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Showing 2 results for Primiparous Women
Aniseh Pourrasmi Mamaghani, Mohammadhiwa Abdekhoda, Parvin Bastani Alamdari, Masoud Mohammadi,
Volume 17, Issue 0 (4-2020)
Volume 17, Issue 0 (4-2020)
Abstract
Background: The rate of cesarean delivery in Iran is four times higher than the standard defined by the World Health Organization. Information counseling is a method for providing accurate information and helping primiparous women to make evidence-based decisions. This research was conducted to determine the effect of information counseling on decision making process of delivery.
Methods: This was a before and after clinical trial in which 120 pregnant women in the 28thweek of the pregnancy with no indication of cesarean sections (CS) and a health record were included. Sample size was calculated using cluster sampling and the formula n= (〖(Z_(α⁄(2- Z_(β ) )) )^2 δ〗^2 )/d^2 . The sample size was approximately 63 individuals. To correct the effect of cluster sampling, the calculated sample volume was multiplied by a factor of 1.4. To further validate the data, the number reached 120. Data gathering tool was a questionnaire designed based on reviewing previous studies and considering the purpose of the study whose validity and reliability were measured. The questionnaires were given to the women in two stages at week 28 and week 36. The interventions were in the form of packages containing brochures and information booklet on the benefits and disadvantages of natural childbirth and cesarean section in addition to training sessions taught by a midwifery specialist. Pros and cons of vaginal and cesarean modes of delivery were presented by training sessions. Women's preferential delivery mode were measured by a pre- and post- questionnaires and follow-up. After data collection, the analysis was performed at two levels of descriptive and inferential statistics. Finally, data were analyzed by SPSS16using t-test.
Results: The findings showed that the main indicators for determining the type of delivery, including awareness about delivery, making decision for delivery mode, understanding the risks of delivery mode, and self-efficacy were significantly associated with educational intervention and counseling (P<0.01). In the pre-intervention phase, 66.7% of women had normal delivery and 33.3% had cesarean section. After intervention, with a significant increase in choosing normal delivery, 78.4% chose natural childbirth and 15.3% chose cesarean section as the best option for delivery. Follow-up results after educational intervention showed that 44.2% of participants in this study performed normal delivery and 50% cesarean section. 8.5% were excluded from the study for certain reasons. After reviewing the results, it was found that encouraging physicians’ team to cesarean section was the main and primary cause of cesarean.
Conclusions: The implementation of information counseling has a great effect on encouraging women to change their decision patterns and self-making decision for VD maternity and reducing CD. However, in practice, certain factors, especially the constant recommendation of physicians’ team to CD as a programmable and convenient delivery, undermine the role of these interventions.
Methods: This was a before and after clinical trial in which 120 pregnant women in the 28thweek of the pregnancy with no indication of cesarean sections (CS) and a health record were included. Sample size was calculated using cluster sampling and the formula n= (〖(Z_(α⁄(2- Z_(β ) )) )^2 δ〗^2 )/d^2 . The sample size was approximately 63 individuals. To correct the effect of cluster sampling, the calculated sample volume was multiplied by a factor of 1.4. To further validate the data, the number reached 120. Data gathering tool was a questionnaire designed based on reviewing previous studies and considering the purpose of the study whose validity and reliability were measured. The questionnaires were given to the women in two stages at week 28 and week 36. The interventions were in the form of packages containing brochures and information booklet on the benefits and disadvantages of natural childbirth and cesarean section in addition to training sessions taught by a midwifery specialist. Pros and cons of vaginal and cesarean modes of delivery were presented by training sessions. Women's preferential delivery mode were measured by a pre- and post- questionnaires and follow-up. After data collection, the analysis was performed at two levels of descriptive and inferential statistics. Finally, data were analyzed by SPSS16using t-test.
Results: The findings showed that the main indicators for determining the type of delivery, including awareness about delivery, making decision for delivery mode, understanding the risks of delivery mode, and self-efficacy were significantly associated with educational intervention and counseling (P<0.01). In the pre-intervention phase, 66.7% of women had normal delivery and 33.3% had cesarean section. After intervention, with a significant increase in choosing normal delivery, 78.4% chose natural childbirth and 15.3% chose cesarean section as the best option for delivery. Follow-up results after educational intervention showed that 44.2% of participants in this study performed normal delivery and 50% cesarean section. 8.5% were excluded from the study for certain reasons. After reviewing the results, it was found that encouraging physicians’ team to cesarean section was the main and primary cause of cesarean.
Conclusions: The implementation of information counseling has a great effect on encouraging women to change their decision patterns and self-making decision for VD maternity and reducing CD. However, in practice, certain factors, especially the constant recommendation of physicians’ team to CD as a programmable and convenient delivery, undermine the role of these interventions.
Houri Alijani , Narjes Sadat Borghei, Naser Behnampour ,
Volume 17, Issue 0 (4-2020)
Volume 17, Issue 0 (4-2020)
Abstract
Background: Pregnancy is considered as a critical stage in the life of a woman due to the creation of new tasks and anxieties, If we consider the fear of childbirth as one of the main causes of pregnancy anxiety, To reduce it, we need to look for other solutions, such as psychological solutions. This study was conducted with the aim of determining the effect of group-based cognitive-behavioral Educations on the fear of delivery of Primiparous mothers.
Methods: This quasi-experimental study with pre-test and post-test design, three groups were conducted in the second half of the year in 1396 cities of Gorgan.The data collection tool was a demographic data form and Wijma Delivery/Expectency fear of childbirth Questionnaire (version A). Primiparous Pregnant mothers who were 20-28 weeks old were asked to participate in the study through the Lean system, and 211 patients were referred to relevant health centers and clinics. They completed the maternity fear questionnaire. Among these mothers, 104 nulliparous women with average score of fear of childbirth of 55 and above were divided into three groups: first and second intervention and control group. Based on ethical considerations, the allocation of mothers to intervention and control groups conducted based on their desire. The first intervention group performed eight sessions of group training based on cognitive-behavioral techniques, the second intervention group spent eight sessions of conventional pregnancy training, and the control group did not receive any training. The scores of fear of childbirth in all three groups before and immediately after intervention were analyzed by ANOVA, Kruskal-Wallis, Wilcoxon and paired t-test using SPSS software version 18, were compared and analyzed statistically. The significance level of the tests was considered to be 0.05.
Results: The results showed that before the intervention, the mean scores of fear of childbirth in the three groups were statistically significant and the first group of intervention (group training based on cognitive-behavioral techniques) had a higher mean scores 92.58 ± 12.70, compared to the second group of intervention (conventional education during pregnancy) was 66.54 ± 10.48 and the control group was 73.33 ± 13.13 (P-value <0.0001). Therefore, comparison of the difference before and after the mean scores and the rate of change in the three groups were used. Also, the mean scores of fear of childbirth after intervention in group training based on cognitive-behavioral techniques were 42.81 ± 18.45 in the conventional education group 67.19 ± 11.91 in control group 83.83 ± 18.28 and (P-value< 0/0001). The comparison of the mean scores of fear of delivery before and after intervention showed that group training based on cognitive-behavioral techniques -49.76 ± 19.86 was more than that of the conventional education groups in the period of pregnancy of 0.65 ± 10.14 And control group 11.5 ± 11.36 had a significant reduction in fear scores, which was statistically significant (P-value <0.0001).
Conclusions: Group-based cognitive-behavioral techniques focusing on reducing childbirth fears have the potential to reduce the fear of childbirth in all domains, for the promotion of normal delivery, the Changing the routine content of traditional pregnancy education is a matter of community based on cognitive-behavioral techniques, Focus on reducing fear of childbirth should be considered by healthcare providers.
Methods: This quasi-experimental study with pre-test and post-test design, three groups were conducted in the second half of the year in 1396 cities of Gorgan.The data collection tool was a demographic data form and Wijma Delivery/Expectency fear of childbirth Questionnaire (version A). Primiparous Pregnant mothers who were 20-28 weeks old were asked to participate in the study through the Lean system, and 211 patients were referred to relevant health centers and clinics. They completed the maternity fear questionnaire. Among these mothers, 104 nulliparous women with average score of fear of childbirth of 55 and above were divided into three groups: first and second intervention and control group. Based on ethical considerations, the allocation of mothers to intervention and control groups conducted based on their desire. The first intervention group performed eight sessions of group training based on cognitive-behavioral techniques, the second intervention group spent eight sessions of conventional pregnancy training, and the control group did not receive any training. The scores of fear of childbirth in all three groups before and immediately after intervention were analyzed by ANOVA, Kruskal-Wallis, Wilcoxon and paired t-test using SPSS software version 18, were compared and analyzed statistically. The significance level of the tests was considered to be 0.05.
Results: The results showed that before the intervention, the mean scores of fear of childbirth in the three groups were statistically significant and the first group of intervention (group training based on cognitive-behavioral techniques) had a higher mean scores 92.58 ± 12.70, compared to the second group of intervention (conventional education during pregnancy) was 66.54 ± 10.48 and the control group was 73.33 ± 13.13 (P-value <0.0001). Therefore, comparison of the difference before and after the mean scores and the rate of change in the three groups were used. Also, the mean scores of fear of childbirth after intervention in group training based on cognitive-behavioral techniques were 42.81 ± 18.45 in the conventional education group 67.19 ± 11.91 in control group 83.83 ± 18.28 and (P-value< 0/0001). The comparison of the mean scores of fear of delivery before and after intervention showed that group training based on cognitive-behavioral techniques -49.76 ± 19.86 was more than that of the conventional education groups in the period of pregnancy of 0.65 ± 10.14 And control group 11.5 ± 11.36 had a significant reduction in fear scores, which was statistically significant (P-value <0.0001).
Conclusions: Group-based cognitive-behavioral techniques focusing on reducing childbirth fears have the potential to reduce the fear of childbirth in all domains, for the promotion of normal delivery, the Changing the routine content of traditional pregnancy education is a matter of community based on cognitive-behavioral techniques, Focus on reducing fear of childbirth should be considered by healthcare providers.
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