تاثیر آموزش شفقت به خود بر بهزیستی ذهنی و دل‌بستگی مادر- جنین در زنان با حاملگی ناخواسته: یک مطالعه نیمه تجربی

هدف: بارداری ناخواسته یکی از مسائل مهم مرتبط با سلامت مادران در دوران بارداری است. هدف از مطالعه حاضر تعیین تاثیر آموزش شفقت به خود بر بهزیستی ذهنی و دل‌بستگی مادر - جنین زنان با حاملگی ناخواسته بود.روش‌ها: این مطالعه باطرح پیش آزمون، پس آزمون، پیگیری و با گروه گواه  نیمه تجربی در 80 زن باردار که بارداری ناخواسته داشتند و مراجعه‌کننده به پایگاه‌های سلامت شهر کرمانشاه انجام شد. نمونه ها به روش خوشه ای و در دسترس انتخاب شدند و از طریق تخصیص تصادفی، به دو گروه آزمایش و کنترل تقسیم گردید. برای جمع‌آوری داده‌ها از پرسشنامه‌های مشخصات جمعیت‌شناسی، بهزیستی ذهنی و دل‌بستگی مادر - جنین استفاده گردید. برای گروه آزمایش، هشت جلسه گروهی به‌صورت یک‌بار در هفته در بازه زمانی 90 دقیقه‌ای آموزش شفقت به خود بر اساس الگوی صیدی برگزار شد و در این مدت گروه کنترل در فهرست انتظار قرار  گرفت. جهت تجزیه‌وتحلیل در نرم‌افزار spss نسخه 25 تحلیلی به‌منظور بررسی شاخص‌های توصیفی از فراوانی، درصد فراوانی، میانگین و جهت بررسی همسانی متغیرهای جمعیت شناختی از آزمون‌های دقیق کای اسکوئر (آزمون دقیق فیشر)، کای اسکوئر و آزمون یومن ویتنی و به‌منظور بررسی یافته‌های از آزمون‌های ناپارامتریک فریدمن و یومن ویتنی استفاده شد.سطح معنی داری برای تمامی آزمون‌ها 05/0 در نظر گرفته شد.نتیجه‌: بر اساس نتایج آزمون فریدمن، در طی زمان مداخله در گروه آزمایش تاثیر معناداری داشته است. همچنین بر اساس نتایج آزمون یومن - ویتنی، بین گروه آزمایش و کنترل در نوبت دوم و سوم سنجش تفاوت معناداری وجود داشت.بر اساس نتایج این پژوهش، آموزش شفقت به خود موجب ارتقاء بهزیستی ذهنی و دل‌بستگی مادر - جنین در زنان دارای بارداری ناخواسته می‌شود؛ بنابراین پیشنهاد می‌گردد، در مراکز ارائه‌دهنده‌ی خدمات به زنان باردار، از آموزش شفقت به خود استفاده گردد.

the impacts of self-compassion training on subjective well-being and maternal-fetal attachment in women experiencing unintended pregnancy: a quasi-experimental study

introductionthe maternity process is one of the evolutionary and delightful events in women’s lives. intended pregnancy is generally viewed as a pleasant issue for families, while unintended pregnancy is usually mentioned as an unpleasant and stressful process for the whole family, especially the mother. unintended pregnancy refers to a pregnancy occurred without couple’s intention for having a baby. when mothers encounter with an unintended pregnancy, it can disturb her and cause psychological consequences such as depression and anxiety. some studies have shown that there is a mutual relationship between mother’s anxiety and attachment to the fetus. that is, mothers having unintended pregnancy experience higher levels of depression and anxiety, therefore they cannot make proper bonding with their fetus. maternal-fetal attachment is defined as a continuous, intimate, and close relationship between the mother and her fetus which is satisfactory for both of them and makes easy the mother-infant relationship after delivery. mother’s attachment to her fetus improves satisfaction and quality of life in mothers. studies have showed that there is a positive relationship between the dimensions of attachment and subjective well-being. subjective well-being explores how people evaluate their lives and it includes life satisfaction, marital life satisfaction, mood, positive emotions, lack of depression and anxiety in two cognitive and affective components. considering the above-mentioned issues, it is expected that when the subjective well-being of mothers improves, the level of their attachment to their fetus increases as well. one way to increase the mother’s attachment to the fetus in such a condition is training, and among the relatively new and effective trainings is self-compassion training. this study tried to examine the impacts of self-compassion training on the subjective well-being and maternal-fetal attachment in women experiencing unintended pregnancy.method this study was conducted using a pre-test, post-test, follow-up design and a semi-experimental control group of 80 pregnant women who had an unintended pregnancy and visited kermanshah health centers. the inclusion criteria for the study are: being in the first or second trimester of pregnancy, not having severe midwifery problems in the recent pregnancy such as uterine bleeding or abnormal results in fetal health screening, the age between 18 and 45, not taking psychoactive drugs or neuroleptics, and being consent to participate in this research. the exclusion criteria are: failure to participate in two or more counseling sessions, pregnancy loss during the study, and unwillingness to participate in or continue the process of this study. participants were selected through cluster and convenient sampling methods. they were divided randomly into control and experimental groups. for collecting data, the demographic characteristics, subjective well-being, and maternal-fetal attachment questionnaires were used. for the experimental group, eight group sessions, each in 90 minutes, once a week were held to train self-compassion. during this time, the control group was placed on the waiting list. the evaluation of the participants was done in the pre-test stage before the start of the intervention, in the post-test stage immediately after the final session of training, and in the follow-up stage, four weeks after the end of the last training session. the data was analyzed using spss version 25. frequency, frequency percentage, and mean were used to check the descriptive indicators, fisher’s exact test, chi square, and mann-whitney test were used to check the homogeneity of demographic variables, and non-parametric friedman and mann-whitney tests were applied to check the findings.resultsthe results of friedman test showed that the mean score of subjective well-being and maternal-fetal attachment in the experimental group increased after the intervention (post test), and four weeks after the end of training. these changes were statistically significant (p<0.001). however, in the control group, this trend was decreasing. therefore, we conclude that there was a significant impact during the intervention in the experimental group. moreover, the results of the mann-whitney test showed that there is a significant difference between the experimental and control groups in the second and third rounds of measurement.discussion and conclusionthe results showed seemingly self-compassion training can lead to the improvement of the subjective well-being and improvement of maternal-fetal attachment in women experiencing unintended pregnancy. it is suggested, therefore, that an independent midwifery counseling unit be stablished that provides counselling and self-compassion based training services for women who are experiencing unintended pregnancy. providing counseling and support services by midwives and health care workers can lead to the women’s adaptive behaviors in this period and increase their ability to face the challenges caused by unintended pregnancy. it also can help them deal with this phenomenon better, be able to cope with this, show a more appropriate reaction, and even have more ability to get pregnant again.