کاربرد تئوری اورم در ارتقای رفتارهای خودمراقبتی زنان باردار در معرض خطر زایمان زودرس: یک کارآزمایی بالینی

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 مربی گروه مامایی، مرکز تحقیقات مراقبت مبتنی بر شواهد، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دانشیار گروه مامایی، مرکز تحقیقات ایمنی بیمار، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 مربی گروه پرستاری، مرکز تحقیقات مراقبت مبتنی بر شواهد، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 استادیار گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: یکی از پرکاربردترین تئوری‌ها در زمینه خودمراقبتی، تئوری اورم است. بر اساس این تئوری، چنانچه بیماران با استفاده از حداکثر توانمندی خود به انجام اقدامات خودمراقبتی بپردازند، به صورت سریع‌تر و جامع‌تر سلامتی خود را باز می­یابند. مطالعه حاضر با هدف تعیین کاربرد تئوری اورم در ارتقای رفتارهای خودمراقبتی زنان باردار در معرض خطر زایمان زودرس انجام شد.
روش‌کار: این مطالعهکارآزمایی بالینی در سال 95-1394 بر روی 176 زن باردار 26-24 هفته در معرض خطر زایمان زودرس مراجعه کننده به مراکز بهداشتی- درمانی وابسته به دانشگاه علوم پزشکی شهر مشهد انجام شد. ابزارهای مورد استفاده شامل پرسشنامه غربالگری زایمان زودرس هولبروک، فرم مشخصات فردی و مامایی و پرسشنامه اقدامات مراقبت‌های دوران بارداری هارت بود. بر اساس پرسشنامه غربالگری زایمان زودرس هولبروک، افراد واجد شرایط ورود به مطالعه انتخاب شدند. بر اساس پرسشنامه اقدامات مراقبت­های دوران بارداری هارت، نیازهای آموزشی گروه مداخله و رفتار­های خودمراقبتی ارزیابی شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون‌های آنالیز واریانس اندازه‌های تکراری، کای دو، تست دقیق فیشر و من ویتنی یو انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: قبل از مداخله آموزشی، میانگین نمره خودمراقبتی دوران بارداری در دو گروه مداخله و کنترل تفاوت آماری معناداری نداشت (899/0=p). اما در هفته اول (0001/0p<) و دوم بعد از مداخله (0001/0p<) و همچنین پس از زایمان (0001/0p<)، میانگین نمره خودمراقبتی دوران بارداری در گروه مداخله بالاتر از گروه کنترل بود.
نتیجه‌گیری: با توجه به نتایج مداخلات آموزشی مبتنی بر تئوری اورم در ارتقاء رفتارهای خودمراقبتی زنان باردار در معرض خطر زایمان زودرس، شناسایی و آموزش خودمراقبتی دوران بارداری مبتنی بر تئوری اورم به زنان در معرض خطر زایمان زودرس در مراکز بهداشتی- درمانی توصیه می‌شود.

کلیدواژه‌ها


عنوان مقاله [English]

Application of Orem's theory for promotion of self-care behaviors of pregnant women at risk for preterm delivery: A clinical trial

نویسندگان [English]

  • Seyedeh Mahboobeh Rezaeean 1
  • Zahra Abedian 2
  • Robab Latifnejad Roudsari 3
  • Seyed Reza Mazloom 4
  • Salmeh Dadgar 5
1 M.Sc. student of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2 Instructor, Department of Midwifery, Evidence-based Care Research Center, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
3 Associate Professor, Department of Midwifery, Patient Safety Research Center, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
4 Instructor, Department of Nursing, Evidence-based Care Research Center, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
5 Assistant Professor, Department of Obstetrics & Gynecology, Women's health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: One of the most widely used theories in the field of self-care is the Orem's theory. According to this theory, patients can recover more quickly and holistically if they carry out their own self cares to the best of their ability. This study was performed with aim to investigate the application of Orem's theory for promotion of self-care behaviors of pregnant women at risk for preterm delivery.
Methods: This clinical trial was done on 176 pregnant women at 24-26 gestational week at risk for preterm delivery who referred to health centers of Mashhad University of Medical Sciences in 2015-2016. The research tools included Holbrook risk-scoring for preterm labor questionnaire, demographic and obstetric questionnaire and Hart prenatal care actions scale. According to Holbrook risk-scoring for preterm labor questionnaire, the women who had inclusion criteria were selected. According to Hart prenatal care actions scale, the educational needs of intervention group and self-care behaviors were evaluated. Data were analyzed by SPSS software (Version16), and repeated measures ANOVA, Chi-square, Fisher exact and Mann–Whitney U tests. P<0.05 was considered significant.
Results: The mean score of prenatal self-care was not significantly different in intervention and control group before educational intervention (P=0.899). But one week (P<0.0001) and two weeks (P<0.0001) after educational intervention and also in postpartum period (P<0.0001), the mean score of prenatal self-care was higher in intervention group compared to control group.
Conclusion: The educational intervention based on Orem’s theory is recommended to increase the prenatal self-care behaviors of pregnant women at risk for preterm delivery, identifying and training the prenatal self-care based on Orem’s theory for women at risk for preterm birth in health care centers.

کلیدواژه‌ها [English]

  • Orem's theory
  • Preterm delivery
  • self-care
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