Evaluation of The Effect of Multimedia Information on Anxiety, Pain, Stress And Fear Levels Before Amniocentesıs And Chorıon Villus Sampling: A Randomized Controlled Study

Prenatal invasive tests such as amniocentesis and chorionic villus sampling are performed to exclude or diagnose fetal chromosomal abnormalities. Most invasive diagnostic methods cause anxiety and fear in individuals, which can be a source of anxiety and depression in individuals. Although prenatal invasive tests are a simple and short procedure, they can result in serious discomfort and increased pain perception. Studies have determined that pregnant women have high anxiety levels before amniocentesis and chorionic villus sampling. Anxiety is the most common negative emotion associated with invasive procedures and is also a determinant of mood and pain sensation after the intervention. Concerns about pain and potential complications increase the anxiety experienced by pregnant women. There are very few studies addressing the psychological aspect associated with prenatal invasive tests. Studies have shown that women who are candidates for amniocentesis experience "state anxiety" and depressive symptoms.

Patient education reduces anxiety and worry. Various methods are used in patient education. Among these, verbal education, written material/brochures and multimedia-based education (videos, compact discs, digital versatile discs and the internet) are the most commonly used. The results regarding which method is more effective in patient education are unclear. Education given to pregnant women about the purposes, benefits, risks and limitations of amniocentesis can reduce anxiety and worry in pregnant women. Education increases pregnant women's awareness of the amniocentesis process and its results. Patients remember 20% of what is explained, 40% of what they read and 80% with multimedia education. Multimedia-based education has become more frequently used in patient education due to developments in the field of information technology. Multimedia education program is implemented through texts, shapes, sounds, animations and video clips to strengthen the learning activity of users. Multimedia not only increases the learning motivation of users, but also increases the learning activity. Multimedia education has no obstacles in terms of space or time. Therefore, if the equipment is ready, the user can directly access a specific topic in the program at any time and from anywhere.

It has been shown that a multimedia education program applied before radiologic imaging, endoscopy, colonoscopy, bronchoscopy, invasive cardiac approaches and arthroscopy does not cause cost loss and reduces patient anxiety. A multimedia education program applied before birth has been shown to increase pregnant women's knowledge and decision-making skills and reduce their anxiety. Multimedia education program before amniocentesis did not provide a significant reduction in the anxiety of pregnant women. In another study, a multimedia education program before amniocentesis; It has been shown to be an easy intervention that can be used to reduce the anxiety of pregnant women.

There are no sufficient studies investigating the effects of multimedia information given before amniocentesis on the anxiety levels of pregnant women. Furthermore, the effectiveness of multimedia information as an intervention to reduce anxiety before chorionic villus sampling has not been investigated. The aim of this study is to investigate the effects of a multimedia information video watched before invasive prenatal diagnostic tests such as amniocentesis and chorionic villus sampling on the anxiety, pain, stress and fear levels of pregnant women.

This prospective randomized controlled study is conducted on pregnant women who are scheduled to undergo amniocentesis and chorionic villus sampling by the responsible physician who applied to University Hospital Gynecology and Obstetrics Clinic, who did not have known cerebrovascular disease, who did not have morbid obesity or heart disease that would prevent the study, who did not have cognitive disorders that would prevent communication, who did not have a history of stroke or related effects, and who agreed to participate in the study. Pregnant women who had previously undergone amniocentesis and chorionic villus sampling and who did not agree to participate in the study are excluded from the study. Informed consent is obtained from the participants before amniocentesis and chorionic villus sampling procedures are performed. We used the CONSORT (Consolidated Standards of Reporting Trials) checklist while writing our report. The study is approved by the University Faculty of Medicine Clinical Research Ethics Committee.