DOI QR코드

DOI QR Code

Do taegyo practices, self-esteem, and social support affect maternal-fetal attachment in high-risk pregnant women? A cross-sectional survey

고위험 임부의 태교실천, 자존감 및 사회적 지지가 모아애착에 영향을 미치는가?: 횡단적 조사 연구

  • Da-In, Kang (Department of Nursing, Pukyong National University) ;
  • Euna, Park (Department of Nursing, Pukyong National University)
  • Received : 2022.08.26
  • Accepted : 2022.12.16
  • Published : 2022.12.31

Abstract

Purpose: The incidence of high-risk pregnancies is increasing in Korea as the birth age increases due to late marriage. Maternal-fetal attachment is an important factor that affects children even after childbirth, but it is difficult for high-risk pregnant women to form maternal-fetal attachment. The current study aimed to explore whether taegyo practice (i.e., pregnant women's efforts for fetal good growth and development), self-esteem, and social support influenced the degree of maternal-fetal attachment in women with high-risk pregnancies. Methods: The participants included 226 pregnant Korean women at ≥20 gestational weeks, hospitalized with 15 high-risk pregnancy conditions as defined by the Ministry of Health and Welfare. Recruitment via convenience sampling was done at four sites in Busan, Korea. Surveys were distributed and collected from February 1 to 28, 2022. Data analysis was conducted using descriptive statistics, the t-test, one-factor analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression. Results: On average, participants were 33.97±4.23 years of age and at 31.65±6.23 gestational weeks. Preterm labor (35.4%) and gestational diabetes (21.0%) were the most common high-risk conditions. Maternal-fetal attachment was positively correlated with taegyo practice (r=.70, p<.001), self-esteem (r=.53, p<.001), and social support (r=.53, p<.001), all with statistical significance. Taegyo practice (β=.50, p<.001) and social support (β=.17, p=.030) explained 53% of variance in maternal-fetal attachment in women with high-risk pregnancies. Conclusion: Nurses caring for women with high-risk pregnancies during hospitalization can use these findings by promoting taegyo practice and enhancing social support to increase maternal-fetal attachment.

Keywords

References

  1. Korean Society of Obstetrics and Gynecology. Classification of high risk pregnancy [Internet]. Seoul: Author; 2017 [cited 2022 Aug 26]. Available from: https://www.ksog.org/ bbs/?code=notice&mode=view&number=3849
  2. Ko SY, Bae JG, Jung SW. A comparative study on the anxiety, depression, and maternal-fetal attachment of high-risk pregnant women and normal pregnant women. J Korean Soc Biol Ther Psychiatry. 2019;25(2):117-126. https://doi.org/10.22802/jksbtp.2019.25.2.117
  3. Korean Statistical Information Service. City, gun, total birth rate, maternity rate by age women [Internet]. Seoul: Author; 2022 [cited 2022 Sep 20]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B81A17&-conn_path=I2
  4. Chang YS. Past, present, and future of neonatology in Korea. J Korean Med Assoc. 2016;59(7):487-489. https://doi.org/10.5124/jkma.2016.59.7.487
  5. Health Insurance Review & Assessment Service. Healthcare big date hub, statistics on diseases of national interest [Internet]. Seoul: Author; 2021 [cited 2022 Aug 26]. Available from: https://www.hira.or.kr/eng/main.do
  6. Bokjiro. Assistance with medical expenses for high-risk pregnant women [Internet]. Seoul: Ministry of Health and Welfare, Korea Social Security Information Service; 2020 [cited 2022 Aug 26]. Available from: https://www.bokjiro.go.kr/ssisteu/twataa/wlfareInfo/moveTWAT52011M.do?wlfareInfoId=WLF00001088&wlfareInfoReldBztpCd=0
  7. Sajjadi AS, Zahrakar K, Mohsenzadeh F, Karamnia M, Shokoohi YM, Alavinezhad S. Efficacy of maternal fetal attachment techniques on enhancing mother's attachment to the fetus. Dev Psycho Iran Psychol. 2016;12(47):281-288.
  8. Son HJ, Park JS. Relationship between preterm labor stress, fetal attachment and maternal role confidence in pregnant women with preterm labor. J Korean Soc Matern Child Health. 2014;18(1):86-96. https://doi.org/10.21896/jksmch.2014.18.1.86
  9. Lee SH, Lee EY. The influence of anxiety and dyadic adjustment on maternal-fetal attachment in high-risk pregnant women. Int J Softw Eng Appl. 2015;9(12):361-372.
  10. Kang SK, Choi JH, Chung MR. The effects of personal characteristics, marital intimacy and family support of pregnant couples on parent-fetal attachment. Early Child Educ Care. 2017;12(2):223-245. https://doi.org/10.16978/ecec.2017.12.2.010
  11. Branjerdporn G, Meredith P, Strong J, Garcia J. Associations between maternal-foetal attachment and infant developmental outcomes: a systematic review. Matern Child Health J. 2017;21(3):540-553. https://doi.org/10.1007/s10995-016-2138-2
  12. Yu M, Kim MO. The contribution of maternal-fetal attachment: taegyo, maternal fatigue and social support during pregnancy. Child Health Nurs Res. 2014;20(4):247-254. https://doi.org/10.4094/chnr.2014.20.4.247
  13. Park SB. Foetal education as primordial type of psychological attachment [master's thesis]. Ulsan: Ulsan University; 2015. 88 p.
  14. Kim BH. The educational characteristics and topology of prenatal education. Korean J Child Educ. 2012;21(3):169-180.
  15. Kim M. Relationship between pregnant stress and taegyo practice of pregnant women with gestational diabetes: based on the mediating effects of social support. J Wellness. 2017;12(1):399-408. https://doi.org/10.21097/ksw.2017.02.12.1.399
  16. Kim S, Cha C. Bed rest experience among high-risk primigravida. J Qual Res. 2018;19(1):1-12. https://doi.org/10.22284/qr.2018.19.1.1
  17. Wilhelm LA, Alves CN, Demori CC, da Silva SC, Meincke SM, Ressel LB. Feelings of women who experienced a highrisk pregnancy: a descriptive study. Online Braz J Nurs. 2015; 14(3):284-293. https://doi.org/10.17665/1676-4285.20155206
  18. Stoodley BH. Society and the adolescent self-image. Am Sociol Rev. 1966;31(1):125-126. https://doi.org/10.2307/2091308
  19. Mercer RT. A theoretical framework for studying factors that impact on the maternal role. Nurs Res. 1981;30(2):73-77. https://doi.org/10.1097/00006199-198103000-00003
  20. Lee SA, Lee SH. Factors influencing maternal-fetal attachment among pregnant women. J Korea Acad-Ind Coop Soc. 2015;16(3):2020-2028. https://doi.org/10.5762/KAIS.2015.16.3.2020
  21. Macola L, do Vale IN, Carmona EV. Assessment of self-esteem in pregnant women using Rosenberg's Self-Esteem Scale. Rev Esc Enferm USP. 2010;44(3):570-577. https://doi.org/10.1590/s0080-62342010000300004
  22. Park SY. Effects of collective art therapy on pregnancy stress and fetal attachment in pregnant women [master's thesis]. Seoul: Myongji University; 2019. 75 p.
  23. Clements AD, Fletcher TR, Childress LD, Montgomery RA, Bailey BA. Social support, religious commitment, and depressive symptoms in pregnant and postpartum women. J Reprod Infant Psychol. 2016;34(3):247-259. https://doi.org/10.1080/02646838.2016.1152626
  24. Nylen KJ, O'Hara MW, Engeldinger J. Perceived social support interacts with prenatal depression to predict birth outcomes. J Behav Med. 2013;36(4):427-440. https://doi. org/10.1007/s10865-012-9436-y
  25. Kwon SH, Lee SH. Relationships among expectant mothers' prenatal attachment, spousal support, and parenting efficacy. J Fam Better Life. 2013;31(5):65-77. https://doi.org/10.7466/JKHMA.2013.31.5.065
  26. Hopkins J, Miller JL, Butler K, Gibson L, Hedrick L, Boyle DA. The relation between social support, anxiety and distress symptoms and maternal fetal attachment. J Reprod Infant Psychol. 2018;36(4):381-392. https://doi.org/10.1080/02646838.2018.1466385
  27. Kim HK. Factors influencing the maternal-fetal attachment of single mother [master's thesis]. Seoul: Seoul National University; 2015. 75 p.
  28. Hwang RH. Relationship between maternal fetal attachment and state anxiety of pregnant women in the preterm labor. Korean J Women Health Nurs. 2013;19(3):142-152. https://doi.org/10.4069/kjwhn.2013.19.3.142
  29. Kim M. Stress, depression, and fetal attachment in pregnant women having infertility treatments. Korean J Women Health Nurs. 2014;20(2):163-172. https://doi.org/10.4069/kjwhn.2014.20.2.163
  30. Kim B, Sung MH. Impact of anxiety, social support, and taegyo practice on maternal-fetal attachment in pregnant women having an abortion. Korean J Women Health Nurs. 2019; 25(2):182-193. https://doi.org/10.4069/kjwhn.2019.25.2.182
  31. Lee SM, Park HJ. Relationship among emotional clarity, maternal identity, and fetal attachment in pregnant women with gestational diabetes mellitus. Korean J Women Health Nurs. 2017;23(2):99-108. https://doi.org/10.4069/kjwhn.2017.23.2.99
  32. STROBE. Strobe checklists: cross-sectional studies [Internet]. Switzerland: Author; 2022 [cited 2022 Dec 13]. Available from: https://www.strobe-statement.org/
  33. Cranley MS. Development of a tool for the measurement of maternal attachment during pregnancy. Nurs Res. 1981; 30(5):281-284. https://doi.org/10.1097/00006199-198109000-00008
  34. Kim GY. Effects on maternal-infant attachment by the taegyo perspective prenatal class [master's thesis]. Seoul: Yonsei University; 2000. 63 p.
  35. Choi YS, Kim HO. A survey on the practice of Taekyo among childbearing couples. J Korean Acad Women Health Nurs. 1995;1(2):153-173.
  36. Rosenberg M. Society and the adolescent self-image. Princeton (NJ): Princeton University Press; 1965. 326 p.
  37. Lee HJ, Won HT. Self-concepts and paranoid tendency. Psychol Sci. 1995;4(2):15-29.
  38. Park JW. Study to development a scale of social support [master's thesis]. Seoul: Yonsei University; 1985. 127 p.
  39. Song JM. The effect of social support on parents' perception of children's behavior in parenting stress situations [master's thesis]. Seoul: Sookmyung Women's University; 1992. 68 p.
  40. Lee EJ, Park JS. Development of a prediction model for postpartum depression: based on the mediation effect of antepartum depression. J Korean Acad Nurs. 2015;45(2):211-220. https://doi.org/10.4040/jkan.2015.45.2.211
  41. Park M, Lee S. Effects of an experience-focused prenatal program on stress, anxiety, childbirth confidence, and maternal-fetal attachment on women in their first pregnancy. Korean J Women Health Nurs. 2018;24(2):126-137. https://doi.org/10.4069/kjwhn.2018.24.2.126
  42. Park JG, Nam SW. The effect of prenatal exercise programs on the fetal attachment of pregnant women. Korean J Sport. 2016;14(4):57-66.
  43. Lee SH, Jung EJ. Factors influencing maternal-fetal attachment among advanced maternal age: anxiety, spousal support. AJMAHS. 2017;7(1):661-671. https://doi.org/10.35873/ajmahs.2017.7.1.059
  44. Kang SK, Chung MR. The relationship between pregnant woman's stress, temperament and maternal-fetal attachment. Korean J Hum Ecol. 2012;21(2):213-223. https://doi.org/10.5934/KJHE.2012.21.2.213
  45. Du L, Gu YB, Cui MQ, Li WX, Wang J, Zhu LP, et al. Investigation on demands for antenatal care services among 2 002 pregnant women during the epidemic of COVID-19 in Shanghai. Zhonghua Fu Chan Ke Za Zhi. 2020;55(3):160-165. https://doi.org/10.3760/cma.j.cn112141-20200218-00112
  46. Ghelichkhani S, Ghalandari L, Chavoshi Y, Momeni M, Moafi F. Evaluation of women's self-esteem during pregnancy and factors affecting it. Health Dev J. 2021;10(1):56-63. https://doi.org/10.22062/JHAD.2021.91586
  47. Jae HY, Chung IS, Jung SW. The mediating effects of the depression, anxiety on the relationship between temperament and character and maternal-fetal attachment in high-risk pregnant women. J Korean Soc Biol Ther Psychiatry. 2019; 25(2):127-137. https://doi.org/10.22802/jksbtp.2019.25.2
  48. Kim SN. Spirituality and self-esteem in middle-aged women. J Korean Acad Psychiatr Ment Health Nurs. 2013;22(2):128-136. https://doi.org/10.12934/jkpmhn.2013.22.2.128
  49. Oliveira DD, Mandu ET. Women with high-risk pregnancy: experiences and perceptions of needs and care. Esc Anna Nery Rev Enferm. 2015;19(1):93-101. https://doi.org/10.5935/1414-8145.20150013
  50. Chung MR, Kang SK, Lee HJ. The relationship between marital quality and parent-fetal attachment by pregnant couples. J Korean Home Econ Assoc. 2012;50(4):51-61. https://doi.org/10.6115/khea.2012.50.4.051
  51. Jo AR, Noh Y. Effects of pregnancy stress and social support on maternal-fetal attachment in pregnant women. Crisisonomy. 2022;18(4):161-172. https://doi.org/10.14251/crisisonomy.2022.18.4.161
  52. Heo JM, Kim MJ, Gim WS. The mediating effect of perceived stress in the relationships among mindfulness, self-compassion, and maternal-fetal attachment. Korean J Stress Res. 2017; 25(4):286-293. https://doi.org/10.17547/kjsr.2017.25.4.286
  53. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173-1182. https://doi.org/10.1037//0022-3514.51.6.1173