بررسی تأثیر آموزش بر اساس مدل اعتقادی بهداشتی بر رفتارهای پیشگیری کننده از بارداری ناخواسته

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی دکتری آموزش سلامت، دانشگاه آزاد اسلامی واحد زرندیه، زرندیه، ایران

2 ستادیار گروه آموزش سالمت، دانشکده بهداشت، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران.

3 استاد گروه بهداشت روان، پژوهشکده علوم بهداشتی جهاد دانشگاهی، دانشگاه علوم پزشکی تهران، تهران، ایران

4 استادیار گروه آموزش سالمت، دانشکده پزشکی، دانشگاه تربیت مدرس، تهران، ایران.

چکیده

مقدمه: تقریباً تمام زنان در سنین باروری در معرض خطر بارداری ناخواسته هستند و کاهش میزان بارداری های
ناخواسته یکی از اولویت های کاری کارکنان بهداشتی است. مطالعه حاضر با هدف تعیین تأثیر آموزش بر اساس مدل
اعتقاد بهداشتی بر رفتارهای پیشگیری کننده از بارداری ناخواسته در زنان دارای بارداری پر خطر قبلی زرندیه انجام شد.
روشکار: این مطالعه مداخله ای شاهددار در سال 1311 بر روی 17 زن 11-41 ساله شوهردار و تحت پوشش مرکز
بهداشت زرندیه انجام شد. نمونه گیری به روش چند مرحله ای تصادفی انجام شد و 44 نفر در گروه آزمون و 41 نفر
در گروه شاهد قرار گرفتند. ابزار گردآوری داده ها پرسشنامه طراحی شده بر اساس مدل اعتقاد بهداشتی بود که پس
از انجام روایی و پایایی، در اختیار افراد قرار گرفت. بر اساس اطالعات به دست آمده از پیش آزمون، برنامه آموزشی
طراحی و برای گروه آزمون اجرا شد. سه ماه بعد از مداخله، ارزیابی ثانویه با استفاده از همان پرسشنامه اولیه انجام و
اطالعات گردآوری شده با آزمون های آماری تی مستقل، تی زوجی و کای دو مورد تجزیه و تحلیل قرار گرفت. میزان
p کمتر از 1/11 معنی دار در نظر گرفته شد.
یافتهها: میانگین نمره آگاهی، رفتارهای پیشگیری کننده از بارداری ناخواسته و تمام اجزاء مدل اعتقاد بهداشتی قبل از
مداخله آموزشی در حد متوسط بود، ولی پس از مداخله آموزشی بین دو گروه آزمون و کنترل در همه متغیرهای ذکر
شده به جز موانع درک شده اختالف معنی داری مشاهده شد )p>1/11(. همچنین میزان استفاده از روش منقطع در
گروه آزمون از 41% به 1/51% کاهش یافت.
نتیجهگیری: برنامه آموزش بهداشت طراحی شده بر اساس مدل اعتقاد بهداشتی برر رفتارهرای پیشرگیری کننرده از
بارداری ناخواسته در زنان مورد مطالعه تأثیر مثبتی داشت و می تواند نقش مرثثری در کراهش میرزان برروز برارداری
ناخواسته داشته باشد

کلیدواژه‌ها


عنوان مقاله [English]

The Effect of Training Based on Health Belief Model on Preventive Behaviors of Unwanted Pregnancy

نویسندگان [English]

  • Mahmoud Karimi 1
  • Iraj Zareban 2
  • Ali Montazeri 3
  • Farkhondeh Amin Shokravi 4
1 Ph.D. Student, Department of Health Education and Promotion, Zarandieh Islamic Azad University, Zarandieh, Iran.
2 Assistant Professor, Department of Health Education, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, Iran.
3 Professor, Department of Mental Health, Iranian Institute of Health Sciences Research, Tehran University of Medical sciences, Tehran, Iran.
4 Assistant Professor, Department of Health Education, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran.
چکیده [English]

Introduction: Almost all active women of reproductive age are at risk of unwanted pregnancy, reducing the rate of which is recognized as a priority for health care professionals. The purpose of this study was to determine the effect of Health Education Program based on Health Belief Model (HBM) on preventive behaviors of unwanted pregnancy among Women with history of previous high risk pregnancy in Zarandieh.
Methods: This case-control research was carried out on 97 married women of age 15 to 49 who were admitted at health center of Zarandieh. A random multiple-stage sampling was used and divided into 48 subjects as case group and 49 subjects as control group. A questionnaire based on HBM was prepared whose validity and reliability was approved and given to samples. Based on the data achieved from the pre-test, an educational program was designed and applied on the case group. Three months after intervention, a second evaluation was conducted by the same questionnaire. Collected data were analyzed by using t-test،paired t-test and chi-square.P value less than 0.05 was considered statistically significant.
Results: Results showed that before training intervention, the mean score of knowledge, preventive behaviors, and all constructs of HBM were more than mediate. After training intervention, significant difference was observed in all variables of both groups (p<0.05). Also, rate of case group's using coitus interrupt was decreased from 40% to 9.65%.
Conclusion: Health education program designed based on Health Belief Model has had a positive effect on the preventive behaviors of unwanted pregnancy and may have an effective role on decreasing unwanted pregnancy incidence rate in women’s.
 

کلیدواژه‌ها [English]

  • Health belief model
  • Health education program
  • Unwanted pregnancy
  • Women
1. Xaverius PK, Tenkku LE, Salas J. Differences between women at higher and lower risk for an unintended
pregnancy. Womens Health Issues 2009 Sep-Oct;19(5):306-12.
2. Green DC, Gazmararian JA, Mahoney LD, Davis NA. Unintended pregnancy in a commercially insured
population. Matern Child Health J 2002 Sep;6(3):181-7.
3. Amani F, Bashiri G, Nahanmoghadam N, Tabarrai Y. [Using the logistic regression model in survey effective
causes on unwanted pregnancy] [Article in Persian]. J Qom Univ Med Sci 2010;4(1):32-6.
4. Upson K, Reed SD, Prager SW, Schiff MA. Factors associated with contraceptive nonuse among US women
ages 35-44 years at risk of unwanted pregnancy. Contraception 2010 May;81(5):427-34.
5. Mortazavi F, Damghanian M, Mottaghi Z, Shariati M. [Women's experiences of unwanted pregnancy] [Article
in Persian]. Behbood 2012;15(6):492-503.
6. Azizi A, Amirian F, Pashaei T, Amirian M. [Prevalence of unintended pregnancy and its relationship with
health-related quality of life for pregnant women’s in Salas city, Kermanshah- Iran] [Article in Persian]. Iran J
Obstet Gynecol Infertil 2011;5:24-9..
7. Amoako JF, Madise NJ. Examining the geographical heterogeneity associated with risk of mistimed and
unwanted pregnancy in Ghana. J Biosoc Sci 2009 Mar;41(2):249-67.
8. Dwyer JM, Jackson T. Unwanted pregnancy, mental health and abortion: untangling the Evidence. Aust New
Zealand Health Policy 2008 Apr 29;5:2.
9. Messer LC, Dole N, Kaufman JS, Savitz DA. Pregnancy intendedness and maternal psychosocial factors and
preterm birth. Matern Child Health J 2005 Dec;9(4):403-12.
10. McNeil TF, Schubert EW, Cantor-Graae E, Brossner M, Schubert P, Henriksson KM. Unwanted pregnancy as a
risk factor for offspring schizophrenia-spectrum and affective disorders in adulthood: a prospective high-risk
study. Psychol Med 2009 Jun;39(6):957-65.
11. Hromi-Fielder AJ, Perez-Escamilla R. Unintended pregnancies are associated with less likelihood of prolonged
breast-feeding: an analysis of 18 Demographic and Health Surveys. Public Health Nutr 2006 May;9(3):306-12.
12. Karimy M, Montazeri A, Araban M. [The effect of an educational program based on health belief model on the
empowerment of rural women in prevention of brucellosis] [Article in Persian]. Arak Med Univ J (AMUJ) 2012
Winter;14(4 Suppl2):85-94.
13. Karimy M, Hasani M, Khorram R, Gafari M, Niknami SH. [The effect of education, based on health belief
model on breast self examination in the Health volunteer in Zarandieh] [Article in Persian]. Tabibe Shargh; J
Zahedan Univ Med Sci 2008;10(4):79-87.
14. Karimy M, Gallali M, Niknami SH, Aminshokravi F, Tavafian SS. [The effect of health education based on
health belief model on performance of Pap smear test among women referring to health care centers in
Zarandieh] [Article in Persian]. J Jahrom Univ Med Sci 2012 Spring;10(1):47-53.
15. Mahoney CA, Thombs DL, Ford OJ. Health belief and self-efficacy models: their utility in explaining college
student condom use. AIDS Educ Prev 1995 Feb;7(1):32-49.
16. Hovell M, Blumberg E, Sipan C, Hofstetter CR, Burkham S, Atkins C. Skills training for pregnancy and AIDS
prevention in Anglo and Latino youth. J Adolesc Health 1998 Sep;23(3):139-49.
17. Kirby D, Korpi M, Adivi C, Weissman J. An impact evaluation of project SNAPP: an AIDS and pregnancy
prevention middle school program. AIDS Educ Prev 1998 Feb;9(1 Suppl):44-61.
18. Ghafari M. [Comparing the efficacy of health belief model and it’s integrated model in AIDS education among
male high school students in Tehran] [Thesis in Persian]. Tehran:Tarbiat Modares University;2007:187-95.
 
19. Asadpour M. [Promotion and maintenance of preventive behaviors from HIV, HBV and HCV infections in
health care worker with using constructs of health belief model in Precede-Proceed model] [Thesis in
Persian].Tehran:Tarbiat Modares University;2009.
20. Shama ME, Fareed NR, Elburgy MD, Mahfouz AA. Application of the Health Belief Model in studying noncompliance
with universal precautions among nurses and laboratory technicians in Alexandria, Egypt. Health
Educ Res 2004;1(93):272-83.
21. Wai CT, Wong ML, Ng S, Cheok A,Tan MH, Chua W, Mak B, et al. Utility of Health Belief Model in
predicting compliance of screening in patients with chronic hepatitis B. Aliment Pharmacol Ther 2005
May;21(10):1255-62.
22. Ratanasuwan T, Indharapakdi S, Promrerk R, Komolviphat T, Thanamal Y. Health belief model about diabetes
mellitus in Thailand: the culture consensus analysis. J Med Assoc Thai 2005 May;88(5):623-31.
23. Austin LT, Ahmad F, McNally MJ, Stewart DE. Breast and cervical cancer screening in Hispanic women: a
literature review using the health belief model. Womens Health Issues 2002 May-Jun;12(3):122-8.
24. Coyle K, Basen-Engquist K, Kirby D, Parcel G, Banspach S, Harrist R, et al. Short-term impact of safer choices:
a multi component, school-based HIV, other STD, and pregnancy prevention program. J Sch Health 1999
May;69(5):181-8.
25. Hazavehei SM, Taghdisi MH, Saidi M. Application of the health belief model for osteoporosis prevention
among middle school girl students, Garmsar, Iran. Educ Health (Abingdon) 2007 May;20(1):23.
26. Tussing K, Chapman-Novakofski K. Osteoporosis prevention education: behavior theories and calcium intake. J
Am Diet Assoc 2005 Jan;105(1):92-7.
27. Peyman N,Heidarnia A,Ghofranipour F, Kazemnejad A, Khodaee GH, Amin Shokravi F. The relationship
between perceived self-efficacy and contraceptive behaviors among Iranian women referring to health centers in
Mashad in order to decrease unwanted pregnancies. J Reprod Infertil 2007 Apr-Jun;8(30):78-90.
28. Shamsi M, Baiati A,Tajik R, Mohammad Beigi A. [Effect of health education program based on health belief
model on preventive behaviors of self-medication in pregnancy mothers in Arak] [Article in Persian].
Pajoohandeh; J Shahidbeheshti Univ Med Sci 2009;14(6):324-31.
29. Yakhforoushha A,Slohi M,Azar FA.[Effects of education via on health belief model on knowledge and attitude
of voluntary health workers regarding Pap Smear] [Article in Persian]. Nurs Midwifery Quarter Shaheed
Beheshti Univ Med Sci 2008;18(62):24-30.
30. Kinsler J, Sneed CD, Morisky DE, Ang A. Evaluation of a school-based intervention for HIV/AIDS prevention
among Belizean adolescents. Health Educ Res 2004 Dec;19(6):730-8.
31. McClendon BT, Prentice-Dunn S, Blake R, McMath B. The role of appearance concern in responses to
intervention to reduce skin cancer risk. Health Educ 2002;102(2):76-83.