Journal of Education and Health Promotion

Abstract BACKGROUND: Perceived stress is one of the causes of preeclampsia; one of the ways to manage 
mental stress is hypnosis. The aim of this study was to determine the effect of hypnosis on perceived 
stress in women with preeclampsia.
MATERIALS AND METHODS: This randomized clinical trial was performed on 80 (40 people in each 
group) pregnant women 28–32 weeks with preeclampsia and hospitalized in two public hospitals in 
Mashhad in 2020. The Cohen Perceived Stress Questionnaire was first completed in two groups. 
Then, in the intervention group, three half‑hour sessions of hypnosis were performed with an interval 
of 3 days (hypnosis consists of three sessions: each session is held for three consecutive nights). 
After each session, the intervention package, which included recording the dialogs of each session 
for posthypnotic suggestion, was delivered to the mothers on a CD to listen to every night before 
bed. The control group received routine care. Then, 2 weeks after the intervention, the Perceived 
Stress Questionnaire was completed by both groups. The results were analyzed by independent 
t‑test, paired t‑test, Mann–Whitney, Chi‑square, Friedman and covariance tests, and by SPSS 16.
RESULTS: At the beginning of the study, there was no statistically significant difference between 
demographic characteristics and the perceived stress score before the intervention between the two 
groups (P > 0.05). However, after the intervention, the mean perceived stress score was a statistically 
significant difference between the intervention and control groups (P = 0.005). Perceived stress after 
the intervention was significantly reduced in the intervention group, which was significant between 
the two groups.
CONCLUSION: Perceived stress in mothers with preeclampsia is reduced by hypnosis.

Abstract BACKGROUND: Spiritual health in the field of health has a great importance in mental disorders and
posttraumatic stress disorders, in treatment process. The present study was done aiming “determine
the effect of spiritual care education on the spiritual health of preeclamptic women with postpartum
stress disorder.”
MATERIALS AND METHODS: This randomized clinical trial was done in 2017 on 260 women with
preeclampsia in Mashhad. Data collection was done with questionnaires Perinatal Posttraumatic
Stress Questionnaire (PPQ), the posttraumatic disorder checklist, Duke University Religion Index,
and the Spiritual Well‑Being Scale (SWBS). In the intervention group, first, women were educated
on spiritual care each day based on Richards and Bergin’s pattern, in three sessions, which lasted
45–60 min. The control group also received routine cares. All units completed the questionnaire
SWBS at the 8th postpartum period. P < 0.05 was meaningful.
RESULTS: After the intervention, this score of spiritual health in the intervention and control groups
had a significant difference with independent test (P = 0.004). Spiritual health significantly increased
in the interventional group.
CONCLUSIONS: Providing spiritual care to pregnant mothers with preeclampsia, increase their
spiritual health.

Abstract BACKGROUND AND OBJECTIVES: Hypertension in pregnancy is one of the most important
unsolved problems in midwifery, and since it is the main cause of maternal death, preventive
intervention measures are essential to control this serious complication. This study aimed to determine
the effect of walking on gestational hypertension disorders in women prone to hypertension.
MATERIALS AND METHODS: This randomized clinical trial was conducted on 72 pregnant women
susceptible to gestational hypertension who were randomly (through a random number table)
assigned into two groups of 36. The pregnant women in the experimental group had walking program
for 20–30 min from weeks 14–34, four times a week. Data were analyzed, via independent t‑test,
Fisher’s exact test, and Chi‑square test.
RESULTS: The results indicated that in the experimental group, 2 cases with transient gestational
hypertension and 1 case of preeclampsia existed, and in the control group, 9 pregnant women
were with gestational hypertension and 4 pregnant women were with preeclampsia. Therefore, the
incidence of these two complications in the experimental group was significantly lower than the control
group (P < 0.05). Moreover, the mean systolic and diastolic blood pressures in the experimental
group were significantly lower than the control group (P < 0.05).
CONCLUSION: Based on the results, the moderate walking, as an easy physical activity, is
recommended for pregnant women susceptible to pregnancy hypertension.

Abstract INTRODUCTION: Preeclampsia is the most common medical complication in pregnancy; along
with bleeding and infection, it is one of the three causes of death in pregnant women. Most of these
deaths were due to delays in the diagnosis and improper midwifery management and care. On
the other hand, the quality of midwifery education has a profound effect on the proper provision of
services. Therefore, the present study has been done to compare the effect of simulation‑, blended‑,
and lecture‑based education on simulated midwife performance in the management of preeclampsia
and eclampsia.
MATERIALS AND METHODS: This three‑group clinical trial study was performed on 90 midwives
of selected hospitals in Mashhad in 2016. Midwives were divided into three groups of simulation‑,
blended‑, and lecture‑based education using the random number table. The simulation group was
trained for 6 h at the Center for Clinical Skills, the blended group was trained for 4 h by lecture, and
6 weeks through the educational website, and the lecture group was trained for 6 h through lecture.
An objective structured clinical test was performed before and 2 weeks after the intervention. Data
were analyzed using SPSS Version 16 software and descriptive statistics, paired t‑test, one‑way
ANOVA, and Wilcoxon and Kruskal–Wallis tests. Significance level was considered to be P < 0.05
in all cases.
RESULTS: The mean score of midwives’ performance was not statistically significant before education
in all three groups (P < 0.05). The mean score of midwives’ performance was significantly increased
in all three groups 2 weeks after education (P < 0.001), and the results of intergroup comparison
showed that the mean score of performance in the simulation group was significantly higher than the
blended group and the lecture group (P < 0.001), and it was higher in the blended group compared
to the lecture group (P < 0.001).
CONCLUSION: Education increased the midwives’ simulated performance in preeclampsia and
eclampsia. The performance of the management of preeclampsia and eclampsia in the simulation
educational group is more than that of the blended and lecture groups, so we can use the simulation
education which is a self‑centered method.

Abstract INTRODUCTION: Posttraumatic stress disorder is an anxiety disorder that occurs after exposure
to an event that causes injury or threat. The prevalence of preeclampsia was reported to be 28%.
Considering the significant role of spiritual care in physical and psychological outcomes of patients,
this study was conducted to determine “the effect of spiritual care education on postpartum stress
disorder in women with preeclampsia”.
MATERIALS AND METHODS: In this randomized clinical trial, 72 pregnant women (36 in each group)
were selected in a convenient way between the ages of 34 and 38 weeks who had preeclampsia and
admitted to two public hospitals in Mashhad. The questionnaires such as Duke University Religion
Index, DASS 21, the Posttraumatic Stress Disorder Checklist (PCL), and  Prenatal Posttraumatic
Stress Questionnaire (PPQ) were used at the beginning in two groups. In the intervention group, first,
women were educated each day based on Richards and Bergin’s pattern, in three sessions, which
lasted 45–60 min. The control group also received routine cares. All units completed questionnaires
such as Prenatal Posttraumatic Stress Questionnaire (PPQ) at the 4th–6th postpartum period. Results
were analyzed by independent t‑test, Mann–Whitney test, Chi‑square test, and SPSS version 16.
RESULTS: The mean change score of postpartum stress disorder in the intervention and control
groups was different after intervention (P = 0.001).
CONCLUSION: Providing spiritual care to pregnant mothers with preeclampsia reduces their risk
of postpartum stress disorder. Therefore, this kind of care as an effective intervention is included in
the routine care of this group with high‑risk pregnancies.