非住院高危險妊娠孕產婦使用行動健康APP對孕期不確定感、孕期壓力及早產徵象監測之成效-以某醫學中心婦產科門診為例

Abstract

研究動機與目的：高危險妊娠孕產婦常因早產風險而面臨高度的不確定感與壓力，加上非住院期間缺乏即時專業資訊與提醒機制，增加孕期焦慮與健康管理困難。因此，本研究旨在探討一款結合衛教內容與早產徵象提醒功能的行動健康APP「好孕媽咪」，是否能有效降低非住院高危險妊娠孕產婦的孕期不確定感、壓力與威脅感受，並提升其早產徵象自我監測行為。研究方法與設計：本研究採準實驗設計，於北部一醫學中心婦產科門診招募63位懷孕週數16-22週之非住院高危險妊娠孕產婦，依日序隨機分派為實驗組（n=32）與對照組（n=31），最終有效樣本為各28位。研究工具包含結構式問卷（含三量表）、早產徵象監測紀錄卡與、APP滿意度調查。實驗組另提供APP下載、操作指導與彈跳提示功能，介入期依個案納入週數為4至12週不等。結果與結論：結果顯示，實驗組孕產婦之整體不確定感由前測34.84降至後測26.04，達顯著差異 (p=0.016），顯示APP能有效降低孕期不確定感；壓力及威脅感整體雖呈現下降趨勢，惟未達統計顯著水準。早產徵象監測方面，實驗組完成監測者達50%，顯著高於對照組之7% （p=0.001），得知APP內建之彈跳提示功能對提升行為依從性具明確效益。此外，APP使用者整體滿意度亦達九成以上。整體而言，「好孕媽咪APP」在降低不確定感與提升監測依從性方面具實質助益，未來可擴展應用於高風險孕產婦照護模式。Background and Purpose: High-risk pregnant women often face significant uncertainty and stress due to the risk of preterm birth. During non-hospitalized periods, the lack of timely professional information and reminder mechanisms can further increase anxiety and hinder effective health management. This study aimed to evaluate the effectiveness of the"Good Pregnancy Mama" mobile health (mHealth) application, which integrates educational content and preterm labor symptom reminders, in reducing uncertainty, stress, and perceived threat during pregnancy, as well as improving self-monitoring behavior for signs of preterm labor among non-hospitalized high-risk pregnant women. Methods and Design: This quasi-experimental study recruited 63 non-hospitalized high-risk pregnant women at 16 to 22 weeks gestation from the obstetrics outpatient department of a medical center in northern Taiwan. Participants were randomly assigned by date into an experimental group (n=32) or a control group (n=31), with 28 valid samples retained in each group. Research instruments included structured questionnaires (comprising three scales), a preterm labor symptom monitoring card, and an APP satisfaction survey. The experimental group was provided with APP installation, user instruction, and weekly reminder functions. The intervention period ranged from 4 to 12 weeks, depending on the gestational week at enrollment.Results and Conclusions: The experimental group's overall pregnancy uncertainty score significantly decreased from 34.84 (pre-test) to 26.04 (post-test) (p=0.016), indicating that the APP effectively reduced uncertainty during pregnancy. While stress and perceived threat also declined, the differences were not statistically significant. Regarding preterm symptom monitoring, 50% of participants in the experimental group completed full monitoring, significantly higher than 7% in the control group (p=0.001), demonstrating the effectiveness of the APP's built-in reminder function in enhancing behavioral adherence. In addition, over 90% of users reported high satisfaction with the APP. In summary, the “Good Pregnancy Mama” mHealth app demonstrated substantial benefits in reducing uncertainty and improving monitoring compliance, with promising potential for application in the care of high-risk pregnant populations.