Evaluation of the effect of education on perceived stress of mother candidates for amniocentesis

BACKGROUND

Amniocentesis is one of the methods for diagnosing prenatal abnormalities. Pregnant women with high-risk fetal screening results are the candidates for amniocentesis. Most of these women are afraid of this procedure because they predict that the test will be painful and worried about its adverse effects on pregnancy, fetal injury, or the risk of maternal death. Therefore, the aim of this study was to determine the effect of education on the perceived stress of mothers who are the candidates for amniocentesis.

MATERIALS AND METHODS

The present study was a quasi-experimental, two-group clinical trial with a parallel design. This study was in three stages: pretest (before intervention), posttest (after intervention), and after amniocentesis. This study was performed on 80 pregnant women who were the candidates for amniocentesis (15-20 weeks of pregnancy) with high-risk fetal screening results referred to the perinatology clinic in Yazd in 2020. The intervention package included training and using breathing techniques, broadcasting educational animations on how to perform amniocentesis, expressing experiences by people who had experienced amniocentesis, and finally visiting the amniocentesis site and getting to know the relevant perinatologist. Data collection tools were demographic and midwifery profile questionnaires and Cohen perceived stress. SPSS software version 16 was used for statistical analysis of data.

RESULTS

The results showed that the research units had high stress at the beginning of the study. The perceived stress score at the beginning of the study in the intervention group was 30.1750 ± 6.53153 and in the control group was 28.2750 ± 8.57841. After the intervention, the participants' stress level decreased below the cutting point. In the experimental group, the mean stresses after the intervention and after amniocentesis were significantly lower than before the intervention; however, after amniocentesis, it was somewhat higher than the postintervention stage. In the preintervention stage, the mean stress score between the two groups was not statistically significant. The difference after the intervention between the two groups was significant (P < 001.0); however, in the postamniocentesis stage, the difference in stress was not significant. After the intervention and after amniocentesis, the perceived stress of pregnant mothers in the experimental group was less than the control group.

CONCLUSION

Considering that the perceived stress in amniocentesis candidate mothers was high in the present study, so that after performing the method, mothers left the center with high stress, it is very important to pay attention to its psychological aspects. Therefore, it is suggested that educational interventions before and during amniocentesis be considered for them along with psychological support and follow-up care after amniocentesis.

The effect of cognitive-behavioral counseling of pregnant women with the presence of a spouse on stress, anxiety, and postpartum depression

BACKGROUND

Pregnant women are classified as one of the vulnerable groups. Physiological and psychological changes during pregnancy predispose them to serious psychiatric disorders; if not identified and treated in time, it can have a negative and long-term impact on mental health. The aim of this study was to determine the effect of cognitive-behavioral counseling of pregnant women with the presence of a spouse on the level of stress, anxiety, and postpartum depression.

MATERIALS AND METHODS

The present study is a clinical trial that was performed on 40 pregnant women with a gestational age of 32-28 weeks (20 in the intervention group, 20 in the control group) who were randomly assigned to the intervention group and the control group according to the inclusion criteria. Cognitive-behavioral group counseling in the presence of spouses was performed by the midwife and under the supervision of a psychologist, in eight sessions, each session lasting 90 min, once a week for the intervention group. The control group received routine care and a counseling session. Data collection tools were demographic information questionnaire and Depression-Anxiety-Stress Scale 21, which were completed before the intervention, immediately after the intervention, and on the 14^th day after delivery in both groups. Data analysis was performed using statistical tests, independent t-test, repeated measures test, Bonferroni post hoc test, and Kolmogorov-Smirnov test.

RESULTS

The results of this study showed that the mean scores of stress, anxiety, and depression in the two groups in the preintervention stage were not significantly different (P < 0.05), but in the postintervention stage and follow-up, the mean scores of stress (P < 0.001), depression (P = 0.010), and anxiety (P = 0.029) in the intervention group were significantly reduced compared to the control group.

CONCLUSION

According to the research findings, cognitive-behavioral group counseling can be effective as an approach in improving the symptoms of stress, anxiety, and depression in pregnant women. Therefore, it is necessary to plan properly to use this counseling approach to manage stress, anxiety, and depression in women during pregnancy.

The effect of education on anxiety of pregnant mothers before amniocentesis

BACKGROUND

Pregnancy alone is associated with many anxieties and worries for many women. Prenatal diagnosis of fetal malformations is one of the most important anxious events for women. Increasing knowledge empowers the person to identify the important issues and by increasing understanding, creates a positive attitude in people. Therefore, the aim of this study was to investigate the effect of education on the level of anxiety of pregnant mothers before invasive screening for fetal abnormalities (amniocentesis).

MATERIALS AND METHODS

This is a quasi-experimental study with two parallel designs in three stages: Pretest (before intervention), posttest (after intervention), and after amniocentesis. This study was performed on 80 pregnant women candidates for amniocentesis (40 pregnant women in the control group and 40 pregnant women in the intervention group) referred to the perinatology clinic in Yazd in 2020. Data collection tools were demographic and midwifery questionnaires and Spiel Berger anxiety questionnaires. In the experimental group, the intervention was performed as group training for 90 min immediately before amniocentesis. In the control group, only routine procedures (brief description by a perinatologist during amniocentesis) were performed. SPSS software version 16 was used to analyze the data.

RESULTS

The mean age of the research units was 67/5 ± 5/33 years. The results of Mann-Whitney intergroup test showed that the mean scores of overt anxiety before the intervention between the control and intervention groups were not significant (P < 0.014) but were significant after training and after amniocenter (P < 0.001). Furthermore, the results of Mann-Whitney group test showed that the mean scores of overt anxiety in the intervention group before and after training were significant (P < 0.001). Furthermore, the results of the control group showed significant results (P < 0.001). The results of the independent t-test showed that the mean scores of latent anxiety before the intervention between the control and intervention groups were not significant (P < 0.194) but were significant after the training (P < 0.57) but The results were not significant after amniocentesis (P < 0.216). Furthermore, the results of paired t-test within the group showed that the mean scores of overt anxiety in the intervention group before and after training was significant (P < 0.001). Furthermore, the results of the control group showed significant results (P < 0.001).

CONCLUSION

The findings of the present study indicate the positive effect of education on anxiety of pregnant women candidates for amniocentesis. The results also show the important role of education on the psychological dimension of high-risk pregnant women in relation to the consequences of pregnancy and childbirth. According to the research results, it seems that education affects the cognitive system and information processing by increasing people's awareness of the amniocentesis process and its consequences.

Clinical error management training for midwifery students in Shahid Sadoughi University of Medical Sciences, Yazd

INTRODUCTION

Today, the quality of health services is considered to be providing "error-free" services, at the right time, by the right person and with the least resources. In recent years, education through evidence-based care has been emphasized by health system policymakers as a way to improve care standards. Therefore, the purpose of this study is to teach clinical error management to midwifery students in Shahid Sadoughi University of Medical Sciences in Yazd.

METHODS

The present study was performed using consensus-based methods based on Delphi technique to identify the most common errors and the best educational solution for its management with the participation of 21 midwives by purposive sampling method in Shahid Sadoughi University of Medical Sciences in Yazd in 2018. The rate of agreement was 75% or more. Descriptive statistical methods and SPSS-18 software were used for analysis.

RESULTS

The most important errors mentioned were as follows: In the field of hospital care, it was the scope of care during labor and in clinical care, it was the scope of prenatal care. The most important error reduction strategies that were considered in the clinical guide in general were emphasizing the following: active supervision of instructors during the provision of students' clinical services, paying attention to the evaluation of service provision with the least incidence of errors in end-of-course evaluation, make changes in clinical teaching methods, attention to the use of active teaching methods and the use of educational software. The cases were considered separately in each of the mentioned errors.

DISCUSSION AND CONCLUSION

Incidence of errors in pregnancy and childbirth as the most errors of midwifery students in the field of hospital and clinical care was agreed on. Therefore, considering this issue and the importance of preventing errors to provide quality services to mothers and infants, it seems that it is time to make changes in clinical education in this field by emphasizing the use of active educational methods.

Female genital mutilation in Southern Iran

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The Most Common Type of HPV in Women with Atypical Squamous Cell of Undetermined Significance (ASCUS) in Pap Smear in Iran-Yazd

INTRODUCTION

Cervical cancer is the third most gynecological cancer and one of the common causes of cancer death in women in Iran and the other developing countries. Human Papilloma Virus (HPV) is a known Risk factor in cervical cancer, but according to HPV deference types, the high risk and low risks differ.

MATERIAL AND METHOD

We evaluate the most common high risk and low risk HPV type in 180 females with an atypical squamous cells of undetermined significance (ASCUS) results in pap smear in Gynecological Oncology Clinic in Shahid Sadoughi Hospital in Yazd, Iran within 2012 to 2014.HPV typing was done with polymerase chain reaction (PCR) method. The data obtained were recorded in a questionnaire and analyzed by SPSS software.

RESULT

More common low risk HPV type in ASCUS patients was type 6 (63.6%) and then type 11 (36.4%). Type 16 was the most common high risk HPV type.

DISCUSSION

HPV DNA typing for better management of women With ASCUS is important and this study showed HPV type 16 is the most prevalent type in ASCUS patients. It seems the living region is important in HPV type distribution and Quadri-valant Vaccine can prevent cervical cancer in Iran because the most common low risk HPV is type6 and 11, and HPV 16 is the most common high risk HPV.

Attitude and practice of pregnant women regarding self-medication in Yazd, Iran

BACKGROUND

Medications, a main strategic commodity in any country, are strictly related to community health and sustainable development. Self-medication and irregular use of medications can increase their adverse effects. This study investigated the factors related to irregular and arbitrary use of medications in pregnant women admitted to health centers and clinics of Yazd, Iran, and their practice in this context.

METHODS

This was a descriptive- analytic cross-sectional study conducted among 180 pregnant women. Participants were selected by cluster sampling. We chose six health centers and clinics from all medical centers in Yazd by a simple random method. A questionnaire was completed by the pregnant women who were consecutively admitted to each center. Data were analyzed by ANOVA, t-test, Chi-square, and Pearson tests with SPSS-15 software.

RESULTS

More than 35% of the women self-medicated during pregnancy. Women with academic degrees scored higher in the knowledge section; however, this difference was not significant.  The mean attitude scores for academic and nonacademic graduates were 34.92 (from 60) and 29.87, respectively while the mean practice scores were 15 (from 20) and 14.25 for academic and non-academic graduates, respectively.

CONCLUSION

The results of this study showed an increased prevalence of self-medication among pregnant women. Because of potential fetomaternal hazards related to medications, it is necessary to conduct educational programs to prevent this harmful habit and attitude in pregnant women.