ارتباط استرس، اضطراب و افسردگی با رفتارهای خودمراقبتی دوران بارداری در زنان در معرض خطر زایمان زودرس

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

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

3 دانشیار گروه مامایی، مرکز تحقیقات ایمنی بیمار، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

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

5 استادیار گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: بارداری با تغییرات گسترده­ روانی و جسمی در مادران باردار همراه می­باشد. استرس، اضطراب و افسردگی از جمله عوامل تأثیرگذار بر عملکرد و عدم توجه به خود در زنان باردار می­­باشد. یکی از پرکاربردترین تئوری­ها در زمینه خودمراقبتی، تئوری اورم است. مطالعه حاضر با هدف تعیین ارتباط رفتارهای خودمراقبتی مبتنی بر تئوری اورم با استرس، اضطراب و افسردگی دوران بارداری در زنان در معرض خطر زایمان زودرس انجام شد.
روش‌کار: این مطالعه همبستگی ­توصیفی در سال 1394 بر روی 176 زن باردار 26-24 هفته در معرض خطر زایمان زودرس مراجعه کننده به مراکز بهداشتی- درمانی وابسته به دانشگاه علوم پزشکی مشهد انجام شد. ابزارهای مورد استفاده شامل پرسشنامه غربالگری زایمان زودرس هولبروک، فرم مشخصات فردی و مامایی، پرسشنامه اقدامات مراقبتی دوران بارداری هارت و پرسشنامه استرس، اضطراب و افسردگی DASS21 بود. بر اساس پرسشنامه غربالگری زایمان زودرس هولبروک، افراد واجد شرایط ورود به مطالعه انتخاب شدند. بر اساس پرسشنامه اقدامات مراقبت­های دوران بارداری هارت، رفتار­های خودمراقبتی و بر اساس پرسشنامه استرس، اضطراب و افسردگی DASS21، اضطراب، افسردگی و استرس ارزیابی شد. تجزیه و تحلیل داده­ها با استفاده از نرم­افزار آماری SPSS (نسخه 16) و آزمون­های­ همبستگی پیرسون و اسپیرمن انجام شد. میزان p کمتر از 05/0 معنی­دار در نظر گرفته شد.
یافته­ها: بین نمره خودمراقبتی با استرس (004/0=p) و افسردگی (032/0=p) ارتباط خطی معنادار و معکوس وجود داشت، اما بین خودمراقبتی و اضطراب ارتباط خطی معناداری مشاهده نشد (374/0=p).
نتیجه‌گیری: افزایش استرس و افسردگی در زنان در معرض خطر زایمان زودرس، باعث کاهش رفتارهای خودمراقبتی در آنان می‌شود، لذا مدیریت و شناسایی زنان باردار در معرض استرس و افسردگی و برنامه‌ریزی و انجام اقدامات مناسب جهت کاهش افسردگی و استرس آنها موجب افزایش سطح خودمراقبتی در زنان در معرض خطر زایمان زودرس خواهد شد.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship of prenatal self-care behaviors with stress, anxiety and depression in women at risk of preterm delivery

نویسندگان [English]

  • Seyedeh Mahboobeh Rezaeian 1
  • Zahra Abedian 2
  • Robab Latifnejad Roudsari 3
  • Seyed Reza Mazloom 4
  • Salmeh Dadgar 5
1 M.Sc. student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2 Instructor, Department of Midwifery, Evidence-based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
3 Associate professor, Department of Midwifery, Patient's Safety Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
4 Instructor, Department of Nursing, Evidence-based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
5 Assistant professor, Department of Obstetrics and Gynecology, Women's Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Pregnancy is associated with extensive mental and physical changes in pregnant women. Stress, anxiety and depression are factors affecting pregnant women’s performance that lead to lack of attention to their own self-care. Orem's self-care theory is one of the most widely used theories in the field of self-care. This study was performed with aim to investigate the relationship of self-care behaviors in pregnancy based on Orem’s theory with stress, anxiety and depression in women at risk of preterm delivery.
Methods: This descriptive correlational study was done on 176 pregnant women in 24-26 week of pregnancy at risk for preterm delivery referring to health centers affiliated to Mashhad University of Medical Sciences in 2015. The research tools included Holbrook risk-scoring for preterm labor questionnaire, demographic and obstetric questionnaire, Hart prenatal care actions scale and DASS21 (stress, anxiety and depression questionnaire). According to Holbrook risk-scoring for preterm labor questionnaire, the subjects who met inclusion criteria were selected. Self-care behaviors were assessed according to Hart prenatal care actions scale, and stress, anxiety and depression were evaluated according to DASS21 questionnaire. Data were analyzed using SPSS software (version16) and using Pearson and Spearman correlation tests. PResults: There was inverse linear significant relationship between prenatal self-care and stress (P =0.004) and depression (P =0.032). But no significant relationship was seen between prenatal self-care and anxiety (P =0.374).
Conclusion: The increasing stress and depression in women at risk of preterm delivery reduce self-care behaviors in these patients. Therefore, management and identifying of pregnant women at risk for stress and depression and planning for reducing their stress and depression will lead to increased self-care behaviors in women at risk for preterm delivery.

کلیدواژه‌ها [English]

  • Anxiety
  • Depression
  • Orem's self-care theory
  • pregnancy
  • stress
  1. Jabbari Z, Hashemi H, Haghayegh SA. Survey on effectiveness of cognitive behavioral stress management on the stress, anxiety and depression of pregnant women. J Health Syst Res 2013; 8(7):1341-7. (Persian).
  2. Bayrami M, Zahmatyar H, Bahadori KJ. Prediction strategies to coping with stress in the pregnancy women with first experience on based factors hardiness and social support. Iran J Nurs Res 2013; 7(27):1-9. (Persian).
  3. Nikrahan GR, Kajbaf MB, Nouri A, Zarean E, Naghshineh E. Assessment of the relationship between personality traits, coping styles with stress and stress level in pregnant women. Iran J Obstet Gynecol Infertil 2011; 14(5):51-9. (Persian).
  4. Cuhadaroglu F. Observing depression and anxiety together in adolescents: a review. Turkish J Psyciatry 1993; 4:183-8.
  5. Shahhosseini Z, Abedian K, Azimi H. Role of anxiety during pregnancy in preterm delivery. Zanjan Univ Med Sci J 2008; 16(63):85-92. (Persian).
  6. Baghi V, Ghanei R, Roohi M, Ghoreishi H, Moradi N. The Relationship between antenatal depression and sleep apnea. Iran J Obstet Gynecol Infertil 2013; 16(52):18-24. (Persian).
  7. Abedian Z, Soltani N, Mokhber N, Esmaeeli H. Relationship between social support and postpartum depression in women with preeclampsia. Iran J Obstet Gynecol Infertil 2015; 17(136):10-8. (Persian).
  8. Omidvar SH, Kheirkhah F, Azimi H. Depression during pregnancy and its related factors. Med J Hormozgan Univ 2007; 11(3):213-9. (Persian).
  9. Ghanei R, Golkar F, Aminpoor E. Foot carein depressed and non-depressed diabetic patients. Modern Cares J 2013; 10(2):124-31. (Persian).
  10. Avelyn G. The relationship between prenatal self-care practices during prenancy and birth out comes among young mothers aged 16 to 24 years delivering at Gweru maternity hospital. [Master Thesis]. Zimbabwe, East Africa: Faculty of Medicine, University of Zimbabwe; 2014.
  11. Rafieefar S, Attarzadeh M, Ahmadzadeh Asl M. Comprehensive system of empowering people to take care of their health. 1st ed. Tehran: Mehrravash; 2005. P. 30-40, 57-84. (Persian).
  12. Habibzadeh H, Davarpanah M, Khalkhali H. The study of the effect of orem self care model on self efficacy in hemodialysis patients in Urmia medical science hospitals during 2011. J Urmia Nurs Midwifery Facul 2012; 10(2):190-9. (Persian).
  13. Naji A, Naroie S, Abdeyazdan G, Dadkani E. Effect of applying self-care orem model on quality of life in the patient under hemodialysis. Zahedan J Res Med Sci 2012; 14(1):8-12. (Persian).
  14. Peter Aggleton HC. Nursing models and nursing practice. 1st ed. Tehran: Boshra; 2003. P. 27.
  15. Alligood MR. Nursing theory: utilization and application. 24th ed. New York: Elsevier Health Sciences; 2006.
  16. Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics. 24th ed. New York: The McGraw-Hill; 2014.
  17. Dalili M, Meybodi MA, Ghaforzadeh M, Farajkhoda T, Vardanjani HM. Screening of preterm labor in Yazd city: transvaginal ultrasound assessment of the length of cervix in the second trimester. Iran J Reprod Med 2013; 11(4):279.
  18. Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth 2015; 28(3):179-93.
  19. Neshat R, Majlesi F, Rahimi A, Shariat M, Pourreza A. Investigation the relationship between preterm delivery and prevalence of anxiety, stress and depression in pregnant women of dorrod health center, Iran in 2010. Iran J Obstet Gynecol Infertil 2013; 16(67):16-24. (Persian).
  20. Sajjadi M, Akbari A, Kianmehr M, Atarodi AR. The relationship between self-care and depression in patients undergoing hemodialysis. Ofogh-E-Danesh 2008; 14(1):13-7. (Persian).
  21. Sea-han CH. Effects of depression and resourcefulness on prenatal self-care in pregnant Thai women with HIV seropositivity. In Midwest Nursing Research Society Conference, Canada; 2001.
  22. Weng LC, Dai YT, Wang YW, Huang HL, Chiang YJ. Effect of self-efficacy, self-care behaviors on depressive symptom of Taiwanese kidney transplant recipients. J Clin Nurs 2008; 17(13):1786-94.
  23. Gonzalez JS, Safren SA, Cagliero E, Wexler DJ, Delahanty L, Wittenberg E, et al. Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes Care 2007; 30(9):2222-7.
  24. Park H, Hong Y, Lee H, Ha E, Sung Y. Individuals with type 2 diabetes and depression symptoms exhibited lower adherence with self-care. J Clin Epidemiol 2004; 57(9):978-84.
  25. Moosavi SA, Aghayan S, Razavianzadeh N, Nourozi N, Khosravi A. Depression and general health status Type II diabetes patients. J Knowl Health 2008; 3(1):44-8. (Persian).
  26. Rostami F, Ramezani BF, Amini K, Pezeshki A. Effect of a self-care educational program based on Orem´s model on stress in patients undergoing hemodialysis. Prev Care Nurs Midwifery J 2015; 5(1):13-22. (Persian).
  27. Khobbin Khoshnazar TA, Izadi-Tameh A, Moghadam nia MT, Farmanbar RO, Rostamnia L, Monfared A. Relevance self efficacy with anxiety and depression among patients receiving hemodialysis referred to hemodialysis unit at educational-therapeutic center in Rasht. J Urmia Nurs Midwifery Facul 2014; 12(9):807-14. (Persian).
  28. Kordi M, Banaee M, Asgharipour N, Mazloum SR, Akhlaghi F. Predicting of self-care behaviors in women with gestational diabetes based belief of person in own ability (self- efficacy). Iran J Obstet Gynecol Infertil 2016; 19(13):6-17. (Persian).
  29. Dehghani H, Dehghani KH, Nasiriani KH, Banaderakhshan H. The effect of familiarization with cardiac surgery process on the anxiety of patients undergoing coronary artery bypass graft surgery. Modern Care J 2013; 10(4):257-63. (Persian).
  30. Ezati N. Effect of knowledge about self care behaviors on fear and anxiety in patients with coronary artery disease. Woman Stud Fam 2012; 5(17):107-29. (Persian).