@2024 Afarand., IRAN

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ISSN: 2252-0805    The Horizon of Medical Sciences 2018;24(4):255-262

Background
Cesarean surgery today is undoubtedly the most commonly used gynecological surgery in the world [1].
Previous Studies
.... [2-8]. Today, there are several patterns of educational interventions for changing health behaviors, of which health belief models are one of the most famous and most successful patterns. The health education pattern was developed in the early 1950s, based on how perception of individuals from a health-threatening condition can change their health behaviors [9] ... [10]. Previous studies have shown different effects of health belief pattern in changing health behaviors, including breast self-examination behavior improvement [12, 11], improving physical activity in middle-aged women and adherence to Pap smear [14]. ... [15-18].
Aim(s)
This study aimed to assess the effect of collaborative educational program based on health belief model regarding safe childbirth on selected delivery mode among pregnant women.
Research type
This research is a field trial.
Research society, place and time
This study was done on pregnant women from several community health centers in Gonabad city.
Sampling method and number
In this study, 100 pregnant women were selected using two-stage cluster sampling method.
Used devices&materials
For sampling, at first two health centers in Gonabad city were randomly selected from five centers. In the second stage, the researchers referred to the selected centers and, using the registration offices of the families covered by these centers, they prepared a sampling framework for pregnant women, based on which the subjects were randomly selected. The final selected subjects were selected following making phone calls with samples and evaluation of their inclusion and exclusion criteria as well as their willingness to participate in the study. The subjects were randomly assigned into the experimental (n=50) and control groups (n=50). The subjects included the women experiencing their first pregnancy and fluent in Persian, with 28-32 weeks of gestational age they had no serious disorder or serious complications during pregnancy and were able to have natural childbirth. Exclusion criteria included the attending similar educational program on delivery methods, pregnancy-related complications, no accurate responses to the questionnaires, and the willingness to withdraw the study. Three subjects were excluded from the study, due to exclusion criteria and finally 97 subjects (49 in the experimental group and 48 in the control group) were analyzed. ... [19]. The data collection tools consisted of demographic and pregnancy characteristics questionnaire, delivery methods scale, health belief model constructs evaluation questionnaire and Sherer self-efficacy questionnaire. ... [20-21]. In order to collect information, necessary permissions were obtained from the University Research Council and Regional Medical Ethics Committee and the researcher referred to the community health centers and selected the subjects by informing them about the research. The subjects were invited to the research via making phone calls. The samples completed all questionnaires while referring to the community health centers. In this study, all ethical standards including confidentiality of information, the right to withdraw from the study and the written informed consent were observed. Pregnant women in the experimental group attended a three-person workshop for six h, in which the information about delivery modes, indications, benefits, and disadvantages of vaginal delivery and cesarean, based on a health belief model was provided. It should be noted that the workshop was designed according to the results of the previous study by Bahri et al. [4], in which perceived sensitivity and perceived benefits constructs were more emphasized. The workshop was taught by the researchers and midwives of community health centers. At first, the normal distribution of the studied variables was investigated using Kolmogorov-Smirnov test, and descriptive and inferential statistics were used according to the variables. SPSS 16 software was used.
Findings by Text
The mean age of participants was 24.26±4.35 years, the average age of the spouses was 28.5±4.48 years and the majority of them 41 (43.3%) were manual workers. The mean age of the gestational age was 27.38±3.32 weeks. There was no significant difference between the two groups in terms of the mentioned variables (p>0.05; Table 1). There was no significant difference in the mean score of knowledge about mode of delivery and delivery self-efficacy between two groups before the intervention (p>0.05). Before intervention, there was no significant difference in two groups in the mean scores of perceived sensitivity, perceived severity, perceived benefits and perceived barriers (p>0.05; Table 2). After intervention, two groups showed a significant difference in mean score of knowledge about mode of delivery and self-efficacy (Table 2). After intervention, a statistically significant difference was observed in two groups in perceived sensitivity, perceived severity and perceived benefits, however no significant difference was found in mean score of perceived barriers after intervention between two groups (Table 2). Although there was no significant difference to select delivery mode before educational intervention in two groups, but after the intervention, two groups showed a significant difference and more subjects in the experimental group selected vaginal delivery (Table 3).
Main comparison to the similar studies
Consistent with the results of this study, Rahimikian et al. reported that following a similar educational program on pregnant women in Shahroud city, the experimental group significantly showed a greater willingness to choose a vaginal delivery [7]. ... [22-25]. The results of this study indicated the significant effects of collaborative education of safe delivery based on health belief model on the knowledge of subjects about delivery modes. Similar results were reported in Khoramabadi et al., Solhi et al. and Baghianimoghadam et al. [23-25]. ... [26, 27].
Suggestions
Using this model and a pilot study on the design of educational interventions based on the health belief model is recommended.
Limitations
None declared.
Conclusions
Collaborative education of safe delivery based on health belief model significantly can lead to choose more vaginal delivery in pregnant women.
Acknowledgments
The authors are thankful to Center for Social Development and Health Promotion as well as to the financial support of the Vice-Chancellor for Research in Gonabad University of Medical Sciences and also Dr. Mrs. Shahla Khosravan, associate professor of Gonabad University of Medical Sciences for her supervision in this research.
Conflict of interest
None declared.
Ethical Permissions
None declared.
Funding Sources
This study (code No.: P/T/555) was sponsored by the Vice-Chancellor of Research of Gonabad University of Medical Sciences.

TABLES and CHARTS

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