Rasoli Massome, Mirrezaie Seyed Mohammad, Fooladi Ensieh, Hosseini Robabeh Zarouj, Fayaz Mahsa
Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
Shahroud University of Medical Sciences, Center for Health-Related Social and Behavioral Sciences Research, Shahroud, Iran.
Turk J Obstet Gynecol. 2019 Mar;16(1):15-22. doi: 10.4274/tjod.galenos.2019.92260. Epub 2019 Mar 27.
The incidence of cesarean section (CS) was estimated as about 48% between 2000 and 2012 in Iran. This study was conducted to assess the effects of reviewing written childbirth scenarios on the selection of delivery method.
This randomized controlled trial was conducted in Shohada Women's Hospital in Behshahr, Mazandaran, Iran, from May to December 2015. A total of 223 women at 28 to 32 weeks of gestation were randomly allocated into three groups; the standard care (control), theory of planned behavior (TPB)-based education, and TPB education plus additional support via written childbirth scenarios (scenario). Participants were assessed at baseline (weeks 28-32) and intervention (week 37 of pregnancy) periods. Both intervention groups (TPB and scenario groups) participated in three learning sessions that were based on TPB, whereas the control group received routine care service.
The frequencies of normal vaginal delivery (NVD) in the scenario, TPB, and control groups were 73.2%, 58.5%, and 45.7%, respectively (p=0.004). The results showed that the relative risks of CS decision in the scenario and TPB groups in comparison with the control group were both 0.87 and statistically significant (p=0.018 and p=0.013, respectively). The relative risk of choosing CS after the removal of obligatory CS cases in the scenario group compared with the control was 0.85.
Written childbirth scenarios that contain information on NVD and CS as additional support are effective educational tools for reducing CS rates.
据估计，2000年至2012年间伊朗剖宫产（CS）的发生率约为48%。本研究旨在评估回顾书面分娩情景对分娩方式选择的影响。
本随机对照试验于2015年5月至12月在伊朗马赞德兰省贝赫沙尔的烈士妇女医院进行。共有223名妊娠28至32周的妇女被随机分为三组；标准护理（对照组）、基于计划行为理论（TPB）的教育组，以及TPB教育加通过书面分娩情景提供额外支持的组（情景组）。在基线期（28 - 32周）和干预期（妊娠37周）对参与者进行评估。两个干预组（TPB组和情景组）参加了基于TPB的三次学习课程，而对照组接受常规护理服务。
情景组、TPB组和对照组的正常阴道分娩（NVD）频率分别为73.2%、58.5%和45.7%（p = 0.004）。结果显示，与对照组相比，情景组和TPB组剖宫产决策的相对风险均为0.87，且具有统计学意义（分别为p = 0.018和p = 0.013）。情景组与对照组相比，在排除强制剖宫产病例后选择剖宫产的相对风险为0.85。
包含NVD和CS信息作为额外支持的书面分娩情景是降低剖宫产率的有效教育工具。
