Factors effecting on health-promoting behaviors in iranian pregnant women and their husbands: the actor-partner interdependence model (APIM)

Abstract

IntroductionPregnancy is an important period of life for women and their husbands as the couple’s health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM).Materials and methodsThis descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier’s Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker’s Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM.ResultsThe pregnant women’s marital adjustment positively affected their health-promoting behaviors (β = 0.456, 95% Cl: 0.491–0.998, p < 0.001) and their husbands’ (β = 0.210, 95% Cl: 0.030–0.726, p = 0.048). Pregnant woman’s depressive symptoms also negatively affected their health-promoting behaviors (β=-0.088, 95% Cl: -0.974–0.074, P = 0.236) and their husbands’ health-promoting behaviors (β=-0.177, 95% Cl: -0.281 – -0.975, P = 0.011). Furthermore, the husband’s marital adjustment only positively affected his studied behaviors (β = 0.323, 95% Cl: 0.0303–0.895, P < 0.001) but did not affect the pregnant woman’s health behaviors. The husband’s depressive symptoms had a negative impact on his studied behaviors (β = 0.219, 95% Cl: -0.122 – -0.917, P = 0.001) and did not affect the pregnant woman’s depressive symptoms. Our findings confirmed the mediating role of depressive symptoms in pregnant women and their husbands on the association of marital adjustment and health-promoting behaviors. According to the actor-partner study, a pregnant woman’s marital adjustment scores positively affected her studied behaviors and her husband (β = 0.071, 95% Cl: 0.042–0.278, P = 0.015) by decreasing her depression score. Therefore, the husband’s marital adjustment score positively affected his studied behaviors by decreasing his depression score (β = 0.084, 95% Cl: -0.053 -0.292, P = 0.005), and it did not affect his wife’s health-promoting behaviors.Discussion and conclusionThese findings suggest healthcare providers, obstetricians, and psychologists evaluate the husbands’ symptoms of depression and health-promoting behaviors in the routine pregnancy care of pregnant women. They also pay great attention to marital adjustment as a determinant of reducing depressive symptoms in pregnant women and their husbands.