Teorilerüstü modele dayalı motivasyonel bireysel danışmanlık girişiminin ve kısa mesaj gönderiminin gebelerde sigarayı bırakma davranışı üzerine etkisi
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu araştırma, ön test-son test, randomize kontrollü, yarı deneysel bir müdahale
araştırmasıdır ve Teorilerüstü Model’e dayalı motivasyonel bireysel danışmanlık
girişiminin ve değişim aşamalarına göre hazırlanmış kısa mesajların cep telefonuna
gönderiminin gebe kadınlarda sigarayı bırakma davranışı üzerine etkisini
değerlendirmek amacıyla yapılmıştır.
Araştırmanın örneklemini 01 Haziran 2018-30 Nisan 2019 tarihleri arasında Söke
Fehime Faik Kocagöz Devlet Hastanesi’nin Kadın Hastalıkları ve Doğum
Polikliniğine başvuran 60 gebe kadın oluşturmuştur. Araştırmada örnekleme alınması
gereken en az birey sayısı hesaplanmış ve effect size:0.39 olarak saptanmıştır.
Örneklem büyüklüğünün belirlenmesi için güç analizi yapılmış (Gpower 3.1.9.2 ile
effect size:0.39, alfa:0.05 power:0.90 ve df:1) ve örnekleme alınması gereken en az
birey sayısının 40 olduğu tespit edilmiştir. Araştırmada kayıp yaşama olasılığına
karşın 30 gebenin girişim grubuna, 30 gebenin kontrol grubuna alınması
planlanmıştır. Girişim grubuna ayrılan dört gebe izlemlere devam etmemiş, bir gebe
de düşük yaptığı için analiz dışı kalmıştır. Kontrol grubunda bulunan iki gebenin
adres ve telefon bilgileri değiştiği için katılımcılara ulaşılamamış, iki gebe erken
doğum, bir gebe düşük yaptığı için analiz dışı kalmıştır. Girişim grubunda 25 gebe,
kontrol grubunda 25 gebe toplam 50 gebe ile çalışma yürütülmüştür. Girişim
grubuna teori temelli motivasyonel bireysel danışmanlık girişimi uygulanmış ve cep
telefonlarına görüşmelere destek olması amacıyla haftada üç gün değişim
aşamalarına uygun olarak WhatsApp kısa mesajı gönderilmiştir. Bu araştırmanın
verilerinin analizi SPSS 21 paket programı kullanılarak yapılmıştır. Girişim grubu
gebe kadınların görüşmelerde belirlenen değişim aşamaları karşılaştırılmış ve
değişim aşamaları arasındaki farkın istatistiksel olarak anlamlı olduğu görülmüştür
(p<0.05). Doğum sonrası izlem karşılaştırmasında girişim ve kontrol grupları
arasında Fagerström Nikotin Bağımlılık Testi puan ortalamaları açısından anlamlı
farklılığın olduğu ve kontrol grubunda Fagerström Nikotin Bağımlılık Testi puan
ortalamalarındaki yüksekliğin istatistiksel olarak anlamlı olduğu tespit edilmiştir (p<0.05). Girişim grubundaki gebe kadınların son izlemde sigara içme davranış
değişimleri ile Karar Verme Dengesi Ölçeği toplam puanları arasında yüksek
dereceli, negatif ve anlamlı bir ilişki görülmüştür (r=-0.73; p<0.05). Gebe kadınların
ön izlem, son izleme göre karbonmonoksit (CO) ölçüm ortalamaları girişim
grubunda 1.9±2.1 ile anlamlı derecede düşük olduğu bulunmuştur (p<0.05). Girişim
grubundaki gebe kadınların hepsi “İkiniz İçin Bırakın” mesaj programını sigara içen
ve bırakmak isteyen arkadaşlarına tavsiye edeceklerini ve bu tip kısa mesaj programı
hizmetlerinin aile sağlığı merkezleri ve hastaneler tarafından verilmesini istediklerini
ifade etmişlerdir.
Araştırma sonuçları gebe kadınlarda sigara bırakmada Teorilerüstü Model’e dayalı
motivasyonel bireysel danışmanlık girişiminin ve değişim aşamalarına göre
hazırlanmış kısa mesajların cep telefonuna gönderiminin gebe kadınların Fagerström
Nikotin Bağımlılık Testi puanlarını ve CO düzeylerini düşürdüğü, davranış
değişiminde olumlu bir etkiye sahip olduğunu göstermektedir.
This study is a pretest-posttest designed, randomized controlled and quasiexperimental intervention research. This study was conducted to evaluate the effect of motivational individual consulting initiative based on Transtheoretical Model and sending text messages prepared according to the stages of change, on the smoking cessation behaviour of pregnant women. The sample group of the study consists of 60 pregnant women who applied to Polyclinic of Gynaecology and Obstetrics of Söke Fehime Faik Kocagöz State Hospital between the dates 01.06.2018 and 30.04.2019. Minimum number of individuals to be included in the sampling was calculated and the effect size was determined as 0.39. To determine the sample size, power analysis was carried out (Gpower 3.1.9.2 and effect size: 0.39, alpha: 0.05 power: 0.90 and df: 1) and the minimum number of individuals to be included in the sampling was determined as 40. It was planned to include 30 pregnant women in the interference group and 30 pregnant women in the control group concerning the possibility of loss. Four pregnant women in the interference group did not continue being monitored, and one pregnant woman was excluded from the analysis since she suffered a miscarriage. Due to change of the address and phone information of the two pregnant women in the control group, they could not be reached, one pregnant woman who suffered a miscarriage and two women with preterm birth were excluded from the analysis. The study was conducted on 50 pregnant women, 25 of them in the interference group and 25 of them in the control group. A theory-based motivational individual counselling initiative has been applied to the interference and WhatsApp text messages have been sent three days a week, in accordance with the stages of change to support the interviews. The data of this study was analysed using SPSS 21 package software. The stages of changes of the pregnant women in the interference group determined during the interviews were compared and it has been determined that the difference between the stages of changes was statistically significant (p<0.05). In the comparison of post-partum monitoring, it was found that there was a statistically significant difference between the interference and control groups in terms of Fagerström Test for Nicotine Dependence Average Points. The high level of Fagerström Test for Nicotine Dependence Average Points in the control group was statistically significant (p<0.05). Between the behavioural changes of the pregnant women of the interference group in the final monitoring and the decisional balance scale total points, a high level, negative and significant relationship was found (r=- 0.73; p<0.05). For the pregnant women of interference and control groups, pre monitoring’s carbon monoxide (CO) measurement averages to the final monitoring was significant low with the rate of 1.9±2.1 in the interference group (p<0.05). All pregnant women in the interference group stated that they would recommend the message campaign called ‘İkiniz İçin Bırakın’ (Quit smoking for both of you) to their friends who smoke and want to quit, and that they asked this kind of text message campaigns to be provided by family health centres and hospitals. The results of the study shows that the motivational individual consulting initiative based on Transtheoretical Model and sending text messages prepared according to the stages of changes, decreased the Fagerström Test for Nicotine Dependence Points and CO level of the pregnant women and has a positive effect on the behavioural change.
This study is a pretest-posttest designed, randomized controlled and quasiexperimental intervention research. This study was conducted to evaluate the effect of motivational individual consulting initiative based on Transtheoretical Model and sending text messages prepared according to the stages of change, on the smoking cessation behaviour of pregnant women. The sample group of the study consists of 60 pregnant women who applied to Polyclinic of Gynaecology and Obstetrics of Söke Fehime Faik Kocagöz State Hospital between the dates 01.06.2018 and 30.04.2019. Minimum number of individuals to be included in the sampling was calculated and the effect size was determined as 0.39. To determine the sample size, power analysis was carried out (Gpower 3.1.9.2 and effect size: 0.39, alpha: 0.05 power: 0.90 and df: 1) and the minimum number of individuals to be included in the sampling was determined as 40. It was planned to include 30 pregnant women in the interference group and 30 pregnant women in the control group concerning the possibility of loss. Four pregnant women in the interference group did not continue being monitored, and one pregnant woman was excluded from the analysis since she suffered a miscarriage. Due to change of the address and phone information of the two pregnant women in the control group, they could not be reached, one pregnant woman who suffered a miscarriage and two women with preterm birth were excluded from the analysis. The study was conducted on 50 pregnant women, 25 of them in the interference group and 25 of them in the control group. A theory-based motivational individual counselling initiative has been applied to the interference and WhatsApp text messages have been sent three days a week, in accordance with the stages of change to support the interviews. The data of this study was analysed using SPSS 21 package software. The stages of changes of the pregnant women in the interference group determined during the interviews were compared and it has been determined that the difference between the stages of changes was statistically significant (p<0.05). In the comparison of post-partum monitoring, it was found that there was a statistically significant difference between the interference and control groups in terms of Fagerström Test for Nicotine Dependence Average Points. The high level of Fagerström Test for Nicotine Dependence Average Points in the control group was statistically significant (p<0.05). Between the behavioural changes of the pregnant women of the interference group in the final monitoring and the decisional balance scale total points, a high level, negative and significant relationship was found (r=- 0.73; p<0.05). For the pregnant women of interference and control groups, pre monitoring’s carbon monoxide (CO) measurement averages to the final monitoring was significant low with the rate of 1.9±2.1 in the interference group (p<0.05). All pregnant women in the interference group stated that they would recommend the message campaign called ‘İkiniz İçin Bırakın’ (Quit smoking for both of you) to their friends who smoke and want to quit, and that they asked this kind of text message campaigns to be provided by family health centres and hospitals. The results of the study shows that the motivational individual consulting initiative based on Transtheoretical Model and sending text messages prepared according to the stages of changes, decreased the Fagerström Test for Nicotine Dependence Points and CO level of the pregnant women and has a positive effect on the behavioural change.
Açıklama
Anahtar Kelimeler
Gebe Kadın, Teorilerüstü Model, Motivasyonel Görüşme, Kısa Mesaj, Sigara Bırakma, Pregnant Women, Transtheoretical Model, Motivational Interviewing, Text Messaging, Smoking Cessation
