GEBELERDE DOĞUM KORKUSUNUN BELİRLENMESİ: RANDOMİZE KONTROLLÜ ÇALIŞMALARIN SİSTEMATİK DERLEMESİ

Öz

Kadınları doğum ve anneliğe geçişe hazırlamaya odaklanan bilgilendirici ve psikolojik müdahaleler gibi nonfarmakolojik yaklaşımların doğum korkusunu azaltmada fayda sağladığı belirtilmektedir. Bu çalışmanın amacı, gebelerde doğum korkusuna yönelik müdahalelere ilişkin randomize kontrollü çalışmaların incelenmesidir. Çalışmada, Aralık 2020-Ocak 2021 tarihleri arasında “pregnant women” and “fear of childbirth” and “randomized controlled trial” anahtar kelimeleri kullanılarak, Google Scholar, PubMed, Scopus, Web of Science ve Cochrane veri tabanları tarandı ve ulaşılan makaleler değerlendirildi. Sistematik derlemeye, yayın dili Türkçe veya İngilizce olan, araştırma örneklemleri gebelerden oluşan, tam metnine ulaşılan, Ocak 2015-Aralık 2019 tarihleri arasında yayınlanan randomize kontrollü çalışmalar alındı. Çalışmadan İngilizce ve Türkçe dışındaki dillerde yazılmış olan derlemeler, sistematik derlemeler, olgu sunumları, tezler, randomize kontrollü dışındaki çalışmalar, kongre kitabında yayınlanan bildiriler, tam metnine ulaşılamayan makaleler dışlandı. Sırası ile başlık, özet ve tam metine göre yapılan inceleme neticesinde alınma kriterlerine uyan 14 makaleye ulaşıldı. Makalelerin seçiminin aşamaları ve kapsam dahilindeki ve hariç tutulan çalışmaların tüm aşamaları PRISMA akış şemasında belirtildi. Gebelerde psiko-eğitim tekniklerinin, ebe tarafından verilen bireysel danışmanlık programının, nefes alma farkındalığının, intrapartum destekleyici bakımın ve doğuma yönelik eğitim müdahalelerinin doğum korkusunu azaltmada etkili olduğu, 18 saatlik farkındalık temelli anneliğe hazırlık programının, gebe kadınlarda doğum korkusunun yanı sıra öz yeterliliği de iyileştirdiği, haptoterapi müdahalesinin doğum korkusunu azaltabilecek belirli becerilerin geliştirilmesini kolaylaştırdığı, distraksiyon tekniklerinin ardından doğum korkusunun düşük olduğu ancak farkın anlamlı olmadığı, gebelerin internet tabanlı bilişsel davranış terapi müdahalesine kıyasla yüz yüze danışmanlıktan daha memnun oldukları belirlendi. İncelenen çalışmalardan 12’sinde doğum korkusunun azaldığı belirlendi.

Anahtar Kelimeler

• Doğum
• Korku
• Gebe Kadın
• Randomize Kontrollü Çalışma

DETERMINATION OF FEAR OF CHILDBIRTH IN PREGNANT WOMEN: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED STUDIES

Öz

It is stated that non-pharmacological approaches such as informative and psychological interventions that focus on preparing women for birth and transition to motherhood are beneficial in reducing the fear of childbirth. The aim of this study is to determine randomized controlled studies on interventions for fear of childbirth in pregnant women. In the study, using the keywords "pregnant women", "fear of childbirth" and "randomized controlled trial” between December 2020 and January 2021, the databases of Google Scholar, PubMed, Scopus, Web of Science, Cochrane were searched, and the obtained articles were evaluated. Randomized controlled studies published between January 2015 and December 2019, whose publication language was Turkish or English, and whose research samples consisted of pregnant women, were included in the systematic review. Reviews, systematic reviews, case reports, dissertations, studies other than randomized controlled trials, papers published in the congress book, and articles whose full text could not be reached were excluded from the study. As a result of the examination made according to the title, abstract and full text, respectively, 14 articles that met the inclusion criteria were found. The stages of selection of articles and all stages of inclusion and exclusion of studies were outlined in the PRISMA flowchart. It was determined that psycho-education techniques, individual counseling program given by midwives, breathing awareness, intrapartum supportive care, and education interventions for birth were effective in reducing fear of childbirth, 18-hour mindfulness-based motherhood preparation program improved self-efficacy as well as reducing fear of childbirth in pregnant women, the haptotherapy intervention facilitated the development of certain skills that could reduce the fear of childbirth, the fear of childbirth was low after the distraction techniques, but the difference was not significant, and the pregnant women were more satisfied with face-to-face counseling compared to the internet-based cognitive behavioral therapy intervention. It was found that fear of childbirth decreased in 12 of the studies examined.

Anahtar Kelimeler

• Birth
• Fear
• Pregnant Women
• Randomized Controlled Trial

Kaynakça

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