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1.
Midwifery ; 103: 103154, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34627102

RESUMO

OBJECTIVE: to evaluate the perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience. DESIGN: descriptive qualitative study. PARTICIPANTS AND SETTING: 13 Iranian women who participated in childbirth preparation classes and had a vaginal delivery were interviewed. MEASUREMENTS: semi-structured interviews were used to collect data. FINDINGS: six main themes were extracted from the data analysis: incentive and learning about pregnancy and childbirth; active participation in labour; sense of self-control; use of non- medical pain relief methods during labour; preferring vaginal birth to caesarean section; and positive childbirth experience. KEY CONCLUSIONS: women reported that participation in childbirth preparation classes prepared them well for a vaginal birth, and these classes were perceived to be associated with a positive childbirth experience. IMPLICATIONS FOR PRACTICE: attendance at childbirth preparation classes is perceived to have a positive effect on vaginal birth. Therefore, encouraging and supporting women to attend the full course of classes has the potential to increase women's preference towards vaginal birth, resulting in a reduction in the caesarean section rate.

2.
Arch Psychiatr Nurs ; 35(5): 465-471, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34561060

RESUMO

AIM: To determine the relationship of health practices with depression and maternal-fetal attachment in adolescent pregnant women. METHODS: This prospective study was conducted on 316 adolescent pregnant women with medical records at the health centers in Tehran, Iran. The participants were selected through the complete enumeration. Data were collected using the socio-demographic and obstetrics questionnaire, the Health Practices Questionnaire-II (HPQ-II), the Edinburgh Postnatal Depression Scale (EPDS), and the Cranley's Maternal-Fetal Attachment Scale (MFAS). The data were analyzed with the Pearson correlation test, the independent t-test, one-way ANOVA, and the general linear model. RESULTS: The mean scores of health practices, depression, and maternal-fetal attachment were 135.3 (SD 9.1, range 34-170), 10.1 (SD 5.4, range 0-30), and 91.6 (SD 8.6, range 24-120), respectively. The results of Pearson correlation test showed that health practices had a significant relationship with depression (r = -0.29) and maternal-fetal attachment (r = 0.37). Results of general linear model showed that an increase in the health practices score led to a significant decrease in depression score during pregnancy [ß = -0.10; 95% CI: -0.17 to -0.04] and a significant increase in maternal-fetal attachment score [ß = 0.30; 95% CI: 0.19 to 0.40]. CONCLUSION: There is significant relationship between health practices and depression, as well as maternal-fetal attachment in adolescent pregnant women. Therefore, intervention to improve one of them may improve the other one(s).

3.
Nurs Open ; 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34553513

RESUMO

AIM: To determine prevalence and predictors of perceived stress in women with threatened preterm labour. DESIGN: Cross-sectional. METHODS: We recruited 409 women with threatened preterm labour, hospitalized at two tertiary hospitals. We assessed their socio-demographic and obstetrics characteristics, and their perceived stress, perceived social support, experience of violence using validated scales. Multiple linear regression was used to determine the predictors. RESULTS: Data from all recruited women were analysed. Most of them had borderline (36%) or high (42%) level stress. Overall, 17 predictors were identified explaining 89.5% of variation in the stress score. Predictors of the higher stress score included: urban living, experience of sexual and psychological violence, perceived insufficient social support, experience of vaginal bleeding during current pregnancy, abnormal results in initial pregnancy tests, having multiple roles at home, being less than 28 weeks pregnant, being parous, sleep disorders, history of health problems, insufficient income and unwanted pregnancy.

4.
Reprod Health ; 18(1): 146, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34229710

RESUMO

BACKGROUND: Women's satisfaction with childbirth experience is considered as one of the quality indicators of the maternity services across the world. However, there is no guideline for improving the experience of childbirth in Iran that is suitable for women with different cultural, economic, and social statuses. The aim of this study is to make recommendations for practice and propose a clinical guideline for improving the experience of women with vaginal births. METHODS/DESIGN: The study design was a mixed method study with a sequential explanatory approach consisting of three phases. The first phase of the study was a cross-sectional study to identify the predictors of traumatic vaginal childbirth experience among 800 primiparous women from Tabriz health centers who had vaginal birth. Data collection tools in this phase were Childbirth Experience Questionnaire (CEQ) and Support and Control in Birth (SCIB). Both tools were validated for Farsi language. The second phase was a qualitative study with 17 in-depth individual interviews among women who took part in the first phase to better understand their reasons that influenced their childbirth experience either positively or negatively. The third phase of the study was to develop recommendations for a proposed clinical guideline through a Delphi study where maternal health experts were selected and invited to take part in the panel. They first rated the proposed recommendations individually and provided written responses on their own agreement or disagreement with each statement in terms of its impact on childbirth experience, feasibility, acceptability, and cost-effectiveness. After three confirmation rounds, the final conscience was reached by the panel members. RESULTS: The results of the quantitative phase showed that the probability of negative experience of childbirth was increased when physical exercise was not implemented during pregnancy, lacking pain relief options, having fear of childbirth, lacking skin to skin contact with the newborn and being unable to initiate breastfeeding in the first hour after birth (P < 0.05). The analysis of qualitative data revealed 13 major theme categories which were related to women's sense of internal control, external control and support. In the third phase of the study, culturally appropriate recommendations were made and an evidence-based clinical guideline was proposed. The proposed guideline was based on the combination of the quantitative and qualitative phases, a review of the literature, and the opinions of Iranian experts using the Delphi technique. CONCLUSION: Given the high prevalence of negative childbirth experience among Iranian primiparous women, the present study may be of great interest for managers, leaders, policymakers, and care providers to improve the quality of the maternity services. However, further studies are required to translate the recommendations into practice and identify enablers and barriers during the implementation of the proposed guideline. To adopt the recommendations at national level, there is a need to further studies to assess the effectiveness of the proposed guideline within different communities across the region and the country.


Assuntos
Parto Obstétrico/psicologia , Parto/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Satisfação do Paciente , Mulheres/psicologia , Estudos Transversais , Parto Obstétrico/métodos , Feminino , Humanos , Recém-Nascido , Irã (Geográfico) , Parto/etnologia , Gravidez , Relações Profissional-Paciente , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Confiança
5.
Int J Nurs Pract ; : e12992, 2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34313366

RESUMO

AIM: The aim of this study was to determine the effect of a lifestyle training package that consisted of a 60- to 90-min session of group training, educational booklet and text messages on physical activity and nutritional status in obese and overweight pregnant women. METHODS: In this randomized controlled trial, 140 obese or overweight women (gestational age: 16-20 weeks) covered by health centres in Tehran, Iran, were equally randomized into two parallel groups using block randomization and stratified by the body mass index. Participants completed the Food Frequency Questionnaire and International Physical Activity Questionnaire at baseline and fourth and eighth weeks after intervention. Participants were 38 obese and 102 overweight women who were later followed-up. RESULTS: After the intervention, the mean weekly intake of the vegetable and fruit subgroups was significantly higher; and intake of fats and oils and the confections subgroups were significantly lower in the intervention compared with the control group (p < 0.05). Although physical activity was higher in the intervention group, 8 weeks after the intervention, this difference was not statistically significant (p > 0.05). CONCLUSIONS: The training package appears to offer a suitable strategy for adjusting the intake of the recommended food subgroups in obese and overweight pregnant women.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34261202

RESUMO

Induction of labor by using available, inexpensive and non-invasive methods with the least side effects is particularly important. A systematic review was conducted to assess the effect of evening primrose oil on cervical ripening in term pregnancies. In this systematic review and meta-analysis of clinical trials, a search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, Clinical Trials.gov, Google Scholar and Persian databases (Magiran, SID, and IRCT.ir) for published related articles without any time limit. The Cochrane handbook was used to determine the risk of bias of the included articles. The obtained data were analyzed in RevMan and reported in forest plots. The Odds Ratio (OR) was used to find the effect of the dichotomous data and the Mean Difference (MD) for the continuous data. The heterogeneity of the studies was assessed using I2, T2 and Chi2. The random effect was used instead of fixed effect if I2 >40%. A total of 28 titles and abstracts were extracted, 9 articles entered into the meta-analysis. The meta-analysis results showed significant differences between EPO and control groups in terms of bishop score (MD=1.32; 95% CI: 0.98 to 1.66), reducing caesarean section rate (OR= 0.61; 95% CI: 0.43 to 0.86), duration of first stage of labor (MD= -98.67; 95% CI: -140.98 to -56.38) and duration of second stage of labor (MD= -10.98; 95% CI: -21.86 to -0.09). There were no significant differences in terms of birth weight (MD= 100.97; 95% CI: -11.91 to 213.84) and the frequency of induction with oxytocin (OR= 0.53; 95% CI: 0.27 to 1.01). It seems evening primrose oil be effective for cervical ripening, reducing cesarean section rate and shortening the duration of labor. Due to the high heterogeneity of the studies, the researchers recommend further researches on the subject using a standard tool based on the CONSORT statement.

7.
BMC Psychiatry ; 21(1): 208, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892677

RESUMO

BACKGROUND: Pregnancy is a challenging period for mothers and fathers. This study aimed to investigate the effect of counseling on stress and anxiety levels of fathers. METHODS: This randomized controlled trial was conducted on 102 spouses of pregnant women in Ardabil, Iran. The participants were randomly assigned to intervention and control groups. The intervention group attended four 60-min counseling sessions at weekly intervals. The perceived stress and anxiety questionnaires were completed before and 4 weeks after the intervention. RESULTS: The mean scores of state anxiety in the intervention group decreased significantly 4 weeks after the intervention compared with the control group (MD: -2.4; 95%CI: - 4.7 to - 0.2; p = 0.030). Four weeks after the intervention, no significant difference was found between the two groups in terms of trait anxiety (p = 0.472) and perceived stress (p = 0.635). CONCLUSIONS: The findings indicate that counseling reduced state anxiety in expectant fathers; therefore, this intervention is recommended to be used to reduce fathers' anxiety. TRIAL REGISTRATION: IRCT2017042910324N38 . Registered 25 June 2017.


Assuntos
Ansiedade , Pai , Ansiedade/terapia , Aconselhamento , Feminino , Humanos , Irã (Geográfico) , Masculino , Gravidez , Gestantes
8.
Nurs Open ; 8(5): 2301-2317, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33683833

RESUMO

AIM: This study aimed to evaluate the effect of prenatal aerobic exercises on maternal and neonatal outcomes. DESIGN: A systematic review and meta-analysis. METHOD: A search was carried out in databases including PubMed, ProQuest, EMBASE, Cochrane Library, Scopus, Web of Science, Magiran and SID until 30 September 2020. Two reviewers independently assessed the articles for quality and risk of bias using the Cochrane handbook. The statistical heterogeneity was determined using the Cochran's Q test and Higgins' I2 coefficient. RESULTS: Of the 2,790 extracted articles, 16 were included in this review. The results of the meta-analysis showed that prenatal exercise can increase the frequency of vaginal delivery significantly (RR: 1.24; 95% CI: 1.08-1.43), but had no statistically significant effect on other maternal and neonatal outcomes, such as first, second and third stages of labour, gestational age at birth, first and fifth-minute Apgar score, umbilical cord pH, neonatal weight, height and head circumference (p > .05). CONCLUSIONS: The meta-analysis results suggested that prenatal exercise can reduce the frequency of caesarean section.


Assuntos
Cesárea , Trabalho de Parto , Parto Obstétrico , Exercício Físico , Feminino , Humanos , Parto , Gravidez
9.
Nurs Open ; 8(5): 2345-2353, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33773071

RESUMO

AIM: This study aimed to determine effectiveness of peanut ball on the duration of the stages of labour and frequency of caesarean section. DESIGN: A systematic review and meta-analysis. METHOD: A comprehensive electronic search was carried out with no time limit until December 2020. Collected data were analysed using software RevMan- version 5.3. Heterogeneity was assessed using I2 , T2 , and 2 . GRADE approach was used to assess the certainty of evidence. RESULTS: The meta-analysis on six clinical trials with 645 participants showed no statistically significant difference between the two groups in caesarean surgery rate (RR = 0.82) and length of the first (MD = -15.64). CONCLUSIONS: Therefore, further clinical trials with stronger evidence should be carried out to assess the effectiveness of peanut ball on caesarean surgery rate and length of first and second stages of labour.


Assuntos
Cesárea , Trabalho de Parto , Arachis , Humanos , Gravidez
10.
Nurs Open ; 8(5): 2892-2900, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33689238

RESUMO

AIM: To develop and validate the nomogram for risk estimation of Caesarean delivery and to compare the effect of cervical ripening balloon, evening primrose oil (EPO) and misoprostol on Bishop Score and duration of the first stage of labour. DESIGN: The first phase is a prospective study, and the second phase is a randomized controlled trial. METHODS: In the first phase, the nomogram will be developed and validated over 300 participants, and in the second phase, the 90 participants will be allocated to three groups: vaginal 25mcg misoprostol, vaginal 4000mg EPO and double-balloon catheter, through block randomization method. The Bishop score will be evaluated every 4 hr, and if required the same dose will be repeated. Maximum waiting time for balloon is 12 hr if not effective, the catheter will be removed, and other interventions will be done according to guidelines. DISCUSSION: The nomogram will help informed decision-making for women undergoing an induction with an unfavourable cervix and introducing effective low-complication methods of labour induction can improve the pregnancy outcomes.


Assuntos
Misoprostol , Ocitócicos , Maturidade Cervical , Cesárea , Feminino , Humanos , Trabalho de Parto Induzido , Ácidos Linoleicos , Nomogramas , Ocitócicos/uso terapêutico , Óleos Vegetais , Gravidez , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Ácido gama-Linolênico
11.
J Obstet Gynaecol Res ; 47(6): 2082-2092, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33749069

RESUMO

AIM: This study aimed to determine the effect of plantar reflexology on the severity of labor pain and childbirth experience (primary outcomes) and the duration of labor stages (secondary outcomes). METHODS: This single-blind randomized controlled trial was performed on 90 women in Al-Zahra and Taleghani hospitals in Tabriz-Iran. Participants were randomly assigned into three groups; Intervention 1 (two 30-min massages at the effective point of pain for each sole), intervention 2 (one 30-min massage at the effective point of pain and one 30-min massage at the heel for each sole), and control (two 30-minute heel massages). Massage was performed once in 4-cm dilatation and the second time in 7-cm dilatation. The severity of pain and childbirth experience were measured by Visual Analogue Scale and Labor Agentry Scale, respectively. Partograph chart was used to measure the length of labor stages. RESULTS: The severity of pain in intervention group 1 was significantly lower than the control group (AMD: -1.7; 9% confidence interval: -2.8 to -0.6; p = 0.001), but there was no significant difference between intervention groups 1 and 2 (p = 0.066) and intervention group 2 and control (p = 0.336). A significant difference was observed between groups in terms of length of the third stage of labor (p = 0.04). There was no significant difference between groups in terms of mean childbirth experience score (p = 0.217), duration of active phase (p = 0.099), and second stage of labor (p = 0.114). CONCLUSION: The results of the study showed that plantar reflexology can reduce the severity of labor pain and the length of third stage of labor.


Assuntos
Dor do Parto , Manipulações Musculoesqueléticas , Feminino , Humanos , Irã (Geográfico) , Dor do Parto/terapia , Parto , Gravidez , Método Simples-Cego
12.
Nurs Open ; 8(5): 2558-2566, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33626230

RESUMO

AIM: To compare primiparous women's childbirth knowledge and their satisfaction with the childbirth preparation classes between regular and irregular attenders. DESIGN: A cross-sectional study. METHOD: This study was conducted on 136 primiparous pregnant women attending health centres in Tabriz, Iran. Women's knowledge on childbirth and their satisfaction with childbirth preparation classes were measured by using reliable tools via interviews. An independent t test was applied to compare women's knowledge and satisfaction scores between regular and irregular attenders. RESULTS: The mean score of knowledge was significantly higher among women who were regular attenders compared to irregular attenders (p < .001). Although there were no significant differences in total satisfaction score between the women (p = .342), women with regular attendance reported that childbirth preparation classes reduced their anxiety about labour. CONCLUSIONS: Regular attendance at childbirth preparation classes is associated with higher women's knowledge and lower feelings of anxiety regarding labour and birth.


Assuntos
Satisfação Pessoal , Educação Pré-Natal , Estudos Transversais , Feminino , Humanos , Parto , Gravidez , Cuidado Pré-Natal
13.
J Obstet Gynaecol ; 41(2): 234-241, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32331505

RESUMO

This randomised clinical trial was conducted on 153 pregnant women. Participants were assigned into two intervention groups including educational software and an educational booklet and a control group through block randomisation. A training session was implemented for the intervention groups at 30-36 weeks and they were taught how to use the educational methods. Participants were followed-up until the childbirth time and the severity of pain was measured at four stage of cervical dilatation (4, 6, 8 and 10 cm) by Visual Analogue Scale (VAS). Spielberger State-Trait Anxiety Inventory was completed at 4-5 cm cervical dilatation. There was no significant difference between groups in terms of the labour pain intensity (p > .05). After intervention, mean (SD) of state anxiety score was 38.7 (2.6) in educational software group, 44.3 (7.4) in educational booklet group and 63.3 (8.2) in control group. Also, mean (SD) of trait anxiety score was 47.4 (2.7) in educational software group, 47.2 (2.4) in educational booklet group and 61.8 (3.9) in control group. The mean state and trait anxiety scores in both intervention groups were significantly lower than control group (p < .001). Both intervention groups were effective in reducing anxiety. Thus, these educational methods should be recommended for pregnant women in clinical practices.IMPACT STATEMENTWhat is already known on this subject? Childbirth is one of the most important crises in women's life, in which stress and other forms of emotional distress such as anxiety are likely to occur during it. Safe practices and effective interventions can be offered to pregnant women to tolerate the labour pain and reduce anxiety during labour.What do the results of this study add? There was no statistically significant difference between two intervention groups (educational software and educational booklet groups) and control group in terms of the pain intensity at the cervical dilatation of 4, 6, 8 and 10 cm. But the state and trait anxiety in both groups (educational software and educational booklet groups) was significantly less than the control group. Also, the anxiety level was significantly lower in the educational software group than the educational booklet group.What are the implications of these findings for clinical practice and/or future research? Educational software and booklet with educational content about position modification during pregnancy, stretching exercises, breathing techniques and exercises, relaxation and lower back massage for reducing anxiety should be recommended for pregnant women in clinical practices.

14.
BMC Pregnancy Childbirth ; 20(1): 669, 2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33153442

RESUMO

BACKGROUND: Childbirth preparation classes can reduce pregnant women's anxiety and fear for their childbirth. However, to evaluate women's feedback and their satisfaction with these classes, there is a need for a standard instrument that is suitable for Iranian context. This study is aimed to translate and conduct a psychometric analysis of the Satisfaction with the Childbirth Education Class Questionnaire (SCECQ) for Iranian population. METHODS: The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. RESULTS: The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2/df ratio was smaller than 5. The overall model validity was confirmed by having the Root Mean Square Error of Approximation (RMSEA) smaller than 0.08. Cronbach's alpha and intraclass correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. CONCLUSION: The Persian version of this questionnaire, entitled SCECQ is a valid and reliable instrument for measuring Iranian women's satisfaction with childbirth education classes.


Assuntos
Satisfação Pessoal , Educação Pré-Natal/estatística & dados numéricos , Psicometria/métodos , Adulto , Feminino , Humanos , Irã (Geográfico) , Gravidez , Educação Pré-Natal/métodos , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Inquéritos e Questionários/estatística & dados numéricos , Traduções , Adulto Jovem
15.
J Matern Fetal Neonatal Med ; : 1-8, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33076724

RESUMO

BACKGROUND: Assessment of women's childbirth experience is an important indicator in maternity services. Positive childbirth experiences improve mothers' health, whereas negative childbirth experiences can cause psychological stresses and, in extreme cases, may lead to postpartum depression. METHODS: In this cohort study, 204 women at 35-37 weeks of gestation were selected using cluster sampling from the health centers of Tabriz, Iran. Women were divided into three groups (68 women in each group) based on their attendance in childbirth preparation classes: (a) non-attenders (did not attend any sessions), (b) irregular attenders (attended 1-3 sessions), and (c) regular attendants (attended 4-8 sessions). Interviews were conducted at one month postpartum to complete the Childbirth Experience Questionnaire (CEQ) and Edinburgh Postnatal Depression Scale (EPDS). The general linear model (GLM) was used to identify associations between women's attendance to the classes and either their childbirth experience or postpartum depression scores. RESULTS: Based on the GLM, the mean score of childbirth experience among the regular attenders was significantly higher than women who were irregular attenders (p = .032) or non-attenders (p < .001). In addition, the mean score of postpartum depression scale was significantly lower among regular attenders compared with non-attenders (p < .001). However, there was no significant difference in postpartum depression score among regular and irregular attenders (p = .257). CONCLUSIONS: Attending prenatal classes was associated with positive childbirth experience and low postpartum depression score.

16.
Reprod Health ; 17(1): 138, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894145

RESUMO

BACKGROUND: Pregnancy, birth, and motherhood are among the most important events of every woman's life. Training and participation of mothers in the decision-making process of delivery play an essential role in physical as well as psychosocial preparation of the mother. The healthcare system can improve and enhance the level of care by involving the patient in their self-care process. The aim of the present study is to assess the implementation of the birth plan for the first time in Iran in Tabriz city. METHODS/DESIGN: The present study uses a mixed-method with a parallel convergence approach, including both quantitative and qualitative phases. The quantitative phase is a randomized controlled clinical trial performed on 106 pregnant women, 32-36 weeks of pregnancy, referring to Taleghani educational hospital in Tabriz city. The participants will be assigned into intervention and control groups using a randomized block method. A training session will be held about the items of the birth plan checklist at weeks 32-36 of gestation for the participants in the intervention group, whereby a mother-requested birth plan will be developed. It will then be implemented by the researcher after admitting them to the delivery ward. Also, those in the control group will receive routine care. During and after the delivery, the questionnaire of delivery information, neonatal information, and Delivery Fear Scale (DFS) will be completed. Also, a partogram will be completed for all participants by the researcher. The participants in both groups will be followed up until six weeks post-delivery, whereby the instruments of Childbirth Experience Questionnaire (CEQ2.0), Edinburgh's Postpartum Depression Scale and PTSD Symptom Scale 1 (PSS-I) will be completed six weeks 4-6 weeks postpartum by the researcher through an interview with participants in Taleghani educational hospital. The general linear model and multivariate logistic regression model will be used while controlling the possible confounding variables. The qualitative phase will be performed to explore the women's perception of the effect of the birth plan on childbirth experience within 4-6 weeks postpartum. The sampling will be of a purposeful type on the women who would receive the birth plan and will continue until data saturation. In-depth, semi-structured individual interviews would be used for data collection. The data analysis will be done through content analysis with a conventional approach. The results of the quantitative and qualitative phases will be analyzed separately, and then combined in the interpretation stage. DISCUSSION: By investigating the effect of implementing the birth plan on the childbirth experience of women as well as other maternal and neonatal outcomes, an evidence-based insight can be offered using a culturally sensitive approach. The presentation of the results obtained from this study using the mixed method may be effective in improving the quality of care provided for women during labor. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N58. Date of registration: July 7, 2020. URL: https://en.irct.ir/user/trial/47007/view.


Assuntos
Trabalho de Parto , Parto , Educação Pré-Natal , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Irã (Geográfico) , Trabalho de Parto/efeitos dos fármacos , Parto/efeitos dos fármacos , Parto/psicologia , Gravidez , Cuidado Pré-Natal , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
BMC Health Serv Res ; 20(1): 894, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962715

RESUMO

BACKGROUND: The absence of Respectful Maternity Care (RMC) deters mothers from seeking maternity care services. Given the importance of RMC and the lack of a standard tool for its assessment in Iran, the present study was conducted to translate and assess the psychometric properties of the RMC questionnaire in Iranian women. METHODS: Forward-backward method was used for translating the questionnaire from English into Persian. A total of 265 postpartum women entered the study by simple random sampling from public and private hospitals in Tabriz, Iran. The validity of the questionnaire was confirmed through the face, content and construct validity. Construct validity was assessed through exploratory and confirmatory factor analyses. The internal consistency and test-retest reliability were used to confirm the reliability of the questionnaire. Internal consistency was examined by measuring the Cronbach's alpha in a sample of 20 mothers, and test-retest stability by calculating the Intraclass Correlation Coefficient (ICC) in the same group of mothers, who had completed the questionnaire twice with a two-week interval. RESULTS: The exploratory factor analysis led to the extraction of one factor. Item 12 was eliminated due to its low factor loading. X2/df was less than 5, and RMSEA was less than 0.08, which confirms the validity of this model. The Cronbach's alpha coefficient was obtained as 0.93 and ICC (with 95% confidence interval) as 0.98 (0.96 to 0.99). CONCLUSION: The results of the study demonstrated that the Iranian RMC scale can be used as a valid and reliable instrument to assess RMC in Iran.


Assuntos
Serviços de Saúde Materna , Respeito , Inquéritos e Questionários , Adulto , Análise Fatorial , Feminino , Humanos , Irã (Geográfico) , Gravidez , Psicometria , Reprodutibilidade dos Testes , Tradução
18.
BMC Int Health Hum Rights ; 20(1): 24, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928215

RESUMO

BACKGROUND: Sexual function is one of the main aspects of life. Pregnancy affects sexual function. The aim of this study was to determine the sexual dysfunction in young pregnant women and its correlation with intimate partner violence (IPV). METHODS: This cross-sectional study was conducted using two-stage cluster sampling method. The data were collected using a socio-demographic questionnaire, Female Sexual Function Index (FSFI), and Conflict Tactics Scale (CTS2). Multivariate logistic regression was used to determine the relationships between sexual dysfunction with IPV and socio-demographic factors. RESULTS: The results of this study on 346 pregnant women aged 18-29 years showed that mean (SD = standard deviation) of the total sexual function score was 25.4 (5.9), within a possible score range of 2 to 36. About 66% of the young pregnant women had a sexual dysfunction. The lowest and the highest prevalence of sexual dysfunction were in sub domains of sexual satisfaction and sexual desire, respectively. The prevalence of overall IPV against young women was 63%. The most common type of IPV experienced by women was psychological aggression (56.6%). There were statistically significant relationships between sexual dysfunction and IPV (OR (Odds Ratio) = 0.4, 95% Confidence Interval = 0.2 to 0.6, p <  0.001), sufficiency of income for expenses (0.2, 0.1 to 0.6, p = 0.005), husband educational level (0.5, 0.3 to 0.9, p = 0.028) and marriage duration (1.9, 1.0 to 3.7, p = 0.044). CONCLUSIONS: Sexual dysfunction has a high prevalence in young pregnant women and IPV had correlation with sexual dysfunction. The routine screening for sexual dysfunction and IPV is recommended during pregnancy for detection and consulting.


Assuntos
Agressão/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Irã (Geográfico)/epidemiologia , Gravidez , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
19.
BMC Pregnancy Childbirth ; 20(1): 468, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32807127

RESUMO

BACKGROUND: Intrapartum respectful maternity care is defined as a fundamental human right that can affect the mother's experiences. This study aimed to determine the status of respectful maternity care and its relationship with childbirth experience among Iranian women. METHODS: This prospective cohort study recruited 334 postpartum women in postpartum wards of two public and four private hospitals in Tabriz, Iran. Quota sampling was used based on the number of births in each hospital. Data were collected through interviews with the use of the following tools: sociodemographic and obstetrics characteristics questionnaire, respectful maternity care scale (6 to 18 h postpartum), and childbirth experience questionnaire (30 to 45 days postpartum). The General Linear Model was used to determine the relationship between respectful maternity care and childbirth experience. RESULTS: The mean respectful maternity care score was 62.58 with a range of 15 to 75, and the total childbirth experience score was 3.29 with a range of 1 to 4. After adjusting for sociodemographic and obstetrics characteristics, a statistically significant direct correlation was found between respectful maternity care and a positive childbirth experience (P < 0.001). CONCLUSIONS: The findings reveals a direct relationship between respectful maternity care and positive childbirth experience. Therefore, it is recommended that mangers and policy makers in childbirth facilities reinforce facilitating a respectful maternity care to improve women's child birth experience and prevent potential adverse effects of negative childbirth experiences.


Assuntos
Parto Obstétrico/normas , Serviços de Saúde Materna/normas , Respeito , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Irã (Geográfico) , Gravidez , Estudos Prospectivos , Autorrelato , Adulto Jovem
20.
BMC Womens Health ; 20(1): 180, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32799875

RESUMO

BACKGROUND: Lack of knowledge and fear of the unknown during pregnancy and childbirth make mothers fearful, worried, and anxious. Maternal fear and anxiety can lead to problems such as preterm childbirth and low birth weight. Increasing women's knowledge through prenatal education can prepare them for childbirth and improve their health. The present study was conducted to compare fear of childbirth, anxiety and depression during pregnancy in three groups of primiparous pregnant women who were either not attending, irregularly attending, or regularly attending childbirth preparation classes. METHODS: A total of 204 primiparous pregnant women attending health centers in Tabriz, Iran, were selected by cluster sampling and assigned to the following three groups: Not attending, irregularly attending (attending one to three sessions of classes) and regularly attending (attending four to eight sessions of classes). Childbirth fear, pregnancy anxiety and depression questionnaires were completed for them through interviews. The general linear model was used to compare their fear of childbirth and prenatal anxiety and depression. RESULTS: According to the general linear model, the scores of fear of childbirth (p <  0.001), anxiety (p <  0.001) and depression (p = 0.006) were significantly lower in the group of pregnant women regularly attending the classes compared to the non-attending group of women. No significant differences were observed between the regularly-attending and irregularly-attending groups in terms of fear of childbirth (p = 0.066), anxiety (p = 0.078), and depression (p = 0.128). CONCLUSION: Prenatal training can reduce fear, anxiety and depression in primiparous women. Incorporating such training into prenatal care helps improve maternal health.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Medo/psicologia , Parto/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Irã (Geográfico) , Paridade , Gravidez , Educação Pré-Natal , Inquéritos e Questionários
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