Sui ji dui zhao yan jiu diao cha chan qian yun dong jiao yu gan yu dui gai shan huai yun fu nu yao bei tong zhi xiao guo

D.Nurs.This study aims to determine the effectiveness of a 12-week mHealth physical activity intervention compared with standard antenatal care in reducing or preventing pregnancy-related lumbopelvic pain (LPP) among pregnant Chinese women in Hong Kong. It was a prospective, single-blind randomized trial conducted at an outpatient clinic of a tertiary care, teaching public hospital in Hong Kong. A total of 134 low-risk pregnant Chinese women in the second trimester who had no contraindications to performing antenatal exercises (as defined by the American College of Obstetricians and Gynaecologists 2015 criteria) were recruited. After baseline assessment, they were allocated randomly to the intervention group and the control group. The intervention group received individual face-to-face education on pregnancy-related LPP based on the Health Belief Model. A written information booklet and demonstration on back-strengthening and core-stability exercises were used. A mobile phone application with a goal setting component was also used to reinforce home exercises. Participants were followed up for 12 weeks and a phone booster was given in the fourth and eighth weeks. The control group received general information on antenatal exercises using a pamphlet published by the Department of Health as a reminder to exercise. Data were collected upon recruitment and in the 12ᵗʰ week after intervention. The primary outcome measure was pain score measured by a self-reported numeric pain rating scale. Secondary outcome measures included energy expenditure in different types and intensities of physical activities, functional disability and prenatal depression scores. Based on the intention-to-treat principle, the effects of the intervention were analysed using a Generalized Estimating Equation model. The intervention group did not exhibit any statistically significant change in all outcome measures. Compared with the control group, participants in the intervention group were physically more active. This result was shown in their increased energy expenditure in total activity, moderate-intensity activity and exercise while spending less energy in sedentary activity after the intervention. However, the results did not reach any statistically significant change. The prevalence of pregnancy-related LPP in this study was 67.9% upon recruitment of the participants, which was comparable to many previous studies. However, the pain intensity of the participants was generally mild in this study. Adherence to the intervention was 38.8%. No adverse event had resulted from the intervention. This study achieved its aim in assessing the effectiveness of a 12-week mHealth physical activity intervention in reducing or preventing pregnancy-related LPP. No significant difference in all outcomes was found between the two groups, possibly due to the floor effect from the low pain intensity of both groups and the low adherence to the intervention. The design and use of mobile phone app in educating the intervention participants were innovative. A study that used an intervention that combined both a theory-based face-to-face counselling and mHealth components in education is scarce, particularly in the local setting. This study contributed to current knowledge on prevalence and impacts of pregnancy-related LPP among pregnant Chinese women in Hong Kong. Future studies to enhance adherence to the mHealth physical activity intervention and qualitative studies to understand women’s view on any enabling or hindering factors to using mobile phone apps as a pregnancy intervention are needed.此研究之目的是了解一項為期12 星期的移動醫療運動介入計劃比一般產前護理在減輕或預防香港孕婦出現懷孕相關下背盆腔痛楚的有效性。研究設計為前瞻性、單盲的隨機抽樣試驗。研究地點位於香港一所公立教學醫院門診。研究共招募了134 名踏入第二孕期，並對於進行產前運動沒有禁忌症的低風險香港孕婦 (按美國婦產科學院2015 年準則而定) ，在基線評估後將她們隨機分配至介入和對照組。關於介入方法；介入組將獲個別面見，透過教育資訊小冊子、強化背部示範和核心穩定練習等，接受以「健康信念模式」為基礎的懷孕下背盆腔痛楚教育。此外，亦使用設有訂立目標功能的手機應用程式，加強家中練習。參加者將獲跟進12 星期，並在第4 及第8 星期獲電話跟進以作鼓勵。對照組將獲發衞生署出版的產前運動健康小冊子，提醒運動的重要性。於招募及介入後第12 星期收集數據，主要量度痛楚評分，並由參加者自行呈報痛楚分數以作量度；其次量度的範圍包括在不同活動類型和強度所消耗的能量、功能障礙以及產前抑鬱評分。根據「治療意向」原理，介入效果以「廣義估計方程式」(Generalized Estimating Equation) 分析。研究結果指出介入組的所有結果量度在統計學上並沒有重大的改變；但是若與對照組別相比，介入組的參加者在接受介入後的確較為活躍，在總活動量、中等強度活動和運動方面消耗較多能量，亦在靜態活動方面消耗較少能量，但相關結果並未達致統計學上的重要性。本研究在招募參加者後的懷孕相關下背盆腔痛流行率為67.9%，與很多過往的研究類同；但是次研究參加者的痛楚卻較為輕微。遵行介入的比率為38.8%；介入方法並沒有引致任何不良反應。作為總結; 是次研究已達致目的，能評估為期12 星期的移動醫療運動介入在治療或預防懷孕相關下背盆腔痛楚的有效性。在兩組的所有量度結果中，並沒有發現重大的差別，這可能由於兩組痛楚輕微以致「低限效應」(floor effect) ，以及遵行介入的比率較低所致。設計和使用手機應用程式以教育介入組參加者尤為創新；此外，在本地層面來說，綜合理論與面見輔導、移動醫療教育元素的研究不甚常見。是次研究增進了不少本地孕婦下背盆腔痛流行性和影響方面的知識。未來需要作進一步研究，以加強參加者遵行移動醫療運動介入，也須進行更多質量研究以了解推動和阻礙女性使用手機應用程式作為懷孕介入的因素。Au-Yeung, Elce.Parallel title from appendix.Thesis D.Nurs. Chinese University of Hong Kong 2019.Includes bibliographical references (leaves 181-198).Abstracts also in Chinese; some appendixes also in Chinese.Title from PDF title page (viewed on 15, April 2021).Au-Yeung, Elce