@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2015;2(1):50-57

Background
... [1-3]. the reports of World Health Organization in 2013 indicate that 289000 women in the world have died due to the side effects of pregnancy and delivery [4].
Previous Studies
... [5-13]. Face to face trainingis one of the common educational methods in health care treatments. In this method, the trainer presents the subject individually and for a particular learner and provides an opportunity for the ideas and feelings to be transmitted verbally and nonverbally between the learner and the teacher [14].... [15, 16]. The results of the study by Casazzo et al. showed that the use of CD is useful in expanding the information, social and physical activities, and reducing the consumption of meals of US teenagers [17]. ... [18].
Aim(s)
This study aimed to compare the effect of face to face and multi-media software trainings on the knowledge of pregnant women about dangerous signs in Karaj health centers.
Research type
This is a quasi-experimental interventional study.
Research society, place and time
This study was conducted in 2013. The population consisted of pregnant women who had referred to health centers of Karaj.
Sampling method and number
The sample size was estimated considering 80% of statistical power, 95% of confidence, sample decline of 20%and the effectiveness of educational methods on the knowledge in the same study [16]with 60 people in each group of face-to-facetrainingreceivers and those receiving the trainingsthrough multimedia software. For the sampling, first 6 health centers were selected simply and randomly by chance from among the list of Karaj health centers. The subjects werechosen in selected centers in the form of simple sampling (available) and finally 120 pregnant women were entered the study. Mothers participating in the study were randomly assigned into one of the groups offace to face and multimedia software training receivers. Criteria for entering the study included the first pregnancy, 6 to 15 weeks of pregnancy, the minimum educational level of guidance school, having access to computer or CD player, knowing how to use these or having access to someone who can help the mothers using this equipment, and lack of receiving formal education about the dangerous signs during pregnancy and after delivery. Exclusion criteria were not observing the compact diskin the Department of Computer and abortion or suffering from the side effects ofpregnancy during the study.
Used devices&materials
The data collection instrument was a researcher-made questionnaire consisting of two parts. In the first part demographic characteristics were measured including age, educational level, employment status, age of pregnancy, duration of marriage, etc. and the second part contained 27 questions of mothers` knowledge about dangerous signs of pregnancy (12 questions), signs of postpartum (8 questions), the most common causes of maternal death (6 questions) and how to deal with the dangerous signs (1 question). In this section, the correct answer was given the score of 1 as was zero scores for the wrong and I do not know answers and earning higher scores indicated greater knowledge of pregnant women about dangerous signs of pregnancy and postpartum.The knowledge questionnaire was prepared after studying the books and articles related to the subject (1-10) and its content validity wasevaluated and approved through examining the notions of 10 professionals of health education and health promotion, and maternal and child health as well as assessing Content Validity Ratio (CVR) and Content Validity Index(CVI). Reliability of the questionnaire was studied by conducting a pilot study and interviews with 30 pregnant women, and measuring the rate of internal and external consistency. In this study, the questions of knowledge questionnaire had the internal consistency (Cronbach's alpha) of0.70. External consistency of the questions (test-retest) had also been approved in the pilot study. Participants in both groups completed their self-report questionnaires before the study and then they were randomly divided into two groups. Mothers taking part in face-to-face training group had a 45-minute session on the dangerous signs of pregnancy and postpartum, the most common causes of maternal death and how to deal with the symptoms. Besides, in the group of multimedia software education, mothers were trained using educational CDs prepared by the Ministry of Health of which their educational content was the same as face-to-face training. After a week, contacts were made with these mothers to ensure there is no problem in using the compact disks. Finally, 10 weeks after receiving the training while taking the subsequent care, the post-test questionnaires were completed by the mothers in both groups. Statistical analysis The data was analyzed using SPSS statistical software (version 16) based on statistical T tests, Wilcoxon, and Mann-Whitney and McNamara tests. The significance level for all the tests was less than 0.05.
Findings by Text
The mean age of participants (±4.39), their mean gestational age (±2.62), and the mean duration of their marriage (±18.59) was 23.37, 9.4 weeks and 24.1 months (median of 18 months), respectively. More than 96% of both groups said their pregnancieswereintended. Majority of subjects in both groups of face to face (33.3%) and multimedia software trainings(45%) had Diploma. Most of the subjects in both groups of face to face(98.3%) and multimedia software trainings (96.7%) were housewives. Almost all the subjects in both groups of face to face (63.3%) and multimedia software training (58.3%), were tenants and most of them (47.5%) reported the governmental health centers as their source of information. No statistically significant difference was observed in both groups between the subjects` age, pregnancy age and duration of their marriage using the Mann-Whitney test (p>0.05). Furthermore, the results of chi-square and Fisher's exact tests showed that there was no statistically significant difference between other mentioned personal details of the two groups (p>0.05). The results of Table 1 indicated that most of subjects’ knowledge was less than 50 % of maximum obtainable score at the beginning of the study illustrating their unawareness of dangerous signs. The test result of Wilcoxon shows the effectiveness of both training methods in informing the mothers about the dangerous signs and this impact has been statistically highly significant (p<0.001). The results of Table 2 showed that based on Mann-Whitney test in comparing the pre and post difference of mothers' awareness scores, no significant differences was observed in dangerous signs’ scores of pregnancy (p=0.752), signs of postpartum (p=0.481) and common causes of maternal death (p=0.968) between the two groups of face to face and multimedia software trainings. Besides, McNamara’s test revealed that there is a statistically significant difference considering the time of referring to a doctor or an obstetrician after the outbreak of symptoms before and after the intervention in two groups of face to face (p=0.041) and multimedia software trainings (p=0.033).
Main comparison to the similar studies
...[2, 7, 8]. In this study, face to face training showed a statistically significant effect in raising the knowledge of mothers. This finding was in line with the results of a study by Derakhshan et al. who had investigated the effect of purposeful training on changing the knowledge and attitude of 70 pregnant women with preeclampsia [12]. ... [13, 17-19] the results of a research by Campbell et al.indicated that people who had been trained using CDs had more self-efficacy and knowledge regarding the consumption of a diet with lower fat compared to the control group [20]. … [21].
Suggestions
Using the software would be a fine alternative for face-to-face training.
Limitations
Collecting data through self-reporting is one of the limitations of this study. Also due to cultural differences in Alborz province, for increasing the generalizability of the results it is suggested to conduct this study in other cities of the province.
Conclusions
The results show that both training methods had been equally effective on the mothers` awareness of dangerous signs.
Acknowledgments
Researchers are grateful to the President of AlborzUniversity of Medical Sciences, Research and Health Deputy of the university, head of health centers in Karaj 1 and 2, doctors and experts of all executive health centers, especially Mrs. YaldaAbdi, the participants in the study and all those who have supported and helped us to conduct this study.
Conflict of interest
Non-declared
Ethical Permissions
To obtain the agreementofpeople before running the study, informed letters of consent were completed by participants and they were informedabout the study objectives, educational content and the number of training sessions.
Funding Sources
This study was financially supported by the Research Department of Alborz University of Medical Sciences and was registered under the number of 2274613.

TABLES and CHARTS

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