Andaroon Nafise, Kordi Masoume, Kimiaee Sayed Ali, Esmaeili Habibollah
School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Midwifery, Evidence-Based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
J Educ Health Promot. 2020 Feb 28;9:35. doi: 10.4103/jehp.jehp_472_18. eCollection 2020.
The most important reasons for choosing cesarean include negative attitude of pregnant women toward natural childbirth, and it is not easy for many women to make a decision about the choice of delivery, Midwives as responsible individuals, play an important role in providing maternal counseling and care during pregnancy and childbirth and the postpartum period. This study was carried out to determine the effect of individual counseling on attitudes and decisional conflict in the choice of delivery among nulliparous women.
This clinical trial was performed on 90 nulliparous women with 28-30 weeks of gestational age, who were referred to health-care centers in Mashhad. They were divided randomly into intervention and control groups. The intervention group received the counseling program individually during three sessions, while the control group received routine care, childbirth attitudes, and decisional conflict on choice of delivery were compared on women of 34-36 weeks of pregnancy. Data collection tools included demographic details form, Childbirth Attitudes Scale and Decisional Conflict Scale; data were analyzed using Chi-square tests, Fisher's exact test, Mann-Whitney test, -test, parried -test, and ANCOVA in SPSS v. 16, and < 0.05 was considered statistically significant.
After consultation, there was a significant difference in attitude score between the intervention group (86.577 ± 13.531) and the control group (69.955 ± 19.858) ( < 0.001), And there was a significant difference in decisional conflict score between the intervention group (0.614 ± 0.626) and the control group (1.216 ± 0.949) ( < 0.001), and there were significant differences between the two groups in terms of preferred delivery ( < 0.001).
According to the results of this randomized control trial, individual counseling in nulliparous women during pregnancy leads to a positive attitude toward natural childbirth, informed decision-making, and increase in the selection of natural childbirth.
选择剖宫产的最重要原因包括孕妇对自然分娩持消极态度，而且许多女性在决定分娩方式时并不容易。助产士作为负责任的个体，在孕期、分娩期及产后为产妇提供咨询和护理方面发挥着重要作用。本研究旨在确定个体咨询对初产妇分娩方式选择的态度及决策冲突的影响。
本临床试验对90名孕28 - 30周的初产妇进行，这些产妇被转诊至马什哈德的医疗保健中心。她们被随机分为干预组和对照组。干预组在三个阶段接受个体咨询项目，而对照组接受常规护理，在孕34 - 36周时比较两组产妇对分娩方式的态度及决策冲突。数据收集工具包括人口统计学详细信息表、分娩态度量表和决策冲突量表；使用SPSS v. 16中的卡方检验、Fisher精确检验、Mann - Whitney检验、t检验、配对t检验和协方差分析对数据进行分析，P < 0.05被认为具有统计学意义。
咨询后，干预组（86.577 ± 13.531）和对照组（69.955 ± 19.858）的态度得分存在显著差异（P < 0.001），干预组（0.614 ± 0.626）和对照组（1.216 ± 0.949）的决策冲突得分存在显著差异（P < 0.001），两组在首选分娩方式方面也存在显著差异（P < 0.001）。
根据这项随机对照试验的结果，孕期对初产妇进行个体咨询可使她们对自然分娩产生积极态度，做出明智决策，并增加自然分娩的选择。
