تبیین ترس از زایمان طبیعی و عوامل مرتبط با آن در زنان نخست باردار: یک مطالعه ترکیبی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه بهداشت باروری، مرکز تحقیقات عوامل اجتماعی سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی لرستان، خرم‌آباد، ایران.

2 استاد گروه بهداشت باروری، دپارتمان مامایی و سلامت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

3 استادیار گروه پرستاری، مرکز تحقیقات عوامل اجتماعی سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی لرستان، خرم‌آباد، ایران.

4 دستیار تخصصی بیماری‌های داخلی، مرکز تحقیقات عوامل اجتماعی سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی لرستان، خرم‌آباد، ایران.

چکیده

مقدمه: ترس از زایمان طبیعی، یک مشکل شایع در زنان باردار می­ باشد. مطالعه حاضر با هدف تبیین ترس از زایمان طبیعی و عوامل مرتبط با آن در زنان نخست باردار انجام شد.
روش‌کار: این مطالعه ترکیبی با رویکرد متوالی - توضیحی از نوع انتخاب مشارکت کنندگان، در سال 94-1393 انجام شد. در فاز کمّی 400 زن نخست باردار با سن حاملگی 32-18 هفته به روش نمونه‌گیری خوشه­ ای چند مرحله ­ای انتخاب شدند. برای گردآوری داده­ ها از پرسشنامه­ های نگرش زایمان، مشخصات دموگرافیک و حمایت اجتماعی نورتوس استفاده شد. آنالیز داده­ ها با آزمون­ های کای اسکوئر، تی، من ویتنی و رگرسیون لجستیک چندگانه انجام شد. در فاز کیفی با 15 زن نخست باردار با نمونه‌گیری مبتنی بر هدف، مصاحبه نیمه‌ساختار یافته عمیق با استفاده از سؤالات باز انجام شد. داده ­ها با استفاده از روش تحلیل محتوای قراردادی مورد تجزیه و تحلیل قرار گرفتند.
یافته ­ها: میانگین نمره ترس از زایمان طبیعی 44/9±86/37 و شیوع آن 8/80% (CAQ≥28) بود. بر اساس نتایج آنالیز رگرسیون لجستیک چندگانه، بین عدم کفایت درآمد (020/0=p)، عدم شرکت در کلاس­ های آمادگی زایمان (040/0=p) و انتخاب روش زایمان طبیعی (001/0>p) با ترس از زایمان ارتباط معنی‌داری وجود داشت. در مرحله کیفی سه درون‌مایه احساس عدم توانمندی برای زایمان طبیعی، سردرگمی در تصمیم‌گیری و نگرانی از عوارض زایمان طبیعی به‌دست آمد.
نتیجه­ گیری: ترس از زایمان طبیعی تحت تأثیر عوامل فردی، اجتماعی و فرهنگی می­باشد. پیشنهاد می­ شود که ارائه دهندگان خدمات سلامت از نتایج این مطالعه جهت اجرای برنامه‌های آموزشی ترغیب کننده زایمان طبیعی استفاده کنند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Fear of natural childbirth and its related factors among primigravid women: a mixed-methods study

نویسندگان [English]

  • Soheila Pirdadeh Beiranvand 1
  • Zahra behboodi moghaddam 2
  • Maryam Hasani 1
  • Shourangiz Beiranvand 3
  • Ali Beygizadeh 4
1 Assistant Professor, Department of Reproductive Health, Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
2 Professor of Reproductive Health, Department of Midwifery And Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Department of Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
4 Resident of Internal Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
چکیده [English]

Introduction: Fear of natural childbirth is a common problem among pregnant women. The present study was performed with aim to explain fear of natural childbirth and its related factors among primigravid women.
Methods: This sequential-explanatory mixed-methods study with participant selection type was conducted in 2014-2015. At quantitative phase, using a multistage cluster sampling method, 400 primigravid women with 18-32 gestation weeks were selected. To collected data, Childbirth Attitude Questionnaire, demographic characteristics, and Northouse Social Support Questionnaire were used. Data analysis was performed using Chi-square, t-test, Mann-Whitney test, and multivariate logistic regression. At qualitative phase, semi-structured individual interviews using open-ended questions was performed on 15 primigravid women who were selected using purposive sampling method. The data were analyzed using conventional content analysis method.
Results: Mean score of fear of natural childbirth was 37.86±9.44 and its prevalence (CAQ≥28) was 80.8%. According to the results of multivariate logistic regression analysis, a significant relationship was found between lack of sufficient income (p=0.020), not participating in childbirth preparation classes (p=0.040) and selection of delivery method (vaginal delivery) (p<0.001) with fear of childbirth. Analysis of data at the qualitative stage led to three themes including feeling of inability for natural childbirth, confusion in decision making and concerns about natural childbirth complications.
Conclusion: Fear of childbirth was influenced by personal, social and cultural factors. Therefore, it is suggested that health service providers use the results of this study to implement educational programs in order to encourage natural childbirth.

کلیدواژه‌ها [English]

  • Cross-Sectional Study
  • Fear
  • Natural Childbirth
  • Primigravida
  • Qualitative Research
  • Women

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 3
خرداد 1403
صفحه 21-36

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