بررسی تأثیر حضور مامای همراه بر اضطراب و ترس از زایمان طبیعی در زنان باردار: کارآزمایی بالینی تصادفی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 مربی گروه فوریت پزشکی، دانشکده پیراپزشکی آمل، دانشگاه علوم پزشکی مازندران، ساری، ایران.

2 مربی گروه مامایی، دانشکده مامایی، دانشگاه علوم پزشکی خراسان شمالی، بجنورد، ایران.

3 مربی گروه اتاق عمل، مرکز بیماری‌های غیرواگیر، دانشکده پیراپزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

4 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

5 مربی گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی سبزوار، خراسان رضوی، ایران.

6 مربی گروه هوشبری، مرکز بیماری‌های غیرواگیر، دانشکده پیراپزشکی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.

10.22038/ijogi.2022.20715

چکیده

مقدمه: اضطراب و ترس از زایمان، یکی از بزرگ‌ترین نگرانی­های زنان باردار می­باشد که ممکن است منجر به درد و طولانی شدن زایمان شود. با توجه به نقش درمانی و حمایتی ماماها، مطالعه حاضر با هدف تعیین تأثیر حضور مامای همراه بر اضطراب و ترس از زایمان طبیعی در زنان باردار انجام شد.
روش ­کار: این مطالعه کارآزمایی بالینی تصادفی در سال 1397 بر روی ۸۰­ زن باردار در بیمارستان حکیم، شهرستان نیشابور انجام­ شد. در گروه مداخله، مامای ­همراه از ابتدای لیبر تا 1 ساعت پس از خروج جفت در­ کنار زنان بود و اقدامات حمایتی برای آنان انجام می­داد، اما گروه کنترل فقط مراقبت­های روتین بخش را دریافت­ کردند. برای دو گروه پرسشنامه اضطراب هامیلتون و پرسشنامه نگرش زایمان هارتمن در سه فاز تکمیل شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار SPSS (نسخه 20) و آزمون­های تی مستقل، کای دو و آنالیز واریانس با اندازه‌های تکراری انجام­ شد. میزان p کمتر از 05/0 معنی­دار در نظر گرفته ­شد.
یافته­ها: بین دو گروه از نظر ویژگی­های فردی- اجتماعی، مامایی، میانگین نمره اضطراب و ترس از زایمان طبیعی در بدو ورود به بخش زایمان، اختلاف معنی­داری وجود نداشت (۰۵/۰<p). حضور مامای ­همراه، میانگین ­نمره اضطراب و ترس از زایمان در فاز ­فعال زایمان و 1 ساعت پس از خروج جفت را در مادران گروه مداخله در مقایسه گروه کنترل به‌طور معنی­داری کاهش ­داد (۰۰۱/۰>p).
نتیجه­ گیری: حضور مامای همراه در بخش­های زایمان به‌­عنوان یک مداخله ساده و غیرتهاجمی، می­تواند منجر به کاهش اضطراب و ترس از زایمان طبیعی در زنان باردار شود.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of presence of midwife (Doula) on anxiety and fear of natural childbirth in pregnant women: Randomized Clinical Trial

نویسندگان [English]

  • Sedigheh Khalili Shomia 1
  • Farzaneh Khodabandeh 2
  • Fatemeh Borzoee 3
  • Ellahe Bahrami Vazir 4
  • Elham Navipour 5
  • Bita Koushki 6
1 Instructor, Department of Medical Emergency, Amol school of Paramedics, Mazandaran University of Medical Sciences, Sari, Iran.
2 Instructor, Department of Midwifery, School of Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran.
3 Instructor, Department of Operating Room, Non Communicable Disease Center, School of Paramedics, Sabzevar University of Medical Sciences, Sabzevar, Iran.
4 Instructor, Department of Midwifery, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
5 Instructor, Department of Community Medicine, Faculty of Medicine, Sabzevar University of Medical Sciences, Khorasan Razavi, Iran.
6 Instructor, Department of Anesthesia, Non Communicable Disease Center, School of Paramedics, Sabzevar University of Medical Sciences, Sabzevar, Iran.
چکیده [English]

Introduction: Anxiety and fear of childbirth is one of the biggest concerns of pregnant women that may lead to the pain and prolonged delivery. Regarding to the midwives' treatment and supportive roles, this study was performed aimed to evaluate the effect of the presence of doula on the fear and anxiety of natural childbirth in pregnant women.
Methods: This randomized clinical trial study was conducted in 2018 on 80 pregnant women in the Hakim Hospital, Neishabour. In the intervention group, doula was with the women from the beginning of labor until one hour after the placenta was removed, doula performed supportive measures for them. But the control group received only routine care. In both groups, the Hamilton Anxiety Rating Scale and the Hartmann Childbirth Attitude Questionnaire were completed in three stages. Data were analyzed by SPSS software (version 20) and Independent t-test, chi-square, analysis of variance with repeated measures. p>0.05 was considered statistically significant.
Results: There were no significant differences between the two group regarding individual socio-demographic, midwifery, the mean score of anxiety and fear of childbirth at the time of entering the delivery ward (P>0.05). The presence of a doula significantly reduced the mean score of anxiety and fear of childbirth in the active phase of labor and one hour after placental remove in the intervention group compared with the control group (P<0.001).
Conclusion: The presence of doula in the delivery wards as a simple and non-invasive intervention can reduces anxiety and fear of natural childbirth in pregnant women.

کلیدواژه‌ها [English]

  • Anxiety
  • Doula
  • fear
  • Natural Childbirth
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