Women-centered Health Behavior Decision-making Process From Pre-pregnancy To Puerperium:A Qualitative Study

Objective:This study aims to investigate interpretative knowledge of women-centered health behavior decision-making from pre-pregnancy through puerperium and to identify the fundamental mechanisms that enable women to make wise choices at various phases of the decision-making process.The study’s objectives include offering detailed advice for enhancing decision-making skills,exploring the significance of women-centered health behavior decision-making behavior,and providing a theoretical framework and empirical support for the practice of women-centered health behavior decision-making.Methods:A grounded theory approach was implemented.Nine postpartum women in the obstetrics department of a Grade A hospital in Changchun,Jilin Province,were chosen as interview subjects using a sample strategy combining purposive and theoretical sampling techniques.The Ethics Review Committee of the School of Nursing at Jilin University gave its clearance for the study,and the formal interview could only go ahead once the interviewees gave their informed consent and signed the consent form.Combining the interview observation approach,the field notes method,and the literature analysis and comparison method,semi-structured one-on-one in-depth interviews with individuals were done.Open coding,axial coding,and selective coding were used in a three-level coding stage.Memo writing,ongoing questioning,and ongoing comparison were used as analytical techniques.The textual data were stored,coded,and categorized using the qualitative research analysis program Nvivo 11.0.Results:1.This study illustrates a model of women-centered decision-making processes from pre-pregnancy to puerperium the core category of "identity transformation: weighing multiple factors," which covers six major categories: "identification with self-identity," "doubt about self-identity," "maintenance of the current situation," "uneasiness about ushering in a new identity," "uncertainty about having a new identity," and "reflection after the dust settles."1.1 Category 1: "Self-identification"(1)Readiness:Physiological preparation: pro-rejection intervention,medication preparation,formation of good habits,maintenance of the daily statusMental preparation: unplanned,unknown state,strong will,unexpectedly smooth(2)Whether the child stays or leaves:The reluctance to cut off: the responsibility of being a mother,the complexity of marital statusConcerns left behind: own situation,family attitude,external support1.2 Category 2: "Self-state of doubt"(1)Overcoming fears: objective constraints,coping with emergencies,learning from your own experience,learning from the experience of others,psychological coping strategies(2)Developing a screening plan: increased wariness,independent weighing of decisions,public voice,professional opinion1.3 Category 3: "The maintenance of the present situation"(1)Maintenance of healthy living behaviors: forming a "comfort zone," improving self-efficacy(2)Upcoming birth intentions: scheduled as intended,with unexpected events breaking1.4 Category 4: "The uneasiness of ushering in a new identity"(1)Women’s empowerment: respecting women’s wishes,following clinical indications,and providing personalized services(2)Different concerns at different stages:Focus on the child(prenatal focus on the health of the child)Focus on oneself(postpartum is mainly concerned with the physical and mental recovery of self)1.5 Category 5: "The overwhelm of having a new identity."(1)Identification of self condition: mental acceptance,physical recovery status,timely self-monitoring(2)Balancing of both mother and baby: first-time mother(inexperienced),second-time mother(energy drain)1.6 Category 6: "Reflections"(1)Weighing the pros and cons: focus on the harms and avoid exaggerating the benefits(2)Behavioral reflections: self-affirmation,contradictory regret(3)Self-growth: knowledge accumulation,spiritual sedimentation(4)Hoping for the future: Self-career planning,family planning2.In different contexts in the home and hospital environments,the decision-making positions of the different players change with the context.2.1 " Family environment and family culture "(1)Uncertainty(2)Belonging(3)Family support2.2 " Hospital environment and hospital culture "(1)Security(2)Authoritative selection(3)Public environment restrictions2.3 " Adaptation of transition between two environments " Conclusions:Women face different contradictions at different stages of the decision-making process and constantly adjust their decision-making mindset and strategies in the face of emerging issues,facilitating women’s continuous self-identity progression and transformation throughout the period.This study explores in depth the developmental process of women-centered health behavior decision-making from the women’s perspective,from the preparation period to the puerperium,and enriches the theoretical research on women-centered health behavior decision-making.1.The extent to which women identify with the transformation of their self-identity varies somewhat across individuals,and it is necessary for healthcare professionals to help women develop good cognitive attitudes to promote adequate physical and mental readiness.2.The majority of women can respond positively and effectively and remain in good condition in the face of various unexpected situations and contingencies.Healthcare professionals are the main source of expertise for women,so they need to continuously improve their professionalism and competence to provide women with scientific,clear,and well-directed decision-making guidance.3.Some women experience a sense of lethargy as they enter the plateau,but most women maintain a high level of self-efficacy,hence,health care providers play a significant part in guiding women to make scientifically dynamic decisions and motivating them to maintain positive health behavior decisions.4.Women face transitions and adaptations from the home environment to the hospital environment during stages such as birth control and labor and delivery,so the strengths of healthcare professionals in empowering women and encouraging women’s decision-making autonomy guided by a woman-centered philosophy need to be more prominent in the medical environment.5.The degree of psychological adjustment,tolerance and physical recovery after childbirth varies from individual to individual,so it is recommended that family members should strengthen family support for women during the puerperium,and medical personnel should strengthen observation and care of women’s postpartum condition and awareness of self-observation after childbirth.6.The construction of a model of women-centered health behavior decision-making process from pregnancy preparation to puerperium can provide a theoretical basis and empirical evidence for the subsequent practice of women-centered health behavior decision-making.