بررسی عوامل موثر بر انتخاب روش زایمان توسط زنان باردار نخست‌زا مراجعه‌کننده به بیمارستان شهید مصطفی خمینی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

2 گروه پزشکی اجتماعی و اخلاق پزشکی، دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

3 گروه زنان ، دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

چکیده

مقدمه و هدف: باورهای مادرانه در انتخاب نوع زایمان تاثیرگذار است. بررسی عوامل تعیین کننده انتخاب روش زایمان با استفاده از الگوی اعتقاد بهداشتی میتواند در پیش بینی نوع زایمان انتخابی توسط مادران کمک کننده باشد. مطالعه اخیر با هدف بررسی عوامل موثر بر انتخاب روش زایمان توسط زنان باردار نخست زا انجام شد.
مواد و روش ها: تعداد 73 خانم باردار نخست زا مراجعه کننده به بیمارستان شهید مصطفی خمینی تهران در سال 1400 وارد مطالعه توصیفی-تحلیلی مقطعی شدند. ابزار جمع آوری داده ها، ٰپرسشنامه ترجیحات زنان باردار برای روش زایمان دکتر زمانی علویجه شامل دو قسمت مشخصات فردی و سؤالات مربوط به الگوی اعتقاد بهداشتی شامل 7 فاکتور خودکارآمدی، برداشت نادرست از مزایای زایمان سزارین، اغراق در خطرات زایمان واژینال، حساسیت درک شده، باورهای عمومی، میل به پذیرش، طرز فکر متخصصان بهداشت (پزشک ، ماما) بود. با نرم افزار SPSS نسخه 16 تجزیه و تحلیل آماری انجام شد.
نتایج: : مقایسه مادران با انتخاب سزارین و مادران با انتخاب زایمان واژینال از نظر میانگین نمره های خودکارآمدی (P=0.005) و برداشت نادرست (P<0.001) و اغراق در خطرات زایمان طبیعی (P<0.001) اختلاف معنی دار داشتند. مقایسه میانگین نمره های حساسیت درک شده ، باورهای عمومی، میل به پذیرش  و طرز فکر متخصصان بهداشت برای مادران با انتخاب روش زایمانی سزارین و واژینال تفاوت مشخص آماری نداشت.
نتیجه‌گیری: یافته ها نشان داد که خودکارآمدی درک شده ، برداشت نادرست و اغراق در خطرات زایمان واژینال پیش بینی کننده نوع زایمان انتخابی است. آموزش مبتنی بر این عوامل می تواند در انتخاب روش زایمان مفید باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of effective factors on the choice of delivery method by nulliparous pregnant women referring to Shaheed Mostafa Khomeini hospital in Tehran

نویسندگان [English]

  • Mohamadamir Koohbor 1
  • Ali Davati 2
  • Ahia Garshasbi 3
  • Farahnaz Torkestani 3
1 Faculty of Medicine, Shahed University, Tehran, Iran
2 Department of Social Medicine, Shahed University, Tehran, Iran
3 Department of Gynecology and Obstetrics, Faculty of Medicine, Shahed University, Tehran, Iran
چکیده [English]

Background and Objective: Maternal beliefs are influential in choosing the type of delivery. the study of determining factors in choosing the method of delivery using the health belief model can be helpful in predicting the type of delivery selected by mothers. the aim of this study was to investigate the factors affecting the choice of delivery method by nulliparous pregnant women.
Materials and Methods: A total of 73 nulliparous pregnant women referred to shaheed mostafa khomeini hospital in Tehran in 1400 entered a cross-sectional descriptive-analytical study. Data collection tool, two-part questionnaire including demographic characteristics and questions related to the health belief model including 7 self-efficacy factors, misconception of the benefits of cesarean delivery, exaggeration in the risks of vaginal delivery, perceived sensitivity, general beliefs, willingness to accept was the mindset of health professionals (physician, midwife). Data analysis was performed with SPSS software version 16.
Results: Comparison of mothers with cesarean section and mothers with vaginal delivery were significantly different in mean scores of self-efficacy (p<0.005), misdiagnosis (p<0.001) and exaggeration of natural childbirth risks (p<0.001). Comparing the mean scores of perceived sensitivity, general beliefs, willingness to accept and the mindset of health professionals for mothers with the choice of cesarean section and natural delivery was not statistically significant.
Conclusion: The findings showed that perceived self-efficacy, misconceptions and exaggerations in the risks of vaginal delivery predict the type of childbirth selected. Education based on these factors can be useful in choosing the method of delivery.

کلیدواژه‌ها [English]

  • Delivery method
  • Health belief model
  • Cesarean section
  • Vaginal delivery

مراجع

  1. Vogel JP, Betrán AP, Vindevoghel N, Souza JP, Torloni MR, Zhang J, et al. WHO multi-country survey on maternal and newborn health research network. use of the robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Global Health 2015 ;3(5):e260-70.
  2. Câmara R, Burlá M, Ferrari J, Lima L, Amim JJ, Braga A, et al. Cesarean section by maternal request. Revista do Colegio Brasileiro de Cirurgioes 2016;43(4):301-10.
  3. Darsareh F, Aghamolaei T, Rajaei M, Madani A. Determinants of caesarean birth on maternal demand in the Islamic Republic of Iran: a review. Eastern Mediterranean Health Journal 2017; 23(6):441-448.
  4. Yazdizadeh B, Nedjat S, Mohammad K, Rashidian A, Changizi N, Majdzadeh R. Cesarean section rate in Iran, multidimensional approaches for behavioral change of providers: a qualitative study. BMC Health Services Research 2011;11(1):1-14.
  5. Azami-Aghdash S, Ghojazadeh M, Dehdilani N, Mohammadi M. Prevalence and causes of cesarean section in Iran: systematic review and meta-analysis. Iranian Journal of Public Health 2014;43(5):545.
  6. Shariat M, Ehdaeevand F, Ataie M, Karami Z, Hadipoor Jahromi LHJ, Farahani Z. Effectiveness of community based intervention on improvement of pregnancy and delivery process in district 4 of Tehran. Tehran University Medical Journal TUMS Publications 2015;73(7):527-34.
  7. Sharifirad G, Rezaeian M, Soltani R, Javaheri S, Mazaheri MA. A survey on the effects of husbands’ education of pregnant women on knowledge, attitude, and reducing elective cesarean section. Journal of Education and Health Promotion 2013; 2:50.
  8. Shahshahan Z, Heshmati B, Akbari M, Sabet F. Caesarean section in Iran. Lancet 2016 ;388(10039):29-30.
  9. Jafarzadeh A, Hadavi M, Hasanshahi G, Rezaeian M, Vazirinejad R, Aminzadeh F, Sarkoohi A. Cesarean or Cesarean Epidemic? Archives of Iranian Medicine 2019;22(11):663-670.
  10. Betran AP, Torloni  M R, Zhang  J J, Gülmezoglu A M. WHO Statement on Caesarean Section Rates: a commentary. An International Journal of Obstetrics and Gynaecology 2016;123(5):667–670.
  11. Moosavi A, Sheikhlou SG, Sheikhlou SG, Abdolahi K, Yaminifar L, Maktabi M. Influencing factors in choosing delivery method: Iranian primiparous women's perspective. Electron Physician 2017;9(4):4150-4.
  12. Shirzad M, Shakibazadeh E, Hajimiri K, Betran AP, Jahanfar S, Bohren MA, et al. Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in Iran: a mixed-methods systematic review. Reproductive Health 2021 2;18(1):3.
  13. Safari-Moradabadi A, Alavi A, Pormehr-Yabandeh A, Eftekhaari TE, Dadipoor S. Factors involved in selecting the birth type among primiparous women. Iranian Journal of Health Education and Health Promotion 2018 3;7:55.
  14. Bam V, Lomotey AY, Kusi-Amponsah Diji A, Budu HI, Bamfo-Ennin D, Mireku G. Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study. Heliyon 2021 11;7(8):e07755.
  15. Jenabi E, Khazaei S, Bashirian S, Aghababaei S, Matinnia N. Reasons for elective cesarean section on maternal request: a systematic review. Journal of Maternal-Fetal & Neonatal Medicine 2020 ;33(22):3867-3872.
  16. Mortazavi F, Mehrabadi M. Predictors of fear of childbirth and normal vaginal birth among Iranian postpartum women: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21(1):316.
  17. Rahnama P, Mohammadi K, Montazeri A. Salient beliefs towards vaginal delivery in pregnant women: A qualitative study from Iran. Reproductive Health 2016; 23;13:7
  18. Zandkarimi E, Moghimbeigi A, Mahjub H. Assessing the Factors Affecting Cesarean Section Selection in Iranian Women Using Multilevel Count Models with Excess Zeros. Iranian Journal of Public Health 2021;50(4):816-824.
  19. Afshari A, Ghafari M. A survey on selection of delivery method by nulliparous pregnant women using health belief model in Semirom, Iran, 2012. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2013;16(47.48):22-9.
  20. Baghianimoghadam M, Baghianimoghadam M, Jozi F, Hatamzadah N, Mehrabbik A, Hashemifard F, et al . The relationship between HBM constructs and intended delivery method. Tolooe Behdasht 2014; 12 (4) :105-116..
  21. Dadipoor S, Mehraban M, Aghamolaei T, Ramezankhani A, Safari-Moradabadi A. Prediction of Birth Type Based on the Health Belief Model. Journal of Family & Reproductive Health 2017;11(3):159-164.
  22. Zamani-Alavijeh F, Shahry P, Kalhori M, Araban M. Pregnant women's preferences for mode of delivery questionnaire: Psychometric properties. Health Education & Health Promotion 2017; 19;6:20.
  23. Khooshideh M, Mirzarahimi T. The Comparison of Maternal and Neonatal Outcomes of Normal Vaginal Delivery versus Unplanned Cesarean Section Delivery. Journal of Ardabil University of Medical Sciences 2017;17(1):122–132.
  24. Ye J, Zhang J, Mikolajczyk R, Torloni MR, Gülmezoglu AM, Betran AP. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. An International Journal of Obstetrics & Gynaecology 2016 ;123(5):745-53.
  25. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychological Review 1977;84(2):191.
  26. Bahri N, Mohebi S, Bahri N, Davoudi Farimani S, Khodadoost L. Factors related to the decision making process of primigravid women about mode of delivery: A theory-based study. The Iranian Journal of Obstetrics, Gynecology and Infertility 2017; 20(8): 42-50.
  27. Khorsandi M, Ghofranipour F, Heydarnia A, Faghihzade S, Akbarzade A, Vafaei M. Survey of perceived self efficacy in pregnant women. Iranian Journal of Medical Sciences 2008; 26(1):89-95.
  28. Kanani S, Allahverdipour H. Self-Efficacy of Choosing Delivery Method and Labor Among Pregnant Women in Pars-Abad City. Journal of Education and Community Health 2014;  (2):39-47.
  29. Loke AY, Davies L, Li SF. Factors influencing the decision that women make on their mode of delivery: The Health Belief Model. BMC Health Services Research 2015;15:274.
  30. Hajian S, Shariati M, Najmabadi KM, Yunesian M, Ajami ME. Psychological predictors of intention to deliver vaginally through the extended parallel process model: a mixed-method approach in pregnant Iranian women. Oman Medical Journal 2013; 28(6):395.
  31. Long Q, Kingdon C, Yang F, Renecle MD, Jahanfar S, Bohren MA, et al. Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in China: A mixed-methods systematic review. PLOS Medicine 2018 ;15(10):e1002672.
  32. Turner C, Young J, Solomon M, Ludlow J, Benness C, Phipps H. Vaginal delivery compared with elective caesarean section: the views of pregnant women and clinicians. BJOG: An International Journal of Obstetrics & Gynaecology 2008;115(12):1494-502.
  33. Guittier M-J, Cedraschi C, Jamei N, Boulvain M, Guillemin F. Impact of mode of delivery on the birth experience in first-time mothers: a qualitative study. BMC Pregnancy and Childbirth 2014;14(1):1-9.
دانشور پزشکی
دوره 29، شماره 6 - شماره پیاپی 157
بهمن و اسفند 1400
صفحه 14-23

فایل ها

هم رسانی

ارجاع به این مقاله

آمار