Comparison of the Effects of Lecture and Cognitive Behavioral Therapy with a Consulting Advisory Approach on the Anxiety Level of Women with High-risk Pregnancy in Comprehensive Health Centers of Sanandaj, Iran

High-risk pregnancy is a kind of pregnancy that causes anxiety and compromises the health of the mother and fetus. The current study aimed to compare the effect of lecture and cognitive behavioral methods on the anxiety level in women with high-risk pregnancy in Sanandaj, Iran.

The present interventional study was a randomized clinical trial performed on 144 women with high-risk pregnancy of 24-35 weeks referring to comprehensive health centers in Sanandaj, within 2018. To select samples, the city was divided into five districts and then the subjects were randomly selected from 6 centers with the highest number of women with high-risk pregnancy. In each center, the sampling units were selected by the available sampling method. Before the intervention, the Spielberger questionnaire was completed to assess the anxiety score. Then the samples were divided into three groups of cognitive behavioral (n =48), lecture (n=48), and control (n=48). The cognitive behavioral group was divided into four groups of 12 participants and the lecture group into two groups of 24 people, each. The intervention was performed twice a week in a 90-120 minute sessions for each cognitive behavioral group and once a week for each lecture group for a period of 4 weeks. The control group also received routine pregnancy care. Four weeks after the intervention, the Spielberger questionnaire was completed again by the researcher for all groups. Data analysis was performed using SPSS software (version 21) and the collected data were analyzed by Kruskal-Wallis, Chi-square, paired t-test, Tukey, covariance analysis, and one-way ANOVA. 

The results of the current study showed that before intervention there was no significant difference in the level of anxiety in the three groups of lecture, cognitive behavioral, and control groups (P<0.05). In addition, no significant difference was observed in the anxiety level of the control group (P>0.05). However, there was a significant difference in the lecture group (P<0.05) and the cognitive behavioral group (P<0.05) and the anxiety in the cognitive behavioral group decreased significantly (P<0.05), compared to the control and lecture groups.

The results of the current study showed that educating with the cognitive behavioral approach and lecture style reduced pregnancy anxiety. Moreover, cognitive behavioral training had a more effective impact on reducing anxiety during pregnancy. Therefore, it was concluded that in lecture and cognitive behavioral methods, mothers gain a higher ability to manage their anxiety and avoid thoughts or behaviors that lead to increased anxiety.