Postpartum Taiwanese women: their postpartum depression, social support and health-promoting lifestyle profiles

Background. To reach the Millennium Development Goals, maternal health-promoting behaviours need to be encouraged after childbirth; little is known about the health-promoting behaviour among first-time mothers during their postpartum period. Aim. To examine levels of engagement in health-promoting behaviours and related factors among postpartum women in Taiwan. Methods. This cross-sectional study was conducted through a convenience sample of 122 qualified women. Participants self-completed a questionnaire and mailed it back using a stamped, self-addressed envelope from July to September 2003. Instruments of this study included a demographic questionnaire as well as three Likert-type scales: the Health Promotion Lifestyle Profile scale, the Edinburgh Postnatal Depression scale and a self-developed social support scale. Results. The average overall Health Promotion Lifestyle Profile score was low (mean, 2-83 SD 1.35), with exercise rated lowest among the six subscales. Postpartum women perceived that they had high levels of social support from their mothers-in-law, mothers and husbands. An astonishing 42.6% of women experienced postnatal depression. Based on results of multiple regressions, 25% of the variance in health-promoting lifestyle practices was explained by postpartum depression and social support. Social support was found to predict all subscales significantly except exercise. Postpartum depression can significantly predict self-actualization, interpersonal relationships, nutrition and stress management. All modifying factors were excluded from the regression model. Conclusions. This study validates the theoretical relationships among concepts in the Health Promotion Model. Nursing interventions are recommended which are tailored to enhance women's social support and decrease their depression to promote their pursuit of healthy lifestyles. Relevance to clinical practice. This study highlights the implications of social support to nursing practice, especially in Chinese culture which has a strict ritual during a women's postpartum period. Findings of this study provide information and data for service planning and community care to support postpartum care in the communities.