Stress and Sleep of Classical Turkish Music in Pregnant Women Diagnosed with Preeclampsia in Clinics The study to be carried out to determine the effect on quality is a randomized controlled experimental research. All patients who comply with the limitations of the study and volunteer will be included in the study. When the studies in the literature are examined, there are a limited number of studies on the effects of music on pregnant women diagnosed with preeclampsia, and no studies have been found on the effects of music on stress and sleep quality in pregnant women with preeclampsia. This research aimed to determine the effect of Classical Turkish Music on stress and sleep quality in pregnant women diagnosed with Preeclampsia in clinics.
Pregnancy is a natural process that has physiological, psychological and sociological effects on women's lives and is special and important for every woman, affecting both the person and her family (Koyucu et al., 2020; Toker, 2018; Coşkun, 2016). Maternal age, number of pregnancies and births, adverse environmental conditions such as alcohol and cigarette use, radiation, malnutrition, diseases the woman has during the pre-pregnancy period or diseases that occur during pregnancy all negatively affect the health of the mother and the fetus, leading to a risky pregnancy. (Taşkın, 2016; Toker, 2018). According to Turkey Demographic and Health Survey 2018 (TNSA, 2018) data, when births occurring in Turkey are examined, it is seen that 65.7% are in any high risk category and 35% are in at least one inevitable high risk category (TNSA , 2018). According to the report titled "Trends in Maternal Mortality" prepared by the World Health Organization (WHO), UNICEF, UNFPA, World Bank Group and UNDESA/Population Division; In 2020, an estimated 287,000 women per year worldwide died from preventable causes related to pregnancy and childbirth, approximately 800 every day; This means that one woman dies every two minutes (UNFPA, 2023; WHO, 2023; UNICEF, 2023; WHO, 2023). According to the 2020 data of the Ministry of Health, maternal mortality rates in our country decreased to 13.1 per hundred thousand as of 2019 (Ministry of Health, 2020). 10-15% of direct maternal deaths worldwide are related to preeclampsia and eclampsia, ranking 3rd among major complications (Akolekar et al., 2013; Demirci, 2022; WHO, 2020). According to 2019 data in our country, the first four most common causes of maternal deaths are; cardiovascular diseases (29%), embolism (16.1%), hypertension (14.2%) and bleeding (10.3%) (Maternal deaths study report, 2021; Republic of Turkey Ministry of Health Health Statistics Yearbook, 2021) . According to 2022 data of the Turkish Gynecology and Obstetrics Association, it is estimated that at least 42,000 maternal deaths annually are caused by preeclampsia (Turkish Gynecology and Obstetrics Association, 2022). Preeclampsia; It is a pregnancy-specific disease and is a symptom characterized by hypertension (systolic blood pressure 140 mmHg and above and/or diastolic blood pressure 90 mmHg and above) and end organ dysfunction with or without proteinuria after the 20th week of pregnancy (Jung and al., 2022). Preeclampsia is a disease whose physiopathology is still not fully known. The decline in prognosis with the disappearance of the placenta after birth indicates that preeclampsia may be of placental origin (Thilaganathan \& Kalafat., 2019). Preeclampsia causes dysfunction in the liver, kidney, uterus, respiratory, cerebrovascular and cardiovascular systems. If it is not diagnosed at an early stage and appropriate treatment is not provided, it may become severe in a short time and turn into eclampsia. Eclampsia is a condition that occurs with the addition of convulsions in a pregnant woman with preeclampsia symptoms, without any neurological or metabolic disease (Hansson et al., 2015; Dag et al., 2015; Günkur, 2019; Akalın \& Şahin, 2018). Since preeclampsia is in the risk category during pregnancy, it may cause increased anxiety in pregnant women regarding birth and motherhood, as well as conditions such as stress and sleep disorders. In this context, the physiological health of the pregnant woman also negatively affects her psychosocial state. Hospitalization experience and bed rest in pregnant women with a risky pregnancy diagnosis such as preeclampsia; Reasons such as being away from family and home, activity limitation, uncertainty, being in an unknown environment, not being able to fulfill their roles, anxiety about the fetus and their own health, repeated laboratory and screening tests can cause stressful results (Gourounti et al., 2015; Özçetin \& Erkan). , 2019). In the studies carried out; It has been determined that the risk of IUGR increases in women with high stress levels during pregnancy, there is an increase in cortisol and adrenaline levels, there is a decrease in dopamine and serotonin levels, the fetus is more active, and mood and irregular sleep changes are experienced more frequently in the pregnant woman (Yousefzadeh, 2022; Spehar et al. ., 2018; Şen, 2020; Karadeniz et al., 2023). Again in the literature; It has been stated that in pregnant women hospitalized in clinics, insomnia complaints are common during hospitalization due to the treatment regimen and hospital conditions, and there is dissatisfaction with sleep quality (Spehar et al., 2018; Şen, 2020; Karadeniz et al., 2023). However, approximately 1/3 of human life is spent sleeping. Restricting sleep or reducing its quality are factors that can cause detrimental effects on life expectancy and quality (Ulusoy, 2020; Reutrakul \& Van, 2018). With sleep problems during pregnancy; adverse perinatal outcomes such as increases in blood pressure, Type of Research: It was planned as a randomized controlled experimental study to determine the effect of Classical Turkish Music on Stress and Sleep Quality in Pregnant Women Diagnosed with Preeclampsia. All patients who comply with the limitations of the study and volunteer will be included in the study. The research is a cross-sectional study, and quantitative data will be collected using the online survey technique, one of the data collection methods.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
142
The music to be used in the research will be applied together with midwifery practices and is not a treatment option, tool or treatment option for any disease. Although listening to Classical Turkish music has no effect on treatment and care, it does not have a harmful effect on pregnant women. The participant can withdraw from the study at any time without giving any reason. The Personal Information Form, Perceived Stress Scale, and Pittsburgh Sleep Quality Index (PSQI) will be administered to the pregnant women in both groups participating in the study by face-to-face interviews with the individuals on the first day of their admission to the clinic. At the end of the third day, the Perceived Stress Scale and Pittsburgh Sleep Quality Index (PSQI) scales will be re-administered to both groups.
Gülay Aksoy
Mersin, Turkey (Türkiye)
Perceived Stress
It was developed by Cohen et al. in 1983, and Turkish validity and reliability studies were conducted by Erci in 2006. Perceived Stress Scale: 7 items containing positive statements (items 4-5-6-7-9-10 and 13) are scored in reverse and consists of 14 items in total. These items are scored by the individual on a 5-point Likert type scale (1=Never, 2=Almost never, 3=Sometimes, 4=Often, 5=Very often). The analysis of the scale is carried out on the total score. A high total score means a high Perceived Stress Level Scale. It can be said that participants whose score range is between 0-35 are at a positive stress level, can cope with stress effectively, and the coping mechanisms they use are functional. It can be said that the methods used by the participants with a score range between 36-56 are not functional and therefore they cannot cope with stress effectively.
Time frame: 15-30 minutes
Sleep Quality
It was developed by Buyssee et al. in 1989 to evaluate sleep quality in clinical research and psychiatric practices, and its Turkish validity and reliability was confirmed by Ağargün et al. in 1996. PSQI is a 24-question index consisting of 20 questions valued from 0 to 3 and 4 open-ended questions. The patient answers 19 questions himself, while the patient's roommate or bedmate answers 5 questions. The 19 questions answered by the patient are evaluated in 7 categories and combined to obtain the PSQI global score, which ranges between 0 and 21. A total score from the scale greater than 5 is evidence of poor sleep quality.
Time frame: 15-30 minutes
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