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Solution Focused Anxiety Management" on Anxiety in Women with a History of Abortion

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Solution Focused Anxiety Management The effectiveness of midwifery consultation in " solution focused anxiety management" on anxiety in women with a history of abortion Seyedeh Marziyeh Bayat Ghiasi 1, Nahid Bolbol Haghighi 2*, Ali Mohammad Nazari 3, Afsaneh Keramat 4, Shahrbanoo Goli 5 1 Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. 2 Assistant Professor, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. 3Associate Professor, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. 4 Professor, Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. 5 Assistant Professor, Department of Epidemiology, School of Health, Shahroud University of Medical Sciences, Shahroud, Iran. Correspondence: Nahid Bolbol Haghighi, Assistant Professor, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. Email: [email protected] ABSTRACT Introduction: Miscarriage can reduce the quality of life by affecting various aspects of one’s life and by creating psychological, physical and marital problems. Miscarriage is considered a major psychological stressor, resulting in high levels of anxiety and mood disorders. Although national and international studies using standard tools have shown that women after miscarriage suffer anxiety, the effect of purposeful interventions to reduce the anxiety has not been well investigated. Accordingly, a study was conducted to evaluate the effectiveness of midwifery counseling based on "solution-focused anxiety management" on anxiety of women with a history of miscarriage. Methodology: This randomized clinical trial study was conducted with the participation of 84 women who had a history of spontaneous miscarriage, less than one week of miscarriage, and high level of anxiety using Beck Anxiety Inventory. Based on random allocation sequence, subjects were assigned into two groups of control (routine health care) and intervention (4-session of solution- focused anxiety management counseling). Demographic Questionnaires and Beck Anxiety Inventory were completed by both groups before and immediately after the intervention and three months after the intervention. Data were compared in two groups using t-test, chi-square (x2), Fisher's exact test, independent t-test, and repeated measures. All relationships were considered significant at a significance level of P <0.05. Results: The intervention used in this study (solution-focused anxiety management counseling) significantly reduced the anxiety of women with a history of spontaneous miscarriage in the intervention group, compared to control group (p-value = 0.001). Mean and standard deviation of anxiety scores of women before and after the intervention were 36.67± 9.07 and 40.12± 20.71, respectively, in the intervention group, and 39.02±9.66 and 38.45± 13.60, respectively, in the control group. Conclusion: based on the results of this interventional study, it seems that using a solution-focused anxiety management approach can reduce the anxiety of women with a history of miscarriage. Thus, using this method for post-miscarriage interventions to control anxiety seems to be one of the purposeful interventions. Keywords: Solution-focused anxiety management counseling, women, anxiety, miscarriage. The World Health Organization defines miscarriage as Introduction termination of pregnancy before 20 weeks of gestation or embryonic weight of less than 500 g [1]. World Health Organization, Centers for Disease Control and Prevention, and the National Statistics Center also define it as termination of Access this article online pregnancy before 20 to 23 weeks of gestation or termination of [2] Website: www.japer.in E-ISSN: 2249-3379 pregnancy with embryonic weight of less than 500 g . In general, miscarriage is divided into three classes of spontaneous, induced and recurrent [2]. Based on studies conducted, with the How to cite this article: Seyedeh Marziyeh Bayat Ghiasi, Nahid Bolbol Haghighi, Ali Mohammad Nazari, Afsaneh Keramat, Shahrbanoo Goli. The increase in population growth, the number of miscarriages has effectiveness of midwifery consultation in " solution focused anxiety increased from 50.4 to 56.3 per year from 1990 to 2014 [3]. Based management" on anxiety in women with a history of abortion. J Adv Pharm Edu on the statistics provided by the Ministry of Health, 80000 Res 2020;10(S4):95-102. Source of Support: Nil, Conflict of Interest: None declared. miscarriages occur in Iran every year [4]. An average of 35 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Non Commercial- ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. © 2020 Journal of Advanced Pharmacy Education & Research | Published by SPER Publication 95 Seyedeh Marziyeh Bayat Ghiasi et al.: The effectiveness of midwifery consultation in " solution focused anxiety management" on anxiety in women with a history of abortion miscarriages per 1000 women aged 15-44 occur annually around information gap and the importance of designing interventional the world [3]. In Iran, miscarriage is prohibited due to cultural, studies on anxiety in people with a history of miscarriage and religious and legal restrictions. For this reason, many since anxiety disrupts women's mental health and even their miscarriages are performed under unfavorable health and hospital quality of life, and the necessity of providing counseling by conditions [5]. Another reason that miscarriage is not accurately midwives to promote the mental health of women who play a identified in statistical reports in Iran is that Iran’s population has major role in prenatal and post-pregnancy care, counselors can decreased in recent years, leading to fewer reports [6]. play a major role in preventing mental health problems. Hence, Miscarriage is one of the significant challenges for women of the present study was conducted to evaluate the effectiveness of childbearing age. Due to psychological and physical problems midwifery counseling based on solution-focused anxiety that occur after miscarriage, it affects various aspects of life and management on anxiety of women with a history of miscarriage. can change the quality of life [7]. A study performed in the United States reported that post-miscarriage psychological problems are Methodology similar to postpartum psychological problems [8], indicating the importance of paying attention to post-miscarriage care. Also, The present study was conducted by considering the Helsinki studies suggest that about 50% of women suffer mental diseases ethics criteria with the ethics code of IR.SHMU.REC.1398.027. after miscarriage and 40% experience symptoms of grief [9]. Also, this randomized intervention study was registered in the Using diagnostic and standard tools, previous international Clinical Trial Registry Center of Iran with the code of studies have shown that anxiety is one of the most common IRCT20190521043657N1. problems caused by miscarriage [10, 11], so that it is considered a Characteristics of the research population: To conduct this psychological destructive factor, leading to a high level of anxiety research, two educational and medical centers affiliated to Alborz [12]. Evidence also suggests that women are at risk for anxiety University of Medical Sciences (Kamali Hospital and Imam Ali symptoms up to four months after miscarriage [13]. To investigate Hospital) were selected for sampling and project the importance of post-miscarriage anxiety, studies have shown implementation. To find women with a history of miscarriage, that psychological counseling, in addition to medical care, is the researcher visited to the hospital (time recorded in the useful in reducing post-miscarriage anxiety [14]. Based on the hospital medical records) at the end of each day and prepared a previous studies, counseling is recommended as one of the most list of nulliparous women with definite symptoms of miscarriage practical and practical methods for treatment of depression and and having the inclusion criteria. According to previous studies anxiety [14]. For example, it has been reported that mood [14] and considering the probability of dropout of samples, the disorders and miscarriage-induced anxiety decrease during the sample size in each group was considered 28 people in each group first year after miscarriage with care-based counseling and over considering the first type error of 5% and test power of 90%. time [15]. In the study conducted by Haj Nasiri et al, results Considering the probability of dropout in samples, their final revealed that cognitive and emotion-based counseling reduced number was estimated at 90 people (45 people in the anxiety and depression in women with an experience of legal intervention group and 45 people in the control group) using the miscarriage [14]. formula of 2 2 2 The level of anxiety after a miscarriage decreases normally over (z(1−α⁄ 2 )+z(1−β)) (σ1+σ2) Based on time of their entry into2 the study and also the reviewing time, but this reduction occurs more quickly in the people n = d . receiving counseling and achieving mental health [16]. of inclusion criteria, they were placed in the central list by the Studies have also shown that counseling by a midwife
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