نشریه انجمن علمی روانشناسی ایران

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار، گروه روان‌شناسی، دانشکده علوم انسانی، دانشگاه حضرت معصومه (س)، قم، ایران.

2 کارشناسی ارشد روان‌شناسی، دانشگاه آزاد اسلامی واحد الکترونیک

چکیده

پژوهش حاضر با هدف پیش­بینی نگرش زنان باردار نخست‌زا به زایمان سزارین، بر اساس اضطراب‌صفت، فاجعه­سازی درد و استرس ادراک‌شده انجام شد. طرح پژوهش از نوع همبستگی و جامعه آماری شامل کلیه زنان باردار نخست‌زای شهر اصفهان در سال 1400-1399 بود که به مراکز خدمات جامع سلامت و پایگاه‌های بهداشت در سطح شهر اصفهان مراجعه کرده بودند و پرونده بارداری داشتند. با تقسیم مراکز بر اساس منطقه جغرافیایی و انتخاب افراد نمونه از هر 5 منطقه جغرافیایی (شمال،‌جنوب، شرق،‌ غرب و مرکز) تلاش شد پیشینه فرهنگی و اقتصادی متفاوت افراد در نمونه لحاظ شود. در نهایت بر اساس ملاک‌های ورود و خروج، داده‌های مربوط به 80 زن باردار وارد تحلیل شد. برای گردآوری داده‌ها از پرسشنامه‌های نگرش به سزارین (ADM)، اضطراب حالت- صفت اسپیلبرگر (STAI)،  فاجعه­سازی درد (PCS) و استرس ادراک‌شده (PSS) استفاده شد. با استفاده از  آزمون کولموگروف– اسمیرنف و میزان چولگی و کشیدگی نرمال بودن داده‌ها تأیید شد. آزمون همبستگی پیرسون نشان داد نگرش به سزارین با هر سه متغیر اضطراب‌صفت، فاجعه‌سازی درد و استرس ادراک‌شده ارتباط مثبت داشت، بدین معنی که هرچه میزان متغیرهای نام‌برده بیشتر باشد، نگرش به سزارین مثبت‌تر است. تحلیل رگرسیون  چندگانه به روش گام به گام نشان داد اضطراب‌صفت، فاجعه­سازی درد و استرس ادراک‌شده به‌ترتیب نگرش زنان باردار نسبت به زایمان سزارین را پیش­بینی کردند. این سه متغیر روی هم 30 درصد واریانس نگرش زنان باردار نخست‌زا به زایمان سزارین را تبیین کردند. اضطراب‌صفت با فراهم آوردن زمینه تجارب عاطفی منفی، همراه با فاجعه‌سازی درد و استرس ادراک‌شده در نگرش مثبت زنان باردار نخست‌زا نسبت به سزارین مؤثر است. 

کلیدواژه‌ها

عنوان مقاله [English]

Predicting attitudes toward cesarean section in pregnant women based on trait anxiety, catastrophic pain and perceived stress

نویسندگان [English]

  • Ashraf Sadat Mousavi 1
  • Afsar Asadian 2

1 Assistant Professor, Department of Psychology, Faculty of Humanities and Social Sciences, Hazrat-e Masoume University (HMU), Qom, Iran

2 M.A. in Psychology, Department of Psychology, Faculty of Humanities and Social Sciences, Islamic Azad University, Electronic Campus, Tehran, Iran

چکیده [English]

The present study was conducted to predict the attitudes of primiparous pregnant women towards cesarean delivery considering trait anxiety, pain catastrophizing, and perceived stress. The research design was correlational. The statistical population included all primiparous pregnant women who gave birth in Isfahan in 2020-2021 and had a pregnancy record in a comprehensive health service center in Isfahan. By considering the geographical region of the health centers and selecting the sample from all five geographical regions (i.e., North, South, East, West, and Center), it was attempted to include the different cultural and economic backgrounds of the participants. Finally, based on the inclusion and exclusion criteria, the data of 80 pregnant women were analyzed. The instruments included the Attitude toward Delivery Mode (ADM) questionnaire (Ghadimi, et al., 2014), Speilberger State-Trait Anxiety Inventory (STAI; Speilberger, 1983), the Pain Catastrophizing Scale (PCS; Rahmati et al., 2017), and the Perceived Stress Scale (PSS; Cohen et al., 1983). The results of the Kolmogorov-Smirnov Test, Skewness, and kurtosis showed that the data were normal. In addition, the Pearson correlation showed that attitudes to cesarean delivery had a positive relation with all of the three variables (i.e., trait-anxiety, catastrophic pain, and perceived stress); an increase in one variable led to a positive attitude towards cesarean delivery. Moreover, the stepwise multiple regression analysis showed that trait anxiety, catastrophic pain, and perceived stress could predict the attitudes towards cesarean, respectively. In sum, these three variables explained 30% of the variance in the attitudes of primiparous pregnant women towards cesarean delivery. Having provided negative emotional experiences, trait-anxiety along with pain catastrophizing and perceived stress was effective in the positive attitudes of primiparous pregnant women towards cesarean.

کلیدواژه‌ها [English]

  • cesarean delivery
  • anxiety trait
  • pain catastrophizing
  • perceived stress
  • primiparous pregnant women
Aguilar-Vafaie, M.E. (2007). Psychometric properties of youth coping responses inventory in a study on patients undergoing treatment for cancer. Iranian Journal of Psychiatry and Clinical Psychology, 12 (4) :315-326. http://ijpcp.iums.ac.ir/article-1-119-en.html. [In Persian]
Andaroon, A., Kordi, M., Kimiaei, S.A., Esmaeili, H. (2017). Relationship between Intensity of fear of Childbirth with choosing mode of delivery in Primiparous Women. The Iranian Journal of Obstetrics, gynecology and Infertility, 20 (5), 68-75. https://doi.org/10.22038/ijogi.2017.9082. [In Persian]
Babanazari, L., Kafi, S.M. (2008). Relationship of pregnancy anxiety to its different periods, sexual satisfaction and demographic factors. Iranian Journal of Psychiatry and Clinical Psychology, 14(2):206-13. http://ijpcp.iums.ac.ir/article-1-473-en.html. [In Persian]
Barlow, D.H., Rapee, R.M. & Reisner, L.C. (2001). Mastering Stress. American Health Publishing Company.
Berggren, N., Blonievsky, T. Derakshan, N. (2015). Enhanced visual detection in trait anxiety. Emotion, 15(4), 477-483. https://doi.org/10.1037/a0039449.
Busch, E.L., Martin, C., DeWalt, D.A. (2015). Sandler RS. Functional health literacy, chemotherapy decisions, and outcomes among a colorectal cancer cohort. Cancer Control, 22(1), 95-101. https://doi.org/10.1177/107327481502200112.
Carter, M.M., & Barlow, D.H. (1995). Learned alarms: The origins of panic. In W. T. O'Donohue & L. Krasner (Eds.), Theories of behavior therapy: Exploring behavior change (pp. 209–228). https://doi.org/10.1037/10169-008.
Cattaruzza, A. (2014). Difficulties in the treatment of depression during pregnancy and postpartum depression. Journal of Infant, Child and Adolescent Psychotherapy, 13,75-87. https://doi.org/10.1080/15289168.2014.880296
Chaves, J. F., Brown, J. M. (1987). Spontaneous cognitive strategies for the control of clinical pain and stress. Journal of Behavioral Medicine, 10, 263–276. https://doi.org/10.1007/BF00846540
Cohen, S., Kamarak, T., Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396. https://psycnet.apa.org/doi/10.2307/2136404
Costello, C., Comrey, A. (1967). Scales for measuring depression and anxiety. Journal of Psychology, 66(2), 303-313. https://doi.org/10.1080/00223980.1967.10544910
Doroudian, N., Maddahi, M.E., Khal'atbary, M. (2019). A Comparison of the Impact of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy on the Emotional Regulation and Self-Efficacy of Women with Social Anxiety. The Women and families Cultural-Educational, 13 (44), 89-108. https://dorl.net/dor/20.1001.1.26454955.1397.13.44.4.7 [In Persian]
Faisal-Cury, A., Rossi Menezes, P. (2007). Prevalence of anxiety and depression during pregnancy in a private setting sample. Archives of Women's Mental Health, 10(1): 25-32. https://doi.org/10.1007/s00737-006-0164-6
Folkman, S., Lazarus, R.S., Pimley, S., Novacek, J. (1987). Age differences in stress and coping processes. Psychology Aging, 2(2), 171-84. https://doi.org/10.1037//0882-7974.2.2.171
Ghadimi, M.R., Rasouli, M., Motahar, S., Lajevardi, Z., Imani, A., Chobsaz, A., Razeghian, S. (2014). Affecting Factors, the Choice of Delivery and Attitude of Pregnant Women Admitted to the Civil Hospitals, the Social Security Organization in 2013. Journal of Sabzevar University of Medical Sciences, 21(2), 310- 319. https://jsums.medsab.ac.ir/article_432.html?lang=en [In Persian]
Ghooshchian, S., Dehghani, M., Khorsandi, M., Farzad. V. (2011). The Role of Fear of Pain and Related Psychological Variables in Prediction of Cesarean Labor. Arak Medical University Journal (AMUJ), 14(3), 45-54. http://jams.arakmu.ac.ir/article-1-798-en.html [In Persian]
Gucht, N., Lewis, K. (2015). Women's experiences of coping with pain during childbirth: A critical review of qualitative research. Midwifery, 31, 349–358. https://doi.org/10.1016/j.midw.2014.12.005
Hannah, M.E., Whyte, H., Hannah, W.J., Hewson, S., Amankwah, K., Cheng, M., Gafni, A., Guselle, P., Helewa, M., Hodnett, E.D., Hutton, E., Kung, R., McKay, D., Ross, S., Saigal, S., Willan, A. (2004). Maternal outcomes at 2 years after planned cesarean section versus planned vaginal birth for breech presentation at term: The international randomized Term Breech Trial. Am J Obstet Gynecol, 191, 917–927. https://doi.org/10.1016/j.ajog.2004.08.004
Holmes, T.H., & Rahe, R.H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11(2), 213–218. https://doi.org/10.1016/0022-3999(67)90010-4
Imanparast, R., Bermas, H., Danesh, E., Ajoudani, Z. (2014). The effect of cognitive behavior therapy on anxiety reduction of first normal vaginal delivery. Journal of Shahid Sadoughi University of Medical Sciences and Health Services, 22(1), 974-980. URL: http://jssu.ssu.ac.ir/article-1-2168-en.html [In Persian]
Koelewijn JM, Sluijs AM, Vrijkotte, T. GM. (2017). Possible relationship between general and pregnancy-related anxiety during the first half of pregnancy and the birth process: a prospective cohort study. BMJ Open,7(5):013413. https://doi.org/10.1136/bmjopen-2016-013413
Leeuw, M., Goossens, M. E., Linton, S. J., Crombez, G., Boersma, K., Vlaeyen, J. W. (2007). The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. Journal of Behavioral Medicine, 30, 77–94. https://doi.org/10.1007/s10865-006-9085-0
McEwen, B.S. (2007). Physiology and neurobiology of stress and adaptation: central role of the brain. Physiological reviews, 87(3), 873-904. https://doi.org/10.1152/physrev.00041.2006
 Moasheri, B.N., Sharifzadehm G., Soltanzadeh, V., Khosravi Givshad, z., Rakhshany Zabol, F. (2016). Relationship between fear of pain, fear of delivery and attitude towards cesarean section with preferred mode of delivery among pregnant women. The Iranian Journal of Obstetrics, gynecology and Infertility, 18, 8-16. https://doi.org/10.22038/ijogi.2016.6562 [In Persian]
Mohammadzadeh, K.A., Afradi Asbaghrani, P. (2015). The effective determinants in willingness to cesarean section (The case of pregnant women in Tehran). Women in Development & Politics, 13(3), 357-376. https://doi.org/10.22059/jwdp.2015.56336 [In Persian]
Mousavi, A.S., Ghorbani, N. (2007). Self-knowledge, self-criticism, and psychological health. Psychological Studies, 2(3&4), 75-91. https://doi.org/10.22051/psy.2006.1688 [In Persian]
Nakamura, N., & Tsong, Y. (2019). Perceived stress, psychological functioning, and resilience among individuals in same-sex binational relationships. Psychology of Sexual Orientation and Gender Diversity, 6(2), 175-181. https://psycnet.apa.org/doi/10.1037/sgd0000318
Orovou, E., Dagla, M., Iatrakis, G., Lykeridou, A., Tzavara, C., Antoniou, E. (2020). Correlation between Kind of Cesarean Section and Posttraumatic Stress Disorder in Greek Women. International Journal Environmental Research and Public Health, 17, 1592. https://doi.org/10.3390/ijerph17051592
Rafiee, B., Akbarzadeh, M., Asadi, N., Zare, N. (2013). Comparison of attachment and relaxation training effects on anxiety in third trimester and postpartum depression among primipara women.   Hayat, 9(1), 76-88. http://hayat.tums.ac.ir/article-1-495-en.html [In Persian]
Rahmati, N., Asghari Moghadam, M., Shairi, M., Paknejad, M., Rahmati, Z., Ghassami, M., Marufi, N., Naeb Aghaee, H. (2017). A Study of the Psychometric Properties of the Pain Catastrophizing Scale Amongst Iranian Patients with Chronic Persistent Pain. Journal of Ilam University of Medical Sciences, 25(1), 63-79. https://doi.org/10.29252/sjimu.25.1.63. [In Persian]
Rasouli, P., Shobeiri, F., Cheraghi, F., Rasouli, R., Ghanbari, V. (2016). Study of the relationship of anxiety and depression in third trimester pregnancy on growth index of neonates and preterm delivery.  Iranian Journal of Pediatric Nursing, 2(4):1-9. http://jpen.ir/article-1-94-en.html [In Persian]
Rosa, F., Perugin, G., Schettini, D. Romano, N., Romeo, S., Podestà, R., Guastavino, A., Casaleggio, A., Gandolfo, N. (2019). Imaging findings of cesarean delivery complications: cesarean scar disease and much more. Insights Imaging, 10(1), 98. https://doi.org/10.1186/s13244-019-0780-0
Sadock, B.J., Sadock, V.A., & Ronize, P. (2014). Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, Eleventh Edition. Lippincott Williams & Wilkins.
Shahhosseini, Z., Abedian, K., Azimi, H. (2008). Role of anxiety during pregnancy in preterm delivery. Journal of Mazandaran University of Medical Sciences, 16 (63):85-92. http://zums.ac.ir/journal/article-1-634-en.html [In Persian]
Siligman, M., walker, E., & Rosenban, D. (2001). Abnormal psychology. New yourk: w.w. notron & company.
Sinaei, A., Abbaspoor, Z., Hashemi, S.E., Javadifar, N. (2018). The Relationship between Perceived Stress and Attitude towards Delivery and Choosing Mode of Delivery among Pregnant Women. Journal of Babol University of Medical Sciences, 20(5), 61-67. http://dx.doi.org/10.18869/acadpub.jbums.20.5.68 [In Persian]
Smeets, T., Otgaar, H., Candel, I. & Wolf, O.T. (2008). True or false? Memory is differentially affected by stress-induced cortisol elevations and sympathetic activity at consolidation and retrieval. Psychoneuroendocrinology, 33(10), 1378-1386. https://doi.org/10.1016/j.psyneuen.2008.07.009
Spaich, S., Welzel, G., Berlit, S., Temerinac, D., Tuschy, B., Sutterlin, M., Kehl, S. (2013). Mode of delivery and its influence on women's satisfaction with childbirth. Eur J Obstet Gynecol Reprod Biol, 170(2):401-406. https://doi.org/10.1016/j.ejogrb.2013.07.040
Speilberger, C.D. (1983). Manual for the State-Trait Anxiety Inventory: STAI (Form y). Palo Alto, CA: Consulting Pssy chologist Press.
Sturgeon, J. A., Zautra, A. J., Arewasikporn, A. (2014). A multilevel structural equation modeling analysis of vulnerabilities and resilience resources influencing affective adaption to chronic pain. Pain, 155(2), 292-298. https://doi.org/10.1016/j.pain.2013.10.007
Sullivan, M.J.L., Bishop, S., & Pivik, J. (1995). The Pain Catastrophizing Scale: development and validation. Psychology Assessment, 7(4), 524-532. https://psycnet.apa.org/doi/10.1037/1040-3590.7.4.524
Sun, Y., Huang, K., Hu, Y., Yan, S., Xu, Y., Zhu, P., et al. (2019). Pregnancy-specific anxiety and elective cesarean sectionin primiparas: A cohortstudy in China. PLoS ONE, 14(5), e0216870. https://doi.org/10.1371/journal.pone.0216870
Szczygiel, D., Buczny, J., Bazinska, R. (2012). Emotion regulation and emotional information processing: the moderating effect of emotional awareness. Personality and Individual differences, 52(3), 433-437. http://dx.doi.org/10.1016/j.paid.2011.11.005
Tavassoli, A., Kalari, F., Zafari Dizji, A. (2014). Social Factors affecting Cesarean Trend in pregnant women. Faslnamah-i akhlaq-i pizishki, 8(29), 145-170. https://doi.org/10.22037/bhl.v1i1.38186 [In Persian]
Watson, D., Clark, L.A., Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect – the Panas Scales. J. Pers. Soc. Psychol. 54, 1063-1070. https://psycnet.apa.org/doi/10.1037/0022-3514.54.6.1063
Wilson Van Voorhis, C.R., L Morgan, B. (2007). Understanding power and rules of thumb for determining sample size. Methods for Psychology, 3(2), 43-50. https://doi.org/10.20982/tqmp.03.2.p043