله 89/38±30/74 و 67/25±37/60 و در گروه مداخله 70/15±32/88 و 14/35±30/117 مت بر دقیقه بود. در پایان مداخله اختلاف دو گروه بر اساس الگوی فعالیت فیزیکی و میزان وزن‌گیری معنی‌دار بود. متوسط فعالیت فیزیکی بین دو گروه در پایان مداخله تفاوت معنی‌داری داشت (001/0>p). آنالیز کوواریانس، تفاوت آماری معنی‌داری را بین دو گروه بر اساس فعالیت فیزیکی کل و تغییرات وزن پس از تعدیل متغیرهای مخدوشگر نشان داد (001/0>p).
نتیجه‌گیری: مداخله خودمدیریتی بر اساس مدل 5آ می‌تواند نقش مؤثری در تغییر رفتار زنان باردار داشته باشد و منجر به ایجاد انگیزه، تغییر نگرش و رفتار آنان شده و به آنها کمک می‌کند برای بهبود وزن‌گیری طبق دستورالعمل و به‌دست آوردن وزن مناسب در بارداری، رفتار و سبک زندگی خود را مدیریت کنند.

کلیدواژه‌ها

عنوان مقاله [English]

The effect of 5A model on behavior change of physical activity in overweight pregnant women

نویسندگان [English]

  • Narmin Ghaderpanah 1
  • Hamideh Mohaddesi 2
  • Davood Vahabzadeh 3
  • Hamidreza Khalkhali 4
1 M.Sc. student of Counselling in Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
2 Assistant professor, Department of Midwifery, Maternal and Childhood Obesity Research Center, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
3 PhD student of Nutrition, Maternal and Childhood Obesity Research Center, Research Centers, Urmia University of Medical Sciences, Urmia, Iran.
4 Associate professor, Department of Biostatistics, Patient Safety Research Center, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
چکیده [English]

Introduction:  Overweight and obesity are considerable challenge for pregnancy care. About 50% of women enter pregnancy with BMI above than 25kg/m2 that can be associated with increased risk in pregnancy. This study was performed with aim to determine the effect of 5A model on behavior change of physical activity in overweight pregnant women.
Methods: This randomized clinical trial was conducted on 120 overweight pregnant women referred to health centers of Urmia during 2015-2016. The control group received routine prenatal care, and intervention group received a face to face training program regarding physical activity based on self-management 5A model. This study was performed during 3 months in 5 steps of question, assessment, guidance, agreement, help, and follow-up. Data were analyzed by SPSS software (version 21) and independent t, Chi-square, and covariance analysis tests. P<0.05 was considered significant.
Results: The mean of total physical activity level in the control group at the start and the end of the intervention was 74.30 ± 38.89 and 60.37 ± 25.67 MET / min, respectively and in the intervention group was 88.32 ± 15.70 and 35.3 ± 117.30 ±35.14 MET / min, respectively. At the end of intervention, the difference of two groups in terms of physical activity and weight gain was significant. The mean of physical activity at the end of intervention was significantly different after the intervention (P <0.001). Analysis of covariance showed a significant difference between the two groups in physical activity and weight changes after adjusting the confounding variables (P <0.001). 
Conclusion: The self-management intervention based on 5A model has an effective role in the changing of pregnant women's behavior and can lead to create motivation, attitude and behavioral modifications. Also it can help them to improve their weight gain according to guidelines through of managing their behavior and life style.

کلیدواژه‌ها [English]

  • Overweight
  • Physical Activity
  • pregnancy weight gain
  • Self-management 5A model

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مجله زنان، مامایی و نازایی ایران
دوره 20، شماره 9
آذر 1396
صفحه 101-114

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