مقایسه تأثیرآموزش گروهی و انفرادی بر نگرانی و اضطراب زنان باردار پیرامون آزمایشات غربالگری اختلالات کروموزومی جنین

نوع مقاله : اصیل پژوهشی

نویسندگان

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

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

3 دانشیار گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

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

5 دانشیار گروه آموزشی علوم تربیتی، دانشگاه فردوسی مشهد، مشهد، ایران.

چکیده

مقدمه:انجام آزمایشات غربالگری اختلالات کروموزومی جنین ممکن است باعث ایجاد نگرانی و اضطراب در مادران باردار شود. مطالعه حاضر با هدف مقایسه تأثیر آموزش گروهی و انفرادی بر نگرانی و اضطراب زنان باردار پیرامون آزمایشات غربالگری اختلالات کروموزومی جنین انجام شد.
روش کار:این مطالعه کارآزمایی بالینی در سال 1393 بر روی 240 زن باردار با سن بارداری کمتر از 10 هفته، در مراکز بهداشتی- درمانی شهر مشهد انجام شد. ابزار گردآوری داده ها، فرم اطلاعات فردی، پرسشنامه نگرانی کمبریج و اضطراب اشپیلبرگر بود. در گروه های مداخله، آموزش انفرادی و گروهی طی دو جلسه به صورت هفته ای یک بار و طی دو هفته متوالی برگزار شد و در گروه کنترل، مراقبت معمول انجام شد. میزان نگرانی و اضطراب زنان باردار قبل از آموزش و نیز در هفته 22-20 بارداری در سه گروه اندازه گیری شد. تجزیه و تحلیل داده ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون های آماری آنالیز واریانس یک طرفه، توکی و آزمون تی انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: میانگین نمره نگرانی زنان باردار در سه گروه آموزش انفرادی (03/8±55/17)، گروهی (87/8±48/19) و کنترل (06/5±18/24) اختلاف آماری معنی داری داشت (001/0=p). همچنین میانگین نمره اضطراب آشکار زنان باردار در سه گروه آموزش انفرادی (01/4±9/46)، گروهی (01/3±5/45) و کنترل (26/5±9/47) و میانگین نمره اضطراب پنهان در سه گروه آموزش انفرادی (34/4±86/45)، گروهی (36/4±73/46) و کنترل (08/5±32/44) اختلاف آماری معنی داری داشت (001/0=p).
نتیجه گیری: با توجه به مؤثر بودن روش های آموزش انفرادی و گروهی در کاهش نگرانی و اضطراب آشکار زنان باردار پیرامون آزمایشات غربالگری اختلالات کروموزومی جنین، می توان هر کدام از این روش های آموزشی را بر حسب شرایط محیط بالین برای ترغیب مادران باردار جهت استفاده از آزمایشات غربالگری استفاده کرد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparing the Effects of Group and Individual Education on Worry and Anxiety of Pregnant Women about Fetal Chromosomal Disorders Screening Tests

نویسندگان [English]

  • Masoumeh kordi 1
  • Sahar Riyazi 2
  • Marzieh Lotfalizadeh 3
  • Mohammad Taghi Shakeri 4
  • Hosein Jafari Suny 5
1 Assistant professor, Department of Midwifery, Evidence-based caring research center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2 M.Sc. student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
3 Associate professor, Department of Obstetrics and Gynecology, Women's Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Professor, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Associate professor, Department of Education Sciences, Mashhad Ferdowsi University, Mashhad, Iran.
چکیده [English]

Introduction: Fetal chromosomal disorders screening tests may cause worry and anxiety in pregnant women. This study was conducted with aim to compare the effects of group and individual education on worry and anxiety of pregnant women about fetal chromosomal disorders screening tests.
Methods: This clinical trial study was performed on 240 pregnant women with gestational age< 10 weeks at Mashhad health care centers in 2014. Data collection tool was individual information form, Cambridge worry and Spielberger anxiety inventory. In the intervention groups, individual and group education was held once a week for two sessions during two consecutive weeks, and in control group, the routine care was performed. The rate of worry and anxiety was measured before education and also in 20-22 weeks of pregnancy in three groups. Data was analyzed using SPSS statistical software (version 16) and ANOVA, Tukey and T-test. PResults: Mean score of worry in pregnant women was significantly different in three groups of individual education (17.55±8.03), group education (19.48±8.87) and control group (24.18±5.06) (P=0.001). Also, mean score of state anxiety in pregnant women was significantly different in three groups of individual education (46.9±4.01), group education  (45.5±3.01) and control group (47.9±5.26), and mean score of trait anxiety was significantly different in three groups of individual education (45.86±4.34), group education (46.73±4.36) and control group (44.32±5.08) (P=0.001).
Conclusion: According to the effectiveness of individual and group education methods to reduce worry and state anxiety in pregnant women about fetal chromosomal disorders screening tests, each of these educational methods can be used on the basis of the clinical environment to encourage the women to use screening tests.

کلیدواژه‌ها [English]

  • Anxiety
  • Chromosomal Disorders
  • Education
  • Screening
  • Worry

مراجع

  1. Ghorbani M, Parsiyan N, Mahmodi M, Jalalmanesh S. The study of incidence of congenital anomalies and relationship between anomakies and personal and family-social factors. Iran J Obstet Gynecol Infertil 2004; 6(2):66-71.
  2. Sadock BJ, Sadock VA. Synopsis of psychiatry. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2003.
  3. Styles screening and diagnosis of fetal abnormalities. Tehran: Ministry of Health and Medical Education; 2011.(Persian).
  4. Georgsson Ohman S. Women's experiences of fetal screening for Down's syndrome by means of an early ultrasound examination. Sweden: Department of Nursing Karolinska Instittet Stockholm; 2005.
  5. Light HK, Fenster C. Maternal concerns during pregnancy. Am J Obstet Gynecol 1974; 118(1):46–50.
  6. Statham H, Green JM, Katesios K. Who worries that something might be wrong with the baby? A prospective study of 1072 women. Birth 1997; 24(4):223–33.
  7. Georgsson Ohman S, Saltvedt S, Grunewald C, Waldenstrom U. Does fetal screening affect women's worries about the health of their baby? A randomized controlled trial of ultrasound screening for Down's syndrome versus routine ultrasound screening. Acta obstet Gynecol Scand 2004; 83(7):634-40.
  8. Statham H, Green JM, Snowdon C. Psychology and social aspects of screening for fetal abnormality, during routine antenatal care. In: Green JM. Women’s experiences of prenatal screening and diagnosis. London: Prenatal diagnosis, Springer; 1994. p. 37-53.
  9. Kleinveld JH. Psychological consequences of prenatal screening. Amsterdam: Dissertation VU Medical Center; 2008.
  10. Baillie C, Mason G. The psychological impact of obstetric ultrasound scans and soft marker screening. Imaging 1997; 9:115-20.
  11. Zlotogorski Z, Tadmor O, Duniec E, Rabinowitz R, Diamant Y. The effect of the amount of feedback on anxiety levels during ultrasound scanning. J Clin Ultrasound 1996; 24(1):21-4.
  12. Crowther CA, Kornman L, O’Callaghan S, George K, Furness M, Willson K. Is an ultrasound assessment of gestational age at the first antenatal visit of value? A randomised clinical trial. Br J Obstet Gynaecol 1999; 106(12):1273-9.
  13. Jepson RG, Hewison J, Thompson AG, Weller D. How should we measure informed choice? The case of cancer screening. J Med Ethics 2005; 31(4):192-6.
  14. Lewis J, Leach J. Discussion of socio-scientific issues: The role of science knowledge. Int J Sci Educ 2006; 28(11):1267-87.
  15. Prokop P, Leskova A, Kubiatko M, Diran C. Slovakian students knowledge of and attitudes toward biotechnology. Int J Sci Educ 2007; 29(7):895-907.
  16. Navei M. Comparison of two methods of teaching and lecturing roles in knowledge, attitudes and decisions about the mode of delivery of pregnant women. [Doctorate Thesis]. Iran. Dental School of Mashhad University of Medical Sciences; 2010. (Persian).
  17. Thornton JG, Hewison J, Lilford RJ, Vail A. A randomised trial of three methods of giving information about prenatal testing. BMJ 1995; 311(7013):1127-30.
  18. Kaiser AS, Ferris LE, Pastuszak AL, Llewellyn-Thomas H, Johnson JA, Conacher S, et al. The effects of prenatal group genetic counselling on knowledge, anxiety and decisional conflict: issues for nuchal translucency screening. J Obstet Gynaecol 2002; 22(3):246-55.
  19. Bjorklund U, Marsk A, Ohman SG. Does an information film about prenatal testing in early pregnancy affect women's anxiety and worries? J Psychosom Obstet Gynaecol 2013; 34(1):9-14.
  20. Michelacci L, Fava GA, Grandi S, Bovicelli L, Orlandi C, Tormbini G. Psychological reactions to ultrasound. Psychother Psychosom 1988; 50(1):1–4.
  21. Zlotogorski Z, Tadmor O, Dumec E, Rabinowitz R, Diamant Y. Anxiety levels of pregnant women during ultrasound examination: coping styles, amount of feedback and learned resourcefulness. Ultrasound Obstet Gynecol 1995; 6(6):425–9.
  22. Garcia J, Bricker L, Henderson J, Martin MA, Mugford M, Nielson J, et al. Women’s views of pregnancy ultrasound: a systematic review. Birth 2002; 29(4):225–50.
  23. Burton BK, Dillard RG, Clark EN. Maternal serum alpha-fetoprotein screening: the effect of participation on anxiety and attitude toward pregnancy in women with normal results. Am J Obstet Gynecol 1985; 152(5):540-3.
  24. Browner CH, Preloran M, Press NA. The effects of ethnicity, education and an informational video on pregnant women's knowledge and decisions about a prenatal diagnostic screening test. Patient Educ Couns 1996; 27(2):135-46.
  25. Marteau TM, Johnston M, Plenicar M, Shaw RW, Slack J. Development of a self-administered questionnaire to measure women's knowledge of prenatal screening and diagnostic tests. J Psychosom Res 1988; 32(4-5):403-8.
  26. Faden RR, Chwalow AJ, Orel-Crosby E, Holtzman NA, Chase GA, Leonard CO. What participants understand about a maternal serum alpha-fetoprotein screening program. Am J Public Health 1985; 75(12):1381-4.
  27. Dormandy E, Hooper R, Michie S, Marteau TM. Informed choice to undergo prenatal screening: a comparison of two hospitals conducting testing either as part of a routine visit or requiring a separate visit. J Med Screen 2002; 9(3):109-14.
  28. Dahl K, Hvidman L, Jorgensen FS, Kesmodel US. Knowledge of prenatal screening and psychological management of test decisions. Ultrasound Obstet Gynecol 2011; 38(2):152-7.
  29. Toghyani R, Ramezani MA, Izadi M, Motie Z. The Effect of Prenatal Care Group Education on Pregnant Mothers' Knowledge, Attitude and Practice. Iran J Med Educ 2008; 7(2):317-23.
  30. Mahram B. Validation of Eshpil berger anxiety test in Mashhad. [Doctorate Thesis]. Iran: University of Oloom Tarbiaty Tabatabaie; 1996. (Persian).
  31. Green JM, Kafetsios K, Stetham HE, Snowdon CM. Factor Structure, Validity and Relibility of the Cambridge Worry Scale in a Pregnant Population. J Health Psychol 2003; 8(6):753-64.
  32. Zaree Mobini F. Effect of smelling lavender essential oil on the first stage of labor anxious,in nulliparous women. [Doctorate Thesis]. Mashhad: Nursing and Midwifery Mashhad University of Medical Sciences; 2008. (Persian).
  33. Kaiser AS, Ferris LE, Katz R, Pastuszak A, Llewellyn-Thomas H, Johnson JA, et al. Psychological responses to prenatal NTS counseling and the uptake of invasive testing in women of advanced maternal age. Patient Educ Couns 2004; 54(1):45-53.
  34. Zlotogorski Z, Tadmor O, Duniec E, Rabinowitz R, Diaman Y. Anxiety levels of pregnant women during ultrasound examination: coping styles, amount of feedback and learned resourcefulness. Ultrasound Obstet Gynecol 1995; 6(6):425-9.

مجله زنان، مامایی و نازایی ایران
دوره 18، شماره 157 - شماره پیاپی 157
هفته سوم مرداد ماه 1394
مرداد 1394
صفحه 1-10

فایل ها

هم رسانی

ارجاع به این مقاله

آمار