@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2014;1(1):62-71
ISSN: 2383-2150 Journal of Education and Community Health 2014;1(1):62-71
Effectiveness of Educational Program Based on the Theory of Reasoned Action to Decrease the Rate of Cesarean Delivery Among Pregnant Women in Fasa, Southern Iran
ARTICLE INFO
Article Type
Original ResearchAuthors
Khani Jeihooni A. (1*)Shahidi F. (1)
Kashfi S.M. (2)
(1*) Department of Public Health and Nursing, School of Health, Fasa University of Medical Sciences, Fasa, Iran
(2) Research Center for Health Sciences and Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Correspondence
Article History
Received: January 15, 2014Accepted: April 22, 2014
ePublished: April 22, 2014
ABSTRACT
Aims
Cesarean section is considered as a major surgery accompanied by several complications. The aim of this study was to investigate the effectiveness of educational program based on the theory of reasoned action to reduce the rate of cesarean section among pregnant women in Fasa, Southern Iran.
Materials & Methods This quasi-experimental study was performed on 100 (50 participants in each of the control and intervention groups) primiparous women in the third trimester of pregnancy admitted to health centers of Fasa city, Fars province, Iran. The data-gathering tool was a multipart questionnaire containing demographic variables and the theory of reasoned action structures. After the pretest, the intervention group underwent exclusive training based on the theory of reasoned action. Then, after 3 months, both groups took part in the posttest. Data was analyzed by paired T-test, independent T-test, chi-square and Fisher exact test using SPSS-18 software.
Findings A significant difference was found between the two groups regarding knowledge, evaluations behavioral outcomes, behavioral beliefs and intention (P<0.001). Chi-square analysis showed a significant difference between the two groups regarding their performance (P<0.001).
Conclusion The present intervention was effective in increasing the pregnant women’s knowledge, evaluations behavioral outcomes, behavioral beliefs and strengthening their intention as well as performance. Therefore, it is suggested to use this model and other systematic trainings for pregnant women to decrease the rate of cesarean section.
Materials & Methods This quasi-experimental study was performed on 100 (50 participants in each of the control and intervention groups) primiparous women in the third trimester of pregnancy admitted to health centers of Fasa city, Fars province, Iran. The data-gathering tool was a multipart questionnaire containing demographic variables and the theory of reasoned action structures. After the pretest, the intervention group underwent exclusive training based on the theory of reasoned action. Then, after 3 months, both groups took part in the posttest. Data was analyzed by paired T-test, independent T-test, chi-square and Fisher exact test using SPSS-18 software.
Findings A significant difference was found between the two groups regarding knowledge, evaluations behavioral outcomes, behavioral beliefs and intention (P<0.001). Chi-square analysis showed a significant difference between the two groups regarding their performance (P<0.001).
Conclusion The present intervention was effective in increasing the pregnant women’s knowledge, evaluations behavioral outcomes, behavioral beliefs and strengthening their intention as well as performance. Therefore, it is suggested to use this model and other systematic trainings for pregnant women to decrease the rate of cesarean section.
CITATION LINKS
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[5]Fathian Z, Sharifirad GR, Hasanzadeh A, Fathian Z. [Study of the effects of behavioral intention model education on reducing the cesarean rate among pregnant women of Khomeiny-Shahr, Isfahan, in 2006]. Zahedan Journal of Re-search in Medical Sciences.2007; 9(4):123-31. (Persian)
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[8]Ghaffari M, Sharifirad GR, Akbari Z, Khorsandi M, Hassanzadeh A. [Health Belief Model-based education & reduction of cesarean among pregnant women: An interventional study]. Health System Research Journal.2011; 7(2):200-8. (Persian)
[9]Koc I. Increased cesarean section rates in Turkey. Eur J Contracept Reprod Health Care.2003; 8(1):1-10.
[10]Shareat M, Majlesi F, Azarei S, Mahmmodi M. [Cesarean rate and factors that influence it in maternities of Tehran]. Payesh.2002; 1(3):5-10. (Persian)
[11]Iran Ministry of Health, Family health office. New system of evaluating and monitoring fertility health program, 2005. http://www.behdasht .gov.ir/. (Accessed September 2009)
[12]Devendra K, Arulkumaran S. Should doctors perform an elective caesarean section on request?. Ann Acad Med Sin-gapore.2003; 32(5):577-81.
[13]World Health Organization. Managing complications in pregnancy and childbirth: A guide for midwives and doctors. Geneva: World Health Organization; 2003. http://www.who.int/mater nal_child_adolescent/documents/9241545879/en/. (Accessed June 2014)
[14]Shiraz University of Medical Sciences, Family Health Unit. Primary results of maternal program indexes, 2011. http://www.dchq.ir/html/modules.php/. (Accessed September 2013)
[15]Tavassoli M, Heydarnia AR. [Investigation of the effect of education on reducing the rate of elective caesarean delivery in pregnant women]. (MSc, health education dissertation), Faculty of Medicine, Tarbiat Modares University, Tehran, 2001. (Persian)
[16]Gutman Y, Tabak N. The intention of delivery room staff to encourage the presence of husbands/partners at cesar-ean sections. Nurs Res Pract.2011; 2011:192649.
[17]Glanz K, Rimer BK, Viswanath K. Health Behavior and Health Education: Theory, Research and Practice. 4th ed. San Francisco: Jossey-Bass publisher; 2008, PP:67-92.
[18]Cai WW, Marks JS, Chen CH, Zhuang YX, Morris L, Harris JR. Increased cesarean section rates and emerging patterns of health insurance in Shanghai, china. Am J Public Health.1998; 88(5):777-80.
[19]Alimohammadian M, Shariat M, Mahmmodi M, Ramezanzadeh F. [Investigation of the effect of pregnant women’s request on the rate of elective caesarean delivery]. Payesh.2003; 2(2):137-43. (Persian)
[20]Rahimikian F, Mirmohamadaliei M, Mehran A, Aboozari-Ghforoodi K, Salmaani-Barough N. [Effect of Education Designed based on Health Belief Model on Choosing Delivery Mode]. Journal of Hayat.2008; 14(3-4):25-32. (Per-sian)
[21]Ganji F, Reisi R, Khosravi SH, Soltani P, Kasiri KA, Jafarzadeh L, and et al. [Effect of a participatory intervention to reduce the number of unnecessary cesarean sections performed in Shahrekord, Iran]. Journal of Shahrekord Uni-versity of Medical Sciences.2006; 8(1):14-8. (Persian)
[22]Goba A, Mirteimouri M, Dashipour AR. [Effect of education on selection of delivery method among pregnant women refered to Aliebneabitaleb hospital of Zahedan in 2004]. (MSc, midwifery dissertation). School of Medicine, Zahedan University of Medical Sciences; 2004; p 22-25. (Persian)
[23]Lagrew DC, Morgan MA. Decreasing the cesarean section rate in a private hospital: success without mandated clinical changes. Am J Obstet Gynecol.1996; 174(1):184-91.
[24]Faraji R, Zahiri Z, Farjad F. [Investigation of pregnant women’s knowledge and attitude toward the delivery modes]. Journal of Gilan University of Medical Sciences.2003; 12(46):69-75. (Persian)
[25]Signorelli C, Cattaruzza MS, Osborn JF. Risk Factors for Cesarean section in Italy: resulted of Multicenter study. Public Health.1995; 109(3):191-9.
[26]Porreco RP. Meeting the challenge of the rising cesarean Birth rate. Obstet Gynecol.1990; 75(1):133-6.
[27]Anderson GM, Loams J. Explaining variations in cesarean section rates, patients, facilities or policities?. Can Med Assoc J.1985; 132(3): 253-6.
[28]Miri MR, Shafiee F, Haydaniya AR, Kazemnejad A. [Study on behavioral intention model (BIM) to the attitude of tribermen towards family planning]. Journal of Mazandaran University of Medical Sciences.2002; 12(37):67-75. (Per-sian)
[29]Ryding EL. Investigation of 33 women who demanded a cesarean section for personal reasons. Acta Obstet Gynecol Scand.1993; 72(4):280-5.
[30]Saisto T, Toivanen R, Salmela-Aro K, Halmesmaki E. Therapeutic group psychoeducation and relaxation in treating fear of childbirth. Acta Obstet Gynecol Scand.2006; 85(11):1315-9.
[2]Amidy M, Akbarzadeh K. [Effect of education on knowledge and attitude of pregnant women about cesarean]. Jour-nal of Ilam University of Medical Science.2005; 13(4):17-26. (Persian)
[3]Sharifirad GR, Rezaeian M, Soltani R, Javaheri S, Amidi-Mazaheri M. A survey on the effects of husbands’ education of pregnant women on knowledge, attitude, and reducing elective cesarean section. J Educ Health Promot.2013; 2:50.
[4]Tabandeh A, Kashani E. [The prevalence of cesarean among employed educated women of medical science groups in Gorgan (2005)]. Journal of Gorgan University of Medical Sciences.2007; 9(2):67-70. (Persian)
[5]Fathian Z, Sharifirad GR, Hasanzadeh A, Fathian Z. [Study of the effects of behavioral intention model education on reducing the cesarean rate among pregnant women of Khomeiny-Shahr, Isfahan, in 2006]. Zahedan Journal of Re-search in Medical Sciences.2007; 9(4):123-31. (Persian)
[6]Cunningham F, Leveno K, Bloom S, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23rd ed. New York: McGraw-hill Publication; 2011: 509-31.
[7]Rezakhani-Moghaddam H, Shojaeizadeh D, Taghdisi MH, Hamidzadeh Y, Savadpour MT. [The effect of education by community health volunteers on choice of delivery kind in pregnant women based on the Behavioral Intention Model (BIM)]. Journal of School of Public Health and Institute of Public Health Research.2012; 10(3):27-40. (Persian)
[8]Ghaffari M, Sharifirad GR, Akbari Z, Khorsandi M, Hassanzadeh A. [Health Belief Model-based education & reduction of cesarean among pregnant women: An interventional study]. Health System Research Journal.2011; 7(2):200-8. (Persian)
[9]Koc I. Increased cesarean section rates in Turkey. Eur J Contracept Reprod Health Care.2003; 8(1):1-10.
[10]Shareat M, Majlesi F, Azarei S, Mahmmodi M. [Cesarean rate and factors that influence it in maternities of Tehran]. Payesh.2002; 1(3):5-10. (Persian)
[11]Iran Ministry of Health, Family health office. New system of evaluating and monitoring fertility health program, 2005. http://www.behdasht .gov.ir/. (Accessed September 2009)
[12]Devendra K, Arulkumaran S. Should doctors perform an elective caesarean section on request?. Ann Acad Med Sin-gapore.2003; 32(5):577-81.
[13]World Health Organization. Managing complications in pregnancy and childbirth: A guide for midwives and doctors. Geneva: World Health Organization; 2003. http://www.who.int/mater nal_child_adolescent/documents/9241545879/en/. (Accessed June 2014)
[14]Shiraz University of Medical Sciences, Family Health Unit. Primary results of maternal program indexes, 2011. http://www.dchq.ir/html/modules.php/. (Accessed September 2013)
[15]Tavassoli M, Heydarnia AR. [Investigation of the effect of education on reducing the rate of elective caesarean delivery in pregnant women]. (MSc, health education dissertation), Faculty of Medicine, Tarbiat Modares University, Tehran, 2001. (Persian)
[16]Gutman Y, Tabak N. The intention of delivery room staff to encourage the presence of husbands/partners at cesar-ean sections. Nurs Res Pract.2011; 2011:192649.
[17]Glanz K, Rimer BK, Viswanath K. Health Behavior and Health Education: Theory, Research and Practice. 4th ed. San Francisco: Jossey-Bass publisher; 2008, PP:67-92.
[18]Cai WW, Marks JS, Chen CH, Zhuang YX, Morris L, Harris JR. Increased cesarean section rates and emerging patterns of health insurance in Shanghai, china. Am J Public Health.1998; 88(5):777-80.
[19]Alimohammadian M, Shariat M, Mahmmodi M, Ramezanzadeh F. [Investigation of the effect of pregnant women’s request on the rate of elective caesarean delivery]. Payesh.2003; 2(2):137-43. (Persian)
[20]Rahimikian F, Mirmohamadaliei M, Mehran A, Aboozari-Ghforoodi K, Salmaani-Barough N. [Effect of Education Designed based on Health Belief Model on Choosing Delivery Mode]. Journal of Hayat.2008; 14(3-4):25-32. (Per-sian)
[21]Ganji F, Reisi R, Khosravi SH, Soltani P, Kasiri KA, Jafarzadeh L, and et al. [Effect of a participatory intervention to reduce the number of unnecessary cesarean sections performed in Shahrekord, Iran]. Journal of Shahrekord Uni-versity of Medical Sciences.2006; 8(1):14-8. (Persian)
[22]Goba A, Mirteimouri M, Dashipour AR. [Effect of education on selection of delivery method among pregnant women refered to Aliebneabitaleb hospital of Zahedan in 2004]. (MSc, midwifery dissertation). School of Medicine, Zahedan University of Medical Sciences; 2004; p 22-25. (Persian)
[23]Lagrew DC, Morgan MA. Decreasing the cesarean section rate in a private hospital: success without mandated clinical changes. Am J Obstet Gynecol.1996; 174(1):184-91.
[24]Faraji R, Zahiri Z, Farjad F. [Investigation of pregnant women’s knowledge and attitude toward the delivery modes]. Journal of Gilan University of Medical Sciences.2003; 12(46):69-75. (Persian)
[25]Signorelli C, Cattaruzza MS, Osborn JF. Risk Factors for Cesarean section in Italy: resulted of Multicenter study. Public Health.1995; 109(3):191-9.
[26]Porreco RP. Meeting the challenge of the rising cesarean Birth rate. Obstet Gynecol.1990; 75(1):133-6.
[27]Anderson GM, Loams J. Explaining variations in cesarean section rates, patients, facilities or policities?. Can Med Assoc J.1985; 132(3): 253-6.
[28]Miri MR, Shafiee F, Haydaniya AR, Kazemnejad A. [Study on behavioral intention model (BIM) to the attitude of tribermen towards family planning]. Journal of Mazandaran University of Medical Sciences.2002; 12(37):67-75. (Per-sian)
[29]Ryding EL. Investigation of 33 women who demanded a cesarean section for personal reasons. Acta Obstet Gynecol Scand.1993; 72(4):280-5.
[30]Saisto T, Toivanen R, Salmela-Aro K, Halmesmaki E. Therapeutic group psychoeducation and relaxation in treating fear of childbirth. Acta Obstet Gynecol Scand.2006; 85(11):1315-9.