Primigravidalara uygulanan çözüm odaklı yaklaşımın psikososyal sağlık, doğum korkusu ve doğum sonu güvenlik hislerine etkisi: Randomize Kontrollü Çalışma
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Tarih
2023, 2023-03-01
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Necmettin Erbakan Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/embargoedAccess
Özet
Araştırma, primigravidalara uygulanan çözüm odaklı yaklaşımın psikososyal sağlık, doğum korkusu ve doğum sonu güvenlik hislerine etkisini belirlemek amacıyla randomize, son test-kontrol gruplu, paralel grup deneysel bir çalışma olarak yapılmıştır. Araştırma, Konya ili kent merkezinde yer alan bir üniversite hastanesinde 20 Eylül 2021-27 Mayıs 2022 tarihleri arasında, araştırmanın dahil edilme kriterlerine uyan 96 primigravida (girişim grubu: 48, kontrol grubu: 48) ile yürütülmüştür. Çalışma grubuna dahil edilen primigravidalar blok randomizasyon yöntemi ile girişim ve kontrol grubuna atanmıştır. Girişim grubunda yer alan gebelere, 32. gebelik haftasında başlanarak, haftada bir defa olmak üzere toplam dört oturum Çözüm Odaklı Yaklaşım Programı uygulanmıştır. Program tamamlandıktan sonra girişim grubundaki gebelere araştırmacı tarafından hazırlanan eğitim kitapçığı verilmiştir. Kontrol grubunda yer alan gebelere ise rutin hastane uygulamalarının dışında herhangi bir müdahalede bulunulmamıştır. Girişim ve kontrol grubunda yer alan gebeler, 35. gebelik haftasının sonunda, 37-40. gebelik haftasında, doğum sonu ilk 24 saat içinde ve doğum sonu birinci haftanın sonunda tekrar değerlendirilmiştir. Verilerin toplanmasında Tanıtıcı Bilgi Formu, Gebelikte Psikososyal Sağlığı Değerlendirme Ölçeği (GPSDÖ), Wijma Doğum Beklentisi/Deneyimi Ölçeği (W-DEQ) A ve B Versiyonları, Annelerin Doğum Sonu Güvenlik Hisleri Ölçeği kullanılmıştır. Verilerin analizinde sayı, yüzde, ortalama, standart sapma, ki-kare testi, bağımsız gruplarda t testi, tekrarlı ölçümlerde tek yönlü ve karma desenli ANOVA testi kullanılmıştır. Girişim ve kontrol grubunda yer alan gebelerin sosyo-demografik ve obstetrik özellikler açısından benzer özelliklere sahip olduğu ve gruplar arasında istatistiksel açıdan fark olmadığı saptanmıştır (p>0,05). Girişim ve kontrol grubunda yer alan gebelerin eğitim öncesi GPSDÖ puan ortalamaları benzerken (p>0,05), girişim grubunda yer alan gebelerin eğitim sonrası puan ortalamalarının anlamlı olarak daha yüksek olduğu (p<0,05) ve etki büyüklüğünün (d=0,445) orta düzeyde olduğu belirlenmiştir. Girişim ve kontrol grubunda yer alan gebelerin eğitim öncesi W-DEQ (A) puan ortalamaları benzerken (p>0,05), girişim grubunda yer alan gebelerin eğitim sonrası ve 37-40. gebelik haftası W-DEQ (A) puan ortalamalarının kontrol grubuna göre anlamlı olarak daha düşük olduğu (p<0,01) ve etki büyüklüklerinin (sırasıyla d=-3,051; d=-3,052) yüksek düzeyde olduğu belirlenmiştir. Girişim grubunda yer alan annelerin W-DEQ (B) toplam puan ortalamalarının, kontrol grubunda yer alan annelerin puan ortalamalarına göre anlamlı derecede daha düşük olduğu (p<0,01) ve etki büyüklüğünün (d=-3,051) yüksek düzeyde olduğu saptanmıştır. Girişim grubunda yer alan annelerin Doğum Sonu Güvenlik Hisleri Ölçeği toplam puan ortalamalarının, kontrol grubunda yer alan annelerin puan ortalamalarına göre anlamlı derecede daha yüksek olduğu (p<0,01) ve etki büyüklüğünün (d=1,852) yüksek düzeyde olduğu belirlenmiştir. Sonuç olarak; primigravidalara uygulanan Çözüm Odaklı Yaklaşım' ın psikososyal sağlık düzeyini arttırdığı ve doğum korkusunu azalttığı saptanmıştır. Gebelikte psikososyal sağlığı güçlendirmenin ve doğum korkusunun yönetilmesinin, doğum sonu döneme olumlu yansıdığı ve annelerin doğum sonu güvenlik hislerini arttırdığı belirlenmiştir. Araştırma sonuçlarına göre; gebelerin psikososyal sağlığını güçlendirmek, doğum korku düzeylerini azaltmak ve doğum sonu güvenlik hislerini arttırmak amacıyla planlanan müdahalelere, Çözüm Odaklı Yaklaşım yöntemine dayalı danışmanlık programının entegre edilmesi önerilmektedir.
The study was conducted as a randomized, post-test-control group, parallel group experimental study in order to determine the effect of the solution-oriented approach applied to primigravidas on psychosocial health, fear of childbirth and postnatal security feelings. The study was carried out in a university hospital located in the city center of Konya, between 20 September 2021 and 27 May 2022, with 96 primigravidas (intervention group: 48, control group: 48) who met the inclusion criteria of the study. Primigravidas included in the study group were assigned to the intervention and control groups by the block randomization method. A total of four sessions of Solution-Focused Approach Program were applied to the pregnant women in the intervention group, once a week, starting at the 32nd gestational week. After the program was completed, a training booklet prepared by the researcher was given to the pregnant women in the intervention group. No intervention was made to the pregnant women in the control group other than routine hospital practices. Pregnant women in the intervention and control groups were re-evaluated at the end of the 35th week of pregnancy, 37-40 in the gestational week, within the first 24 hours postpartum and at the end of the first postpartum week. Information Form, Pregnancy Psychosocial Health Assessment Scale (PPHAS), Wijma Birth Expectancy/Experience Scale (W-DEQ) A and B versions and Mothers' Postnatal Sense of Security Scale were used to collect data. In the analysis of the data, number, percentage, mean, standard deviation, chi-square test, t-test for independent groups, one-way and mixed-pattern ANOVA test were used for repeated measurements. It was determined that the pregnant women in the intervention and control groups had similar socio-demographic and obstetric characteristics and there was no statistical difference between the groups (p>0.05). While the mean PPHAS scores of the pregnant women in the intervention and control groups were similar before the education (p>0.05), the mean scores of the pregnant women in the intervention group after the education were significantly higher (p<0.05) and the effect size (d=0.445) was determined to be moderate. While the mean W-DEQ (A) scores of the pregnant women in the intervention and control groups were similar before the education (p>0.05), the pregnant women in the intervention group were post-training and 37-40 week of gestation W-DEQ (A) mean scores were significantly lower than the control group (p<0.01) and the effect sizes (d=-3.051; d=-3.052, respectively) were found to be high. W-DEQ (B) total mean scores of the mothers in the intervention group were significantly lower than the mean score of the mothers in the control group (p<0.01) and the effect size (d=-3,051) was found to be high. Postnatal Sense of Security Scale mean scores of the mothers in the intervention group were significantly higher than the mean scores of the mothers in the control group (p<0,01) and the effect size (d=1,852) was found to be high. In conclusion; It was determined that the Solution-Focused Approach applied to primigravidas increased the psychosocial health level and decreased the fear of childbirth. It was determined that strengthening psychosocial health and managing the fear of childbirth during pregnancy have a positive effect on the postpartum period and increase the postnatal security feelings of mothers. According to the research results; It is recommended that a counseling program based on the Solution-Focused Approach should be integrated into the planned interventions in order to strengthen the psychosocial health of pregnant women, reduce their fear of childbirth and increase their postnatal security feelings.
The study was conducted as a randomized, post-test-control group, parallel group experimental study in order to determine the effect of the solution-oriented approach applied to primigravidas on psychosocial health, fear of childbirth and postnatal security feelings. The study was carried out in a university hospital located in the city center of Konya, between 20 September 2021 and 27 May 2022, with 96 primigravidas (intervention group: 48, control group: 48) who met the inclusion criteria of the study. Primigravidas included in the study group were assigned to the intervention and control groups by the block randomization method. A total of four sessions of Solution-Focused Approach Program were applied to the pregnant women in the intervention group, once a week, starting at the 32nd gestational week. After the program was completed, a training booklet prepared by the researcher was given to the pregnant women in the intervention group. No intervention was made to the pregnant women in the control group other than routine hospital practices. Pregnant women in the intervention and control groups were re-evaluated at the end of the 35th week of pregnancy, 37-40 in the gestational week, within the first 24 hours postpartum and at the end of the first postpartum week. Information Form, Pregnancy Psychosocial Health Assessment Scale (PPHAS), Wijma Birth Expectancy/Experience Scale (W-DEQ) A and B versions and Mothers' Postnatal Sense of Security Scale were used to collect data. In the analysis of the data, number, percentage, mean, standard deviation, chi-square test, t-test for independent groups, one-way and mixed-pattern ANOVA test were used for repeated measurements. It was determined that the pregnant women in the intervention and control groups had similar socio-demographic and obstetric characteristics and there was no statistical difference between the groups (p>0.05). While the mean PPHAS scores of the pregnant women in the intervention and control groups were similar before the education (p>0.05), the mean scores of the pregnant women in the intervention group after the education were significantly higher (p<0.05) and the effect size (d=0.445) was determined to be moderate. While the mean W-DEQ (A) scores of the pregnant women in the intervention and control groups were similar before the education (p>0.05), the pregnant women in the intervention group were post-training and 37-40 week of gestation W-DEQ (A) mean scores were significantly lower than the control group (p<0.01) and the effect sizes (d=-3.051; d=-3.052, respectively) were found to be high. W-DEQ (B) total mean scores of the mothers in the intervention group were significantly lower than the mean score of the mothers in the control group (p<0.01) and the effect size (d=-3,051) was found to be high. Postnatal Sense of Security Scale mean scores of the mothers in the intervention group were significantly higher than the mean scores of the mothers in the control group (p<0,01) and the effect size (d=1,852) was found to be high. In conclusion; It was determined that the Solution-Focused Approach applied to primigravidas increased the psychosocial health level and decreased the fear of childbirth. It was determined that strengthening psychosocial health and managing the fear of childbirth during pregnancy have a positive effect on the postpartum period and increase the postnatal security feelings of mothers. According to the research results; It is recommended that a counseling program based on the Solution-Focused Approach should be integrated into the planned interventions in order to strengthen the psychosocial health of pregnant women, reduce their fear of childbirth and increase their postnatal security feelings.
Açıklama
Doktora Tezi
Anahtar Kelimeler
Gebelik, Çözüm Odaklı Yaklaşım, Doğum Korkusu, Psikososyal Sağlık, Güvenlik Hissi, Pregnancy, Solution-Focused Approach, Fear of Childbirth, Psychosocial Health, Sense of Security
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Anık Çankaya, Y. (2023). Primigravidalara uygulanan çözüm odaklı yaklaşımın psikososyal sağlık, doğum korkusu ve doğum sonu güvenlik hislerine etkisi: Randomize Kontrollü Çalışma. (Yayımlanmamış doktora tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Hemşirelik Anabilim Dalı, Konya.
