تاثیر آموزش ایمن سازی در مقابل تنش بر اضطراب و کیفیت خواب زنان باردار در سه ماهه ی سوم بارداری

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد روان شناسی عمومی، دانشگاه شهید باهنر کرمان

2 دانشیار گروه روان شناسی، دانشگاه شهید باهنر کرمان

چکیده

مقدمه: هدف مطالعه‌ی حاضر  بررسی تاثیر آموزش ایمن‌سازی در مقابل تنش بر اضطراب و کیفیت خواب زنان باردار در سه‌ماهه‌ی سوم بارداری بوده است.
روش‌کار: در این کارآزمایی بالینی با طرح پیش‌آزمون-پس‌آزمون با استفاده از روش نمونه‌گیری خوشه‌ای، از میان کل زنان باردار مراجعه‌کننده به دو مرکز بهداشتی نبی اکرم (ص) و معراج شهرستان بوشهر در زمستان 1391، از بین افرادی که در هفته‌ی 31 و 32 بارداری قرار داشته و دارای معیارهای ورود به پژوهش بودند، 40 نفر انتخاب و به صورت تصادفی در دو گروه آزمون و شاهد قرار گرفتند. پس از اجرای پیش‌آزمون گروه آزمون به مدت 7 جلسه تحت آموزش ایمن‌سازی در مقابل تنش قرار گرفت. ابزار سنجش شامل پرسش‌نامه‌های اضطراب بک و کیفیت خواب پیترزبورگ بود. داده‌ها با آزمون تی مستقل و تحلیل کوواریانس با استفاده از نرم‌افزار SPSS نسخه‌ی 16 تحلیل گردیدند.
یافته‌ها: میانگین نمرات پس‌آزمون گروه آزمون در اضطراب و اختلال خواب نسبت به پیش‌آزمون و گروه شاهد، کاهش معنی‌داری داشت (01/0=P) که نشان می‌دهد آموزش ایمن‌سازی در مقابل تنش، توانسته اضطراب و اختلال خواب دوره‌ی بارداری را به طور قابل ملاحظه‌ای کاهش دهد.
نتیجه‌گیری: به نظر می‌رسد استفاده از مداخله‌های روان‌شناختی از نوع آموزش ایمن‌سازی می‌تواند در کاهش آسیب و ارتقای سلامت زنان در دوره‌ی بارداری مفید و موثر باشد.

کلیدواژه‌ها


1. Birami M, Zahmat Yar H, Bahadori Khosroshahi J. [Strategies for coping with stress during pregnancy predict the components of hardiness and social support in nulliparous pregnant women]. Nursing research 2012; 7: 1-9. (Persian)

2. Van Bussel JC, Spitz B, Demyttenaere K. Women's mental health before, during, and after pregnancy: a population-based controlled cohort study. Birth 2006; 33(4): 297-302.

3. Lee AM, Lam SK, Chong CS, Sze ML, Stephanie MB, Chui HW, et al. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 2007; 110(5): 1102-12.

4. Teixeira C, Figueiredo B, Conde A, Pacheco A, Costa R. Anxiety and depression during pregnancy in women and men. J Affect Disord 2009; 119: 142-8.

5. Figueiredo B, Conde A. Anxiety and depression symptoms in women and men from early pregnancy to 3 months postpartum: parity differences and effects. J Affect Disord 2011; 132(1-2): 146-57.

6. Martini J, Knappe S, Beesdo-Baum K, Lieb R, Wittchen HU. Anxiety disorders before birth and self-perceived distress during pregnancy: associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev 2010; 86(5): 305-10.

7. Rondo P, Ferreira R, Nogueira F, Ribeiro M, Lobert H, Artes R. Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr 2003; 57(2): 266-72.

8. Nasiri Amiri F, Salmalian H, Haji Ahmadi M, Ahmadi AM. [Relationship between maternal anxiety in the incidence of spontaneous preterm birth]. Journal of Babul University of Medical Sciences 2009; 11(4): 42-8. (Persian)

9. O'Connor TG, Ben Shlomo Y, Heron J, Golding J, Adams D, Glover V. Prenatal anxiety predicts Individual differences in cortisol in pre-adolescent children. Biol Psychiatry 2005; 58(3): 211-17.

10. Gheraat L. [Mental health during pregnancy]. Rasekhoon 2012; 46. Available from: URL; http://www.rasekhoon.net/article/show-108953.aspx (Persian)

11. Littleton HL, Breitkopf CR, Berenson AB. Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: A meta-analysis. Am J Obstet Gynecol 2007; 196: 424-32.

12. Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 2010; 67: 1012-24.

13. Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Biox M. Depression and anxiety during pregnancy and six months postpartum: a follow-up study. Acta Obstet Gynecol Scand 2006; 85(8): 937-44.

14. Lee KA, Gay C. Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gynecol 2004; 191: 2041-60.

15. Dzaja A, Arber S, Hislop J, Kerkhofs M, Kopp C, Pollmacher T, et al. Women’s sleep in health and disease. J Psychiatr Res 2005; 39: 55-76.

16. Okun ML, Coussons-Read ME. Sleep disruption during pregnancy: How does it influence serum cytokines? J Reprod Immunol 2007; 73: 158-65.

17. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse D, Spong CY. Williams’s obstetrics. 23th ed. New York: McGraw Hill; 2009: 1234.

18. Marcks B, Weisberg R, Edelen M, Keller M. The relationship between sleep disturbance and the course of anxiety disorders in primary care patients. Psychiatr Res 2010; 2: 134-9.

19. Ahmadi Sh, Khankeh H, Mohammadi F, Khoshknab Fallahi M,  Rezasltany P. [Limiting the effects on sleep quality of elderly care]. Journal of ageing 2010; 16: 7-15. (Persian)

20. Facco FL, Kramer J, Ho KH, Zee PC, Grobman WA. Sleep disturbances in pregnancy. Obstet Gynecol 2010; 115(1): 77-83.

21. Gallo A, Lee K. Sleep characteristics in hospitalized antepartum patients. J Obstet Gynecol Neonatal Nurs 2008; 37(6): 715-21.

22. Higgins N, Leong E, Park CS, Facco FL, McCartky  RJ, Wong CA. The Berlin Questionnaire for assessment of sleep disordered breathing risk in parturient and non-pregnant women. Int J Obstet Anesth 2011; 20: 22-5.

23. Moradkhani M, Malik Zadegan A, Ashayeri H, Haqqani H. [The effect of relaxation on sleep disturbance third trimester]. Iranian journal of nursing 2010; 23: 52-8. (Persian)

24. Lyfr G. [Maternal and child health nursing textbook]. Shawky M, Sanjari M. (translators). Tehran: Safe; 2008: 31-41. (Persian)

25. Kamysheva E, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. Examination of a multi-factorial model of body-related experiences during pregnancy: The relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes. Body Image 2008; 5: 152-63.

26. Skouteris H, Wertheim E, Germano C, Paxton S, Milgrom J. Assessing sleep during pregnancy. A study across two time points examining the Pittsburgh sleep, quality index and associations with depressive symptoms. Womens Health Issues 2009; 19: 45-51.

27. Chang J, Pien G, Duntley S, Macones G. Sleep deprivation during pregnancy and maternal and fetal outcomes: Is there a relationship? Sleep Med Rev 2010; 14: 107-14.

28. Goyal D, Gay C, Lee K. Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Arch Womens Ment Health 2009; 12: 229-37.

29. Dorheim SK, Bondevik GT, Eberhard-Gran M, Bjorvatn B. Sleep and depression in postpartum women: A population-based study. Sleep 2009; 32: 847-55.

30. Pires GN, Andersen ML, Giovenardi M, Tufik S. Sleep impairment during pregnancy: Possible implications on mother-infant relationship. Med Hypothes 2010; 75: 578-82.

31. Friedman SH, Resnick PJ. Postpartum depression: An update. Womens Health (Lond Engl) 2009; 5: 287-95.

32. Knutson KL, Spiegel K, Penev P, Van Cauter E. The metabolic consequences of sleep deprivation. Sleep Med Rev 2007; 11: 163-78.

33. Al Lawati NM, Patel SR, Ayas NT. Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration. Prog Cardiovasc Dis 2009; 51: 285-93.

34. Ayas NT, White DP, Al-Delaimy WK. A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care 2003; 26: 380-4.

35. Biehl DA, Liese AD, Haffner SM. Sleep duration as a risk factor for incident type 2 diabetes in a multiethnic cohort. Ann Epidemiol 2009; 19: 351-7.

36. Dare Shori Mohammadi Z, Basak Nejad S, Sarvghadi C. [The effectiveness of the approach to stress management training group cognitive-behavioral therapy on anxiety/trait anxiety and mental health of nulliparous women. Jentashapir 2012; 3(4): 495-504. (Persian)

37. Abdollahzadeh Rafi M, Hassan Zadeh aval M, Mohammadi M, Taheri SH, Hussain M. The relationship between social support and depression and anxiety in the third trimester. Nursing Research.2012; 7, 26, 1-10. (Persian)

38. Hoseinabadi R, Nourozi K, Pouresmail Z, Karimlu M, Maddah Sadat SB, Cheraghi MA. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Complement Ther Clin Pract 2010; 16(2): 81-5. (Persian)

39. Meichenbaum D. [Stress inoculation training]. Mobini C. (translator). Tehran: Markaz; 2007: 10-100. (Persian)

40. Haljyn R, Vytbvrn SA. Psychopathology. Mohammadi S. (translator). Tehran: Ravan; 2011; 250-80. (Persian)

41. Delawar A. [Research methods in psychology]. 4th ed. Tehran: Islamic Azad University; 2009: 99. (Persian)

42. Meichenbaum D. [Stress inoculation training]. Mobini C. (translator). Tehran: Roshd; 2008. (Persian)

43. Beck AT, Steer RA. The Beck anxiety inventory manual. San Antonio, TX: Psychological Corporation; 1990.

44. Osman A, Hoffman J, Barrios FX, Kopper BA, Breitenstein JL, Hahn SK. Factor structure, reliability, and validity of the Beck Anxiety Inventory in adolescent psychiatric inpatients. J Clin Psychol 2002; 58(4): 443-56.

45. Kaviani H, Mousavi AS. Psychometric properties of the Beck Anxiety Inventory Iran population age and sex classes. Journal of Tehran University of Medical Sciences 2008; 66(2): 136-40. (Persian)

46. Knutson KL, Rathouz PJ, Yan LL, Liu K, Lauderdale DS. Stability of the Pittsburgh sleep quality index and the Epworth sleepiness questionnaires over 1 year in early middle-aged adults: the CARDIA study. Sleep 2006; 29(11): 1503-6.

47. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28(2): 193-213.

48. Mokarami HR, Cacao H, Dehdashti AR, Jahani Y, Abraham H. [General health sleep quality in shift workers than in an automotive workshop in 2008]. Journal of Kermanshah University of Medical Sciences 2010; 14(3): 237-43. (Persian)

49. Malek M, Helwani GH, Fallah H, Jafari Nodoushan R. [Pittsburgh sleep quality index correlation of road accidents with truck drivers]. Journal of occupational medicine specialist 2011; 3(1): 14-20. (Persian)

50. Afkham Ebrahimi A, Ghalebandi MF, Salehi M, Kafiyan Tafti AR, Vakili Y, Akhlaghi Farsi E. [Sleep parameters and factors affecting sleep quality in selected patients referred to hospital outpatient Prophet (PBUH)]. Journal of Iran University of Medical Sciences 2008; 15: 31-8. (Persian)

51. Soleimani M, Nasiri Z, Zoonemat Kermani A, Hosseini F. [Sleep quality compared to two hours for nurses with and without rotation]. Iran journal of nursing 2006; 20: 29-38. (Persian)

52. Aghajanloo A, Haririan HR, Ghafouri-Fard M, Bagheri H, Ebrahimi SM. Quality of sleep during exams students at Zanjan University of Medical Sciences. Journal of nursing and midwifery, Birjand University of Medical Sciences 2011; 8(4): 230-7. (Persian)

53. Agha-Jani A, Qureshi SA. [Sleep quality in medical students of Zanjan]. Journal of Tehran University of Medical Sciences 2008; 66(1): 61-7. (Persian)

54. Ghamari M. [Effects of stress inoculation training program in reducing student anxiety]. Iranian journal of counseling association 2008; 7: 107-16. (Persian)

55. Hosseinzadeh AS. [The effect of stress inoculation training on reducing anxiety and depression in patients with MS]. Tehran: Islamic Azad University; 2007. (Persian)

56. Purhomayun C. [Effects of stress inoculation training on social adjustment of students MUI freshman dorm]. MS. Dissertation. Marvdasht: Azad University of Marvdasht; 2008. (Persian)

57. Flaxman PE, Bond FW. A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training. Behav Res Ther 2010; 48: 816-20.

58. Davis E. Heart and hands; A midwifes guide to pregnancy and birth. 4th ed. Toronto: Celestial Arts; 2007: 105-38.

59. Chang MX, Wang SX, Chen CH. Effect of message on pain and anxiety during labour: A randomized controlled trial in Taiwan. J Adv Nurs 2002; 38(1): 68-73.

60. Karamoozian M. [Effectiveness of cognitive-behavioral stress management intervention on anxiety and depression during pregnancy and apgar score of newborns]. Shahid Bahonar University of Kerman; 2013: 86. (Persian)

61. Mosalanejad L, Kheshti AS, Gholami B. [Evaluation of mental health during pregnancy and psychological factors]. Journal of medical sciences 2008; 5(5): 22-9. (Persian)

62. Shah-Hosseini Z, Abedian K, Azimi H. [The relationship between anxiety in pregnancy and preterm delivery]. Medical sciences journal of Zanjan University 2008; 16: 85-92. (Persian)