Design
This research is a semi-experimental educational study of pre- post-test types, with a control group and code of ethics IR.ARAKMU.REC.1398.229, to investigate the effect of Transactional Analysis (TA) training on quality of life and marital intimacy in women with UP who were referred to the Kausar Specialized Clinic of Arak University of Medical Sciences.
Sample size and Participants
The sample size was determined based on previous studies and according to α = 0.05, β = 0.2, S2 = 1.2, S1 = 1.7, and d = 1.6, 32 people in each group. After informing and using convenient sampling, out of 250 volunteers who gave written consent, 148 people who met the criteria for entering the research, were completed the short-form questionnaires of the World Health Organization Quality of Life (WHOQOL-BREF) and intimacy (pre-test). Then, 64 people who scored below 65 on the WHOQOL-BREF and below 205 in intimacy (Cut of the point) were randomly divided into two intervention and control groups of 32 (Fig. 1).
Internal criteria
Age 35 − 18 years, gestational age 26 − 13 weeks (second trimester), Unplanned pregnancy, Lack of suffering from a known physical or mental disease (according to the participant statement), Lack of using anti-stress, anxiety and depression drugs (according to the participant statement), Obtaining a score of less than 65 from the WHOQOL-BREF and less than 205 from the Bagarozi Intimacy Questionnaire.
External Criteria
Unwillingness to continue participation, absence of 2 or more sessions in the study, failure to complete homework in two or more sessions, and the occurrence of unfortunate events for the participant during the study.
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WHOQOL-BREF: This scale was created in 1996 by a group of experts from the World Health Organization by adjusting the items of the 100-question form of this questionnaire. The questionnaire includes 26 physical, psychological, social, environmental, and general questions. Each theme is scored separately and based on a Likert scale from 1 to 5. According to the World Health Organization scoring, the minimum score of each area is 4, and the maximum is 20, where four is the worst and twenty is the best sign of the desired dimension. A higher score indicates a better condition of the person. In this study, a total score lesser than the average (65) was considered a low quality of life score (Cut of points) (13). In Iran, the validity and reliability of this tool were investigated by Vahedi. In this research, the correlation of this questionnaire was obtained in all areas above 70 using Cronbach’s alpha (14). Etemadi applied for the first time, and the validity of this questionnaire has been confirmed as 0.94 based on Cronbach's alpha in the Etemadi study.
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Bagarozi Marital Intimacy: It was prepared and arranged by Bagarozi in 2001 with 41 questions and eight emotional, psychological, intellectual, sexual, physical, spiritual, aesthetic, and entertainment-social dimensions. Themes are scored separately with a Likert scale from 1 to 10. One is based on nothing till ten means that there is a lot of. For every dimension, the highest score is 50, and in spiritual intimacy is 60. The higher score indicates greater intimacy. Bagarozi reported the validity of this questionnaire as 95% (13). In Iran, Etemadi applied for the first time, and the validity of this questionnaire has been confirmed as 0.94 based on Cronbach's alpha in the Etemadi study (5). In this study, the total score of the questionnaire lesser than the average (205), was considered a low Marial intimacy score (Cut of points) (14).
Procedure design:
After obtaining and submitting the necessary permits from the Arak University of Medical Sciences, a study call was announced to the women referring to Kausar Specialized Clinic in Arak. The participants were given information about the research, the confidentiality of personal data, withdrawal from the study at any time according to their wishes, and the presentation of the research results upon request. With available sampling, after obtaining written consent, a pre-test was taken from WHOQOL-BREF and marital intimacy questionnaires from the participants who met the research criteria.
In the second stage, 64 people who gained scored below the average on WHOQOL-BREF and Bagaroozi's marital intimacy questionnaires, were randomly placed into two intervention and control groups of 32. The intervention group, in addition to receiving the usual services, after dividing 32 people into four groups of 8 people, received an 8-session educational protocol (two-hour session every week) from a professional Transactional Analysis trainer in Kausar Clinic in Arak (Table 1). After the end of the sessions, both groups were given a post-test using pre-test questionnaires. Data were analyzed by spss software version 26 and chi-square, independent t, and paired t-tests. After collecting the data, for ethics, a 2-hour training session was held for the control group. In this study, providing questionnaires, training, and data analysis were done by different people. The data collector and analyzer were not aware of the group allocation.
Table 1
Protocol of training sessions
Sessions | Contents |
Session 1 | Introducing the members and their purpose to each other, summarizing the meetings and rules, describing the analysis of conversational communication and family functioning |
Session 2 | Acquaintance with the child's personality and its types (natural child (positive and negative), adapted child (positive and negative), and rebellious child (with various examples), presentation of homework for the next session |
Session 3 | Checking the homework of the previous session. Description of the parent's personality and its types (supporting parent, witnessing parent and blaming parent and the positive and negative aspects of each with examples), participation of members by providing examples of the use of parent in their family life, presentation of homework for the next meeting |
Session 4 | Checking the homework of the previous session, describing the adult's personality, with examples, participation of members with examples of adult me in their family life, drawing a diagram of emotional states, presenting a summary of the session, presenting the assignment for the next session |
Session 5 | Investigate the assignments of the previous session, describing personality diseases such as rejection, contamination, and dominance by drawing the answer to the questions, and presenting the homework for the next session. |
Session 6 | Examining the homework of the previous session, teaching life situations, I am not well, you are not well, I am well, you are not well, I am not well, you are not well, presenting the assignment for the next session |
Session 7 | Examining the assignment of the previous session, teaching the types of complementary, cross, and hidden conversational communication with examples, and presenting the homework for the next session |
Session 8 | Examining the assignment of the previous session, explaining the three parts of the brain (reptilian brain, limbic brain, and neocortex brain) and their effects on relationships. The participation of members with examples of their family disputes and presenting and exploring solutions with each other's help, conducting a post-test |