The Effect of Web Based Education on the Level of Self-Confidence and Anxiety in Care of Parents of Premature Infants

Öz

Background: In discharge training for the parents of premature newborns, the internet can be used as an alternative method. Objectives: To assess the effect of web-based education given to the parents of premature newborns on self-confidence and anxiety level towards attachment. Methods: The study was carried out semi-experimentally in the order of pretest- posttest control group in order to assess the efficiency of web-based education which has been applied to parents of premature infants to concern level and confidence level for their baby care ability. One hundred seventy-two parents of one hundred forty premature infants were taken to study, 87 of whom were to the intervention group and 85 of whom to control group which were determined through randomization method. Data of the study were collected via a question inquiry form of identifier of parents and newborn, rating form of posttest, Pharis Self-confidence Scale and Beck Anxiety Inventory. Consultation programme, given to parents of infants in the intervention group, relating to traits of premature infants, infants’s life at house, relation of parent-infant, premature newborn care, observation after discharge from hospital, common desease problems and for 3 weeks education about the cases of emergency, conducted through http://kuvozdehayatvar.com website. parents, in the control group, after being concluded of gathering data process, permitted to benefit from the website. Parents, in the control group, after being concluded of gathering their data process, permitted to benefit from the website. Education's efficiency, in research, assessed by comparing the control groups and intervention groups, and Pharis Self-confidence Scale, Beck Anxiety Inventory of both pretest and posttest. Results: Before the training it was determined that Pharis Self-confidence Scale score medians in the study group (intervention: 39,00 ± 20,0; control: 45,36 ± 12,28; p = 0,000) were lower than those of the parents in control group and this difference was statically significant. After the training, it was determined that Pharis Self-confidence Scale score medians in the study group (intervention: 55,78 ± 8,44; control: 45,91 ± 11,62) were higher than those of the parents in control group and this difference was statically significant. 102 In the study group was determined that Beck Anxiety Inventory score medians (intervention: 28,35 ± 11,81; control: 23,11 ± 11,39) were higher than those of the parents in control group and this difference was statically significant. After the training, it was determined that Beck Anxiety Inventory score medians in the study group (intervention: 12,05 ± 5,76; control: 20,55 ± 7,60) were lower than those of the parents in control group and this difference was statically significant. In the light of the research results, “while web-based education which has been applied to parents of premature infants succeeded in decreasing the level of anxiety, increased the self-confidence for newborn-care. Conclusion: Web-based education has led to the conclusion that parents of premature newborns are effective in increasing self-confidence in infant care and reducing their anxiety levels.

Anahtar Kelimeler

• Premature,Web Based Education,Self - confidence,Anxiety,Midwifery

Web Tabanlı Eğitimin Prematüre Yenidoğanların Ebeveynlerinin Bakımdaki Özgüven ve Kaygı Düzeylerine Etkisi

Öz

Giriş: Prematüre yenidoğanların ebeveynlerine yönelik verilecek olan taburculuk eğitiminde, internet alternatif bir yöntem olarak kullanılabilir. Amaç: Prematüre yenidoğanların ebeveynlerine verilen web tabanlı eğitimin bakıma yönelik özgüven ve kaygı düzeylerine etkisini değerlendirmektir. Yöntem: Araştırma ön test- son test kontrol gruplu düzende yarı-deneysel randomize kontrollü bir çalışma olup, http://kuvozdehayatvar.com isimli web sitesi üzerinden gerçekleştirilmiştir. Çalışma grubundaki ebeveynlere 3 haftalık planlı eğitim ve danışmanlık programı bu web sayfası üzerinden yürütülmüştür. Kontrol grubundaki ebeveynlerin taburculuk eğitimine müdahale edilmemiş, standart hastane taburculuk protokolü uygulanmıştır. Araştırma verileri tanıtıcı bilgi formu, son test değerlendirme formu, Pharis Özgüven Ölçeği (PÖÖ) ve Beck Anksiyete Ölçeği (BAÖ) ile toplanmıştır. Eğitimin etkinliği ön test ve son test ölçek puanları karşılaştırılarak değerlendirilmiştir. Bulgular: Çalışma grubundaki ebeveynlerin ön-test PÖÖ puan ortalamaları kontrol grubundakilere göre daha düşük (U = 2479.00, p < .05), son-testte ise çalışma grubundakilerin PÖÖ puan ortalamaları kontrol grubundakilere göre daha yüksek olduğu (t = 6.39, p < .05) saptanmıştır. Çalışma grubu ön-test BAÖ puan ortalamaları kontrol grubundakilere göre daha yüksek (t = 2.96, p < .05), son-testte ise çalışma grubundakilerin BAÖ puan ortalamaları kontrol grubundakilere göre daha düşük olduğu (t = -8.29, p < .05) belirlenmiştir. Sonuç: Web tabanlı eğitimin prematüre yenidoğanların ebeveynlerinin bebek bakımına yönelik özgüveni artırma ve kaygı düzeylerini azaltmada etkili olduğu sonucuna varılmıştır.

Anahtar Kelimeler

• Prematüre,Web Eğitimi,Özgüven,Kaygı,Ebelik

Kaynakça

1. 1. World Health Organization (WHO). (2018). Pretem Birth. URL: http://www.who.int/news-room/fact-sheets/detail/preterm-birth. 10 Mart 2019.
2. 2. Ghartey K, Coletta J, Lizarraga L, Murphy E, Ananth CV, Gyamfi-Bannerman C. Neonatal respiratory morbidity in the early term delivery. AJOG 2012;207(4):292-e1.
3. 3. Liu L. Oza S. Hogan D, Chu Y, Perin J, Zhu J et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. The Lancet 2016;388(10063):3027-3035.
4. 4. Erdeve Ö. Aile merkezli bakım ve yenidoğan yoğun bakım ünitesi tasarımında ailenin yeri. Gülhane Tıp Dergisi 2009; 51:199-203.
5. 5. Montirosso R, Fedeli C, Del Prete A, Calciolari G, Borgatti R, NEO-ACQUA study Group. Maternal stress and depressive symptoms associated with quality of developmental care in 25 Italian Neonatal Intensive Care Units: A cross sectional observational study. IJNS 2014;51(7):994-1002.
6. 6. Schappin R, Wijnroks L, Uniken Venema M, Jongmans MJ. Rethinking stress in parents of preterm infants: a meta-analysis. PloS One 2013;8(2):54992.
7. 7. Brandon DH, Tully KP, Silva SG, Malcolm WF, Murtha AP, Turner BS et al. Emotional responses of mothers of late-preterm and term infants. JOGNN 2011;40(6):719-731.
8. 8. Fegran L, Helseth S, Fagermoen M. A comparison of mothers’ and fathers’ experiences of the attachment process in a neonatal intensive care unit. JCN 2008;17(6):810-816.

9. 9. Candelori C, Trumello C, Babore A, Keren M, Romanelli R. The experience of premature birth for fathers: the application of the Clinical Interview for Parents of High-Risk Infants (CLIP) to an Italian sample. Frontiers in Psychology 2015; 6:1444.
10. 10. McManus BM, Poehlmann J. Maternal depression and perceived social support as predictors of cognitive function trajectories during the first 3 years of life for preterm infants in Wisconsin. Child Care Health Dev 2012;38(3):425-434.
11. 11. Arslan FT, Turgut R. Prematüre bebek annelerinin evdeki bakım gereksinimleri ve bakım verme yeterliliklerini algılama durumları. DEUHFED 2013;6(3):119-124.
12. 12. Balcı S. Bebek ve annenin taburculuğa hazırlanması. I. Yenidoğan Yoğun Bakım Hemşireliği ve I. Çocuk Yoğun Bakım Hemşireliği Sempozyumu; 10-14 Aralık 2011; İstanbul.
13. 13. Özkan H, Polat S. Maternal identity development education on maternity role attainment and my baby perception of primiparas. Asian Nursing Research 2011;5(2):108-117.
14. 14. Gund A, Sjöqvist BA, Wigert H, Hentz E, Lindecrantz K, Bry K. A randomized controlled study about the use of e Health in the home health care of premature infants. BMC Medical Informatics and Decision Making 2013;13(1):22.
15. 15. Kuo SC, Chen YS, Lin KC, Lee TY, Hsu CH. Evaluating the effects of an Internet education programme on newborn care in Taiwan. JCN 2009; 18:1592-1601.
16. 16. Pharis M.E. Age and sex differences in expectations for infants and the parenting role among couples in a first pregnancy and among university students. Doctoral Dissertation, University of Texas at Austin 1978; Texas, Austin.
17. 17. Çalışır H. İlk Kez Anne Olan kadınların annelik rolü başarımlarını etkileyen etmenlerin incelenmesi, Doktora Tezi. Ege Üniversitesi Sağlık Bilimleri Enstitüsü 2003; İzmir, Türkiye.
18. 18. Walker LO, Crain H, Thompson E. Mothering behavior and maternal role attainment during the postpartum period. Nursing Research 1986;35(2):68-71.
19. 19. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 1988; 56:893-897.
20. 20. Ulusoy M, Şahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. Journal of Cognitive Psychotherapy 1998; 12:163-172.
21. 21. Başer, M., Mucuk, S., Korkmaz, S., & Seviğ, Ü. (2005). Postpartum dönemde anne ve babaların yenidoğan bakımına ilişkin gereksinimlerinin belirlenmesi. Journal of Health Sciences, 14, 54-58.
22. 22. Premji SS, Pana G, Currie G, Dosani A, Reilly S, Young M et al. Mother's level of confidence in caring for her late preterm infant: A mixed methods study. JCN 2018;27(5-6):e1120-e1133.
23. 23. Noergaard B, Ammentorp J, Fenger-Gron J, Kofoed PE, Johannessen H, Thibeau S. Fathers' Needs and Masculinity Dilemmas in a Neonatal Intensive Care Unit in Denmark. Advances in Neonatal Care 2017;17(4):E13.
24. 24. Lindberg B, Öhrling K. Experiences of having a prematurely born infant from the perspective of mothers in northern Sweden. IJCH 2008;67(5):461-471.
25. 25. Rogers CE, Kidokoro H, Wallendorf M, Inder TE. Identifying mothers of very preterm infants at-risk for postpartum depression and anxiety before discharge. Journal of Perinatology 2013;33(3):171.
26. 26. Segre LS, McCabe JE, Chuffo-Siewert R, O’hara MW. Depression and anxiety symptoms in mothers of newborns hospitalized on the neonatal intensive care unit. Nursing Research 2014;63(5):320.
27. 27. Jubinville J, Newburn-Cook C, Hegadoren K, Lacaze-Masmonteil T. Symptoms of acute stress disorder in mothers of premature infants. Advances in Neonatal Care 2012;12(4):246-253.
28. 28. Gomes GC, Coelho MF, Mota MS, de Souza NZ, de Oliveira PK. Experience of the father in face of child’s hospitalization in neonatal intensive care unit. J. Nurs. Socioe. Health 2015;2(1):59-65.
29. 29. Ireland J, Khashu M, Cescutti-Butler L, Van Teijlingen E, Hewitt-Taylor J. Experiences of fathers with babies admitted to neonatal care units: a review of the literature. JNC 2016;22(4):171-176.
30. 30. Raffray M, Semenic S, Osorio Galeano S, Ochoa Marín SC. Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers. Investigacion y Educacion En Enfermeria 2014;32(3):379-392.
31. 31. Lopez GL, Anderson KH, Feutchinger J. Transition of premature infants from hospital to home life. Neonatal Network: NN 2012;31(4):207.
32. 32. Osorio-Galeano SP, Ochoa-Marín SC, Semenic S. Preparing for post-discharge care of premature infants: Experiences of parents. Investigacion y Educacion En Enfermeria, 2017;35(1):100-106.
33. 33. Petty J, Whiting L, Green J, Fowler C. Parents’ views on preparation to care for extremely premature infants at home. Nursing Children and Young People 2018;30(6).
34. 34. Shieh SJ, Chen HL, Liu FC, Liou CC, Lin YIH, Tseng HI et al. The effectiveness of structured discharge education on maternal confidence, caring knowledge and growth of premature newborns. JCN 2010;19(23‐24):3307-3313.
35. 35. Galeano MD, Carvajal BV. Coping in mothers of premature newborns after hospital discharge. Newborn and Infant Nursing Rev 2016;16(3):105-109.
36. 36. Lindberg B, Axelsson K, Öhrling K. Taking care of their baby at home but with nursing staff as support: The use of videoconferencing in providing neonatal support to parents of preterm infants. JNN 2009;15(2):47-55.
37. 37. Garfield CF, Lee YS, Kim HN, Rutsohn J, Kahn JY, Mustanski B et al. Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application. Internet Interventions 2016; 4:131-137.
38. 38. Cheng YC, Chen LL, Chang YS, Li TC, Chen CJ, Huang LC. The effectiveness of learning portfolios in learning participation and learners’ perceptions of skills and confidence in the mother of preterm infant. Midwifery 2018; 62:86-91.
39. 39. Forsythe PL, Willis V. Parenting preemies: A unique program for family support and education after NICU discharge. Advances in Neonatal Care 2008;8(4):221-230.
40. 40. Khazaii T, Taheri F, Hosseini SM, Parhiz Z, Namdari S. The Effects of Preterm Infant Care Education on Stress Among the Mothers of Preterm Infants Hospitalized in Neonatal Intensive Care Units. Modern Care Journal 2018;15(1).
41. 41. Silva IOAMD, Aredes NDA, Bicalho MB, Delácio NCB, Mazzo LDL, Fonseca LMM. Booklet on premature infants as educational technology for the family: quasi-experimental study. Acta Paulista de Enfermagem 2018;31(4):334-341.
42. 42. Kim JS, Shin HS. Effects of a discharge education program using on-line community for parents of premature infants. Journal of Korean Academy of Child Health Nursing 2010;16(4):344-351.
43. 43. Lindberg B, Öhrling K. An internet-based intervention program for supporting families with prematurely born infants. Open Journal of Nursing, 2012;2(2):72.
44. 44. Feil EG, Bagget K, Davis B, Leve C, Landry SH, Sheeber LB. Who Participates in an Internet-Based Research Program for Mothers of Infants? A Secondary Prevention Research Study among Low-Income Families. Journal of Applied Research on Children 2014;5(1):4.
45. 45. Lakshmanan A, Santo E, McCormick MC, Belfort M. Parental preference and ability to participate in web-based developmental screening and surveillance: Preliminary evidence for preterm infants after NICU discharge. Clinical Pediatrics 2014;53(13):1278-1284.
46. 46. Plantin L, Daneback K. Parenthood, information and support on the internet. A literature review of research on parents and professionals online. BMC Family Practice 2009;10(1):34.
47. 47. DeLuca JM, Kearney MH, Norton SA, Arnold GL. Internet use by parents of infants with positive newborn screens. Journal of Inherited Metabolic Disease 2012;35(5):879-884.