The effect of nursing care on stress, prenatal adaptation, contraction, cortisol and birth week in threat of preterm birth

Objective: The aim of this study was to examine stress, prenatal adaptation, contraction, cortisol and birth week of effect of nursing care in threat of preterm birth. Method: The study was carried out in two stages. The first stage, determine the experience, feelings and thoughts of the women who are diagnosed with threatened preterm birth in the clinic. A total of 12 individuals were interviewed. The data were collected by semi-structured interview form and evaluated by content analysis. In the second stage, the research was a pre-post single-blind randomized controlled trial. The study was conducted with a total of 66 women in threat of preterm birth process; 33 in the intervention group and 33 in the control group. The intervention group was provided with relaxation oriented based nursing care. The data were collected before the intervention, in threat of preterm birth process and after the birth. In the evaluation of the data; MANOVA, One-Way ANOVA, Bonferroni Adjusted Paired T Test, İndependent Sample T Test, Dependent Sample T Test, Covariance Analysis (Ancova), Kaplan Meier Survival Analysis-Logrank Test and Structural Equation Model-Path Analysis were used. Results: The first stage, five main themes were identified: meaning of the threatened preterm birth, causes of the threatened preterm birth, problems caused by threatened preterm birth, coping and expectations and suggestions. In the second stage, a statistically significant difference was found between the the score averages of the intervention and control groups on both state anxiety and cortisol levels in terms of group, time, and group-time interaction (p <0.05). A statistically significant difference was found in the intervention group in the level of knowledge, the duration of sleep and the amount of fluid they received, nursing care satisfaction, birth weeks and the severity of contractions at the second day (p <0.05). Conclusion: Threatened preterm birth influences to women by physically and psychological. Relaxation-oriented nursing care was found to reduce the state anxiety of women, to increase the level of knowledge, to decrease the level of cortisol and these factors contributed to the normal limits of birth weeks. Therefore, it is recommended to use this program in the process of threat of preterm birth. Key Words: Threat preterm birth, Relaxation-focused nursing care, State anxiety, Cortisol level.