Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Yüksek ve Düşük Riskli Gebeliği Olan Kadınların Uyku Kalitesi, Yorgunluk ve Stres Düzeyinin Karşılaştırılması: Tanımlayıcı Çalışma
Comparison of Sleep Quality, Fatigue and Stress Level of Women with High and Low-Risk Pregnancies Sleep, Fatigue and Stress in Pregnant Women: Descriptive Study
Bihter AKINa , Süreyya KILIÇb , Sema DERELİ YILMAZa
aSelçuk Üniversitesi Sağlık Bilimleri Fakültesi, Ebelik Bölümü, Konya, Türkiye
bKonya Şehir Hastanesi, Konya, Türkiye
Turkiye Klinikleri J Health Sci. 2024;9(1):60-6
doi: 10.5336/healthsci.2023-99203
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışma yüksek ve düşük riskli gebeliği olan kadınların uyku kalitesi, yorgunluk ve stres düzeyinin karşılaştırılması amacıyla gerçekleştirilmiştir. Gereç ve Yöntemler: Araştırmanın evrenini 15 Haziran-15 Aralık 2021 tarihleri arasında bir hastanenin perinatoloji servisine riskli gebelik sebebiyle yatışı yapılan tüm gebeler ve hastaneye kontrol amacıyla gelen düşük riskli tüm gebeler oluşturmuştur. Araştırma tanıtıcı özellikler soru formu, Pittsburgh Uyku Kalitesi İndeksi (PUKİ), Yorgunluk İçin Görsel Benzerlik Skalası (YİGBS) ve Gebelik Stresini Değerlendirme Ölçeği (GSDÖ) kullanılarak; yüksek riskli gebelik grubunda 178, düşük riskli gebelik grubunda 178 olmak üzere toplam 356 gebe ile gerçekleştirilmiştir. Verilerin analizinde Mann-Whitney U ve Kruskal Wallis testi kullanılmıştır. Bulgular: PUKİ toplam puanı medyan değeri yüksek riskli gebelerde 11, düşük riskli gebelerde ise 6 bulunmuştur. GSDÖ medyan değeri yüksek riskli gebelerde 118, düşük riskli gebelerde 102'dir. YİGBS medyan değeri ise yüksek riskli gebelerde 79, düşük riskli gebelerde ise 77'dir Yüksek riskli gebelik grubundaki kadınların, düşük riskli gebelere oranla yüksek stres düzeyine ve kötü uyku kalitesine sahip olduğu belirlenmiştir (p<0,05). İki grup arasında yorgunluk düzeyi bakımından anlamlı fark bulunmamıştır (p>0,05). Sonuç: Hastaneye yatışı yapılan gebelerin genel fiziksel iyilik hâlinin yanı sıra stres, uyku ve yorgunluk durumlarının ebeler tarafından değerlendirilerek, iyileştirmeye yönelik müdahalelerin yapılmasının kadın sağlığı üzerinde uzun vadede etkileri olacağı düşünülmektedir.

Anahtar Kelimeler: Yüksek riskli gebelik; uyku; yorgunluk
ABSTRACT
 Objective: The study was carried out to compare the sleep quality, fatigue, and stress level of women with high and low-risk pregnancies. Material and Methods: The population of the study consisted of all pregnant women who were admitted to the perinatology service of a hospital between June 15 and December 15, 2021 due to risky pregnancy and all low-risk pregnant women. The research was conducted with a total of 356 pregnant women, 178 in the high-risk pregnancy group and 178 in the low-risk pregnancy group, using the descriptive characteristics questionnaire, Pittsburgh Sleep Quality Index (PSQI), Pregnancy Stress Assessment Scale (PSAS) and Scale to Assess Fatigue (SAF) Mann-Whitney U and Kruskal-Wallis tests were used in the analysis of the data. Results: The median value of the PSQI total score was found to be 11 in high-risk pregnant women and 6 in low-risk pregnant women. The PSAS median value is 118 in high-risk pregnant women and 102 in low-risk pregnant women. SAF median value is 79 in high-risk pregnant women and 77 in low-risk pregnant women. It was determined that women in the high-risk pregnancy group had higher stress levels and poor sleep quality compared to low-risk pregnant women (p<0.05). There was no significant difference between the two groups in terms of fatigue level (p>0.05). Conclusion: It is thought that evaluating the general physical well-being of pregnant women who are hospitalized, as well as stress, sleep, and fatigue, and making interventions to improve them will have long-term effects on women's health.

Keywords: High-risk pregnancy; sleep; fatigue
REFERENCES:
  1. Coco L, Giannone TT, Zarbo G. Management of high-risk pregnancy. Minerva Ginecol. 2014;66(4):383-9. [PubMed] 
  2. Beers MH. The Merck Manual of Medical Information: Second Home Edition: Simon and Schuster. 2nd ed. USA: Pocket Books; 2004.
  3. ACOG Practice bulletin no. 134: fetal growth restriction. Obstet Gynecol. 2013;121(5):1122-33. [Crossref]  [PubMed] 
  4. ACOG Practice Bulletin No. 190 Summary: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131(2):406-8. [Crossref]  [PubMed] 
  5. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Obstetrics and the Society forMaternal-FetalMedicin. ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstet Gynecol. 2019;133(2):e97-e109. [Crossref]  [PubMed] 
  6. Alfadhli EM. Gestational diabetes mellitus. Saudi Med J. 2015;36(4):399-406. [Crossref]  [PubMed]  [PMC] 
  7. Filipek A, Jurewicz E. Preeklampsja - choroba kobiet w ciąży [Preeclampsia - a disease of pregnant women]. Postepy Biochem. 2018;64(4):232-29. Polish. [Crossref]  [PubMed] 
  8. Kattah AG, Garovic VD. The management of hypertension in pregnancy. Adv Chronic Kidney Dis. 2013;20(3):229-39. [Crossref]  [PubMed]  [PMC] 
  9. Medeiros AL, Santos SR, Cabral RW, Silva JP, Nascimento NM. Assessing nursing diagnoses and interventions in labour and high-risk pregnancies. Rev Gaucha Enferm. 2016;37(3):e55316. Portuguese, English. [Crossref]  [PubMed] 
  10. Gourounti K, Karpathiotaki N, Karapanou V, Antzaklis P, Daskalakis G. Validation of the High-Risk Pregnancy Stress Scale in a sample of hospitalized Greek high-risk pregnant women. Women Health. 2016;56(6):680-94. [Crossref]  [PubMed] 
  11. Hall WA, Stoll K, Hutton EK, Brown H. A prospective study of effects of psychological factors and sleep on obstetric interventions, mode of birth, and neonatal outcomes among low-risk British Columbian women. BMC Pregnancy Childbirth. 2012;12:78. [Crossref]  [PubMed]  [PMC] 
  12. Koyucu RG, Ülkar D, Erdem B. Primipar ve multipar gebelerin gebelik streslerinin karşılaştırılması [Comparison of pregnancy stresses in primiparous and multiparous pregnants]. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi. 2020;8(3):652-63. [Crossref] 
  13. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. [Crossref]  [PubMed] 
  14. Ağargün MY, Kara H, Anlar O. Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği [Validity and reliability of the Pittsburgh sleep quality index]. Türk Psikiyatri Dergisi. 1996;7(2):107-15. [Link] 
  15. Lee KA, Zaffke ME. Longitudinal changes in fatigue and energy during pregnancy and the postpartum period. J Obstet Gynecol Neonatal Nurs. 1999;28(2):183-91. [Crossref]  [PubMed] 
  16. Yurtsever S. Hemodiyaliz hastalarında yorgunluğun değerlendirilmesi [Evaluation of fatigue on hemodialysis patients]. Hemşirelikte Araştırma Geliştirme Dergisi. 2003;5(2):3-12. [Link] 
  17. Chen CH. Revision and validation of a scale to assess pregnancy stress. J NursRes. 2015;23(1):25-32. [Crossref]  [PubMed] 
  18. Akın Ö, Erbil N. Turkish validity and reliability study of the Pregnancy Stress Rating Scale. 11th Athens Congress on Women's Health Disease, Oral Presentation-51; 6-8 September 2018; Athens, Greece: Hellenic PAG Society; 2018. [Link] 
  19. Soğukpınar N, Akmeşe ZB, Hadımlı A, Balçık M, Akın B. Doğumevlerinde riskli gebelik profili: İzmir ili örneği [Risky pregnancy profile in maternity hospitals: sample of İzmir province]. Journal of Academic Research in Nursing. 2018;4(1):37-44. [Link] 
  20. Jaruamornjit Y, Kaewrudee S, Sothornwit J. Differences in postpartum contraceptive choices and patterns following low- and high-risk pregnancy. Contraception. 2022;107:52-7. [Crossref]  [PubMed] 
  21. Zaki NF, Mesbah Y, Sabri Y, Shams M, Bahammam A. Sleep during high-risk pregnancy: an Egyptian study. Middle East Current Psychiatry. 2016;23(3):142-6. [Crossref] 
  22. Spehar SM, Mission JF, Amanda Shupe, Facco FL. Prolonged antepartum hospitalization: no time for rest. J Perinatol. 2018;38(9):1151-6. [Crossref]  [PubMed]  [PMC] 
  23. Yehia DBM, Malak MZ, Al-Thwabih NN, Awad RR, Al-Ajouri ES, Darwish SS, et al. Psychosocial factors correlate with fatigue among pregnant women in Jordan. Perspect Psychiatr Care. 2020;56(1):46-53. [Crossref]  [PubMed] 
  24. Çetin FC, Demirci N, Çalık KY, Akıncı AÇ. Gebelikte olağan fiziksel yakınmalar [Common physical complaints during pregnancy]. Zeynep Kamil Tıp Bülteni. 2017;48(4):135-41. [Crossref] 
  25. Oskay ÜY, Coşkun A. Hastanede yatak istirahatindeki yüksek riskli gebelerde ortaya çıkan sorunların giderilmesinde verilen kapsamlı hemşirelik bakımının etkinliği [Effectiveness of comprehensive nursing care relieving problems of hospitalized high-risk pregnant women in bed rest]. TAF Preventive Medicine Bulletin. 2012;11(2):163-72. [Crossref] 
  26. Baran GK, Şahin S, Öztaş D, Demir P, Desticioğlu R. Gebelerin algılanan stres düzeylerinin ve stres nedenlerinin değerlendirilmesi [Assessment of perceived stress levels and stress factors in pregnant women]. Cukurova Medical Journal. 2020;45(1):170-80. [Crossref] 
  27. Gümüşdaş M, Apay S, Özorhan E. Riskli olan ve olmayan gebelerin psiko-sosyal sağlıklarının karşılaştırılması [Comparison of psycho-social health in pregnant women with and without risk]. Sağlık Bilimleri ve Meslekleri Dergisi. 2014;1(2):32-42. [Crossref] 
  28. Ertekin Pinar S, Daglar G, Duran Aksoy O. The effect of stress management training on perceived stress, anxiety and hopelessness levels of women with high-risk pregnancy. J Obstet Gynaecol. 2022;42(1):17-22. [Crossref]  [PubMed] 
  29. Sarmasti N, Ayoubi SH, Mahmoudi G, Heydarpour S. Comparing perceived social support and perceived stress in healthy pregnant women and pregnant women with preeclampsia. Ethiop J Health Sci. 2019;29(3):369-76. [PubMed]  [PMC] 
  30. Bahadır Yılmaz E, Şahin E. Gebelerin prenatal sıkıntı düzeyleri ile ilişkili faktörler [Factors associated with prenatal distress levels of pregnant women]. Journal of Psychiatric Nursing. 2019;10(3):197-203. [Link] 
  31. Saur AM, Dos Santos MA. Risk factors associated with stress symptoms during pregnancy and postpartum: integrative literature review. Women Health. 2021;61(7):651-67. [Crossref]  [PubMed] 

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