KADIN MERKEZLİ BAKIMIN YAŞAM BULGULARI, KAYGI VE KONFOR DÜZEYLERİNE ETKİSİ: RANDOMİZE KONTROLLÜ ÇALIŞMA

Amaç: Araştırmada erken postpartum dönemde verilen kadın merkezli bakımın kadınların yaşam bulguları, kaygı ve konfor düzeyleri üzerine etkisinin değerlendirilmesi amaçlandı. Yöntem: Araştırma tek körlü randomize kontrollü bir çalışmadır. Deney ve kontrol gruplarının her birine permütasyon blok randomizasyon yöntemiyle 120 kadın atandı. Deney grubuna kadın merkezli bakım, kontrol grubuna standart bakım verildi. Analizlerde tanımlayıcı istatistikler, Ki-kare, Mann Whitney-U, Kruskal Wallis, Wilcoxon Ranks Testleri kullanıldı. p<0.05 değeri anlamlı kabul edildi. Bulgular: Sosyo-demografik ve obstetrik özellikler açısından iki grupta benzerdi (p>0.05). Deney ve kontrol grubunun Durumluk, Sürekli Kaygı ve Postpartum Konfor Ölçeği son test puan ortalamaları arasında fark saptandı (p=0.001; p=0.002; p=0.001). Deney grubunun Durumluk, Sürekli Kaygı ve Postpartum Konfor Ölçeği ön testleri ile son testlerinin toplam puan ortalamaları arasında fark bulundu (p=0.001). Sonuç: Erken postpartum dönemde kadın merkezli bakım alanların standart bakım alanlara göre durumluluk ve sürekli kaygı düzeylerinin daha düşük, konfor düzeylerinin ise daha yüksek olduğu saptandı. Kaygı düzeyi düşük olan, kadın merkezli bakım alan kadınların nabız hızının ve sistolik kan basıncının daha düşük olduğu belirlendi.

Anahtar Kelimeler:

Postpartum, Kadın Merkezli Bakım, Standart Bakım, Yaşam Bulguları, Konfor, Kaygı

THE EFFECTS OF WOMAN-CENTERED CARE ON VITAL SIGNS, ANXIETY AND COMFORT LEVELS: A RANDOMIZED CONTROLLED TRIAL

Objective: The aim of the study was to evaluate the effects of the woman-centered care given in the early postpartum period on vital signs, anxiety and comfort levels. Method: The study is a single-blind, randomized controlled trial. 120 women were assigned to each of the experimental and control groups by the permutation block randomization method. Woman-centered care was given to the experimental group and standard care to the control group. Descriptive statistics, Chi-square, Mann Whitney-U, Kruskal Wallis, Wilcoxon Ranks Tests were used in the analyses. A value of p<0.05 was considered significant. Results: Socio-demographic and obstetric characteristics were similar in both groups (p>0.05). There was a difference between posttest mean scores from the State, Trait Anxiety, and Postpartum Comfort Scales of the experimental and control groups (p=0.001; p=0.002; p=0.001). A difference was also identified between pretest and posttest total mean scores from the State, Trait Anxiety, and Postpartum Comfort Scales of the experimental group (p=0.001). Conclusion: In the early postpartum period, the recipients of woman-centered care were found to have lower state and trait anxiety levels and higher comfort levels compared to the recipients of standard care. It was determined that the pulse and systolic blood pressure were lower in women with low anxiety levels receiving woman-centered care.

Keywords:

Postpartum, Woman-Centered Care, Standard Care, Vital Signs, Comfort, Anxiety,

PDF

___

Fontein-Kuipers Y, Boele A, Stuij C. Midwives' perceptions of influences on their behaviour of woman-centered care: a qualitative study. Frontiers in Womens Health. 2016;1(2):20-26.
Fontein-Kuipers Y, de Groot R, van Staa A. Woman-centered care 2.0: Bringing the concept into focus. European journal of Midwifery. 2018;2(5):1-12.
Akuamoah-Boateng J, Spencer R. Woman-centered care: women's experiences and perceptions of induction of labor for uncomplicated post-term pregnancy: A systematic review of qualitative evidence. Midwifery. 2018;67:46-56.
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led versus other models of care for childbearing women. Cochrane Database Syst Rev. 2016;28(4):CD004667.
Hua J, Zhu L, Du L, et al. Effects of midwife-led maternity services on postpartum wellbeing and clinical outcomes in primiparous women under China’s one-child policy. BMC Pregnancy and Childbirth. 2018;18(1):1-9.
Hollander M, de Miranda E, Vandenbussche F, van Dillen J, Holten L. Addressing a need. Holistic midwifery in the Netherlands: A qualitative analysis. PLoS One. 2019;14(7):e0220489.
Erkaya R, Türk R, Sakar T. Determining comfort levels of postpartum women after vaginal and caesarean birth. Procedia-Social and Behavioral Sciences. 2017;237:1526-1532.
Turkish Statistical Institute (TÜİK). Birth statistics. 2018. Access date:10.12.2018.
Aksoy Derya Y, Pasinlioğlu T. The effect of nursing care based on comfort theory on women's postpartum comfort levels after caesarean sections. International Journal of Nursing Knowledge. 2017;28(3):138-144.
WHO, WHO recommendations: intrapartum care for a positive childbirth experience. 2018. Access date:14.11.2018.
Spielberger CD, Gorsuch RC, Luschene RE. Manual for the State-Trait Anxiety Invenntory. Polo Alto (CA): Consulting Psychologists Press; 1970.
Öner N, Le Compte A. State-Trait Anxiety Invenntory Hand Book. Istanbul: Bogazici University Publication; 1983.
Karakaplan S, Yıldız H. A study on developing a Postpartum Comfort Questionnaire. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi 2010;3(1):55-65.
WHO, WHO recommended interventions for improving maternal and newborn health: integrated management of pregnancy and childbirth (No. WHO/MPS/07.05). 2007. Access date:06.12.2018.
WHO, Pregnancy, childbirth, postpartum, and newborn care: a guide for essential practice. 2003. Access date:06.12.2018.
McKinney J, Keyser L, Clinton S, Pagliano C. ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol. 2018;132(3):784-785.
Geneva Foundation for Medical Education and Research, Obstetrics and gynecology guidelines. 2018. Access date:23.12.2018.
The Royal College of Midwives (RCM), RCM electronic letter HQ 2017. 2018. Access date: 13.01.2022.
Marín-Morales D, Toro-Molina S, Peñacoba-Puente C, Losa-Iglesias M, Carmona-Monge FJ. Relationship Between Postpartum Depression and Psychological and Biological Variables in the Initial Postpartum Period. Matern Child Health J. 2018;22(6):866-873.
Radoš SN, Tadinac M, Herman R. Anxiety during pregnancy and postpartum: course, predictors and comorbidity with postpartum depression. Acta Clinica Croatica. 2018;57(1):39.
Kildea S, Simcock G, Liu A, et al. Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing: the Queensland flood study. Archives of Women's Mental Health. 2018;21(2):203-214.
Macpherson I, Roqué-Sánchez MV, Legget FO, Fuertes F, Segarra I. A systematic review of the relationship factor between women and health professionals within the multivariant analysis of maternal satisfaction. Midwifery. 2016;41:68-78.
Khdir RM, Abdul-sahib SH. Immediately Postpartum Care among Nurses/Midwives in Rania City. Erbil Journal of Nursing and Midwifery. 2018;1(2):57-64.
Taylor D, Fleischer A, Meirowitz N, Rosen L. Shock index and vital-sign reference ranges during the immediate postpartum period. Int J Gynaecol Obstet. 2017;137(2):192-195.
ACOG, ACOG practice bulletin No. 212: pregnancy and heart disease. Obstet Gynecol. 2019;133:e320-e356.
Chauhan G, Tadi P. Physiology, Postpartum Changes. Treasure Island (FL): StatPearls Publishing; 2021.
Puspitasari R, Haryanti P. The Relationship between anxiety, depression, and vital signs among postpartum mothers in Yogyakarta. Journal Pendıdıkan Keperawatan Indonesıa 2021;7(1):25-32.
Farr SL, Dietz PM, O'Hara MW, Burley K, Ko JY. Postpartum anxiety and comorbid depression in a population-based sample of women. Journal of Women's Health. 2014;23(2):120-128.
Altemus M, Redwine LS, Leong YM, Frye CA, Porges SW, Carter CS. Responses to laboratory psychosocial stress in postpartum women. Psychosomatic Medicine. 2001;63(5):814-821.