Journal of Hayat
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تأثیر مشاوره فردی بر انگیزه و ترس از زایمان طبیعی در زنان سزارین قبلی براساس مدل فوگ
The effect of individual counseling based on the Fogg model on the motivation and fear of natural childbirth in women with previous cesarean section
مراقبتهاي مامايي
Midwifery Care
پژوهشي
Research
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,"sans-serif""><b><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.3pt">زمینه و هدف: </span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">ترس از زایمان یکی از علل انتخاب سزارین است. با توجه به عواقب سزارینهای تکراری، مداخلاتی که میزان ترس از زایمان را کنترل نمایند در تصمیم مادر برای نوع زایمان اهمیت دارند</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black">.</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"> هدف از تحقیق حاضر، تعیین تأثیر مشاوره فردی بر انگیزه و ترس از زایمان طبیعی در زنان سزارین قبلی براساس مدل فوگ است</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.3pt">.</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.3pt"></span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,"sans-serif""><b><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.1pt">روش بررسی:</span></span></span></span></i></b><i> </i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">در این کارآزمایی بالینی تعداد 62 زن باردار سزارین قبلی مراجعهکننده به مراکز جامع سلامت مشهد در سال 1399، با تخصیص تصادفی در دو گروه مداخله و کنترل قرار گرفتند. در گروه مداخله، مشاوره فردی مبتنی بر مدل فوگ، در هفتههای 30-28 بارداری در دو جلسه حضوری 60-45 دقیقه<span style="letter-spacing:-.1pt"></span>ای، هر دو هفته یک بار و یک جلسه غیرحضوری در کانال تلگرامی ارایه شد. <span style="letter-spacing:-.1pt">ابزار گردآوری داده</span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.1pt">ها، فرم مشخصات فردی، پرسشنامه انگیزه مدل فوگ و پرسشنامه انتظار/ تجربه ویجما بود. پرسشنامهها در ابتدای مطالعه و دو هفته بعد از پایان مداخله تکمیل و تجزیه و تحلیل با استفاده از آزمونهای آماری </span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">توسط نرم<span style="letter-spacing:-.1pt"></span>افزار </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black">SPSS</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"> نسخه 25 <span style="letter-spacing:-.1pt">در سطح معناداری 05/0</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.1pt">p<</span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.1pt"> انجام یافت</span></span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:163.05pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,"sans-serif""><b><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.1pt">یافتهها</span></span></span></span></i></b><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.1pt">: </span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">میانگین اختلاف قبل و بعد از مداخله نمره ترس از زایمان، در گروه مداخله 07/20</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"Cambria","serif""><span style="color:black">±</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">84/15 و در گروه کنترل 28/23</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"Cambria","serif""><span style="color:black">±</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">06/6 بود. مشاوره با رویکرد فوگ تغییرات معنادار بیش</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">تری در نمره ترس از زایمان گروه مداخله نسبت به گروه کنترل ایجاد کرده است (</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">001/0</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black">p<</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">) اما تغییرات صورت گرفته در انگیزه به لحاظ آماری معنادار نبود</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,"sans-serif""><b><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.3pt">نتیجهگیری: </span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">مشاوره با رویکرد فوگ نمره ترس از زایمان را کاهش داد. استفاده از این روش مشاوره به منظور کاهش ترس از زایمان و به</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">کارگیری راهکارهایی در جهت افزاش انگیزه زایمان طبیعی پس از سزارین پیشنهاد میشود</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.3pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,"sans-serif""><b><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black">ثبت کارآزمایی بالینی: </span></span></span></i></b><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black">IRCT20200105046014N1</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"><span style="letter-spacing:-.3pt"></span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,"sans-serif""><i><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:"B Yagut""><span style="color:black"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.1pt">Background & Aim:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif"">Fear of childbirth is one of the reasons for choosing cesarean section. Given the consequences of repeated cesarean section, interventions that control the fear of childbirth are important in mother's decision for the mode of birth. The aim of the study is to assess the effect of individual counseling based on the Fogg model on the motivation and the fear of natural childbirth in women with previous cesarean section</span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.4pt">Methods & Materials:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif"">In this clinical trial, <span style="letter-spacing:-.1pt">62 pregnant women with a previous cesarean section, referred to Mashhad Comprehensive Health Centers in 2020, were randomly assigned into intervention or control groups.</span> <span style="letter-spacing:-.1pt">In the intervention group, individual counseling based on the Fogg model was provided in two face-to-face 45-60 minute sessions biweekly and one non-face-to-face session on the Telegram channel at 28-30 weeks of pregnancy. Data was collected by a demographic form, the motivation questionnaire, and the Wijma expectation/ experience questionnaire at the beginning and two weeks after the intervention. Data analysis was performed using statistical tests by the SPSS software version 25 at a significance level of 0.05</span></span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.4pt">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.1pt"><span style="layout-grid-mode:line">Results:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.1pt">The mean difference of the fear of childbirth score before and after the intervention was 15.84±20.07 for the intervention group and 6.06±23.28 for the control group. Counseling with the fog approach has significantly changed the fear of childbirth score in the intervention group compared to the control group (<i>P</i><0.001), but the changes in </span></span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.1pt">motivation </span></span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.1pt">were not statistically significant</span></span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"><span style="letter-spacing:-.3pt"><span style="layout-grid-mode:line">Conclusion:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif"">Counseling with the Fogg approach reduced the fear of childbirth score. It is recommended to use this counseling method to reduce the fear of childbirth, and to use strategies to increase the motivation for natural childbirth after cesarean section.</span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif"">Clinical trial registry:</span></span></b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""> IRCT20200105046014N1</span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,"sans-serif""><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="color:black"></span></span></span></span></span></span></span></span><br>
مدل فوگ, ترس از زایمان, سزارین, زایمان طبیعی پس از سزارین, انگیزه
Fogg model, fear of childbirth, cesarean section, vaginal birth after cesarean, motivation
259
271
http://hayat.tums.ac.ir/browse.php?a_code=A-10-3876-2&slc_lang=fa&sid=1
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