Motivasyonel Görüşme Tekniğinin Antenatal Dönemde Kullanimi

Motivasyonel görüşme (MG) yöntemi özellikle değişim için isteksiz veya ambivalan duyguve düşünceleri olan kişilerde kullanışlı bir yöntemdir. MG’de değişimi konuşmanın amacıiçsel motivasyonu ortaya çıkarmaktır. Bunun için MG’de açık uçlu soru sorma (Open-endedquestions), doğrulama (Affirmation), yansıtmalı dinleme (Reflective listening) ve özetleme(Summarizing) yöntemleri kullanılmaktadır. MG’nin temel ilkeleri; empati gösterme,çelişkileri belirleme, direnci çözme ve öz-yeterliliği desteklemedir. Gebelik dönemindekadının değişen beden algıları, yeni keşfedilen sosyal ve duygusal rollere uyumu gebekadında motivasyonu arttıran doğal bir değişim süreci yaratmaktadır. Dolasıyla gebelik,sağlık davranışı değişikliğini başlatmak ve sürdürmek için potansiyel, güçlü öğretilebilirandır. Ülkemizde antenatal dönemde MG ile yapılan çalışmalar incelendiğinde 4 adetlisansüstü teze ulaşılmıştır. Bunlardan ilki MG ile gebelerde sigara bıraktırma çalışmasıdır.Çalışmada 38 gebeye beş müdahale görüşmesi ve 3 izlem ziyareti yapılmış ve gebelerin%39.5’inin sigarayı bıraktığı ve öz-yeterlilik puanlarının yükseldiği bulunmuştur. Emzirmeyidesteklemede gebelik boyunca sürdürülen MG’nin etkisinin incelendiği çalışmada antenatal32-36. hafta, postnatal ilk gün, 4-6. hafta, 4. ayda olmak üzere dört MG’de verilertoplanmıştır. Müdahale grubundaki annelerin kontrol grubundakilere göre daha kısa süredeemzirmeye başlama, ilk emzirme deneyimlerinde daha az sorun yaşama, emzirmede kendinegüvenme düzeyi puan ortalamasında ve ilk besin olarak daha fazla anne sütü vermeoranlarında artış bulunmuştur. Calpbinici ve Yücel’in (2020) primipar gebelere MG yöntemiile verilen eğitim programının doğum korkusuna, doğumda öz-yeterliliğe ve doğum şeklineetkisini değerlendirdikleri çalışmada müdahale grubundaki 37 gebeye haftada bir olmak üzeretoplam dört oturumda bireysel olarak “Doğum Korkusuna Yönelik MG Yöntemine DayalıEğitim Programı” uygulanmıştır. Çalışma sonucunda MG yöntemi ile verilen eğitimprogramının primiparlarda doğum korkularını azalttığı ve doğumda öz-yeterliliklerini artırdığıbelirlenmiştir. MG ile yapılan bir diğer çalışmada 33 GDM’li gebeye planlı davranış teorisitemelli MG ile yapılandırılmış eğitim programı uygulanmış ve GDM‘li gebelerde tutum,öznel norm ve niyete etki ederek diyabet yönetimine katkı sağladığı bulunmuştur. Hemşireler,eğitimleri boyunca MG adı altında özel bir eğitim almamakla birlikte, MG’nin temel ilkeleriniprofesyonel meslek hayatlarında kullanmaya ilişkin temel bilgi ve beceriye çoğunluklasahiptir. MG becerilerini geliştirmek isteyen hemşirelerin; uzmanlar tarafından yurtiçinde/dışında düzenlenen kurslara katılarak MG tekniği hakkındaki bilgi ve deneyimleriniarttırabilirler. Böylece bireyleri sağlıklı davranış değişikliğine yöneltmede MG tekniği iledanışmanlık yapabilirler.Anahtar Kelimeler: motivasyonel görüşme tekniği, antenatal dönem, hemşirelikMotivational interviewing (MI) method is especially useful for people who are reluctant tochange or have ambivalent feelings and thoughts. The purpose of talking change in MI is toreveal intrinsic motivation. For this, open-ended questions, affirmation, reflective listeningand summarizing methods are used. The basic principles of MI; showing empathy, identifyingconflicts, resolving resistance, and promoting self-efficacy. Changing body perceptions ofwomen during pregnancy and adaptation to newly discovered social and emotional rolescreate a natural changing process that increases motivation in pregnant women. Pregnancy isa potentially powerful “teachable moment” to initiate and maintain health behavior change.When the studies conducted with MI in the antenatal period in our country were examined, 4theses were reached. The first study is smoking cessation in pregnant women with MI. It wasfound that 39.5% of the pregnants quit smoking and their self-efficacy scores increased. In astudy examining the effect of MG continued throughout pregnancy in supportingbreastfeeding, it was found that mothers in intervention group started to breastfeed in a shortertime than the control group, had fewer problems in their first breastfeeding experience,increased self-confidence in breastfeeding. Calpbinici and Yücel (2020), in which theyevaluated the effect of the training program given to primiparous pregnant women with MI onfear of birth, self-efficacy at birth and delivery method, it was determined that the trainingprogram given with the MI reduced the fear of birth and increased their self-efficacy at birth.In another study, a planned behavioral theory-based MI-structured training program wasapplied to 33 pregnant women with GDM, it was found that MI contributed to diabetesmanagement by affecting attitudes, subjective norms and intentions. Although nurses don’treceive a special education under the name of MI during their education, they often have thebasic knowledge and skills to use the basic principles of MI in their professional lives. Nurseswho want to improve their MI skills; they can participate in the courses organized by expertsin the country / abroad. Thus, they can provide counseling with the MI technique in directingindividuals to healthy behavior change.Keywords: motivational interview technique, antenatal period, nur</p

Application of the PRECEDE-PROCEED Planning Model in Designing a Genital Health Program

© 2022 The authors.Background: Lack of knowledge and incorrect practices regarding genital hygiene increase the risk of infection. Women can be protected from these infections by teaching correct genital hygiene behaviors through health education based on recognized models. The aim of this study was to design an educational program to improve women's genital health behaviors based on the PRECEDE-PROCEED model. Methods: This study was an application of the PRECEDE-PROCEED model as a planning tool to design a program to improve genital health behaviors. A comprehensive literature review was performed in Google Scholar, Council of Higher Education Thesis Center, PubMed, and ProQuest databases using the keywords “PRECEDE-PROCEED MODEL” and other related keywords in Turkish and English language from 2000 to 2021. The model was explained in light of the literature, and an exemplary program to improve genital hygiene behaviors was proposed in line with the model steps. Results: First, using the PRECEDE phase of the model, women's educational needs related to genital health behaviors were determined and the related problems were identified. Then, the PROCEED phase of the model was used for planning, implementation, and evaluation of the educational program based on the educational objectives. Conclusion: The PRECEDE-PROCEED model provides a framework for nurses to maintain and improve the health of the female genital system. Using this model, it is possible to inform women about genital health, encourage them to participate in self-care, improve health outcomes, and increase their quality of life (QoL)

Awareness of urinary incontinence in pregnant women as a neglected issue: a cross-sectional study

Background Pregnancy and labor are independent risk factors for the development of urinary incontinence (UI). Although UI is common during pregnancy, it is a health problem mostly neglected by pregnant women. The high prevalence of UI in pregnancy and its effects on the postpartum period justifies the need to determine the knowledge and attitudes of pregnant women regarding the prevention and management of UI. It is necessary to increase the awareness of pregnant women about UI, educate, consultant, and integrate pelvic floor muscle training into prenatal care services. This study aims to determine the UI awareness of pregnant women and their knowledge and attitudes in this context. Methods This cross-sectional study was conducted with 255 pregnant women in a university hospital in Turkey between March and September 2020. Data were collected using the Incontinence Knowledge Questionnaire (PIKQ) and Urinary Incontinence Attitude Scale (UIAS). Results The UI prevalence was 51% during pregnancy. The mean score of PIKQ was 8.07±2.64, and only 6.3% of participants correctly answered all the questions regarding UI. The mean score of UIAS was 42.33±3.48. A positive correlation was found between UI knowledge and attitude score (r=0.35, p=0.00). Conclusions The results showed that although UI is prevalent during pregnancy, pregnant women’s knowledge of UI is poor. Nearly half of pregnant women need information. They tend to display positive attitudes towards UI, but not sufficient to improve their health-seeking behavior. Strategies should be developed to increase pregnant women’s awareness of UI and to encourage them health-seeking behaviors for the prevention/management of UI during prenatal visits