妊婦のセルフケア自己効力感についての研究

• Published in: Japanese Journal of Health Education and Promotion Vol. 23; no. 3; pp. 171 - 181
• Main Author: 甲斐 寿美子
• Format: Journal Article
• Language: Japanese
• Published: 日本健康教育学会 2015; JAPANESE SOCIETY OF HEALTH EDUCATION AND PROMOTION
• Subjects: generalized self-efficacy; pregnant women; psycho-somatic symptoms; self-care; セルフケア; 妊婦; 心身症状; 特性的自己効力感
• ISSN: 1340-2560; 1884-5053
• DOI: 10.11260/kenkokyoiku.23.171

Objective: To clarify the components of self-efficacy for self-care behaviors in pregnant women, and to examine the effects of generalized self-efficacy attentiveness toward health during pre-pregnancy, health-promoting behaviors, and psychosomatic symptoms.Methods: A cross-sectional study was conducted among 590 pregnant women through a written questionnaire. 589 valid responses were collected. The survey comprised items concerning self-efficacy for self-care behaviors in pregnant women, generalized self-efficacy, attentiveness toward health during pre-pregnancy, health-promoting behaviors, subjective symptoms, and basic attributes. An exploratory factor analysis was conducted on the survey items concerning self-efficacy for self-care behaviors in pregnant women. A regression analysis was conducted using the scores of each question item as independent variables, and the three factors of self-efficacy for self-care behaviors in pregnant women as dependent variables.Results: Three factors were identified as the components of self-efficacy for self-care behaviors in pregnant women: “confidence in health management and life adjustment,” “confidence in the self-awareness of one's daily physical condition,” and “confidence in a normal course of pregnancy and delivery.” These three factors were influenced by generalized self-efficacy (β = 0.36, 0.16, 0.32, p < 0.01), attentiveness toward health during pre-pregnancy (β = 0.25, 0.12, 0.26, p < 0.01), health-promoting behaviors (β = 0.22, 0.13, 0.12, p < 0.01), and the pre-pregnancy self-awareness score (β = -0.07, p < 0.10, β = 0.18, p < 0.01, β = -0.22, p < 0.01).Conclusion: To increase self-efficacy for self-care behaviors in pregnant women, focus should be put on health awareness, health-promoting behaviors, and subjective symptoms in the pre-pregnancy period. Health guidance and support for reducing subjective symptoms should be provided for them from this period. 目的：妊婦のセルフケア自己効力感の構成要素を明らかにし，特性的自己効力感と非妊娠時の健康に注意する意識，健康取組行動，心身症状が，妊婦のセルフケア自己効力感に与える影響を検討した．方法：妊婦590名に対して質問紙調査による横断研究を行った．有効回答は589名であった．調査項目は妊婦のセルフケア自己効力感，特性的自己効力感，非妊娠時の健康に注意する意識，健康取組行動，自覚症状，基本属性とした．妊婦のセルフケア自己効力感の調査項目に対して探索的因子分析を行った．各質問項目を得点化して独立変数とし，妊婦のセルフケア自己効力感の3因子を従属変数とする回帰分析を行った．結果：妊婦のセルフケア自己効力感を構成する3つの因子が特定された．「健康管理と生活調整の確信」「日常的体調自覚の確信」「正常妊娠経過・正常分娩に向けた確信」である．この妊婦のセルフケア自己効力感の3因子は，特性的自己効力感（β＝0.36，0.16，0.32，p＜0.01），非妊娠時の健康に注意する意識（β＝0.25，0.12，0.26，p＜0.01），健康取組行動（β＝0.22，0.13，0.12，p＜0.01），非妊娠時の心身症状の自覚得点（β＝－0.07，p＜0.10，β＝0.18，p＜0.01，β＝－0.22，p＜0.01）からの影響を受けていた．結論：妊婦のセルフケア自己効力感を高めるためには，非妊娠時からの健康意識や健康取組行動，自覚症状に着目し，非妊娠時から健康取組行動を指導し，自覚している心身症状を軽減できるように援助する必要があることが示された．