The effect of a self-care program based on the teach back method on the postpartum quality of life

Authors

  • Hedyeh Riazi Ph.D., Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Keywords:

Self-care, Teach Back method, Postpartum quality of life

Abstract

Background: The postpartum period is a critical stage of life with major changes in the quality of life. Therefore, special consideration is needed to this issue.  

Objective: To determine the effect of a self-care program based on the Teach Back method on the postpartum quality of life.

Methods: This experimental study was conducted on eighty postpartum women who had given birth in health centers across Darreh Shahr County, Ilam Province, Iran in 2016. The control group received only routine postpartum care according to the national guidelines. The trial group received the routine care in addition to two sessions of physical and psychological postpartum self-care based on the Teach Back method. The two groups were assessed in terms of their quality of life before and after the intervention using the Postpartum Quality of Life Questionnaire. The data were analyzed using SPSS version 21. Descriptive statistic tests, Chi squared, independent-samples t-test, paired-samples t-test, Wilcoxon and Mann Whitney’s test was used. 

Results: Before the intervention, the postpartum quality of life score was 106.23±11.866 in the trial group and 107.30±13.197 in the control group; after the intervention, the score was 124.73±10.706 and 115.03±12.687 in the two groups respectively, suggesting a significant inter-group difference after the intervention (p<0.001). Significant differences were also observed between the two groups in terms of the mother's feelings toward herself, toward her child and toward her spouse and others, and physical health before and after the intervention (p<0.001). 

Conclusions: Using the Teach Back model for a self-care program appears to dramatically improve the postpartum quality of life and is therefore recommended as a useful method for postpartum care.

Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015012820854N1.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

 

References

Ghodsbin F, Yazdani K, Jahanbin I, Keshavarzi S. The Effect of Education on Health-Promoting Behaviors

at The First Six Weeks Post-Delivery On The Quality Of Life Of Primiparous Women. Armaghane-danesh.

; 17(4(70)): 279-88.

Nazik E, Erylmaz G. The prevention and redaction of postpartum complications: orem’s model. Nurs Sci

Q. 2013; 26(4): 360-4. doi: 10.1177/0894318413500402. PMID: 24085674.

Orem DE. A concept of self care for the rehabilitation client. Rehabil Nurs. 1985; 10(3): 33-6. doi:

1002/j.2048-7940.1985.tb00428.x. PMID: 3846326.

Hammoudeh W, Mataria A, Wick l, Giacaman R. In search of health: quality of life among postpartum

Palestinian women. Expert Rev Pharmacoecon Outcomes Res. 2009; 9(2): 123-32. doi: 10.1586/erp.09.8.

PMID: 19402799.

Woolhouse H, Gartland D, Perlen S, Donath S, Brown SJ. Physical depression in the first 12 months

postpartum: results of an Austrialian nulliparous pregnancy cohort study. Midwifery. 2014; 30(3): 378-84.

doi: 10.1016/j.midw.2013.03.006. PMID: 23619027.

Sadat Z, Abedzadeh-Kalahroudi M, Kafaei Atrian M, Karimian Z, Sooki Z. The impact of postpartum on

quality of life in women after child’s birth. Iran Red Crescent Med J. 2014; 16(2): e14995. doi:

5812/ircmj.14995. PMID: 24719747, PMCID: PMC3965880.

Webb DA, Bloch JR, Coyne JC, Chung EK, Bennett IM, Culhane JF. Postpartum physical symptoms in

new mothers: their relationship to functional limitations and emotional well-bing. Birth. 2008; 35(3): 179- 87. doi: 10.1111/j.1523-536X.2008.00238.x. PMID: 18844643, PMCID: PMC3815625.

Huang K, Tao F, Liu L, Wu X. Does delivery mode affect women’s postpartum quality of life in rural

China? J Clin Nurs. 2012; 21(11-12): 1534-43. doi: 10.1111/j.1365-2702.2011.03941.x. PMID: 22023714.

Cheng CY, Li Q. Integrative review of research on general health status and prevalence of common

physical health conditions of women after childbirth. Women's Health Issues. 2008; 18(4): 267-80. doi:

1016/j.whi.2008.02.004. PMID: 18468922.

Williams A, Herron-Marx S, Carolyn H. The prevalence of enduring postnatal perineal morbidity and its

relationship to perineal trauma. Midwifery. 2007; 23(4): 392-403. doi: 10.1016/j.midw.2005.12.006.

PMID: 17335531.

Taheri-Kalani F, Mami S, Direkvand-Moghadam A, Kaikhavani S, Delpisheh A. Comparison of the effect

of delivery type on the quality of life in women attending to health centers of Ilam and Aivan during 2013.

J Shahrekord Univ Med Sci. 2014; 16(2): 90-6.

Akbarzadeh M, Toosi M, Zare N, Sharif F. Effect of Relaxation Training to Pregnant Mothers on Quality

of life and Postpartum Blues. Knowledge & Health. 2012; 7(2): 83-8.

Kim Y, Dee V. Self-Care for Health in Rural Hispanic Women at Risk for Postpartum Depression. Matern

Child Health J. 2016. doi: 10.1007/s10995-016-2096-8. PMID: 27435729.

Wilson FL, Baker LM, Nordstrom CK, Legwand C. Using the teach-back and Orem's Self-care Deficit

Nursing theory to increase childhood immunization communication among low-income mothers. Issues

Compr Pediatr Nurs. 2008; 31(1): 7-22. doi: 10.1080/01460860701877142. PMID: 18300059.

Negarandeh R, Mahmoodi H, Noktehdan H, Heshmat R, Shakibazadeh E. Teach back and pictorial image

educational strategies on knowledge about diabetes and medication/dietary adherence among low health

literate patients with type 2 diabetes. Prim Care Diabetes. 2013; 7(2): 111-8. doi:

1016/j.pcd.2012.11.001. PMID: 23195913.

Yue Z, Li C, Weilin Q, Bin W. Application of the health belief model to improve the understanding of

antihypertensive medication adherence among Chinese patients. Patient Educ Couns. 2015; 98(5): 669-73.

doi: 10.1016/j.pec.2015.02.007. PMID: 25746128.

Tol A, Majlesi F, Shojaeizadeh D, Esmaelee Shahmirzadi S, Mahmoudi Majdabadi M, Moradian M. Effect

of the educational intervention based on the health belief model on the continuation of breastfeeding

behavior. J Nurs Edu. 2013; 2(2): 39-47.

Safarzade S, Behboodi MZ, Safari M. The impact of education on performing postpartum exercise based

on health belief model. Medical Journal of Mashhad University of Medical Sciences. 2014; 57(6): 776-84.

Troy NW, Dalgas-Pelish P. The effectiveness of a self-care intervention for the management of postpartum

fatigue. Appl Nurs Res. 2003; 16(1): 38-45. doi: 10.1053/apnr.2003.50001. PMID: 12624861.

White M, Garbez R, Carroll M, Brinker E, Howie-Esquivel J. Is “teach-back” associated with knowledge

retention and hospital readmission in hospitalized heart failure patients? J Cardiovasc Nurs. 2013; 28(2):

-46. doi: 10.1097/JCN.0b013e31824987bd. PMID: 22580624.

Schillinger D, Piette J, Grumbach K, Wang F, Wilson C, Daher C, et al. Closing the loop: physician

communication with diabetic patients who have low health literacy. Arch Intern Med. 2003; 163(1): 83-90.

doi: 10.1001/archinte.163.1.83. PMID: 12523921.

Wilson FL, Mayeta-Peart A, Parada-Webster L, Nordstrom C. Using the teach-back method to increase

maternal immunization literacy among low-income pregnant women in Jamaica: a pilot study. J Pediatr

Nurs. 2012; 27(5): 451-9. doi: 10.1016/j.pedn.2011.05.004. PMID: 22920656.

Sudore RL, Schillinger D. Interventions to improve care for patients with limited health literacy. J Clin

Outcomes Manag. 2009; 16(1): 20-9. PMID: 20046798, PMCID: PMC2799039.

Bickmore TW, Pfeifer LM, Paasche-Orlow MK. Using computer agents to explain medical documents to

patients with low health literacy. Patient Educ Couns. 2009; 75(3): 315-20. doi: 10.1016/j.pec.2009.02.007.

PMID: 19297116, PMCID: PMC2692364.

Kandula NR, Malli T, Zei CP, Larsen E, Baker DW. Literacy and retention of information after a

multimedia diabetes education program and teach-back. J Health Commun. 2011; 16 Suppl 3: 89-102. doi:

1080/10810730.2011.604382. PMID: 21951245.

Mir Molayii T, Moshrefi M, Kazem nejad A, Farivar F, Morteza H. The effect of education on the

pregnancy’s nutrition behaviors. Hayat. 2009; 15(4): 35-42.

Atinga R, Baku A, Adongo P. Drivers of prenatal care quality and uptake of supervised delivery services in

Ghana. Ann Med Health Sci Res. 2014; 4(Suppl 3): S264-71. doi: 10.4103/2141-9248.141970. PMID:

, PMCID: PMC4212388.

Renfrew MJ, McFadden A, Bastos MH, Campbell J, Channon AA, Cheung NF, et al. Midwifery and

quality care: findings from a new evidence-informed framework for maternal and newborn care. Lancet.

; 384(9948): 1129-45. doi: 10.1016/S0140-6736(14)60789-3. PMID: 24965816.

Dalir Z, Reihani Z, Mazlom SR, Vakilian F. Effect of Training Based on Teach Back Method on Self-care

in Patients with Heart Failure. J Mazandaran Univ Med Sci. 2016; 25(134): 209-20.

Nasiri A, Poodineh moghadam M. Effect of an educational plan based on Teach-Back method on

hemodialysis patients' self-care deficits. Mod Care J. 2012; 9(4): 344-54.

Hatefi Moadab N, Elahi N, Moradbeygi K, Fakhri M, Latifi SM, Elhami S. Effect of Teach- Back

Educational Method on Surgical Anxiety in Primiparous Cesarean Section Women. Journal of Clinical

Research Paramedical Sciences. 2015; 4(2): 169-77.

Sadat Z, Abedzadeh-Kalahroudi M, Kafaei Atrian M, Karimian Z, Sooki Z. The impact of postpartum

depression on quality of life in women after child's birth. Iran Red Crescent Med J. 2014; 16(2): e14995.

doi: 10.5812/ircmj.14995. PMID: 24719747, PMCID: PMC3965880.

Torkan B, Parsaee S, Lamiean M, Kazemnejed A, Montazeri A. Comparative study of quality of life of

mothers in two natural delivery and cesarean methods. J Esfahan Nursing and Midwifery College. 2007;

: 78-85.

Jeon M, Hwang Y. Effects of an Educational Program on Pre-and Postpartum Self-care Knowledge,

Efficacy of Self-care, and Interest in Health of Marriage Immigrant Women in South Korea. JCIT. 2013;

(14): 508-14.

Slater B, Dalawari P, Huang Y. Does the teach-back method increase patient recall of discharge

instructions in the emergency department? Annals of Emergency Medicine. 2013; 62(4): S20. doi:

1016/j.annemergmed.2013.07.335.

Logsdon MC, Davis D, Eckert D, Smith F, Stikes R, Rushton J, et al. Feasibility of Two Educational

Methods for Teaching New Mothers: A Pilot Study. Interact J Med Res. 2015; 4(4): e20. doi:

2196/ijmr.4583. PMID: 26449647, PMCID: PMC4704909.

Apay SE, Çapik A, Nazik E, Özdemir F. The Effect of the Care Given Usıng Orem’s Self-Care Model on

the Postpartum Self-Evaluation. International Journal of Caring Sciences. 2015; 8(2): 393-403.

Liu N, Mao L, Sun X, Liu L, Yao P, Chen B. The effect of health and nutrition education intervention on

women's postpartum beliefs and practices: a randomized controlled trial. BMC Public Health. 2009; 9(1):

doi: 10.1186/1471-2458-9-45. PMID: 19183504, PMCID: PMC2640472.

Karuna M. Quality of Life of New Parents Participating in a Community-based, Professionally-facilitated

New Parent Support Group. University of Washington. 2014. Available from:

http://hdl.handle.net/1773/26725.

Barkin JL, Wisner KL. The role of maternal self-care in new motherhood. Midwifery. 2013; 29(9): 1050-5.

doi: 10.1016/j.midw.2012.10.001. PMID: 23415369.

Stacks AM, Muzik M, Wong K, Beeghly M, Huth-Bocks A, Irwin JL, et al. Maternal reflective functioning

among mothers with childhood maltreatment histories: links to sensitive parenting and infant attachment

security. Attach Hum Dev. 2014; 16(5): 515-33. doi: 10.1080/14616734.2014.935452. PMID: 25028251,

PMCID: PMC4146668.

Shorey S, Chan SW, Chong YS, He HG. Perceptions of primiparas on a postnatal psychoeducation

programme: the process evaluation. Midwifery. 2015; 31(1): 155-63. doi: 10.1016/j.midw.2014.08.001.

PMID: 25174540.

Bahrami N, Simbar M, Bahrami S. The effect of prenatal education on mother’s quality of life during first

year postpartum among iranian women: a randomized controlled trial. Int J Fertil Steril. 2013; 7(3): 169-74.

PMID: 24520482, PMCID: PMC3914493.

Oshvandi Kh, Jokar M, Khatiban M, Keyani J, Yousefzadeh MR, Sultanian AR. The Effect Of Self Care

Education Based on Teach Back Method on Promotion of Self Care Behaviors In Type Ii Diabetic Patients:

A Clinical Trial Study. Iranian Journal of Diabetes and Metabolism. 2014; 13(2): 131-43.

Morrell CJ, Spiby H, Stewart P, Walters S, Morgan A. Costs and effectiveness of community postnatal

support workers: randomised controlled trial. BMJ. 2000; 321(7261): 593-8. PMID: 10977833, PMCID:

PMC27472.

Stamp GE, Williams AS, Crowther CA. Evaluation of antenatal and postnatal support to overcome

postnatal depression: a randomized, controlled trial. Birth. 1995; 22(3): 138-43. PMID: 7575861.

Gunn J, Lumley J, Chondros P, Young D. Does an early postnatal check-up improve maternal health:

results from a randomised trial in Australian general practice. Br J Obstet Gynaecol. 1998; 105(9): 991-7.

PMID: 9763051.

Bodhare TN, Sethi P, Bele SD, Gayatri D, Vivekanand A. Postnatal quality of life, depressive symptoms,

and social support among women in southern India. Women Health. 2015; 55(3): 353-65. doi:

1080/03630242.2014.996722. PMID: 25719436.

Valiani M, Haghighatdana Z, Ehsanpour S. Comparison of childbirth training workshop effects on

knowledge, attitude, and delivery method between mothers and couples groups referring to Isfahan health

centers in Iran. Iran J Nurs Midwifery Res. 2014; 19(6): 653-8. PMID: 25558265, PMCID: PMC4280732.

Maharlouei N, Rezaianzadeh A, Hesami E, Moradi F, Mazloomi E, Joulaei H , et al. The preference of

Iranian women to have normal vaginal or cesarean deliveries. J Res Med Sci. 2013; 18(11): 943-50. PMID:

, PMCID: PMC3906784.

Ghotbi F, Akbari Sene A, Azargashb E, Shiva F, Mohtadi M, Zadehmodares S, et al. Women's knowledge

and attitude towards mode of delivery and frequency of cesarean section on mother's request in six public

and private hospitals in Tehran, Iran, 2012. J Obstet Gynaecol Res. 2014; 40(5): 1257-66. doi:

1111/jog.12335. PMID: 24689693.

Tugut N, Golbasi Z, Bulbul T. Quality of Sexual Life and Changes Occurring in Sexual Life of Women

With High-Risk Pregnancy. J Sex Marital Ther. 2016; 22: 1-10. doi: 10.1080/0092623X.2016.1141816.

PMID: 26800362.

Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I. Women's sexual health after childbirth.

BJOG. 2000; 107(2): 186-95. PMID: 10688502.

Aln BJSE. Berek & Novaks Gynocology. 15th Ed. Philadelphia Lippincott ،Williams and Winlkinson.

; 270-304.

Wilmoth MC. Sexuality: A critical component of quality of life in chronic disease. Nurs Clin North Am.

; 42(4): 507-14. doi: 10.1016/j.cnur.2007.08.008. PMID: 17996752.

Cantarino SG, Pinto JM, Fabião JA, García AM, Abellán MV, Rodrigues MA. The Importance of

Religiosity/Spirituality in the Sexuality of Pregnant and Postpartum Women. PLoS One. 2016; 11(6):

e0156809. doi: 10.1371/journal.pone.0156809. PMID: 27309528, PMCID: PMC4911065.

Hipp LE, Kane Low L, van Anders SM. Exploring women's postpartum sexuality: social, psychological,

relational, and birth-related contextual factors. J Sex Med. 2012; 9(9): 2330-41. doi: 10.1111/j.1743- 6109.2012.02804.x. PMID: 22672428

Published

2022-01-18

Issue

Section

Articles