تأثیر شمارش حرکات جنین بر سلامت روان مادر در سه ماهه سوم بارداری: یک مطالعه تصادفی کنترل شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه مامائی، دانشکده پرستاری و مامائی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران.

2 کارشناس ارشد مامائی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.

3 استادیار گروه زنان، دانشکده پزشکی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران.

چکیده

مقدمه: اضطراب، یکی از مشکلات روان شناختی زنان باردار است که گاهی می تواند شکل بیمارگونه به خود گرفته و بهداشت روانی مادر را تحت تأثیر قرار دهد. مطالعه حاضر با هدف تعیین تأثیر شمارش حرکات جنین بر سلامت عمومی مادر انجام شد.
روش کار: این مطالعه نیمه تجربی در سال 1392 بر روی 208 زن نخست زا انجام شد. افراد به طور تصادفی در دو گروه قرار گرفته و در هفته 28 بارداری، پرسشنامه GHQ-28 را تکمیل کردند، سپس گروه مداخله اقدام به شمارش حرکات جنین از هفته 37-28 بارداری کرده و گروه کنترل از مراقبت های معمول برخوردار شدند. هر دو گروه در هفته 37 بارداری مجدداً پرسشنامه را تکمیل و نتایج مقایسه شد. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماری SPSS (نسخه 16) و آزمون های تی مستقل، تی زوج، کای اسکوئر و آزمون دقیق فیشر استفاده شد و میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: میانگین نمرات GHQ در گروه مداخله در هفته 28 و 37 بارداری به ترتیب 23/10±52/23 و 12/10±09/21 بود که تفاوت از نظر آماری معنی دار بود (025/0=p). این میزان در گروه شاهد به ترتیب 43/9±69/23 و 60/8±88/23 بود و تفاوت معنی داری بین دو گروه وجود نداشت (52/0=p). در مقایسه میانگین نمرات بین دو گروه مشخص شد که در هفته 28 بارداری تفاوت معنی دار نبود (37/0=p)، اما در هفته 37 تفاوت معنی دار بود (002/0=p) و شمارش حرکات جنین توانسته است سطح سلامت روانی مادر را نسبت به گروه کنترل بهبود بخشد. تفاوت معنی داری در میانگین دفعات نگرانی مادر در اثر کاهش حرکات جنین (36/0=p) و بستری شدن به دلیل آن (25/0=p) و میانگین سن بارداری در زمان کاهش حرکت جنین در دو گروه وجود نداشت (19/0=p).
نتیجه گیری: شمارش حرکات جنین توسط مادردر هفته های 28 تا 37 بارداری سلامت عمومی مادر را بهبود می بخشد.

کلیدواژه‌ها

عنوان مقاله [English]

Effects of fetal movement counting on mental health of mother in third trimester: A Randomized Controlled Trial

نویسندگان [English]

  • Masoumeh Delaram 1
  • Farzaneh Soltani Poor 2
  • Loabat Jafarzadeh 3
1 Assistant professor, Department of Midwifery, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
2 M.Sc. of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
3 Assistant professor, Department of Obstetrics and Gynecology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
چکیده [English]

Introduction: Anxiety is one of the psychological problems in pregnant women that sometimes takes the pathological form and affects the mental health of mother. This study was performed with aim to determine the effects of fetal movement counting on general health of mother.
Methods: This Quasi-Experimental study was performed on 208 nulliparous women who were randomly divided into two groups. At 28 weeks of gestation, they completed the GHQ-28, then the intervention group started to count fetal movements from 28 to 37 weeks of gestation and the control group received routine care. Again, both groups completed the questionnaire at 37 weeks of gestation and the results were compared. Data analysis was performed with SPSS software (Version 16), t-test, paired-t, Chi Square and fisher Exact tests and PResults: Means scores of GHQ in intervention group at 28th and 37th of pregnancy were 23.52±10.23 and 21.09±10.12, respectively that the difference was significant (P=0.025). The means in control group were 23.69±9.43 and 23.88±8.60, respectively that the difference was not significant (P=0.52). In comparing the mean scores in two groups, it was found that the difference was not significant at 28 weeks of gestation (P=0.37), but it was significant in 37 weeks of gestation (P=0.002), and counting of fetal movements could improve the mental health of mothers compared to control group. There was no significant difference between two groups in the mean frequency of maternal concern about decreased fetal movement (P=0.36), hospitalization due to it (P=0.25) and the mean of gestational age at the time of decreased fetal movement (P=0.19).
Conclusions: Counting of fetal movements by mother at 28 to 37 weeks of gestation improves the general health of mother.

کلیدواژه‌ها [English]

  • fetal movement counting
  • General Health
  • Third trimester of pregnancy

مراجع

  1. Mardani Hamuleh M, Ebrahimi E. Mental Health Status of Pregnant Women Referring to Shahinshahr Health Care Centers . Journal of Research Development in Nursing & Midwifery 2010;7(1):27-33.
  2. Sadeghi A, Sirati-nir M, Hajiamini Z, Ebadi A, Naderi Z, Mehdizade S. The effect of exercise on level of general health of pregnant women referred to a prenatal-care-clinic of Baghiatallah hospital. Journal of Shahid Beheshti school of Nursing and Miwifery 2012; 22(77).(Persian).
  3. Figueiredo B, Conde A. Anxiety and depression in women and men from early pregnancy to 3-months postpartum. Arch Womens Ment Health  2011;14(3):247-55.
  4. Simon GE. Social and economic burden of mood disorders. Biol Psychiatry. 2003; 54(3):208-15.
  5. Van den Bergh BR, Mulder EJ, Mennes M, Glover V. Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neurosci Biobehav Rev 2005; 29(2):237-58.
  6. Neugebauer R, Kline J, Stein Z, Shrout P, Warburton D, Susser M. Association of stressful life events with chromosomally normal spontaneous abortion. Am J Epidemiol 1996; 143(6):588-96.
  7. Paarlberg KM1, Vingerhoets AJ, Passchier J, Dekker GA, Van Geijn HP. Psychosocial factors and pregnancy outcome: a review with emphasis on methodological issues. J Psychosom Res 1995; 39(5):563-95.
  8. Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M. Depression and anxiety during pregnancy and six months postpartum: a follow-up study. Acta Obstet Gynecol Scand  2006; 85(8):937-44.
  9. Bastani F, Hidarnia A, Kazemnejad A, Vafaei M, Kashanian M. A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery Womens Health  2005; 50(4):e36-40.
  10. Urizar GG Jr, Muñoz RF. Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants. Psychoneuroendocrinology 2011; 36(10):1480-94.
  11. Yang M, Li L, Zhu H, Alexander IM, Liu S, Zhou W, et al. Music therapy to relieve anxiety in pregnant women on bedrest: a randomized, controlled trial. MCN Am J Matern Child Nurs 2009; 34(5):316-23.
  12. 12- Guszkowska M, Langwald M, Sempolska K.  Does Physical Exercise Help Maintain Mental Health During Pregnancy? A Comparison of Changes in Mental Health in Participants of Physical Exercise Classes and Childbirth Classes. J Phys Act Health 2014; 12(1):30-6.
  13. 13-Abasi E, Tafazzoli M, Esmaili H,  Hasanabadi H. The effect of maternal–fetal attachment education on maternal mental health. Turk J Med Sci 2013; 43(5): 815-20.
  14. Alhusen JL, Hayat MJ, Gross D. A longitudinal study of maternal attachment and infant developmental outcomes. Arch Womens Ment Health  2013; 16(6):521-9.
  15. Hart R, McMahon CA. Mood state and psychological adjustment to pregnancy. Arch Womens Ment Health 2006; 9(6):329-37.
  16. Lindgren K. Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Res Nurs Health 2001; 24(3):203-17.
  17. Saastad E, Winje BA, Israel P, Frøen JF. Fetal movement counting--maternal concern and experiences: a multicenter, randomized, controlled trial. Birth 2012; 39(1):10-20.
  18. Saastad E1, Israel P, Ahlborg T, Gunnes N, Frøen JF. Fetal movement counting--effects on maternal-fetal attachment: a multicenter randomized controlled trial. Birth 2011; 38(4):282-93.
  19. Noorbala Ahmad Ali, Bagheri Yazdi Seyed Abbas, Asadi Lari Mohsen, Vaez Mahdavi Mohammad Reza . Mental Health Status of Individuals Fifteen Years and Older in Tehran-Iran (2009) . Iranian Journal of Psychiatry and Clinical Psychology  J of Andeesheh Va Raftar 2011;16(4): 479-83.(Persian) .
  20. Akbarzadeh M ,Toosi M Zare N, Sharif F. Effect of learning attachment behaviors on anxiety and maternal fetal attachment in first pregnant women. Journal of Knowledge and Health 2012; 7(2): 21-34.(Persian).
  21. Saastad E, Ahlborg T, Frøen JF. Low maternal awareness of fetal movement is associated with small for gestational age infants. J Midwifery Women’s Health 2008; 53(4):345-52.
  22. Abasi E, Tafaoli M, Esmaeili H. The Effect of Foetal Movement Counting on Primipara Maternal Foetal Attachment. Journal of Mazandaran University of Medical Sciences 2010; 20(77):53-60.(Persian).
  23. Condon JT, Corkindale C. The correlates of antenatal attachment in pregnant women. Br J Med Psychol 1997;70 ( Pt 4):359-72.
  24. Gaffney KF. Maternal-fetal attachment in relation to self-concept and anxiety. Matern Child Nurs J 1986; 15(2):91-101.
  25. Brown MA, Solchany JE. Two overlooked mood disorders in women: subsyndromal depression and prenatal depression. Nurs Clin North Am 2004; 39(1):83-95.
مجله زنان، مامایی و نازایی ایران
دوره 18، شماره 139 - شماره پیاپی 139
هفته اول فروردین ماه 1394
فروردین 1394
صفحه 8-14

فایل ها

هم رسانی

ارجاع به این مقاله

آمار