بررسی تأثیر اجرای برنامه کلاس‌های آمادگی زایمان مبتنی بر دستورالعمل کشوری بر ترس از زایمان طبیعی در زنان باردار: یک کارآزمایی بالینی تصادفی شده

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، معاونت بهداشتی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

2 پزشک عمومی، مرکز مدیریت بیماری‌های واگیردار، معاونت بهداشت، وزارت بهداشت درمان و آموزش پزشکی، تهران، ایران.

3 کارشناس مامایی، معاونت بهداشتی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

4 استادیار گروه آمار حیاتی، دانشکده بهداشت، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

5 دانشیار گروه مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

چکیده

مقدمه: ترس از زایمان موجب افزایش مداخلات مامایی، ایجاد عوارض برای مادر و جنین و یکی از عوامل مهم و تأثیر‌گذار در افزایش نرخ سزارین می‌باشد. مطالعه حاضر با هدف بررسی تأثیر برنامه کلاس‌های آمادگی برای زایمان کشوری بر ترس از زایمان طبیعی با ابزار ترس از زایمان ویجما انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده طی سال‌های 97-1396 بر روی 132 زن نخست باردار در مراکز بهداشتی درمانی سبزوار انجام گرفت. افراد به‌طور تصادفی به دو گروه مداخله و کنترل تقسیم شدند. گروه مداخله در کلاس‌های آمادگی دوران بارداری شرکت کردند و گروه کنترل تنها مراقبت‌های معمول دوران بارداری را دریافت کردند. قبل و بعد از مداخله و 14 روز پس از زایمان، پرسشنامه ترس از زایمان ویجما ورژن A و B توسط مادران تکمیل گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های تی تست و تحلیل واریانس در اندازه‌گیری‌های مکرر انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: میانگین نمره کل پرسشنامه و نمرات فاکتورهای پرسشنامه ترس از زایمان ویجما به غیر از فاکتور ترس از آسیب جنین در گروه مداخله به‌طور معناداری بالاتر از گروه کنترل بود (05/0>p). همچنین نمرات تمام فاکتورها به جزء ترس از آسیب به جنین در گروه مداخله از پیش‌آزمون به پس‌آزمون و پیگیری افزایش ‌یافت (05/0>p). نمرات فاکتور ترس از آسیب جنین در گروه مداخله در پس‌آزمون و در گروه کنترل بعد از زایمان کاهش یافت و مقایسه میانگین‌ها تفاوت معنی‌داری را بین دو گروه نشان ‌داد (01/0=p).
نتیجه‌گیری: کلاس‌های آمادگی برای زایمان برگزار شده در سبزوار موجب افزایش ترس از زایمان شد، لذا محتوای این آموزش‌ها باید مورد بررسی قرار گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

Effects of childbirth preparation classes program based on national guideline on fear of childbirth in pregnant women: a randomized clinical trial

نویسندگان [English]

  • Maryam Mehrabadi 1
  • Maryam Masoudifar 2
  • Aghdas Parvizi 3
  • Mohammad Hasan Rakhshani 4
  • Forough Mortazavi 5
1 M.Sc. of Midwifery, Deputy of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
2 General Physician, Center for Communicable Disease Control and Prevention, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran.
3 B.Sc. of Midwifery, Deputy of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
4 Assistant Professor, Department of Biostatistics, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
5 Associate Professor, Department of Midwifery, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
چکیده [English]

Introduction: Fear of childbirth increases obstetrical interventions, and causes complications for mother and fetus and is one of the important factors affecting the increased rate of cesarean. This study was performed with aim to investigate the effects of childbirth preparation classes program on fear of normal vaginal delivery measured with Wijma Delivery-Expectancy questionnaire.
Methods: This randomized clinical trial study was performed on 132 nulliparous women in Sabzevar Health Centers during 2017-2018. The subjects were randomly divided into two groups of intervention and control. The intervention group participated in childbirth preparation classes and the control group received only the routine prenatal care. Wijma Delivery Expectancy Questionnaire (W-DEQ) Version A&B was completed before and after the intervention and 14 days after delivery by the mothers. Data were analyzed by SPSS software (version 22) and t-test and Repeated Measurement Variance Analysis.  P<0.05 was considered statistically significant.
Results: The mean total score of questionnaire and all the factors except the fear of fetal injury were significantly higher in the intervention group than the control group (p <0.05). Also, the scores of all factors except fear of fetal injury increased in the intervention group from pre-test to post-test and follow-up (P <0.05). The scores of fear of fetal injury in the intervention group decreased in post-test while in the control group decreased after childbirth; comparison of means showed difference between two groups (p=0.01).
Conclusion: Childbirth preparation classes held in Sabzevar increased the fear of childbirth. Therefore, the content of this training course must be assessed.

کلیدواژه‌ها [English]

  • Childbirth
  • fear
  • Postpartum
  • pregnancy
  • Prenatal training
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