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Lin-Lewry M, Tu HR, Au HK, Nguyen CTT, Lee GT, Kuo SY. Psychometric evaluation of the wijma delivery expectancy/experience questionnaire for pregnant women in Taiwan. Midwifery 2024; 140:104207. [PMID: 39413582 DOI: 10.1016/j.midw.2024.104207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 09/28/2024] [Accepted: 10/07/2024] [Indexed: 10/18/2024]
Abstract
BACKGROUND Fear of childbirth profoundly affects women's ability to cope during pregnancy and influences birth outcomes. In Taiwan, there's a lack of validated tools for assessing childbirth fear. OBJECTIVE To evaluate the psychometric properties of the Taiwanese version of the Wijma delivery expectancy/experience questionnaire version A (WDEQ-A) in pregnant women. METHODS We conducted a cross-sectional study with pregnant women, using the WDEQ-A and a Visual Analogue Scale to assess childbirth fear. We employed the Edinburgh Postpartum Depression Scale, State-Trait Anxiety Inventory, and Mindful Attention Awareness Scale to measure depressive symptoms, anxiety, and mindfulness, respectively. We evaluated internal consistency reliability and construct validity using exploratory factor analysis and Rasch analysis. Pearson correlations measured the association between childbirth fear and psychological variables. The receiver operating characteristic curve was used for determining the sensitivity and specificity indices. RESULTS The WDEQ-A demonstrated excellent reliability (Cronbach's alpha = 0.93) and revealed a three-factor structure, including fear, lack of positive anticipation, and isolation. Rasch analysis supported the dimensionality of each of the three revised factors. The total score significantly correlated with depression (r = 0.56), anxiety (r = 0.19), and mindfulness (r = -0.40) (Ps < 0.001). The optimal cut-off for WDEQ-A was established at 55.5, with a sensitivity of 83 % and a specificity of 65 %. CONCLUSIONS The Taiwanese version of WDEQ-A proved to be a reliable and valid tool for assessing fear of childbirth in pregnant women, demonstrating excellent psychometric properties. IMPLICATION FOR PRACTICE These findings can assist midwives in Taiwan in identifying and promptly providing effective strategies for women experiencing a high fear of childbirth.
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Affiliation(s)
- Marianne Lin-Lewry
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan
| | - Huei-Rong Tu
- Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cai Thi Thuy Nguyen
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam; Research Institute for the Humanities and Social Sciences, National Science and Technology Council, Taiwan / Center for the Advancement of the Humanities and Social Sciences, National Taiwan University, Taipei, Taiwan
| | - Gabrielle T Lee
- Applied Psychology, Faculty of Education, Western University, London, ON, Canada
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan; Nursing Department, Taipei Medical University Hospital, Taipei, Taiwan.
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Joyce GS, Shukla R. Developing a Tool for Assessing Perceived Parental Socialization of Emotions in Adolescents and Young Adults. Cureus 2024; 16:e65748. [PMID: 39211676 PMCID: PMC11360947 DOI: 10.7759/cureus.65748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION Parenting practices have been described as the practices employed by a parent and the parent-child communication, with the focus on raising a child in the best possible manner while instilling cultural, ethical, and personal values. One similar yet different construct that holds significance in the development of a child is parental socialization of emotion. Parental socialization of emotion is the interaction between the parents and child regarding the emotional experience of the child. This has been considered an essential marker of the development of the emotional and social competence of an individual. There are several scales in the aspect of parenting practices. However, scales for parental socialization of emotion especially considering the perception of adolescents and young adults have yet to fully be explored. METHODS The aim of the study is to establish a comprehensive tool that enables the measurement of perceived parental socialization of emotion (PPSE). The process of tool construction, data collection, and analysis was done in five phases that included reviewing existing tools and identification of domains (Phase 1); generation of an item pool (Phase 2); content validity, face validity, and inter-rater reliability (Phase 3); finalization of the tool for data collection (Phase 4); and data collection and analysis (Phase 5). The study for tool construction included participants from ages 13-28 years representing adolescents and young adults from schools and colleges located in New Delhi, India, as well as Gwalior, Madhya Pradesh, India. The research design used was a cross-sectional design, and the data were collected through purposive sampling, including males (N = 337) and females (N = 424). Exploratory factor analysis (EFA) was used to check the factorability and for item reduction. RESULTS The results aided in reducing the number of items from 160 to 46 including the process of content validity, inter-rater reliability, item-total statistic, and factor loading of EFA. The factors above the eigenvalue of 3 were retained while items above the factor loading of 0.50 were taken into consideration. A good Cronbach's alpha coefficient of 0.88 for the overall tool was established, with 0.89, 0.84, and 0.87 for the domains Awareness, Acceptance, and Coaching, respectively. CONCLUSION The scale constructed includes both the positive and negative emotions of an individual and tries to understand the perspective of the receiver of the parenting practice. The study helps in understanding the phenomenon of PPSE, which might also aid in creating awareness regarding efficient parenting practices.
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Affiliation(s)
- Grace S Joyce
- Department of Psychology, Christ (Deemed to be University) Delhi NCR, Delhi, IND
| | - Ridhima Shukla
- Department of Psychology, Christ (Deemed to be University) Delhi NCR, Delhi, IND
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Shareef N, Said P, Lamers S, Nieuwenhuijze M, de Vries M, van Dillen J. The contribution of birth plans to shared decision-making from the perspectives of women, their partners and their healthcare providers. PLoS One 2024; 19:e0305226. [PMID: 38924004 PMCID: PMC11207161 DOI: 10.1371/journal.pone.0305226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The birth plan is a document expressing a pregnant woman's childbirth preferences, enabling communication of expectations and facilitating discussions among women, their partners, and healthcare providers for key birthing decisions. There has been limited research on the role of birth plans in shared decision-making (SDM). Our study aims to explore how the use of birth plans can contribute to SDM from women's, partners, and healthcare providers' perspectives. METHODS We conducted in-depth interviews with women, their partners, and their healthcare providers. We used a thematic analysis to identify themes and subthemes. Furthermore, we created a grounded theory about the role of birth plans as a tool in SDM. RESULTS Three main themes were created: ''Creating a birth plan", ''Getting all on board" and ''Birth plans in the daily practice of decision-making". Most women, partners, and healthcare providers agreed that birth plans can facilitate communication and SDM. Women and their partners viewed the birth plan as a tool to prepare for birth. Most healthcare providers mentioned the birth plan as a tool to get to know the women, their partners, and their preferences. Barriers are the attitude of healthcare providers toward birth plans, such as their evident resistance to the birth plan itself or to certain preferences. Another barrier is the assumption women and their partners may have that these plans can accurately predict the childbirth experience, enhancing the chance of a disappointing, negative experience. Some healthcare providers view birth plans as barriers to SDM. CONCLUSION The use of a birth plan seems to promote women's, partners', and healthcare providers' involvement in the birth process, and seems suitable to facilitate SDM. Further research is required to explore strategies for overcoming barriers, including healthcare providers' attitudes toward birth plans and the expectations of women and their partners regarding their role.
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Affiliation(s)
- Naaz Shareef
- Faculty of Medical Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Poshya Said
- Faculty of Medical Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Silke Lamers
- Faculty of Medical Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Universiteitssingel 60, Maastricht, The Netherlands
- CAPHRI, Maastricht University, Universiteitssingel 60, Maastricht, The Netherlands
| | | | - Jeroen van Dillen
- Department of Obstetrics, Radboud University Medical Center, Nijmegen, Netherlands
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Masroor P, Mehrabi E, Nourizadeh R, Pourfathi H, Asghari-Jafarabadi M. The comparison of the effect of non-pharmacological pain relief and pharmacological analgesia with remifentanil on fear of childbirth and postpartum depression: a randomized controlled clinical trial. BMC Pregnancy Childbirth 2024; 24:305. [PMID: 38654255 PMCID: PMC11040826 DOI: 10.1186/s12884-024-06270-z] [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: 07/29/2023] [Accepted: 01/12/2024] [Indexed: 04/25/2024] Open
Abstract
INTRODUCTION Childbirth may be associated with psychological, social, and emotional effects and provide the background for women's health or illness throughout their life. This research aimed at comparing the impact of non-pharmacological pain relief and pharmacological analgesia with remifentanil on childbirth fear and postpartum depression. MATERIALS AND METHOD This randomized clinical trial with two parallel arms was conducted on 66 women with term pregnancy referred to Taleghani Hospital in Tabriz for vaginal delivery during September 2022 to September 2023. First, all of the eligible participants were selected through Convenience Sampling. Then, they were randomly assigned into two groups of pharmacological analgesia with remifentanil and non-pharmacological analgesia with a ratio of 1:1 using stratified block randomization based on the number of births. Before the intervention, fear of childbirth (FOC) was measured using Delivery Fear Scale (DFS) between 4 and 6 cm cervical dilatation. Pain and fear during labor in dilatation of 8 cm were measured in both groups using VAS and DFS. After delivery, FOC was assessed using Delivery Fear Scale (W DEQ Version B) and postpartum depression using the Edinburgh's postpartum depression scale (EPDS). Significance level was considered 0.05. Mean difference (MD) was compared with Independent T-test and ANCOVA pre and post intervention. RESULTS The mean score of FOC in the non-pharmacological analgesia group was significantly lower than that in the pharmacological analgesia group after the intervention by controlling the effect of the baseline score (MD: -6.33, 95%, Confidence Interval (CI): -12.79 to -0.12, p = 0.04). In the postpartum period, the mean score of FOC in the non-pharmacological analgesia group was significantly lower than that in the pharmacological analgesia group after controlling the effect of the baseline score (MD: -21.89; 95% CI: -35.12 to -8.66; p = 0.002). The mean score of postpartum depression in the non-pharmacological analgesia group was significantly lower than that in the pharmacological analgesia group (MD: -1.93, 95% CI: -3.48 to -0.37, p = 0.01). TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20170506033834N10. Date of registration: 05/07/2022 Date of first registration: 05/07/2022. URL: https://www.irct.ir/trial/61030; Date of recruitment start date05/07/2022. CONCLUSION The study results indicated a reduction in FOC and postpartum depression among parturient women receiving non-pharmacological strategies with active participation in childbirth compared to women receiving pharmacological analgesia. Owing to the possible side effects of pharmacological methods for mother and fetus, non-pharmacological strategies with active participation of the mother in childbirth are recommended to reduce the FOC and postpartum depression.
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Affiliation(s)
- Parinaz Masroor
- Midwifery Department, Faculty of Nursing and Midwifery, Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Esmat Mehrabi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Roghaiyeh Nourizadeh
- Midwifery Department, Faculty of Nursing and Midwifery, Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hojjat Pourfathi
- Department of Anesthesiology and Pain Management, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3004, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Varela P, Zervas I, Vivilaki V, Lykeridou A, Deltsidou A. Validity and reliability of the Greek version of Wijma delivery expectancy/experience questionnaire (Version A) among low-risk pregnant women. BMC Psychol 2024; 12:165. [PMID: 38504313 PMCID: PMC10953171 DOI: 10.1186/s40359-024-01662-4] [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: 10/23/2022] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Fear of childbirth is a frequent health issue for pregnant women. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is a widely used instrument to measure the fear of childbirth during the antenatal period. The aim of the study was to assess the psychometric properties of the W-DEQ (version A) in a sample of Greek pregnant women. METHODS Low-risk pregnant women in the second or third trimester of pregnancy (N = 201) were invited to participate in the study and to complete a booklet of questionnaires including the Greek versions of W-DEQ-A, State-Trait Anxiety Inventory (STAI), Coping Orientations to Problems Experienced (Brief COPE), Perceived Stress Scale (PSS-10) and Edinburgh Postnatal Depression Scale (EPDS). Exploratory (EFA) and confirmatory factor analysis (CFA) was performed. RESULTS The mean age of participants was 34.2 years (SD = 4.3 years). EFA yielded six factors ("Lack of self-efficacy", "Lack of positive anticipation", "Lack of feeling lonely", "Concerns about delivery and losing control", "Calmness", and "Concern for the child") of 33 items of W-DEQ-A. CFA confirmed the multidimensionality of the instrument. All Cronbach's alpha were over 0.7, indicating acceptable reliability of the factors. All factors were significantly correlated with each other, and convergent validity was demonstrated by a significant association with stress, anxiety, and depression among low-risk pregnant women. CONCLUSION The Greek version of W-DEQ-A proved to be a valid and reliable instrument of fear of childbirth among Greek low-risk pregnant women.
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Affiliation(s)
- Pinelopi Varela
- Department of Midwifery, University of West Attica, Athens, Greece.
| | - Ioannis Zervas
- National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, MD, Greece
| | | | | | - Anna Deltsidou
- Department of Midwifery, University of West Attica, Athens, Greece
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Alivand Z, Nourizadeh R, Hakimi S, Esmaeilpour K, Mehrabi E. The effect of cognitive-behavioral therapy and haptonomy on fear of childbirth in primigravida women: a randomized clinical trial. BMC Psychiatry 2023; 23:929. [PMID: 38082410 PMCID: PMC10712131 DOI: 10.1186/s12888-023-05414-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Considering the role of fear of childbirth (FOC) in the enhancement of unnecessary cesarean sections (CS), the present study aimed at evaluating the effect of Cognitive-Behavioral Therapy (CBT) and haptonomy on the FOC (as primary outcome) and intended birth method and final birth method (as secondary outcomes) among primigravida women. METHODS This randomized clinical trial was conducted on 99 primigravida women in Tabriz, Iran 2022. Participants were assigned to three groups with a ratio of 1:1:1 using stratified block randomization based on the fear intensity. One of the intervention groups (n = 33) received eight group sessions of CBT from 24 to 28 weeks of gestation and the other intervention group (n = 33) received haptonomy during seven sessions once a week. The control group (n = 33) received routine prenatal care. The Wijma questionnaire was completed by the participants before the intervention, after the intervention at 35-37 weeks of gestation, and after birth. The intended birth method was investigated before and after the intervention at 35-37 weeks of gestation. The final birth method and the reasons for CS were recorded based on the mother's medical profile. The one-way ANOVA was used before the intervention and RMANOVA after the intervention to compare the mean scores of FOC among the three groups. Further, chi-square test was applied to compare the intended and final birth method. RESULTS The mean (standard deviation: SD) of FOC in the CBT group changed from 74.09 (11.35) at 24-28 weeks of gestation to 46.50 (18.28) at 35-37 weeks and 48.78 (20.64) after birth (P < 0.001). The means (SDs) of FOC in the haptonomy group were 76.81 (13.09), 46.59 (15.81), and 45.09 (20.11), respectively (P < 0.001). The mean (SD) of FOC in the control group decreased from 70.31 (6.71) to 66.56 (18.92) and then, increased to 71.00 (21.14) after birth (P = 0.878). After the intervention, there was no statistically significant difference among the three groups in terms of the intended birth method (P = 0.278), and final birth method (P = 0.107). CONCLUSION The findings of the present study revealed that both CBT and haptonomy interventions reduce FOC. Although the desire for vaginal birth and final vaginal birth in the haptonomy group was more than that in the other two groups, there was no statistically significant difference among the three groups. TRIAL REGISTRATION Iranian Registry of Clinical Trials: IRCT20170506033834N9. Date of registration: 02.01.2022. URL: http://en.irct.ir .
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Affiliation(s)
- Zahra Alivand
- Student Research Committee, Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran
| | - Roghaiyeh Nourizadeh
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran.
| | - Sevil Hakimi
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | | | - Esmat Mehrabi
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
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Hosaini S, Yazdkhasti M, Moafi Ghafari F, Mohamadi F, Kamran Rad SHR, Mahmoodi Z. The relationships of spiritual health, pregnancy worries and stress and perceived social support with childbirth fear and experience: A path analysis. PLoS One 2023; 18:e0294910. [PMID: 38060610 PMCID: PMC10703247 DOI: 10.1371/journal.pone.0294910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Given maternal health is a major health indicator, the present research aimed at determining the causal relationships of spiritual health, worries, stress and perceived social support with the fear and experience of childbirth in pregnant women. METHODS The present longitudinal prospective research recruited 352 pregnant women presenting to selected health centers in Qazvin, Iran in 2021. The data were collected using the Childbirth Experience Questionnaire-2 (CEQ-2), the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Persian version of the Pregnancy Worries and Stress Questionnaire (PWSQ), the Spiritual Health Questionnaire, the Socioeconomic Status (SES) questionnaire and a sociodemographic checklist, and were analyzed in SPSS-25 and Lisrel-8.8. RESULTS The mean age of the participants was 28.1±6.8 years. According to the results of the path analysis, among the variables related to fear of childbirth, childbirth experience (B = -0.37, CI:-0.44;-0.22) in the direct path and perceived social support (B = -0.51, CI:-0.58;-0.43) in both direct and indirect paths demonstrated the most significant negative relationship. Among the variables related to childbirth experience, pregnancy worries and stress had a negative causal relationship (B = -0.06, CI:-0.079;-0.043) in the direct path, spiritual health showed the highest significant positive relationship (B = 0.01, CI: 0.008; 0.012) in the indirect path, and perceived social support (B = 0.112, CI: 0.092; 0.131) and the number of children (B = 0.32,CI: 0.30; 0.34) demonstrated the highest significant positive relationship in both direct and indirect paths. In other words, childbirth experience becomes more desirable as spiritual health, social support, and the number of children increases, and it becomes less desirable as pregnancy worries and stress rise. CONCLUSION According to the present findings, various psychological, social, and spiritual factors are associated with childbirth fear and experience. It is thus necessary to utilize appropriate methods and promote training and support to reduce the adverse outcomes of childbirth.
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Affiliation(s)
- Saeideh Hosaini
- Social Determinants of Health Research Institute for Prevention of Noncommiunicable Disease, Qazvin University of medical sciences, Qazvin, Iran
| | - Mansoureh Yazdkhasti
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farnoosh Moafi Ghafari
- Department of Midwifery, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farima Mohamadi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Khademioore S, Ebrahimi E, Khosravi A, Movahedi S. The effect of an mHealth application based on continuous support and education on fear of childbirth, self-efficacy, and birth mode in primiparous women: A randomized controlled trial. PLoS One 2023; 18:e0293815. [PMID: 37910495 PMCID: PMC10619799 DOI: 10.1371/journal.pone.0293815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The Fear of Childbirth (FOC) is associated with several adverse health outcomes for children and women. This study aimed to evaluate the effectiveness of an interactive mobile health application named Tele-midwifery with an emphasis on continuous care and education, on FOC, self-efficacy, and childbirth mode in primiparous women. METHODS Seventy primiparous women attending the prenatal clinic of Baharlou Hospital in Tehran, Iran, were randomly assigned to two parallel intervention and control groups with 35 participants each. Women in the intervention group received Tele-midwifery for eight weeks, whereas women in the control group only received routine care. The Wijma delivery expectancy/experience questionnaire and the Childbirth Self-Efficacy Inventory were used to measure the FOC and self-efficacy at baseline and eight weeks after the intervention. The FOC and birth mode were also measured after birth. RESULTS There was a significant decrease in FOC among women in the intervention group compared to control groups after eight weeks of intervention (- 20.9 [95% Confidence Interval,-24.01 to-17.83], p < 0.001), and after birth (- 30.8, [95% CI-33.8 to-27.97], p < 0.001). After eight weeks, the mean self-efficacy score in the intervention group was significantly higher than the control group (p < 0.001). Compared to the control group, the intervention group had a lower C-Section (CS) rate (p = 0.03). CONCLUSIONS Tele-midwifery intervention reduced FOC, increased women's self-efficacy in childbirth, and decreased the number of CS in a group of first-time mothers. Healthcare providers can use the mHealth approach to support pregnant women with FOC. TRIAL REGISTRATION Registration number: IRCT20200122046227N1, Registered on 27 January 2020.
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Affiliation(s)
- Sahar Khademioore
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ebrahimi
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Khosravi
- Department of Epidemiology, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Shohreh Movahedi
- Department of Obstetrics and Gynecology Tehran University of Medical Sciences, Tehran, Iran
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Effati Daryani F, Mohammadi A, Mirghafourvand M. Childbirth self-efficacy and fear of childbirth and their predictors in adolescent and adult pregnant women referring to health centres of Urmia-Iran: a cross-sectional study. BMJ Open 2023; 13:e077043. [PMID: 37848306 PMCID: PMC10582945 DOI: 10.1136/bmjopen-2023-077043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/29/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Adolescent pregnancy as a growing phenomenon in the world has been investigated from different aspects. However, the examination of childbirth fear and self-efficacy has received less attention. Therefore, this study was conducted to compare the self-efficacy and fear of childbirth and to determine their predictors in adolescent and adult pregnant women. DESIGN In this comparative cross-sectional study, participants were selected through two-stage cluster sampling method. Data were collected using the Childbirth Self-Efficacy Inventory and Wijma Delivery Expectancy/Experience Questionnaire. The Pearson correlation test, independent t-test, and general linear model were used for data analysis. SETTING Urmia health centres, Iran in 2020. PARTICIPANTS Three hundred and sixty adults and adolescent pregnant women. RESULTS The mean (SD) of fear of childbirth was 114.7 (14.1) and 108.1 (23.1) in adolescent and adult pregnant women, respectively. The mean (SD) of childbirth self-efficacy in the active phase and the second stage of labour respectively were also obtained 208.8 (28.6) and 203.5 (32.1) for adolescent pregnant women and 213.8 (25.7) and 212.0 (26.5) for adult ones. There was a significant difference between adolescent and adult pregnant women in fear of childbirth (p=0.001), self-efficacy expectancy (p=0.003) and total childbirth self-efficacy (p=0.008) in the second stage of labour. After adjusting the sociodemographic characteristics, the mean score of fear of childbirth was significantly higher in adolescent pregnant women than in adult ones whereas the mean total self-efficacy score in the second stage of labour was significantly lower in adolescent pregnant women than in adult ones. CONCLUSION This study showed that adolescent pregnant women had more fear of childbirth and low self-efficacy than adult mothers, and there was also a relationship between fear of childbirth and self-efficacy. Paying more attention to fear and self-efficacy in childbirth and their predictors by health providers can improve pregnancy and childbirth outcomes.
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Affiliation(s)
- Fatemeh Effati Daryani
- Midwifery Department, Urmia University of Medical Sciences, Urmia, Iran (the Islamic Republic of)
| | - Azam Mohammadi
- Midwifery Department, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
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Mohaghegh Z, Javadnoori M, Najafian M, Abedi P, Kazemnejad Leyli E, Montazeri S, Bakhtiari S. Effect of birth plans integrated into childbirth preparation classes on maternal and neonatal outcomes of Iranian women: A randomized controlled trial. Front Glob Womens Health 2023; 4:1120335. [PMID: 37091299 PMCID: PMC10117766 DOI: 10.3389/fgwh.2023.1120335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Background Involvement of women in the decision-making process during childbirth plays an important role in their physical and psychosocial preparation. A birth plan allows the woman to express her expectations and facilitates her participation in her own care. The present study is the first to assess the implementation of birth plans integrated into childbirth preparation classes in Tehran, Iran. Methods This study is a randomized controlled clinical trial performed on 300 pregnant women at 32-33 weeks of gestation referring to four public health centers in Tehran, Iran. The participants were randomly allocated into intervention and control groups using block randomization method. A training session on the items of the birth plan checklist was held in the fifth session of childbirth preparation classes for the participants in the intervention group. Accordingly, a birth plan was prepared according to the requests of mothers. The birth plan was implemented after the women were admitted to the maternity ward. The primary outcomes were frequency of vaginal birth, mean duration of labor stages, and mean score of childbirth satisfaction. We used a checklist of maternal and neonatal outcomes, Mackey's childbirth satisfaction questionnaire, and a partogram form for data collection. Independent t-test, Mann-Whitney U-test, Chi-square test, Fisher's exact test, and logistic regression were used for data analysis. Results Vaginal birth rates were significantly higher in women who had birth plans compared with those without (81.9% vs. 48.7%, p < 0.001). Also, the lengths of the first and the second stages of labor were significantly shorter in women having a birth plan (p = 0.02). Women in the birth plan group were significantly more satisfied with the process of labor and childbearing (p < 0.001), and started breastfeeding after birth earlier than those in the control group (p < 0.001). Conclusion Having a birth plan and attending childbirth preparation classes can increase the rate of normal vaginal birth. Also, according to our results, women's participation in the decision- making process and fulfilling their preferences during birth can improve maternal and neonatal outcomes and childbirth satisfaction.Trial registration: IRCT20190415043283N2. 2020-12-07.
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Affiliation(s)
- Zaynab Mohaghegh
- Department of Midwifery, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Javadnoori
- Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Correspondence: Mojgan Javadnoori
| | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Department of Midwifery, Menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Kazemnejad Leyli
- Department of Biostatistics, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Simin Montazeri
- Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Bakhtiari
- Midwifery Department, Rosie Hospital, Cambridge University Hospitals NHS, Cambridge, United Kingdom
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Han L, Wu J, Wu H, Liu J, Liu Y, Zou Z, Liu J, Bai J. Validating the use of the Wijma Delivery Expectancy/Experience Questionnaire in Mainland China: a descriptive, cross-sectional study. BMC Pregnancy Childbirth 2022; 22:931. [PMID: 36510165 PMCID: PMC9743539 DOI: 10.1186/s12884-022-05283-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Fear of childbirth (FOC) is a common psychological problem in Chinese pregnant women. FOC can influence both maternal health and infants' wellness. Special assessment tools for FOC in Mandarin Chinese are currently lacking. The aim of this study was to evaluate the psychometric properties of the Mandarin Chinese of the Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A). METHODS We recruited 364 Chinese pregnant women from April 2021 to July 2021. Translation and cultural adaptation, as well as reliability and validity testing were conducted. Analyses included the content validity, structural validity, criterion-related validity, convergent validity and reliability. The content validity indices were used to assess the content validity of the tool. The structural validity was tested through exploratory factor analysis and confirmatory factor analysis. The Cronbach's alpha coefficient was used to evaluate the reliability of the W-DEQ-A Chinese version. RESULTS The Chinese translation showed excellent similarities and equivalence to the original version, with the satisfactory content validity. Factor analysis indicated 5 factors, accounting for 57% of the total variance. Both criterion-related validity and convergent validity proved to be acceptable. The reliability was tested with a Cronbach's alpha coefficient of 0.911 for the total scale. CONCLUSION The W-DEQ-A Chinese version is a reliable and valid tool to identify FOC in Mandarin Chinese-speaking populations.
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Affiliation(s)
- Lu Han
- School of Nursing, Wuhan University, Hubei, China
| | - Jiaxin Wu
- School of Nursing, Wuhan University, Hubei, China
| | - Hengchang Wu
- School of Public Health, Wuhan University, Hubei, China
| | - Jun Liu
- School of Nursing, Wuhan University, Hubei, China
| | - Yanqun Liu
- School of Nursing, Wuhan University, Hubei, China.
| | - Zhijie Zou
- School of Nursing, Wuhan University, Hubei, China.
| | - Juan Liu
- Department of Obstetrics and Gynecology, Zhongnan Hospital affiliated with Wuhan University, Hubei, China
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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12
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Khwepeya M, Chipojola R, Gondwe KW, Huang HC, Kuo SY. The Chichewa Wijma delivery expectancy/experience questionnaire: a factor analytic study for postpartum women in Malawi. J Psychosom Obstet Gynaecol 2022; 43:593-600. [PMID: 36194674 DOI: 10.1080/0167482x.2022.2126309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022] Open
Abstract
OBJECTIVE To test the validity and reliability of the Chichewa Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) in Malawian postpartum women. METHODS A cross-sectional study of postnatal women (N= 415) at 1 day after vaginal birth was conducted at a district hospital in Malawi. The W-DEQ, Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life Scale were used to measure fear of birth (FOB), depressive symptoms and quality of life (QoL). Principal component analysis (PCA) and confirmatory factor analysis (CFA), Cronbach's alpha, the average variance extracted (AVE) and the composite reliability (CR) and Pearson correlation were used to test the construct validity, reliability, convergent and divergent validity of the Chichewa W-DEQ (CW-DEQ). RESULTS The participants had a mean age of 28.3 ± 6.7 years. A multidimensional structure containing three factors - a lack of positive feelings, fear and concerns about childbirth - with an appropriate model fit was reported for the CW-DEQ version. The Cronbach's α of the CW-DEQ was 0.87. The AVE and CR values were highly acceptable in lack of positive feelings - 0.17 (0.68), and concerns about childbirth - 0.79 (0.88) factors which proved the convergent validity of each; however, was marginally acceptable in the fear factor - 0.14 (0.53). Low range of correlations between the CW-DEQ constructs (r = 0.27 ∼ 0.42, p < .001), confirmed the divergent validity. CONCLUSIONS In this study, we found the CW-DEQ to be a reliable and valid tool for assessing FOB in postpartum women.
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Affiliation(s)
- Madalitso Khwepeya
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, ROC.,College of Medicine, Chang Gung University, Taoyuan, ROC.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, ROC
| | - Roselyn Chipojola
- Public Health Department, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | | | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, ROC
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, ROC
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Ghaffari SF, Elyasi F, Nikbakht R, Shahhosseini Z. A structural equation model analysis of the relationship between maternal fear of childbirth and expectant fathers' fear of childbirth: The mediating role of fathers' depression, anxiety, and stress. Brain Behav 2022; 12:e2802. [PMID: 36288399 PMCID: PMC9759126 DOI: 10.1002/brb3.2802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/21/2022] [Accepted: 10/08/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Some fathers experience traumatic and unpleasant feelings such as fear of childbirth during pregnancy and childbirth. This study aimed to determine the mediating role of the expectant fathers' depression, anxiety, and stress in the relationship between maternal fear of childbirth and paternal fear of childbirth. METHODS In this cross-sectional study, using a two-stage sampling method, 502 expectant Iranian fathers and their wives in the second half of pregnancy were recruited. The participants completed self-administered questionnaires, including the fathers' fear of childbirth scale, the Wijma delivery expectancy/experience questionnaire, and the depression, anxiety, and stress scale-21. To analyze the data, structural equation modeling was employed in the Amos software version 24. RESULTS Results indicated an acceptable fit of the model to the data. Maternal fear of childbirth was associated with paternal fear of childbirth, directly (β = 0.23, p = .046) and indirectly through the mediator of paternal depression, anxiety, and stress (β = .17, p = .007). The expectant fathers' stress had a greater impact on their fear of childbirth. CONCLUSIONS By considering the role of maternal fear of childbirth as well as expectant fathers' depression, anxiety, and stress on paternal fear of childbirth, it seems this study has some practical implications for improving the fathers' psychological well-being.
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Affiliation(s)
| | - Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Nikbakht
- Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zohreh Shahhosseini
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Massae AF, Larsson M, Leshabari S, Mbekenga C, Pembe AB, Svanberg AS. Fear of childbirth: validation of the Kiswahili version of Wijma delivery expectancy/experience questionnaire versions A and B in Tanzania. BMC Pregnancy Childbirth 2022; 22:882. [PMID: 36447188 PMCID: PMC9707257 DOI: 10.1186/s12884-022-05134-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/14/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Fear of childbirth is common both before and after childbirth, often leading to complications in mother and new-born. The Wijma Delivery Expectancy/Experience Questionnaires (W-DEQ) are commonly used to measure fear of childbirth among women before (version A) and after childbirth (version B). The tools are not yet validated in the Tanzanian context. This study aimed to validate the reliability, validity, and factorial structure of their Kiswahili translations. METHODS A longitudinal study was conducted in six public health facilities in the Pwani region, Tanzania. In all, 694 pregnant and 625 postnatal women were concurrently selected and responded to W-DEQ-A and W-DEQ-B. Validation involved: translating the English questionnaires into Kiswahili; expert rating of the relevancy of the Kiswahili versions' items; computing content validity ratio; piloting the tools; data collection; statistical analysis with reliability evaluated using Cronbach's alpha and the intraclass correlation coefficient. Tool validity was assessed using factor analysis, convergent and discriminant validity. Exploratory factor analysis and confirmatory factor analysis were conducted on data collected using W-DEQ-A and W-DEQ-B, respectively. RESULTS Exploratory factor analysis revealed seven factors contributing to 50% of the total variation. Four items did not load to any factor and were deleted. The factors identified were: fear; lack of self-efficacy; lack of positive anticipation; isolation; concerns for the baby; negative emotions; lack of positive behaviour. The factors correlated differently with each other and with the total scores. Both Kiswahili versions with 33 items had good internal consistency, with Cronbach's alphas of .83 and .85, respectively. The concerns for the baby factor showed both convergent and discriminant validity. The other six factors showed some problems with convergent validity. The final model from the confirmatory factor analysis yielded 29 items with good psychometric properties (χ2/df = 2.26, p = < .001, RMSEA = .045, CFI = .90 and TLI = .81). CONCLUSIONS The Kiswahili W-DEQ-A-Revised and W-DEQ-B-Revised are reliable tools and measure fear of childbirth with a multifactorial structure, encompassing seven factors with 29 items. They are recommended for measuring fear of childbirth among pregnant and postnatal Tanzanian women. Further studies are needed to address the inconsistent convergent validity in the revised versions and assess the psychometric properties of W-DEQ-A among pregnant women across gestational ages.
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Affiliation(s)
- Agnes F. Massae
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden ,grid.25867.3e0000 0001 1481 7466Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, P.O. BOX 65001, Dar Es Salaam, Tanzania
| | - Margareta Larsson
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Sebalda Leshabari
- grid.25867.3e0000 0001 1481 7466Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, P.O. BOX 65001, Dar Es Salaam, Tanzania
| | - Columba Mbekenga
- grid.442446.40000 0004 0648 0463Faculty of Nursing and Midwifery, Hubert Kairuki Memorial University, Dar Es Salaam, Tanzania
| | - Andrea B. Pembe
- grid.25867.3e0000 0001 1481 7466Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Agneta S. Svanberg
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Ahmadpour P, Moosavi S, Mohammad-Alizadeh-Charandabi S, Jahanfar S, Mirghafourvand M. Effect of implementing a birth plan on maternal and neonatal outcomes: a randomized controlled trial. BMC Pregnancy Childbirth 2022; 22:862. [PMID: 36419027 PMCID: PMC9682672 DOI: 10.1186/s12884-022-05199-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The birth plan is an approach for pregnant women to offering their expectations of labor and birth. The purpose of this study was to investigate the effect of birth plan on maternal and neonatal outcomes. METHODS This study was a randomized controlled clinical trial performed on 106 pregnant women, 32-36 weeks of pregnancy, referring to Taleghani educational hospital in Tabriz city-Iran. Participants were randomly assigned to the two groups of birth plan and control using a randomized block method. Participants in the birth plan group received the interventions based on the mother's requested birth plan. The birth plan included items of the mother's preferences in labor, mobility, eating and drinking, monitoring, pain relief, drug options, labor augmentation, pushing, amniotomy, episiotomy, infant care, and caesarean section. The control group received routine hospital care. The primary outcomes were childbirth experience and duration of the active phase of labor and the secondary outcomes were support and control in labor, fear of labor, post-traumatic stress disorder (PTSD), postpartum depression, duration of the second and third phases of labor, frequency of vaginal delivery, frequency of admission of newborn in NICU (Neonatal Intensive Care Unit), the mean first and fifth minute Apgar scores. The socio-demographic and obstetrics characteristics questionnaire, Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-versions A), and Edinburgh Postnatal Depression Scale (EPDS) were completed at the beginning of the study (at the gestational age of 32-36 weeks). The questionnaire of delivery information, neonatal information, and Delivery Fear Scale (DFS) was completed during and after the delivery. Also, a partogram was completed for all participants by the researcher. The participants in both groups followed up until 4-6 weeks post-delivery, whereby the instruments of Childbirth Experience Questionnaire 2.0 (CEQ2.0), Support and Control In Birth (SCIB) scale, EPDS, and PTSD Symptom Scale 1 (PSS-I) were completed by the researcher through an interview. The independent t-test, the chi-square test, and ANCOVA was used to analyze. RESULTS The mean (SD) of CEQ score was singificnalty higher in in the birth plan group (3.2 ± 0.2) compared to the control (2.1 ± 0.2) (MD = 1.0; 95% CI: 1.1 to 0.9; P˂0.001). Also, the mean (SD) SCIB score in the birth plan group was significantly higher than that of those in the control group (P˂0.001). The mean scores of DFS (P = 0.015), EPDS (P˂0.001), and PTSD (P˂0.001) as well as the frequency of emergency caesarean section (P = 0.007) in the birth plan group were significantly lower than those in the control group. CONCLUSION This was the first study to assess the implementation of a birth plan in Iran. Based on the findings, a birth plan improves childbirth experiences; increases perceived support and control in labor; reduces fear of delivery; suppresses psychological symptoms of depression and PTSD, and increases the frequency of vaginal delivery. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N58. Date of registration: 07/07/2020; URL: https://en.irct.ir/trial/47007 ; Date of first registration: 19/07/2020.
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Affiliation(s)
- Parivash Ahmadpour
- grid.412888.f0000 0001 2174 8913Students’ Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sanaz Moosavi
- grid.412888.f0000 0001 2174 8913Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz , Iran
| | | | - Shayesteh Jahanfar
- grid.253856.f0000 0001 2113 4110Public Health Department, Central Michigan University, Michigan, USA
| | - Mojgan Mirghafourvand
- grid.412888.f0000 0001 2174 8913Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz , Iran
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Kananikandeh S, Shokravi FA, Mirghafourvand M, Jahanfar S. An educational programme based on salutogenesis theory on childbirth fear and delivery method among nulliparous women: A mixed methods research protocol. Nurs Open 2022; 10:1909-1922. [PMID: 36336796 PMCID: PMC9912410 DOI: 10.1002/nop2.1414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/25/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022] Open
Abstract
AIM Designing, executing and testing a training intervention based on enhanced concepts of salutogenesis theory for managing fear of childbirth and choice of delivery method among nulliparous women. DESIGN A Sequential-Exploratory Mixed Methods Research. METHODS In the first phase (qualitative approach), the determinants of childbirth fear among nulliparous women will be explored. In the second phase (systematic review), the factors of childbirth fear among them will be summarized. In the third phase, the content of the educational intervention is developed based on the common factors of childbirth fear obtained from the previous two phases of the study. In the fourth phase (randomized controlled trial), two intervention and the control groups will be compared based on primary and secondary outcomes. DISCUSSION Using salutogenesis theory in a few interventional studies on various health areas has produced promising results. Based on the evidence, women had less sense of coherence with a strong childbirth fear. Therefore, developing an effective intervention based on this theory can probably help manage childbirth fear and reduce the costs of any potential consequences.
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Affiliation(s)
- Safieh Kananikandeh
- Department of Health Education and Health Promotion, Faculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Farkhondeh Amin Shokravi
- Department of Health Education and Health Promotion, Faculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Shayesteh Jahanfar
- MPH Program, Department of Public Health and Community MedicineTufts University School of MedicineBostonMassachusettsUSA
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Khojasteh F, Afrashte M, Khayat S, Navidian A. Effect of cognitive-behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:311. [PMID: 36439000 PMCID: PMC9683451 DOI: 10.4103/jehp.jehp_133_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Fear of childbirth is a common problem during pregnancy, which can give rise to sleep disorders and diminish sleep quality. This study aimed to determine the effect of cognitive-behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers who visited the slum health centers of Zahedan city, Iran, in 2020. MATERIALS AND METHODS This quasi-experimental study was conducted in 2020 on 100 pregnant adolescent slum dwellers between 11 and 19 years old at 24-28 weeks pregnant. Multi-stage sampling was used and the participants were randomly divided into an intervention and a control group. The intervention group received four sessions of cognitive-behavioral training at weekly intervals. The control group only received routine care. The Wijma Delivery Expectancy/Experience Questionnaire and the Pittsburgh Sleep Quality Index were filled before and 4 weeks after the training course. The data were analyzed in SPSS 21 using independent t-test, paired t-test, Fisher's exact test, and Chi-squared test. and covariance. A P value of < 0.05 was considered significant. RESULTS After the intervention, the fear of childbirth significantly decreased (P = 0.004), and sleep quality significantly improved (P = 0.001) in the intervention group compared with the control group. The results of analysis of covariance to control the significant effect of pre-test scores showed that the mean score of fear of childbirth (P = 0.03) and mean score of sleep quality (P = 0.001) in the two groups after the intervention was statistically significant. CONCLUSION The results showed that in addition to reducing fear of childbirth, cognitive-behavioral training improved the sleep quality of women in the intervention group. Therefore, this training could be used as an easy and accessible method without complications to improve women's health.
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Affiliation(s)
- Farnoosh Khojasteh
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdie Afrashte
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Samira Khayat
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Navidian
- Department of Nursing, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Ghaffari SF, Elyasi F, Mousavinasab SN, Shahhosseini Z. The effect of midwifery-led counseling on expectant fathers' fear of childbirth: a smartphone- based randomized controlled trial. BMC Pregnancy Childbirth 2022; 22:285. [PMID: 35382772 PMCID: PMC8985284 DOI: 10.1186/s12884-022-04638-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Expectant fathers experience a range of different emotions during their wife's pregnancy; one of these feelings is fear. It has adverse consequences on both the father and his family. The aim of this study was to investigate the effect of midwifery-led counseling on the fear of childbirth among expectant fathers. METHODS A two-armed parallel design randomized controlled trial was conducted from July to August 2020. Fifty expectant fathers with severe fear of childbirth at the 24th-27th weeks of gestation, in the Iranian setting, were assigned to intervention and control groups (allocation ratio1:1) using permuted block randomization. Participants assigned to the intervention group were engaged in six 60-90-min midwifery-led counseling sessions (twice a week) in the Skyroom platform. Measures were administered at recruitment, post-intervention, and one-month follow-up. The primary outcome was the change in fear of childbirth score between groups over time. Secondary outcomes were changes in the General Self-Efficacy score as well as changes in the frequency of the preferred type of delivery between groups over time. RESULTS The mean age of the participants was 31.64 (3.33) years. In the intention-to-treat analysis, the fear of childbirth score in the intervention group significantly decreased (β = - 11.84; 95% Confidence Interval: - 21.90 to - 1.78; P = 0.021) compared to that of the control group. In terms of secondary outcomes, the intervention group showed a significant increase in General Self-Efficacy compared to the intervention group at one-month follow-up measurement (β = 1.43; 95% Confidence Interval: 0.28 to 2.58; P = 0.014). However, the frequency of preferred delivery type was not significantly different between the intervention and control groups (P = 0.139). CONCLUSIONS Midwifery-led counseling can be an effective approach in reducing expectant fathers' childbirth fear with potential clinical significance. Although the inconclusive results imply more research on this issue. TRIAL REGISTRATION Registration number: IRCT20150608022609N6 . Registered 12/04/2019.
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Affiliation(s)
| | - Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Zohreh Shahhosseini
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Psychometric Characteristics of a Questionnaire Measuring Hopefulness: An Exploratory and Confirmatory Factor Analysis Approach. HEALTH SCOPE 2021. [DOI: 10.5812/jhealthscope.119157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: In the third millennium, which is called the information era, despite the technological growth and industrialization, lack of hopefulness is seen in the general population, especially among the youth. Therefore, hope is one of the critical issues that should be promoted among the youth. Objectives: This study was aimed at evaluating a hopefulness questionnaire among the youth. Methods: This cross-sectional study with an exploratory approach was carried out among the Iranian youth population in 2020. All students of Shahed University in Tehran (estimated as 5000 people) were considered the study population, 600 of whom were selected as the study sample by the simple random sampling method. For data collection, a researcher-made questionnaire was utilized. Data analysis was performed by SPSS v. 21 and LISREL v. 8.80. Alpha Cronbach coefficient was used to investigate the reliability of the questionnaire. Results: The results showed the adequate reliability of the hopefulness questionnaire. Also, the findings showed that three latent variables in the questionnaire had significantly larger values than the other factors. Therefore, with three latent factors, the hopefulness questionnaire was significantly saturated. Cronbach’s alpha coefficient for the 33 items of the questionnaire was 0.80. Conclusions: It was found that the questionnaire constructs are useful in predicting hopefulness intention. The scale consisted of three factors that did not completely replicate the factors found in previous studies. The use of this tool is recommended for all age groups.
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Mortazavi F, Mehrabadi M. Predictors of low birth satisfaction among Iranian postpartum women: A cross-sectional study. Nurs Open 2021; 9:604-613. [PMID: 34719125 PMCID: PMC8685877 DOI: 10.1002/nop2.1104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/17/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Aim To investigate predictors of low birth satisfaction in a sample of Iranian postpartum women. Design This was a cross‐sectional study. Methods This study was conducted on 767 postpartum women using a convenience sampling method between June and September 2019. We collected data on socio‐demographic variables, maternal well‐being, fear of childbirth and birth satisfaction. We used multiple linear regression analyses to determine predictors of low birth satisfaction. Results The women who gave birth by elective caesarean, emergency caesarean and vaginal birth were 13.2%, 19.06% and 67.8%, respectively. Predictors of low birth satisfaction were primiparity [Beta = −0.131, CI (−2.745, −1.021)], low level of well‐being [−0.119, (−2.514, −0.844)], low [−0.193 (−5.052, −2.568)] and moderate [−0.143 (−2.999, −1.199)] satisfaction with pregnancy, moderate satisfaction with spouse's emotional/financial support [−0.150 (−3.718, −1.595)], emergency caesarean [−0.086 (−2.713, −0.360)], severe fear of childbirth [−0.315 (−5.701, −3.911)] and long interval between admission to hospital and giving birth [−0.188 (−0.233, −0.119)].
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Affiliation(s)
- Forough Mortazavi
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Maryam Mehrabadi
- Health Chancellery, Sabzevar University of Medical Sciences, Sabzevar, Iran
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21
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Abdul Kadir A, Noor NM, Mukhtar AF. Development and validation of the knowledge and attitude regarding childhood vaccination (KACV) questionnaire among healthcare workers: the Malay version. Hum Vaccin Immunother 2021; 17:5196-5204. [PMID: 34714713 DOI: 10.1080/21645515.2021.1989915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Health care workers play an important role in supporting childhood vaccination as they are the most trusted source of vaccine-related information for parents. However, there is limited validated tools to measure their knowledge and attitude on childhood vaccination. This study aims to develop and validate knowledge and attitude regarding childhood vaccination (KACV) questionnaire among healthcare workers. The questionnaire was developed based on literature reviews and underwent a sequential validation process, including content, face validity and exploratory factor analysis. However, the attitude section is unidimensional and has undergone reliability analysis only. The preliminary knowledge questionnaire contains 33 items and the attitude questionnaire consists of 17 items. The preliminary KACV showed a high item Content Validity Index and Face Validity Index. The final questionnaire consists of 10 items for knowledge and 15 items for attitude. The Cronbach alpha for the knowledge and attitude section were 0.896 and 0.861, respectively. KACV is a valid and reliable tool to measure healthcare workers' knowledge and attitude on childhood vaccination.
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Affiliation(s)
- Azidah Abdul Kadir
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ahmad Faiq Mukhtar
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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22
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Barkhori A, Pakmanesh H, Sadeghifar A, Hojati A, Hashemian M. Preoperative anxiety among Iranian adult patients undergoing elective surgeries in educational hospitals. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:265. [PMID: 34485562 PMCID: PMC8396057 DOI: 10.4103/jehp.jehp_815_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/23/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although surgical techniques have been improving, preoperative anxiety is still a challenge in preoperative care and is known as an expected response experienced by patients waiting to undergo surgery. The present study aimed to compare preoperative anxiety levels in three educational hospitals in Kerman. MATERIALS AND METHODS This cross-sectional study was conducted in three educational hospitals in Kerman, Iran, from December 2017 to May 2018. The participants were 100 patients from each hospital (300 patients in sum) who were selected through the convenience sampling method. Sampling was not restricted to sex and type of surgery. The 40-item Spielberger State-Trait Anxiety Inventory was administered to the patients to assess the level of preoperative anxiety experienced by them. Bivariate linear regression models were used to compare the preoperative state anxiety levels based on the patients' demographic information. A multivariate linear regression model was used to determine the predictors of preoperative state anxiety. RESULTS The participants were 149 males and 151 females with a mean age of 36.38 (12.75) years (age range: 12-79 years). Almost two-third of the patients showed upper-middle symptoms of state anxiety (n = 197, 65.7%) followed by upper-middle symptoms of trait anxiety (40% and 49.3%, respectively). There was a significant relationship between the patient's sex and state anxiety (P = 0.05) and also between trait anxiety and state anxiety (P ≤ 0.001). It was shown that train anxiety could predict state anxiety before surgery (B: 0.53, 95% confidence interval: 0.44, 0.62; P ≤ 0.001). CONCLUSION The results of the present study confirmed the presence of preoperative anxiety in a sample of Iranian patients. Although the anxiety scores were not very high, organizing intervention and training programs to control and reduce preoperative anxiety among patients seems essential.
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Affiliation(s)
- Ali Barkhori
- Department of Anesthesiology and Pain Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Pakmanesh
- Department of Urology, Kerman University of Medical Sciences, Kerman, Iran
| | - Amirreza Sadeghifar
- Department of Orthopedic Surgery, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Hojati
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Morteza Hashemian
- Department of Anesthesiology and Pain Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Souto SPAD, Prata AP, Albuquerque RSD, Almeida S. Psychometric properties of the European Portuguese version of the Wijma Delivery Expectancy/Experience Questionnaire in pregnant women. Health Care Women Int 2021; 45:603-620. [PMID: 34283010 DOI: 10.1080/07399332.2021.1932892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 10/20/2022]
Abstract
The researchers' aim is to examine the psychometric properties of the European Portuguese version of the Wijma Delivery Expectancy/Experience Questionnaire version A (WDEQ-A). Data from 669 pregnant Portuguese women was collected between June and October of 2019. From the initial 33-item Portuguese version of the WDEQ-A, a 27-item instrument was developed. Five-factor solution explained 63.8% of the total variance. The factors defined by the researchers were: fear/lack of self-efficacy, loneliness, negative appraisal, lack of positive anticipation and concern for the child. Cronbach's alpha coefficient was 0.934. The European Portuguese version of the WDEQ-A is a reliable and valid tool to measure fear of childbirth on both nulliparous and multiparous women and can be a useful tool for cross-cultural research. Moreover, researchers support the use of this tool in clinical practice to recognize and address fearful women during prenatal period.
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Affiliation(s)
- Sandra Patrícia Arantes do Souto
- Centre for Interdisciplinary Research in Health: Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal
| | - Ana Paula Prata
- CINTESIS - Center for Health Technology and Services Research, Escola Sperior de Enfermagem do Porto, Porto, Portugal
| | | | - Sofia Almeida
- Centre for Interdisciplinary Research in Health: Institute of Health Sciences, Universidade Católica Psortuguesa, Porto, Portugal
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24
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Roldán-Merino J, Ortega-Cejas CM, Lluch-Canut T, Farres-Tarafa M, Biurrun-Garrido A, Casas I, Castrillo-Pérez MI, Vicente-Hernández MM, Jimenez-Barragan M, Martínez-Mondejar R, Hurtado-Pardos B, Cabrera-Jaime S. Validity and reliability of the Spanish version of the "Wijma Delivery Expectancy/Experience Questionnaire" (W-DEQ-B). PLoS One 2021; 16:e0249942. [PMID: 33901208 PMCID: PMC8075224 DOI: 10.1371/journal.pone.0249942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/26/2021] [Indexed: 11/18/2022] Open
Abstract
The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-B) is an instrument that allows the experiences around fear of childbirth to be examined after the birth. It is currently the most widely used to measure different aspects related to the fear of childbirth and enables healthcare and additional assistance to women after birth to be adapted according to their needs. The objective of this study was to translate the W-DEQ-B into Spanish and analyse its reliability and validity. The study was carried out in two phases: (1) transcultural adaption of the questionnaire to Spanish and (2) a transversal study in a sample of 190 postpartum women from Sexual and Reproductive Health Clinics in the province of Barcelona (Spain). The psychometric properties were examined in terms of reliability (internal consistency and temporal stability) and construct validity (confirmatory factorial analysis [CFA] and exploratory factorial analysis [EFA]). The results of the CFA did not confirm unidimensionality of the W-DEQ-B questionnaire. The EFA suggested four very similar, but not identical, dimensions to those obtained in other studies in which the W-DEQ-B has been evaluated. Both the Cronbach's alpha and the omega coefficient were adequate for the total questionnaire and for each of the four dimensions. The results of this study confirm that the W-DEQ-B is multi-dimensional. In the Spanish version of the W-DEQ-B-Sp four dimensions have been identified that allow the experiences around fear of childbirth to be examined after the birth. The Spanish version of the WDEQ-B (WDEQ-B-Sp) is reliable and valid for the measurement of fear of childbirth in clinical practice and for use in future research.
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Affiliation(s)
- Juan Roldán-Merino
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
- Research Group GEIMAC (Consolidated Group 2017–1681: Group of Studies of Invariance of the Instruments of Measurement and Analysis of Change in the Social and Health Areas), Barcelona, Spain
| | - Celia Maria Ortega-Cejas
- Midwife, Sexual and Reproductive Health Clinic (ASSIR), Mollet del Vallès Barcelona, Barcelona, Spain
| | - Teresa Lluch-Canut
- Research Group GEIMAC (Consolidated Group 2017–1681: Group of Studies of Invariance of the Instruments of Measurement and Analysis of Change in the Social and Health Areas), Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mariona Farres-Tarafa
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
- Member Research Group GRISIMula (Grupo emergente 2017 SGR 531; Grupo en Recerca Enfermera en Simulación), Barcelona, Spain
- Secretary, GRISCA Research Group (Nursing Simulation in Catalonia and Andorra Research Group), Barcelona, Spain
| | - Ainoa Biurrun-Garrido
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
| | - Irma Casas
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Preventive Medicine Service, Hospital Germans Trias i Pujol, Barcelona, Spain
- Research Group Innovation in Respiratory Infections and Tuberculosis Diagnosis (Group Consolidat 2017 SGR 494), Barcelona, Spain
| | | | | | - Marta Jimenez-Barragan
- Midwifery Coordinator, Sexual and Reproductive Health Clinic (ASSIR) Fundació Assistencial Mútua Terrassa, (Terrassa) Midwife, Sexual and Reproductive Health Clinic (ASSIR) Rambla Terrassa, (Terrassa) Docente en Fundació Universitaria del Bages, Barcelona, Spain
| | | | - Barbara Hurtado-Pardos
- Campus Docent, Sant Joan de Déu—Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
- Research Group GIES (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain
| | - Sandra Cabrera-Jaime
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Corporate Care Management, Institut Català d’Oncologia (ICO), L’Hospitalet de LLobregat, Barcelona, Spain
- GRIN Group, IDIBELL, Institute of Biomedical Research, Barcelona, Spain
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25
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Mortazavi F, Mehrabadi M. Predictors of fear of childbirth and normal vaginal birth among Iranian postpartum women: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:316. [PMID: 33882872 PMCID: PMC8058756 DOI: 10.1186/s12884-021-03790-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/09/2021] [Indexed: 01/11/2023] Open
Abstract
Background Fear of childbirth (FOC) may contribute to postpartum depression, impaired maternal-infant relation, and preference for cesarean in future pregnancies. We aimed to investigate predictors of FOC and normal vaginal birth among postpartum women who had planned for a normal vaginal birth. Methods This cross-sectional study was conducted in 2019 with postpartum women during the first 24 h after the birth. A sample of 662 women, selected using a convenient sampling method, filled out the questionnaire composed of socio-demographic and obstetric questions and the Wijma Delivery-Expectancy Questionnaire (W-DEQ). We used multiple logistic regression analyses to determine predictors of FOC and normal vaginal birth. Results The percentage of women with mild (score ≤ 37), moderate (38–65), high (66–84), severe (85–99), and intense FOC (score ≥ 100) were 7.9, 19.5, 40.9, 21.1, and 10.6% respectively. Predictors of intense FOC were age < 30, primiparity, low maternal satisfaction with pregnancy, and a low level of perceived marital satisfaction. Overall, 21.8% of women gave birth by cesarean. Predictors of normal vaginal birth were birth weight < 4 kg, spontaneous onset of labor pain, mother’s age < 30, term pregnancy, having a doula, multiparity, satisfaction with husband’s support, and overall satisfaction with pregnancy. A high level of perceived marital/sexual satisfaction was a risk factor for cesarean. Mode of birth was not a predictor of postpartum FOC. Conclusions The rate of severe and intense FOC among this group of postpartum women is high. Our findings highlight modifiable factors for reducing FOC and increasing normal vaginal birth. In designing programs to increase the rate of normal vaginal birth, the following factors should be considered: limiting induced labor, encouraging women to recruit a doula to help them at labor, facilitate husband’s attendance throughout antenatal/intrapartum, and postnatal care to support his wife, and pay attention to women’s common misunderstandings about the effect of vaginal birth on marital/sexual relationship. Our findings indicate that seeking novel ways to promote marital/sexual satisfaction and helping women to have a smooth, hassle-free pregnancy may contribute to a reduction in the rate of the FOC. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03790-w.
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Affiliation(s)
- Forough Mortazavi
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Pardis Building, Towhidshahr Blvd, Sabzevar, Iran.
| | - Maryam Mehrabadi
- Health Chancellery, Sabzevar University of Medical Sciences, Sabzevar, Iran
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26
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Reliability and validity study of the Spanish adaptation of the "Wijma Delivery Expectancy/Experience Questionnaire" (W-DEQ-A). PLoS One 2021; 16:e0248595. [PMID: 33740006 PMCID: PMC7978360 DOI: 10.1371/journal.pone.0248595] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022] Open
Abstract
The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-A) is an instrument that evaluates fear of childbirth through the expectations of women in relation to childbirth and their experience during the birth. The objective of this study was to translate the W-DEQ-A into Spanish and analyse its reliability and validity. The study was carried out in two phases: (1) adapting the questionnaire to Spanish and (2) a transversal study in a sample of 273 pregnant women in the Sexual and Reproductive Health centres in the Metropolitan Northern Barcelona in Catalonia (Spain). The psychometric properties were analysed in terms of reliability and construct validity. The confirmatory factorial analysis did not confirm the unidimensionality of the original structure of the WDEQ-A, as happened with the other studies in which it has previously been validated. The result of the exploratory factorial analysis suggests four factors, or dimensions, very similar but not identical to those obtained in other analysis studies of the W-DEQ-A. The Cronbach alpha and the omega scale were also adequate for all the scales and for each of the dimensions. The results of this study confirm the findings of other studies that suggest that the W-DEQ-A is multi-dimensional. In the Spanish version of the W-DEQ-A four dimensions have been identified to explore fear of childbirth in pregnant women. The Spanish version of the WDEQ-A (WDEQ-A-Sp) is reliable and valid for the measurement of fear of childbirth in clinical practice and for use in future research.
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27
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Ghaffari SF, Sharif Nia H, Elyasi F, Shahhosseini Z, Mohammadpoorsaravimozafar Z. Design and psychometric evaluation of the fathers' fear of childbirth scale: a mixed method study. BMC Pregnancy Childbirth 2021; 21:222. [PMID: 33743619 PMCID: PMC7981919 DOI: 10.1186/s12884-021-03696-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/04/2021] [Indexed: 01/18/2023] Open
Abstract
Background Fear of childbirth is reported in 13% of fathers, and it may have adverse consequences for the fathers’ health as well as their families. To reduce the fear of childbirth in the expectant fathers, an appropriate screening tool is needed. Due to the lack of a valid and reliable questionnaire to measure fathers’ fear of childbirth, this study was conducted to develop the Fathers’ Fear of Childbirth Scale and evaluate its psychometric properties. Methods This mixed method study was conducted in two phases. In the qualitative phase (or item generation), semi-structured interviews were conducted with 20 expectant fathers, and a literature review was performed to generate the Fathers’ Fear of Childbirth Scale items pool. In the quantitative phase (or psychometric evaluation), reliability as well as face, content, and construct validity of this scale were evaluated. To establish construct validity, exploratory and confirmatory factor analyses were performed. Reliability was evaluated through internal consistency and composite reliability measures. Results The primary version of Fathers’ Fear of Childbirth Scale contained 32 items, which were reduced to 17 items while establishing construct validity. Exploratory factor analysis extracted two factors, namely fear of childbirth process (12 items) and fear of hospital (5 items). These factors explained 50.82% of the total variance. Goodness of fit indices within the confirmatory factor analysis was acceptable. Internal consistency and composite reliability indices of all the factors were greater than 0.70. Conclusion The Fathers’ Fear of Childbirth Scale has a suitable validity and reliability for assessing fear of childbirth in fathers. It is a simple report instrument that can be easily implemented by health care professionals. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03696-7.
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Affiliation(s)
| | - Hamid Sharif Nia
- Amol Faculty of Nursing, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohreh Shahhosseini
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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28
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Shakarami A, Iravani M, Mirghafourvand M, Jafarabadi MA. Psychometric properties of the Persian version of delivery fear scale (DFS) in Iran. BMC Pregnancy Childbirth 2021; 21:147. [PMID: 33602180 PMCID: PMC7890816 DOI: 10.1186/s12884-021-03634-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present study was to evaluate the psychometric properties of the Persian version of delivery fear scale (DFS) among Iranian women population. METHODS This is a methodological study that was conducted to evaluate the psychometric properties of DFS. Convenience sampling was used to select 200 pregnant women from the maternity ward of Razi Hospital in Ahvaz, Iran. In the first step, the scale was translated into Persian using backward-forward translation method. Afterwards, the following types of validity were examined: face validity based on impact score, construct validity based on confirmatory factor analysis (CFA), and concurrent validity. The Pearson correlation test was used to determine the correlation of DFS with pregnancy-related anxiety questionnaire (PRAQ), Childbirth Attitude Questionnaire (CAQ), Spielberger's state-trait anxiety inventory (STAI), and the short form of Lowe's childbirth self-efficacy inventory. Reliability of DFS was assessed by determining internal consistency (Cronbach's alpha) and split-half method. RESULTS CFA had satisfactory validity considering x2⁄df < 5 and the RMSEA < 0.08. /the obtained Cronbach's alpha coefficient was 0.77. The split-half coefficient of the questionnaire was 0.83, indicating an acceptable reliability for the questionnaire. The results showed that DFS had a direct significant correlation with the CAQ (r = 0.72), PRAQ (r = 0.74), STAI-Y1 (r = 0.71) and STAI-Y1 (r = 0.63) and a reverse significant correlation with subscales of the short form of Lowe's childbirth self-efficacy inventory including outcome expectancy (r= -0.75) and self-efficacy expectancy (r= -0.76). CONCLUSIONS The findings of the present study confirm the validity and reliability of the Persian version of DFS as an instrument for measuring fear of childbirth (FOC) in Iranian women population.
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Affiliation(s)
- Aazam Shakarami
- MSc of Midwifery, Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mina Iravani
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mojgan Mirghafourvand
- Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Faculty of Health, Professor of Biostatistics, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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29
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Martin C, Jones C, Marshall CA, Huang C, Reeve J, Fleming MP, König J, Jomeen J. Fear of childbirth measurement: appraisal of the content overlap of four instruments. J Reprod Infant Psychol 2020; 40:329-341. [DOI: 10.1080/02646838.2020.1861226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Colin Martin
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, UK
| | - Catriona Jones
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, UK
| | - Claire A. Marshall
- East Yorkshire Perinatal Mental Health Liaison Team, Humber Teaching NHS Foundation Trust, Hull, UK
| | - Chao Huang
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, UK
| | - Joanne Reeve
- Academy of Primary Care, Hull York Medical School, University of Hull, Hull, UK
| | - Mick P. Fleming
- Faculty of Wellbeing, University College Isle of Man, Isle of Man, UK
| | - Julia König
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Julie Jomeen
- Faculty of Health Sciences, Southern Cross University, Lismore, Australia
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30
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Jomeen J, Martin CR, Jones C, Marshall C, Ayers S, Burt K, Frodsham L, Horsch A, Midwinter D, O'Connell M, Shakespeare J, Sheen K, Thomson G. Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research. J Reprod Infant Psychol 2020; 39:2-15. [PMID: 33206580 DOI: 10.1080/02646838.2020.1843908] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: To discuss and develop a statement on the current state of the evidence and opinion in Fear of Childbirth (FoC) and Tokophobia (Tocophobia), and to provide recommendations. Background: A group met in 2019 to discuss the state of clinical and academic knowledge relating to FoC/Tokophobia. Five key areas were agreed as the focus of the meeting. Methods: 12 internationally acknowledged experts, in this or a closely related area (e.g. PTSD) met to discuss their understanding of the evidence for FoC/ Tokophobia and current practice. The consensus described in this paper constitutes the expression of the general opinion of the participants and does not necessarily imply unanimity. Keys points: Work focussed on tokophobia is recent and there remains a wide range of issues, which were addressed in the workshop including complexity in defining prevalence, a theoretical lack of understanding, which creates challenge for robust assessment and the identification of risk factors. An improved aetiological and developmental understanding of the tokophobia is required to underpin appropriate, effective and evidence-based interventions. Evaluation of pathways of care and relevant interventions, should be a focus of future research. Conclusion: Significant gaps remain within the FoC/tokophobia knowledge base. Further research is necessary.
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Affiliation(s)
- J Jomeen
- School of Health & Human Sciences, Southern Cross University , Bilinga, Australia.,Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK
| | - C R Martin
- School of Health & Human Sciences, Southern Cross University , Bilinga, Australia.,Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK.,School of Nursing and Allied Health, Buckinghamshire New University , High Wycombe, UK
| | - C Jones
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK
| | - C Marshall
- Perinatal Mental Health Team, Humber Teaching NHS Foundation Trust , Hull, UK
| | - S Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London , London, UK
| | - K Burt
- Expert by Experience , UK
| | - L Frodsham
- Obstetric Medicine, Guy's and St Thomas' NHS Foundation Trust , London, UK
| | - A Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne , Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital , Lausanne, Switzerland
| | - D Midwinter
- Maternity and Midwifery Services, North Lincolnshire and Goole NHS Foundation Trust , Scunthorpe, UK
| | - M O'Connell
- School of Nursing and Midwifery, Royal College of Surgeons Ireland in Bahrain , Adliya, Bahrain
| | | | - K Sheen
- School of Psychology, Faculty of Health, Liverpool John Moores University , Liverpool, UK
| | - G Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire , Lancashire, UK.,School of Education, Health and Social Studies, Dalarna University , Falun, Sweden
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31
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Evaluation of the birth plan implementation: a parallel convergent mixed study. Reprod Health 2020; 17:138. [PMID: 32894145 PMCID: PMC7487561 DOI: 10.1186/s12978-020-00989-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy, birth, and motherhood are among the most important events of every woman's life. Training and participation of mothers in the decision-making process of delivery play an essential role in physical as well as psychosocial preparation of the mother. The healthcare system can improve and enhance the level of care by involving the patient in their self-care process. The aim of the present study is to assess the implementation of the birth plan for the first time in Iran in Tabriz city. METHODS/DESIGN The present study uses a mixed-method with a parallel convergence approach, including both quantitative and qualitative phases. The quantitative phase is a randomized controlled clinical trial performed on 106 pregnant women, 32-36 weeks of pregnancy, referring to Taleghani educational hospital in Tabriz city. The participants will be assigned into intervention and control groups using a randomized block method. A training session will be held about the items of the birth plan checklist at weeks 32-36 of gestation for the participants in the intervention group, whereby a mother-requested birth plan will be developed. It will then be implemented by the researcher after admitting them to the delivery ward. Also, those in the control group will receive routine care. During and after the delivery, the questionnaire of delivery information, neonatal information, and Delivery Fear Scale (DFS) will be completed. Also, a partogram will be completed for all participants by the researcher. The participants in both groups will be followed up until six weeks post-delivery, whereby the instruments of Childbirth Experience Questionnaire (CEQ2.0), Edinburgh's Postpartum Depression Scale and PTSD Symptom Scale 1 (PSS-I) will be completed six weeks 4-6 weeks postpartum by the researcher through an interview with participants in Taleghani educational hospital. The general linear model and multivariate logistic regression model will be used while controlling the possible confounding variables. The qualitative phase will be performed to explore the women's perception of the effect of the birth plan on childbirth experience within 4-6 weeks postpartum. The sampling will be of a purposeful type on the women who would receive the birth plan and will continue until data saturation. In-depth, semi-structured individual interviews would be used for data collection. The data analysis will be done through content analysis with a conventional approach. The results of the quantitative and qualitative phases will be analyzed separately, and then combined in the interpretation stage. DISCUSSION By investigating the effect of implementing the birth plan on the childbirth experience of women as well as other maternal and neonatal outcomes, an evidence-based insight can be offered using a culturally sensitive approach. The presentation of the results obtained from this study using the mixed method may be effective in improving the quality of care provided for women during labor. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N58. Date of registration: July 7, 2020. URL: https://en.irct.ir/user/trial/47007/view.
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Mortazavi F, Mehrabadi M, Hollins Martin CJ, Martin CR. Psychometric properties of the birth satisfaction scale-revised (BSS-R) in a sample of postpartum Iranian women. Health Care Women Int 2020; 42:836-851. [PMID: 32804591 DOI: 10.1080/07399332.2020.1802464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Childbirth satisfaction may positively affect maternal intention to have a future pregnancy and preference to have a cesarean. We translate the UK-Birth-Satisfaction-Scale-Revised (UK-BSS-R) into Persian and validate an Iranian-BSS-R for future use in this population. In total, 784 mothers who were hospitalized in postpartum wards completed the Persian version of the BSS-R. The confirmatory factor analysis on 10-items scale confirmed the conventional three-factor structure. The Cronbach's alpha of the Iranian-BSS-R subscales and the total score were within the range of 0.53-0.76. Our findings provide further evidence that the BSS-R is an internationally reliable and valid instrument to measure birth satisfaction.
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Affiliation(s)
- Forough Mortazavi
- Department of Midwifery, School of Nursing & Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Maryam Mehrabadi
- Health Chancellery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Colin R Martin
- Institute for Clinical and Applied Health Research (ICAHR) , University of Hull, Hull, UK
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes. BMC WOMENS HEALTH 2020; 20:180. [PMID: 32799875 PMCID: PMC7429472 DOI: 10.1186/s12905-020-01048-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
Background Lack of knowledge and fear of the unknown during pregnancy and childbirth make mothers fearful, worried, and anxious. Maternal fear and anxiety can lead to problems such as preterm childbirth and low birth weight. Increasing women’s knowledge through prenatal education can prepare them for childbirth and improve their health. The present study was conducted to compare fear of childbirth, anxiety and depression during pregnancy in three groups of primiparous pregnant women who were either not attending, irregularly attending, or regularly attending childbirth preparation classes. Methods A total of 204 primiparous pregnant women attending health centers in Tabriz, Iran, were selected by cluster sampling and assigned to the following three groups: Not attending, irregularly attending (attending one to three sessions of classes) and regularly attending (attending four to eight sessions of classes). Childbirth fear, pregnancy anxiety and depression questionnaires were completed for them through interviews. The general linear model was used to compare their fear of childbirth and prenatal anxiety and depression. Results According to the general linear model, the scores of fear of childbirth (p < 0.001), anxiety (p < 0.001) and depression (p = 0.006) were significantly lower in the group of pregnant women regularly attending the classes compared to the non-attending group of women. No significant differences were observed between the regularly-attending and irregularly-attending groups in terms of fear of childbirth (p = 0.066), anxiety (p = 0.078), and depression (p = 0.128). Conclusion Prenatal training can reduce fear, anxiety and depression in primiparous women. Incorporating such training into prenatal care helps improve maternal health.
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Affiliation(s)
- Robab Hassanzadeh
- Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran
| | - Fateme Abbas-Alizadeh
- Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- South Asia Infant Feeding Research Network (SAIFRN), School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Abdollahi S, Faramarzi M, Delavar MA, Bakouei F, Chehrazi M, Gholinia H. Effect of Psychotherapy on Reduction of Fear of Childbirth and Pregnancy Stress: A Randomized Controlled Trial. Front Psychol 2020; 11:787. [PMID: 32528340 PMCID: PMC7265090 DOI: 10.3389/fpsyg.2020.00787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/31/2020] [Indexed: 01/24/2023] Open
Abstract
Introduction The fear of childbirth (FOC) has an adverse effect on the physical and mental health of pregnant women and increases adverse maternal and fetal outcomes. Previous research reported the effect of psychological interventions such as cognitive behavioral therapy, relaxation therapies, and short-term psycho-educational intervention on FOC. We examined whether adding motivational interviewing (MI) psychotherapy to prenatal usual care (PUC) is superior to PUC alone to reduce the scores of FOC, pregnancy stress, and self-efficacy. Materials and Methods An RCT with two-arm parallel groups and 1:1 allocation ratio assigned 70 pregnant women (aged 18–50) attending public health centers in an education hospital in Iran to receive five sessions of group MI psychotherapy plus PUC (N = 35) or to receive PUC alone (N = 35). The primary outcomes were the FOC scores (Wijma Delivery Expectancy/Experience Questionnaire, W-DEQ), pregnancy-specific stress (Prenatal Distress Questionnaire, NuPDQ), anxiety (Spielberger state anxiety), and Childbirth Self-Efficacy Index (CBSI) at 5 weeks post-randomization. Additional measures included subscales of the W-DEQ and the NuPDQ, patients’ compliance, and satisfaction with psychotherapy intervention at 5 weeks post-randomization as secondary outcomes. Main Results The post-trial results indicated that the outcome scores diminished more considerably in psychotherapy than in PUC for total FOC scale with a large effect size (B = −23.54, p = < 0.001, η2η2 = 0.27), for total pregnancy stress with a large effect size (B = −4.51, p = < 0.001, η2 = 19), and for state anxiety with a large effect size (B = −12.42, p = < 0.001, η2 = 0.22). However, the score of self-efficacy and concern about physical symptoms did not differ between the psychotherapy and PUC groups (P < 0.05). Discussion Adding 5 weeks of group psychotherapy to PUC could be considered as an adjunctive care option for reducing FOC, pregnancy stress, and general anxiety in pregnant women in the third trimester. Future research may focus on sustaining the effects and evaluating the economic impacts of adding psychotherapy to PUC.
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Affiliation(s)
- Somayeh Abdollahi
- Counseling in Midwifery, Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Mouloud Agajani Delavar
- Community Health, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Bakouei
- Reproductive Health, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Epidemiology & Biostatics, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Biostatistics, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Andaroon N, Kordi M, Ghasemi M, Mazlom R. The Validity and Reliability of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) in Primiparous Women in Mashhad, Iran. IRANIAN JOURNAL OF MEDICAL SCIENCES 2020; 45:110-117. [PMID: 32210487 PMCID: PMC7071547 DOI: 10.30476/ijms.2019.45326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Although pregnancy and childbirth are physiological processes, fear of childbirth is a common problem that is often associated with requests for cesarean delivery.
This study was undertaken to determine the validity and reliability of the Wijma Delivery Expectancy/Experience Questionnaire A (W-DEQ [A]) primiparous women in Mashhad, Iran. Methods: This study was conducted on 220 primiparous women with a gestational age of 28-30 weeks referred to health centers in Mashhad. Using demographic questionnaire, Beck’s Anxiety Inventory,
Beck’s Depression Inventory, and the W-DEQ (A), for determining the validity and reliability of the W-DEQ (A), first two linguists translated the questionnaire into Persian; then,
two other linguists translated the Persian version back into English. The content validity of this version was then assessed by expert faculty members. The final version was sent
to the questionnaire’s original developers (Klass Wijma and Barbro Wijma) and then used after their approval. Factor analysis was used to analyze the data. Results: The result of actor analysis revealed six factors, forming 58.8% of the total variance. The reliability of this questionnaire was confirmed with a Cronbach’s alpha coefficient of 0.84,
and the fear of childbirth was found to be correlated with Beck’s anxiety (r=0.414) and depression (r=0.287) scores. Conclusion: The W-DEQ (A) is a valid and reliable tool for measuring the fear of childbirth and is recommended to be used for measuring the fear of childbirth among Iranian women.
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Affiliation(s)
- Nafise Andaroon
- Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Kordi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marzieh Ghasemi
- Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Mazlom
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Johnson AR, Kumar MG, Jacob R, Jessie MA, Mary F, Agrawal T, Raman V. Fear of Childbirth among Pregnant Women Availing Antenatal Services in a Maternity Hospital in Rural Karnataka. Indian J Psychol Med 2019; 41:318-322. [PMID: 31391663 PMCID: PMC6657479 DOI: 10.4103/ijpsym.ijpsym_292_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Pregnancy, though joyful, may be a time of fear and anxiety. Twenty percent of pregnant women in developed nations report a fear of childbirth, and 6%-10% describe a severe fear that is crippling. This could lead to adverse maternal and fetal outcomes. Data on fear of childbirth among pregnant women are lacking in India and would help in incorporating measures to enhance routine antenatal care. METHODOLOGY With the objective of documenting fear of childbirth and associated factors, a cross-sectional study was conducted in rural Karnataka among women availing antenatal care services, using a face-validated 30 item questionnaire developed by the authors which was then scored to determine fear of childbirth. RESULTS Of 388 women studied, 45.4% (176) had a fear of childbirth. The commonest fears documented were: not feeling confident about childbirth, being afraid or tense about the process of childbirth, fear of labor pains, and fear of cesarean section. Teenage pregnancy, nulliparity, primigravida status, and having no living child were significantly associated with fear of childbirth. CONCLUSION Overall, 45.4% (176) of women had a fear of childbirth. It is important to identify and address the various fears of childbirth that women may have, as revealed by this study, with a view to providing information and reassurance to the mother, with the aim of improved maternal and fetal outcomes.
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Affiliation(s)
- Avita Rose Johnson
- Department of Community Health, St. John's Medical College, Bengaluru, Karnataka, India
| | - Melvin G Kumar
- Department of Community Health, St. John's Medical College, Bengaluru, Karnataka, India
| | - Rosy Jacob
- Department of Community Health, St. John's Medical College, Bengaluru, Karnataka, India
| | - Maria Arul Jessie
- Department of Community Health, St. John's Medical College, Bengaluru, Karnataka, India
| | - Fabiyola Mary
- Department of Community Health, St. John's Medical College, Bengaluru, Karnataka, India
| | - Twinkle Agrawal
- Department of Community Health, St. John's Medical College, Bengaluru, Karnataka, India
| | - Vijaya Raman
- Department of Psychiatry, St. John's Medical College, Bengaluru, Karnataka, India
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König J. The German W-DEQ version B—Factor structure and prediction of posttraumatic stress symptoms six weeks and one year after childbirth. Health Care Women Int 2019; 40:581-596. [DOI: 10.1080/07399332.2019.1583230] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Julia König
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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Reliability and validity of the Chinese version neuropathic pain symptom inventory in patients with colorectal cancer. J Formos Med Assoc 2018; 117:1019-1026. [DOI: 10.1016/j.jfma.2017.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/15/2017] [Accepted: 11/21/2017] [Indexed: 01/19/2023] Open
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Mortazavi F, Agah J. Childbirth Fear and Associated Factors in a Sample of Pregnant Iranian Women. Oman Med J 2018; 33:497-505. [PMID: 30410692 DOI: 10.5001/omj.2018.91] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives Fear of childbirth is common during pregnancy and may contribute to several adverse outcomes. We aimed to investigate childbirth fear and associated factors in a sample of pregnant Iranian women. Methods This cross-sectional study was conducted on 525 pregnant women in Sabzevar, Iran from December 2016 to March 2017. The Wijma Delivery Expectancy/Experience Questionnaires (W-DEQ) was used to investigate fear of childbirth. Results The mean W-DEQ score was 67.6±23.5. Of 525 women, 19.6% and 6.1% experienced moderate (mean W-DEQ score ≥ 85) and severe (mean W-DEQ score ≥ 100) fear of childbirth, respectively. W-DEQ scores were not different in the categories of gestational age, parity, maternal age, educational level, body mass index, and employment status (p > 0.050). The mean score of childbirth fear was significantly higher in multiparas who preferred cesarean in comparison to those who preferred vaginal delivery (p < 0.032). The mean score of childbirth fear was significantly higher in nulliparas with a lower family income compared to those with a higher family income (p < 0.011). In nulliparas, predictors of moderate and severe childbirth fear were women's description of their present pregnancy (odds ratio (OR) = 2.600; 95% confidence interval (CI): 1.323-5.112), and receiving a low level of emotional support from their husband (OR = 4.450; 95% CI: 1.349-14.674), respectively. In multiparas, predictors of childbirth fear were unwanted pregnancy (OR = 2.930; 95% CI: 1.549-3.541), experiencing moderate to severe dyspareunia in the first intercourse (OR = 2.829; 95% CI: 1.479-5.414), having a low level of physical activity (OR = 1.942; 95% CI: 1.014-3.716), and perceived a low level of health (OR = 3.415; 95% CI: 1.172-9.950). Conclusions We observed a relatively high prevalence of childbirth fear in pregnant women in Iran. Interventions should be implemented in high-risk women considering psychological variables.
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Affiliation(s)
- Forough Mortazavi
- Department of Midwifery, School of Medicine, Sabzevar University of Medical Sciences, University Pardis, Sabzevar, Iran
| | - Jila Agah
- Department of Obstetrics and Gynecology, School of Medicine, Sabzevar University of Medical Sciences, University Pardis, Sabzevar, Iran
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