Hildingsson I, Nordin-Remberger C, Wells MB, Johansson M. Cluster Analysis of Fear of Childbirth, Anxiety, Depression, and Childbirth Self-Efficacy.
J Obstet Gynecol Neonatal Nurs 2024;
53:522-533. [PMID:
38782047 DOI:
10.1016/j.jogn.2024.04.004]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE
To identify clusters of women based on anxiety, depression, fear of birth, and childbirth self-efficacy and factors associated with the clusters.
DESIGN
Cross-sectional survey.
SETTING
Online in Sweden.
PARTICIPANTS
Pregnant women (N = 1,419).
METHODS
We collected data through online questionnaires. We included scales to measure anxiety, depression, worries about and fear of birth, and self-efficacy in a kappa-means cluster analysis. We calculated odds ratios with 95% confidence intervals between clusters and background variables.
RESULTS
We identified 4 clusters based on severity: Resourceful-Robust, Resourceful-Fearful, Vulnerable-Fearful, and Fragile-Fearful. Participants in the Resourceful-Fearful and Vulnerable-Fearful clusters were more likely to report mental health problems than those in the Resourceful-Robust cluster. Participants in the Vulnerable-Fearful and Fragile-Fearful clusters were more likely to report mental health problems than those in the Resourceful-Robust cluster. Participants in the Fragile-Fearful cluster were more likely to be multiparous, report that their pregnancy was not normal, and prefer cesarean birth than those in the Resourceful-Robust cluster.
CONCLUSIONS
Women with childbirth fear may be vulnerable to anxiety and depression during the perinatal period, although the severity might vary. Self-efficacy might be a mediator against mental health problems. Findings demonstrated levels of severity, and the one-size-fits-all approach in Swedish health care may benefit from a more targeted approach for women with fear of childbirth.
Collapse