بررسی عوامل مرتبط با رفتارهای مقابله ای با درد زایمان

نوع مقاله : اصیل پژوهشی

نویسندگان

1 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 کارشناس ارشد مامایی، مرکز بهداشت ثامن، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه روان پزشکی، مرکز تحقیقات روان پزشکی و علوم رفتاری، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

4 استاد گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: درد، تجربه ادراکی پیچیده ای است که تحت تأثیر عوامل روانی - اجتماعی گسترده ای قرار می گیرد. مقابله
با درد زایمان به عنوان افکار و رفتارهای خاصی تعریف می شود که افراد از آنها برای اداره درد یا واکنش های عاطفی
خویش به درد زایمان استفاده می کنند. با توجه به مطالعات محدود در این زمینه، مطالعه حاضر با هدف بررسی
عوامل مرتبط با رفتارهای مقابله ای با درد زایمان انجام شد.
روشکار: این مطالعه همبستگی دو مرحله ای در سال 1390 بر روی 120 زن باردار کم خطر 36 تا 40 هفته که
جهت زایمان به بیمارستان ام البنین مراجعه کرده بودند، انجام شد. افراد به روش آسان انتخاب و پرسشنامه های
اطلاعات فردی، سوابق مامایی و سبک زندگی را تکمیل کردند. این افراد تا شروع زایمان حقیقی پیگیری شدند،
سپس در مرحله دوم نمونه گیری، از اتساع 3-5 سانتی متر تا زایمان، پرسشنامه مشاهده ای رفتار مقابله ای با درد
زایمان، طی انقباضات رحمی و هر نیم ساعت یک بار (4-12 نوبت) تکمیل شد. روایی محتوای این پرسشنامه انجام و
پایایی آن با آلفای کرونباخ سنجیده شد. داده ها پس از گردآوری با استفاده از نرم افزار آماری SPSS (نسخه 16) و
آزمون های آماری کراسکال والیس، آنالیز واریانس و ضریب همبستگی اسپیرمن مورد تجزیه و تحلیل قرار گرفت.
میزان p کمتر از 0/05 معنی دار در نظر گرفته شد.
یافتهها: میانگین سنی افراد مورد مطالعه، 25/1 سال با انحراف معیار 4/9 و در محدوده سنی 18 تا 35 سال بود. بر
اساس نتایج مطالعه، 19 نفر (16/2%) از افراد، دارای رفتارهای مقابله ای نامطلوب نسبت به درد زایمان، 60 نفر
(50%) دارای رفتارهای قابل قبول و 41 نفر (33/8%) دارای رفتارهای مطلوب بودند. نظر مادر درباره درد زایمان
(p<0/015)، تجربه زایمان قبلی (p<0/006)، مدت زمان صرف شده جهت امور مذهبی (p<0/001)، طول فاز فعال
مرحله اول (p<0/001)، میانگین شدت درد (p<0/001) و اضطراب در بدو ورود به مطالعه (p<0/001) با رفتارهای
مقابله ای با درد زایمان ارتباط معناداری داشت.
نتیجهگیری: مقابله با درد دارای ویژگی هایی خاص و تأثیراتی گوناگون در روند زایمان بوده و این مقوله باید در اداره
 بالینی زائو، علاوه بر علائم فیزیولوژیک و آزمایشات کلینیکی، نیز گنجانده شود. 

کلیدواژه‌ها


عنوان مقاله [English]

Investigating the Factors Associated with Labor Pain and Coping Behavior

نویسندگان [English]

  • Nahid Golmakani 1
  • Bibi Marzieh Hashemi Asl 2
  • Seyed Alireza Sadjadi 3
  • Monireh Pourjavad 4
1 Lecturer of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 M.Sc. of Midwifery, Samen Health Care Center, University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Professor, Department of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Pain is a complex perceptional experience that is influenced by psychosocial factors. Coping with labor pain is a defined behavior that is applied to control the pain or emotional reactions to it by every individual. Regarding few researches in this issue, the present study is aimed to investigate the factors associated with pain and coping behaviors.
Methods: This two-phase correlational study was implemented on 120 low-risk pregnant women, in the 36 to 40 weeks of pregnancy, who have referred to Om-Al-Banin Hospital for delivery. The participants were easily selected. Their demographic information, obstetric record, and life style forms were completed. The samples were monitored until the beginning of laboring time. Then in the second phase of sampling, every half an hour during uterine contractions, observation form of coping behavior toward labor pain was filled out from the dilatation of 3–5 cm up to childbirth. The questionnaire content validity was checked and its reliability was assessed by Cronbach's Alpha. Data were analyzed by SPSS software version 16, Kruskal-Wallis, variance analysis and Spearman correlation coefficient statistical tests. P value less than 0.05 was considered statistically significant.
Results: The average age of samples was 25.1 years with a standard deviation of 4.9 and its range was between 18 to 35 years. Based on results, 16.3% of the pregnant women showed unfavorable, 50% acceptable and 33.7% favorable coping behavior toward labor pain. The results of correlation tests revealed that mothers' idea about childbirth (p<0.015), previous delivery experience (p<0.006), the time spent for religious affairs (p<0.000), length of active phase of the first stage (p<0.000), the mean pain intensity (p<0.000) and anxiety due to entering the research (p<0.001) were significantly associated with coping behaviors toward labor pain.
Conclusion: Coping with pain is accompanied with specific characteristics and various effects in labor process. So, more attention should be paid to clinical controlling the parturient, as well as, physiological signs, and clinical examinations.
 

کلیدواژه‌ها [English]

  • Childbirth
  • Coping behavior
  • Labor pain
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