بررسی میزان آگاهی و خودمراقبتی مادران تحت عمل جراحی سزارین از مراقبت‌های بعد از بی‌حسی اسپاینال

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار آموزش پزشکی، گروه اتاق عمل، دانشکده پیراپزشکی، دانشگاه علوم پزشکی البرز، البرز، ایران.

2 کارشناس ارشد اتاق عمل، کمیته تحقیقات دانشجویی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی البرز، البرز، ایران.

3 استادیار گروه آمار زیستی و اپیدمیولوژی، مرکز تحقیقات بیماری‌های غیرواگیر، دانشکده بهداشت، دانشگاه علوم پزشکی البرز، البرز، ایران.

10.22038/ijogi.2025.88448.6452

چکیده

مقدمه: سزارین یکی از رایج‌ترین جراحی زنان در جهان است که عمدتاً با استفاده از روش بی‌حسی اسپاینال انجام می­ شود. این روش بیهوشی؛ علی‌رغم مزایای متعدد برای مادر و نوزاد، با عوارض احتمالی همراه است. آگاهی و خودمراقبتی صحیح مادران می­ تواند به پیشگیری از بروز این عوارض بیانجامد. مطالعه حاضر با هدف بررسی میزان آگاهی و خودمراقبتی مادران تحت جراحی سزارین از مراقبت‌های پس از بی‌حسی اسپاینال انجام شد.
روش‌کار: این مطالعه توصیفی- مقطعی در سال 1403 بر روی 255 مادر تحت جراحی سزارین با روش بیهوشی اسپاینال در مرکز درمانی- آموزشی کمالی کرج انجام شد. اطلاعات مربوط به میزان آگاهی و خودمراقبتی بیماران تحت جراحی سزارین، با استفاده از پرسشنامه استاندارد شده‌ای که شامل سؤالات دموگرافیک، بررسی میزان آگاهی و خودمراقبتی بود، ارزیابی شد. تجزیه و تحلیل داده­ ها با استفاده از نرم‌افزار آماری SPSS (نسخه 28) و آزمون ­های تحلیل واریانس و رگرسیون خطی چندگانه انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: بر اساس نتایج، میانگین نمره آگاهی بیماران 72/5±21/7 و میانگین نمره خودمراقبتی آنها 40/2±32/14 به‌دست آمد. آگاهی شرکت‌کنندگان در سطح ضعیفی قرار داشت، درحالی‌که عملکرد خودمراقبتی نسبتاً خوب ارزیابی شد. همچنین همبستگی مثبت و معنی‌داری بین آگاهی و خودمراقبتی (001/0>p، 395/0=r) مشاهده گردید. بر اساس نتایج آزمون رگرسیون، سه متغیر زمینه‌ای سابقه بی‌حسی اسپاینال، داشتن عوارض بعد از بی‌حسی و سطح تحصیلات توانستند آگاهی را پیش‌بینی کنند (05/0>p).
نتیجه ­گیری: سطح آگاهی مادران تحت جراحی سزارین با بی‌حسی اسپاینال نسبت به مراقبت‌های بعد از عمل پایین بود و عملکرد خودمراقبتی آنان در سطح نسبتاً مناسبی قرار داشت. همچنین رابطه مثبت و معناداری بین دو متغیر آگاهی و خودمراقبتی مشاهده شد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Level of Awareness and Self-Care of Mothers Undergoing Cesarean Section Regarding Post-Spinal Anesthesia

نویسندگان [English]

  • Leila Sadati 1
  • Seyedeh Maryam Seyd 2
  • Seyedeh Sanaz Mirrahimi 2
  • Parisa Rezanejad 3
  • Fatemeh Soltan 2
1 Assistant Professor of Medical Education, Department of Operating Room, School of Paramedical Sciences, Alborz University of Medical Sciences, Alborz, Iran.
2 M.Sc. of Operating Room, Student Research Committee, Faculty of Paramedical Sciences, Alborz University of Medical Sciences, Alborz, Iran.
3 Assistant Professor, Department of Biostatistics and Epidemiology, Non-Communicable Disease Research Center, School of Health, Alborz University of Medical Sciences, Alborz, Iran.
چکیده [English]

Introduction: Cesarean section (C/S) is one of the most common gynecological surgeries worldwide, primarily performed under spinal anesthesia. Despite its numerous benefits for mothers and newborns, this anesthesia method carries potential complications. Adequate awareness and self-care among mothers can prevent many of these complications. This study was conducted with aim to assess the level of awareness and self-care of mothers undergoing cesarean section regarding post-spinal anesthesia care.
Methods: This descriptive cross-sectional study was conducted in 2024 on 255 mothers undergoing cesarean section with spinal anesthesia at the Kamali Medical-Educational Center in Karaj. Information related to the level of awareness and self-care of patients undergoing cesarean section was assessed using a standardized questionnaire that included demographic questions, awareness and self-care. Data analysis was performed using SPSS statistical software (version 28) and analysis of variance and multiple linear regression tests. P<0.05 was considered significant.
Results: Based on the results, the mean score of patients' awareness was 7.21±5.72 and the mean score of self-care was 14.32±2.40. The participants' awareness was at a poor level, while self-care performance was assessed as relatively good. Also, a positive and significant correlation was observed between awareness and self-care (r=0.395, p<0.001). The results of the regression test showed that three background variables: history of spinal anesthesia, having complications after anesthesia, and level of education were able to predict awareness (p<0.05).
Conclusion: The level of awareness of mothers undergoing cesarean section with spinal anesthesia regarding postoperative care was low and their self-care performance was at a relatively adequate level. Also, a positive and significant relationship was observed between the two variables of awareness and self-care.

کلیدواژه‌ها [English]

  • Awareness
  • Cesarean Section
  • Complications
  • Self-Care
  • Spinal Anesthesia

مراجع

  1. Shahid N, Rashid AM. Knowledge, fear and acceptance rate of spinal anesthesia among pregnant women scheduled for cesarean section: a cross-sectional study from a tertiary care hospital in Karachi. BMC anesthesiology 2024; 24(1):408.
  2. Angolile CM, Max BL, Mushemba J, Mashauri HL. Global increased cesarean section rates and public health implications: A call to action. Health science reports 2023; 6(5):e1274.
  3. Iddrisu M, Khan ZH. Anesthesia for cesarean delivery: general or regional anesthesia—a systematic review. Ain-Shams Journal of Anesthesiology 2021; 13(1).
  4. Pardo MC, Miller RD. Miller’s Basics of Anesthesia. 8nd Elsevier; 2022.
  5. Upadya M, Saneesh PJ. Anaesthesia for non-obstetric surgery during pregnancy. Indian Journal of Anaesthesia 2016; 60(4):234-41.
  6. Afolabi BB, Lesi FE. Regional versus general anaesthesia for caesarean section. Cochrane database of systematic reviews 2012(10).
  7. Šklebar I, Bujas T, Habek D. Spinal anaesthesia-induced hypotension in obstetrics: prevention and therapy. Acta Clinica Croatica 2019; 58(Suppl 1):90.
  8. Lee JE, George RB, Habib AS. Spinal-induced hypotension: incidence, mechanisms, prophylaxis, and management: summarizing 20 years of research. Best Practice & Research Clinical Anaesthesiology 2017; 31(1):57-68.
  9. Singh D, Yadav JB, Singh AK, Rai MK, Rai M. Comparing the effect of phenylephrine bolus and phenylephrine infusion for maintaining arterial blood pressure during cesarean delivery under spinal anesthesia: a randomized prospective study. Cureus 2023; 15(7).
  10. Alnaeli G, Hwisa S, Elmaggoze S, Ajaj A, Alkayakh S. Factors Influence Shivering Phenomenon Post Spinal Anesthesia. Libyan Journal of Medical Research 2024; 18(1):47-54.
  11. Somri M, Teszler CB, Vaida SJ, Yanovski B, Gaitini D, Tome R, et al. Postdural puncture headache: an imaging-guided management protocol. Anesthesia & Analgesia 2003; 96(6):1809-12.
  12. Gramke HF, de Rijke JM, van Kleef M, Raps F, Kessels AG, Peters ML, et al. The prevalence of postoperative pain in a cross-sectional group of patients after day-case surgery in a university hospital. The Clinical journal of pain 2007; 23(6):543-8.
  13. Choi PT, Galinski SE, Takeuchi L, Lucas S, Tamayo C, Jadad AR. PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. Canadian Journal of Anesthesia 2003; 50(5):460-9.
  14. Aldrete JA, Barrios-Alarcon J. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2004; 92(5):767-8.
  15. Aryasa T, Pradhana AP, Ryalino C, Hartawan IG. Post-spinal backache after cesarean section: A systematic review. Bali Journal of Anesthesiology 2021; 5(4):234-8.
  16. Shiferaw AA, Mamo FT. Shoulder Tip Pain During and After Caesarean Section under Spinal Anaesthesia: Incidence, Severity, and Associated Factors in a Tertiary Hospital in Ethiopia; 2025.
  17. Fink C, Diener MK, Bruckner T, Müller G, Paulsen L, Keller M, et al. Impact of preoperative patient education on prevention of postoperative complications after major visceral surgery: study protocol for a randomized controlled trial (PEDUCAT trial). Trials 2013; 14(1):271.
  18. Bellamy R. An introduction to patient education: theory and practice. Medical teacher 2004; 26(4):359-65.
  19. Bacha UQ, Rashid M, Sidiq S. Patient awareness about spinal anaesthesia in our rural obstetric population. Indian Journal of Clinical Anaesthesia 2023; 6(2):289-92.
  20. Yaqoub RM, Khouj MA, Alsaif AA, Eissa GA, Alhemdi JA, Albasri S, et al. Awareness and knowledge of caesarean section complications among women in Jeddah, Saudi Arabia. Cureus 2022; 14(12).
  21. Charpota M, Ajmera V. A Descriptive Study to assess the learning needs and self-care practice regarding post natal care among mothers who underwent LSCS with a view to develop and distribute an information booklet at selected hospital in Udaipur city, Rajasthan. International Journal of Nursing Education and Research 2022; 10(2):133-6.
  22. Malekshoar M, Vatankhah M, Rasekh Jahromi A, Ghasemloo H, Mogharab F, Ghaedi M, et al. Shivering control in women under spinal anesthesia: A narrative review on the role of drugs. The Iranian Journal of Obstetrics, Gynecology and Infertility 2021; 24(7):61-9.
  23. Moisa RC, Negrut N, Macovei IC, Moisa CC, John HT, Marian P. The impact of fentanyl and morphine on maternal hemodynamics in spinal anesthesia for cesarean section. Pharmaceuticals 2025; 18(3):392.
  24. Sadati L, Mashak B, Tayebi Arasteh M, Nouri Khaneghah Z, Faryab Asl M, Salehi T. Studying the Effect of Wearing Compression Socks on Hypotension and the Amount of Administrated Ephedrine after Spinal Anesthesia in the Candidates for Cesarean Section. Journal of Clinical and Basic Research 2018; 2(3):10-8.
  25. Mashe V. Knowledge and Attitudes on Selfcare Practices Following Child Birth by Caesarean Section at Marondera Hospital in Zimbabwe. Cognizance Journal of Multidisciplinary Studies 2022; 2(8):1-39.
  26. Huh H. Postoperative nausea and vomiting in spinal anesthesia. Korean journal of anesthesiology 2023; 76(2):87-8.
  27. Ghasemloo H, Sadeghi SE, Jarineshin H, Rastgarian A, Taheri L, Rasekh Jahromi A, et al. Control of nausea and vomiting in women undergoing cesarean section with spinal anesthesia: A narrative review study on the role of drugs. The Iranian Journal of Obstetrics, Gynecology and Infertility 2021; 24(7):98-107.
  28. Zirak N, Soltani G, Hafizi L, Mashayekhi Z, Kashani I. Shoulder pain after caesarean section: Comparison between general and spinal anaesthesia. Journal of Obstetrics and Gynaecology 2012; 32(4):347-9.
  29. Atuhaire S. Knowledge and Practices of Post Cesarean Section Mothers Towards Self-Care After Delivery at Mbarara Regional Referral Hospital. Student's Journal of Health Research Africa 2021; 2(3):13.
  30. Mulayim B, Celik NY, Kaya S, Yanik FF. Early oral hydration after cesarean delivery performed under regional anesthesia. International Journal of Gynecology & Obstetrics 2008; 101(3):273-6.
  31. Wollman SB, Marx GF. Acute hydration for prevention of hypotension of spinal anesthesia in parturients. Obstetrical & Gynecological Survey 1968; 23(9):864-6.
  32. I Hassan S, Ibrahim El-Feshawy N, Hassan Ahmed A. Effect of Elastic Abdominal Binder on Post Cesarean Pain, Distress, Mobilization and Women’s Satisfaction. Egyptian Journal of Health Care 2021; 12(1):364-82.
  33. Macabasco-O’Connell A, DeWalt DA, Broucksou KA, Hawk V, Baker DW, Schillinger D, et al. Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. Journal of general internal medicine 2011; 26(9):979-86.
  34. Rezaie R, Mohammad-Alizadeh-Charandabi S, Nemati F, Mirghafourvand M. The effect of self-care counseling on health practices of adolescent pregnant women: a randomized controlled trial. BMC pregnancy and childbirth 2021; 21(1):726.
  35. Endalew M, Endalew N, Agegnehu A, Mekonnen Z, Teshome D. Knowledge and attitude towards anesthesia for cesarean section and its associated factors among pregnant women attending antenatal care: A cross sectional study. Annals of Medicine and Surgery 2022; 75:103299.
  36. Anvari HM, Haki BK, Ghorbanian N. Evaluation of patients’ awareness for elective surgery referred to Al-Zahra and Imam Reza hospitals in Tabriz on spinal and general anesthesia and their selection factors in the preoperative anesthetic in 2011-2012. Jentashapir Journal of Health Research 2013; 4(1).
  37. Rabiu A, Abubakar IS, Dai Muhammad A. Knowledge, attitude, and perception of pregnant women toward anesthesia for cesarean section at Aminu Kano Teaching Hospital. Sahel Medical Journal 2019; 22(1):33-7.
  38. Mohammadian erdi A, Mobaraki asl N, Pourfarzi F, Shamshirband M, Yousefian M. The effect of preoperative education on anxiety and acceptance of spinal anesthesia among mothers undergoing elective cesarean section. J Anesth Pain 2022;13(3):162-170.
  39. Costa MF. Health belief model for coronavirus infection risk determinants. Revista de saude publica 2020; 54:47.
مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 8
آبان 1404
صفحه 41-53

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