آموزش برنامۀ مداخلاتی آموزشی-روانی ویژۀ مادران نوزاد نارس و ارزیابی اثربخشی آن بر استرس فرزندپروری و بهبود رابطۀ مادر- نوزاد
محورهای موضوعی : تربیتیسمیه حبیب پور 1 , غلامعلی افروز 2 , محسن شکوهی یکتا 3 , محمد علی بشارت 4 , ولی الله فرزاد 5 , مریم نخشب 6
1 - استادیارگروه روان شناسی، دانشگاه آزاد اسلامی، واحدنکاء، نکاء، ایران
2 - استاد گروه روان شناسی کودکان استثنایی، دانشکده روان شناسی و علوم تربیتی، تهران، ایران
3 - استاد گروه روان شناسی کودکان استثنایی، دانشکده روان شناسی و علوم تربیتی، دانشگاه تهران، تهران، ایران
4 - استاد روان شناسی گروه روان شناسی عمومی، دانشکده روان شناسی و علوم تربیتی، دانشگاه تهران، تهران، ایران
5 - دانشیارگروه روان شناسی عمومی، دانشکده روان شناسی و علوم تربیتی، دانشگاه خوارزمی، کرج، ایران
6 - دانشیار گروه علوم پزشکی ایران، دانشکده علوم پزشکی، دانشگاه مازندران، ساری، ایران
کلید واژه: مادران, استرس فرزندپروری, برنامه مداخله ای, نوزاد نارس, تعامل والد - نوزاد,
چکیده مقاله :
هدف این پژوهش آموزش برنامۀ مداخلهای آموزشی– روانی و ارزیابی اثربخشی آن بر استرس فرزندپروری و بهبود رابطۀ مادر- نوزاد بود . این پژوهش یک کارآزمایی بالینی تصادفی بود که در سال 1396انجام شده است. جامعۀ آماری این پژوهش عبارت است از کلیۀ مادران داری نوزاد نارس، بیمارستانهای استان مازندران که از این میان 40 مادر به روش نمونهگیری هدفمند انتخاب شدهاند و به صورت تصادفی در دو گروه آزمایش و کنترل قرارگرفتهاند. برنامۀ محققساختۀ مداخلهای روانشناختی-آموزشی شامل دوازده جلسۀ یکساعته و ابزارهای پژوهش شامل مقیاس محققساختۀ استرس فرزندپروری (1397) و چکلیست محققساختۀ تعامل مادر-نوزاد (1397) بوده و برای تجزیه و تحلیل دادههای پژوهش از طرح اندازهگیری مکرر و تجزیه و تحلیل واریانس چندمتغیره استفاده شده است. نتایج نشان میدهد که مداخلات آموزشی-روانی ویژۀ مادران نوزاد نارس، بر میزان کاهش استرس فرزندپروری و سه مولفۀ آن آشفتگی والدینی، تعامل آشفتۀ والد - نوزاد و انتظارات منفی والدینی اثر معنا داری گذاشته ((P<0.01 همچنین تعامل والد-نوزاد نیز بهبود پیدا کرده است((P<0.01. نتایج آزمونهای تعقیبی نشان داده است که تنها مؤلفۀ رفتارهای احساسی تعامل والد - نوزاد متأثر شده است .(p<0.05) نتایج پژوهش نشان میدهد که برنامۀ مداخلاتی آموزشی-روانی بر کاهش استرس فرزندپروری و بهبود رابطۀ مادر-نوزاد مؤثر بوده است؛ بنابراین پیشنهاد میشود از اینگونه برنامهها در ارتقای کیفیت زندگی مادران با نوزاد نارس استفاده شود.
The purpose of the present study was an Instruction of psycho-educational intervention program and its effectiveness on parental stress and the improvement of mother-infant relationship. This research was in fact an accidental clinical tria that which was done in 2016.The statistical population of this study includes all mothers have a premature baby hospital of Mazandaran province , of these 40 mothers were selected by purposive sampling. And randomly divided into groups, control group and experimental group. Researcher- made Educational -psychological intervention program was twelve one-hour sessions. The tools used in this research were Parenting stress researcher made scale(2017)whose questions were selected from four scales of common parenting stress. And also a researcher made infant-mother interaction checklist(2017).It is worth mentioning that items of the checklist were selected from four checklist of common infant-mother interaction. To analyze the research data, Repeated measurement method and Multivariate analysis of variance were used.The results show that special psychological educational intervention for mothers of pre mature infants reduced the stress of parenting in mothers of premature infants and its three component such as parental disturbances, parental-infant disturbances and parental expectations (P < 0.01). And also improved mother-infant interaction(P<0.01). The results of follow-up tests showed that only component of sensitive behavior of mother-infant interaction has been affected(P < 0.05). The results of the study show psychoeducational intervention program reducing child stress and improving the mother-child relationship-baby has effect.Therefore, it is recommended to use this model of programs of mothers with premature babies.
Abidin, R. R., (2014).Parenting stress index. 12th ed. USA: Pediatric Psychology Press.
Alaei, F., Meteor, M., Mohammadi Lanjabadi, R., & Alavi Majd, H.(1384). Investigation the attachment behaviors of mothers in the first encounter with newborns in one of the teaching hospitals affiliated to Aldam university of Medical sciences and health services Journal of shahid beheshti scholl of nersing and midwifery, 15(51), 31-42.
Anthony, ll., Gil, KM., & Schanberg, LE.(2010). Brief report: Parental Perceptions of child vulnerability in children with chronic illness Journal pediatrpsychol,28(3), 90-185.
Barim Nejad, L., Mehrnoosh, N., Seyed Fatemi, N., & Haggani, H.(1393). The effect of parent empowerment program on reducing parenting stress: A quasi- experimental study Journal of Research in nursing and Midwifery, 18(3), 32-43.
Berns, SD., Boyle, MD., & Popper, B. (2014). Result of the Premature birth national need-gap study Journal of Perinatal , 27(2), 38-44.
Borghini, A., Habersaat, S., Forcada- Guex, M., Nessi, J., Pierrehumber, B., Ansermet, F., Muller-Nix, C. (2014). Effects of an early intervention onmaternal post-traumatic stress symptoms and the quality of mother-infantinteraction:the case of preterm Infant Behavior & Development Journal, 37(5), 624-631.
Browne, Jv., & Talmi, A. (2012). Family –based interventions to enhance infant-Parent relationships in the neonatal intensive care unit Journal of pediatr psycho, 30(8), 667-770.
Dezvari, N., Alaei kahroudi, f., Khan Ali Agan, L., & Talebi Ghaneh, A. (1396). Maternal infant attachment rate and related factors in hospitalized preterm infant Journal of Health and care, 17(4), 340-349.
Elkowitz, P., Papageorgiou, A., Bardin, C.,& Wang, T. (2018). Persistent maternal anxiety affects the interaction between mothers and their very low birth weight children at 24 months. Early Hum Dev Jan, 85(1), 51-60.
Ershadmanesh, M., Afjeie, S., Akrami, F., Jafari Pardasti, H., Habib Elahzi, As., Heidarzadeh, M., Khazaei, S., & Darvari, M. (1395). Evaluation of the effectiveness of Kangaroo care in neonates in the intensive care unit Research in nursing and Midwifery, 6(2), 12-23.
Evans, T., Whittingham, K., Sanders, M., Colditz, P., & N Boyd, R.(2014). Are Parentingintervention effective in improving the relationship between mothers and their preterm infant Journal of Behavior& Development,37(2), 131-154.
Evans, T., Whittingham, K., Sanders, M., Colditz, P., N Boyd, R.(2016). Are Parentingintervention
effective in improving the relationship between mothers and their preterm infant.Journal of Behavior& Development Journal,37(2), 131-154.
Fata, L., Mutabi, F., Mohammadkhani, Sh., Zohreh, B.& Kazemzadeh Atofi, M. (1395). Student life skills training (Third edition). Tehran: Danesh Publishing.
Fergusson, DM., Lynskey, MT., & Horwood, LJ. (2000).The effect of maternal depression on maternal ratings of child behavior journal Abnorm child psychology, 21(2), 245-270.
Hassanzadeh, S., Noorabadi, Z., Gholam Ali lavasai, M., & Farzad Mehr, M.(1395). The effectiveness of coping skill training on parental stress of mother with deaf children 1 to 3 years old in gorgan Journal of Exceptional Education, 14(6), 34-52.
Hold-Davis, D., Traut, W., Levy, J., Shea, T., Michael, O., Geraldo,V., & David, R. (2014). Maternally administered interventions for pretermInfant in the NICU, Effects on maternal psychologhical distress andmother-infant interaction Infant Behavior & Development Journal, 37(20),695-710.
Ishizaki, Y., Nagahama, T., & Kaneko, K.(2015). Mental Health of Mothers and Thier Premature Infants for The Prevention of Child Abuse and Maltreatment Journal of research in Nursing and Midwifery, 5(3A), 45-51.
Karami, K., Rostami, sh., & Ghadirian, F.(1388). The effect of education –supportive intervention on the stress of mothers of premature infants during hospitalization Journal of lorestan university of Medical sciences, 11(2), 78-90.
Karbandi, S., Momenizadeh, A., Heidarzadeh, M., Mazlum, S., & Hassanzadeh, M.(1394).The effect of maternal empowerment program on the duration of hospitalization and readmission of permature infants Journal of babol university of Medical sciences, 17(10), 28-32.
Kulgelman, A., Inbar-Sanado, E., Makhoul, I., Leshem, M., & Zangan, S.(2015). Inatrogenesis in neonatal intensive care units: Observational and interventional Prospective Multicenter study pediatrics,122(3), 550-558.
Land Sem Inger, P., Handegard, B., Tunby, J., Ulvund, S., & John, A. (2014).Early intervention program reduces stress in parents of preterm during childhood,a randomized controlled trial Applied Psychology Journal, 46(14), 171-184.
Margaret, M,.& Miles, M.(1998). Parental stress scale: neonatal intensive care unit. 3th ed. Carrington Hall: school of nursing, university of North Carolina.
Martin, A., Brooks-Gunn, J., Klebanov, P., Buke, S., &McCormick, C.(2008). Long-term maternal effects of early childhood intervention: finding from the infant health and development program(IHDP) Journal of Applied Developmental Psychology, 29( 14), 101-117.
Mianiee Pardasty, S., Allah karharoudi, F., Rasooli, M., & Zakher Tafreshi, M.(1393). The effectiveness of the opportunity program created to empower on stress, Maternal anxiety and maternal involment in the intensive care unit. Journal of Research in Nursing and Midwifery, 19(3), 72-89.
Momeni zadeh, A., Zerati, H., Shahin far, J., & Ghorbanzadeh, M.(2017). Stress coping styles in mothers with premature infants admitted to the neonatal intensive care unit. Journal of pediatric Nursing, 2(1), 14-19.Pour movahed, Z., & Aryaie nezade, A.(2020). Comparison of attachment and social support in mothers of healthy and premature infants admitted to the intensive care unit Journal of health and care, 22(4), 1-10.Rabiei pour, S., & Vatan khah alam dari, N.( 2020). The effect of heart writing on stress and satisfaction of mothers of hospitalized preterm infants.Journal of Urmia school of Nursing and Midwifery,17(8), 656-666.
Rasti, M., Ali abadi, F., Shafaroodi, N., Rafiei, F., & Vaklani, M. (1393). Explaining the educational needs of parents of Premature infants admitted to the neonatal intensive care unitJournal of Modern Rehabilitation, 8(4), 12-32.
Schappin, R., Wijnroks, L., Uniken Venemam, M., Wijnberg-Williams, B., Veenstra, R., koopman-Esseboom, C., Mulder-De Tollenaet, S., Van der Tweel, I., & Jongmans, M.(2013). Brief Parenting intervention for parents of NICU graduates: a Randomized , Clinical trial of primary care triple p. London: Pediatrics Press.
Shaw, R., Carrie, J., Sweeter, N., St John, E., Lilo, J., Corcoran, B., Shelley, H., Howell, W., & Benitz, N. (2013). Prevention of postpartum traumatic stress In Mothers with pre term infants, Manual Development and evaluation.Issuesin Mental Health Nursin, 34(67), 578-589.
Torres, B., Alonso-Arbiol, I., Cantero, M, & Abubakar, A.(2011). Infant-Mother Attachment can Be Improved through Group intervention: A preliminary Evalution in spain in a Non-Randomized Controlled Trial. The Spanish Journal Of Psychology, 14( 2), 630-638.
Trombini, E., Surcinelli, P., Piccioni, A., Alessandroni, R., & Faldella, G.(2012). Environmental factors associated with stress in mothers of preterm newborns Journal of actaPediatr , 97(1), 894-8.
Zahed pasha, Y., Arzani, A., khafari, S., Darvish, A.,& Esmaili, S.(1398). The effect of a virtual ownership-based educational program on the stress and anxiety of parents with infants admitted to nicu. Scientific Journal of Babol university of Medical Sciences, 21(1), 364-371.
Wu, Y., Leng Hon, W., Hsu Chyong-Hsin, C., Gau, S., chin, N., Yang, M., Fang, L., Hsu, H., Yu, Y., Wu, Y., Chen, L, & Jeng, S. (2014). A randomizedcontrolled trial of clinic-based and home-based interventions in comparison with usual care for preterm infants: Effects and mediators Research In Developmental Disabilities Journal, 35(4 ), 23-45.
_||_