بررسی تأثیر تلفیق مشاوره روانی و آموزش طب فشاری با رویکرد زوج درمانی بر تهوع و استفراغ بارداری

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مشاوره در مامایی، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

2 مربی گروه مامایی، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

3 استادیار گروه مامایی، مرکز تحقیقات پرستاری، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

4 استادیار گروه مامایی، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

5 استادیار گروه آمار زیستی و اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

چکیده

مقدمه: تهوع و استفراغ، یکی از شکایات شایع دوران بارداری است که اغلب به‌صورت یکی از اولین علائم حاملگی بعد از اولین عقب‌افتادگی عادت ماهیانه اتفاق می‌افتد. یک الگوی قوی از افسردگی، اضطراب و استرس در زنان با تهوع استفراغ شدید بارداری وجود دارد. بسیاری از زنان به این علت دچار انزوای فیزیکی، اجتماعی و روانی می‌گردند و کیفیت زندگی آنها تحت تأثیر قرار می‌گیرد. مطالعه حاضر با هدف تأثیر تلفیق مشاوره روانی و طب فشاری با رویکرد زوج درمانیبر شدت و طول مدت تهوع و استفراغ در زنان باردار انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 1395 بر روی 92 زن باردار 10-6 هفته و همسران آنها انجام شد. جهت گروه مداخله علاوه بر مراقبت­های معمول دوران بارداری، سه جلسه­ 90 دقیقه­ای مشاوره روانی و طب فشاری برگزار شد، اما گروه کنترل فقط مراقبت­های معمول بارداری را دریافت کردند. سپس اطلاعات قبل و بعد از مداخله توسط پرسشنامه شاخص رودز جمع‌آوری گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های کای اسکوئر، آنالیز واریانس یک‌طرفه و آنالیز کواریانس انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته­ها: بعد از مداخله، شدت و مدت تهوع و استفراغ در گروه مداخله نسبت به گروه شاهد به‌طور معنی‌داری کاهش یافت (001/0>p).
نتیجه‌گیری: تلفیق مشاوره روانی و طب فشاری می‌تواند باعث کاهش طول مدت و شدت تهوع و استفراغ ­گردد.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of combination of psychological counseling and acupressure training with couple therapy approach on nausea and vomiting in pregnancy

نویسندگان [English]

  • Zahra Saeedi 1
  • Katayoun Alidoosti 2
  • Firoozeh Mirzaee 3
  • Atefeh Ahmadi 4
  • Tania Dahesh 5
1 M.Sc. Student of Counseling in Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
2 Instructor, Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
3 Assistant professor, Department of Midwifery, Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
4 Assistant professor, Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
5 Assistant professor, Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
چکیده [English]

Introduction: Nausea and vomiting is one of the most common complains during pregnancy, which often occur as one of the first signs of pregnancy after the first rebound of the menstrual period. There is a strong pattern of depression, anxiety, and stress in women with severe nausea and vomiting of pregnancy. Many women become physically, socially and psychologically isolated and their quality of life is affected. This study was performed with aim to investigate the effect of combination of psychological counseling and acupressure with couple therapy approach on the severity and duration of nausea and vomiting in pregnant women.
Methods: This clinical trial was performed on 92 pregnant women with gestational age of 6 to 10 weeks and on their husbands in 2016. For the intervention group, in addition to the routine prenatal care, three 90 minutes sessions of psychological counseling and acupressure were held; but the control group only received routine prenatal care. Then, data were collected before and after the intervention by Rhodes index. Data were analyzed by SPSS software (version 22) and Chi-square, one-way ANOVA and covariance analysis. p <0.005 was considered significant.
Results: The severity and duration of nausea and vomiting significantly decreased in the intervention group compared to the control group (p<0.001).
Conclusion: The combination of psychological counseling and acupressure can reduce the duration and severity of nausea and vomiting.

کلیدواژه‌ها [English]

  • Acupressure
  • Counseling
  • nausea and vomiting
  • pregnancy
  1. Shishehgar F, Peyman A. Characteristics of nausea and vomiting in pregnancy and its association with quality of ‎life. J Holistic Nurs Midwifery 2009; 19(1):16-21. (Persian(.
  2. Abedian Z, Abbaszadeh N, Latifnejad Roudsari R, Shakeri MT. The effect of telephone support on the severity of nausea and vomiting in the first trimester of pregnancy in the primiparous women. Iran J Obstet Gynecol Infertil 2014; 17(118):18-29. (Persian(.
  3. Jouybari L, Sanagu A, Chehrehgosha M. Quality of life in women with nausea and vomiting of pregnancy. Qom Univ Med Sci J 2012; 6(2):88-94. (Persian(.
  4. Kuo SH, Wang RH, Tseng HC, Jian SY, Chou FH. A comparison of different severities of nausea and vomiting during pregnancy relative to stress, social support, and maternal adaptation. J Midwifery Womens Health 2007; 52(1):e1-7.
  5. Smith C, Crowther C, Beilby J, Dandeaux J. The impact of nausea and vomiting on women: a burden of early pregnancy. Aust N Z J Obstet Gynaecol 2000; 40(4):397-401.
  6. Attard CL, Kohli MA, Coleman S, Bradley C, Hux M, Atanackovic G, et al. The burden of illness of severe nausea and vomiting of pregnancy in the United States. Am J Obstet Gynecol 2002; 186(5):S220-7.
  7. Jouybari L, Sanagu A, Chehrehgosha M. Quality of life in women with nausea and vomiting of pregnancy. Qom Univ Med Sci J 2012; 6(2):88-94. (Persian).
  8. Soltani AZ, Kajuri MD, Safavi SH, Hosseini FA. Frequency and severity of nausea and vomiting in pregnancy and the related factors among pregnant women. Iran J Nurs 2007; 19(48):95-102. (Persian).
  9. Isbir GG, Mete S. The effect of counselling on nausea and vomiting in pregnancy in Turkey. Sex Reprod Healthcare 2016; 7:38-45.
  10. Tam WH, Lee DT, Chiu HF, Ma KC, Lee A, Chung TK. A randomised controlled trial of educational counselling on the management of women who have suffered suboptimal outcomes in pregnancy. BJOG 2003; 110(9):853-9.
  11. Aghadam SK, Mahfoozi B. Evaluation of the effects of acupressure by sea band on nausea and vomiting of pregnancy. Iran J Obstet Gynecol Infertil 2010; 13(2):39-44. (Persian).
  12. Lee EJ, Frazier SK. The efficacy of acupressure for symptom management: a systematic review. J Pain Symptom Manage 2011; 42(4):589-603.
  13. Snourani S, Aparnak F, Sadr NR, Ebrahimzadeh S. Comparison of K-K9 and P6 points acupressure on nausea and vomiting in the first half of pregnancy. Int J Reprod Biomed 2011; 9(1):74-5. (Persian).
  14. Modares M, Besharat S, Mahmoudi M. Effect of Ginger and Chamomile capsules on nausea and vomiting in pregnancy. J Gorgan Univ Med Sci 2012; 14(1):46-51. (Persian).
  15. Soleimani M, Shakib-Khankandi A, Ghahremanfard F, Mirmohammadkhani M. Arterial oxygen saturation and severity of nausea and vomiting during chemotherapy: a pilot study. Tehran Univ Med J 2015; 72(10):698-705. (Persian).
  16. Puangsricharern A, Mahasukhon S. Effectiveness of auricular acupressure in the treatment of nausea and vomiting in early pregnancy. J Med Assoc Thai 2008; 91(11):1633-8.
  17. Kugahara T, Ohashi K. Characteristics of nausea and vomiting in pregnant Japanese women. Nurs Health Sci 2006; 8(3):179-84.
  18. Liu MC, Kuo SH, Lin CP, Yang YM, Chou FH, Yang YH. Effects of professional support on nausea, vomiting, and quality of life during early pregnancy. Biol Res Nurs 2014; 16(4):378-86.
  19. Belluomini J, Litt RC, Lee KA, Katz M. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstet Gynecol 1994; 84(2):245-8.
  20. Harmon D, Gardiner J, Harrison R, Kelly A. Acupressure and the prevention of nausea and vomiting after laparoscopy. British journal of anaesthesia. 1999;82(3):387-90.
  21. Shafi Abadi A. Education and career advice. Tehran: Samt Publications; 2004. (Persian).
  22. Moeen Z. Mental health in pregnancy period. 1st ed. Tehran: Centeral Rehabilitation Organization; 2002. (Persian).
  23. Bastani F, Hidarnia A, Kazemnejad A, Vafaei M, Kashanian M. A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery Womens Health 2005; 50(4):e36-40.
  24. Lawrence E, Rothman AD, Cobb RJ, Rothman MT, Bradbury TN. Marital satisfaction across the transition to parenthood. J Family Psychol 2008; 22(1):41.