Study Type: The study was planned in a descriptive-correlational design to examine the relationship between orthorexia nervosa and healthy lifestyle behaviors in pregnant women.
Study Population and Sample: The population of the study consisted of pregnant women aged 18 years and over registered in a state hospital in a provincial center located in Eastern Turkey. The optimal sample size was calculated as a total of 197 pregnant women with a confidence level of 95% at alpha = .05 [20]. The study was completed with 234 volunteer pregnant women who agreed to participate.
Place and Time of Study: The study was conducted face-to-face with pregnant women residing in a city center between October 2022 and January 2023.
Inclusion Criteria: Pregnant women who (1) volunteered to participate in the study, (2) were 18 years of age or older, (3) did not have any known chronic disease, (4) did not have auditory or visual problems that prevented participation were included in the study.
Exclusion Criteria: Pregnant women who did not volunteer to participate in the study were excluded.
Data Collection: The data were collected using the Socio-Demographic Information Form prepared by the researchers in the light of the literature, the Orthorexia Nervosa 15 Scale, and the Healthy Lifestyle Behavior Scale II.
Orthorexia-15 Scale (ORTO-15): The ORTO-15 scale is a 15-question Likert-type scale developed by Donini et al. (2005). The Turkish validity and reliability study of the scale developed to determine healthy eating obsession in individuals was conducted by Arusoğlu et al. (2008) [21]. The questions are scored on a 4-point Likert scale (always, frequently, occasionally, and never) using the present tense and assess individuals' obsessive behaviors in selecting, purchasing, preparing, and consuming foods that they define as healthy. A score of "1" is given to answers that are a discriminating criterion for orthorexia, and a score of "4" is given to answers that indicate a tendency towards normal eating behavior. The scale can be scored between 15-60 points. Lower scores indicate greater orthorexic tendency. The items assess individuals' behaviors of choosing, purchasing, preparing, and consuming foods that they consider to be healthy. Statements aimed at evaluating individuals both emotionally and rationally were developed. Therefore, some of the items examine the "cognitive-rational domain" (1, 5, 6, 11, 12, 14) while others examine the "clinical domain" (3, 7, 8, 9, 15), and the "emotional domain" (2, 4, 10, 13). Three different cut-off points (<35, <40, <45) were found in the ORTO-15 test developed by Donini. In the Turkish validity study conducted by Arusoğlu et al., when the 25th and 75th percentiles were analyzed, the cut-off point of the scale was found to be "33". Orthorexic symptoms were expected to be observed at or below this cut-off point. Those who scored ≤33 points on the ORTO-15 were considered orthorexic and those who scored >33 points were considered normal [22]. In the present study, participants who scored ≤33 points on ORTO-15 were considered orthorexic and those who scored >33 points were considered normal. The Cronbach Alpha of the scale is 0.62. In this study, the Cronbach Alpha of the scale was calculated as 0.84.
Healthy Lifestyle Behavior Scale II (HLSBS): The Turkish validity and reliability study of the scale developed by Walker et al. was conducted by Bahar et al. [23]. The scale consists of 52 items and six sub-dimensions (health responsibility, physical activity, nutrition, mental development, interpersonal relationships, and stress management). The 4-point Likert scale has a score range of 52-208. The scale consists of items on health responsibility (3,9,15,21,27,33,39,45,51), physical activity (4,10,16,22,28,34,40,46), nutrition (2,8,14,20,26,32,38,44,50), mental development (6, 12,18,18,24,30,36,42,48,52), interpersonal relationships (1,7,13,19,25,31,37,43,49) and stress management (5,11,17,23,29,35,41,47). The Cronbach's alpha of the scale is 0.92. In the present study, the Cronbach's alpha of the scale was found to be 0.96.
Data Analysis
The SPSS 22.0 package program was used for data analysis. Mean, number, percentage distributions and standard deviation were used to display descriptive characteristics. The Cronbach's α reliability coefficient was used to determine the internal consistency of the ON scale. Regression analysis was used to determine the effect of independent variables on the dependent variable. In the present study, analysis results were considered statistically significant at a confidence interval of 95% and a significance level of p < 0.05.