Health Perception/ Health Management

1. When was your last check-up since you've been pregnant? How often do you go to
the hospital to have your check-up
2. Is this your first pregnancy?
3. What is your definition of being healthy? Do you consider yourself healthy?
4. Do you take any vitamins or mesdication?
5. Do you exercise? If yes what kind of exercise do you do and how often?

Nutritional- Metabolic

1. What did you last eat before coming here?

2. What do you usually eat lunch? (Breakfast,lunch, snack if any and dinner)
3. Do you take nutritional supplements?
4. Do you drink alcohol?
5. How many glasses of water do you drink everyday?

Elimination

1. How often do you eliminate?

2. what is the color of your stool?
3. How often do you urinate in a day?
4. Usually what is its color? What is its smell?
5. Do you have any problems or difficulty regarding your eliminating and urinating?

Activity/Exercise

1. Do you engage yourself in any physical activities?

2. What do you usually do during your leisure time?
3. What are your hobbies?
4. Do you have or done any extreneous activities while you are pregnant?
5. What is your job?
6. Does your work affect your health? How?

Cognitive - Perceptual

1. Do you have any problems during pregnancy?

2. Do you have any idea or imformation on what to do when you are pregnant?
3. What did you do when you knew you were pregnant?
4. How are you emotionally and physically during your pregnancy?
5. Do you have any mood swing while/ after you were pregnant?

Sleep/Rest

1. How many hours do you sleep?

2. Do you have any problem sleeping? What causes your sleep problems?
3. Do you take naps? How long?
4. Do you get tired easily? Why?
5. Does your work or activities you do daily make you tired?

Self perception/ self concept

1. How do you describe yourself?

2. How do you feel after giving birth? Are you happy about it?
3. How do you feel about being a mother?
4. Are you aware of the changes in your body? Are you okay with it?

Roles/relationship

1. Was your usband present during and after your pregnancy?

2. How can you meet the responsibilities of a mother?
3. How is your relationship with your family?
4. How many children do you have
5. Are you close with your children?
6. Do you have any problems with your husband or children?

Coping/stress tolerance

1. How was your mood during and after your pregnancy?

2. Were you stressed after giving birth? If yes? What are the reasons?
3. What do you do when your stress?
4. Do you have someone to talk about it?
5. Are you comfortable talking to your husband or any family member when you have
problems.

Value - Belief

1. What is your religion?

2. How does your religion affect your way of living?
3. Do you believe in faith healing?
4. How does your faith affect your life?
5. How does your beliefs guide you through your decisions?