| ObjectiveBased on the compilation of ancient and modern TCM literature,this paper conducts a survey and research on TCM health maintenance methods for women in Hong Kong during pregnancy and puerperium.Through 401 cases of TCM health maintenance methods for women in Hong Kong during pregnancy and puerperium,it provides useful exploration of the application path of TCM in health care in Hong Kong.MethodsA cross-sectional survey and retrospective analysis of TCM health care perceptions,attitudes and behaviors were recruited from Chinese women who lived in Hong Kong for a long time and had given birth and passed the exclusion criteria between April 2019 and March 2021.The sample size was determined by finding domestic and international literature for comparison and using a pre-pregnancy biased body ratio estimation method.Recruiting subjects from several Hong Kong social media platforms maternal and parenting information exchange groups,the target women were invited to fill out online questionnaires by snowball sampling until the sample size demand was met to compensate for the difficulty in finding survey respondents face-to-face under the pandemic.SPSS version 26.0 statistical software was used for data analysis and processing.Reliability analysis was performed on the recovered questionnaire data;descriptive statistics and frequency analysis methods were used to analyze the status of pre-pregnancy body type,their subhealth status during pregnancy and childbirth,and their health maintenance methods.Since the maternal TCM perceptions of individual characteristics basically did not conform to normal distribution,a nonparametric test(Mann-Whitney test or Kruskal-Wallis test)was used to test whether there was a difference in their overall distribution.We also considered individual characteristics and the preaching pathway of the wellness method,the discourse of sitting on the moon,and the obedience of the wellness method for the column table analysis to explore whether their composition ratios were the same.The normality test was performed to check whether each maternal women’s subhealth dimension and preconception TCM body type status conformed to a normal distribution,and the result was that they all did not conform to a normal distribution,and Spearman’s rank correlation was used to test whether the distribution situation of each maternal women’s subhealth dimension and preconception TCM body constitution was correlated.ResultsThe survey was conducted between May 2021 and December 2021,and 407 questionnaires were collected.6 cases that responded to have suffered from serious illnesses in the year before pregnancy were excluded,and all the remaining 401 cases were included in this study,and the results focused on the content related to dietary regimen.1.84.0%of women reported that knowledge of TCM health care has a positive impact on physical and mental health during pregnancy and puerperium,in terms of compliance with TCM health care methods during pregnancy,40.2%of women often or always obeyed TCM methods during pregnancy,chi-square test suggested that age(χ2=8.937,P<0.05),education(χ2=13.942,P<0.01),occupation(χ2=33.831,P<0.01),and compliance with TCM health care methods during pregnancy were significantly different.Women with advanced maternal age,high education level and high occupational skill level had better ability to follow TCM regimen during pregnancy.The results of the study are consistent with the economic,educational and technical level characteristics of Hong Kong women and are conducive to the promotion of TCM health maintenance methods during pregnancy.2.In terms of compliance with TCM health maintenance methods during the puerperium,92.0%of women practiced confinement during the puerperium;regarding the purpose of confinement,91.6%of women indicated that it was for postpartum recovery;68.0%of women indicated that they had the most say during confinement;45.8%of women hired a postnatal health caregiver during the puerperium,and the main reason was that they thought the caregiver was more experienced than the elders(88.2%).The chisquare test suggested that women’s education(χ2=24.546,P<0.01)and monthly household income(χ2=15.369,P<0.01)were significantly different from compliance with TCM methods during the puerperium,and women with higher education and better economic conditions were more able to comply with TCM methods during the puerperium.The ability of women with higher education and better economic conditions to comply with puerperal TCM methods was better.In this study,it was found that it was common for women in Hong Kong to receive traditional confinement during the puerperium,and more women complied with TCM health care methods during the puerperium than during pregnancy,while women with a greater sense of autonomy were more able to practice TCM health care according to their personal perceptions.3.The results of women’s demand for TCM health maintenance methods were generally consistent,with 72.6%and 81.5%of women expecting to know about dietary health maintenance during pregnancy and puerperium.Regarding the agreement level of different TCM dietary regimen,the agreement level was ranked from low to high with a score of 1,2 and 3.The highest level of agreement was "only take tonic after the lochia has cleared",with a mean value of 2.79 and a median score of 3.The lowest level of agreement was "drinking alcohol in moderation during the second trimester of pregnancy can promote the circulation of qi and blood and help in childbirth",with a mean value of 1.28.Overall,women had a higher level of agreement with TCM dietary regimen integrating modern nutritional theory,and their attitude toward traditional dietary regimen in the puerperium was more positive than that in pregnancy.4.There was variability between age,number of pregnancies,occupational skill level and household income and women’s agreement with TCM dietary regimen.By nonparametric test,the mean rank of consent to TCM dietary regimen in pregnancy was significantly higher among older pregnant women(P<0.05),the mean rank of consent to TCM dietary regimen in the postpartum period was significantly higher among women with one pregnancy than those with two pregnancies(P<0.05),the mean rank of consent to TCM dietary regimen in the postpartum period was higher among women with manager and executive level personnel than most other occupation,the mean rank order of methodological agreement was significantly higher among women with middle household income than among women with other household incomes for TCM dietary regimen for pregnant women(P<0.01)and for postpartum TCM dietary regimen(P<0.05).The findings are consistent with the demographic trends and major economic conditions characteristic of pregnant women in Hong Kong,suggesting that most women in Hong Kong are more receptive to TCM dietary regimen methods that incorporate modern nutritional theories.5.This study found that dietary regimen(including TCM dietary regimen and modern nutrition theory)was commonly used by Hong Kong women to intervene in various subhealth conditions during pregnancy and puerperium.The majority of women chose dietary regimen to manage constipation during pregnancy,sparse breast milk and puerperal constipation,with a total of 253(73.6%),380(64.4%)and 127(61.2%)counts,respectively.This was followed by the management of puerperal breast blockage,puerperal hair loss,nausea and vomiting during pregnancy,and puerperal fatigue,with 181(35.4%),168(37.9%),158(36.5%),and 129(28.1%)counts of puerperal fatigue,respectively.The results showed that TCM dietary regimen and modern nutrition theory are commonly used to solve several subhealth problems during pregnancy and puerperium,especially in puerperium regimen,TCM dietary regimen plays an important role.6.In this study,several factors concerning the application of TCM dietary regimen in Hong Kong women during pregnancy and delivery were identified.Spearman’s correlation analysis was used to investigate the correlation between subhealth status during pregnancy and delivery and women’s pre-pregnancy body constitution,and the results showed that the rank correlation coefficients of each subhealth status dimension during pregnancy and prepregnancy balanced body constitution ranged from-0.132 to-0.22,(P<0.05),which were significantly negatively correlated.The rank correlation coefficients of each subhealth status dimension during pregnancy and pre-pregnancy biased body constitution ranged from 0.112 to 0.487,(P<0.05),which were significantly positively correlated.By Spearman’s correlation analysis,the rank correlation coefficients of puerperal subhealth dimensions and pre-pregnancy balanced body constitution ranged from-0.094 to-0.2,(P<0.05),which was a significant negative correlation;the rank correlation coefficients of puerperal subhealth dimensions and pre-pregnancy biased body constitution ranged from 0.135 to 0.441,(P<0.05),which was a significant positive correlation.The findings suggest that the differences in women’s pre-pregnancy body mass have the potential to influence physical and mental health during pregnancy and puerperium.7.This study found that the promotion and education of TCM health care methods in Hong Kong also influenced women’s application of TCM dietary regimen during pregnancy and puerperium.Only 39.2%of women indicated that the sources of promotion and education were accurate and reliable,and the internet or social media was one of the most important ways to promote TCM health care methods during pregnancy and puerperium(55.6%),and only very few women(10.5%)agreed with its reliability.On the contrary,women considered consultation at TCM clinics(51.6%)and clinical obstetrics and gynecology departments(41.9%and 34.2%)to be accurate and reliable,but these TCM health promotion methods were not commonly available in Hong Kong.On the other hand,the promotion of TCM health education by postnatal health caregivers(42.6%)was commonly found to be reliable(33.4%)in Hong Kong.The findings suggest that there is an imbalance between Chinese and Western health care services during pregnancy and puerperium in Hong Kong and that there is still room for improvement in women’s access to TCM health care methods,and reveal the potential of the postnatal health care industry in providing individualized TCM diet education on health care methods,which will have a positive impact on the development of TCM and women’s health care in Hong Kong through improving women’s health care education pathways.Conclusion1.Hong Kong women were generally positive and consistent about TCM health care during pregnancy and puerperium,and the high compliance rate was consistent with the high educational level and strong sense of personal autonomy of Hong Kong pregnant women,which is conducive to the implementation of TCM health care during pregnancy and puerperium.The results of the study demonstrate that TCM dietary regimen combined with modern nutrition is commonly used by Hong Kong women in "treating the disease before it happens".2.The new model of TCM dietary regimen is a combination of traditional TCM regimen theory and modern nutrition,and is reflected in the adjustment of interventions according to individual characteristics and body constitution differences.The health maintenance program for Hong Kong women can start from the pre-pregnancy period with the identification of body constitution and the popularization of TCM diet and nutrition;and make use of the comprehensive maternity services in Hong Kong to educate pregnant women about the new model of TCM diet and health maintenance.3.The results of the study found that Hong Kong women often use a combination of Chinese and Western dietary regimen to intervene in various subhealth conditions during pregnancy and puerperium,and more clinical data are needed to confirm the effectiveness of the new TCM dietary regimen in intervening in various subhealth conditions during pregnancy and childbirth.The correlation between maternal subhealth conditions and prepregnancy biased body constitution also needs more in-depth research design to prove the effectiveness of pre-pregnancy TCM dietary regimen to intervene the biased constitution for maternal health. |
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