Mercer'in annelik kuramına dayalı eğitim ve danışmanlığın maternal bağlanma ve annelik fonksiyonu üzerine etkisi: Randomize kontrollü çalışma
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Tarih
2024
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Annelik rolü, kadının doğum sonrası bebeğiyle bağ kurarak bu yeni kimliği benimsemesi sürecidir. Bu dönemde anne, kişisel değerlerini, deneyimlerini ve çevresinden aldığı desteği kullanarak annelik sorumluluklarını yerine getirir. Bu araştırma, Mercer'in annelik kuramına dayalı eğitim ve danışmanlık programının maternal bağlanma ve annelik fonksiyonu üzerine etkisini belirlemek amacıyla, son test paralel gruplu randomize kontrollü deneysel bir çalışma olarak yapılmıştır. Araştırma, bir üniversite hastanesinde, 15 Eylül 2023-30 Haziran 2024 tarihleri arasında, araştırmanın dâhil edilme kriterlerine uyan 56 gebe (çalışma grubu: 28, kontrol grubu: 28) ile yapılmıştır. Örneklemdeki gebeler çalışma ve kontrol gruplarına blok randomizasyon yöntemi ile atanmıştır. Çalışma grubunda yer alan gebelere, haftada iki gün, altı oturum, toplam sekiz saat olmak üzere Mercer'in Annelik Kuramına Dayalı Eğitim ve Danışmanlık Programı uygulanmıştır. Eğitim ve Danışmanlık Programı tamamlandıktan sonra çalışma grubundaki gebelere araştırmacı tarafından hazırlanan eğitim kitapçığı verilmiştir. Kontrol grubunda yer alan gebelere ise rutin hastane uygulamalarının dışında herhangi bir müdahale yapılmamıştır. Çalışma ve kontrol grubunda yer alan gebeler, doğum sonu ilk 24 saat içinde, doğum sonu birinci ve dördüncü ayın sonunda değerlendirilmiştir. Verilerin toplanmasında "Kişisel Bilgi Formu, Maternal Bağlanma Ölçeği (MBÖ), Barkin Annelik Fonksiyonu Envanteri (BAFÖ)" kullanılmıştır. Verilerin analizinde sayı, yüzde, minimum, maksimum, median, ortalama, standart sapma ki-kare testi, bağımsız örneklem t testi, Mann Whitney U testi, bağımlı örneklem t testi ve Wilcoxon testi kullanılmıştır. Çalışma grubunda yer alan gebelerin sosyo-demografik ve obstetrik özellikler açısından incelendiğinde çalışma ve kontrol grubundaki gebeler çalışma durumu hariç benzer özelliklere sahip olduğu ve gruplar arasında istatistiksel açıdan fark olmadığı saptanmıştır (p>0,05). Çalışma ve kontrol grubunda yer alan gebelerin eğitim sonrası birinci ayda yapılan ilk ölçümde MBÖ puan ortalamaları benzerken (p>0,05), çalışma grubunda yer alan gebelerin dördüncü ayda yapılan ikinci değerlendirmede ölçülen son ölçüm MBÖ puanının kontrol grubundan büyük olduğu puan ortalamalarının anlamlı olarak daha yüksek olduğu (p<0,05) ve etki büyüklüğünün (d=1,717) büyük etki düzeyinde olduğu belirlenmiştir. Çalışma ve kontrol grubunda yer alan gebelerin eğitim sonrası birinci ayda yapılan ilk ölçümde BAFÖ puan ortalamalarının anlamlı olarak farklı olduğu (p<0,05), dördüncü ayda yapılan son ölçümde çalışma grubunun BAFÖ puan ortalamalarının kontrol grubundan büyük olduğu (p<0,05) ve etki büyüklüklerinin (sırasıyla d=0,642; d=1,492) orta ve büyük etki düzeyinde olduğu belirlenmiştir. Sonuç olarak; gebelere uygulanan Mercer'in annelik kuramına dayalı eğitim ve danışmanlığın maternal bağlanma düzeyini ve annelik fonksiyonunu arttırdığı tespit edilmiştir. Gebelik döneminde uygulanan eğitim ve danışmanlık programının gebelerin bilgi düzeylerini arttırdığı, doğum ve doğum sonu süreçleri yönetmelerini destekleyerek annelik sürecine olumlu yansıdığı bununla birlikte annelerin maternal bağlanma düzeylerini ve annelik fonksiyonlarını arttırdığı saptanmıştır. Araştırma bulgularına dayanarak, doğum sonrası dönemde gebelerin maternal bağlanma düzeylerini ve annelik fonksiyonlarını artırmayı hedefleyen eğitim ve danışmanlık programlarının, Mercer'in Annelik Kuramı temel alınarak sistematik bir şekilde yapılandırılması önerilebilir.
The maternal role is the process of adopting this new identity by bonding with her baby after birth. In this period, the mother fulfills her maternal responsibilities by using her personal values, experiences and the support she receives from her environment. This study was conducted as a post-test parallel group randomized controlled experimental study to determine the effect of a training and counseling program based on Mercer's maternal theory on maternal attachment and maternal functioning. The study was conducted in a university hospital between September 15, 2023 and June 30, 2024 with 56 pregnant women (study group: 28, control group: 28) who met the inclusion criteria. Pregnant women in the sample were assigned to the study and control groups by block randomization method. The pregnant women included in the sample were assigned to the study and control groups by block randomization method. The pregnant women in the study group received the Education and Counseling Program based on Mercer's Maternal Theory two days a week, six sessions, for a total of eight hours. After the Education and Counseling Program was completed, the training booklet prepared by the researcher was given to the pregnant women in the study group. Pregnant women in the control group did not receive any intervention other than routine hospital practices. Pregnant women in the study and control groups were evaluated within the first 24 hours postpartum and at the end of the first and fourth months postpartum. "Personal Information Form, Maternal Attachment Scale (MAS), and Barkin Index of Maternal Functioning (BIMF)" were used to collect the data. Number, percentage, minimum, maximum, median, mean, standard deviation, chi-square test, independent sample t test, Mann-Whitney U test, dependent sample t test, and Wilcoxon test were used to analyze the data. When the pregnant women in the study group were examined in terms of socio-demographic and obstetric characteristics, it was found that the pregnant women in the study and control groups had similar characteristics except for employment status and there was no statistical difference between the groups (p>0.05). While the mean MAS scores of the pregnant women in the study and control groups were similar in the first measurement made in the first month after the training (p>0.05), it was determined that the post-test MAS score of the pregnant women in the study group measured in the second evaluation made in the fourth month was significantly higher than the control group (p<0.05) and the effect size (d=1.717) was at the large effect level. It was determined that the BIMF mean scores of the pregnant women in the study and control groups were significantly different (p<0.05) in the first measurement made in the first month after the training, in the last measurement made in the fourth month, the BIMF mean scores of the study group were greater than the control group (p<0.05) and the effect sizes (d=0.642; d=1.492, respectively) were at the moderate and large effect level. As a result, it was determined that education and counseling based on Mercer's maternal theory applied to pregnant women increased maternal attachment level and maternal function. It was determined that the education and counseling program applied during pregnancy increased the knowledge levels of pregnant women, supported them to manage birth and postpartum processes and reflected positively on the motherhood process, and increased the maternal attachment levels and maternal functions of mothers. Based on the findings of the study, it is recommended that education and counseling programs aiming to increase maternal attachment levels and maternal functions of pregnant women in the postpartum period should be structured systematically based on Mercer's Maternal Theory.
The maternal role is the process of adopting this new identity by bonding with her baby after birth. In this period, the mother fulfills her maternal responsibilities by using her personal values, experiences and the support she receives from her environment. This study was conducted as a post-test parallel group randomized controlled experimental study to determine the effect of a training and counseling program based on Mercer's maternal theory on maternal attachment and maternal functioning. The study was conducted in a university hospital between September 15, 2023 and June 30, 2024 with 56 pregnant women (study group: 28, control group: 28) who met the inclusion criteria. Pregnant women in the sample were assigned to the study and control groups by block randomization method. The pregnant women included in the sample were assigned to the study and control groups by block randomization method. The pregnant women in the study group received the Education and Counseling Program based on Mercer's Maternal Theory two days a week, six sessions, for a total of eight hours. After the Education and Counseling Program was completed, the training booklet prepared by the researcher was given to the pregnant women in the study group. Pregnant women in the control group did not receive any intervention other than routine hospital practices. Pregnant women in the study and control groups were evaluated within the first 24 hours postpartum and at the end of the first and fourth months postpartum. "Personal Information Form, Maternal Attachment Scale (MAS), and Barkin Index of Maternal Functioning (BIMF)" were used to collect the data. Number, percentage, minimum, maximum, median, mean, standard deviation, chi-square test, independent sample t test, Mann-Whitney U test, dependent sample t test, and Wilcoxon test were used to analyze the data. When the pregnant women in the study group were examined in terms of socio-demographic and obstetric characteristics, it was found that the pregnant women in the study and control groups had similar characteristics except for employment status and there was no statistical difference between the groups (p>0.05). While the mean MAS scores of the pregnant women in the study and control groups were similar in the first measurement made in the first month after the training (p>0.05), it was determined that the post-test MAS score of the pregnant women in the study group measured in the second evaluation made in the fourth month was significantly higher than the control group (p<0.05) and the effect size (d=1.717) was at the large effect level. It was determined that the BIMF mean scores of the pregnant women in the study and control groups were significantly different (p<0.05) in the first measurement made in the first month after the training, in the last measurement made in the fourth month, the BIMF mean scores of the study group were greater than the control group (p<0.05) and the effect sizes (d=0.642; d=1.492, respectively) were at the moderate and large effect level. As a result, it was determined that education and counseling based on Mercer's maternal theory applied to pregnant women increased maternal attachment level and maternal function. It was determined that the education and counseling program applied during pregnancy increased the knowledge levels of pregnant women, supported them to manage birth and postpartum processes and reflected positively on the motherhood process, and increased the maternal attachment levels and maternal functions of mothers. Based on the findings of the study, it is recommended that education and counseling programs aiming to increase maternal attachment levels and maternal functions of pregnant women in the postpartum period should be structured systematically based on Mercer's Maternal Theory.
Açıklama
Doktora Tezi
Anahtar Kelimeler
Annelik Fonksiyonu, Annelik Rolü, Bağlanma, Gebelik, Hemşire, Maternal Bağlanma, Maternal Attachment, Maternal Role, Maternal Function, Attachment, Pregnancy, Nurse
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Dağ Tüzmen, H. (2024). Mercer'in annelik kuramına dayalı eğitim ve danışmanlığın maternal bağlanma ve annelik fonksiyonu üzerine etkisi: Randomize kontrollü çalışma. (Yayımlanmamış doktora tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Hemşirelik Anabilim Dalı, Konya.
