Exploring preconception policies and health with adult daughters, their maternal mothers and healthcare providers in rural Zhejiang Province, P.R. China.

摘要

Purpose. This dissertation research defined the concept of preconception health and care in China using Chinese governmental policies and the viewpoints of adult daughters, their maternal mothers, and healthcare providers.;Methods. Policy and interview texts consisted of two study data sources. The field work of the study was conducted in Tonglu County, Zhejiang, China. Fourteen (n = 14) nationally and provincially issued policy documents met the inclusion criteria. Eighty-six (n = 86) in-depth individual interviews were completed by 3 groups of study participants, namely adult daughters (n = 40), their maternal mothers (n = 10), and healthcare providers ( n = 36). Critical discourse analysis was used to analyze the policy and interview texts. The yin-yang dyad was used to represent the results, consistent with Chinese philosophy.;Results. From the policy texts, preconception health is defined as a health condition: (a) before marriage and (b) after marriage. Preconception care is defined as: (a) menstrual care, (b) married women's care, (c) intending to be married couple's care, (d) couple's family planning, and (e) married couple's care. The view that policy language was too formalistic was a major concern from the adult daughter and healthcare provider groups. Adult daughters defined preconception health as: (a) keeping free from diseases, (b) keeping free from menstrual abnormalities, (c) maintaining physical strength, and (d) maintaining a positive emotional and mental state. They defined preconception care as care to: (a) keep from diseases, (b) keep from menstrual abnormalities, (c) maintain physical strength, and (d) maintain a positive emotional and mental state. Menstrual health and care was the main preconception related topic circulated within the daughter-mother dyad.;Conclusions. The study found that the concept of preconception health and care is mainly constructed by marriage in Chinese policy text, and a disjunction between the preconception policies and the participants' viewpoints exists. Furthermore, rural women anchored on both the biomedical and nonbiomedical discourses in defining preconception health and care. The findings expanded the current biomedical-oriented preconception health and care evidence. The Chinese knowledge on preconception health added richness to the western viewpoint of preconception health promotion.