| The "Zhiweibing(Preventive treatment of disease)and Health Care " service is guided by the national "Zhiweibing/Prevention of Disease" health project and the development of health services.Through cross-disciplinary integration and collaborative innovation,it strives to meet people's growing needs for health.As the key health care population of public health services,the maternal health is not only related to the recovery of women physical functions,but also the determinants of protecting and promoting the health of newborn babies and improving the birth quality of infants.It is related to the development of population quality of our country and the health of the two generations.In recent years,the occurrence of depression during pregnancy and postpartum has shown an upward trend,which has had serious adverse effects on maternal and child health.This has attracted many scholars to conduct a large number of studies on issues related to depression during pregnancy and postpartum.The previous studies found that found that,although there are many studies on maternal depression from the perspective of Chinese and Western medicine or social support,there are few comprehensive applications of “prevention of disease”and health management theory,or the model including the effects of social factors on maternal health.For this reason,there is a vague acknowledgement on the prevention and control of maternal depression from the social perspective.Based on this,the study constructs a theoretical framework for the treatment of depression and health care during pregnancy and postpartum.From the perspective of individual-level health of pregnant women and parturients,the concept of “prevention of treatment”and health care services are combined.With the logic of “social factors-depression-health”,it has theoretically explored and applied tests on the direct or indirect effects of various dimensions of external social factors on depression during pregnancy and postpartum,and evaluated the implementation in order to more profoundly reveal the inner connection between the theory of Chinese medicine and individual health,and the hierarchical relations between the theory of TCM regimen and health promotion.Aims:This staudy aimed to establish a model of “Zhiweibing and Health Care” in the period of maternal depression;to evaluate its implementation effect in order to reduce the incidence of depression during pregnancy and postpartum;to effectively manage maternal health,and improve the physical and mental health of pregnant women and parturients.Methods:(1)On the basis of literature review and logical derivation,established a theoretical analysis framework for the service of "Zhiweibing and Health Care" for depression during pregnancy and postpartum;(2)Through expert consultation,constructed a model of "Zhiweibing and Health Care" in the period of maternal depression;(3)On the basis of the first two points,formed a path diagram of the structural equations for the model of “Zhiweibing and Health Care” for depression during pregnancy and postpartum;(4)Under the guidance of the model combined with the the trans-theoretical model,the SIPOC Model and the design steps of the UN health intervention program,to design a service scheme for "Zhiweibing and Health Care" through qualitative research;(5)A randomized controlled trial was used.Pregnant women were randomly divided into intervention group(334 persons)and control group(293 persons)and filled in the baseline data form.During the whole experiment,the control group only accepted the maternal health care under the national basic public health service standard,and the intervention group accepted the measures of "Zhiweibing and Health Care" on the basis of receiving the maternal health management service in the national basic public health service standard.The experiment lasted for 7 months,and the data were collected at 30-36 weeks of pregnancy,1 week of postpartum and 42 days after delivery respectively;(6)AMOS statistical software was adopted to analyze the direct and indirect effects of the various dimensions of the model of "Zhiweibing and Health Care" during pregnancy and postpartum.Through the distribution of impact paths,visually observed and described the interactions between the various dimensions of the variables;(7)Statistical analysis of basic demographic characteristics and physical fitness of the maternal in the intervention group and the control group was performed by using SPSS statistical software;the maternal in the intervention group and the control group were statistically described;the depression and social factors scores of the intervention group and the control group before intervention were compared by the use of Chi-square test;the depression mean and social factor scores of the intervention group and the control group in different maternity periods were compared by the use of Bonferroni test;(8)Evaluated the service of "Zhiweibing and Health Care" during pregnancy and postpartum from the perspectives of management and economics.Results:(1)The model of “Zhiweibing and Health Care”in depression during pregnancy and postpartum plays a role through value cognition and humanistic harmony.Among them,value cognition has a direct impact on depression,and can also have an indirect effect on the interpersonal harmony.Its standardized direct effect is-0.32,standardized indirect effect is-0.14,and its standardized effect is-0.23;humanistic harmony can be directly affecting depression during pregnancy and postpartum,its standardized direct effect is-0.33;(2)Through the intervention of “Zhiweibing and Health Care”,the mean scores of depression during pregnancy and postpartum depression were lower in the intervention group than that in the control group,and the difference was statistically significant(P<0.001);the incidence of pregnancy depression and postpartum depression in the intervention group was lower than that in the control group,and the difference was statistically significant(P<0.001).(3)Through the intervention of “Zhiweibing and Health Care”,the mean scores of the human environment and the social participation in the intervention group were increased,and the difference was statistically significant compared with baseline data(P<0.001);the scores of social factors of women in the control group remained unchanged,the difference was not statistically significant(P>0.001).(4)Through the intervention of “Zhiweibing and Health Care”,the ratio of the mothers seeking to help from others increased from 6.9% to 15.5%;the rate of active participation in pregnancy related activities increased by 30%;the rate of chatting with acquaintance mothers rose to 92%;the ratio of leaving messages and check messages every day in the We Chat mother group raised to 95%;(5)The satisfaction rate of the We Chat group was 86.2%,the satisfaction of the public platform was 70.2%,the satisfaction rate of the “Liao Liao Ba” was 63.3%,and the satisfaction of the frequency of message-pushing was 95.7%.Conclusions:(1)Social factors are multidimensional variables,which are mainly reflected in the two important dimensions of value cognition and humanistic harmony.The optimism and mutual benefit constitute the structure of individual value cognition.The interpersonal environment and the social participation are the main components of the humanistic harmony.There is an interaction between value cognition and humanistic harmony.(2)The individual's value cognition and humanistic harmony can directly affect the state of depression.Value cognition can indirectly affect the state of depression through humanistic harmony.Therefore,there is a hierarchical relationship between the various dimensions of social factors on the status of depression during pregnancy and postpartum,and there is an intermediary transmission mechanism in the relationship between value cognition and humanistic harmony.(3)Compared with a single application model,the comprehensive application of "Zhiweibing" and health care,and with a comprehensive consideration of the relationships and advantages of them,has a stronger explanatory power,and has more profoundly revealed the intrinsic link between social theory of Chinese medicine and maternal health.(4)The service of "Zhiweibing and Health Care" for depression during pregnancy and postpartum can prevent or reduce the occurrence of depression.Through Internet information technology,it can effectively improve the efficiency and quality of the healthcare service of pregnancy and maternity,and realize the implementation of personalized health education and healthcare service,and promote the maternal health. |
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