Comparing the Effect of Educational Software and Booklet on Knowledge Level Regarding Labor Pain Management: A Randomized Controlled Clinical Trial

More than 90% of the stress and anxiety during pregnancy is associated with birth process (1). Labor pain as biological, psychological and social phenomenon, has complex and multiple relationships with many psychological, cultural and racial dimensions and the economic status of human. Therefore, seeking strategies to reduce or eliminate such pain has always been a demand of most mothers and relevant people involved in this domain. Lack of awareness and fear of unknown issues related to pregnancy and childbirth leads to maternal anxiety during this period. As a result of fear and anxiety, stress hormones are increased and may lead to premature delivery, lack of labor progress, low birth weight and fetal hypoxia (2). Women’s access to all health services along with increasing their awareness through education and counseling during pregnancy and childbirth are among important factor in preventing mortality and complications during this period. Increasing knowledge and skills during pregnancy prepares mothers for birth and promotes their health status. Today, education is one of the indispensable elements of human life, and in many parts of the world, education about pregnancy and childbirth, which aims to raise awareness of pregnant women and their partners about childbirth and parenthood, are offered to women as part of routine prenatal care (3). So far, different educational methods have been applied to educate learners, but problems including lack of expert and experienced trainers, new educational facilities in the region and the possibility to access to modern educational technology as well as the problem related to learners’ presence in the classroom setting, led to the development of remote teaching learning methods and strategies using educational software and technologies (4,5). In the booklet training method, the learner is provided with knowledge and experience at the same time and is applied more for educated people and this method can be used when there is not sufficient number of trainers. The training booklet is recommended as a teaching method while comparing the effect of face-to-face training and the booklet-based training method on the patient’s learning after urinary tract surgeries (6). In another study, although the impact of individual training of health workers was more effective in raising awareness of mothers towards infants’ anthropometric changes, the impact of this type of remote training was effective as well (7). The disadvantages of training booklet include lack of infrastructure, limited access to teachers, lack of adequate educational Abstract Objectives: In all parts of the world, education about pregnancy and childbirth are offered to women as part of routine care. This study aimed to compare the effect of software and booklet on knowledge regarding labor pain management. Materials and Methods: This randomized controlled clinical trial was conducted on 153 pregnant women referring to healthcare centers of Miandoab city in West Azerbaijan province, Iran in 2015-2016. Participants were assigned into 2 intervention groups (educational software and educational booklet) and the control group. A single face-to-face session was held by the researcher for intervention group on the management of labor pain in 30-34 weeks of pregnancy and booklet and software were presented. The questionnaire of knowledge of labor pain management was completed by the participants before and four weeks after the intervention. Analysis of covariance (ANCOVA) with baseline score adjustment was used to compare the mean score of knowledge between the study groups. Results: By adjusting the baseline score, the mean score of knowledge after the intervention in both software group (mean difference = 5.5; CI 95%: 4.6 to 6.3) and booklet group (3.4; 2.5 to 4.2) was significantly higher than the control group. Also, the increase in knowledge score in the software group (2.1; 1.2 to 9.2) was significantly higher than the booklet group. Conclusion: The results show that both software and booklet are effective in improving maternal knowledge about managing the labor pain and the software is more effective than booklet, thus, it seems that e-learning can be used as replacement for traditional educational methods.