The evaluation and development of the roles of nurses and midwives in decreasing cigarette smoking and prevention of cigarette smoke in pregnant women

Main objective of the study is to conduct an intervention program for nurses and midwives in order to improve their skills in prevention of smoking among pregnant women. For this intervention study, the public health centers of Konak district has been stratified according to their socioeconomic levels as good-fair-poor. Two centers from the poor socioeconomic level, two from the fair level and three from the good socioeconomic level has been randomly and all pregnant women who were on the fourth month have been recruited from these centers (n=307). In these seven centers there were 40 midwives and nurses who were included for our study. Three centers have been randomized to intervention group and four centers to control group. At baseline, a questionnaire has been applied to recruited pregnant women to determine the prevalence of smoking and to investigate the skills and attitudes of nurses and midwives about smoking counseling. A training program, covering two-hour lecture and one-hour discussion about smoking counseling, has been conducted among the nurses and midwives of intervention group. Questionnaire has been reapplied to nurses and midwives after five months to see the change in attitude and skill. In order to assess the effect of counseling, the smoking information of pregnant women has been collected in three months period after the delivery. Chi-square and Fisher?s exact test has been used for categorical variables and Mann-Whitney U test has been used for continuous variables for statistical data analysis. There were no differences between the nurses and midwives of intervention and control groups in terms of answers to skill and attitude questions, skill and attitude scores and proper counseling attitudes at baseline. The 20 % of pregnant women in intervention group and 20.3 % in control group were smoking at baseline. The 53.3 % of pregnant women in intervention group and 46.2 % in control group were passive smokers at their home at baseline. The counseling attitudes scores of intervention group were significantly higher than the control group after training. Although proper counseling scores were higher in intervention group, no significant difference has been detected. Although rates of smoking and passive smokers decreased during the subsequent interview, no significant difference has been detected. In conclusion, it has been obtained a successful result from this interventional study, although limited.