Mental models of pregnancy may explain low adherence to folic acid supplementation guidelines: a cross-sectional international survey
Mental models of pregnancy may explain low adherence to folic acid supplementation guidelines: a cross-sectional international survey
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怀孕心理模式可能是叶酸补充指南遵守率低的原因：一项横断面国际调查
DOI：
10.1016/j.ejogrb.2014.02.011
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发表时间：
2014-05-01
影响因子：
2.6
通讯作者：
Boivin, Jacky
中科院分区：
文献类型：
--
作者：
Fulford, Bethan;Macklon, Nick;Boivin, Jacky
目的：怀孕心理模式是指妇女对其怀孕是否容易导致不良健康结果的看法。心理模式影响怀孕期间的健康行为。在目前的研究中，我们研究了怀孕的心理模式是否与叶酸补充指南的依从性有关。研究设计：在四个国家（法国、德国、比利时和波兰）对计划怀孕的妇女（计划怀孕者，n = 325）或怀孕前18周内的妇女（目前怀孕，n = 326）进行横断面调查。使用逻辑回归来检查怀孕的心理模型（即妇女是否觉得不服用叶酸补充剂容易受到健康后果的影响）、母亲背景和使用叶酸补充剂之间的关联。结果：大多数妇女（82.8%）听说过叶酸，但只有45.5%的妇女服用叶酸补充剂。在计划怀孕的妇女和目前怀孕的妇女之间，叶酸补充剂的使用没有差别。认为自己拥有良好的一般健康和产科健康（例如，没有疾病或流产史）以及生活在不利健康环境（例如，吸烟、生活贫困）的妇女的心理模式是不容易受到艾滋病的影响。不服用叶酸补充剂对健康的影响（p < 0.001），服用叶酸补充剂最少的人（p < 0.01）。中介分析表明，感知易感性是看似不同的叶酸补充预测因素（即母亲背景特征）运作的共同途径。结论：产妇背景特征可能影响妇女妊娠心理模式及其对健康并发症的易感性。因此，心理模式可能是解释叶酸补充指南依从性差的共同因素。研究结果表明，在“无懈可击的母亲”的心理模型中，对健康威胁的感知易感性降低了，因为人们认为母亲的健康状况可以保护怀孕免受威胁，而在“无懈可击的怀孕”的心理模型中，感知易感性降低了，因为怀孕被视为自然健康或免疫风险。对于想要增加对围孕期健康建议的依从性的执业医师的挑战是引出和纠正患者对怀孕的错误信念。2014爱思唯尔爱尔兰有限公司版权所有。
Objective: Mental models of pregnancy refer to women's perceptions of whether their pregnancies are susceptible to poor health outcomes. Mental models influence health behaviour during pregnancy. In the present study we examined whether mental models of pregnancy are linked to compliance with folic acid supplementation guidelines.Study design: Cross-sectional survey implemented in four countries (France, Germany, Belgium, and Poland) of women planning a pregnancy (pregnancy planners, n = 325) or within the first 18 weeks of pregnancy (currently pregnant, n = 326). Logistic regression was used to examine the association between mental models of pregnancy (i.e. whether women felt susceptible to the health consequences of not taking folic acid supplements), maternal background, and use of folic acid supplements.Results: Most women (82.8%) had heard of folic acid but only 45.5% were taking folic acid supplements. Use of folic acid supplements did not differ between pregnancy planners and currently pregnant women. Women who believed that they had good general and obstetric health (e.g. no history of illness or miscarriage) and those living in adverse health environments (e.g. smoking, living in poverty) had mental models of being insusceptible to the. health consequences of not taking folic acid supplements (p < 0.001) and were the lowest users of folic acid supplements (p < 0.01). Mediation analyses showed that perceived susceptibility was the common pathway through which the seemingly disparate predictors of folic acid supplementation (i.e. maternal background characteristics) operate.Conclusions: Maternal background characteristics may shape women's mental models of pregnancy and its susceptibility to health complications. Mental models could therefore be the common factor explaining poor adherence to folic acid supplementation guidelines. Findings suggest that in the 'invulnerable mum' mental model, perceived susceptibility to health threats is reduced because the good health of the mother is believed to protect the pregnancy from threat, whereas in the 'invulnerable pregnancy' mental model, perceived susceptibility is reduced because pregnancy is viewed as naturally robust or immune to risk. The challenge for the practitioner wanting to increase adherence to periconceptional health advice is to elicit and correct patients' erroneous beliefs about pregnancy. (C) 2014 Elsevier Ireland Ltd. All rights reserved.