Effect of Educational Package on Primiparous Mother's Postpartum Lifestyle: A Randomized Controlled Trial.

Abstract

Abstract: Background: Having a healthy lifestyle have a special significance in the postpartum period (A healthy lifestyle is important in the postpartum period) and proper lifestyle education can play an important role in promoting health of mother and her Child. This research aimed to determine the effect of educational package on nulliparous mother's lifestyle during postpartum period. Method: This randomized clinical trial was carried out on 220 nulliparous mothers in the postpartum ward. The subjects were allocated into Education group (112 mothers) and control group (108 mothers) using block randomization method. Intervention group received face to face education, telephone counseling, booklets and educational SMS (for fathers and mothers) and control group received postpartum ward's routine educations. Data was collected in Hospital discharge day, second and sixth weeks of postpartum by using questionnaires of socio- demographic, knowledge and belief questionnaire, health –related behaviors questionnaire, Food frequency questionnaire (FFQ), short form of International physical activity questionnaire (IPAQ) and postpartum health problems checklist. The descriptive and analytical statistics including Chi –square test, independent t –test, Fisher's exact test, Chi –square test for trend, the general linear model, logistic regression (binary logistic regression), Mann –Whitney U were used for data analysis. Findings: There were no significant statistic differences in terms of demographic characteristics (except for woman's education, husband's education and job), pre –intervention lifestyle knowledge and belief scores and also frequency of health problems during pregnancy between two groups. Six weeks after childbirth, there were no significant differences between two groups in terms of physical activity status (p=0.121) and nutrition, except for milk and dairy products consumption that mothers in educational group had more consumption compared to control group (p=0.041). Furthermore, education could significantly improve some health behaviors of nulliparous mother's in educational group, including first day of brushing start, located under direct sunlight, room's air condition, number of rooms air conditioning (during the first 2 weeks), keeping warm, how to do the job and taking the iron tablet compared to the control group. With adjusting woman's education, husband's education and job variables and pre –intervention knowledge and belief score, post intervention differences of knowledge and belief score between two groups was significant (p<0.001). The mean scores of knowledge {adjusted mean difference (Confidence Interval 95%): 17.2(14.3 to 20.2)} among the intervention group was significantly higher than those in control group. Also, lifestyle education could decrease the changes of constipation, hemorrhoids, Anal fissure, abdominal pain, headache, sutures pain and infection, sleep problems during the second weeks of postpartum more of 50% among educational group in comparison with the control group, and also during the sixth weeks of postpartum lifestyle education could decrease the chances of constipation, hemorrhoids, Anal fissure, cold and fever, Backache, fatigue or weakness and sadness and discomfort and vaginal infection during the sixth weeks of postpartum more of 50% among educational group in comparison with the control group. Conclusion: The results of the study indicate that lifestyle education could have a positive impact on improving the knowledge and belief regarding postpartum healthy lifestyle, health –related behaviors as no impact in improving the physical activity and nutritional status of nulliparous mothers.