目的探究基于健康行为改变整合理论(ITHBC)的群组孕期体重管理模式,对高龄初产妇管理效果的研究。方法选取河南省平顶山市妇幼保健院2017年5月-2019年5月期间128例高龄初产妇作为研究对象,按照管理模式不同分为对照组和观察组。对照组64例给予传统的孕期保健管理模式,观察组64例给予基于ITHBC理论的群组孕期体重管理模式。对比两组初产妇自我管理能力,体重控制效果、母婴结局。结果两组初产妇干预后遵医行为、日常生活行为、自我防护行为、胎儿监护行为评分较干预前均升高,且观察组高于对照组(P<0.05)。两组初产妇分娩前体重、BMI、体重增加率及BMI增加率较干预前均升高,且观察组低于对照组(P<0.05)。观察组阴道产率(90.63%)高于对照组(64.06%),胎吸助产率6.25%低于对照组(20.31%),剖宫产率3.13%低于对照组(15.63%),以上差异均具有统计学意义(P<0.05)。新生儿窒息率1.56%低于对照组(7.81%),正常体质量儿率93.75%高于对照组(89.06%),差异无统计学意义(P> 0.05)。结论基于ITHBC理论的群组孕期体重管理模式,对于高龄初产妇利用及时督促反馈机制调控体重控制效果,调节自我管理能力,降低不良母婴结局发生,提高临床疗效。

Objective To explore the effect of group pregnancy weight management model based on the integrated health behavior change(ITHBC) theory on the management of primiparas of advanced age.Method 128 cases of primiparas of advanced age in maternal and child health hospital of Pingdingshan from May 2017 to May 2019 were selected as the research objects and divided into the control group and the observation group, according to different interventions. 64 cases in the control group were given the traditional management mode of pregnancy health care, while 64 cases in the observation group were given the group weight management mode based on ITHBC theory. The self-management ability, weight control effect and maternal and infant outcomes of the two groups were compared.Result With intervention, the scores of compliance behavior, daily life behavior, self-protection behavior and fetal monitoring behavior in both groups were higher than before, the scores in the observation group were higher than those in the control group(P< 0. 05). The weight, BMI, weight gain rate and BMI increasing rate of primiparas before delivery in both two groups were also higher than before, but data of the observation group was lower than those of the control group(P< 0. 05). The vaginal delivery rate was 90. 63% in the observation group, higher than 64. 06% in the control group, the fetal suction rate was 6. 25%, lower than20. 31% in the control group, and the cesarean section rate was 3. 13%, lower than 15. 63% in the control group(P< 0. 05). The neonatal asphyxia rate was 1. 56%, lower than 7. 81% in the control group, and the normal weight infant rate was 93. 75%, higher than 89. 06% in the control group, but the differences were not statistically significant(P> 0. 05).Conclusion the group pregnancy weight management model based on ITHBC theory can promote the weight control effect of elderly primiparas with using timely supervision and feedback mechanism. The intervention can also enhance self-management ability, reduce the occurrence of adverse maternal and infant outcomes.