Effects of prenatal education on complaints during pregnancy and on quality of life

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Effects

of

prenatal

education

on

complaints

during

pregnancy

and

on

quality

of

life

Seda

Karaçay

Yikar,

Ev

_şen

Nazik

*

CukurovaUniversity,FacultyofHealthSciences,DepartmentofObstetricsandGynecologicNursing,01330,Adana,Turkey

ARTICLE INFO Articlehistory: Received2March2018

Receivedinrevisedform13August2018 Accepted16August2018 Keywords: Prenataleducation Complaintsinpregnancy Qualityoflife ABSTRACT

Objective:Thestudywasconductedtodeterminetheeffectsofprenataleducationonqualityoflifeand

complaintsduringpregnancy.

Methods:Thisstudyisaquasi-experimentalresearchwithacontrolgroup.PersonalInformationFormand

ScaleofComplaintsduringPregnancyandtheirEffectsonQualityofLife(SCPEQL)wereusedtocollectthe

data.Thirtyparticipantswereincludedinboththecontrolandtheinterventiongroups(N=60).

Results:ThemeanscoresofSCPEQLoftheinterventiongroupwas46.221.1andthemeanscoresof

SCPEQLofthecontrolgroup was99.821.6in2ndtrimester.Inthe3rd trimester,themeanscore ofSCPEQL

oftheinterventiongroupwas43.516.4,andthemeanscoreofSCPEQLofthecontrolgroupwas

108.016.8.Thedifferencebetweenthegroupswasstatisticallysigniﬁcantin2ndand3rdtrimesters

(p<0.05).

Conclusion:Findingsofthestudysuggestthatprovidingprenataleducationreducescomplaintsand

increasesqualityoflifeofpregnantwomen.

Practiceimplications:Assessingcomplaintsduringpregnancybynursesisapartoftheprenatalcare.

Therefore,nursesshouldevaluatepregnancy-relatedcomplaints.Qualityoflifeshouldbeincreasedby

givingeffectiveeducationaboutcomplaintsduringpregnancy.

1.Introduction

Pregnancy, a physiological event that poses an important burdenandstressforthewoman’sbody,lasts280daysfromthe lastdayofmenstruation,or40weeks.Actuallengthofpregnancy is267daysfromthedayoffertilization[1–3].Pregnancycauses many important changes in the maternal organism such as anatomical, physiological,biochemical, and psychological [4–6]. Thereasonforthesechangesaretheprotectionofthedeveloping fetus, satisfying metabolic needsand removingwaste that has been formed, experiencing anatomical changes for the birth process,andprotectingthehealthofboththemotherandthefetus [2,4,5]. Women mayhavesome physicalcomplaintsassociated withthechangesthatoccurduringpregnancy[3].Intheliterature, pregnantwomenontheirI.trimesterhavebeenobservedtohave complaintssuchasnausea,vomiting,nasalcongestion,tiredness, urinaryfrequency, urinary tractinfection,sensitivity in breasts, ptyalism,andincreasedvaginaldischarge.InastudybyBaietal. [6]themostcommoncomplaintsthewomenhadweretiredness,

nausea,and frequenturination,andin NazikandEry_ılmaz’s[7] study,nauseaand vomiting,tiredness,sore breasts,and urinary frequency were reported. In a study by Aydemir [8] pregnant womenontheirI.trimesterwereidentiﬁedtoexperiencenausea, urinaryfrequency,andtiredness.Intheliterature, complaintsof havingpyrosis,increasedappetite,edema,varicoseveins, consti-pation, haemorrhoid, gas, back pain, muscle cramps, Brakston Hickscontractions,frequenturination,tiredness,poorsleep,and skinproblems werereportedin the 2ndand 3rd trimesters of pregnancy [1,2,9]. In a study by Panicker et al. [10] pregnant women reported having skin problems Sleep problems were reportedinstudiesbyHungandChiang[11]andTaşkıran[12]and urinary frequency, constipation, and edema in Türkmen’s [13] study.Inaddition,Arabac_ıoglu[14]reportedthatpregnantwomen experiencedptyalismandtirednessduringpregnancy.

Whereasmedicalprofessionalsregardphysicaland psycholog-icalproblemsoccurringduringpregnancyasminorsituationsthat donotneedtreatment,theyareperceivedasarealproblembythe woman and her family, and it narrows down the difference betweenbeinghealthyandsick[3].Therefore,itisimportantthat thewellbeingofthepregnantwomanisassessedandmaintained duringprenatalperiod[1].Intheliterature,thenotionofqualityof lifehasbeendevelopedtoassesswellbeing.Qualityoflifeincludes * Correspondenceauthor.

E-mailaddresses:sedakrcy@hotmail.com(S.K.Yikar),enazik@cu.edu.tr

(E.Nazik).

https://doi.org/10.1016/j.pec.2018.08.023

ContentslistsavailableatScienceDirect

Patient

Education

and

Counseling

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family,work,andsocioeconomicstatus,thedifferencesbetween therealityandtheaims,expectations,hopes,anddreamsofthe individual,aswellasthesatisfactiontheindividualsgetfromtheir dailylives, and their perceptionof wellbeing [15]. Adapting to changesinpregnancy,and qualityof life,aredirectlyrelated to eachother,andifthewomencannotadaptsufﬁciently,qualityof life will be affected negatively [14]. There are studies in the literaturethatsuggestthatcomplaintsduringpregnancydecrease thequalityoflifeofthewomen[3,16–18].Therefore,itisimportant thatthecausesofordinarychangesareidentiﬁedcorrectly,and thatthewomanissupportedandcounselledinaddressingthese problems.Nursesandmidwivesworkinginthisareashouldassess thewomanholisticallyand givethenecessary prenatalcare to concludethepregnancywithahealthymotherandachild[2].

Therearestudiesintheliteraturethatareaimedtoinvestigate thecomplaintsduringpregnancy,andhowtheyaffectqualityof life [3,7,8,14,18–20]. However, no studies were found where education was provided to reduce the complaints during pregnancyand to increase thequality of life of theindividual. Therefore, this study aimed to assess the effects of prenatal educationin reducingthecomplaintsduringpregnancy, andits effectsonqualityoflife.

2.Methods

Theresearchisdesignedasaquasi-experimentalstudywitha control group to assess the effects of prenatal education on complaintsduringpregnancyandonqualityoflife.

The study was conducted in polyclinic of obstetric and gynecologic hospital in Adana between September 2016 and May2017.

2.1.Experimentalandcontrolgroupinterventions

Thepopulationofthestudyconsistsofpregnantwomenwho appliedfor prenatalappointments inobstetric and gynecologic hospitalinAdana,RepublicofTurkey.

The sample of the study consists of pregnant women who appliedtothehospitalduringtheperiodofSeptember01,2016and May15,2017,andwhoweresuitableforthecriteriaofthestudy, andacceptedtoparticipateinthestudy.

Thecriteriaforparticipatinginthestudywere: 1 Being18yearsorolder,

2 Nothavingadiagnoseforriskedpregnancy 3 Beingprimigravida

4 Havingalivingandonlyonefetus 5 Beingatleastprimaryschoolgraduate

6 Beingopentocommunicationandco-operation 7 UnderstandingandspeakingTurkish

8 Notparticipatinginthepregnantwomen_’seducationclasses Todeterminethesamplesize,apoweranalysiswasconducted. Whencalculatingthesamplesize,SCPEQLtotalscore,whichcanbe foundinÖzorhan’s[21]study,wasused.Inthis study,pregnant womenwerefoundtohaveaSCPEQLtotalscoreof60.511.25.

In a poweranalysisperformed byusing GPower3.1 (http:// www.gpower.hhu.de/)program,totalsamplesizewasfoundtobe 6whenusingstudentt-testandtaking80%powerandalfa=005. Thestudywasconductedwith60women(30intheexperimental, 30inthecontrolgroup).

2.2.Datacollection

Forcollectingthedata,a“PersonalDataForm”,whichincluded descriptive data of the pregnant women, and the “Scale of

ComplaintsDuringPregnancyandEffectsonQualityofLife”were usedtoassessthecomplaintsduringpregnancyandtheireffects onqualityoflife.Datawascollectedbytheresearcherduringin personmeetings.

2.2.1.Personaldataform

Theformconsistedof10questionsincludingsociodemographic information(age,educationalstatus,workstatus,economicstatus, familytypeetc.)andthedesireforpregnancy.

2.2.2.Scaleofcomplaintsduringpregnancyandeffectsonqualityof life(SCPEQL)

SCPEQLwasdevelopedin2008byFoxcroftetal.inAustraliafor health personnel to identify the frequency of the complaints duringpregnancy,andtoassesshoweachofthemaffectwomen’s dailylives.InTurkey,thereliabilityandvalidityofthescalewas conducted by Özorhan in 2016. Cronbach’s alpha internal consistencylevel was foundtobe0.91. Thescale has42 items intotal,andconsistsoftwoparts.Intheﬁrstpart,thefrequencyof thecomplaintsofthewomeninthelastmonthisassessed,andisa four-pointlikertscaleinwhich“never” (0),“rarely”(1), “some-times” (2), and “often”(3) can be chosen. If thewomen have complaints,andtheymarkbetween1–3intheﬁrstpart,second part will be completed. The second part assesses how the complaints of the women affect their daily activities and is a three-pointlikertscaleinwhich“doesnotrestrict”(0),“restrictsa little(1)”,and “restrictsa lot (2)” canbechosen. In thisstudy, Cronbach’salphainternalconsistencyoftheSCPEQLwasfoundto be0.75.Thelowestscorethatcanbeobtainedfromthescaleis0 andthehighestis210.Ariseinthetotalscoreindicatesbad/weak/ lowmaternalandfetaloutcomes[21].

2.3.Collectionofthedata

ThedatawascollectedbetweenSeptember2016andMay2017 bytheresearcherduringinpersonmeetings.

Theresearchwasconductedwithanexperimentalandacontrol group, two groups in total. Meetings were arranged with the pregnantwomenwhoappliedtotheclinic,whomettheinclusion criteriaandwhoacceptedvoluntarilytoparticipateinthestudy, andthedatawascollectedaftergivingwomeninformationabout thepurposeofthestudy.

Amongstthepregnantwomencomingtotheclinic,meetings withthecontrolgroupwereﬁrstarrangeduntiltheComplaints During Pregnancy Education Booklet printing process was completed.Afterthebookletwas completed,meetingswiththe womenintheexperimentalgroupwereorganized.

Toassessthecomplaintsduringpregnancyandtheireffectson qualityoflife,eachwomanwasvisitedapproximatelyonthelast threeweeksof eachtrimester (1st trimester10-14.weeks,2nd trimester22-24.weeks,3rdtrimester34.weekandabove),three timesintotal.

2.3.1.Experimentalgroup

1interview: wasconductedbetweenthe10-14.weeks.On the firstmeeting,thepregnantwomenweremetinpersonandthe “Personal Data Form” and the “Scale of Complaints During PregnancyandEffectsonQualityofLife”werecompleted.Next, inpersoneducationwasgivenonpregnantwomen’scomplaints bybenefitingfrom“ComplaintsDuringPregnancyBooklet”.The booklet,which wascreated bytheresearchersinlight ofthe literature, consists of two chapters. In the first chapter, information about the anatomy and mechanism of female reproductive organs, and the formation of pregnancy were explained, and in the second chapter, complaints during pregnancy,thereasons,andcopingstrategieswerepresented.

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The duration of the education varied depending on the frequencyofthecomplaints, andontheeffects onqualityof life.Thebookletwasgiventothewomenontheﬁrstmeeting. 2interview:wasconductedbetweenthe22-24.weeks.Scaleof ComplaintsDuringPregnancyandEffectsonQualityofLifewas completed once more during in person meetings, and the educationregardingthecomplaintswasrepeated.

3interview:wasconductedonthe34.weekand after.Scaleof ComplaintsDuringPregnancyandEffectsonQualityofLifewas completedoncemore.

2.3.2.Controlgroup

Threemeetings(1sttrimesterbetweenthe10-14.weeks,2nd trimesterbetweenthe22-24.weeks,3rdtrimesteronthe34.week orafter)weremadewiththewomenchosenforthecontrolgroup. Thewomeninthecontrolgroupdidnotreceiveanyintervention exceptfromtheroutinenursingcareinthehospital.Intheﬁrst meeting,“PersonalDataForm”and “ScaleofComplaintsDuring PregnancyandEffectsonQualityofLife”werecompleted.Onthe secondand thethird meetings,theScale ofComplaints During PregnancyandEffectsonQualityofLifewascompletedagainon thephone(Fig.1).

2.4.Statisticalanalyses

Percentage, arithmetic mean, standard deviation, chi-square test,Mann-WhitneyUtestandWilcoxontestwereusedtoanalyze thedata.

Whenconductingthestatisticalanalysesofthestudy,thedata was grouped to simplify the data. In the ﬁrst part of SCPEQL, women who chose “rarely”, “sometimes” and “often” were

consideredtohavecomplaints,andthewomenwhochose“never” wereconsiderednottohaveanycomplaints.

Regardingthecomplaintsthataffecteverydaylife,whichwasin the second partof the SCPEQL, women who chose “restrictsa little”,and “restrictsalot”, wereconsideredtohavecomplaints thataffecttheireverydaylives,andwomenwhochose“doesnot restrict” wereconsideredtohavecomplaintsthat do notaffect theireverydaylives.

2.5.Ethicalprinciplesoftheresearch

Beforeconductingtheresearch,approvalfromtheEthicsBoard oftheSchoolofMedicine,CukurovaUniversity(15.07.2016/55-45), writtenapprovalsfromtheinstitutionsinwhichthestudywasto be performed, and verbal consent from the participants were obtained. Before collecting the data, ethical principles,namely “InformedConsent,”“ConfidentialityandProtectionofCon fidenti-ality,” and “Respect to Autonomy” principles were fulfilled by explainingtheaimofthestudytothewomen,byreportingthatthe informationobtainedwouldbekeptconfidential,andbyincluding theindividualswhovoluntarilywantedtoparticipateinthestudy. Inaddition,possiblequestionsofthewomenwereansweredafter thecompletionofthesurvey,andnecessaryinformationwasgiven. 3.Results

3.1.Findingsregardingsociodemographicvariablesofthepregnant women

Socio-demographic characteristics of the experimental and controlgroupswerehomogeneous,andthedifferencebetweenthe groupswasnotstatisticallysigniﬁcant(p>005)inthestudy. 3.2.Findingsregardingthecomplaintsofpregnantwomenintheir1st trimester

Whenthemostfrequentcomplaintsintheexperimentaland controlgroupswereinvestigated,thesubjectsintheexperimental group most commonly reported tiredness or fatigue, urinary frequency,nauseaandchangesintaste/smell,hiporpelvicpain, breast pain, and feeling depressed. Most commonly reported complaintsofpregnantwomeninthecontrolgroupweretiredness orfatigue,nausea,feelingdepressed,hiporpelvicpain,drymouth, breastpain,andchangesintaste/smell.Thedifferencesbetween the experimental and the control group was not statistically signiﬁcant in terms of complaintsexperienced during the ﬁrst trimester(p>005)(Table1).

3.3.Findingsregardingthecomplaintsofpregnantwomenintheir2nd trimester

Whencomparingtheexperimentalandthecontrolgroups,the differences between the groups was found to be statistically signi_ﬁcant, and the control group reported having more com-plaintssuchasconstipation,poorsleep,thrush,sciatica/paindown the back of their legs, hip or pelvic pain, heart palpitation, shortnessofbreath,itchyskin,stretchmarks,andswollenhandsor feet(p<005)(Table2).

3.4.Findingsregardingthecomplaintsofpregnantwomenintheir3rd trimester

When comparing the experimental and the control groups, complaints regarding tiredness or fatigue, reﬂux, constipation, restless legs, cramps in legs, urinary frequency, incontinence/ leakingurine, thrush,carpel tunnel(numb hands),sciatica/pain Fig.1.Researchﬂowchart.

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down the back of their legs, back pain, breast pain, heart palpitation, shortness of breath, altered body image, varicose veins,brownmarksontheirfaces,itchyskin,stretchmarks,and swollenhands orfeetsuggestedthatthewomeninthecontrol group had more complaints, and the difference between the groupswasstatisticallysigniﬁcant(p<005)(Table3).

3.5.MainscoresoftheSCPEQLofthepregnantwomen

WhencomparingthemeanscoresofSCPEQLofthepregnant womenintheir1sttrimester,themeanscoresoftheSCPEQLofthe interventiongroupwas85.922.6,themeanscoresofSCPEQLof thecontrolgroupwas78.025.6,andthedifferencebetweenthe groupswasnotstatisticallysigniﬁcant(p>005)(Table4).

WhencomparingthemeanscoresofSCPEQLofthepregnant womenintheir2ndtrimester,themeanscoresoftheSCPEQLinthe interventiongroupwas46.221.1,themeanscoresoftheSCPEQL ofthecontrolgroupwas99.821.6,andthedifferencebetween thegroupswasstatisticallysigniﬁcant(p<005)(Table4).

Forthewomenintheir3rdtrimester,thetotalmeanscoresof theSCPEQLoftheinterventiongroupwas43516,4,andthetotal meanscoresoftheSCPEQLofthecontrolgroupwas108.016.8. Thedifferencebetweenthegroupswasstatisticallysigniﬁcantin 2ndand3rdtrimestersofthepregnancy(p<0.05)(Table4).

4.Discussionandconclusion 4.1.Discussion

Womenintheexperimentalgroupintheir1sttrimesterwere seentoexperiencemostlytirednessorfatigue,urinaryfrequency, nausea,taste/smellchanges,hiporpelvicpain,sorebreasts,feeling depressed,sorenipples,drymouth,poorsleep,increasedvaginal discharge,backpain,headache,andforgetfulness.Womeninthe control group were noticed to experience mostly tiredness or fatigue,changesintaste/smell,drymouth,sorebreasts,nausea, feeling depressed, hip/lower back pain, reﬂux, headache, and urinary frequency. Womenin their1st trimester inthe experi-mentalgroupwerenotedtoexperienceallthecomplaintsonthe scale except for swollen hands or feet and pregnancy mask, whereas the women in the control group experienced all the complaintsonthescale,and thedifferencebetweenthegroups wasnotstatisticallysigniﬁcant(p>005)(Table1).Womenintheir 1sttrimesterwereseentoexperiencesimilarcomplaintsinthe literatureinaccordancewiththisstudy’sresults.

Intheir2ndtrimester,themostcommoncomplaintsofwomen in the experimental group were identi_ﬁed to be tiredness or fatigue,alteredbodyimage,feelingdepressed,changesinnipples, urinaryfrequency,hip/lowerbackpain,forgetfulness,restlesslegs, Table1

ComparisionofComplaintsofPregnancyin1stTrimester.

Symptom Casegroup

n% Controlgroup n% p 1.Tirednessorfatigue 2893.3 2893.3 1.000X2 2.Nausea 2686.7 2376.7 0.317X2 3.Vomiting 1756.7 1963.3 0.598X2 4.Reﬂux 1860.0 2273.3 0.273X2 5.Constipation 1136.7 1653.3 0.194X2 6.Haemorroid 516.7 930.0 0.220X2 7.Drymouth 2273.3 2480.0 0.542X2 8.Foodcravings 1860.0 2066.7 0.592X2 9.Poorsleep 2273.3 1756.7 0.176X2 10.Restlesslegs 1963.3 1240.0 0.074X2 11.Legscamps 1860.0 1446.7 0.301X2 12.Snoring 26.7 13.3 0.554X2 13.Urinaryfrequency 2893.3 2273.3 0.112X2 14.Incontinence/leakingurine 516.7 620.0 0.739X2

15.Increasedvaginaldischarge 2273.3 2066.7 0.573X2

16.Thrush 930.0 930.0 1.000X2

17.Changesinlibido 2170.0 1653.3 0.184X2

18.Painfulveinsinvagina 26.7 516.7 0.228X2

19.Carpeltunnel(numbhands) 1343.3 1653.3 0.438X2

20.Sciatica/paindownthebackofyourlegs 1550.0 1550.0 1.000X2

21.Backpain 2273.3 2170.0 0.774X2

22.Hiporpelvicpain 2583.3 2376.7 0.519X2

23.Breastpain 2583.3 2480.0 0.739X2 24.Headache 2273.3 2273.3 1.000X2 25.Sorenipples 2273.3 2170.0 0.774X2 26.Dizziness 1756.7 1550.0 0.605X2 27.Faiting 310.0 26.7 0.640X2 28.Heartpalpitation 1446.7 1550.0 0.796X2 29.Shortnessofbreath 1446.7 1860.0 0.301X2 30.Taste/smellcahanges 2686.7 2790.0 0.688X2 31.Forgetfulness 2273.3 1756.7 0.176X2 32.Feelingdepressed 2480.0 2376.7 0.754X2 33.Anxiety 2066.7 1963.3 0.787X2 34.Vividdreams 310.0 13.3 0.301X2

35.Alteredbodyimage 1963.3 1550.0 0.297X2

36.Greaskyskin/acne 930.0 826.7 0.774X2

37.Varicosevens 310.0 826.7 0.095X2

38.BrownMarksonface 00.0 26.7 0.150X2

39.Itchyskin 1343.3 930.0 0.284X2

40.Changesinnipples 1963.3 1860.0 0.791X2

41.StrechMarks 13.3 516.7 0.085X2

42.Swollenhandsorfeet 00.0 413.3 0.112X2

X2

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poorsleep and leg cramps.On the otherhand, women in the controlgroupwereseentomainlyexperiencetirednessorfatigue, hiporlowerbackpain,alteredbodyimage,changesin nipples, poor sleep, urinary frequency, dry mouth, increase vaginal discharge,itchyskin, shortnessof breath,heart palpitationand feeling depressed (Table 2).In accordance with the study, the women in their2ndtrimester wereseen toexperience similar complaintsintheresearchesbyNazikandEryılmaz[7],Taşkıran [12]ÇobanandYan_ıkkerem[22]andCarvalhoetal.[23]

Whencomparingthecomplaintsexperiencedbythewomenin theexperimentalandinthecontrolgroup;womenintheir2nd trimesterhadcomplaintsregardingconstipation,drymouth,poor sleep,thrush, sciatica/pain downthe backof theirlegs, hipor pelvic pain, heart palpitation, shortness of breath, itchy skin, stretch marks and swollen hands or feet, and the difference between the groups was found to be statistically signiﬁcant (p<005)(Table2).Theseresultssuggestthattheeducationduring theﬁrstmeeting,andtheinformationontheComplaintsDuring Pregnancyand Education Booklet were effective in preventing thesecomplaints.

In the3rdtrimester, womenin theexperimental grouphad mostcommonlycomplaintsoftirednessorfatigue,legcramps,hip orlowerbackpain,tirednessorfatigue,alteredbodyimage,poor sleep,urinary frequency, feeling depressed,anxiety, changes in

nipples, shortness of breath, and forgetfulness. Women in the controlgroup,ontheotherhand,reportedhavingcomplaintsof mainlyhiporpelvicpain,reﬂux,restlesslegs,swollenhandsorfeet andshortnessofbreath,poorsleep,changesinnipples,backpain, urinaryfrequency,andalteredbodyimage(Table3).Inaccordance withthestudy,NazikandEryılmaz[7],Aydemir[8],Panicker[10], Nacar[24],Türkmen[14]andAyan[22]foundthatwomenintheir 3rdtrimesterhadsimilarcomplaints.

Thestudyresultsrevealedthathewomenintheexperimental groupintheir3rdtrimesterexperiencedlesstirednessorfatigue, reflux,constipation,hemorrhoids,restlesslegs,legcramps,urinary frequency,thrush,carpeltunnel(numbhands),sciatica/paindown the backof theirlegs, backpain, sore breasts, heart palpation, shortness of breath, altered body image,varicose veins, brown marks on face, itchy skin, stretch marks, incontinence/leaking urine,swollenhandsorfeet,andtherewasasignificantdifference between the groups (p<005) (Table 3). In the 3rd trimester, women in the experimental group reported having much less complaintsthanthewomeninthecontrolgroup,suggestingthat the repetitive education given to the women was effective.In accordancewiththestudy,inaresearchbyAltıparmak[25],where effectsofprenataleducationoninformationandsatisfactionlevel wasassessed,therewasastatisticallysignificantdifferenceinthe informationscoresbeforeandaftertheeducation(p<005)sinthe Table2

ComparisionofComplaintsofPregnancyin2ndTrimester.

Symptom Casegroup

16.Thrush 723.3 1550.0 0.032X2

21.Backpain 1550.0 2066.7 0.190X2

37.Varicosevens 516.7 723.3 0.519X2

39.Itchyskin 1343.3 2376.7 0.008X2

41.StrechMarks 930.0 1756.7 0.037X2

X2

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partofthestudywherecopingwiththechanges andtheusual complaintsoccurringduringpregnancywascovered

Inthisstudy,thelowerthemeanscoresobtainedbythewomen fromthescaleis,thehigheristhequalityoflife.Nostudieswere foundintheliteraturethatusedtheScaleofComplaints during PregnancyandTheirEffectsonQualityofLife.Inthe1sttrimester, themeanscoresofwomenintheexperimentalgroupontheScaleof ComplaintsduringPregnancy andTheirEffectsonQualityofLifewas foundtobehigher.However,inthe2ndandthe3rdtrimesters,the totalscoreonthescaleofthewomenintheexperimentalgroupwas foundtobelowerthanofthecontrolgroup(Table4).Thedecreasein themeanscoresobtainedbythewomenontheScaleofComplaints

duringPregnancyandTheirEffectsonQualityofLifeanditbeing statistically signiﬁcant implies that the education given on the complaintsduringpregnancywaseffective.Similarly,inYenal’s[26] study“EffectsofaWeb-BasedPregnancyEducationProgramonDaily Living Activities of PregnantWomen”, aftereducation,the total scoresondailyactivitiesofpregnantwomenincreasedcomparedto thescoresbeforetheeducation,andthedifferencewasstatistically signiﬁcant(p<005)Inastudyby _Isbir[27]pregnantwomenwho experiencednauseaandvomitingwereeducatedaccordingtoRoy AdaptationModel,andaftertheeducation,thewomencopedbetter with nausea and vomiting, and adapted better to the role of motherhood.InastudybyAltıparmakandCoskun[25]attheendof Table3

ComparisionofComplaintsofPregnancyin3rdTrimester.

Symptom Casegroup

16.Thrush 413.3 2170.0 0.000X2

21.Backpain 1550.0 2790.0 0.000X2

37.Varicosevens 516.7 1240.0 0.045X2

39.Itchyskin 1446.7 2686.7 0.001X2

41.StrechMarks 930.0 2480.0 0.000X2

X2

Ki-karetest(Fishertest).

Table4

ExperimentalAndControlGroupPregnantSCPEQLComparisonOfPointsAverage. Casegroup Means.sMedyan Controlgroup Means.sMedyan p 1stTrimester 85.922.683.5 78.025.674.5 0.156m 2ndTrimester InGroupChangep 46.221.144.0 0.000w 99.821.6102.5 0.000w 0.000m 3rdTrimester InGroupChangep 43.516.443.0 0.000w 108.016.8112.0 0.000w 0.000m m Mann-whitneyutest/w WilcoxonTest.

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the education given to the pregnant women, which included complaintsduringpregnancy,thegroupthatreceivedtheeducation hadanincreaseintheinformationlevelregardingthecomplaints, andthewomencopedbetterwiththecomplaintsInSerçekus’[28] study“InvestigationThatEffectofChildbirthEducationClassesand IndividualEducationonPregnancy andPostpartumAdaptation”,the education given to pregnant women decreased the complaints duringpregnancy.

4.2.Conclusions

Prenatal education was found to decrease the complaints during pregnancy, and increase the quality of life of pregnant womeninthestudy.Inaccordancewiththeﬁndingsofthisstudy, followingsuggestionscanbemade;

Evaluating the complaints during pregnancy by the nurses baringinmindthatthecomplaintsaffectthequalityoflife, Improvingthe role ofan educator,which isone of the most

importantrolesofanurse,

Increasingeducationalactivitiesregardingprenatalcare, Providingregularin-serviceeducationtothenurses/midwives

forthemtopassinformationcorrectlyandefﬁcientlytopregnant women,

Conductingthestudywithalargersamplesize. 4.3.Practiceimplications

Prenataleducationdecreasedthecomplaintsduringpregnancy andincreasedthequalityoflifeinthisstudy.Theseresultssuggest that education about complaints during pregnancy given to pregnantwomenbynursesandmidwivesareeffective.Therefore, nursesandmidwivesgivingprenataltrainingshouldquestionthe complaintsduringpregnancyandtheireffectsonqualityoflife.In addition,nursesandmidwivesshouldprovidenecessaryeducation andcounselingtopregnantwomen.

Contributionoftheauthors

All authors have contributed significantly to this article to designofthework;analysis,orinterpretationofdataforthework and all authors are in agreement with the content of the manuscript. Authors' contributions SKY collected the data. EN analyzed the data. EN and SKY drafted and finalized the manuscript. Allauthorscontributed tothedesign of thestudy, andreviewedthemanuscript.Allauthorsreadandapprovedthe finalmanuscript.

Disclosure

Theauthorsreportnoconﬂictofinterest. Funding

This study is a master thesis. The author(s) received the following ﬁnancialsupport forthe research, authorship,and/or publication of this article: This study was supported by the researchfundfromCukurovaUniversitywiththeProjectnumber TYL-2016-7517.

Acknowledgements

Theauthorsgratefultoallthepatientswhoparticipatedinthis studyandtotheCoordinatorshipofScientiﬁcResearchProjectsof CukurovaUniversitywhichsupportsbytheresearchfund.

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