| BackgroundYin-deficiency constitution is a constitution characterized by low Deficiency of Yin fluid,sperm,blood and other Yin fluid in the body,and mainly characterized by internal heat due to deficiency of Yin-deficiency constitution.Single-biased constitution accounts for the highest proportion(8.69%～10.42%)in postpartum woman.Postpartum woman with Yin-deficiency constitution are prone to problems such as lack of breast milk after childbirth,the lochia never stopped,and abnormal pelvic floor muscle strength,which seriously affect their physical and mental health.Among them,diet and exercise,as an important means of postpartum physical conditioning,has a positive effect on maternal physical and mental rehabilitation,but at present there is no postpartum diet and exercise intervention program for women with Yin-deficiency constitution.ObjectivesTo construct a diet combined with exercise program for postpartum women with Yin-deficiency constitution based on TCM constitution identification during postpartum period,explore the clinical effectiveness and acceptability of the program,and provide a reasonable scientific basis for standardized comprehensive physique management during postpartum period.Methods(1)Construction of diet combined with exercise program for postpartum women with Yin-deficiency constitution based on TCM constitution identificationBased on the theoretical basis of TCM constitution identification,a research team was set up to conduct a comprehensive search of Chinese and foreign language databases to extract contents related to postpartum diet and exercise suitable for postpartum women with Yin-deficiency constitution.Focusing on clinical problems through case analysis.Qualitative interviews with women with Yin-deficiency constitution to understand their needs for postpartum diet and exercise guidance.Drafting a program through 3 group discussions.Conducting 2 rounds of Delphi expert consultation,revise and finalize the final program.(2)Evaluation of diet combined with exercise program for postpartum women with Yin-deficiency constitution based on TCM constitution identificationTo conduct a quasi-experimental,a convenience sample of postpartum women with Yin-deficiency who gave birth in a tertiary hospital in Shenzhen from October 2022 to February 2023 was selected as the study population.The control group adopted conventional postpartum care,health education,and follow-up measures,while the experimental group on the basis of the control group,applied a postpartum diet combined with exercise program for women with Yin-deficiency constitution based on TCM constitution identification,and collected quantitative data on postpartum day 2,day 28 and,day 42 to evaluate effectiveness,with validity evaluation indicators including Yin-deficiency constitution scores,lochia expulsion time and postpartum complication rate,and collected qualitative data at the 42-day postpartum follow-up,and the experimental group was interviewed to understand the effectiveness and experience of their participation in the program and to evaluate the acceptability of the program.Results(1)Construction of diet combined with exercise program for postpartum women with Yin-deficiency constitution based on TCM constitution identificationThe preliminary literature review of this study ultimately included eight guidelines,two expert consensus articles,and five books to provide a reference for protocol construction.The results of the case analysis showed that the current status of diet and exercise guidance for Yin-deficiency constitution in the postpartum in the study clinic was not promising.The qualitative study explored the needs for the construction of this program,which were mainly information needs,physiological needs,and social needs.The first draft was formed after 3 rounds of discussion in the subject research group.Conducting 2 rounds of Delphi expert correspondence,the Delphi expert correspondence included a total of 15 experts,the effective recall rate was 100%in both rounds,the authority coefficients of the expert correspondence were 0.83 and 0.84,the coefficients of variation of the indicators at all levels were 0.00～0.27 and 0.00～0.12,and the Kendall’s coefficient of concordance were 0.42 and 0.50(P<0.01),and the final constructed scheme included 6 primary indicators,20 secondary indicators,and 50 tertiary indicators.(2)Evaluation of diet combined with exercise program for postpartum women with Yin-deficiency constitution based on TCM constitution identificationA total of 81 postpartum women with Yin-deficiency were included in the quasi-experimental.The results showed that after 28 and 42 days of intervention,the Yin-deficiency constitution scores of the experimental group were lower than those of the control group,and the differences in time effect,intergroup effect and interaction effect were statistically significant(P<0.001).After 42 days of intervention,lochia expulsion time and postpartum complication rate of experimental group were lower than those of control group(P<0.05).A total of 11 women with Yin-deficiency constitution in the experimental group were included in the qualitative study.The qualitative results were grouped into four main themes:knowledge benefits,building social support networks,promoting postpartum health management behaviors,and stress and challenges.The results of the study indicate that women with Yin-deficiency constitution have benefited from participation in the program,which is highly acceptable and provides suggestions for future improvement and dissemination of the program.ConclusionsThis study was based on the theoretical basis of TCM constitution identification,through literature review,case analysis,qualitative interview,group discussion,and Delphi method to jointly construct a postpartum diet combined with exercise program for women with Yin-deficiency constitution,and this program is clinically acceptable,scientific,comprehensive and feasible,and can serve as a reference for the future management of TCM constitution in the postpartum period. |
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