Gebelikte Bulantı-Kusma Şiddeti ile Aktivite Denge Arasındaki İlişki

Yıl 2022, Cilt: 4 Sayı: 2, 148 - 54, 01.05.2022

Deniz Uğur Cengiz Zeliha Özşahin

https://doi.org/10.37990/medr.1020903

Öz

Amaç: Erken gebelik döneminde görülen bulantı kusma ilk trimesterdeki gebe kadınların hastanede yatmalarının en yaygın nedenleri arasındadır. Bu araştırmanın amacı, gebelikte bulantı-kusma şiddetinin aktiviteye özgü denge güven arasındaki ilişkiyi belirlemektir.
Materyal ve Metot: Araştırma kesitsel olarak bir kamu üniversitesine bağlı gebe eğitim sınıfında yürütülmüştür. Örneklem büyüklüğü etki büyüklüğü hesaplamasına göre 208 gebe olarak hesaplanmış olup 216 gebe ile çalışma tamamlanmıştır. Verilerin toplanmasında; “Kişisel Tanıtım Formu”, “PUQE Testi (Pregnancy- Unique Quantification of Emesis and nausea) “Aktiviteye Özgü Denge Güven Ölçeği” kullanılmıştır. İstatistiksel değerlendirmede; aritmetik ortalama, yüzdelik dağılım, standart sapma, pearson korelasyon, linear regresyon analizi, güvenirlik analizi için Cronbach Alfa (α), Geçerlilik analizinde CR (Composite Reliability) ve AVE (Average Variance Extracted) kullanılmıştır.
Bulgular: APUQE testi toplam puan ortalamasının 6.28 ±2.60 olduğu, gebelerin %62.04’ünün hafif, %37.96’sının orta düzeyde bulantı-kusma yaşadığı, ağır düzeyde ise gebelerin hiçbirinin bulantı-kusma yaşamadığı belirlendi. ASBCS puan ortalamasının ise 53.56 ± 26.37 olduğu belirlendi. PUQE testi sınıflandırılmasına göre ASBCS toplam puan ortalamasının istatiksel açıdan farklılık gösterdiği ve bulantı kusma şiddeti orta düzeyde olan gebelerin hafif düzeyde olan gebelere göre daha fazla aktiviteye özgü denge güvenlerinin daha az olduğu belirlendi (p<0.05). PUQE testi puan ortalaması ile aktiviteye özgü denge güven arasında negatif yönde yüksek düzeyde önemli ilişki (r=-0.760; p<0.05) ve linear regresyon analizi sonucunda bulantı kusma şiddetinin aktiviteye özgü denge güveni etkilediği saptandı.
Sonuç: Sonuç olarak bulantı kusma şiddetinin aktiviteye özgü denge güveni etkilediği ve bulantı kusma şiddeti arttıkça aktiviteye özgü denge güvenin azaldığı söylenebilir. Sağlık çalışanları fiziksel aktivite yetersizliğinin olumsuz sonuçlarını göz önünde bulundurarak bakım planını oluşturmalıdır.

Anahtar Kelimeler

Bulantı kusma, gebelik, aktiviteye özgü denge güven

Teşekkür

Katılımcı gebelere teşekkür ederiz.

The Relationship between Nausea-Vomiting Severity and Activity Balance in Pregnancy

Öz

Aim: Nausea and vomiting seen in early pregnancy are among the most common reasons for hospitalization of pregnant women in the first trimester. The aim of this study is to determine the relationship between the severity of nausea-vomiting during pregnancy and activity-specific balance-confidence.
Material and method: The study was conducted cross-sectionally in a pregnant education class of a public university between June and September 2021. The sample size was calculated as 208 pregnant women according to the effect size calculation and the study was completed with 216 pregnant women. In the collection of data; “Personal Presentation Form”, “PUQE Test (Pregnancy- Unique Quantification of Emesis and nausea) “Activity-Specific Balance Confidence Scale” was used. In statistical evaluation; Arithmetic mean, percentile distribution, standard deviation, pearson correlation, linear regression analysis, Cronbach Alpha (α) for reliability analysis, CR (Composite Reliability) and AVE (Average Variance Extracted) were used for validity analysis.
Results: It was determined that the mean PUQE test total score was 6.28±2.60, 62.04% of the pregnant women experienced mild nausea-vomiting, 37.96% of them had moderate nausea-vomiting, and none of the pregnant women had severe nausea-vomiting. The mean ASBCS score was found to be 53.56±26.37. It was determined that the mean ASBCS total score differed statistically according to the PUQE test classification, and the pregnants with moderate nausea and vomiting severity had more activity-specific balance confidence than mild pregnant women (p<0.05). It was determined that there was a highly significant negative correlation (r=-0.760; p<0.05) between the PUQE test mean score and activity-specific balance confidence, and the severity of nausea and vomiting affected activity-specific balance confidence as a result of linear regression analysis.
Conclusion: As a result, it can be said that the severity of nausea and vomiting affects activity-specific balance confidence and as the severity of nausea and vomiting increases, activity-specific balance confidence decreases. Health workers should create a care plan by considering the negative consequences of physical activity insufficiency.

Anahtar Kelimeler

Nausea, vomiting, pregnancy, activity-specific balance confidence

Kaynakça

• Alpar C. Spor Sağlık Ve Eğitim Bilimlerinden Örneklerle Uygulamali İstatistik Ve Geçerlik Güvenirlik (2016).
• Amezcua-Prieto C, et al. Changes in leisure time physical activity during pregnancy compared to the prior year. Maternal And Child Health Journal. 2013; 17(4): 632-638.
• Ay Ç.K. and Y.A. Derya. The relationship between birth fear and psychosocial health level of nausea-vomiting severity in pregnancy: an example from turkey." Current Psychology. 2021; 1-11.
• Ayhan Ç, et al. Aktiviteye Özgü Denge Güven Ölçeğinin Türkçe Versiyonu: Yaşli Bireylerde Kültürel Adaptasyon, Güvenirlik Ve Geçerlik Çalişmasi.
• Bai G, et al. Associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy: The Generation R Study. Plos One. 2016; 11(11): E0166133.
• Bhavana G, et al. Assessment of otolith function using vestibular evoked myogenic potential in women during pregnancy. Brazilian Journal Of Otorhinolaryngology. 2020;
• Black F.O. Maternal susceptibility to nausea and vomiting of pregnancy: Is The Vestibular System Involved?" American Journal Of Obstetrics And Gynecology. 2010; 186(5): S204-S209.
• Chan R.L, et al. Maternal Influences On Nausea And Vomiting In Early Pregnancy. Maternal And Child Health Journal. 2011; 15(1): 122-127.
• Chortatos A, et al. Pregnancy Complications And Birth Outcomes Among Women Experiencing Nausea Only Or Nausea And Vomiting During Pregnancy In The Norwegian Mother And Child Cohort Study. Bmc Pregnancy And Childbirth. 2015; 15(1): 1-11.
• Clark S, et al. The impact of nausea and vomiting of pregnancy on quality of life: report of a national consumer survey and recommendations for improving care. Obstetrical & Gynecological Survey. 2013; 68(9): S1-S10.
• Currie S, et al. Reducing the decline in physical activity during pregnancy: a systematic review of behaviour change interventions. Plos One. 2013; 8(6): E66385.
• Çırak Y, et al. Pregnancy physical activity questionnaire (ppaq): reliability and validity of turkish version. Journal Of Physical Therapy Science. 2015; 27(12): 3703-3709.
• Da Silva Schmidt, P.M, et al. Hearing And Vestibular Complaints During Pregnancy. Brazilian Journal Of Otorhinolaryngology. 2010; 76(1): 29-33.
• Davies G.A, et al. Joint sogc/csep clinical practice guideline: exercise in pregnancy and the postpartum period. Canadian Journal Of Applied Physiology. 2003; 28(3): 329-341.
• Derya YA, et al. Gebelikteki Yakınmaların Yaşam Kalitesine Etkisi Ile Psikososyal Sağlık Düzeyi Arasındaki İlişkinin İncelenmesi. Turkish Journal Of Family Medicine And Primary Care. 2018; 12(3): 171-177.
• Dipietro L, et al. Benefits of physical activity during pregnancy and postpartum: an umbrella review." Medicine And Science In Sports And Exercise. 2019; 51(6): 1292.
• Einarson T.R, et al. Quantifying The Global Rates Of Nausea And Vomiting Of Pregnancy: A Meta-Analysis. Journal Of Population Therapeutics And Clinical Pharmacology. 2013; 20(2).
• Gaston A. and A. Cramp. "Exercise during pregnancy: a review of patterns and determinants." Journal Of Science And Medicine In Sport. 2011; 14(4): 299-305.
• Heitmann K, et al. The Burden Of Nausea And Vomiting During Pregnancy: Severe Impacts On Quality Of Life, Daily Life Functioning And Willingness To Become Pregnant Again–Results From A Cross-Sectional Study. Bmc Pregnancy And Childbirth. 2017; 17(1): 1-12.
• Hinkle S.N, et al. Association of nausea and vomiting during pregnancy with pregnancy loss: A Secondary Analysis Of A Randomized Clinical Trial. Jama Internal Medicine. 2016; 176(11): 1621-1627.
• Jafari-Dehkordi E, et al. Comparison of quince with vitamin b6 for treatment of nausea and vomiting in pregnancy: A Randomised Clinical Trial." Journal Of Obstetrics And Gynaecology. 2017; 37(8): 1048-1052.
• Jebali F, et al. A Rare complication of vomiting in pregnancy: Wernicke Encephalopathy. Revue Neurologique. 2017; 173(10): 663-666.
• Kaplan T, et al. Yaşlı Bireylerde ayakkabı uygunluğunun düşme korkusuna olan etkisinin araştırılması." Journal Of Exercise Therapy And Rehabilitation. 2018; 5(3): 167-172.
• Khan T, et al. Physical activity and the risk for gestational diabetes mellitus amongst pregnant women living in Soweto: A Study Protocol. Bmc Women's Health. 2016; 16(1): 1-6.
• Kiratli D. and T. Yavan. Gebelikte bulantı kusma yaşama durumu, etkileyen faktörler ve baş etme yöntemlerinin belirlenmesi. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2021; 6(2): 21-29.
• Kizilirmak A. and S. Timur. Gebelerin bulantı kusma ile baş etme yöntemleri. Florence Nightingale Journal Of Nursing. 2011; 19(3): 129-134. Ko Y.-L, et al. Physical Activities During Pregnancy And Type Of Delivery In Nulliparae. European Journal Of Sport Science. 2016; 16(3): 374-380.
• Koren G, et al. Motherisk—PUQE (Pregnancy-Unique Quantification Of Emesis And Nausea Scoring System For Nausea And Vomiting Of Pregnancy. American Journal Of Obstetrics And Gynecology. 2002; 186(5): S228-S231.
• Kramer J, et al. Nausea and vomiting of pregnancy: prevalence, severity and relation to psychosocial health. Mcn: The American Journal Of Maternal/Child Nursing. 2013; 38(1): 21-27.
• Kumar R, et al. Ear, nose, and throat manifestations during pregnancy. Otolaryngology--Head And Neck Surgery. 2001;145(2): 188-198.
• Lacasse A. and A. Bérard. Validation of the nausea and vomiting of pregnancy specific health related quality of life questionnaire. Health And Quality Of Life Outcomes. 2008; 6(1): 1-6.
• Lacasse A, et al. Epidemiology of nausea and vomiting of pregnancy: prevalence, severity, determinants, and the importance of race/ethnicity. Bmc Pregnancy And Childbirth. 2009; 9(1): 1-9.
• Laitinen L, et al. Nausea and vomiting of pregnancy: associations with personal history of nausea and affected relatives. Archives Of Gynecology And Obstetrics. 2020; 302(4): 947-955. Locock L, et al. (2008). Women's Responses To Nausea And Vomiting In Pregnancy. Midwifery. 2008; 24(2): 143-152.
• Mazzotta P, et al. Attitudes, management and consequences of nausea and vomiting of pregnancy in the united states and Canada." International Journal Of Gynecology & Obstetrics. 2000;70(3): 359-365.
• Mete S, et al. "Gebelikte bulantı-kusması olan hastaların hastaneye yatış endikasyonlarının değerlendirilmesinde PUQE (Pregnancy-Unique Quantification Of Emesis And Nausea) testinin yeri." Journal Of Clinical Obstetrics & Gynecology. 2009; 19(6): 317-321.
• O'brien B. and S. Naber. Nausea and vomiting during pregnancy: Effects On the quality of women's lives. Birth. 1992;19(3): 138-143.
• Özdemir Ö.Ç, et al. Gebelerde fiziksel aktivite ve yaşam kalitesi arasındaki ilişki. Anadolu Kliniği Tıp Bilimleri Dergisi. 2017; 22(2): 95-102.
• Pearce EE, et al. Strategies To Promote Physical Activity During Pregnancy. American Journal Of Lifestyle Medicine. 2013; 7(1): 38-50.
• Poyatos‐León R, et al. Effects of exercise during pregnancy on mode of delivery: A Meta‐Analysis. Acta Obstetricia Et Gynecologica Scandinavica. 2015; 94(10): 1039-1047.
• Tosun Ö.Ç. and RE. Okyay. Gebelik Sürecinde Fiziksel Aktivite Değişimlerinin İncelenmesi. Sağlık Bilimleri ve Meslekleri Dergisi. 2018; 5(3): 333-341.
• Wang H, et al. Severe Nausea And Vomiting In Pregnancy: Psychiatric And Cognitive Problems And Brain Structure In Children. Bmc Medicine. 2020; 18(1): 1-14.
• Zhang H, et Al. Risk Factors Of Prolonged Nausea And Vomiting During Pregnancy. Risk Management And Healthcare Policy. 2020; 13: 2645.