Authors
1 School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
2 Faculty of educational and psychology , Ferdowsi University of Mashhad,
3 Department of Midwifery, School of Nursing and Midwifery, Evidence‑Based Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
INTRODUCTION: Each mother has the legal right to decide about her delivery, but this decision
should be made based on scientific knowledge. Instructions during pregnancy help to choose the
proper type of delivery. This study conducted aimed to compare two instructional methods of role
playing and lecture on primigravida decision about type of delivery.
SUBJECTS AND METHODS: In this single‑blind clinical trial 67 primigravida, 34–36 week were
selected using multi‑stage sampling and assigned into two groups randomly. Decision‑making
(before, 2‑week after, and at admission in maternity department) was tested by a questionnaire. In
role‑playing group, advantages and disadvantages of two type delivery were presented by role‑playing
in 90‑min by three scenarios. In lecture group, it was also presented in a 90‑min lecture. Data were
analyzed by mean difference test, Fisher test, independent and paired t‑test.
RESULTS: Two groups showed a significant difference in terms of decision at admission to
maternity department (P = 0.000). 75% of lecture group and 100% of role‑playing group selected
normal delivery. Postintervention knowledge score in lecture group was 18 ± 5.3 and in role‑playing
group 17.1 ± 4.0. Percent of change in knowledge scores in two groups was significant (P = 0.001).
Participants’ attitude, before and after the intervention, in both groups was significant (P < 0.05).
Mean difference of pre‑ and post‑test in relation to two groups’ knowledge and attitude scores was
not significant (P > 0.05).
CONCLUSION: In this research, lecture was more effective in raising knowledge level, and role
playing was more effective in raising decision to vaginal delivery and reducing elective caesarean
section. It is therefore suggested to use both teaching methods altogether for pregnant women to
decrease the rate of unnecessary cesarean.
Keywords
Williams Obstetrics. 22nd ed. New York: The McGraw‑Hill
Professional Publishing; 2014. p. 590.
2. Sharifirad G, Fathian Z. Survey of pregnant women view than
vaginal and cesarean delivery based on behavioral intention
model. J Illam Univ Med Sci 2007;1:19‑23.
3. Ewles L, Simnett I. Promoting Health: A Practical Guide. 5th ed.
London: Elsevier; 2003.
4. Nuri T. Reasons of Cesarean Choice in Pregnant Women Refer to
Rasht Health Centers. Midwifery, MSc Thesis, Tehran University
of Medical Sciences; 2004.
5. Abedian Z, Navaee M, Jafarisani H, Ebrahimzadeh S, Arani A
Comparison of the effect of two teaching methods of role playing
and lecture on primigravida women’s knowledge, attitude and
decision making in relation to type of delivery. J Obstet Gynecol
Infertil 2012;14:25‑35
6. Mohammaditabar S, Kiani A, Haidari M. Assessmen of
nulliparous women tendencies to choose the type of delivery.
J Babol Univ Med Sci 2009;3:54‑9.
7. Negahban T, Ansari A. Whether the fear of delivery can be predict
the emergency caesarean among the primigravida women? J Nurs
Midwifery Tehran Med Sci 2008;14:73‑81.
8. Amu O, Rajendran S, Bolaji II. Should doctors perform an elective
caesarean section on request? Maternal choice alone should not
determine method of delivery. BMJ 1998;317:463‑5.
9. Hammond JS, Keeney RL, Raiffa H. “The hidden traps in decision
making”. Harvard Business Review on Decision Making. Boston:
Harvard Business School Press; 2001:143‑168.
10. Hildingsson I, Thomas JE. Women’s perspectives on maternity
services in Sweden: Processes, problems, and solutions.
J Midwifery Womens Health 2007;52:126‑33.
11. AmidyM, Akbarzadeh K. Effect of health education on knowledge
and attitudes of pregnant women in cesarean section. J Illam Univ
Med Sci 2005;13:17‑26.
12. Lashgari M, Delavari S, Markazi Moghaddam N, Gorouhi F. Effect
of training programs of pregnant women on their delivery type
selection: A single blind, randomized control trial. J Tehran Army
Univ Med Sci 2005;3:679‑84.
13. Fathian Z, Sharifirad G, Hasanzade A, Fathian Z. Study of the
effects of behavioral intention model education on reducing the
cesarean rate among pregnant women of Khomeyni‑Shahr. J East
Med 2006;9:123‑31.
14. Saberian M, Hajiaghajani S. The process of curriculum planning
in medical science. Tehran: Salemi Publications; 2006. p. 43‑54.
15. Christine E. Teaching Skills Development Manual. A Guide for
Teachers of Health Workers. Translated by: Mahmudi Mohsen.
Tehran: Bustan Tohid Publications; 1998. p. 161.
16. Cacioppo J, Petty R, Kao C, Rodriguez R. Central and peripheral
routes to persuasion: An individual difference perspective. J Pers
Soc Psychol 1986;51:1032‑43.
17. Joyner B, Young L. Teaching medical students using role play:
Twelve tips for successful role plays. Med Teach 2006;28:225‑9.
18. DeNeve K, Heppner M. Role play simulations: The assessment
of an active learning technique and comparisons with traditional
lectures. Innov Higher Educ 1997;21:231‑46.
19. MacLaren J, Cohen L, Larkin K, Shelton E. Training nursing
students in evidence‑based techniques for cognitive‑behavioral
pediatric pain management. The Journal of nursing education.
2008;47:351.
20. Azizi F. Medical Education, Challenges and Prospects. Tehran:
Education Deputy and Affairs of Student, Ministry of Health and
Medical Education; 2003.
21. Joyce BR, Weil M, Calhoun E. Models of Teaching. 7th ed. Tehran:
Kamale Tarbiat Publications; 2004.
22. Festinger L, Carlsmith JM. Cognitive consequences of forces
compliance. J Abnormal and Social Psychology 1959;58:203‑10.
23. Kian FR, Miralimohamadi M, Abbas M, Gazaforudi KA,
Barugh NS. Effect of Health Belief Model education on chosen
delivery method. J Nurs Midwifery Tehran Univ Med Sci (Hayat)
2008;14:25‑32.
24. Yaghubian M, Yaghubi T, Salmeh F, Golmohammadi F, Safari H.
Comparison of the effects of education booklet and lecture
method with booklet training on the knowledge of nurses about
professional rules. Iran J Med Educ 2009;9:372‑81.
)