تأثیر آرام ‌سازی پیشرونده عضلانی بر وقوع زایمان زودرس در زنان نخست باردار مراجعه‌کننده به مراکز بهداشتی درمانی شهر همدان

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار گروه مامایی، مرکز تحقیقات مراقبت‌های مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران

2 کارشناس ارشد مشاوره در مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

3 دانشیار گروه مامایی، مرکز تحقیقات مراقبت‌های مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

4 دانشیار گروه اپیدمیولوژی، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی همدان، همدان، ایران.

چکیده

مقدمه: زایمان زودرس، عامل اصلی مرگ و‌ میر و بیماری‌های دوران نوزادی می‌باشد. با توجه به اینکه تأثیر آرام‌سازی پیشرونده عضلانی بر وقوع زایمان زودرس زنان باردار به اندازه کافی مورد توجه قرار نگرفته است، لذا مطالعه حاضر با هدف ارزیابی تأثیر آرام‌سازی پیشرونده عضلانی بر وقوع زایمان زودرس در زنان نخست باردار شهر همدان انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 1394 بر روی 120 زن نخست باردار در هفته 22-21 بارداری در شهر همدان انجام شد. افراد ابتدا پرسشنامه اطلاعات فردی و پرسشنامه‌ اضطراب اسپیل برگر را تکمیل کردند و به صورت تصادفی به دو گروه 60 نفره کنترل و مداخله تقسیم شدند. گروه کنترل فقط مراقبت‌های معمول را دریافت کردند، اما گروه مداخله علاوه بر مراقبت‌های معمول، پس از فراگیری تکنیک آرام‌سازی عضلانی، به مدت 10 هفته این تمرینات را در منزل انجام دادند و برگه ثبت عملکرد روزانه را تکمیل کردند و تا هفته 32 بارداری از نظر وقوع زایمان زودرس پیگیری شدند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماریSPSS  (نسخه 20) و آزمون‌های تی تست، کای اسکوئر و تحلیل کوواریانس انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: دو گروه قبل از مداخله از نظر سطوح اضطراب آشکار و پنهان همگن بودند، اما پس از مداخله در گروه کنترل افزایش معنادار (001/0>p) و در گروه آزمون کاهش معناداری (001/0>p) در میانگین اضطراب آشکار و پنهان مشاهده شد. همچنین در گروه کنترل زایمان زودرس به طور معناداری بیشتر از گروه مداخله رخ داده بود (04/0=p). 
نتیجه‌گیری: آموزش تکنیک آرام‌سازی پیشرونده عضلانی به زنان باردار می‌تواند تأثیر بسزایی بر کاهش اضطراب و کاهش وقوع زایمان زودرس داشته باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Effects of progressive muscle relaxation on preterm delivery among primigravida women referred to health care centers in Hamadan

نویسندگان [English]

  • Fatemeh Shobeiri 1
  • Masoome Taravati Javad 2
  • Farzaneh Soltani 3
  • Manoochehr Karami 4
1 Associate professor, Department of Midwifery, Mother & Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
2 M.Sc. in Midwifery Consulting, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
3 Associate professor, Department of Midwifery, Mother & Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
4 Associate professor, Department of Epidemiology, Social Determinants of Health Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
چکیده [English]

Introduction: Preterm delivery is the main cause of mortality and neonatal diseases. Since the effect of progressive muscle relaxation on preterm delivery in pregnant women has not been paid enough attention, therefore, this study was performed with aim to evaluate the effect of progressive muscle relaxation on preterm delivery of primigravida women referred to health care centers in Hamadan.
Methods: This clinical trial study was performed on 120 primigravida women at 21-22 gestational week in Hamadan in 2015. At first, the subjects completed demographic questionnaire and Spielberger questionnaire and were randomly assigned to intervention and control groups (60 women in each group). The control group only received routine prenatal care, but experimental group in addition to routine prenatal care, learned muscle relaxation techniques and performed these exercises at home for 10 weeks, and completed daily performance sheet and were followed up to 32 weeks of gestation in terms of preterm delivery. Data were analyzed by SPSS software (version 20), and t-test, Chi-square, and covariance analysis. PResults: Two groups were homogenous in terms of state and trait anxiety levels before the intervention, but after the intervention, state and trait anxiety in the control group was significantly increased (P<0.001), and significantly decreased in experimental group (P<0.001). Also, preterm delivery was significantly higher in control group than experimental group (P=0.04).
Conclusion: Teaching progressive muscle relaxation techniques to pregnant women can have a significant impact on reducing anxiety and preterm delivery.

کلیدواژه‌ها [English]

  • Anxiety
  • pregnancy
  • Preterm delivery
  • Progressive muscle relaxation
  1. Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth 2015; 28(3):179–93.
  2. Mehraban Z, Alizadeh L, Narimani M. Maternal prenatal pregnancy-related anxiety and spontaneous preterm birth in Ardabil health centers in 2011. Urmia Med J 2013; 23(6):670-5. (Persian).
  3. Shahhosseini Z, Abedian K, Azimi H. Role of anxiety during pregnancy in preterm delivery. ZUMS J 2008; 16(63):85-92. (Persian).
  4. Neshat R, Majlesi F, Rahimi A, Shariat M, Pourreza A. Investigation the relationship between preterm delivery and prevalence of anxiety, stress and depression in pregnant women of Dorrod Health Center, Iran in 2010. Iran J Obstet Gynecol Infertil 2013; 16(67):16-24. (Persian).
  5. Sanchez SE, Puente GC, Atencio G, Qiu C, Yanez D, Gelaye B, et al. Risk of spontaneous preterm birth in relation to maternal depressive, anxiety and stress symptoms. J Reprod Med 2013; 58(1-2):25-33.
  6. Sanginabadi M, Seifrabie MA. A comparative evaluation of maternal & Neonatal complications in women between outpatients & inpatients with preterm premature rupture of the membranes. Sci J Hamadan Nurs Midwifery Facul 2014; 22(2):26-32. (Persian).
  7. Shobeiri F, Nazari M. Assessment of cervical erosion in Hamedan city, Iran. Pak J Biol Sci 2007; 10(19):3470-2.
  8. Shobeiri F, Nazari M. Patterns of weight gain and birth weight amongst Indian women. Iran J Med Sci 2006; 31(2):94-7. (Persian).
  9. Nasiri Amiri F, Salmalian H,  Haji Ahmadi M, Ahmadi AM. Association between prenatal anxiety and spontaneous preterm birth. Journal of Babol University of Medical sciences. 2009; 4 (51):42-48. (persian).
  10. Rafiee B, Akbarzade M, Asadi N, Zare N. Comparison of attachment and relaxation training effects on anxiety in third trimester and postpartum depression among primipara women. Hayat 2013; 19(1):76-88. (Persian).
  11. Shobeiri F, Jenabi E. The effects of vitamin E on muscular pain reduction in students affected by premenstrual syndrome. Iran J Obstet Gynecol Infertil 2014; 17(96):1-5. (Persian).
  12. Rajeswari S. Efficacy of progressive muscle relaxation on stress anxiety and pregnancy outcome among primigravidae. [PhD Thesis]. India: Sri Ramachandra University; 2014.
  13. Alder J, Urech C, Fink N, Bitzer J, Hoesli I. Response to induced relaxation during pregnancy: comparison of women with high versus low levels of anxiety. J Clin Psychol Med Settings 2011; 18(1):13-21.
  14. Adewuya AO, Ola BA, Aloba OO, Mapayi BM. Anxiety disorders among Nigerian women in late pregnancy: a controlled study. Arch Womens Mental Health 2006; 9(6):325-8.
  15. Smith SS, Shen H, Gong QH, Zhou X. Neurosteroid regulation of GABA(A) receptors: focus on the alpha4 and delta subunits. Pharmacol Ther 2007; 116(1):58-76.
  16. Sadeghi N, Azizi S, Molaeinezhad M. Anxiety status in pregnant mothers at third trimester of pregnancy and its related factors in referrals to Bandar Abbas Hospitals in 2012. Iran J Obstet Gynecol Infertil 2014; 17(122):8-15. (Persian).
  17. Akbarzade M, Toosi M, Zare N, Sharif F. Effect of relaxation and attachment behaviors training on anxiety in first-time mothers in Shiraz city, 2010: A randomized clinical trial. Qom Univ Med Sci J 2013; 6(4):14-23. (Persian).
  18. MirBagher AN, Ranjbar N. Effects of recitation of holy Quran on anxiety of women before cesarean section: a randomize clinical trial. Qom Univ Med Sci J 2012; 4(1):15-9. (Persian).
  19. Domar AD, Eyvazzadeh A, Allen S, Roman K, Wolf R, Orav J, et al. Relaxation techniques for reducing pain and anxiety during screening mammography. Am J Roentgenol 2005; 184(2):445-7.
  20. Kordi M, Nasiri S, Gharavi MM, Ebrahimzadeh S. Evaluating the effect of progressive muscle relaxation training with guided imagery on the severity of depressive symptoms in postpartum period. Iran J Obstet Gynecol Infertil 2012; 15(8):17-24. (Persian).
  21. Consonni EB, Calderon IM, Consonni M, De Conti MH, Prevedel TTs, Rudge MV. A multidisciplinary program of preparation for childbirth and motherhood: maternal anxiety and perinatal outcomes. Reprod Health 2010; 7(28):1-6.
  22. Fink NS, Urech C, Cavelti M, Alder J. Relaxation during pregnancy: what are the benefits for mother, fetus, and the newborn? A systematic review of the literature. J Perinat Neonatal Nurs 2012; 26(4):296-306.
  23. Bastani F, Hidarnia A, Montgomery KS, Aguilar-Vafaei ME, Kazemnejad A. Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes? A randomized controlled trial. J Perinat Neonatal Nurs 2006; 20(2):138-46.
  24. Akmese ZB, Oran NT. Effects of progressive muscle relaxation exercises accompanied by music on low back pain and quality of life during pregnancy. J Midwifery Womens Health 2014; 59(5):503-9.
  25. Sam ML. Effectiveness of progressive muscle relaxation technique on anxiety. Sinhgad J Nurs 2014; 51:120.
  26. Mahram B. Validity of Spielberger state-trait anxiety inventory (STAI) in Mashhad city. Tehran: Allameh Tabatabaei University; 1993. (Persian).
  27. Jabbari Z, Hashemi H, Haghayegh SA. Survey on effectiveness of cognitive behavioral stress management on the stress, anxiety, and depression of pregnant women. Health Sys Res 2012; 8(7):1341-7. (Persian).
  28. Guszkowska M, Langwald M, Sempolska K. Influence of a relaxation session and an exercise class on emotional states in pregnant women. J Reprod Infant Psychol 2013; 31(2):121-33.
  29. Rahimi F, Ahmadi M, Rosta F, Majd HA, Valiani M. Effect of relaxation training on pregnancy anxiety in high risk women. Safe Prom Injury Prev 2014; 2(3):180-8. (Persian).
  30. Spielberg CD. Manual for the State/Trait Anxiety Inventory. Palo Alto. CA: Consulting Psychologists Press; 1983.
  31. Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC psychiatry 2008; 8(1):41.
  32. Tragea C, Chrousos GP, Alexopoulos EC, Darviri C. A randomized controlled trial of the effects of a stress management programme during pregnancy. Complement Ther Med 2014; 22(2):203-11.
  33. Orr ST, Reiter JP, Blazer DG, James SA. Maternal prenatal pregnancy-related anxiety and spontaneous preterm birth in Baltimore, Maryland. Psychosom Med 2007; 69(6):566-70.
    1. Tehranian N, Shobeiri F, Pour FH, Hagizadeh E. Risk factors for breast cancer in Iranian women aged less than 40 years. Asian Pac J Cancer Prev 2010; 11(6):1723-5.
    2. Shobeiri F, Nazari M. Age at menopause and its main predictors among Iranian women. Int J Fertil Steril. 2014;8(3):267-72.
    3. Ding XX, Wu YL, Xu SJ, Zhu RP, Jia XM, Zhang SF, et al. Maternal anxiety during pregnancy and adverse birth outcomes: a systematic review and meta-analysis of prospective cohort studies. J Affect Disord 2014; 159:103-10.