Effect of Korean medicine health promotion program for maternal health

Joo-Hee Seo; Eun-Young Ji; Hyun-Ji Lee; Min-Jeong Park; Seo, Joo-Hee; Ji, Eun-Young; Lee, Hyun-Ji; Park, Min-Jeong

doi:10.13048/jkm.19021

JKM > Volume 40(2); 2019 > Article

Seo, Ji, Lee, and Park: Effect of Korean medicine health promotion program for maternal health

Original Article

The Journal of Korean Medicine 2019; 40(2): 106-118.

Published online: June 30, 2019

DOI: https://doi.org/10.13048/jkm.19021

Effect of Korean medicine health promotion program for maternal health

Joo-Hee Seo¹^{, 2}

, Eun-Young Ji²

, Hyun-Ji Lee³

, Min-Jeong Park²^{, 4}

¹Department of Korean Neuropsychiatry, National Medical Center

²Korean Academy of Breastfeeding Medicine

³Korea Health Promotion Institute

⁴National Development Institute of Korean Medicine

Correspondence to: 박민정, 서울시 중구 퇴계로 173 남산스퀘어 빌딩 12 층 한약진흥재단, Tel: +82-2-3662-4558, Fax: +82-2-3662-6716, E-mail: mj.park@nikom.kr, mjimage@hanmail.net

Received September 5, 2018 Revised May 28, 2019 Accepted May 29, 2019

Abstract

Objectives

The aim of this study is to survey on the effect of Korean medicine health promotion program for maternal health.

Methods

We conducted Korean medicine health promotion program for maternal health to pregnant women who agreed to participate in this program among 10 public health center. Before and after program, we surveyed the Knowledge Score of Maternal Health Care, Practice of Health Behavior, (Traditional) Child Care Recognition, Depression, Child Caring Confidence and analyzed DID(Difference In Difference).

Results

The Knowledge Score of Maternal Health Care of intervention group was improved about 1 point. The improvement of (Traditional) Child Care Recognition was significant. Depression score of intervention group was improved high significantly. The Child Caring Confidence of intervention group was improved about 1.3 point.

Conclusion

As a result of analyzing the effect of Korean medicine health promotion program for maternal health, it is confirmed that this program can have an impact on improving Knowledge Score of Maternal Health Care, (Traditional) Child Care Recognition, Depression, Child Caring Confidence. It will be necessary to continue and develop this program widely.

Keywords: Pregnant, Korean medicine, Health promotion, Maternal health, Depression, Public health

Table 1

Korean Medicine Health Promotion Program for Maternal Health

Session	Subject	Contents	Duration of time
1	Maternity class (Health care during pregnancy)	- Caution and Living Tips during pregnancy (Food, Nutrients, Disease etc) - Create a community using SNS : Education for Pregnancy Depression and The Importance of Pregnant Women’s Social Support	60 minutes
2	Prenatal education class (Making Placenta Jar)	- The Meaning of prenatal education by Brain Science - Practice of making Placenta Jar(traditional umbilical cord storage ceramic)	120 minutes
3	Post-natal care class (Postnatal Health Management)	- Postpartum psychological and physical changes - Physical difference between Western pregnant women and Eastern pregnant women - Understanding of postpartum disease and Korean medicine - Guide for taking postpartum herbal medicine	60 minutes
4	Parenting Class (Naturalism neonatal care) (Husband participation available)	- Pregnant experience for husband(Understanding what it is like for a pregnant wife by wearing a fake pregnancy belly) - Breast Care - Neonatal care applied by traditional attachment theory (How to fasten Podaegi - Korean swaddling)	60 minutes

Table 2

Difference In Difference(DID) analysis overview

	Before policy intervention/pre	After policy intervention/post	Time lag (Program implementation status)
Korean medicine pregnant woman education program target person (treatment group)	B= μ+S	D= μ+S+T+E	T+E
Korean medicine pregnant women education program non-breacher (control group)	A= μ 1)	C= μ+T	T3)
Differences between groups	S2)	S+E	E4)

Remark :

1) μ = Before the program, ‘Knowledge score of pregnant women’s health management’, ‘traditional childcare recognition’, ‘evaluation of practice of health behavior’, ‘self-confidence in child caring’, ‘feeling after birth’

2) S = Group differences between intervention and control groups

3) T = Differences caused by the time lapse between before and after policy intervention

4) E = Pure policy effects of the maternal education program

Table 3

Comparison of General Characteristics of Target Groups

Variable	Treatment group (n=172)	Control group (n=227)	Remarks
Variable	continuous variable continuous variable Continuous Variable: Average±Standard Deviation Interval Variable: The Ratio		Remarks
Age	32.1±4.0	31.9±3.9	Pregnant woman full age
Education level	87.1%	88.1%	Ratio of university graduates
Participation in economic activities (worker)	20.7%	17.9%	Percentage of full-time and part-time workers
Household income	3.8±1.6	3.6±1.4	1(less than 1 million won per month)-5(more than 401 million won per month)
Number of pregnancy weeks	26.4±7.0	27.0±6.9	Current pregnancy week
Birth experience (childbirth experiencer)	22.8%	19.6%	Percentage of birth experience
Subjective health	2.1±1.6	2.2±1.9	1(Very healthy)-5(Very unhealthy)
Fetal health	1.5±1.6	1.7±1.9	1(Very healthy)-5(Very unhealthy)
Family type	100%	100%	Only couple or couple + for children(nuclear family)
Family cooperation	2.0±1.6	1.9±1.4	1(Very cooperative)-5(Very uncooperative)
Height	152.8±35.8	159.8±16.9	Pregnant woman’s current height
Weight	58.7±14.4	61.8±10.0	Pregnant woman’s current weight
Previous education experience	38.8%	30.8%	Previous education experience rate

Table 4

Program Effect (DID) for Knowledge Score of Maternal Health Care

			Regression coefficient (B)	Standard error (SE)	Significance (p-value)
Program effect (DID)			1.0574	0.2388	<.0001
Distribution of program effects (DDD)	Variable	(reference group)
	Age	(under 35 years)	−0.3349	0.1418	0.0182
	Education level	(less than high school graduate)	0.9462	0.1855	<.0001
	Economic activity	(housewife)	−0.3752	0.1548	0.0153
	Household income	(less than 3 million won per month)	0.2467	0.1247	0.0478
	Previous educational experience	(No educational experience)	0.7676	0.1268	<.0001
	Birth experience	(No birth experience)	−0.1743	0.1496	0.2441
	Subjective health status of pregnant women	(Below average)	0.0027	0.3601	0.9939
	Fetal health status	(Below average)	−0.1675	0.5558	0.7632
	Number of pregnancy weeks 1	(Midterm pregnancy)	0.4052	0.1830	0.0268
	Number of pregnancy weeks 2	(Late pregnancy)	0.3781	0.1878	0.0440
	Family cooperation	(Not cooperative)	−0.0684	0.1655	0.6795

Table 5

Program Effect (DID) for Practice of Health Behavior

			Regression coefficient (B)	Standard error (SE)	Significance (p-value)
Program effect (DID)			0.3178	0.4156	0.4444
Distribution of program effects (DDD)	Variable	(reference group)
	Age	(under 35 years)	0.4284	0.2469	0.0827
	Education level	(less than high school graduate)	0.9039	0.3243	0.0041
	Economic activity	(housewife)	−0.5831	0.2688	0.0301
	Household income	(less than 3 million won per month)	0.5370	0.2172	0.0134
	Previous educational experience	(No educational experience)	0.6020	0.2207	0.0064
	Birth experience	(No birth experience)	−0.2691	0.2599	0.3004
	Subjective health status of pregnant women	(Below average)	0.7682	0.6249	0.2189
	Fetal health status	(Below average)	−3.6637	0.9861	0.0002
	Number of pregnancy weeks 1	(Midterm pregnancy)	−0.2486	0.3189	0.4357
	Number of pregnancy weeks 2	(Late pregnancy)	−0.1413	0.3272	0.6659
	Family cooperation	(Not cooperative)	0.9138	0.2891	0.0016

Table 6

Program Effect (DID) for (Traditional) Child Care Recognition

			Regression coefficient (B)	Standard error (SE)	Significance (p-value)
Program effect (DID)			4.7696	0.7720	<.0001
Distribution of program effects (DDD)	Variable	(reference group)
	Age	(under 35 years)	−0.6178	0.4299	0.1507
	Education level	(less than high school graduate)	0.7780	0.5611	0.1656
	Economic activity	(housewife)	−0.0208	0.4677	0.9645
	Household income	(less than 3 million won per month)	0.5538	0.3771	0.1419
	Previous educational experience	(No educational experience)	1.1851	0.3829	0.0020
	Birth experience	(No birth experience)	1.3094	0.4524	0.0038
	Subjective health status of pregnant women	(Below average)	0.1162	1.0838	0.9146
	Fetal health status	(Below average)	−3.5753	1.6724	0.0325
	Number of pregnancy weeks 1	(Midterm pregnancy)	0.9402	0.5509	0.0879
	Number of pregnancy weeks 2	(Late pregnancy)	1.1041	0.5653	0.0508
	Family cooperation	(Not cooperative)	2.1512	0.4997	<.0001

Table 7

Program Effect (DID) for Depression

			Regression coefficient (B)	Standard error (SE)	Significance (p-value)
Program effect (DID)			4.5292	1.8829	0.0162
Distribution of program effects (DDD)	Variable	(reference group)
	Age	(under 35 years)	1.5515	1.1175	0.1650
	Education level	(less than high school graduate)	2.4106	1.4667	0.1003
	Economic activity	(housewife)	−0.7401	1.2180	0.5434
	Household income	(less than 3 million won per month)	3.4281	0.9833	0.0005
	Previous educational experience	(No educational experience)	2.3186	0.9997	0.0204
	Birth experience	(No birth experience)	−1.6600	1.1815	0.1600
	Subjective health status of pregnant women	(Below average)	1.6597	2.8323	0.5579
	Fetal health status	(Below average)	−7.1257	4.3727	0.1032
	Number of pregnancy weeks 1	(Midterm pregnancy)	1.8906	1.4399	0.1892
	Number of pregnancy weeks 2	(Late pregnancy)	−0.3467	1.4777	0.8145
	Family cooperation	(Not cooperative)	5.0675	103080	0.0001

Table 8

Program Effect (DID) for Child Caring Confidence

			Regression coefficient (B)	Standard error (SE)	Significance (p-value)
Program effect (DID)			1.3434	0.5900	0.0228
Distribution of program effects (DDD)	Variable	(reference group)
	Age	(under 35 years)	0.3927	0.3498	0.2616
	Education level	(less than high school graduate)	0.5197	0.4591	0.2577
	Economic activity	(housewife)	−0.5264	0.3815	0.1677
	Household income	(less than 3 million won per month)	−0.0177	0.3082	0.9542
	Previous educational experience	(No educational experience)	0.8490	0.3133	0.0067
	Birth experience	(No birth experience)	1.9494	0.3698	<.0001
	Subjective health status of pregnant women	(Below average)	−0.6378	0.8864	0.4718
	Fetal health status	(Below average)	−1.8447	1.3685	0.1777
	Number of pregnancy weeks 1	(Midterm pregnancy)	−0.8214	0.4506	0.0683
	Number of pregnancy weeks 2	(Late pregnancy)	−0.9216	0.4631	0.0466
	Family cooperation	(Not cooperative)	0.8164	0.4095	0.0462

Table 9

Comprehensive Evaluation of Adjusted value

Variable	Before program implementation				After program implementation
	Treatment group		Control group		Treatment group		Control group
	average	Standard deviation	average	Standard deviation	average	Standard deviation	average	Standard deviation
Knowledge Score of Maternal Health Care	9.8	1.7	9.6	1.6	11.0	1.6	9.7	1.5
Practice of Health Behavior	32.0	3.0	32.2	2.6	32.7	2.6	32.5	2.7
(Traditional) Child Care Recognition	31.5	5.5	30.4	3.8	36.7	5.2	31.0	3.9
Depression	79.4	12.2	79.8	10.2	80.7	10.2	76.7	16.6
Child Caring Confidence	23.2	4.0	23.0	3.9	25.1	4.2	23.6	3.6

참고문헌

1. Chang DM. Current Status and Policy Recommendations of Oriental Public Health Programs. Kor J Oriental Preventive Medical Society. 2007; 11:2. 101–112.

2. 보건복지부·한국건강증진개발원. 2013 지역사회통합건강증진사업 안내. 2013.

3. 이수진 , 한은경 , 이현지 . 지역사회 한의약건강증진사업을 통한 공공보건의료 역할 강화. 한의정책. 2016; 4:1. 40–52.

4. Kim YR. Depression during Pregnancy and the Postpartum. Korean J Psychosomatic Medicine. 2007; 15:1. 22–28.

5. Joen KG. Development of Korean Version of CES-D. In : Korean psychology 92 annual conference academic presentation paper collection; p. 437–445.

6. Lurie IZ. Differential effect of the state children’s health insurance program expansions by children’s age. Health Services Research. 2009; 44:5. 1504–1520.

7. Ministry of Health & Wellfare. Direction for Korean Medicine Health Promotion Program in 2013. Ministry of Health & Wellfare;2012.

8. 이선동 . 한의약건강증진프로그램 개발 및 지역사회 연계방안 연구. 대한한의학회. 보건복지부;2014. 11. 28.

9. Lederman RP, Weigarten CG. Postpartum self evaluation questionnaire:Measures of Maternal Adaptation. Birth Defects Original Article Series. 1981; 22:6. 201–231.

10. Bae GM, Cho HS, Lee IS. The Review of Postpartum Care Beliefs and Practices.

11. According to the Cultures. The journal of oriental obstetrics & gynecology. 2009; 22:1. 231–242.

12. Bae GM, Cho HS, Lee SH, Lee IS. Literature analysis with the recent trend of researches concerning the postpartum depression and Sanhupung. The journal of oriental obstetrics & gynecology. 2009; 22:2. 172–188.

13. Cooper PJ, Campbell EA, Day A, Kennerley H, Bond A. Non-psychotic psychiatric after childbirth-a prospective study of prevalence, incidence, course and nature. British Journal of Psychiatry. 1988; 152:6. 799–806.

14. Graff LA, Dyck DG, Schaloow JR. Predicting postpartum depressive symptoms-a structural modelling analysis. Percept Mot Shills. 1991; 73:1137–1138.