تأثیر برنامه مراقبت حمایتی بر داغدیدگی در زنان با سقط زودرس

نوع مقاله: اصیل پژوهشی

نویسندگان

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

2 دانشجوی کارشناسی ارشد مشاوره در مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه روان‌شناسی بالینی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 استاد گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: شکست در انجام وظایفی همچون تولید مثل، منجر به کاهش اطمینان به خود و تشدید فرآیند داغدیدگی می‌شود. برنامه مراقبت حمایتی بر تجربیات زن از سقط، برگشت به زندگی عادی و نگرانی در مورد حاملگی بعدی تأکید می­کند. مطالعه حاضر با هدف تعیین تأثیر برنامه مراقبت حمایتی بر داغدیدگی در زنان با سقط زودرس انجام شد.
روش‌کار­: این مطالعه کارآزمایی بالینی در سال 1395 بر روی 60 زن دچار سقط بستری در بخش زنان بیمارستان‌های ام البنین (س)، امام رضا (ع) و قائم (عج) مشهد انجام شد. برای زنان گروه مداخله، سه جلسه آموزشی مبتنی بر تئوری سوانسون برگزار شد. در گروه کنترل، مراقبت‌های معمول بخش انجام شد. قبل از مداخله، 4 و 8 هفته پس از سقط، پرسشنامه داغدیدگی پس از سقط توسط زنان هر دو گروه تکمیل شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 5/11) و آزمون‌های تی مستقل، من ویتنی، تحلیل واریانس با اندازه­های تکراری، کای اسکوئر و دقیق کای اسکوئر انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ها: میانگین نمره داغدیدگی زنان گروه مداخله، در هر دو مرحله­ 4 هفته و 8 هفته بعد از سقط زنان به‌طور معنی­داری کمتر از زنان گروه کنترل بود (001/0>p). بر اساس نتایج تحلیل واریانس با اندازه­های تکراری، طی مراحل مختلف سنجش داغدیدگی، تفاوت نمره زنان گروه مداخله از نظر آماری معنی‌دار بود (001/0>p)، ولی در گروه کنترل از نظر آماری معنی­دار نبود (899/0=p).
نتیجه­گیری: برنامه مراقبت حمایتی مبتنی بر تئوری سوانسون، می­تواند داغدیدگی زنان دچار سقط را کاهش دهد.

کلیدواژه‌ها


عنوان مقاله [English]

The Effect of Supportive care program on women's Bereavement with early Miscarriage

نویسندگان [English]

  • Nahid Golmakani 1
  • Maryam Ahmadi 2
  • Negar Asgharipour 3
  • Habibollah Esmaeli 4
1 Assistant Professor in Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 M.Sc. Student in Midwifery counseling, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor of Clinical Psychology, Faculty of Medical, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Professor, Depatment of Bio statistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Failure to perform tasks such as reproduction, lead to a decrease in self confidence and increase of bereavement process. Structured consultation had emphasis on the experiences of women from abortion, return to normal life, and worry about the next pregnancy. This study aimed to the effect of Supportive care program on women's bereavement with early Miscarriage was designed.
Methods and materials: This clinical trial was conducted involving 60 women with miscarriage women admitted to Omolbanin, Imam Reza and Ghaem Mashhad hospitals in 2016. Three sessions were held based on the Swanson theory for women in the intervention group. It was done routine cares in the control group. Baseline, 4 and 8 weeks after the abortion, Perinatal Bereavement Grief Scale were completed by women in both groups. Data using SPSS statistical software (v. 11.5) and Independent t test, Mann-Whitney, Repeated measure ANOVA, Chi-square, Exact chi-square were analyzed. The p value less than 0.05 was considered significant.
Results: The average score of bereavement in four and eight weeks post-abortion of women in the intervention group statistically significantly was less than in the control group (p< 0.001). The results of repeated measure ANOVA showed that there was a statistically significant in the different bereavement score measurement of women in the intervention group (p< 0.001) but there wasn't statistically significant difference in the control group (p=0.899).
Conclusions: Swanson theory-based structured program can decrease bereavement of women who have had a miscarriage.

کلیدواژه‌ها [English]

  • Support
  • Bereavement
  • Women
  • Miscarriage
  • Supportive care
  1. Berek JS, Novak E. Berek and Novak’s gynocology. 14th ed. Philadelphia: Lippincott Willims & Wilkins; 2012. P. 577-604.
  2. Nikpour B, Majlessi F, Tol A, Eshraghi N. Assessment of induced abortions and its effective factors in comparison with spontaneous abortions among women refer to hospitals in south of Tehran. Fam Health 2013; 1(3):14-20. (Persian).
  3. Ehdaivand F. Evaluation of risk factors associated with abortion in hospital patients Ardabil. [Master Thesis]. Ardabil, Iran: Ardabil University of Medical Sciences; 2002. (Persian).
  4. Lasker JN, Toedter LJ. Predicting outcomes after pregnancy loss: results from studies using the Perinatal Grief Scale. Illness Cris Loos 2000; 8(4):350-72.
  5. DeBackere KJ, Hill PD, Kavanaugh KL. The parental experience of pregnancy after perinatal loss. J Obstet Gynecol Neonat Nurs 2008; 37(5):525-37.
  6. Kashanian M, Akbarian AR, Shabandoost SH. Pregnancy outcome following one previous spontaneous abortion. Razi J Med Sci 2004; 11(41):463-71. (Persian).
  7. Bansen SS, Stevens RN. Women's experiences of miscarriage in early pregnancy. J Nurse Midwifery 1992; 37(2):84-90.
  8. Worden JW. Grief counselling and grief therapy: a hand-book for the mental health practitioner. 2nd ed. New York: Springer Publications; 1991.
  9. Kroth J, Garcia M, Hallgren M, LeGrue E, Ross M, Scalise J. Perinatal loss, trauma, and dream reports. Psychol Rep 2004; 94(3):877-82.
  10. Dibaei A, Saadati N. A study of prevalence, demographic characteristics, causes and side effects of abortions in clients referred to hospitals of Ahwaz University. Jundishapur Sci Med J 2008; 7(1):12-22. (Persian).
  11. Kaplan HI, Sadock BJ. Synopsis of psychiatry behavioral science clinical psychiatry. 8th ed. New York: Lippincott Williams & Wilkins; 2000. P. 847-56.
  12. Ritsher J, Neugebauer R. Perinatal Bereavement Grief Scale: distinguishing grief from depression following miscarriage. Assessment 2002; 9(1):31-40.
  13. Beutel M, Willner H, Deckardt R, Von Rad M, Weiner H. Similarities and differences in couples’ grief reactions following a miscarriage: results from a longitudinal study. J Psychosom Res 1996; 40(3):245-53.
  14. Speraw SR. The experience of miscarriage: how couples define quality in health care delivery. J Perinatal 1994; 14(3):208-15.
  15. Adolfsson A. Women’s well-being improves after missed miscarriage with more active support and application of Swanson’s Caring Theory. Psychol Res Behav Manag 2011; 4:1-9.
  16. Dickson N. A theory of caring for midwifery. Aust Coll Midwives Inc J 1997; 10(2):23-8.
  17. Caelli K, Downie J, Letendre A. Parent’s experiences of midwifery managed care following the loss of a baby in previous pregnancy. J Adv Nurs 2002; 39(2):127–36.
  18. Swanson KM. Empirical development of a middle range theory of carring. Nurs Res 1991; 40(3):161-6.
  19. Swanson KM. Nursing as informed carring for the well-being of the others. Image J Nurs Sch 1998; 25(4):352-7.
  20. Ardekani ZB, Akhondi MM, Sadeghi MR, Sadri-Ardekani H. The necessity of a comprehensive study on abortion in Iran. J Reprod Infertil 2005; 6(4):299-320.
  21. Murray JA, Terry DJ, Vance JC, Battistutta G, Connolly Y. Effects of a program of intervention on parental distress following infant death. Death Stud 2000; 24(4):275–305.
  22. Kong GW, Chung TK, Lok IH. The impact of supportive counselling on women’s psychological wellbeing after miscarriage. BJOG 2014; 121(10):1253-62.
  23. Adolfsson A, Larsson PG, Wijma B, Berterö C. Guilt and emptiness: women's experiences of miscarriage. Health Care Women Int 2004; 25(6):543-60.
  24. Swanson KM, Chen HT, Graham CJ, Wojnar DM, Petras A. Resolution of depression and grief during the first year after miscarriage: a randomized controlled clinical trial of couples-focused interventions. J Womens Health 2009; 18(8):1245-57.
  25. Forest GC, Standish E, Baum JD. Support after perinatal death: a study of support and counselling after perinatal bereavement. Br Med J 1982; 285(6353):1475-9.
  26. Nielsen S, Hahlin M, Moller A. Bereavement, grieving and psychological morbidity after first trimester spontaneous abortion: comparing expectant management with surgical evacuation. Hum Reprod 1996; 11(8):1767-70.
Adolfsson A, Bertero C, Larsson PG. Effect of a structured follow-up visit to a midwife on women with early miscarriage. Acta Obstet Gynecol Scand 2006; 85(3):330-5