Lifestyle practices of Jordanian pregnant women

Health-promoting behaviors and intermediary social determinants of health in low and high-risk pregnant women: an unmatched case-control study

Background

High-risk pregnancies require increased health and care resources to reduce the severe perinatal consequences. The adoption of a health-promoting lifestyle and social determinants is an important strategy for achieving the desired outcomes of pregnancy. This study aimed to compare intermediate determinants of social health in low and high-risk pregnant women.

Methods

This unmatched case-control study was performed with a ratio of 1: 2 and 300 pregnant women including 200 healthy and 100 pregnant women with gestational hypertension were included using the available sampling technique. Data were collected using socio-demographic and obstetrics, Health-promoting behaviors, Self-efficacy, Perceived stress, and Social support questionnaires by the self-report method.

Results

There was no significant difference in the demographic characteristics between the two groups, except for the spouse's education status. The total score of health-promoting behaviors and social support in the healthy group was significantly higher than women with gestational hypertension. However, the perceived stress in women with gestational hypertension was significantly higher than in the healthy group. In the multivariate analysis, those women with high stress [AOR 1.13, 95% CI (1.08–1.18)] and whose Spouse’s Educational status was low [AOR 4.94, 95% CI (1.54–15.81)] had higher odds of gestational hypertension than women who haven’t respectively. The development of gestational hypertension was decreased by increasing the score of social support [AOR 0.96, 95% CI (0.93–0.98)]. The results showed that the two variables of social support (β=0.331) and self-efficacy (β=0.215) have the greatest impact on the score of health-promotion behaviors, respectively. Based on regression analysis, 21.2% of the health-promotion behaviors changes could be explained by three independent variables.

Conclusion

Women with gestational hypertension have unhealthier lifestyles. Having a high level of stress is a risk factor for gestational hypertension but Social support has a protective effect on it. Recognizing the risk factors of gestational hypertension could help the determination of high-risk cases and it is important to pay attention to women's psychosocial to create appropriate sources of social support and provide the necessary action to reduce stress.

Association between Perceived Social Support and Health-Promoting lifestyle in Pregnant Women: A Cross-Sectional Study

Introduction: Adopting health-promoting lifestyle might be affected by a variety of factors. The existing evidence suggests that social support can improve health by fulfilling physical and mental needs. This study aimed to investigate the association between social support and health-promoting lifestyle in Pregnancy. Methods: Using multistage cluster sampling method, this cross-sectional study was conducted on 360 pregnant women. Data were collected using three questionnaires, including a self-reported demographic and obstetric, health-promoting lifestyle profile and perceived social support questionnaires. Data were analyzed using a t-test, repeated measures ANOVA, and multivariate linear regression model with SPSS software ver. 21 with. Results: The mean (SD) of health-promoting behaviors was 135.21(20.03). Amongst the different dimensions of health-promoting behaviors, the highest mean was detected in spiritual growth 26.84 (4.90) and nutrition 26.17 (4.22), respectively. Meanwhile, the lowest scores were detected in sub-domains of stress management 19.80 (3.78) and physical activity 16.71(4.14), respectively. The mean (SD) of perceived social support was 60.31 (14.75), and 51.7% of the participants had intermediate social support. Results indicated a significant difference between the mean score of Health-Promoting Lifestyle at different levels of social support. There was a direct and significant association between the scores of social support and health-promoting behavior (r=0.36; P<0.001). Conclusion: Pregnant women with better perception of social support had a better performance in adopting health-promoting Lifestyle. However, the status of health behaviors and social support was not favorable. Thus, there is a need to intervene and design programs to help pregnant women and improve their health.

Barriers and Facilitators Associated with Physical Activity in the Middle East and North Africa Region: A Systematic Overview

Increasing physical inactivity levels in the Middle East and North Africa (MENA) region is a public health concern. We aimed to synthesize barriers and facilitators to physical activity and make appropriate recommendations to address physical inactivity. We conducted an overview of systematic reviews on physical activity barriers and facilitators in 20 MENA countries by systematically searching MEDLINE/PubMed and Google Scholar for systematic reviews published between 2008 and 2020. Our overview included four systematic reviews and 119 primary studies with data from 17 MENA countries. Lack of suitable sports facilities, time, social support and motivation, gender and cultural norms, harsh weather, and hot climate were the most commonly reported barriers to physical activity. Socio-demographic factors negatively associated with physical activity participation include advanced age, being female, less educated, and being married. Motivation to gain health benefits, losing/maintaining weight, being male, dietary habits, recreation, and increased Body Mass Index are positively associated with increased levels of physical activity. Interventions promoting physical activity in MENA should target schoolchildren, women and girls, working parents, and the elderly. Country-specific sociocultural and environmental factors influencing physical activity should be considered in the design of interventions. Current and future policies and national interventions must be consistently evaluated for effectiveness and desired outcomes.

Physical activity and sedentary behaviour in the Middle East and North Africa: An overview of systematic reviews and meta-analysis

To support the global strategy to reduce risk factors for obesity, we synthesized the evidence on physical activity (PA) and sedentary behaviour in the Middle East and North Africa (MENA) region. Our systematic overview included seven systematic reviews reporting 229 primary studies. The meta-analysis included 125 prevalence measures from 20 MENA countries. After 2000, 50.8% of adults (ranging from 13.2% in Sudan to 94.9% in Jordan) and 25.6% of youth (ranging from 8.3% in Egypt to 51.0% in Lebanon) were sufficiently active. Limited data on PA behaviours is available for MENA countries, with the exception of Gulf Cooperation Council countries. The meta-regression identified gender and geographical coverage among youth, and the PA measurement as predictors of PA prevalence for both adults and youth. Our analysis suggests a significant PA prevalence increase among adults over the last two decades. The inconsistency in sedentary behaviour measurement is related to the absence of standardized guidelines for its quantification and interpretation. The global epidemic of insufficient PA is prevalent in MENA. Lower PA participation among youth and specifically females should be addressed by focused lifestyle interventions. The recognition of sedentary behaviour as a public health issue in the region remains unclear. Additional data on PA behaviours is needed from low- and middle-income countries in the region.

Comparison of health-promoting behaviours, eating behaviour patterns and perceived social support in normal-weight and overweight pregnant women: An unmatched case-control study

Aim

The interventions based on adopting a healthy lifestyle during pregnancy have conflicting results. This study aimed to compare health-promoting, dietary patterns and social support in normal and overweight pregnant women.

Design

An unmatched case-control design was used.

Methods

A total of 360 pregnant women were selected using multistage cluster sampling and divided into two groups of normal and overweight cases. Data were collected using demographic and obstetrics characteristics, health-promoting lifestyle, perceived social support and eating behaviour questionnaires.

Results

The evaluation of the health-promoting behaviours and dietary patterns demonstrated a significant difference between the mean of total scores and their subdomains including self-actualization, nutrition, consumption of healthy and low-fat foods, fast food and sweets, as well as emotional eating and accidental planning. There was no significant difference between the two groups about social support.

Predictors of Health-Promoting Lifestyle in Pregnant Women Based on Pender's Health Promotion Model

Background and Objectives

Pregnancy causes changes in women’s lifestyle; therefore, their health-promoting behaviors should be improved in order to avoid problems during this critical period, which requires knowledge of the factors affecting these behaviors. This study was conducted to determine the predictors of health-promoting lifestyles in pregnant women based on Pender’s health promotion model constructs.

Methods

This descriptive study was carried out on 300 pregnant women in their second and third trimesters of pregnancy and sought to determine the correlation between lifestyle and the constructs of Pender’s health promotion model. Data were collected using a demographic questionnaire, the Health Promoting Lifestyle Profile II (HPLP-II) and a questionnaire based on Pender’s model constructs. Data were analyzed using descriptive and analytical statistics.

Findings

A health-promoting lifestyle had a significant positive correlation with the constructs of social support and perceived benefits and a significant negative correlation with the construct of perceived barriers (P<0.05). A health-promoting lifestyle also had a significant relationship with the constructs of perceived barriers, social support and perceived benefits in pregnant women (P<0.05) based on the results of the regression analysis. The regression coefficients showed that all the three variables can significantly explain the variance in health promoting lifestyles in pregnant women (P<0.05).

Conclusion

According to the results of the present study and based on the constructs of Pender’s health promotion model, social support, perceived benefits and perceived barriers were the most important predictors of health-promoting lifestyles in pregnant women. These predictor constructs are recommended to be further considered in designing and implementing training packages and interventions for promoting pregnant women’s lifestyle.

Psychosocial factors correlate with fatigue among pregnant women in Jordan

PURPOSE

The study aimed to assess the correlation between fatigue and psychological factors, namely stress, social support, self-esteem, and depression among pregnant women in Jordan.

DESIGN AND METHODS

A cross-sectional design was suggested. Cluster stratified random sampling technique was adopted. Fatigue assessment scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, Multidimensional Social Support Scale, and Beck's Depression Inventory were used.

FINDINGS

A total of 580 pregnant women were included. Overall, 67.4% of the participants experienced fatigue, about 74.0% had moderate to high stress, 56.0% had moderate social support, around 89.0% had normal self-esteem, and 43.1% experienced moderate to extreme depression. Stress, self-esteem, and depression were correlated with fatigue.

PRACTICE IMPLICATIONS

This study can help develop proper psychosocial care and sustain mental health among women during pregnancy.

Examining the effect of mindfulness-based art therapy (MBAT) on stress and lifestyle of Iranian pregnant women

The purpose of this study was to determine the effect of mindfulness-based art therapy (MBAT) in decreasing stress and improving on pregnant women's life style in Neyshabur, Iran 2018. The participants of the present quasi-experimental study were 84 pregnant women. The findings showed that the MBAT group demonstrated a significant decrease in symptoms of distress and significant improvements in key aspects of the health-related style of life as measured by Health Promoting Lifestyle Profile-II questionnaire. Moreover, it was found that the MBAT intervention had a significant effect on improving lifestyle behaviours (p < .05). The highest mean score of lifestyle was for the sub-domain of nutrition (31.35 ± 5.34), while the lowest score was achieved by the sub-domains of physical activity (13.55 ± 1.89).The mean (SD) score of stress management was (19.12 ± 1.54). This investigation of MBAT provides initial encouraging data that support a possible future role for the intervention as a psychosocial option for decreasing symptoms of distress in pregnant women and improving their lifestyle.Impact statementWhat is already known on this subject? Mindfulness-based art therapy is a blend of basic meditation principles and art therapy. The results of this study showed that mindfulness-based art therapy (MBAT) could decrease the stress and improve lifestyle behaviours in pregnant women.What do the results of this study add? The results of the present study showed that mindfulness-based art therapy (MBAT) during pregnancy decreased the stress and improved life style. It is believed that changing lifestyle to include mind-body medicine such as MBAT in pregnant women will greatly reduce stress responses, and help protect pregnant women from disease during pregnancy.What are the implications of these findings for clinical practice and/or further research? The study showed the important role of mindfulness-based art therapy (MBAT) during pregnancy in reducing stress and improving life style.

Spiritual Health and Physical Activity Among Iranian Pregnant Women

This study was aimed to investigate the relationship between spiritual health and physical activity among Iranian pregnant women during 2015. A cross-sectional descriptive-analytic design was adopted. A total number of 411 participants were selected by convenience sampling from Iranian women who regularly attended health centers for prenatal care. Data were collected using demographic questionnaire and Health-Promoting Lifestyle Profile questionnaire, 2nd edition. (Spiritual health and physical activity are two components of health-promoting lifestyle.) The data were analyzed, using descriptive statistics, t test, one-way ANOVA, Pearson's correlation coefficient, and regression. p values <0.05 were considered significant. The mean age of pregnant women was 27.90 ± 6.03 years. Spiritual health had the highest score (25.86 ± 4.7) and physical activity had the lowest score (11.31 ± 3.27), among six Health-Promoting Lifestyle Profile subscales. In fact, there was a statistically significant correlation between spiritual health and physical activity (p = 0.000). According to results, pregnant women have higher spiritual health and lower physical activity scores. There was a statistically significant correlation between spiritual health and physical activity. The findings of this study can be used in prenatal care, midwifery education, and maternal health policies.

Experiences related to health promotion behaviors in overweight pregnant women: a qualitative study

BACKGROUND

The adoption of health behaviors by pregnant women causes their improved health and achievement of appropriate pregnancy outcomes as well as improving the quality of life of the mother and infant. Limited studies have examined such behaviors in pregnant women, especially in overweight mothers. The purpose of this study was to explore the experiences of overweight pregnant women in relation to lifestyle changes during pregnancy to improve their health.

METHODS

This qualitative study was carried out with content analysis approach in Tabriz-Iran in 2017. Using purposive sampling, pregnant women with the Body Mass Index of overweight at the preconception were selected considering other inclusion criteria and the sampling was continued to saturate the findings. The data were collected by the first author through semi-structured face-to-face interviews with 32 overweight pregnant women through 18 deep individual interviews and three group interviews. The MAXQDA software version 10 was used for data analysis. Data strength was confirmed by participants and external control.

RESULTS

Most participants were Primigravida 20 (62.5%) and with high-level education 25 (78.1%). Qualitative data analysis led to the emergence of three main themes: "physical self-care", "mental self-care", and "risk perception". The first two themes present the nature of health promotion behaviors in overweight pregnant women; the third theme expresses their feelings and perception of behaviors related to health promotion.

CONCLUSION

Health promoting behaviors include behavioral and cognitive actions resulting from a perception of the risk caused by overweight pregnant mothers. Therefore, pregnancy is the right time to evaluate behaviors and to use high motivation of women to guide them in choosing healthy behaviors and helping them to adhere to health related behaviors.

Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature

Background

Physical inactivity is associated with excess weight and adverse health outcomes. We synthesize the evidence on physical inactivity and its social determinants in Arab countries, with special attention to gender and cultural context.

Methods

We searched MEDLINE, Popline, and SSCI for articles published between 2000 and 2016, assessing the prevalence of physical inactivity and its social determinants. We also included national survey reports on physical activity, and searched for analyses of the social context of physical activity.

Results

We found 172 articles meeting inclusion criteria. Standardized data are available from surveys by the World Health Organization for almost all countries, but journal articles show great variability in definitions, measurements and methodology. Prevalence of inactivity among adults and children/adolescents is high across countries, and is higher among women. Some determinants of physical inactivity in the region (age, gender, low education) are shared with other regions, but specific aspects of the cultural context of the region seem particularly discouraging of physical activity. We draw on social science studies to gain insights into why this is so.

Conclusions

Physical inactivity among Arab adults and children/adolescents is high. Studies using harmonized approaches, rigorous analytic techniques and a deeper examination of context are needed to design appropriate interventions.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5472-z) contains supplementary material, which is available to authorized users.

Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial

BACKGROUND

Although it is known that lifestyle behaviors of pregnant women are closely related to maternal and fetal health, number of data concerning efficacy of intervention on lifestyle during pregnancy is limited. The purpose of this study is to determine the effect of lifestyle interventions on improving dietary habits and lifestyle behaviors, ensuring gestational weight gain (GWG) within recommended levels and limiting postpartum weight retention (PWR).

METHODS

The study was conducted as a randomized controlled trial in a family health center located in Istanbul, Turkey, between June 2011 and July 2012. The primary outcomes were GWG, and the proportion of pregnant women whose GWG was within the Institute of Medicine (IOM) guidelines. One hundred two pregnant women with gestation ≤12 weeks, age ≥18 years, gravidity ≤2, and who did not intend to lose weight in prepregnancy period were randomly included in this study as intervention (n = 51) and control (n = 51) groups. The study was completed with 45 women for each group. The control group received routine antenatal care. The intervention group was received an individualized lifestyle intervention focusing on healthy lifestyle, diet, exercise, and weight monitoring as four sessions at 12-15, 16-18, 20-24, and 37 weeks gestation. Lifestyle behaviors were evaluated with Health-Promoting Lifestyle Profile-II. Dietary habits were assessed by 3-day dietary recalls, and weight was followed from pregnancy until 6 weeks postpartum.

RESULTS

The lifestyle interventions had a significant effect on improving lifestyle behaviors, protein intake, percentage of energy from protein, calcium, magnesium, iron, zinc, and vegetable intakes when adjusted for confounders (p < 0.05). The proportion of women who were within the IOM recommendations was higher in the intervention group (51.1 %) than in the control group (28.9 %) The odds ratio for GWG within IOM was statistically significant between the groups (OR = 0.59, 95 % CI, 0.45-0.72). There were no difference between groups in terms of the other dietary intakes, total GWG, and PWR (p > 0.05).

CONCLUSIONS

Lifestyle intervention improves the lifestyle behaviors during pregnancy and increases the appropriate GWG for prepregnancy body mass index (BMI), but it has a limited effect in terms of improving dietary habits and has no effect on PWR.

Effect of parity on healthy promotion lifestyle behavior in women

BACKGROUND

Health-promoting lifestyle behaviors are not only for the prevention of a disease or discomfort, but are also behaviors that aim to improve the individual's general health and well-being. Nurses have an important position in the development of healthy lifestyle behaviors in women.

OBJECTIVE

The aim of this study was to assess the effect of parity on health-promoting lifestyle behaviors in women.

METHOD/DESIGN

This descriptive and cross-sectional survey was performed in Adana, Turkey. This study was conducted with 352 women. The questionnaire consisted of two parts; the first part consisted of questions that assessed the socio-demographic and obstetric characteristics, and the second part employed the "Health Promotion Lifestyle Profile Scale" (HPLP). Data analysis included percentage, arithmetic average, and ANOVA tests.

RESULTS

The results revealed that 24.1% of the women had no parity, 13.6% had one parity, 30.7% had two parities, 14.6% had three parities, and 17% had four and above parities. The mean total HPLP was 126.66±18.12 (interpersonal support subscale, 24.46±4.02; nutrition subscale, 21.59±3.92; self-actualization subscale, 24.42±4.30; stress management subscale, 18.73±3.81; health responsibility subscale, 21.75±4.31; and exercise subscale, 15.71±4.22).

CONCLUSIONS

The health behavior of women was moderate. A statistically significant correlation was found between the number of parities and the Health Responsibility, Nutrition, Interpersonal Support, which is the subscale of the HPLP Scale.

Relationship between Health Promoting Lifestyle and Perceived Stress in Pregnant Women with Preeclampsia

INTRODUCTION

Lifestyle during pregnancy has long-term effects on health of mother and child. Having previous illness or unexpected maternal or fetal conditions such as preeclampsia can complicate pregnancy and interfere with health-promoting behaviors and cause stress might interfere with health-promoting behaviors. This study was carried out to examine the relationship between health-promoting lifestyles and perceived stress in women with preeclampsia.

METHODS

This study is a descriptive correlation design that was conducted on 182 pregnant women with preeclampsia attending in the high risk clinics of Al-Zahra and Talegani hospitals in Tabriz 2014. Data gathering tools were three: demographics, health-promoting lifestyle (HPLP-II), and perceived stress questionnaires. SPSS Ver. 13 was used for data analysis.

RESULTS

The mean (SD) of health promoting lifestyle among pregnant women with preeclampsia was 2.4 (0.4). Among the dimensions of health promoting life style, the highest mean score was for sub domain of nutrition, i.e. 2.8 (0.5), and the lowest score was achieved by the sub-domains of physical activity, i.e. 1.5 (0.5).The mean (SD) score of perceived stress was 27.3 (7.1). There was reverse relationship between perceived stress and health -promoting behaviors.

CONCLUSION

Based upon the results, health promoting behaviors were decreased by increment of perceived stress. Therefore, midwives can help women with preeclampsia by promoting health behaviors to reduce their stress and increase health-promoting behaviors.

Health-promoting lifestyle behaviours in pregnant women in Turkey

This study aims to describe the health-promoting lifestyle behaviours of pregnant women. The study was carried out with pregnant women who applied to the polyclinics in different maternity and children hospitals located in Adana, Turkey, between 1 March and 30 May 2009. The data collection tools used in the study were (i) a questionnaire that was used to collect sociodemographic data from the participants and (ii) the Health Promoting Lifestyle Profile II (HPLP II). The results obtained from the study showed that total HPLP II scores were moderate; the highest scores were obtained on the spiritual growth dimension and the lowest scores on the physical activity dimension. Pregnant women with older age, those with a higher educational level, those with a better socioeconomic status and those living in a nuclear family were found to be more likely to have health-promoting lifestyles. Health promotion and healthy lifestyle need to be an integral part of health services provided for pregnant women. Midwives and nurses have prominent roles in encouraging pregnant women to engage in health-promoting behaviours.

Pregnant Turkish women with low income: their anxiety, health-promoting lifestyles, and related factors

This paper presents anxiety levels, health-promoting lifestyles and related factors among pregnant Turkish women with low income. A descriptive correlation and cross-sectional study was conducted at a state maternity hospital in Western Turkey. The paper reports on the data (n = 195) from the Spielberg State and Trait Anxiety Inventory (STAI), the Health-Promoting Lifestyle Profile (HPLP) and a sociodemographic questionnaire. The average HPLP score was low (mean 2.57, SD 0.42). The average STAI score was high (40.67 ± 9.48; 46.40 ± 8.09, respectively). A significant relation was detected between the trait anxiety, state anxiety, antenatal visit, perception of social support, living environment, family type and HPLP (P < 0.05). A moderately negative relation was detected between the mean STAI and HPLP scores. The findings indicate information and data should be provided for service planning and community care to support pregnant Turkish women with low income in communities.

Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants

Recent findings suggest that elevated stress levels during the pre- and postpartum period are related to poor maternal and infant health outcomes; yet, few studies have prospectively examined the efficacy of stress management interventions on regulating stress levels among mothers and their infants. The current study examined whether a prenatal cognitive behavioral stress management (CBSM) intervention would be effective in regulating salivary cortisol (a biological marker of stress) and self-reported stress levels among mothers and their infants at six and 18 months postpartum, relative to two control groups. Our sample was comprised of predominantly Spanish-speaking, low-income women (80%; mean age=25±5 years) who were screened for depression during their second trimester of pregnancy (M=16±5 weeks of gestation). Women at high risk for depression [i.e., having either a past history of major depression or current elevated symptoms of depression (≥16 on CES-D)] were randomized to either a CBSM group (n=24) or a usual care (UC) group (n=33), while a low risk comparison (LRC) group (n=29) was comprised of women not meeting either depression criteria. ANCOVA analyses demonstrated that: (1) infants of women in the CBSM and LRC groups had significantly lower cortisol levels than infants of women in the UC group at six months postpartum (p<.001); and (2) women in the CBSM group had lower cortisol levels than women in the UC group at 18 months postpartum (p<.01). These results suggest that prenatal CBSM interventions may be efficacious in regulating biological markers of stress among mothers and their infants, thereby decreasing their risk for developing health complications over time.

Swaziland rural maternal care: Ethnography of the interface of custom and biomedicine

A retrospective ethnographic enquiry was used to examine the values and beliefs that underpin Swazi women's birth practices during pregnancy, labour, birth and the postnatal period. An unstructured interview guide was used to conduct 15 one-to-one audio-taped interviews in the field. Results revealed that although Swazi women embraced modern biomedical practices, they also largely adhered to customary practices, including use of traditional model of causation of illness, and the use of traditional medicines during childbirth. Recommendations include parallel antenatal education, which gives credence to the customs within the context of scientific modernity. In addition, changes are needed to public health policy that allows parallel systems of care to be delivered within the context of community midwifery practice.

Muslim women's experiences of suffering in Jordanian intensive care units: a narrative study

This paper explores Muslim women's experiences of suffering in Jordanian intensive care units. A narrative approach was employed to access women's stories of their critical illness. Sixteen women who had spent at least 48 hours in intensive care were recruited from two hospitals in a Jordanian city and took part in between one and three interviews over a six-month period. Women's accounts of suffering were pervaded with physical, social, spiritual and technological themes. Pain was a central strand in the women's accounts and was experienced often as severe, overwhelming and disturbing to their sleep. The sudden onset of illness, the unfamiliar ICU environment and feeling of uncertainty made it difficult for the women to interpret their experiences. Religious beliefs and cultural norms helped the women make sense of their suffering. Social support, especially from the family, was reported by the women to be essential: a lack of social support was seen as a symbol of death. This study emphasises the importance of looking at a patient who is critically ill as a whole person within the context of their cultural, spiritual and biographical milieu.

Significant effects of Fatwa-based perception on contraceptive practice among Muslim women in south Jordan under the early stage of fertility transition

An interview survey of 450 Muslim women in a rural village of south Jordan under the early stage of fertility transition was conducted to explore major causes of contraceptive use, taking both their sociodemographic attributes and fatwa (Islamic jurisprudence)-based perception into account. Discriminant analysis, which was performed for the subject women divided into 15- to 29-, 30- to 39-, and 40- to 49-year age groups, revealed that "the number of living children" in the former and "to do contraception for good care of children" in the latter played significant roles in discrimination into contraceptive user and nonuser groups for any age groups. To cope with demographically and socioeconmically vulnerable situations, contraceptive prevalence rate should be increased by means of government-led family planning programs in cooperation with the imam (Muslim religious leaders and priests) through fatwa, in which special attention is paid to traditional norms, represented by good childcare.

Padrão de atividade física entre gestantes atendidas pela estratégia saúde da família de Campina Grande - PB

INTRODUÇÃO: A atividade física realizada durante a gestação vem sendo discutida devido aos seus efeitos benéficos tanto para a saúde materna como para o crescimento fetal e desfechos gestacionais, porém ainda são escassos estudos sobre o padrão de atividade física neste período. OBJETIVO: Avaliar o padrão de atividade física entre gestantes atendidas pela estratégia Saúde da Família (ESF) do município de Campina Grande/PB. MÉTODOS:Foi acompanhada uma coorte observacional de gestantes (n=118), a partir da 16ª semana gestacional, durante os anos de 2005 a 2006. A cada quatro semanas eram aferidas as condições clínicas, socioeconômicas e obstétricas, incluindo a aplicação de um questionário específico sobre atividade física na 16ª, 24ª e 32ª semanas gestacionais. A avaliação foi feita a partir da somatória do equivalente metabólico (METs) e as atividades cotidianas foram divididas em quatro grupos: atividades laboral, doméstica e caminhada, além de inatividade. As gestantes foram classificadas de acordo com o padrão de atividade física realizado em: sedentárias, praticantes de atividades física leve, moderada e vigorosa. Os dados foram analisados no programa Epi Info 3.4.1. RESULTADOS: As características socioeconômicas da coorte estudada indicaram majoritariamente gestantes de baixo poder aquisitivo, baixa escolaridade e baixo percentual de mulheres economicamente ativas. O padrão de atividade física observado foi baixo desde o primeiro trimestre gestacional, oscilando entre o leve e o sedentário, e foi diminuindo com o evoluir da gravidez, com 100% das gestantes alcançando o padrão sedentário na 32ª semana. Em relação aos grupos de atividades, observou-se um predomínio de atividades domésticas, seguidas pelas atividades de lazer. CONCLUSÃO:Na coorte estudada verificou-se um padrão de atividade física inadequado desde o início da gestação, agravando-se no terceiro trimestre gestacional.

Jordanian women?s perceptions of post-partum health care

PURPOSE

This qualitative descriptive study aimed to explore Jordanian childbearing women's perceptions of their needs for health care and the post-partum healthcare services they received.

METHODS

Twenty-four Jordanian childbearing women participated in the focus groups. Discussions focused on infant and maternal health concerns, access to post-partum health care, including family-planning services, the characteristics and behaviour of healthcare providers, and suggestions for the provision of quality maternal post-partum health care.

FINDINGS

The majority of the women indicated that most of the services perceived and provided during the post-natal period were related to child care. They indicated that they attend post-natal visits mostly for treatment, family planning and/or child care and stated that they have not been told about the post-natal visits during pregnancy, or after giving birth.

CONCLUSIONS

Study findings provided insight and understanding of women's perspectives on post-partum health care and implied a need to translate qualitative findings into clinical practice guidelines. It is suggested that the Jordanian Ministry of Health develops a comprehensive plan to improve educational offerings for post-partum women, and ensure that all healthcare facilities offer affordable and high-quality post-partum health care.