Document Type : Original Article
Authors
- . Hossein Shahnazi
- . Sahar Sabooteh
- . Gholamreza Sharifirad
- . Kamal Mirkarimi 1
- . Akbar Hassanzadeh 2
1 Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
2 Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan
Abstract
Background: According to investigations, pregnant women hypothesized that anxiety is a
common factor that will improve spontaneously; they are not aware of its side effects on the fetus,
baby, and pregnancy outcome, as a whole. Other studies have also not tried to design a theoretical
framework based on Health Education Models (HBMs) to overcome this problem. The current
study aimed at exploring the effectiveness of education on the anxiety of nulliparous women based
on a HBM. Materials and Methods: An experimental study on 88 eligible nulliparous women
(n = 44 per group), from Doroud city, was performed in 2012. The data was collected using a
researcher made questionnaire. Education was conducted in three sessions tailored with HBM
constructs with the help of lectures, group discussions, inquiries, Power Point presentations,
and booklets. Evaluation performed using a posttest four and eight weeks after last session. The
collected data were analyzed using statistical tests, including Chi-square, independent t-test, and
repeated measure Analysis of Variance (ANOVA) by the significance level of 0.05. Results: The
mean score of knowledge, perceived sensitivity, perceived severity, perceived benefits and
barriers, cues to action, self efficacy, and behavior, four weeks after intervention (P < 0.001) and
eight weeks after intervention (P < 0.001) were significantly more in the case group Than the
control group. ANOVA with repeated measures showed a significant increase in the case group
in knowledge (from 32.1 to 89.1), perceived sensitivity (from 34.8 to 91.5), perceived severity
(from 31.82 to 88.48), perceived benefits (from 39.28 to 92.41), perceived barriers (from 26.93 to
88.61), cues to action (from24.65 to 92.03), self efficacy (from 29.71 to 88.75), and behavior (from
28.83 to 94.63). Changes were not significant in the control group. Conclusion: The effect of HBM
and education on increasing knowledge and changing people’s beliefs and behavior, in terms
of anxiety based pregnancy, should make health planners and authorities pay more attention to
these issues. Moreover, it will help in the betterment of the health of mothers and babies.
Keywords
Cultural Affairs and Prevention Publication. 2001.
2. Nicols F, Zwelling E. Maternal and newborn nursing. Philadelphia:
W. B. Saunders Co; 1997.
3. Dennerstein L, Estebri J, Mors K. Women’s Health (Psychosocial
aspects and mental health). Tehran: Boshra Publication; 2003.
4. Mardanihamule M, Ebrahimi E. Mental Health Status of Pregnant
Women Referring to Shahinshahr Health Care Centers. Bouyeh
journal Gorgan Univ Med Sci 2010;7:27‑33.
5. Alipour Z, Lamyian M, Hajizadeh E. Anxiety during Pregnancy:
A Risk Factor for Neonatal Physical outcome. J Urmia Nurs
Midwifery Fac 2011;9:30‑8.
6. Dunkel Schetter C, Tanner L. Anxiety, depression and stress in
pregnancy: Implications for mothers, children, research, and
practice. Curr Opin Psychiatry 2012;25:141‑8.
7. Babanazari L, Kafi SM. Comparative study of anxiety in relation
to different periods of pregnancy, marital satisfaction and
demographic factors. Iranian Journal of Psychiatry and Clinical
Psychology. 2008;14:206‑13.
8. Shayeghian Z, Rasolzadeh Tabatabaey SK, Seddighilooye E. Effect
of Maternal Anxiety during Third Trimester on Pregnancy Outcomes
and Infants’ Mental Health. Journal of Faculty of Nursing and
Midwifery. 2009;14:57‑64.
9. Ghazavi H, Ahadi M, Aghasi Yazdi Z, Behzadmehr A. Anxiety in
pregnancy. J Raze Behzistan 2008;17:19‑21.
10. Nasiri AF, Salmalian H, Hajiahmadi M, Ahmadi AM. Association
between Prenatal Anxiety and Spontaneous Preterm Birth. J Babol
Univ Med Sci 2009;11:42‑8.
11. Toosi M, Akbarzadeh M, Zare N, Sharif F. Effects of attachment
behaviors education on anxiety and attachment of mother to baby
at first pregnancy. J Fac Nurs Midwifery 2011;17:69‑79.
12. Bazrafshan MR, Ghorbani Z. The Effect of slow stroke back massages
on anxiety among primigravid women. J Fac Nurs Midwifery
2010;16:34‑40.
13. Shahidi LH, Moghimian M, Tavakkoli Zadeh J. The comparison of
depression in wanted and unwanted pregnancies. J Gonabad Univ
Med Sci Health Serv 2002;8:90‑5.
14. Motevally E, Faizi Z, Ganji T, Haghani H. Effect of watching childbirth
by videotape on anxiety level of primigravid mothers. Iran J Nurs
2003;15‑16:100‑4.
15. Glance K, Marcus F, Barbara L. Health behavior and health
education (Theory, Research, Operation). Translated by: Forough S.
Tehran: Ladan Publication; 1997. p. 68‑84.
16. Khazaie PM, Ebadiazar F, Solhi M, Asadilari M, Abdi N. Study in the
effect of education through Health Belief Model on the perceptions
of girl Students in primary school about breakfast and snack in
Noshahr‑2007. Toloo e Behdasht 2008;7:51‑63 [Persian].
17. Shojaezadeh D, Mehrabbaic A, Mahmoodi M, Salehi L. To
evaluate of efficacy of education based on Health Belief Model
on knowledge, attitude and practice among women with low
socioeconomic status regarding osteoporosis prevention. Iran J
Epidemiol 2011;7:30‑7.
18. Ebadi Fard Azar F, Solhi M, Zohoor AR, Hosseini AM. The effect
of Health Belief Model on promoting preventive behaviors of
osteoporosis among rural women of Malayer. J Qazvin Univ Med
Sci Health Serv 2012;16:58‑64.
19. Bahadoran P, Mohamadalibeygi N. Stress and anxiety during
pregnancy. J Nurs Midwifery Res 2005;27:18‑23.
20. Nasiri M. Pregnancy and Childbirth Mental Health. Tehran: Boshra
publication; 2000.
21. Mohebi M. Effect of nutrition education program on the
recommended weight gain in during pregnancy application of
Health Belief Model: A randomaized cilinical trial. J Qom Univ Med
Sci 2012;6:23‑30.
22. Ghaffari M, Sharifirad GH, Akbari Z, Khorsandi M, Hassanzadeh A.
Health belief model‑Based education and reduction of cesarean
among pregnant women: An interventional study. Health Syst
Res 2011;7:200‑8.
23. Charron‑Prochownik D, Sereika SM, Becker D, Jacober S,
Mansfield J, White NH, et al. Reproductive health beliefs and
behaviors in teens with diabetes: Application of the Expanded
Health Belief Model. Pediatr Diabetes 2001;2:30‑9.
24. Ebadifardazar F, Solhi M, Pakpurhajiagha A, Yekaninejad MS. The
impact of health education through Health Belief Model (H.B.M)
on mother’s perceptions about obesity children obese male
student in elementary schools (17th district, Tehran City). J Health
Adm 2006;8:7‑14.
25. Sharifirad GH, Hazavehie SM, Mohebi S, Rahimi MA, Hasanzadeh A.
The effect of educational program based on Health Belief
Model (HBM) on the foot care by type II diabetic patients. Iran J
Endocrinol Metab 2006;8:231‑9.
26. Tajik R, Shamsi M, Mohamadbeigi A. Knowledge, attitude and
behavior of mothers in the arbitrary use of drugs in Arak. Payesh.
J Iran Inst Health Sci Res 2011;10:197‑204.
27. Hassani L, Aghamolaei T, Tavafian SS. Exercise self‑efficacy,
exercise perceived benefits and barriers among students in
Hormozgan University of Medical Sciences. Iran J Epidemiol
2009;4:9‑15.
28. Bastani F, Heidarnia AR, Vafaei M, KazemNejad A, Kashanian M.
The effect of relaxation training based on self‑efficacy theory
on mental health of pregnant women. Iran J Psychiatry Clin
Psychol 2006;12:109‑116.
29. Rahimi S, Sayed RE. Reproductive health beliefs and behaviors in
teens with diabetes. Iran Nurs Period 2004;17:6‑10.
30. Nejadsadeghi E, Taghdisi MH. Evaluation of pregnant
women in the field of urinary tract infection according to the
components of Health Belief Model. J Jahrom Med School 2011;
8:36‑42.
31. Askernejad M, Bakhshi H. Analysis of awareness, attitude and
actions of pregnant women of Rafsanjan towards the importance
of care taking during pregnancy in the year 2000. Rafsanjan Med
Sci Univ Mag 2002;1:1‑7.
32. Rahimikian F, Mirmohamadali M, Mehran A, Aboozari K,
Salmaanibarough N. Effect of education designed based on Health
Belief Model on choosing delivery mode. J Fac Nurs Midwifery
2009;14:25‑32.
33. Sharifirad GH, Hazavei MM, Hasan‑ Zadeh A, Danesh‑Amouz A.The effect of health education based on Health Belief Model on
preventive actions of smoking in grade one, middle school students.
Arak Med Univ J 2007;10:79‑86.
34. Torshizi L, Anoosheh M, Ghofranipour F, Ahmadi F, Houshyar‑Rad A.
The effect of education based on Health Belief Model on preventive
factors of osteoporosis among postmenopausal women. Iran J Nurs
2009;22:71‑82.
35. Lagampan S, Lapvongwatana P, Tharapan C, Nonthikorn J. Health
Belief Model teaching program for thalassemia education in high
school students. Chula Med J 2004;48:723‑35.
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