0-6 aylık bebeği olan annelerin gebeliği planlama durumlarının postnatal depresyon ve maternal bağlanmaları ile ilişkisinin değerlendirilmesi
Evaluation of the pregnancy planning status of mothers with 0-6 months baby and its relationship of postnatal depression and maternal attachments
- Tez No: 794967
- Danışmanlar: PROF. DR. MUSTAFA ÇELİK
- Tez Türü: Tıpta Uzmanlık
- Konular: Aile Hekimliği, Family Medicine
- Anahtar Kelimeler: Mother-infant attachment, maternal attachment, postnatal depression, unplanned pregnancy, EPDS, MAI, LMUP
- Yıl: 2023
- Dil: Türkçe
- Üniversite: Sağlık Bilimleri Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Aile Hekimliği Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 105
Özet
Amaç: Aile hekimleri için kadınların gebelikte veya lohusalık döneminde yaşamaları muhtemel psikososyal problemlerin risk faktörlerini tespit etmek, erken dönemde müdahale etmek önem arz etmektedir. Plansız gebeliklerin postnatal depresyon ve düşük maternal bağlanma açısından risk faktörü olduğunu gösteren çalışmalar mevcuttur. Bu çalışmada, literatürden farklı olarak standart bir ölçek kullanılarak gebelik planlama durumunun tespit edilmesi; postnatal depresyon ve maternal bağlanma ile ilişkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 23 Haziran 2022 ile 23 Eylül 2022 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesi Aile Hekimliği Poliklinikleri ve Çocuk Sağlığı ve Hastalıkları Sağlam Çocuk Polikliniğine başvuran 0-6 ay arasındaki bebeği olan ve araştırmaya katılmaya gönüllü olan, 18 yaş üstü 204 kişi dahil edildi. Katılımcılara sosyodemografik sorular içeren anket formu, Londra Plansız Gebeliği Belirleme Ölçeği (LPGBÖ), Edinburgh Postnatal Depresyon Ölçeği (EPDÖ) ve Maternal Bağlanma Ölçeği (MBÖ) yüz yüze görüşme yöntemi ile uygulandı. Araştırma boyunca toplanan veriler, IBM SPSS 28.0 (Statistical Package for Social Sciences, version 28.0) programı ile analiz edildi. İstatistiksel olarak p
Özet (Çeviri)
Aim: It is important for family physicians to identify the risk factors of psychosocial problems that women may experience during pregnancy or puerperium, and to intervene in the early period. There are studies showing that unplanned pregnancies are risk factors for postnatal depression and poor maternal attachment. In this study, it was aimed to determine pregnancy planning status by using a standard scale, unlike the literature, and to evaluate its relationship with postnatal depression and maternal attachment. Materials and Methods: The study included 204 people over the age 18, who had a 0-6 month old baby, who applied to Ankara Training and Research Hospital Family Medicine outpatient clinics and Child Health and Diseases Well-baby outpatient clinics between June 23, 2022 and September 23, 2022 and volunteered to participate in the study. A survey containing questions about sociodemographic data, London Measure of Unplanned Pregnancy (LMUP), Edinburgh Postnatal Depression Scale (EPDS), Maternal Attachment Inventory (MAI), was applied to the participants by face-to-face interview method. The collected data were analyzed using IBM SPSS 28.0 (Statistical Package for Social Sciences, version 28.0) program. A p value < 0.05 was considered to show a statistically significant test result. Results: 204 people participated in the study. The mean age of the participants was 28±5.1 years and ranged between 18-46 years. The mean age of their babies was 2.5±1.8 months. According to LMUP, 27 participants (13.2%) with unplanned pregnancy and 177 participants (86.8%) with planned pregnancy were found. It was determined that the participants who stated that they got married reluctantly, who thought of terminating the pregnancy in the early stages of pregnancy, who smoked cigarettes, had more unplanned pregnancies. According to EPDS, 32 (15.7%) participants with risk of postnatal depression (PND) and 172 participants (84.3%) without risk of PND were found. It was found that the participants with a high education level, low marital satisfaction, personal and family history of psychiatric illness had a higher risk of PND. The mean age of the babies of those with PND risk was found to be higher than those without the risk. The mean MAI scores of the participants was calculated as 100.7±5.0 (min:76, max:104). It was determined that maternal attachment decreased as paternal age, number of pregnancies and births, and number of living children increased. Maternal attachment levels were found to be lower in those with a family history of psychiatric illness. Maternal attachment levels of those with unplanned pregnancy were found to be significantly lower than those with planned pregnancy (p=0,004). In parallel, a weak positive correlation was found between LMUP scores and MAI scores (r=+0,194; p=0,005). There was no significant relationship between pregnancy planning status and PND risk, but EPDS scores of those with unplanned pregnancy were higher than those with planned pregnancy (p=0,693). No significant relationship was found between the risk of PND and maternal attachment. Conclusion: When the findings of our study were evaluated, it was concluded that unplanned pregnancies affected mother-infant attachment negatively, but could not be found as a risk factor for postnatal depression. In the light of the literature, it is seen that unplanned pregnancies are risk factors for PND and poor mother-baby attachment, and the subject should be investigated in studies with greater samples in the future. It is recommended that the determination of pregnancy planning status with a standard scale should be provided in national studies and the evaluations should be done with these data. It is recommended that family physicians identify women with unplanned pregnancies as soon as possible and provide appropriate counseling.
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