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研究生: 張仲瑋
Chang, Chung-Wei
論文名稱: 以e化健康照護系統提供周產期婦女自我管理
Utilizing e-Healthcare Systems to Empower Women to Self-management during the Perinatal Period
指導教授: 侯廷偉
Hou, Ting-Wei
共同指導教授: 許玉雲
Hsu, Yu-Yun
學位類別: 博士
Doctor
系所名稱: 工學院 - 工程科學系
Department of Engineering Science
論文出版年: 2023
畢業學年度: 112
語文別: 英文
論文頁數: 90
中文關鍵詞: 孕期照護產後照護妊娠高血壓智慧醫療跨平臺行動裝置
外文關鍵詞: Maternity Care, Postpartum Care, Hypertension Disorders of Pregnancy, eHealth, Multi-platform, Mobile devices
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  • 本研究主要是研發一個孕期健康管理系統,可以幫忙懷孕婦女不只在懷孕期間,甚至在產後均可提供完善的照顧,使媽媽們能掌握自己及嬰兒的健康。高品質的護理照顧對懷孕婦女來說是很重要的,在專業護理師們及研發人員討論下,本研究設計出一個不只是網站系統還可在手機執行的孕期健康管理系統。
    本系統依懷孕時間可分成四大系統,第一個是產前健康管理系統,功能有孕婦的基本資料管理、孕期產檢記錄、孕婦自我健康管理記錄及衛教指導資訊,第二個是孕婦體重管理系統,功能有利用估計的方法計算出食物的熱量卡路里、孕婦體重的正常曲線範圍及健康專區包含飲食指南等,第三個是訓練拉梅茲呼吸法的工具,功能分別為文字說明拉梅茲呼吸指引、影片解說各階段操作方法、自我練習導引,可透過即時反應呼吸的波形曲線來加強練習及修正及每次的使用紀錄,最後一個是產後妊娠高血壓健康管理系統,功能有自我健康管理記錄,包含血壓、脈搏、體重、用藥紀錄等,再來是適合產後運動的教學影片,還有智慧聊天室,一些常見的問與答及衛教資訊均已建置於系統中。護理師可透過這系統的後台管理介面追踪孕婦的健康狀況,一旦健康監測值超出正常範圍,護理師會直接與孕婦聯繫,確保該婦女的健康是安全無虞的。
    本研究在系統建置完成後,以問卷調查的方式進行系統滿意度評估。結果顯示,大部份的使用者對整體系統感到滿意並認為本系統對於孕期前後的健康照護有所幫助。

    This study aimed to develop a comprehensive pregnancy health management system to assist pregnant women throughout their pregnancy and postpartum phases. It collaborated with professional nurses and researchers to create a web-based and mobile phone-executable pregnancy health management system.
    The system was structured into four main components, each corresponding to a specific stage of pregnancy. The first component, the Prenatal Health Management System, encompassed various features such as managing the pregnant woman's basic information, recording maternity checkups, documenting self-health management, and offering health education guidance. The second component, the Maternal Weight Management System, included functionalities like estimating calorie intake from food, establishing a normal weight range curve, and providing dietary guidance. The third component was a tool for training Lamaze Breathing techniques. This tool explained Lamaze Breathing Guidelines through text and demonstrated each stage's operation via video. Records of practice sessions were maintained as well. The final component, the Postpartum Hypertension Health Management System, enabled self-health management recording, covering parameters like blood pressure, pulse, weight, and medication. Additionally, the system featured instructional postpartum exercise videos and a smart chat room. Nurses could monitor pregnant women's health through the system's backend management interface.
    To evaluate the system's effectiveness, a questionnaire survey was conducted after system implementation. Users expressed high satisfaction with the system's capabilities, underscoring its utility in maternal health management.

    摘要 I Abstract II 誌謝 III Contents IV List of Tables VI List of Figures VII List of Abbreviations IX Chapter 1 Introduction 1 1.1 Background 1 1.2 Motivation 3 1.3 Approach 4 Chapter 2 Related works 7 2.1 Previous works 7 2.2 Related research 8 2.3 Mobile Website Programming Language 10 2.3.1 HTML5 10 2.3.2 jQuery 11 2.3.3 PHP 12 Chapter 3 System design 13 3.1 Agile Software Development 13 3.2 Progressive Web App 15 3.3 System Architecture 17 3.4 Use Case Diagram 18 3.5 System Exchange Process 19 3.6 PregnantMomCare System 20 3.6.1 PrenatalCare System 21 3.6.2 MomweightCare System 22 3.6.3 SPBIL App 22 3.6.4 PostpartumCare System 23 Chapter 4 Implementation 24 4.1 PrenatalCare System 24 4.2 MomweightCare System 28 4.3 SPBIL App 32 4.4 PostpartumCare System 34 4.5 Evaluation 42 4.6 Discussion 55 Chapter 5 Conclusion 60 5.1 Conclusion 60 5.2 Future work 60 References 62 附錄A 產前自我照護資訊管理系統評估調查問卷 70 附錄B 孕產期體重及飲食管理系統評估調查問卷 72 附錄C 拉梅茲呼吸方法應用程式評估調查問卷 74 附錄D 產後高血壓健康管理系統評估調查問卷 76

    [1] F. Fatehi, R. Wootton, Telemedicine, “telehealth or e-health? A bibliometric analysis of the trends in the use of these terms”, J. Telemed. Telecare. vol.18, pp. 460–464,2012. doi:10.1258/jtt.2012.GTH108.
    [2] World Health Organization (WHO), “Global diffusion of eHealth: Making universal health coverage achievable,” 2016, Available: http://who.int/goe/publications/global_diffusion/en/.
    [3] R. Fletcher, G. Vimpani, G. Russell, and D. Keatinge, “The evaluation of tailored and web-based information for new fathers,” Child: Care, Health and Development, vol. 34, no. 4. pp. 439–446, 2008, doi: 10.1111/j.1365-2214.2008.00811.x.
    [4] S. P. Rowland, J. E. Fitzgerald, T. Holme, J. Powell, and A. McGregor, “What is the clinical value of mHealth for patients?,” npj Digit. Med., vol. 3, no. 1, pp. 1–6, 2020, doi: 10.1038/s41746-019-0206-x.
    [5] WHO, UNICEF UNFPA, and WORLD BANK GROUP and UNDESA/Population Division, “Trends in maternal mortality 2000 to 2020: estimates, ” 2023.
    [6] Salomonsson B, Gullberg MT, Alehagen S, Wijma K. “Self-efficacy beliefs and fear of childbirth in nulliparous women,” J Psychosom Obstet Gyneco,34(3),116-121, 2013.
    [7] Sercekus P, Baskale H. “Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment,” Midwifery, 34,166-172, 2016.
    [8] G. Latendresse, “The Interaction Between Chronic Stress and Pregnancy: Preterm Birth from A Biobehavioral Perspective,” J. Midwifery Women’s Heal., vol. 54, no. 1, pp. 8–17, 2009, doi: 10.1016/j.jmwh.2008.08.001.
    [9] Health Promotion Administration, Ministry of Health and Welfare (Taiwan), Maternal Health Booklet, July. 2020.
    [10] M.Hong et al., “Weight gain rate in the second and third trimesters and fetal growth in women with gestational diabetes mellitus: a retrospective cohort study,” BMC Pregnancy Childbirth, vol. 22, no. 1, pp. 1–10, 2022, doi: 10.1186/s12884-022-04762-4.
    [11] J Han, G Ohaegbulam, F Yan, M Lindsay, FH Geary and R Lee, “Gestational Weight Gain in Patients With Obesity and Diabetes A Comparison of 2009 Institute of Medicine Versus 2019 JAMA Recommendations [A270],” Obstetrics & Gynecology, Volume 139, Supplement 1, pp. 78S-78S(1), 2022, doi: 10.1097/01.AOG.0000825640.83284.87.
    [12] Institute of Medicine (US), National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines, Weight Gain During Pregnancy: Reexamining the Guidelines - PubMed - NCBI, 2009. Available: https://www.ncbi.nlm.nih.gov/pubmed/20669500. Accessed Oct 5, 2020.
    [13] Fenwick, J., Gamble, J., Nathan, E., Bayes, S., & Hauck, Y., "Pre-and postpartum levels of childbirth fear and the relationship to birth out come in a cohort of Australian women," Journal of Clinical Nursing,18(5), 667-677, 2009.
    [14] Y.Deng et al., “A comparison of maternal fear of childbirth, labor pain intensity and intrapartum analgesic consumption between primiparas and multiparas: A cross-sectional study,” Int. J. Nurs. Sci., vol. 8, no. 4, pp. 380–387, 2021, doi: 10.1016/j.ijnss.2021.09.003.
    [15] D. Bick, S. A. Silverio, A. Bye, and Y. S. Chang, “Postnatal care following hypertensive disorders of pregnancy: a qualitative study of views and experiences of primary and secondary care clinicians,” BMJ Open, vol. 10, no. 1, 2020, doi: 10.1136/bmjopen-2019-034382.
    [16] J. A.Hutcheon, S.Lisonkova, andK. S.Joseph, “Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy,” Best Pract. Res. Clin. Obstet. Gynaecol., vol. 25, no. 4, pp. 391–403, 2011, doi: 10.1016/j.bpobgyn.2011.01.006.
    [17] Brown MA, Magee LA, Kenny LC, et al. “Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice, ” Hypertension, 72(1),24-43, 2018, doi:10.1161/HYPERTENSIONAHA.117.10803.
    [18] M. D. Lindheimer, S. J. Taler, and F. G. Cunningham, “Hypertension in pregnancy,” J. Am. Soc. Hypertens., vol. 4, no. 2, pp. 68–78, 2010, doi: 10.1016/j.jash.2010.03.002.
    [19] Cunningham, e.a., “Pregnancy hypertension,” In Willams obstetrics, 23 Edition. p.706-756, 2010.
    [20] L.Magee and P.vonDadelszen, “Prevention and treatment of postpartum hypertension,” Cochrane Database Syst. Rev., vol. 2013, no. 4, 2013, doi: 10.1002/14651858.CD004351.pub3.
    [21] A. B. Geremew, M. M. Boke, and A. E. Yismaw, “The Effect of Antenatal Care Service Utilization on Postnatal Care Service Utilization: A Systematic Review and Meta-analysis Study,” J. Pregnancy, vol. 2020, 2020, doi: 10.1155/2020/7363242.
    [22] M. M. Islam andM. S. Masud, “Determinants of frequency and contents of antenatal care visits in Bangladesh: Assessing the extent of compliance with the WHO recommendations,” PLoS One, vol. 13, no. 9, pp. 1–22, 2018, doi: 10.1371/journal.pone.0204752.
    [23] J. Rivera et al., “Mobile apps for weight management: A scoping review,” JMIR mHealth uHealth, vol. 4, no. 3, pp. 1–9, 2016, doi: 10.2196/mhealth.5115.
    [24] S. L. Holzmann and C. Holzapfel, “A scientific overview of smartphone applications and electronic devices for weight management in adults,” J. Pers. Med., vol. 9, no. 2, 2019, doi: 10.3390/jpm9020031.
    [25] A. Jhala, “A Study to Assess the Effectiveness of Lamaze Breathing on Labor Pain and Anxiety Towards Labor Outcome among Primigravida Mothers During Labor in Community Health Center, Kolar Road, Bhopal (M.P.),” Indian J. Obstet. Gynecol., vol. 5, no. 1, pp. 19–22, 2017, doi: 10.21088/ijog.2321.1636.5117.2.
    [26] Cheng C-Y, Fowles ER, Walker LO. “Postpartum Maternal Health Care in the United States: A Critical Review,” J Perinat Educ,15(3),34-42, 2006. doi:10.1624/105812406x119002.
    [27] World Health Organization (WHO), “Postnatal care of the mother and newborn 2013,” World Heal. Organ., pp. 1–72, 2013, [Online]. Available: http://apps.who.int/iris/bitstream/10665/97603/1/9789241506649_eng.pdf.
    [28] Ann C. Celi, Ellen W. Seely, Penny Wang, Ann M. Thomas & Louise E. Wilkins-Haug. “Caring for Women After Hypertensive Pregnancies and Beyond: Implementation and Integration of a Postpartum Transition Clinic,” Maternal and Child Health Journal, vol. 23, pp. 1459-1466, 2019.
    [29] J.Vora, P.Devmurari, S.Tanwar, S.Tyagi, N.Kumar, andM. S.Obaidat, “Blind signatures based secured E-healthcare system,” CITS 2018 - 2018 Int. Conf. Comput. Inf. Telecommun. Syst., no. Cc, pp. 1–5, 2018, doi: 10.1109/CITS.2018.8440186.
    [30] Z. Jin and Y. Chen, “Telemedicine in the cloud era: Prospects and challenges,” IEEE Pervasive Comput., vol. 14, no. 1, pp. 54–61, 2015, doi: 10.1109/MPRV.2015.19.
    [31] R. Kraft et al., “ESano - An eHealth Platform for Internet- and Mobile-based Interventions,” Proc. Annu. Int. Conf. IEEE Eng. Med. Biol. Soc. EMBS, pp. 1997–2002, 2021, doi: 10.1109/EMBC46164.2021.9629534.
    [32] F. Bert et al., “Pregnancy e-health: A multicenter Italian cross-sectional study on internet use and decision-making among pregnant women,” J. Epidemiol. Community Health, vol. 67, no. 12, pp. 1013–1018, 2013, doi: 10.1136/jech-2013-202584.
    [33] A. Munandar, A. Setyanto, S. Raharjo, and G. Wicahyono, “Pregnancy mapping and monitoring web based geographic’s information system,” 2019 4th Int. Conf. Inf. Technol. Inf. Syst. Electr. Eng. ICITISEE 2019, vol. 6, pp. 490–494, 2019, doi: 10.1109/ICITISEE48480.2019.9003916.
    [34] G. Eysenbach, “What is E-health?,” Journal of Medical Internet Research, vol. 3, 2001. Available at http://www.jmir.org/2001/2/e20. Accessed June 25, 2020.
    [35] M. Schrepp and J. Thomaschewski, “Design and Validation of a Framework for the Creation of User Experience Questionnaires,” Int. J. Interact. Multimed. Artif. Intell., vol. 5, no. 7, pp. 88–95, 2019, doi: 10.9781/ijimai.2019.06.006.
    [36] I. Kurniawan, “The Effect Of The Information System Quality, Service Quality, And User Satisfaction On Academic Information System User Loyalty,” Lume, vol. 10, no. 05, p. 5, 2021, [Online]. Available: www.ijstr.org.
    [37] S. A. Onashoga, A. S. Sodiya, T. O. Omilani, and H. O. Ajisegiri, “A mobile phone-based antenatal care support system,” Proc. - ICSEng 2011 Int. Conf. Syst. Eng., pp. 410–415, 2011, doi: 10.1109/ICSEng.2011.81.
    [38] J. Tang, C. Abraham, E. Stamp, C. Greaves, “How can weight-loss app designers’ best engage and support users? A qualitative investigation,” Br. J. Health Psychol, 20,151–171, 2015. doi:10.1111/bjhp.12114.
    [39] K. S. Gibson, T.P. Waters, P.M. Catalano, “Maternal weight gain in women who develop gestational diabetes mellitus, ” Obstet. Gynecol, 119(3), 560–565, 2012. doi:10.1097/AOG.0b013e31824758e0.
    [40] A. Rhodes, A. D. Smith, P. Chadwick, H. Croker, and C. H. Llewellyn, “Exclusively digital health interventions targeting diet, physical activity, and weight gain in pregnant women: Systematic review and meta-analysis,” JMIR mHealth uHealth, vol. 8, no. 7, 2020, doi: 10.2196/18255.
    [41] Lothian, J. A., “Lamaze Breathing What Every Pregnant Woman Needs to Know,” The Journal of Perinatal Education, 20(2),118-120, 2011, doi:10.1891/1058-1243.20.2.118.
    [42] C. Wu et al., “The combined effects of Lamaze breathing training and nursing intervention on the delivery in primipara A PRISMA systematic review meta-analysis,” Med. (United States), vol. 100, no. 4, pp. 1–8, 2021, doi: 10.1097/MD.0000000000023920.
    [43] Lazdam M, de la Horra A, Diesch J, Kenworthy Y, Davis E, Lewandowski AJ,
    Szmigielski C, Shore A, Mackillop L, Kharbanda R, et al, “Unique blood pressure characteristics in mother and offspring after early onset preeclampsia,” Hypertension,
    2012;60:1338–1345. doi: 10.1161/HYPERTENSIONAHA.112.198366.
    [44] McManus RJ, Mant J, Bray EP, Holder R, Jones MI, Greenfield S, Kaambwa B, Banting M, Bryan S, Little P, Williams B, Hobbs FD, “Telemonitoring and self-management in the control of hypertension (TASMINH2): a randomised controlled trial,” Lancet, 2010;376:163–172.
    doi: 10.1016/S0140-6736(10)60964-6.
    [45] McManus RJ, Mant J, Haque MS, et al, “Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease: the TASMIN-SR randomized clinical trial, ” JAMA. 2014;312:799–808.
    doi: 10.1001/jama.2014.10057.
    [46] National Institute for Clinical Excellence (NICE), “Clinical Guideline 107 (CG107),” 2011. https://www.nice.org.uk/guidance/cg107.
    [45] T. Krishnamurti, A. L. Davis, G. Wong-Parodi, B. Fischhoff, Y. Sadovsky, and H. N. Simhan, “Development and testing of the myhealthypregnancy app: A behavioral decision research-based tool for assessing and communicating pregnancy risk,” JMIR mHealth uHealth, vol. 5, no. 4, pp. 1–11, 2017, doi: 10.2196/mhealth.7036.
    [46] N. D. Valakunde et al., “Smart ASHA pregnancy monitoring system,” 2017 Int. Conf. Big Data, IoT Data Sci. BID 2017, vol. 2018-Janua, pp. 185–192, 2018, doi:10.1109/BID.2017.8336596.
    [47] J. Kitt et al., “Postpartum blood pressure self-management following hypertensive pregnancy: Protocol of the Physician Optimised Postpartum Hypertension Treatment (POP-HT) trial,” BMJ Open, vol. 12, no. 2, 2022, doi: 10.1136/bmjopen-2021-051180.
    [48] A. E. Cairns, K. L. Tucker, C. Crawford, R. J. McManus, and J. Powell, “Implementing self-management: A mixed methods study of women’s experiences of a postpartum hypertension intervention (SNAP-HT),” Trials, vol. 21, no. 1, pp. 1–13, 2020, doi: 10.1186/s13063-020-04394-z.
    [49] HTML5, Available at https://html.spec.whatwg.org/, Accessed Nov 4, 2020.
    [50] jQuery, Available at https://jquery.com/, Accessed Nov 4, 2020.
    [51] PHP, Available at https://www.php.net/, Accessed Nov 4, 2020.
    [52] M. Lindvall et al., “Agile software development in large organizations,” Computer (Long. Beach. Calif)., vol. 37, no. 12, pp. 26–34, 2004, doi: 10.1109/MC.2004.231.
    [53] S. I. Adam and S. Andolo, “A New PHP Web Application Development Framework Based on MVC Architectural Pattern and Ajax Technology,” 2019 1st Int. Conf. Cybern. Intell. Syst. ICORIS 2019, vol. 1, no. August, pp. 45–50, 2019, doi: 10.1109/ICORIS.2019.8874912.
    [54] Douglas Crockford, "Introducing JSON," Available at http://www.json.org/, Accessed Nov 4, 2020.
    [55] jQuery Mobile, Available at https://jquerymobile.com/, Accessed Nov 4, 2020.
    [56] Highcharts, Available at https://www.highcharts.com/, Accessed Nov 4, 2020.
    [57] Mei-ling Gao, e.a., “Practical Obstetric & Gynecologic Nursing,” Farseeing Publishing Co., 9 Edition. p.482-484, 2021.
    [58] T.W.M., The Research Methods Knowledge Base, 2nd ed., http://www.socialresearchmethods.net/kb/scallik.php, Accessed Nov 12, 2021.

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