Comparison of pregnant women from public and private health care: a psychological approach

Meireles, Juliana Fernandes Filgueiras; Neves, Clara Mockdece; Nacif, Marcella Fernandes Paticcié; Carvalho, Pedro Henrique Berbert de; Ferreira, Maria Elisa Caputo

doi:10.1590/1806-93042019000100005

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Revista Brasileira de Saúde Materno Infantil

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 19 (1) • Jan-Mar 2019 • https://doi.org/10.1590/1806-93042019000100005 copy

Comparison of pregnant women from public and private health care: a psychological approach

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to compare sociodemographic, anthropometric and psychological factors in pregnant women receiving public and private health care, as well as verify the influence of eating attitudes, depressive symptoms, self-esteem and anxiety on body attitudes in both sectors.

Methods:

this study included 386 pregnant women aged 18-46 (mean of 29.32 ± 6.04 years). Instruments were applied to evaluate body attitudes, eating attitudes, depressive symptoms, self-esteem and anxiety. Anthropometric and obstetric data were collected. Descriptive, comparative and correlational analyses were performed.

Results:

troubled sociodemographic characteristics, negative body attitudes, inappropriate eating attitudes, depressive symptoms, low self-esteem, and high levels of trait and state anxiety were significantly higher among participants receiving public health care (p<0.05). Eating attitudes and self-esteem directly influenced the body attitudes of those receiving public health care (R² adjusted=0.336, p<0.001) and private health care (R² adjusted=0.324, p<0.001).

Conclusions:

it was concluded that the sociodemographic, anthropometric, and psychological factors were more worrying in pregnant women receiving care in the public sector when compared to those of the private sector.

Key words
Body image; Pregnancy; Mental health; Public health

	Public Sector		Private Sector		χ² (df)	p
	(n=198)		(n=188)
Level of schooling^a a difference found among all the categories;					162.761 (2)	<0.001^* * p<0.05.
Elementary school	74	37.4	6	3.2
High school	108	54.5	54	28.7
Higher education/Graduate level	16	8.1	128	68.1
Marital status^b b difference between the categories single and married/lives with a partner;					37.676 (2)	<0.001^* * p<0.05.
Single	69	34.8	17	9.0
Married/Lives with the parter	126	63.6	169	89.9
Divorced/widow	3	1.6	2	1.1
Number of children					81.185 (1)	<0.001^* * p<0.05.
Primigravida	61	30.8	144	76.6
Multigravida	137	69.2	44	23.4
Relationship with the baby's father					18.769 (1)	<0.001^* * p<0.05.
Good	174	87.9	186	98.9
Poor	24	12.1	2	1.1
Family support^c c performing the test was not possible because of the rule that none of the cells can be equal 0;					-	-
Yes	184	92.9	188	100.0
No	14	7.1	0	-
Pregnancy planning					4.698 (1)	<0.001^* * p<0.05.
Yes	75	37.9	137	72.9
No	123	62.1	51	27.1
Possibility of abortion					6.957 (1)	0.008^* * p<0.05.
Yes	16	8.1	4	2.1
No	182	91.9	184	97.9
Socioeconomic level^d d difference between B and C.					139.00 (3)	<0.001^* * p<0.05.
A	1	0.5	17	9.0
B	40	20.2	133	70.7
C	129	65.2	36	19.2
D/E	28	14.1	2	1.1

Statistics	Public Sector	Private Sector	T	p	D-Cohen
	X̅ ± SD	X̅ ± SD
Age (years)	28.10 ± 6.67	30.61 ± 5.01	-4.193	<0.001^* * significant for p<0.05.	0.42
BMI (kg/m²)	28.32 ± 6.60	25.93 ± 6.70	3.532	<0.001^* * significant for p<0.05.	0.36
Total BAQ	125,15 ± 17.28	117.42 ± 16.45	4.497	<0.001^* * significant for p<0.05.	0.46
Physical attractiveness	16.94 ± 3.04	17.90 ± 2.46	-3.396	0,001^* * significant for p<0.05.	0.35
Disparagement	15.75 ± 4.70	12.79 ± 3.69	6.914	<0.001^* * significant for p<0.05.	0.70
Total fat	31.19 ± 10.25	34.83 ± 10.00	4.229	<0.001^* * significant for p<0.05.	0.36
Body salience	21.23 ± 4.45	20.35 ± 3.88	2.070	0,039^* * significant for p<0.05.	0.21
Lower body fatness perception	12.03 ± 2.87	12.02 ± 2.86	0.032	0,975	0.01
Strength and fitness	17.94 ± 3,18	18.03 ± 3.14	-0.271	0,787	0.03
EAT-26	15.17 ± 10.50	12.39 ± 7.77	7.003	<0.001^* * significant for p<0.05.	0.30
BDI	12.89 ± 10.67	7.90 ± 5.32	5.857	<0.001**	0.60
RSS	4,43 ± 3.48	7.06 ± 3.84	4.117	<0.001^* * significant for p<0.05.	0.72
STAI-trait	15.82 ± 3.51	14.46 ± 2.97	7.440	<0.001^* * significant for p<0.05.	0.42
STAI-state	17.69 ± 2.96	15.42 ± 3.04	2.959	0.003^* * significant for p<0.05.	0.76

Variables		1	2	3	4	5	6	7
1.	Total BAQ	-	0.337^* * p<0.05.	0.434^* * p<0.05.	0.363^* * p<0.05.	0.406^* * p<0.05.	0.147^* * p<0.05.	0.302^* * p<0.05.
2.	BMI (kg/m²)	0.286^* * p<0.05.	-	0.106	0.072	0.105	0.158^* * p<0.05.	-0.002
3.	EAT-26	0.510^* * p<0.05.	0.123	-	0.200^* * p<0.05.	0.103	0.110	0.234^* * p<0.05.
4.	BDI	0.359^* * p<0.05.	0.129	0.320^* * p<0.05.	-	0.535^* * p<0.05.	0.271^* * p<0.05.	0.442^* * p<0.05.
5.	RSS	0.365^* * p<0.05.	0.029	0.171^* * p<0.05.	0.491^* * p<0.05.	-	0.245^* * p<0.05.	0.344^* * p<0.05.
6.	STAI-trait	0.270^* * p<0.05.	0.165^* * p<0.05.	0.344^* * p<0.05.	0.503	0.234^* * p<0.05.	-	0.359^* * p<0.05.
7.	STAI-state	0.256^* * p<0.05.	0.149^* * p<0.05.	0.320^* * p<0.05.	0.481^* * p<0.05.	0.303^* * p<0.05.	0.542^* * p<0.05.	-

	Block	R²	R² adjusted	F	p	F²-Cohen
Public Sector						0.51
EAT-26	1	0.191	0.187	45.661	<0.001^* * p<0.05.
RSS	2	0.343	0.336	50.046	<0.001^* * p<0.05.
Private Sector						0.48
EAT-26	1	0.247	0.243	59.115	<0.001^* * p<0.05.
RSS	2	0.331	0.324	44.357	<0.001^* * p<0.05.

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[TFN1] χ²= Chi-square tes t; df= degrees of freedom;

[TFN2] ^a
difference found among all the categories;

[TFN3] ^b
difference between the categories single and married/lives with a partner;

[TFN4] ^c
performing the test was not possible because of the rule that none of the cells can be equal 0;

[TFN5] ^d
difference between B and C.

[TFN6] ^*
p<0.05.