Comparison of Health-Promoting Lifestyles between Postnatal Han Taiwanese and Indigenous Women

台灣漢族與原住民婦女的產後健康生活型態的比較研究

10.1097/JNR.0b013e3181edef18

柯淑華(Shu-Hua Ko)；陳彰惠(Chung-Hey Chen)

健康促進生活型態 ； 產後婦女 ； 原住民婦女 ； health-promoting lifestyles ； postnatal women ； indigenous women

The Journal of Nursing Research

18卷3期（2010 / 09 / 01）

191 - 198

英文

背景　產後婦女的健康促進生活型態是一個重要議題，然而文化差異所扮演的角色很少被探討。 目的　本研究的目的是進一步了解台灣產後婦女的健康促進生活型態，並比較台灣漢族與原住民產婦在健康促進生活型態上的差異及兩組的預測因子。 方法　本研究為橫斷式比較性研究，使用健康促進生活型態問卷調查314位產後六週的婦女，比較居住於高雄市的台灣漢族產後婦女及居住在屏東縣的原住民婦女的產後健康促進行為。 結果　台灣漢族與原住民產後婦女在年齡、教育程度、有無職業、社經地位、家庭形態、及產後的主要照顧者上有顯著的差異。漢族婦女在整體健康促進生活型態、自我實現、壓力處置、營養、及人際支持的原始得分高於原住民婦女。但是經過共變異數分析，發現兩組在這些項目上並未達統計上的顯著差異。原住民婦女在健康責任及運動的得分顯著高於漢族婦女。複迴歸分析結果顯示，就業與母奶哺餵是漢族婦女較佳健康促進生活型態的預測因子，但僅共可解釋8.2%的總變異量。而較高教育年數及中社經地位是原住民婦女較佳健康促進生活型態的預測因子，解釋力亦僅共為22.0%的總變異量。 結論／實務應用　本研究發現，台灣漢族和原住民產後婦女的健康促進生活型態中，健康責任及運動二構面有顯著差異，健康促進生活型態之預測因子也不相同。本研究結果支持文化可能是影響台灣產後婦女健康促進生活型態的重要因子。護理人員在提供不同族群產後婦女的健康照護時，應該具文化敏感度以提供更有效的產後照護。

Background: The health-promoting lifestyle of postpartum women is an important issue, but few studies have been undertaken to examine the role of cultural difference. Purpose: The purpose of this study was to better understand the health-promoting lifestyles of postnatal mothers in Taiwan in terms of differences between ethnic Han Taiwanese and indigenous women and of factors predicting health-promoting lifestyles in the two groups. Methods: For this cross-sectional comparative study, data on postnatal health-promoting behaviors, as measured using the Health-Promoting Lifestyle Profile (HPLP), were collected from 314 mothers during their sixth postpartum week. HPLP scores of ethnic Han Taiwanese mothers living in Kaohsiung City, and indigenous women living in Pingtung County were then compared. Results: Han Taiwanese and indigenous mothers differed significantly in terms of age, education, employment status, socioeconomic status, type of family, and primary postnatal helper. Han Taiwanese had better original scores in overall health-promoting lifestyle, self-actualization, stress management, nutrition, and interpersonal support. However, these differences did not achieve statistical significance when subjected to analysis of covariance. Indigenous participants had significantly higher scores in terms of health responsibility and exercise than Han Taiwanese women. Significant predictors of higher HPLP score in the Han Taiwanese group included employment status and breast-feeding, which together accounted for 8.2% of total variance. In the indigenous group, significant predictors of higher HPLP score included more years of education and middle socioeconomic status, which together accounted for 22.0% of total variance. Conclusions/Implications for Practice: Results showed significant differences in the health responsibility and exercise subscales and significant differences in key predictors between the Han Taiwanese and the indigenous groups. Findings support the role of culture as a significant factor affecting the health-promoting lifestyle of postnatal women in Taiwan. Nurses should be aware of cultural mores and influences when delivering healthcare to postpartum mothers of different ethnic groups to maximize postnatal care efficacy.

1. Chen, L. L.,Wang C. C.(2000).Attitude and behavior towards postpartum recuperation in traditional Chinese medicine.Nursing Research (Taiwan),8(1),49-58.
   連結：
2. Lin, S. H.(2009).Interpretation of ritual and the dietary culture in the Taiwanese local history.Chinese Journal,18,67-101.
   連結：
3. Council of Indigenous People, Executive Yuan, Taiwan, ROC. (2009). Statistical yearbook of population and health amongst Taiwan's indigenous groups. Retrieved September 20, 2009, from http://www.apc.gov.tw/main/pda/docDetail/detail_TCA.jsp?docid=PA000000003465&linkRoot=&url=(Original work published in Chinese)
4. Ayaz, S.,Efe, S. Y.(2008).Potentially harmful traditional practices during pregnancy and postpartum.The European Journal of Contraception and Reproductive Health Care,13(3),282-288.
5. Callahan, T.,Caughey, A. B.(2007).Blueprints obstetrics & gynecology.Philadelphia:Lippincott.
6. Chang, Y. H.,Chen, P. C.,Hsieh, C. J.,Jeng, S. F.,Liao, H. F.,Su, Y. N.(2007).Perinatal and infant health outcomes among neonates born to aboriginal parents in Taiwan.Acta Paediatrica Taiwanica,48(3),135-140.
7. Chen, C. H.(2001).Association of work status and mental wellbeing in new mothers.Kaohsiung Journal of Medical Sciences,17(11),570-575.
8. Chen, C. M.,Kuo, S. F.,Chou, Y. H.,Chen, H. C.(2007).Postpartum Taiwanese women: Their postpartum depression, social support and health-promoting lifestyle profiles.Journal of Clinical Nursing,18(6),1550-1560.
9. Chien, L. Y.,Tai, C. J.,Ko, Y. L.,Huang, C. H.,Sheu, S. J.(2006).Adherence to "doing-the-month" practices is associated with fewer physical and depressive symptoms among postpartum women in Taiwan.Research in Nursing & Health,29(5),374-383.
10. Ciou, H. J.(2004).Qualitative research and statistical analysis in social & behavioral sciences.Taipei:Wu-Nan.
11. Contoyannis, P.,Jones, A. M.(2004).Socio-economic status, health and lifestyle.Journal of Health Economics,23(5),965-995.
12. Duffy, M. E.(1988).Determinants of health promotion in midlife women.Nursing Research,37(6),358-362.
13. Freudenberg, N.(2007).From lifestyle to social determinants: New directions for community health promotion research and practice.Preventing Chronic Disease,4(3),A47.
14. Heh, S. S.(2004)."Doing the Month" and social support.Fu-Jen Journal of Medicine,2(2),11-17.
15. Huang, Y.,Chiou, C.(1996).Assessment of the Health-Promoting Lifestyle Profile on reliability and validity.Kaohsiung Journal of Medical Sciences,12(9),529-537.
16. Lin, T.(1978).Psychiatry and society.Taipei:Modern Medicine.
17. Lo, H.M.,Hsu, N.,Wu-Chen, Y.M.,Chu, H. C.,Ling, C. H.,Lee, L. L.(2005).Comparison of attitudes and compliant behaviors between Han and aboriginal postpartum women during "doingthe-month" and its influencing factors.Tzu Chi Nursing Journal,4(4),70-78.
18. Mattson, S.,Smith, J. E.(2004).Core curriculum for maternal-newborn nursing.St. Louis, MO:W. B. Saunders.
19. Navarro, A., Voetsch, K., Liburd, L., Bezold, C., & Rhea, M.(2006).Recommendations for future efforts in community health promotion: Report of the National Expert Panel on Community Health PromotionRecommendations for future efforts in community health promotion: Report of the National Expert Panel on Community Health Promotion,Atlanta, GA:Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health.
20. Raven, J. H.,Chen, Q.,Tolhurst, R. J.,Garner, P.(2007).Traditional beliefs and practices in postpartum period in Fujian Province, China: A qualitative study.BMC Pregnancy and Childbirth,7, 8
21. Tai, F. T.(2006).Relationship of weight changes in postpartum women.New Taipei Journal of Nursing,8(2),21-30.
22. Tian, J. I.(2003).Traditions and conventions of Taiwan's indigenous peoples.Taipei:Wu-Ling.
23. Walker, S. N.,Sechrist, K. R.,Pender, N. J.(1987).The Health-Promoting Lifestyle Profile: Development and psychometric characteristics.Nursing Research,36(2),76-81.
24. Wang, S. Y.,Jiang, X. Y.,Jan, W. C.,Chen, C. H.(2003).A comparative study of postnatal depression and its predictors in Taiwan and mainland China.American Journal of Obstetrics and Gynecology,189(5),1407-1412.
25. Wang, S.,Chen, C.,Chang, P.,Kao, S.(2004).Factors related to health promoting life style behaviors among postpartum women during their "doing the month" period.Journal of Taichung Nursing College,3,13-39.
26. Wu, M. L.,Tu, J. T.(2005).SPSS & the application and analysis of statistics.Tiapei:Wu-Nan.

1. Mastel-Smith, Beth,Lin, Yu-Hua,Lin, Chin-Nu,Alfred, Danita(2015).Cultural Competence and Related Factors Among Taiwanese Nurses.The Journal of Nursing Research,23(4),252-261.
2. Yu, Chen-Hsiang,Yang, Chiu-Ling,Chen, Chung-Hey(2013).Development and Validation of the Postpartum Sleep Quality Scale.The Journalof Nursing Research,21(2),148-154.
3. 陳政友,梁秉義(2014)。花蓮縣多元就業開發方案勞工失業經驗、族群與健康生活型態相關研究。健康促進與衛生教育學報，42，27-58。