COVID-19 Pandemi Sürecinde Ebelik Öğrencilerinde Progresif Gevşeme Egzersizleri ve Akran Desteğinin Kaygı ve Uyku Düzeyine Etkisi: Randomize Kontrollü Çalışma

Öz

Amaç: COVID-19 pandemi sürecinde ebelik öğrencilerinde progresif gevşeme egzersizlerinin ve akran desteği programının kaygı ve uyku düzeyleri üzerine etkisini belirlemektir. Gereç ve Yöntem: Randomize kontrollü bir müdahale çalışmasıdır. Çalışmaya ebelik bölümü öğrencileri (n=360) dâhil edildi. Dâhil edilme kriterlerine uyan 104 öğrenci, progresif gevşeme egzersizi (PGE) grubu (n=35), akran destek programı (ADP) grubu (n=34) ve kontrol grubu (n=35) olmak üzere 3 gruba ayrıldı. PGE grubuna online gevşeme egzersiz programı verildi. ADP grubuna çevrimiçi bir akran destek programı verildi. Veri toplama araçları olarak; sosyo-demografik bilgileri içeren tanıtıcı bilgi formu, Spielberger’in Durumluk ve Sürekli Kaygı Envanteri (STAI-I-II) ve Pittsburgh Uyku Kalitesi İndeksi (PUKİ) kullanıldı. Bulgular: Gruplar belirtilen özellikler açısından bağımsız ve homojen idi. Gruplara göre ön test STAI-I ve PUKİ puanları açısından istatistiksel olarak anlamlı farklılık yoktu (p>0,05). PGE ve ADP gruplarının son test STAI-I ve PUKİ puanları, kontrol grubuna göre anlamlı düzeyde daha düşük tespit edildi (sırasıyla, F=9,749; P=0,000; χ2=15,382; P=0,000). Sonuç: PGE ve ADP ebelik öğrencilerinin COVID-19 pandemisi sırasında uyku kalitesini ve kaygı düzeylerini iyileştirmede etkili yöntemlerdir.

Anahtar Kelimeler

• COVID-19
• Ebelik öğrencileri
• Kaygı
• Progresif gevşeme egzersizi
• Uyku
• Akran desteği

Effects of Peer Support and Progressive Relaxation Exercises on Sleep Quality and Anxiety in Midwifery Students during COVID-19 Pandemic: A Randomized Controlled Trial

Öz

Aim: This study aims to determine the effect of progressive relaxation exercises and peer support program on anxiety and sleep levels in midwifery students during the COVID-19 pandemic. Material and Method: This is a randomized controlled interventional study. The study consisted of midwifery students (n=360). One hundred and four students who met the inclusion criteria were divided into three groups: the progressive relaxation exercise group (PRE) (n=35), the peer support program group (PSP) (n=34), and the control group (n=35). The PRE and PSP groups were provided with online support for 30 minutes a day for 30 days. In addition, the PSP group was given 24/7support by peer trainers on necessary issues by sharing their contact information. Data were collected at the beginning and end of the study. The data collection tools included a descriptive data form with questions about socio-demographic characteristics, the Spielberger State-Trait Anxiety Inventory (STAI-I-II), and the Pittsburgh Sleep Quality Index (PSQI). Results: The groups were independent and homogeneous in terms of the specified characteristics. There was no statistically significant difference between the groups in terms of the scores from the pretest administration of the STAI-I and PSQI (p>0,05). The scores of the PRE and PSP groups from the posttest administration of the STAI-I and PUKI were found to be significantly lower than those of the control group (F=9,749; P=0,000; χ2=15,382; P=0,000, respectively). Conclusion: PRE and PSP are effective methods for improving midwifery students’ sleep quality and anxiety levels during the COVID-19 pandemic.

Anahtar Kelimeler

• COVID-19
• Midwifery students
• Anxiety
• Progressive Relaxation exercise
• Sleep
• Peer support

Kaynakça

1. Ağargün, M.Y, Kara, H., & Anlar, O. (1996). Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi, 7(2), 107-115.
2. Bastani, F., Hidarnia, A., Kazemnejad, A., Vafaei, M., & Kashanian, M. (2005). A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. Journal of midwifery & women's health, 50(4), e36-e40. https://doi.org/10.1016/j.jmwh.2004.11.008
3. Bostani, S., Rambod, M., Irani, P.S., & Torabizadeh, C. (2020). Comparing the effect of progressive muscle relaxation exercise and support group therapy on the happiness of nursing students: a randomized clinical trial study. International Journal of Africa Nursing Sciences, 13, 100218. https://doi.org/10.1016/j.ijans.2020.100218
4. Buysse, D., Reynolds, C., Monk, T., Berman, S.R., & Kupfer, D.J. (1989). The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4
5. Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 2020. https://doi.org/10.1016/j.psychres.2020.112934.
6. Desouzart, G., Filgueiras, E., & Matos, R. (2015). Relationship between postural reeducation technique during sleep and relaxation technique in sleep quality. Procedia Manufacturing, 3, 6093-6100. https://doi.org/10.1016/j.promfg.2015.07.756
7. Doğan, N. (2021). Peer supports and problem solving skills of nursing and midwifery students. Yükseköğretim ve Bilim Dergisi, 11(1), 150-161. DOI: 10.5961/jhes.2021.437
8. Doğu-Kökçü, Ö. (2020). Hemşirelik ve ebelik 1. sınıf öğrencilerinin öğrenme stillerinin akran desteği ile ilişkisi. Journal of Human Rhythm, 6(4), 147-160. https://dergipark.org.tr/en/down load/article-file/1279173

9. Gao, R., Lv, Y., Li, X., Zhou, K., Jin, X., Dang. S.,. … Li, N. (2014). Effects of comprehensive sleep management on sleep quality in university students in mainland China. Sleep Biol. Rhythms, 12, 194–202. https://doi.org/10.1111/sbr.12063
10. Gangadharan, M.P., & Madani, M. A. (2018). Effectiveness of progressive muscle relaxation techniques on depression, anxiety and stress among undergraduate nursing students. Int J Health Sci Res, 8(2),155-163.
11. Genç-Kumtepe, E., Toprak, E., Öztürk, A., Tuna-Büyükköse, G., Kılınç, H., & Aydın-Menderis, İ. (2019). Açık ve uzaktan öğrenmede destek hizmetleri: Yerelden küresele bir model önerisi. Açıköğretim Uygulamaları ve Araştırmaları Dergisi, 5(3), 41-80.
12. Hogan, R., Fox, D., & Barratt-See, G. (2017) Peer to peer mentoring: Outcomes of third-year midwifery students mentoring first-year students. Women and Birth, 30(3), 206-213. https://doi.org/10.1016/j.wombi.2017.03.004.
13. Horgan, A., Sweeney, J., Behan, L. & McCarthy, G. (2016). Depressive symptoms, college adjustment and peer support among undergraduate nursing and midwifery students. Journal of Advanced Nursing, 72(12), 3081– 3092. doi: 10.1111/jan.13074
14. Jacobson, E. Progressive relaxation. (1938). The American Journal of the Medical Sciences. 196(5), 732.
15. Korkut, S., Ulker, T., Çidem, A., & Sahin, S. (2021).The effect of progressive muscle relaxation and nature sounds on blood pressure measurement skills, anxiety levels, and vital signs in nursing students. Perspectives in Psychiatric Care, 57, 1782-1790.
16. Kosmadakis, G.C., & Medcalf, J.F. (2008). Sleep disorders in dialysis patients. The International journal of artificial organs, 31(11), 919-927. https://doi.org/10.1177/039139880 803101101
17. Li, Y., Qin Q., Sun, Q., Sanford, L.D., Vgontzas, A.N., & Tang, X. (2020). Insomnia and psychological reactions during the COVID-19 outbreak in China. Journal of Clinical Sleep Medicine, 16(8). https://doi.org/10.5664/jcsm.8524
18. Liu, K., Chen, Y., Wu, D., & Lin, R. (2020). Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complementary Therapies in Clinical Practice, 39:101132 https://doi.org/10.1016/j.ctcp.2020.101132
19. McLoughlin, C. (2002). Learner support in distance and networked learning environments: Ten dimensions for successful design. Distance Education, 23(2), 149-162. https://doi.org/10.1080/0158791022000009178
20. Merakou, K., Tsoukas, K., Stavrinos, G., Amanaki, E., Daleziou, A., Kourmousi, N., ... & Barbouni, A. (2019). The effect of progressive muscle relaxation on emotional competence: Depression–anxiety–stress, sense of coherence, health-related quality of life, and well-being of unemployed people in Greece: An intervention study. Explore, 15(1), 38-46. https://doi.org/10.1016/j.explore.2018.08.001
21. Marques, D.R., Gomes, A.A., & Gellis, L.A. (2019). Insomnia in college students: specificities regarding psychological treatment. sleep and hypnosis: A Journal of Clinical Neuroscience and Psychopathology, 21(3):175-187http://dx.doi.org/10.5350/Sleep. Hypn. 201 9.21.0186
22. Mazer, J.P., & Thompson, B. (2011). The validity of the student academic support scale: Associations with social support and relational closeness. Communication Reports, 24(2), 74-85. https://doi.org/10.1080/08934215.2011.622237
23. Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical perspective. Psychiatric Rehabilitation Journal, 25(2), 134-141. https://doi.org/10.1037/h0095032 44
24. Nyamute, L., Mathai, M., & Mbwayo, A. (2021). Quality of sleep and burnout among undergraduate medical students at the university of Nairobi, Kenya. BJPsych Open, 7(S1), S279-S279. http://erepository.uonbi.ac.ke/handle/11295/108163
25. Onieva-Zafra, M.D., Fernández-Muñoz, J.J., Fernández-Martínez, E., García-Sánchez, F.J., Abreu-Sánchez, A., & Parra-Fernández, M.L. (2020). Anxiety, perceived stress and coping strategies in nursing students: a cross-sectional, correlational, descriptive study. BMC Medical Education, 20(1), 1-9. https://doi.org/10.1186/s12909-020-02294-z
26. Öner, N. & Le Compte, A. (1985). Süreksiz Durumluk / Sürekli Kaygı Envanteri El Kitabı (2. Baskı). İstanbul: Boğaziçi Üniversitesi Yayınları.
27. Passos, G.S., Poyares, D., Santana, M.G., D’Aurea, C.V.R., Youngstedt SD, Tufik S, & de Mello MT. (2011). Effects of moderate aerobic exercise training on chronic primary insomnia. Sleep medicine, 12(10): 1018-1027. DOI: 10.1016/j.sleep.2011.02.007
28. Rambod, M., Pourali-Mohammadi, N., Pasyar, N., Rafii, F., & Sharif, F. (2013). The effect of Benson's relaxation technique on the quality of sleep of Iranian hemodialysis patients: a randomized trial. Complementary therapies in medicine, 21(6), 577-584. https://doi.org/10.1016/j.ctim.2013.08.009
29. Siengsukon, C.F., Al-dughmi,M., & Stevens, S. (2017). Sleep health promotion: practical ınformation for physical therapists, Physical Therapy, 97(8): 826–836
30. Spielberger, C.D. (2010). State-Trait Anxiety Inventory. In I.B. Weiner & W.E. Craighead (Eds.), The Corsini Encyclopedia of Psychology. John Wiley & Sons, Inc. https://doi.org/10.1002/9780470479216.corpsy0943
31. Tambağ, H. (2020). Examination of nursing students' anxiety levels related to clinical practice with respect to peer support. Perspectives in Psychiatric Care. 57(3):1114-1119 DOI: 10.1111/ppc.12664
32. Tasnim, S., Rahman, M., Pawar, P., Chi, X., Yu, Q., Zou, L., ... & Hossain, M. M. (2020). Epidemiology of sleep disorders during COVID-19 pandemic: A systematic scoping review. MedRxiv. doi: https://doi.org/10.1101/2020.10.08.20209148
33. Torabizadeh, C., Bostani, S., & Yektatalab, S. (2016). Comparison between the effects of muscle relaxation and support groups on the anxiety of nursing students: a randomized controlled trial. Complementary Therapies in Clinical Practice, 25, 106-113. doi: 10.1016/j.ctcp.2016.09.001.
34. Tuncer, A., Enzin, F., Felek-Eri S.G., Dinler, E., Pelin Z., & Bayramlar, K. (2020). Uyku bozukluklarında egzersiz tedavisinin önemi. Zeugma Sağlık Araştırmaları Dergisi, 2(2):89-97.
35. Whiteman, S D., Barry, A.E., Mroczek, D.K., & MacDermid Wadsworth, S. (2013). The development and implications of peer emotional support for student service members/veterans and civilian college students. Journal of Counseling Psychology, 60(2), 265. https://doi.org/10.1037/a0031650
36. Viner R.M., Russell, S.J., Croker, H., Packer, J., Ward, J., Stansfield C., … & Booy, R. (2020). School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. The Lancet Child & Adolescent Health, 4(5), 397-404. http://doi.org/10.1016/S2352-4642(20)30095-X