Factors Predicting Self-Care Behavior Among Pregnant Women in Nakhon Ratchasima Province

Abstract

Introduction Pregnancy is a transformative period involving both physical and psychological changes. The provision of high-quality prenatal care is crucial for minimizing complications throughout all stages of pregnancy and childbirth. 

Objective This study aimed to 1) describe self-care behaviors of pregnant women 2) describe the relationship between predisposing factors, enabling factors, and reinforcing factors with self-care of pregnant women, and 3) examine the predictive factors of self-care behaviors in pregnant women. 

Design Descriptive predictive design using the PRECEDE-PROCEED Model as a conceptual framework 

Methods The sample comprised 218 pregnant women aged 15-45 years receiving prenatal care at government hospitals in Nakhon Ratchasima Province. Sample selection employed a multi-stage random sampling. The research instrument consisted of a questionnaire with five sections including: 1) Personal characteristics, such as age, educational attainment, family income, and the quality of antenatal care; 2) Pregnancy knowledge; 3) Attitudes towards self-care behaviors, perceived benefits and barriers related to self-care during pregnancy, accessibility to antenatal care services, and support from family, friends, and medical personnel; 4) Self-care behaviors during pregnancy; and 5) Pregnancy and childbirth outcomes. Data were analyzed using descriptive and inferential statistics, including Pearson correlation, Chi-square test, and Multiple linear regression analysis. 

Results In a sample of pregnant women with an average age of 27.22 years (SD=6.48), the mean score for self-care behaviors during pregnancy was high (M= 3.45, SD=0.27). Furthermore, 74.77% received quality antenatal care, 37.61% achieved weight gain within standard guidelines, 97.20% delivered at full term, and 96.33% of newborns had appropriate birth weights. Correlation analysis revealed significant associations between self-care behaviors and predisposing, enabling, and reinforcing factors. Self-care behaviors during pregnancy showed significant correlations with attitude towards self-care behavior, perceived benefits, and perceived barriers, (r=.426, .340, -.460, p<.001) and age (r=.201, p=.001). Additionally, knowledge about pregnancy was positively correlated with self-care behaviors (r=.163, p=.008), as well as access to prenatal health services (r=.411, p<.001) and social support from family, peers, and healthcare providers (r=.418, p<.001). Multiple regression analysis identified three variables predicting 28.10% of self-care behaviors during pregnancy (Adjusted R2= .271, F= 27.854, p<.001): age (β = .133, p=.024), perceived barriers to self-care during pregnancy (β = -.319, p<.001), and social support from family, peers, and medical personnel (β = .257, p<.001). 

Recommendation The findings of this research have practical implications for promoting health behaviors in pregnant women. This includes designing age-appropriate activities, mitigating barriers to healthcare during pregnancy, engaging families in antenatal care, emphasizing the role of midwives in care, and providing comprehensive and easily accessible information to pregnant women.