عوامل مؤثر بر فرآیند تصمیم‌گیری زنان نخست باردار در مورد انتخاب روش زایمان: یک مطالعه تئوری محور

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی گناباد، گناباد، ایران.

2 استادیار گروه آموزش بهداشت و ارتقای سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی قم، قم، ایران.

3 کارشناسی ارشد بهداشت مادر و کودک، مرکز بهداشت شماره سه، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 کارشناس مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی گناباد، گناباد، ایران.

چکیده

مقدمه: آمار سزارین در ایران بالاتر از حد استاندارد است و توجه به عوامل مؤثر بر فرآیند تصمیم‌گیری زنان جهت انتخاب روش زایمان می­تواند به شناسایی علل افزایش آن کمک کند. مطالعه حاضر با هدف بررسی عوامل مؤثر بر فرآیند تصمیم‌گیری زنان جهت انتخاب روش زایمان با استفاده از مدل باور بهداشتی انجام شد.
روش کار: این مطالعه مقطعی در فاصله زمانی خرداد 1393 تا فروردین 1396 بر روی 321 زن نخست باردار که بارداری طبیعی و سالم بالاتر از 26 هفته داشتند، در شهر گناباد انجام شد. ابزار گردآوری اطلاعات مشتمل بر پرسشنامه مشخصات فردی و باروری، پرسشنامه آگاهی در مورد مزایا و معایب زایمان طبیعی و سزارین، پرسشنامه سنجش سازه­های مدل باور بهداشتی و پرسشنامه انتخاب روش زایمان بود. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: 238 نفر (1/74%) از زنان زایمان طبیعی و 83 نفر (9/25%) سزارین را انتخاب کرده بودند. از بین سازه­های مدل باور بهداشتی، سازه­های حساسیت درک شده (023/0=p) و منافع درک شده (001/0=p) بین دو گروه اختلاف آماری معنی‌داری داشت، اما آگاهی، شدت درک شده و موانع درک شده بین دو گروه اختلاف آماری معنی‌داری نشان نداد (05/0p>). متغیرهای سن، تحصیلات و شغل زن باردار بین دو گروه اختلاف آماری معنی‌دار نداشتند، اما منبع کسب اطلاعات در مورد روش­های زایمانی بین دو گروه که زایمان طبیعی یا سزارین را انتخاب کرده بودند، اختلاف آماری معنی‌داری داشت (008/0=p).
نتیجه‌گیری: نتیجه اصلی مطالعه مبین ارتباط سازه­های حساسیت درک شده و منافع درک شده با روش انتخابی جهت زایمان بود. از این یافته می­توان در برنامه‌ریزی­های آموزشی جهت زنان باردار با تأکید بیشتر بر سازه­های معنی‌دار مدل باور بهداشتی استفاده کرد.

کلیدواژه‌ها

عنوان مقاله [English]

Factors related to the decision making process of primigravid women about mode of delivery: A theory-based study

نویسندگان [English]

  • Narjes Bahri 1
  • Siamak Mohebi 2
  • Nasrin Bahri 3
  • Samaneh Davoudi Farimani 4
  • Leili Khodadoost 4
1 Assistant professor, Department of Midwifery, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.
2 Assistant professor, Department of Health Education and Health Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.
3 M.Sc. of Mother and Child Health, Health Center Number Three, Mashhad University of Medical Sciences, Mashhad, Iran.
4 B.Sc. of Midwifery, Student Research Committee, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.
چکیده [English]

Introduction: The rate of cesarean section in Iran is three times higher than standard and attention to the factors affecting decision making process of women to choose mode of delivery helps to recognize the causes of its high rate. This study was performed with aim to investigate the factors affecting decision making process of women to choose mode of delivery based on the Health Belief Model (HBM).
Methods: This cross-sectional study was performed on 321 primigravid women who had normal and healthy pregnancy with gestational age of higher than 26 weeks in Gonabad from June 2014 to April 2017. Data collection tools included the questionnaire of personal and reproduction characteristics, the questionnaire of awareness about the advantages and disadvantages of vaginal delivery and cesarean section, the questionnaire of assessing HBM, and the questionnaire of choosing the mode of delivery. Data was analyzed by SPSS software (version16). P<0.05 was considered significant.
Results: 238 women (74.1%) had selected vaginal delivery and 83 (25.9%) cesarean. Among the HBM constructs, two groups were significantly different in terms of perceived susceptibility (p= 0.023) and perceived benefits (p= 0.001), but there was no significant difference between two groups in terms of knowledge, perceived severity and perceived barriers (p>0.05). Two groups were not significantly different in terms of age, education and occupation of pregnant women (p> 0.05), but a significant difference was found between those who had selected vaginal delivery and those who had selected cesarean in terms of sources of information about delivery mode (p= 0.008). 
Conclusion: The main findings of this study showed a relationship between perceived susceptibility and perceived benefits with intended mode of delivery. This finding can be used in designing educational programs for pregnant women with more emphasis on significant structures of HBM.

کلیدواژه‌ها [English]

  • Cesarean section
  • decision making
  • Health belief model
  • Vaginal delivery

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مجله زنان، مامایی و نازایی ایران
دوره 20، شماره 8
آبان 1396
صفحه 42-50

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