الفهرس 
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Abstract
Anxiety during COVID-19 was proved to be the independent predictor of health- related behavior among primigravida women. Based on the obtained findings; mental health screening of primigravida women is mandatory at the outset of any public health emergency in order to decrease the risk of emotional sequel amid the perinatal period. It is important to increase primigravida women awareness regarding the significance of seeking maternal health services for physical and psychological symptoms during COVID-19 pandemic or any future pandemics, living safety and emotionally supported, eating healthy, staying active, following antenatal visits regularly, sleeping enough, proper vaccinations, proper hygienic care and following appropriate preventive measures is a great way to stay healthy. Healthy behaviors can save lives, save money, and improve health and wellbeing for primigravida women and their fetus.
The aim of this study was to explore the relationship between anxiety level and health related behavior among primigravida women amid ambiance of COVID-19 pandemic.
The study was conducted in the outpatient clinic of antenatal unit at El Shatby maternity hospital. The hospital is affiliated to the University of Alexandria. A convenience sample of 200 pregnant women was attended to the previously mentioned setting proportionally allocated according to the turnover rate in this setting with specific inclusion criteria as (Normal course of pregnancy and willing to participate in the study)
Three tools were developed and used by researcher to collect the necessary data Tool one: Primigravida Socio-demographic and clinical data structured interview, which entailed two sections assessed primigravida Socio-demographic characteristics as age, level of education ,types of family ,family income and nature of current pregnancy including: whether it was planned or not, weeks of gestation, number of antenatal visits, presence of minor discomforts and presence of any complications.
Tool two: Pregnant women’s health- related behavior changes during COVID-19 structured interview schedule: By using adapted from (Tian et al; 2020). It is used to assess health related behavior change among pregnant women during COVID-19
Tool three: Corona disease anxiety scale (CDAS): By using 18 items that encompasses two main sections. The first section explores the physical symptoms and the second section that measures the psychological symptoms.
Data were collected over a period of four months, started from the end of October 2021 till the end of Februry2022,the structured interview time took approximately 20-30 minutes for each women ,three days per week(from 8:30am to 12 pm)were specified for data collection with an average of 6-7 interviews was performed per day.
The findings of the study were:
Socio- demographic and clinical characteristics:
The present study demonstrated that almost two thirds(69.5%) of them were between 15 to 25 years old. A minority of the studied primigravida women were either illiterate or just to read and write. The majority of the studied women were housewives.
Subject’s current pregnancy profile:
The present study represented the majority of the study subjects were planned for pregnancy. Nearly one-third (34%)of them had more than 28 weeks of gestation and three quarter(75.5%) of the subjects attended more than four ANC visits.
The studied women according to their healthy behaviors during COVID-19 pandemic: It was revealed that about three fifth of the study subjects reported fair health-related behaviors (59%). Those who had good health-related behaviors constituted 40%.
Primigravida women’s level of anxiety:
More than four fifths (82%) of the study subjects reported mild anxiety, smallest proportion (18%)of them had moderate to severe anxiety.
The relationship between primigravida women Descriptive statistics
Of key variables (anxiety level and health related behavior):
There was statistical significant relationship with the studied women‘s health-related behavior and anxiety level, including; healthy diet regimen, follow up visits, and protective personal measures .This means that the anxiety level, the higher the degree of performing strict health-related behaviors measures.
Conclusion:
Pregnant woman’s health related behavior showed statistical significant relationship with primigravida women’s‘ age, level of education, and family income .However, anxiety about COVID-19 pandemic among primigravida, higher anxiety during the COVID-19 pandemic was linked to higher the degree of performing healthy diet regimen, follow up visits, and protective personal measures.
Recommendations:
Based on the findings of this study, the following recommendations were suggested:
- In-service training of maternity nurses to identify and provide proper management approach for a risky primigravida women who suffere from psychological disturbance or improper practice to health related behavior during pregnancy.
-Health care providers should screen pregnant women for psychological disorders associated with exposure to pandemic diseases with provision of supportive psychological health services, as well as interventions to reduce exposure should be considered for integration into antenatal care services.
- Nursing curriculum should include social and cultural factors that affect health related behaviors for women during pregnancy
-Increase awareness of pregnant women about the importance of improving the quality of health related behavior and psychological health during pregnancy through effective education for health care professionals in different health services locations
-Studies should be done to find out how difficult it is for Egyptian women to get antenatal care during future pandemics.
-Studies should be done on the extent to which pregnant women adhere to seasonal influenza vaccination and its impact on the health of the mother and fetus.
-Study can be applied to a large sample in a different setting so that the findings can be generalized to a large population.
Implication for future pandemics:
It has been well recognized that care providers can make the difference for improving the mental and physical health of pregnant women experiencing anxiety. For the safeguarding of pregnant women’s mental health throughout the pandemic era, early detection of inadequate social support and financial challenges is advised. During pandemic conditions, pregnant women should have immediate access to psychosocial counseling and receive obstetric treatment.