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http://dx.doi.org/10.4069/kjwhn.2020.06.17

Effects of a supportive program on uncertainty, anxiety, and maternal-fetal attachment in women with high-risk pregnancy  

Kim, Hyun Jin (Department of Nursing, Samsung Medical Center)
Chun, Nami (College of Nursing, Sungshin Women's University)
Publication Information
Women's Health Nursing / v.26, no.2, 2020 , pp. 180-190 More about this Journal
Abstract
Purpose: The purpose of this study was to identify the effects of a supportive program on uncertainty, anxiety, and maternal-fetal attachment in high-risk pregnant women. Methods: The participants were 59 high-risk pregnant women admitted to the maternal-fetal intensive care unit. The control group (n=30) received usual treatment and antenatal care, while the experimental group (n=29) received an additional supportive program. Uncertainty, anxiety, and maternal-fetal attachment were measured in both groups prior to the intervention and at 3 days and 10 days after the intervention (or at discharge). Data were analyzed with the t-test, chi-square test, repeated-measures analysis of covariance, and the Greenhouse-Geisser correction in SPSS version 23.0. Results: A supportive program including information provision, nutritional care, emotional care, and exercise care was developed from the literature. All variables except women's length of stay were found to be homogeneous the between experimental and control groups in the pre-test. Length of stay was calculated as a covariate for testing hypotheses. There was a significant difference in state anxiety over time between the two groups, while there were no differences in uncertainty or maternal-fetal attachment. Conclusion: This supportive program was identified as an effective nursing intervention on state anxiety in high-risk pregnant women during their stay in the maternal-fetal intensive care unit. It is suggested that nurses could apply this program to alleviate high-risk pregnant women's state anxiety, and that this program could be modified to be more effective on uncertainty and maternal-fetal attachment in high-risk pregnant women.
Keywords
Anxiety; Maternal-fetal relations; Pregnancy, High-risk; Program; Uncertainty;
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Times Cited By KSCI : 14  (Citation Analysis)
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1 US Department of Health and Human Services; National Institutes of Health. High-risk pregnancy [Internet]. Bethesda: Author; 2018 [cited 2020 Jun 13]. Available from: https://www.nichd.nih.gov/health/topics/high-risk
2 Loyet M, McLean A, Graham K, Antoine C, Fossick K. The fetal care team: care for pregnant women carrying a fetus with a serious diagnosis. MCN Am J Matern Child Nurs. 2016;41(6):349-355. https://doi.org/10.1097/NMC.0000000000000278   DOI
3 Oliveira DC, Mandu ENT. Women with high-risk pregnancy: experiences and perceptions of needs and care. Esc Anna Nery. 2015;19(1):93-101. https://doi.org/10.5935/1414-8145.20150013
4 Lee J, Choi E. Stress and coping style of high-risk pregnant women spouse. Korean J Women Health Nurs. 2010;16(3):234-244. https://doi.org/10.4069/kjwhn.2010.16.3.234   DOI
5 Kingston D, Janes-Kelley S, Tyrrell J, Clark L, Hamza D, Holmes P, et al. An integrated web-based mental health intervention of assessment-referral-care to reduce stress, anxiety, and depression in hospitalized pregnant women with medically high-risk pregnancies: a feasibility study protocol of hospital-based implementation. JMIR Res Protoc. 2015;4(1):e9. https://doi.org/10.2196/resprot.4037   DOI
6 Kwon MK, Bang KS. Relationship of prenatal stress and depression to maternal-fetal attachment and fetal growth. J Korean Acad Nurs. 2011;41(2):276-283. https://doi.org/10.4040/jkan.2011.41.2.276   DOI
7 Hwang RH. Relationship between maternal fetal attachment and state anxiety of pregnant women in the preterm labor. Korean J Women Health Nurs. 2013;19(3):142-152. https://doi.org/10.4069/kjwhn.2013.19.3.142   DOI
8 Kim EM, Hong S. Impact of uncertainty on the anxiety of hospitalized pregnant women diagnosed with preterm labor: focusing on mediating effect of uncertainty appraisal and coping style. J Korean Acad Nurs. 2018;48(4):485-496. https://doi.org/10.4040/jkan.2018.48.4.485   DOI
9 Park HJ, Sung MH. Effects of music therapy on stress of preterm labor and uterine contraction in pregnant women with preterm labor. Korean J Women Health Nurs. 2017;23(2):109-116. https://doi.org/10.4069/kjwhn.2017.23.2.109   DOI
10 Choi MS, Park YJ. The effects of relaxation therapy on anxiety and stress of pregnant women with preterm labor. Korean J Women Health Nurs. 2010;16(4):336-347. https://doi.org/10.4069/kjwhn.2010.16.4.336   DOI
11 Spielberger CD, Gorsuch R, Lushene RE. Manual for the state-trait anxiety inventory. Palo Alto: Califonia Consulting Psychologist Press; 1970. 24 p.
12 Janighorban M, Allahdadian M, Mohammadi F, Dadkhah A, Eslami A. Need for consultation and training during bed rest in women with high risk pregnancy experience: a qualitative study. Int J Pediatr. 2016;4(5):1705-1714. https://doi.org/10.22038/ijp.2016.6700
13 Yu WJ, Song JE. Effects of abdominal breathing on state anxiety, stress, and tocolytic dosage for pregnant women in preterm labor. J Korean Acad Nurs. 2010;40(3):442-452. https://doi.org/10.4040/jkan.2010.40.3.442   DOI
14 Mishel MH. The measurement of uncertainty in illness. Nurs Res. 1981;30(5):258-263. https://doi.org/10.1097/00006199-198109000-00002   DOI
15 Han Dy, Lee JH, Jeon GG. Spielberger's state-trait anxiety inventory-form Korean YZ. Seoul: Hakjisa; 2000.
16 Cranley MS. Development of a tool for the measurement of maternal attachment during pregnancy. Nurs Res. 1981;30(5):281-284. https://dx.doi.org/10.1097/00006199-198109000-00008   DOI
17 Lee KS, Kim JH, Hong SJ, Chang HY, Shin YJ, Kim MS. The validation study of maternal fetal attachment scale. Korean J Dev Psychol. 2013;26(4):81-91.
18 Hogan S, Sheffield D, Woodward A. The value of art therapy in antenatal and postnatal care: a brief literature review with recommendations for future research. Int J Art Ther. 2017;22(4):1-11. https://doi.org/10.1080/17454832.2017.1299774   DOI
19 Wang HJ, Kim IO. Effects of a mobile web-based pregnancy health care educational program for mothers at an advanced maternal age. J Korean Acad Nurs. 2015;45(3):337-346. https://doi.org/10.4040/jkan.2015.45.3.337   DOI
20 Lindsay KL, Gibney ER, McAuliffe FM. Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries. J Hum Nutr Diet. 2012;25(6):534-546. https://doi.org/10.1111/j.1365-277X.2012.01253.x   DOI
21 Hesketh KR, Evenson KR. Prevalence of U.S. Pregnant Women Meeting 2015 ACOG Physical Activity Guidelines. Am J Prev Med. 2016;51(3):e87-e89. https://doi.org/10.1016/j.amepre.2016.05.023   DOI
22 Chuang LL, Lin LC, Cheng PJ, Chen CH, Wu SC, Chang CL. Effects of a relaxation training programme on immediate and prolonged stress responses in women with preterm labour. J Adv Nurs. 2012;68(1):170-180. https://doi.org/10.1111/j.1365-2648.2011.05765.x   DOI
23 Kim HS, Kim S. Effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus. J Korean Acad Nurs. 2013;43(1):69-80. https://doi.org/10.4040/jkan.2013.43.1.69   DOI
24 Shin HH, Shin YH, Kim GE. Effect of cognitive behavioral therapy (CBT) for perinatal depression: a systematic review and meta-analysis. J Korea Acad Industr Coop Soc. 2016;17(11):271-284. https://doi.org/10.5762/KAIS.2016.17.11.271   DOI
25 Kim SH, Lee HJ. Effects of supportive nursing care program on hip function, anxiety and uncertainty for patients with total hip arthroplasty. J Korean Acad Nurs. 2013;19(3):419-431. https://doi.org/10.22650/JKCNR.2013.19.3.419
26 Kim SH, Cho Chung HI. Stress, coping style and nursing needs for hospitalized pregnant women due to preterm labor. Korean J Women Health Nurs. 2015;21(2):83-92. https://doi.org/10.4069/kjwhn.2015.21.2.83   DOI
27 Cho YH, Chun N. Effect of structured information on immediate preoperative anxiety and uncertainty for women undergoing laparoscopic hysterectomy. Korean J Women Health Nurs. 2015;21(4):321-331. https://dx.doi.org/10.4069/kjwhn.2015.21.4.321   DOI
28 Wee H, Park SY. The relationship between anxiety, depression, prenatal stress, maternal-fetal attachment and gratitude. J Korean Soc Matern Child Health. 2012;16(2):274-286. https://doi.org/10.21896/jksmch.2012.16.2.274   DOI