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系統識別號 U0026-0602201819063800
論文名稱(中文) 孕期身體活動量與睡眠品質、憂鬱及壓力的相關性
論文名稱(英文) Physical activities during pregnancy: Associations with sleep quality, depression and stress
校院名稱 成功大學
系所名稱(中) 健康照護科學研究所
系所名稱(英) Institute of Allied Health Sciences
學年度 106
學期 1
出版年 107
研究生(中文) 劉玉湘
研究生(英文) Yu-Hsiang Liu
電子信箱 ns236@fy.edu.tw
學號 TA8981021
學位類別 博士
語文別 中文
論文頁數 111頁
口試委員 指導教授-陳彰惠
召集委員-劉影梅
口試委員-李靜芳
口試委員-周學雯
口試委員-周汎澔
中文關鍵字 三個孕期  身體活動量  睡眠品質  憂鬱情緒  壓力知覺 
英文關鍵字 Physical activities  sleep quality  depression  stress  one way ANOVA 
學科別分類
中文摘要 中文摘要
背景:規律適度的身體活動對身心健康有益,但是台灣女性有46.6%-64.2%不運動,加上婦女一旦懷孕,怕動了胎氣,基於保護胎兒,避免流產的理由,或是因為疲累、沒時間。國內外的文獻發現孕婦在懷孕期間活動量均比一般族群少。婦女因懷孕生理變化,導致睡眠周期的改變,加上胎動、子宮收縮、背痛及頻尿等因素,睡眠品質較一般未懷孕婦女差,孕期睡眠困擾的發生率在58%-77.2%。孕期發生憂鬱的狀況在西方國家的發生率為9%-44%,在台灣約有48.7%。懷孕對婦女即是壓力事件,壓力過大對孕婦本身、胎兒都會產生不良影響。孕期中婦女的身體活動量是否影響其身心的變化,對於孕期身體活動量與孕期睡眠品質、憂鬱程度及壓力的相關性國內外的研究甚少,本研究欲了解孕期身體活動量與孕期婦女之身心健康的相關性。
目的:本研究目的在探討第一、二、三孕期之身體活動量與睡眠品質、憂鬱程度及壓力知覺之差異,及其相關性。
方法:本研究採橫斷性調查,立意取樣,三個孕期共收案366位,第一孕期、114位,第二孕期130位,第三孕期122位。研究工具包含人口學基本資料,匹茲堡睡眠品質量表,愛丁堡孕期憂鬱量表,自覺壓力量表,國際身體活動量表。
結果:研究結果顯示:1.三個孕期的人口學資料沒有顯著差異,在產科學變項基本資料中也沒有顯著差異,2第二孕期在工作活動量及一週有助於健康身體活動多於第三孕期,第三孕期之交通活動量多於第一孕期。將身體活動量分割為三等級做卡方檢定,三個孕期之身體活動量在家事活動量及一週有助健康身體活動量有顯著差異,第三孕期家事活動量足夠者多於第一孕期,一週有助健康身體活動量不足者第一孕期多於第三孕期,一週有助健康高身體活動量第二孕期多於第三孕期。三個孕期在與睡眠品質量表,憂鬱程度及壓力知覺之平均值並無顯著差異,睡眠品質以5分為切割點,憂鬱情緒以9分為切割,卡方檢定(Chi-square χ2 )在三個孕期睡眠品質有顯著差異,第三孕期睡眠品質差者多於第一孕期,第一孕期睡眠品質好的多於第三孕期。3.不同身體活動量與睡眠品質、憂鬱情緒及壓力知覺單因子變異數分析,身體活動量與睡眠品質、憂鬱情緒傾向及壓力知覺有顯著差異。4.以皮爾森積差做相關檢定,身體活動量與睡眠品質、憂鬱情緒有顯著正相關,與壓力知覺之間的關係,則無顯著相關,睡眠品質與憂鬱情緒、壓力知覺有顯著正相關,憂鬱情緒與壓力知覺有顯著正相關。
結論:研究結果顯示不同孕期之婦女身體活動量不同,由於孕婦身體活動量以工作為主要,休閒活動量少,導致總計一週有助於健康的身體活動高活動量的孕期婦女睡眠品質欠佳,也較有憂鬱情緒及壓力知覺。隨著孕期的進展,第三孕期婦女睡眠品質比第一孕期差,睡眠品質受孕期、活動量、憂鬱情緒及壓力知覺影響。婦女健康照護人員需關注不同孕期婦女的健康狀態,依據孕期婦女需求,提供身體活動、睡眠及情緒的照護策略。
英文摘要 Introduction: Regular exercise good for psychosomatic health that diseases risk was decreased in physical, improve depress and release stress in psychological. 46.6-64.2 % women don’t do exercise special pregnant woman in Taiwan. The reason base on protect fetal, avoid abortion, feel tired and no available time. Literature review found that pregnant woman physical activity less than others population. Because hormone changes and uterine enlarge that sleep cycle change. In addition fetal movement, uterine contraction, back pain and urinary frequency result in sleep quality worse than nonpregnant woman. Sleep disturbance prevalence were 58-77.2% during pregnancy. Depended on instrument assessment result in deferent depress incidence during pregnancy. West pregnant woman depress prevalence 9-44%, 48.7% in Taiwan. Pregnancy is stressor for woman. Over loading stress damage mother and fetal. Woman’s sleep quality, depression and stress could be better whether physical activity or not. However, physical activity’s relation to sleep quality, depression and stress remains unclear in pregnant women during their three trimesters.
Purpose: The study wants to understand how pregnant woman physical activity is different in three trimesters. To explore physical activity in healthy pregnant women in relation to physical activities, sleep quality, depression and stress among the three trimesters.
Methods: This was a cross-sectional research design. A purposive sampling technique be used to recruit 366 participants from two certified prenatal centers in southern Taiwan. The data was collected that 114 participants during 1st trimester, 130 participants during 2nd trimester and 122 participants during 3rd trimester. The inclusive criteria were pregnant women who were in their first, second or third trimester, normal pregnancy and single fetal pregnant. Pregnant women who can read Chinese filled out the questionnaires. Five instruments were used: a demographics and obstetric questionnaire, the Pittsburgh Sleep Quality Index(PSQI), the Edinburgh Perinatal Depression Scale (EPDS), the Perceived Stress Scale(PSS), the International Physical Activity Questionnaire (IPAQ). Seven dimensions in the Pittsburgh Sleep Quality Index subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication and daytime dysfunction. The Edinburgh Perinatal Depression Scale and the Perceived Stress Scale both had ten items. Physical activity included five dimensions which work, housework, transport, leisure time and sitting. Count five dimension’s physical activity amount then category physical activity level to high physical activity, sufficiency physical activity, insufficiency physical activity. Data entering were double checked by a trained assistant before performing analysis. Statistical analysis will be performed using SPSS 20.0 statistical software. Tests for differences in baseline characteristics among the three groups included Chi-square test for categorical variables and t-test for continuous variables. One-way ANOVA and independent t-test were used to examine the relations between categorical variables and three trimester measures. Individual categorical variables were described in terms of frequency and percentage, whereas continuous variables were described in terms of mean and standard deviation. Pearson correlation were used to investigate factors associated with the physical activity and physical activity’s relation to sleep quality, depression and stress.
Result: The results showed (1) there were no differences in demographic data between the three trimesters, included age, marital status, education, spouse education and occupation. There were no significant difference in the number of existing children, whether or not to plan for pregnancy, whether to participate in prenatal class in the obstetric variables. (2) There was no significant difference in mean of sleep quality, depression and stress perception among three trimesters. There were significant differences in physical activities of work, transport, transport with walk, leisure in walk and weekly physical activity among three trimesters. The amount of work physical activity and weekly physical activity in the second trimester was greater than that in the third trimester. Transport physical activity and physical activity in transport with walk in the third trimester were both greater than that in the first trimester. If the scores of physical activity do cut off, divided into insufficient, adequate, and a high degree of activity. There was significant in Chi-square test of housework physical activity among three trimesters. The scores of sleep quality do cut off, less than or equal to 5 means good sleep quality, greater than 5 means poor sleep quality. The scores of depression do cut off, less than or equal to 9 means normal, greater than 9 means depression. There was significant in Chi-square test of sleep quarity among three trimesters by. (3) There was significant difference in physical activity, sleep quality, depression in three trimesters. There was significant correlation physical activity, sleep quality, depression in Pearson's correlation coefficient. (4) the correlation among physical activity, sleep quality, depression, and stress was examined by Pearson's product-moment correlation coefficient. Physical activity was positively associated with sleep quality (r=0.13, P=.01), depression (r=0.14, P=.009), and stress (r=0.11, P=.04). Sleep quality was positively associated with depression (r=0.53, P=.000) and stress (r=0.41, P=.000). Depression was positively associated with stress (r=0.70, P=.000); and All of these estimates were statistically significant.
Conclusion: The results pointed out the physical activity of women in different trimesters. Pregnant women were poor sleep quality by the progress of pregnancy. The third trimester women sleep quality worse than the first trimester. Professional caregivers understand the needs of care of women during pregnancy. Clinical care professionals need to concern about different trimester pregnant women's health status. can develop different strategies. According to pregnant women needs provide physical activity, sleep and emotional care strategies.
論文目次 中文摘要 I
英文摘要 IV
致謝 IX
目錄 XI
圖目錄表 XIII
第一章緒論1
第一節研究動機及重要性1
第二節研究目的 5
第三節名詞定義 5
第二章文獻查證 8
第一節孕期身體活動量 8
第二節孕期睡眠 13
第三節孕期憂鬱 22
第四節孕期壓力 24
第三章研究方法 27
第一節研究架構 27
第二節研究對象及倫理考量 29
第三節研究工具 30
第四節資料收集 36
第五節資料分析 37
第四章結果 39
第一節孕婦之基本屬性 39
第二節不同孕期之基本屬性差異 43
第三節不同孕期身體活動量測量結果 49
第四節不同孕期睡眠品質、憂鬱情緒及壓力知覺測量結果 62
第五節身體活動量與睡眠品質、憂鬱情緒及壓力知覺分析 65
第六節身體活動量與睡眠品質、憂鬱情緒及壓力知覺的相關性 66
第七節基本資料與身體活動量關係 68
第五章討論 73
第一節人口學及產科學基本資料73
第二節不孕期身體活動量 75
第三節睡眠品質 77
第四節憂鬱情緒 77
第五節壓力知覺 78
第六章結論與建議 80
第一節結論 80
第二節建議 82
第三節研究貢獻 83
第四節研究限制 83
參考文獻 85
附錄一已發表之文章 97
附錄二IRB審核通過證明書 98
附錄三研究同意書 99
附錄四量表授權使用同意書 100
附錄五研究量表 101
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