Effectiveness of a Nurse-led Program to Enhance Self-efficacy of Pregnant Adolescents and Reduce their Fear of Childbirth: A Randomized Controlled Trial
DOI:
https://doi.org/10.60099/prijnr.2023.260325Keywords:
Application, Childbirth self-efficacy, Fear of childbirth, Nurse-led program, Pregnant adolescentsAbstract
Fear of childbirth is a common feeling experienced by pregnant women, and it can occur before, during, or after childbirth. Intense fear has a detrimental effect on physical and psychological statuses of the pregnant women. The aim of this randomized controlled trial was to examine the effectiveness of a nurse-led program together with the mobile phone application to enhance pregnant adolescents’ childbirth self-efficacy and reduce their fear of childbirth. The sample was pregnant adolescents receiving antenatal care in a regional hospital in Southern Thailand. Using the minimization procedure, pregnant adolescents were assigned to either an experimental group receiving the program (n = 64) or a control group receiving routine care (n = 64). The instruments used for data collection consisted of a demographic characteristics form, the Fear of Childbirth in the Third Trimester Questionnaire, and the Thai Childbirth Self-Efficacy Inventory. Data were analyzed using descriptive statistics, paired t-test, and independent t-test.
The results showed that after completion of the intervention program, the participants in the experimental group had a significantly higher mean score on childbirth self-efficacy and lower fear of childbirth than before the intervention. When comparing the two groups after completion of the program, results showed a significantly higher childbirth self-efficacy mean score, and lower fear of childbirth mean score in the experimental group than those in the control group. The results indicate that application of childbirth self-efficacy enhancement program can increase self-efficacy and reduce fear of childbirth in pregnant adolescents. Therefore, it is a promising program for caring pregnant adolescents but needs to be tested with other samples before implementation in practice.
References
World Health Organization (2021). Adolescent pregnancy fact sheet [Internet]. 2021 Jan [cited 2021 Mar 9]. Available from: http://www.who.int/mediacentre/factsheets/fs364/en/
World Health Organization (2021). Indicator sheets–Adolescent birth rate [Internet]. [cited 2021 Mar 9]. Available from: https://www.monitor.srhr.org/related-sheets/Indicator_sheets_together_dec2020.pdf
Department of Health, Ministry of Public Health. Statistics of birth rate in women aged 10-14 years. [Internet]. 2021
[cited 2021 Mar 9]. Available from: http://www.rh.anamai.moph.go.th/all_file64.pdf
The Bureau of Registration Administration. Situation of childbirth among Thai teenagers [Internet]. 2021 [cited 2021 Mar 9]. Available from: https://www.bora. dopa.go.th/index.php/th/
Kaeomaungfang R, Suppasri P, Siriarunrat S. Effect of yoga training on stress reduction in primiparuos pregnant adolescents. NJPH. 2018;27(1):73-84 (in Thai).
Jantacumma N, Powwattana A, Lagampan S, Chansatitporn N. Predictive model of quality of life among Thai pregnant adolescents. Pacific Rim Int J Nurs Res. 2018;22(1):30-42.
Franji´ CS. Adolescent pregnancy is a serious social problem. J Gynecol Res Obstet. 2018;4:6-8.
Prabdin J, Phumdoung S, Thitimapong B. Fear of childbirth among pregnant adolescents in the third trimester and its related factors. JNSH. 2017;40(2):96-106 (in Thai).
Bałdyga AB, Kozak AB, Klusek CŁ, Stadnicka G, Dobrowolska B. Attitudes of teenage mothers towards pregnancy and childbirth. Int J Environ Res Public Health. 2020;17:1-10. doi: 10.3390/ijerph17041411. DOI: https://doi.org/10.3390/ijerph17041411
Poggi L, Goutaudier N, Séjourné N, Chabrol H. When fear of childbirth is pathological: the fear continuum. Matern Child Health J. 2018;22:772-8. DOI: https://doi.org/10.1007/s10995-018-2447-8
Dwiarini M, Chou HF, Gau ML, Liu CY. Relationship between fear of childbirth, self-efficacy, and length of labor among nulliparous women in Indonesia. Midwifery. 2022; 105:1-7. doi: 10.1016/j.midw.2021.103203. DOI: https://doi.org/10.1016/j.midw.2021.103203
Tupsai T, Xuto P, Chaloumsuk N. Social support, fear of childbirth, and childbirth self-efficacy among primigravidas. J Nurs Healthc. 2019;37(2):150-9 (in Thai).
Prasan S, Siriarunrat S, Tachasuksri T. Effects of continuous labor support programme on fear of childbirth and childbirth outcomes among primiparous women. NJPH. 2021;31(1): 148-60 (in Thai).
Permsup N, Sawatphanit W, Deoisres W. Effect of childbirth preparation on fear of childbirth, labor pain coping behaviors, and satisfaction with childbirth experience in primiparous at a hospital under the jurisdiction of Royal Thai Navy. RTNNMDjournal. 2017;44(2):55-72 (in Thai).
Howarth AM, Swain NR. Skills-based childbirth preparation increases childbirth self-efficacy for first time mothers. Midwifery. 2019;70:105-5. doi: 10.1016 /j. midw.2018. .12.017. DOI: https://doi.org/10.1016/j.midw.2018.12.017
Edalati MP, Moghadam NK, Shahesmaeili A, Nejad PS. Exploring the effect of mindfulness-based stress reduction on childbirth fear among single child mothers in the city of Kerman, Iran. Medsurg Nurs. 2017;7(4):1-7. doi: 10.5812/msnj.90247. DOI: https://doi.org/10.5812/msnj.90247
Kordi M, Bakhshi M, Masoudi S, Esmaily H. Effect of a childbirth psychoeducation program on the level of fear of childbirth in primigravid women. Evid Based Care J. 2017;7(3):26-34. doi: 10.22038/EBCJ.2017.25676. 1575.
Fenwick J, Toohill J, Gamble J, Creedy DK, Buist A, Turkstra E. Effects of a midwife psychoeducation intervention to reduce childbirth fear on women’s birth outcomes and postpartum psychological wellbeing. BMC Pregnancy Childbirth. 2015;15(1):1-8. doi: 10.1186/s12884-015-0721-y. DOI: https://doi.org/10.1186/s12884-015-0721-y
Firouzan L, Kharaghani R, Zenoozian S, Moloodi R, Jafari E. The effect of midwifery led counseling based on Gamble’s approach on childbirth fear and self-efficacy in nulligravida women. BMC Pregnancy Childbirth. 2020;20(522):1-7. doi: 10.1186/s12884-020-03230-1. DOI: https://doi.org/10.1186/s12884-020-03230-1
Liu YM, Chu HC. Impacts of a mobile childbirth educational game on learning achievement, self-efficacy and postnatal depression for puerperal women. IIAI-AAI. 2018;7:350-3.doi: 10.1109/IIAI-AAI.2018.00075. DOI: https://doi.org/10.1109/IIAI-AAI.2018.00075
Edwards R, Way S, Hundley V. Can an educational web-intervention, co-created by service users alongside self-efficacy theory, affect nulliparous women’s experiences of early labour? A study protocol for a randomized control trial (the L-TEL Trial). Evid Based Midwifery. 2019;17(4):121-7.
Karapakdee C, Deoisres W, Chuahorm U. Effects of labor support program by a female relative on fear of childbirth and perception of childbirth experience among first-time adolescent mothers. JFONUBUU. 2019;27(2):20-9 (in Thai).
Budsaengdee B, Chankhao C. Effect of using an application for enhancing childbirth self-efficacy to cope with labor pain and perception of the childbirth experience of nulliparous pregnant adolescents. TRC Nurs J. 2021;14(1):241-55 (in Thai).
Dick-Read G. Childbirth without fear: the original approach to natural childbirth. 5th ed. New York, NY: Harper & Row Publishers; 1984.
Lowe NK. Maternal confidence in coping with labor: a self-efficacy concept. J Obstet Gynecol Neonatal Nurs. 1991;20(6):457-63. DOI: https://doi.org/10.1111/j.1552-6909.1991.tb01711.x
Mayer RE. Multimedia learning. 3th ed. United Kingdom: Cambridge University Press; 2021. DOI: https://doi.org/10.1017/9781108894333.003
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191-215. DOI: https://doi.org/10.1037/0033-295X.84.2.191
Munkhondya BM, Munkhondya TE, Chirwa E, Wang H. Efficacy of companion-integrated childbirth preparation for childbirth fear, self-efficacy, and maternal support in primigravid women in Malawi. BMC Pregnancy Childbirth. 2020;20(48):1-12. doi: 10.1186/s12884-019- DOI: https://doi.org/10.1186/s12884-019-2717-5
-5.
Khwanmueang P, Chunuan S, Thitimapong B. Effect of childbirth preparation program with continuous labor support on labor pain of first-time teenage pregnant women. NJPH. 2020;30(3):115-27 (in Thai).
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New York: Lawrence Erlbaum Associates; 1988.
Mazúchová L, Škodová Z, Kelčíková S, Rabárová A. Factors associated with childbirth-related fear among Slovak women. Cent Eur J Nurs Midwifery. 2017;8(4): 742-8. doi: 10.15452/CEJNM.201708.0027. DOI: https://doi.org/10.15452/CEJNM.2017.08.0027
Khwepeya M, Lee GT, Chen S, Kuo S. Childbirth fear and related factors among pregnant and postpartum women in Malawi. BMC Pregnancy Childbirth. 2018;18(391): 1-10. doi: 10.1186/s12884-018-2023-7. DOI: https://doi.org/10.1186/s12884-018-2023-7
Fisher C, Hauck Y, Fenwick J. How social context impacts on women’s fear of childbirth: a western Australian example. Soc Sci Med. 2006;63:64-75. DOI: https://doi.org/10.1016/j.socscimed.2005.11.065
Tanglakmankhong K, Perrin NA, Lowe NK. Childbirth self-efficacy inventory and childbirth attitudes questionnaire: psychometric properties of Thai language versions. J Adv Nurs. 2011;67(1):193-203. DOI: https://doi.org/10.1111/j.1365-2648.2010.05479.x
Farrah AA, Abu-Dawood AK. Using mobile phone applications in teaching and learning process. Int J Educ Res. 2018; 3(2):48-67. doi: 10.29252/ijree.3.3.48. DOI: https://doi.org/10.29252/ijree.3.2.48
Rattanaseleevong S. The exposure to game advertising with decision-making behavior of online games on mobile phones. JCMN. 2017;4(2):33-45 (in Thai).
Souto SP, Albuquerque RS, Silva RC, Guerra MJ, Prata AP. Midwife interventions to reduce fear of childbirth in pregnant women: a scoping review protocol. JBI Evid Synth. 2021; 19(11):2045-57. doi: 10.11124/JBISRIR-D-19-00198. DOI: https://doi.org/10.11124/JBIES-21-00394
Webb R, Bond R, Romero B, Mycroft R, Ayers S. Interventions to treat fear of childbirth in pregnancy: a systematic review and meta-analysis. Psychol Med. 2021;51:1964-77. doi: 10.1017/S0033291721002324. DOI: https://doi.org/10.1017/S0033291721002324
Korn L, Koren G, Yaakov A, Madar G, Blau A. Evaluating the effectiveness of childbirth preparation courses on women’s self-efficacy among ultra-orthodox Jewish religious women in Israel. Healthcare. 2021;9:1-9. doi: 10.3390/healthcare9070818. DOI: https://doi.org/10.3390/healthcare9070818
Kuttasing S, Deoisres W, Siriarunrut S. Factors related to perceived childbirth self-efficacy in primiparous pregnant women. JFONUBUU. 2019;27(2):104-14 (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pacific Rim International Journal of Nursing Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.