الفهرس 
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Abstract
SUMMARY
Hospitalization often is prescribed for women experiencing complications of pregnancy. In the light of the extensive use of anteparturn bed rest, more information is needed about the physical and psychosocial effects of prolonged bed rest on pregnant women.
Preliminary studies indicate that pregnant women on bed rest experience physiologic deconditioning, dysphoria, and prolonged postpartum recovery. Several studies have delineated stressors associated with high-risk pregnancy and antepartum hospitalization. However, none of these studies has focused specifically on the experience of prolonged bed rest during a high-risk pregnancy, particularly from the perspective of women. Indicates that lack of qualitative research on stressors constitutes a major gap in the literature.
The aim of this study was to assess psychosocial stressors and responses among hospitalized high-risk pregnant women. The study was conducted at high-risk pregnancy wards in Obstetric and Gynecology Hospital – affiliated to Ain Shams University Hospitals. A descriptive cross-sectional study design was used to accomplish the aim of the study. The subjects were 50 hospitalized high-risk pregnant women, admitted in the previously mentioned setting and fulfilling the following criteria age between 20 and 45 years, from all educational levels, of different socioeconomic classes, agreed to participate in the study, and had no previous history of neurological or psychotic disorder.
Data were collected through an interview questionnaire form, which consisted of five parts: socio-demographic data about the patient, details of high-risk pregnant women health history, mother’s knowledge regarding high-risk pregnancy, high-risk pregnancy physical, environmental, social, economical and psychological stressors, and hospitalized high-risk pregnant women’s responses to stressors. As well as the classification of risk status of the pregnancy scale to select the high-risk group of the risk pregnancy in the hospital antenatal wards. A pilot study was carried out on eight hospitalized high-risk pregnant women. The field work lasted from the end of March to the end of August 2011.
The main finding of this study revealed that:
• An analysis of demographic characteristics of the hospitalized pregnant women showed that less than half of them (46%) were aged between 25-<30 years, and half of them (50%) fallen between 17-<20 years old at marriage. Three fifths of them (60%) were primary educated, while only 8% were university educated. The entire sample (100%) was not working, and less than half of the sample (46%) the adequacy of their monthly income was enough to some extent.
• An analysis of obstetric health history of the hospitalized pregnant women showed that near half (52%) of the studied sample were willingly conceived. More than one third of the studied sample (36%) had chronic medical diseases. As regards time space between pregnancies one fifth of them (20%) fallen between one to three months. slightly more than half of them (58%) had previous high risk pregnancy.
• During the hospitalization period, more than three quarter (78%) of hospitalized high-risk pregnant women had good level of knowledge regarding high-risk pregnancy and hospitalization.
• Stressors that faced the hospitalized high-risk pregnant women in this study were presented as following, almost two third (66%) of hospitalized high-risk pregnant women experienced social stressors, more than three fifths of them experienced physical (62%) and economical (64%) stressors; while less than three fifth of them (58%) experienced environmental and psychological stressors.
• Hospitalized high risk pregnant women experienced positive responses regarding crises (76%), economical burden (58%), tension and anxiety (52%), interaction problems (82%). and sexual relation prevention (73.9%), while they experienced negative response regarding lack of adequate information (70%).
• Statistically significant relations were revealed between physical, social, and psychological stressors experienced by hospitalized high-risk pregnant women and their age (p= 0.05, 0.05 & 0.001 respectively).
• There were statistically significant differences between social, psychological and economical stressors experienced by hospitalized high-risk pregnant women and their age at marriage (p= 0.01, 0.001 & 0.001 respectively). Stressors were sever among women married after age of twenty, meanwhile economical stressors were sever among women married before age of twenty.
• Statistically significant relations were found between physical, social, psychological, and economical stressors experienced by hospitalized high-risk pregnant women and their adequacy of monthly income (p= 0.05, 0.05, 0.001 & 0.001 respectively).
• Social, environmental, economical and psychological stressors among hospitalized high-risk pregnant women were statistically significant with hospital stay duration (p=0.05, 0.05, 0.05 & 0.01 respectively). It was found that stressors among hospitalized high-risk pregnant women were severe at first two weeks of hospitalization.
• There were statistically significant differences between women responses to crises and responses to tension and anxiety and their adequacy of monthly income (p=0.05).
• Statistically significant differences between hospitalized high-risk pregnant women`s responses to tension and anxiety and women age as well as their adequacy of monthly income (p=0.05 & 0.01 respectively). The response was negative among age group 20-<30 years, and among women married before twenty years old.
• Statistically significant differences were obvious between women responses to lack of information and women educational level and adequacy of monthly income (p=0.05). The responses were negative among women with moderate educational level, and those who had not enough monthly income.
• A statistically significant relation were found between total stressors experienced by hospitalized high-risk pregnant women and their exposure to previous high-risk pregnancy and hospitalization (p=0.05). The total stressors experienced by hospitalized high-risk pregnant women were sever among women exposed to previous high-risk pregnancy and hospitalization.
It is concluded that high-risk pregnant women experience variety of physical, economical, environmental, and psychosocial stressors. The hospitalized women had a good level of knowledge regarding their different aspects of high-risk pregnancy conditions. Their responses were varied from positive responses regarding crises, economical burden, tension and anxiety, interaction problems and sexual relation prevention, while they experienced negative response regarding lack of adequate information.
In the light of these findings, it is recommended that educational program for hospitalized high-risk pregnant women regarding stress management, positive responses and adaptive coping to different stressors facing them, continuous training programs for the nurses to; develop interventions to alleviate boredom, reduce the sense of being imprisoned, and combat loneliness and depression; and apply nursing practices that will prevent or at least minimize the physical and psychosocial problems. Health care professionals should encourage the development of antepartum day care units for women with high risk pregnancies as an alternative to hospitalization.