Gebelerin Prekonsepsiyonel Bakım ve Danışmanlık Alma Durumları ve İlişkili Faktörler

Abstract

Amaç: Bu çalışmada, gebelerin prekonsepsiyonel bakım ve danışmanlık (PKB) alma durumlarının ve ilişkili faktörlerin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kesitsel ve tanımlayıcı tipte bir online anket çalışmasıdır. Temmuz-Aralık 2020 tarihleri arasında yürütülmüştür. Çalışmada, veri toplama aracı olarak katılımcıların, sosyodemografik özelliklerini ve PKB durumlarını değerlendiren, 42 sorudan oluşan bir anket kullanılmıştır. Bulgular: Çalışmaya katılan 280 gebenin yaş ortalaması 30,4 ± 4,55 yıldır. Gebelerin %31,4'ü kendisinin, %11,8'i ise eşlerinin gebelik öncesi bakım ve danışmanlık aldığını bildirmiştir. Gelirin gidere denk olması, gebeliğin planlı olması, gebe kalmak için tedavi alınması, gebelik öncesi dönemde korunma yöntemleri hakkında bilgi alınması PKB ve danışmanlık almayı artıran faktörler olarak saptanmıştır. PKB aldığını ifade eden gebelere, bakım veren sağlık çalışanı tarafından PKB kapsamında yapılanlar incelendiğinde gebelik öncesi dönemde folik asit reçetesi %75,7 ile en yüksek orana sahip iken; en az ise %10,4 oranı ile aile içi şiddete maruz kalıp kalmadıklarının sorgulanması olmuştur. Gebelerin çoğunluğunun kadın hastalıkları ve doğum uzmanından, ikinci olarak aile hekimlerinden danışmanlık aldığı bulunmuştur. Danışmanlık almayanların; %54,2'si konu hakkında bilgi sahibi olmadığını, %33,3'ü gebelik öncesi danışmanlık almayı gerekli görmediğini, %12,5'i ise istenmeyen gebelik olduğunu ifade etmiştir. Sonuç: Gebelerin, PKB ve danışmanlık alma oranları düşük bulunmuştur. PKB ve danışmanlık açısından üreme çağındaki kişilerin bilgilendirilmesi ve her temasta konu hakkında farkındalığın artırılması gerekmektedir.

Keywords

• Prekonsepsiyonel bakım
• gebe
• danışmanlık

Preconception care and counseling status and related factors in pregnant women

Abstract

Aim: This study aimed to evaluate the preconception care and counseling (PCC) status and related factors in pregnant women. Materials and Methods: It is a cross-sectional and descriptive online survey study. It was conducted between July and December 2020. A questionnaire consisting of 42 questions that evaluated the socio-demographic characteristics and PCC status of the participants was used as a data collection tool in the study. Results: The mean age of 280 pregnant women participating in the study was 30.4±4.55 years. 31.4% of pregnant women are themselves, and 11.8% of them reported that their spouses received PCC. Middle-income level, planning pregnancy, receiving treatment for pregnancy, and obtaining information about prevention methods in the pre-pregnancy period, were found to be factors that increase receiving PCC. When examining the pregnant women who stated that they received PCC within the scope of PCC by the caregiving healthcare worker, folic acid prescription in the antenatal period had the highest rate with 75.7%, with at least 10.4%, it was questioned whether they were exposed to domestic violence or not. It was found that most pregnant women received consultancy from gynecologists and obstetricians and secondly from their family physicians. Of those who do not receive PCC, 54.2% of them stated that they did not have information about the subject, 33.3% did not find it necessary to get PCC before pregnancy, and 12.5% stated that they had an unintended pregnancy. Conclusions: The rates of pregnant women receiving PCC were low. In terms of PCC, it is necessary to inform individuals of reproductive age and raise awareness about the subject at each contact.

Keywords

• Preconception care
• pregnancy
• counseling

References

1. 1. Johnson K, Posner SF, Biermann J, Cordero JF, Atrash HK, Parker CS, et al. Recommendations to improve preconception health and Health Care—United States: report of the CDC/ATSDR preconception care work group and the select panel on preconception care. Morbidity and Mortality Weekly Report: Recommendations and Reports. 2006;55(6):1-CE-4.
2. 2. Pandolfi E, Gonfiantini MV, Gesualdo F, Romano M, Carloni E, Mastroiacovo P, et al. A cohort study of a tailored web intervention for preconception care. BMC medical informatics and decision making. 2014;14(1):33.
3. 3. Atrash H, Jack BW, Johnson K, Coonrod DV, Moos M-K, Stubblefield PG, et al. Where is the “W” oman in MCH? American Journal of Obstetrics and Gynecology. 2008;199(6):S259-S65.
4. 4. Cefalo RC, Bower WA, Moos M-K. 1 Preconception care: a means of prevention. Baillière's Clinical Obstetrics and Gynaecology. 1995; 9:403-16.
5. 5. Hillemeier MM, Weisman CS, Chase GA, Dyer AM, Shaffer ML. Women's preconceptional health and use of health services: implications for preconception care. Health services research. 2008;43(1p1):54-75.
6. 6. Baysoy NG, Özkan S. Gebelik Öncesi (Prekonsepsiyonel) Bakım: Halk Sağlığı Perspektifi. Gazi Medical Journal. 2012;23(3);77-90.
7. 7. Genç Koyucu R, Tosun Y, Katran B. Üreme Çağındaki Kadınlarda Prekonsepsiyonel Danışmanlık İhtiyaçları. JAREN/Hemşirelik Akademik Araştırma Dergisi. 2017;3(3):116-21.
8. 8. Williams L, Zapata LB, D’Angelo DV, Harrison L, Morrow B. Associations between preconception counseling and maternal behaviors before and during pregnancy. Maternal and child health journal. 2012;16(9):1854-61.

9. 9. Short VL, Oza-Frank R, Conrey EJ. Preconception health indicators: a comparison between non-Appalachian and Appalachian women. Maternal and child health journal. 2012;16(2):238-49.
10. 10. Asresu TT, Hailu D, Girmay B, Abrha MW, Weldearegay HG. Mothers’ utilization and associated factors in preconception care in northern Ethiopia: A community based cross sectional study. BMC pregnancy and childbirth. 2019;19(1):1-7
11. 11. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, (2014). 2013 Türkiye Nüfus ve Sağlık Araştırması (TNSA). Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Kalkınma Bakanlığı ve TÜBİTAK, Ankara, Türkiye.
12. 12. Kozhimannil KB, Fontaine P. Care from family physicians reported by pregnant women in the United States. The Annals of Family Medicine. 2013;11(4):350-4.
13. 13. Kitamura K, Fetters MD, Ban N. Preconception care by family physicians and general practitioners in Japan. BMC family practice. 2005;6(1):1-8.
14. 14. Zhao X, Jiang X, Zhu J, Li G, He X, Ma F, et al. Factors influencing the quality of preconception healthcare in China: applying a preconceptional instrument to assess healthcare needs. BMC pregnancy and childbirth. 2014;14(1):1-10
15. 15. Hawks RM, McGinn AP, Bernstein PS, Tobin JN. Exploring preconception care: insurance status, race/ethnicity, and health in the pre-pregnancy period. Maternal and child health journal. 2018;22(8):1103-10.
16. 16. Hosli E, Elsinga J, Buitendijk S, Assendelft W, Van der Pal-de Bruin K. Women’s motives for not participating in preconception counseling: qualitative study. Public Health Genomics. 2008;11(3):166-70
17. 17. Ding Y, Li XT, Xie F, Yang YL. Survey on the Implementation of Preconception Care in S hanghai, C hina. Paediatric and perinatal epidemiology. 2015;29(6):492-500
18. 18. Kramer MS, Séguin L, Lydon J, Goulet L. Socio‐economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatric and perinatal epidemiology. 2000;14(3):194-210.
19. 19. United Nations. Sustainable development goals report 2016: UN; 2016.
20. 20. Shadab P, Nekuei N, Yadegarfar G. The prevalence of preconception care, its relation with recipients' individuality, fertility, and the causes of lack of checkup in women who gave birth in Isfahan hospitals in 2016. J Educ Health Promot. 2017;6:88:1-5.
21. 21. Forster DA, Wills G, Denning A, Bolger M. The use of folic acid and other vitamins before and during pregnancy in a group of women in Melbourne, Australia. Midwifery. 2009;25(2):134-46.
22. 22. Poels M, van Stel HF, Franx A, Koster MP. Actively preparing for pregnancy is associated with healthier lifestyle of women during the preconception period. Midwifery. 2017;50:228-34
23. 23. Kurzawińska G, Magiełda J, Romała A, Bartkowiak-Wieczorek J, Barlik M, Drews K, et al. Demographic factors determining folic acid supplementation in pregnant and childbearing age women. Ginekologia polska. 2018;89(4):212-7.
24. 24. Ray JG, Singh G, Burrows RF. Evidence for suboptimal use of periconceptional folic acid supplements globally. BJOG: An International Journal of Obstetrics & Gynaecology. 2004;111(5):399-408.
25. 25. Cogswell ME, Scanlon KS, Fein SB, Schieve LA. Medically advised, mother’s personal target, and actual weight gain during pregnancy. Obstetrics & Gynecology. 1999;94(4):616-22.
26. 26. McDonald SD, Pullenayegum E, Taylor VH, Lutsiv O, Bracken K, Good C, et al. Despite 2009 guidelines, few women report being counseled correctly about weight gain during pregnancy. American journal of obstetrics and gynecology. 2011;205(4):333. e1-. e6.
27. 27. Stengel MR, Kraschnewski JL, Hwang SW, Kjerulff KH, Chuang CH. “What my doctor didn't tell me”: Examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Women's Health Issues. 2012;22(6):e535-e40.
28. 28. Bradley F, Smith M, Long J, O'Dowd T. Reported frequency of domestic violence: cross sectional survey of women attending general practice. Bmj. 2002;324(7332):271.
29. 29. Marais A, De Villiers P, Möller A, Stein DJ. Domestic violence in patients visiting general practitioners--prevalence, phenomenology, and association with psychopathology. South African medical journal= Suid-Afrikaanse tydskrif vir geneeskunde. 1999;89(6):635-
30. 30. Hamberger LK, Saunders DG, Hovey M. Prevalence of domestic violence in community practice and rate of physician inquiry. Family medicine. 1992;24(4):283-7.
31. 31. Shawe J, Patel D, Joy M, Howden B, Barrett G, Stephenson J. Preparation for fatherhood: a survey of men’s preconception health knowledge and behaviour in England. PLoS One. 2019;14(3):e0213897.