Volume 30, Issue 3 (Summer 2022)
Avicenna J Nurs Midwifery Care 2022, 30(3): 200-210 |
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Aazadi Moghtader A, Masoumi S Z, Khodakarami B, Roshanaei G, Parsa P. The effect of counseling based on the model of continuous care led- midwife on nausea and vomiting during pregnancy in patient referred to comprehensive health centers in Hamadan, 2020. Avicenna J Nurs Midwifery Care 2022; 30 (3) :200-210
URL: http://nmj.umsha.ac.ir/article-1-2380-en.html
URL: http://nmj.umsha.ac.ir/article-1-2380-en.html
Azadeh Aazadi Moghtader1 
, Seyedeh Zahra Masoumi * 2, Batul Khodakarami3 , Ghodratollah Roshanaei4 , Parisa Parsa5
, Seyedeh Zahra Masoumi * 2, Batul Khodakarami3 , Ghodratollah Roshanaei4 , Parisa Parsa5
1- Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
2- Mother and Child Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran ,zahramid2001@gmail.com
3- Mother and Child Care Research Center, Midwifery Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
4- Department of Biostatistics, School pf public health, Hamadan University of Medical Sciences, Hamadan, Iran
5- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
2- Mother and Child Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran ,
3- Mother and Child Care Research Center, Midwifery Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
4- Department of Biostatistics, School pf public health, Hamadan University of Medical Sciences, Hamadan, Iran
5- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Background and Objective
Nausea and vomiting are among the most common complaints of women during pregnancy, affecting about 80% of pregnant women. Failure to treat nausea and vomiting can cause dehydration, electrolyte imbalance, urinary excretion of ketones, lethargy, irritability, sleep disorders, and confusion in women. In most cases, psychological support can be effective in the reduction of nausea and vomiting of pregnancy. Previouslu conducted studies confirmed the clinical effectiveness of the model of continuous midwife-led care during pregnancy, childbirth, and post-birth. Considering the high prevalence of nausea and vomiting in pregnancy, the present study aimed to assess the effect of the model of continuous midwifery-led care on the reduction of nausea and vomiting in pregnancy.
Materials and Methods
This two-arm clinical trial study was conducted on 60 pregnant women who met the inclusion criteria. The inclusion criteria were as follows: the age range of 18-35 years, singleton pregnancy, gestational age of 8-12 weeks estimated by ultrasound or the first day of the last menstrual period (LMP). Mild and moderate nausea and vomiting (scores 4-12) based on the Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire, no use of anti-nausea medication, absence of mental disorder and specific underlying disease, no smoking and alcohol consumption, reading and writing literacy, as well as a willingness to participate in counseling sessions.
On the other hand, the exclusion criteria enailed interrupting the study for any reason, such as miscarriage, homorage, or severe nausea and vomiting. The research instrument used was a three-part questionnaire (demographic, midwifery, and questions related to nausea and vomiting of pregnancy) and PUQE-24 questionaire. Pregnant women were assigned to two groups of intervention and control using the permuted block randomization. In the intervention group, three face-to-face counseling sessions were held (each session lasting 45-60 min). The questionnaire was completed daily by the subjects early in the morning, regarding the symptoms exoerinced on the previous day.
Finally, a questionnaire that was completed by pregnant women for 17 days (three days before the study and two weeks during the study) was collected. Data analysis was performed using SPSS statistical software (version 21), and a p-value less than 0.05 was considered significant.
On the other hand, the exclusion criteria enailed interrupting the study for any reason, such as miscarriage, homorage, or severe nausea and vomiting. The research instrument used was a three-part questionnaire (demographic, midwifery, and questions related to nausea and vomiting of pregnancy) and PUQE-24 questionaire. Pregnant women were assigned to two groups of intervention and control using the permuted block randomization. In the intervention group, three face-to-face counseling sessions were held (each session lasting 45-60 min). The questionnaire was completed daily by the subjects early in the morning, regarding the symptoms exoerinced on the previous day.
Finally, a questionnaire that was completed by pregnant women for 17 days (three days before the study and two weeks during the study) was collected. Data analysis was performed using SPSS statistical software (version 21), and a p-value less than 0.05 was considered significant.
Results
Repeated measures analysis of variance (RMANOVA) regarding the first question of the PUQE questionnaire (evaluating the meane duration of nausea or stomach problems during the day) during three time periods (three days before the commencement of the study, the first week of the study, and the second week of the study), for the second question of the questionnaire (mean vomiting frequency during the day) and for the third question (mean retching frequency during the day) in the intervention group demonstrated that the intervention decreased the mean scores of nausea episodes (P<0.001). Nonetheless, the difference between the two groups during two weeks was not statistically significant for any of the questions (P<0.05).
Conclusion
As evidenced by the results of the current study, holding counseling sessions based on the model of continuous midwife-led care in the first week of the study did not significantly reduce the severity and frequency of nausea and vomiting compared to the control group. Nonetheless, in the second week of the study, with the continuation of the follow-up process and the increase in the number of counseling sessions, the mean overall severity of nausea and vomiting, as well as the mean retching episodes, decreased significantly compared to the control group. Therefore, it is recommended to use the model of continuous midwife-led care to reduce nausea and vomiting during pregnancy.
Type of Study: Original Research |
Subject:
Midwifery
Received: 2021/09/11 | Accepted: 2022/03/16 | Published: 2022/09/5
Received: 2021/09/11 | Accepted: 2022/03/16 | Published: 2022/09/5
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