The Effect of a Birth Preparation Program with Spousal Participation Based on Self-Efficacy Theory on Fear of Childbirth, Self-Efficacy, Mode of Delivery and Outcomes: Study Protocol for a Randomised Trial
Yıl 2025,
Cilt: 27 Sayı: 3, 225 - 246, 31.12.2025
Fatma Nur Duman
,
Zehra Gölbaşı
Öz
Aim: This protocol presents the design of a study aimed at investigating the effects of a self-efficacy–based birth preparation programme with spousal participation on fear of childbirth, self-efficacy, mode of delivery, and birth interventions.
Methods: The study was designed as a pre-test, post-test, parallel group, randomised controlled trial. The population of the study will consist of nulliparous pregnant women and their spouses who apply to the hospital, and the sample will include of a total of 60 couples, with 30 couples allocated to the experimental group and 30 to the control group, based on power analysis. A pre-test will be administered to eligible couples prior to randomization. Following randomization a birth preparation programme based on self-efficacy theory with spousal participation will be applied to the couples included in the experimental group, and no intervention will be applied to the control group. Data collection has started and is expected to be completed in May 2025.
Conclusion: It is anticipated that eliminating the fear of childbirth in both expectant mothers and fathers will increased competence levels regarding the birth process; thus the social support received by pregnant women from their spouses may be positively affected and vaginal birth rates may increase through enhanced self-efficacy for vaginal birth.
Etik Beyan
Ethical approval was obtained from the Lokman Hekim University Scientific Research Ethics Committee (Date: 30.01.2024, Code No: 2024009, Decision No: 2024/16) and institutional permission was obtained from Lokman Hekim Akay Hospital.
Kaynakça
-
Abdolalipour, S., Mohammad-Alizadeh Charandabi, S., Mashayekh-Amiri, S., & Mirghafourvand, M. (2023). The effectiveness of mindfulness-based interventions on self-efficacy and fear of childbirth in pregnant women: A systematic review and meta-analyses. Journal of Affective Disorders, 333, 257-270. https://doi.org/10.1016/j.jad.2023.04.020
-
Akın, B., & Koçoğlu, D. (2017). Randomize kontrollü deneyler. Hacettepe University Journal of Nursing Faculty, 4(1), 73-92.
-
Alizadeh-Dibazari, Z., Abdolalipour, S., & Mirghafourvand, M. (2023). The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy and Childbirth, 23(1), 541. https://doi.org/10.1186/s12884-023-05867-0
-
Alpar, R., & Uludag, A. K. (2003). Reducing the bias in clinical trials (Randomization & Blinding). FABAD J. Pharm. Sci., 28(1), 113-122.
-
AlSomali, Z., Bajamal, E., & Esheaba, O. (2023). The Effect of structured antenatal education on childbirth self-efficacy. Cureus. https://doi.org/10.7759/cureus.39285
-
Antoine, C., & Young, B. K. (2021). Cesarean section one hundred years 1920–2020: the good, the bad and the ugly. Journal of Perinatal Medicine, 49(1), 5-16. https://doi.org/10.1515/jpm-2020-0305
-
Bakermans‐Kranenburg, M. J., Lotz, A., Alyousefi‐van Dijk, K., & van IJzendoorn, M. (2019). Birth of a Father: Fathering in the First 1,000 Days. Child Development Perspectives, 13(4), 247-253. https://doi.org/10.1111/cdep.12347
-
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. https://doi.org/10.1037/0033-295X.84.2.191
-
Bergström, M., Rudman, A., Waldenström, U., & Kieler, H. (2013). Fear of childbirth in expectant fathers, subsequent childbirth experience and impact of antenatal education: subanalysis of results from a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 92(8), 967-973. https://doi.org/10.1111/aogs.12147
-
Brixval, C. S., Axelsen, S. F., Thygesen, L. C., Due, P., & Koushede, V. (2016). Antenatal education in small classes may increase childbirth self-efficacy: Results from a Danish randomised trial. Sexual & Reproductive Healthcare, 10, 32-34. https://doi.org/10.1016/j.srhc.2016.03.003
-
Broglio, K. (2018). Randomization in clinical trials: Permuted blocks and stratification. Journal of the American Medical Association, 327(9), 880. https://doi.org/10.1001/jama.2018.6360
-
Butcher, N. J., Monsour, A., Mew, E. J., Chan, A.-W., Moher, D., Mayo-Wilson, … Offringa, M. (2022). Guidelines for reporting outcomes in trial reports: The CONSORT-outcomes 2022 extension. Journal of the American Medical Association, 328(22), 2252-2264. https://doi.org/10.1001/jama.2022.21022
-
Calpbinici, P., & Ozcirpan, Ç. Y. (2023). The effect of the training program provided to primiparous pregnant women through the motivational interview method on their fear of childbirth, childbirth self-efficacy, and delivery mode: a randomized controlled trial. Current Psychology, 42(25), 21609-21623. https://doi.org/10.1007/s12144-022-03285-7
-
Calpbinici, P., Uzunkaya Öztoprak, P., Terzioğlu, F., & Üstün, Y. (2023). The Fathers’ Fear of Childbirth Scale: a Turkish validity and reliability study. Journal of Reproductive and Infant Psychology, 1-15. https://doi.org/10.1080/02646838.2023.2225084
-
Carlsson, I.-M., Ziegert, K., & Nissen, E. (2015). The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes. Midwifery, 31(10), 1000-1007. https://doi.org/10.1016/j.midw.2015.05.005
-
Cohen, L., Manion, L., & Morrison, K. (2002). Research Methods in Education. Routledge. https://doi.org/10.4324/9780203224342
-
Demir, F., Ozsaker, E., & Ilce, A. O. (2008). The quality and suitability of written educational materials for patients. Journal of clinical nursing, 17(2), 259-265. https://doi.org/10.1111/j.1365-2702.2007.02044.x
-
Dencker, A., Nilsson, C., Begley, C., Jangsten, E., Mollberg, M., Patel, H., … Sparud-Lundin, C. (2019). Causes and outcomes in studies of fear of childbirth: A systematic review. Women and Birth, 32(2), 99-111. https://doi.org/10.1016/j.wombi.2018.07.004
-
Doak, L. G., Doak, C. C., & Meade, C. D. (1996, September). Strategies to improve cancer education materials. In Oncology nursing forum (Vol. 23, No. 8, pp. 1305-1312).
-
Ersoy, Y., & Kukulu, K. (2011). Doğum Eyleminde Öz-Yeterlilik Ölçeğinin Geçerlik ve Güvenirlik Çalışması [Unpublished master's thesis]. Akdeniz University, Antalya, Turkey.
-
Ghaffari, S. F., Sharif Nia, H., Elyasi, F., Shahhosseini, Z., & Mohammadpoorsaravimozafar, Z. (2021). Design and psychometric evaluation of the fathers’ fear of childbirth scale: a mixed method study. BMC Pregnancy and
Childbirth, 21(1), 222. https://doi.org/10.1186/s12884-021-03696-7
-
Gökdoğan, F., Kır, E., Özcan, A., Cerit, B., Yıldırım, Y. ve Akbal, S. (2003, Eylül). Eğitim kitapçıkları güvenilir mi? 2. Uluslararası 9. Ulusal Hemşirelik Kongresi'nde sunulan bildiri, Antalya.
-
Hildingsson, I., Haines, H., Karlström, A., & Nystedt, A. (2017). Presence and process of fear of birth during pregnancy—Findings from a longitudinal cohort study. Women and Birth, 30(5), e242-e247. https://doi.org/10.1016/j.wombi.2017.02.003
-
Hildingsson, I., Johansson, M., Fenwick, J., Haines, H., & Rubertsson, C. (2014). Childbirth fear in expectant fathers: Findings from a regional Swedish cohort study. Midwifery, 30(2), 242-247. https://doi.org/10.1016/j.midw.2013.01.001
-
Ip, W., Chung, T. K., & Tang, C. S. (2008). The Chinese childbirth self‐efficacy inventory: the development of a short form. Journal of Clinical Nursing, 17(3), 333-340. https://doi.org/10.1111/j.1365-2702.2006.01919.x
-
Isbir, G., Serçekuş, P., Yenal, K., Okumuş, H., Durgun Ozan, Y., Karabulut, Ö., …Erdoğan, S. (2024). The prevalence and associated factors of fear of childbirth among Turkish pregnant women. Journal of Reproductive and
Infant Psychology, 42(1), 62-77. https://doi.org/10.1080/02646838.2022.2057938
-
Korukcu, O., Bulut, O., & Kukulu, K. (2016). Psychometric Evaluation of the Wijma Delivery Expectancy/Experience Questionnaire Version B. Health Care for Women International, 37(5), 550-567. https://doi.org/10.1080/07399332.2014.943838
-
Korukcu, O., Kukulu, K., & Fırat, M. Z. (2012). The reliability and validity of the Turkish version of the Wijma Delivery Expectancy/Experience Questionnaire (W‐DEQ) with pregnant women. Journal of Psychiatric and Mental Health Nursing, 19(3), 193-202. https://doi.org/10.1111/j.1365-2850.2011.01694.x
-
Lippke, S. (2017). Self-Efficacy Theory. Içinde Encyclopedia of Personality and Individual Differences (ss. 1-6). Springer International Publishing. https://doi.org/10.1007/978-3-319-28099-8_1167-1
-
Long, Q., Kingdon, C., Yang, F., Renecle, M. D., Jahanfar, S., Bohren, M. A., & Betran, A. P. (2018). Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in China: A mixed-methods systematic review. PLOS Medicine, 15(10), e1002672. https://doi.org/10.1371/journal.pmed.1002672
-
O’Connell, M. A., Khashan, A. S., & Leahy-Warren, P. (2021). Women’s experiences of interventions for fear of childbirth in the perinatal period: A meta-synthesis of qualitative research evidence. Women and Birth, 34(3), e309-e321. https://doi.org/10.1016/j.wombi.2020.05.008
-
Opiyo, N., Kingdon, C., Oladapo, O. T., Souza, J. P., Vogel, J. P., Bonet, M., Bucagu, M., Portela, A., McConville, F., Downe, S., Gülmezoglu, A. M., & Betrán, A. P. (2020). Non-clinical interventions to reduce unnecessary caesarean sections: WHO recommendations. Bulletin of the World Health Organization, 98(1), 66-68. https://doi.org/10.2471/BLT.19.236729
-
Organisation for Economic Co-operation and Development. (2023). Health at a Glance 2023. https://data.oecd.org/healthcare/caesarean-sections.htm
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Republic of Turkey Ministry of Health General Directorate of Health Information Systems. (2023). Sağlık İstatistikleri Yıllığı. https://ohsad.org/wp-content/uploads/2024/10/Saglik-Istatistikleri-Yilligi-2023-Haber-Bulteni.pdf
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Reyes, E., & Rosenberg, K. (2019). Maternal motives behind elective cesarean sections. American Journal of Human Biology, 31(2). https://doi.org/10.1002/ajhb.23226
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Ryding, E. L., Lukasse, M., Parys, A. Van, Wangel, A., Karro, H., Kristjansdottir, H., Schroll, A., & Schei, B. (2015). Fear of childbirth and risk of cesarean delivery: A cohort study in six european countries. Birth, 42(1), 48-55. https://doi.org/10.1111/birt.12147
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Sercekus, P., & Yenal, K. (2015). Doğuma hazırlık sınıflarının Türkiye’deki gelişimi. Turkiye Klinikleri J Obstet Womens Health Dis Nurs-Special Topics, 1(1), 33-35.
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Öz Yeterlilik Kuramına Dayalı Eş Katılımlı Doğuma Hazırlık Programının Doğum Korkusu, Öz Yeterliliği, Doğum Şekli ve Sonuçlarına Etkisi: Randomize Kontrollü Çalışma Protokolü
Yıl 2025,
Cilt: 27 Sayı: 3, 225 - 246, 31.12.2025
Fatma Nur Duman
,
Zehra Gölbaşı
Öz
Amaç: Bu protokol, öz yeterlilik kuramına dayalı eş katılımlı doğuma hazırlık programının doğum korkusu, öz yeterliliği, doğum şekli ve doğumda uygulanan müdahaleler üzerindeki etkisini araştırmayı amaçlayan bir çalışmanın tasarımını sunmaktadır.
Yöntem: Çalışma ön-test, son-test, paralel gruplu, randomize kontrollü bir çalışma olarak planlanmıştır. Araştırmanın evrenini hastaneye başvuran nullipar gebeler ve eşleri, örneklemini ise güç analizi sonucunda deney ve kontrol gruplarında 30'ar çift olmak üzere toplam 60 çift oluşturacaktır. Uygun çiftlere ön test uygulanacaktır. Randomizasyon sonucunda deney grubuna dahil edilen çiftlere eş katılımlı öz yeterlilik teorisine dayalı bir doğuma hazırlık programı uygulanacak, kontrol grubuna ise herhangi bir müdahale uygulanmayacaktır.
Sonuç: Bu çalışma ile hem anne adaylarının hem de baba adaylarının doğum korkusunun giderilmesinin, eşlerin doğum sürecine ilişkin yeterlilik düzeylerinin artmasına katkı sağlayacağı, bu durumun gebelerin eşlerinden aldıkları sosyal desteği olumlu yönde etkileyeceği ve vajinal doğuma ilişkin öz yeterlilik düzeyinin artmasıyla vajinal doğum oranlarının yükselmesine katkıda bulunacağı düşünülmektedir.
Etik Beyan
Etik onay Lokman Hekim Üniversitesi Bilimsel Araştırmalar Etik Kurulu'ndan (Tarih: 30.01.2024, Kod No: 2024009, Karar No: 2024/16) ve kurum izni Lokman Hekim Akay Hastanesi'nden alınmıştır.
Kaynakça
-
Abdolalipour, S., Mohammad-Alizadeh Charandabi, S., Mashayekh-Amiri, S., & Mirghafourvand, M. (2023). The effectiveness of mindfulness-based interventions on self-efficacy and fear of childbirth in pregnant women: A systematic review and meta-analyses. Journal of Affective Disorders, 333, 257-270. https://doi.org/10.1016/j.jad.2023.04.020
-
Akın, B., & Koçoğlu, D. (2017). Randomize kontrollü deneyler. Hacettepe University Journal of Nursing Faculty, 4(1), 73-92.
-
Alizadeh-Dibazari, Z., Abdolalipour, S., & Mirghafourvand, M. (2023). The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy and Childbirth, 23(1), 541. https://doi.org/10.1186/s12884-023-05867-0
-
Alpar, R., & Uludag, A. K. (2003). Reducing the bias in clinical trials (Randomization & Blinding). FABAD J. Pharm. Sci., 28(1), 113-122.
-
AlSomali, Z., Bajamal, E., & Esheaba, O. (2023). The Effect of structured antenatal education on childbirth self-efficacy. Cureus. https://doi.org/10.7759/cureus.39285
-
Antoine, C., & Young, B. K. (2021). Cesarean section one hundred years 1920–2020: the good, the bad and the ugly. Journal of Perinatal Medicine, 49(1), 5-16. https://doi.org/10.1515/jpm-2020-0305
-
Bakermans‐Kranenburg, M. J., Lotz, A., Alyousefi‐van Dijk, K., & van IJzendoorn, M. (2019). Birth of a Father: Fathering in the First 1,000 Days. Child Development Perspectives, 13(4), 247-253. https://doi.org/10.1111/cdep.12347
-
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. https://doi.org/10.1037/0033-295X.84.2.191
-
Bergström, M., Rudman, A., Waldenström, U., & Kieler, H. (2013). Fear of childbirth in expectant fathers, subsequent childbirth experience and impact of antenatal education: subanalysis of results from a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 92(8), 967-973. https://doi.org/10.1111/aogs.12147
-
Brixval, C. S., Axelsen, S. F., Thygesen, L. C., Due, P., & Koushede, V. (2016). Antenatal education in small classes may increase childbirth self-efficacy: Results from a Danish randomised trial. Sexual & Reproductive Healthcare, 10, 32-34. https://doi.org/10.1016/j.srhc.2016.03.003
-
Broglio, K. (2018). Randomization in clinical trials: Permuted blocks and stratification. Journal of the American Medical Association, 327(9), 880. https://doi.org/10.1001/jama.2018.6360
-
Butcher, N. J., Monsour, A., Mew, E. J., Chan, A.-W., Moher, D., Mayo-Wilson, … Offringa, M. (2022). Guidelines for reporting outcomes in trial reports: The CONSORT-outcomes 2022 extension. Journal of the American Medical Association, 328(22), 2252-2264. https://doi.org/10.1001/jama.2022.21022
-
Calpbinici, P., & Ozcirpan, Ç. Y. (2023). The effect of the training program provided to primiparous pregnant women through the motivational interview method on their fear of childbirth, childbirth self-efficacy, and delivery mode: a randomized controlled trial. Current Psychology, 42(25), 21609-21623. https://doi.org/10.1007/s12144-022-03285-7
-
Calpbinici, P., Uzunkaya Öztoprak, P., Terzioğlu, F., & Üstün, Y. (2023). The Fathers’ Fear of Childbirth Scale: a Turkish validity and reliability study. Journal of Reproductive and Infant Psychology, 1-15. https://doi.org/10.1080/02646838.2023.2225084
-
Carlsson, I.-M., Ziegert, K., & Nissen, E. (2015). The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes. Midwifery, 31(10), 1000-1007. https://doi.org/10.1016/j.midw.2015.05.005
-
Cohen, L., Manion, L., & Morrison, K. (2002). Research Methods in Education. Routledge. https://doi.org/10.4324/9780203224342
-
Demir, F., Ozsaker, E., & Ilce, A. O. (2008). The quality and suitability of written educational materials for patients. Journal of clinical nursing, 17(2), 259-265. https://doi.org/10.1111/j.1365-2702.2007.02044.x
-
Dencker, A., Nilsson, C., Begley, C., Jangsten, E., Mollberg, M., Patel, H., … Sparud-Lundin, C. (2019). Causes and outcomes in studies of fear of childbirth: A systematic review. Women and Birth, 32(2), 99-111. https://doi.org/10.1016/j.wombi.2018.07.004
-
Doak, L. G., Doak, C. C., & Meade, C. D. (1996, September). Strategies to improve cancer education materials. In Oncology nursing forum (Vol. 23, No. 8, pp. 1305-1312).
-
Ersoy, Y., & Kukulu, K. (2011). Doğum Eyleminde Öz-Yeterlilik Ölçeğinin Geçerlik ve Güvenirlik Çalışması [Unpublished master's thesis]. Akdeniz University, Antalya, Turkey.
-
Ghaffari, S. F., Sharif Nia, H., Elyasi, F., Shahhosseini, Z., & Mohammadpoorsaravimozafar, Z. (2021). Design and psychometric evaluation of the fathers’ fear of childbirth scale: a mixed method study. BMC Pregnancy and
Childbirth, 21(1), 222. https://doi.org/10.1186/s12884-021-03696-7
-
Gökdoğan, F., Kır, E., Özcan, A., Cerit, B., Yıldırım, Y. ve Akbal, S. (2003, Eylül). Eğitim kitapçıkları güvenilir mi? 2. Uluslararası 9. Ulusal Hemşirelik Kongresi'nde sunulan bildiri, Antalya.
-
Hildingsson, I., Haines, H., Karlström, A., & Nystedt, A. (2017). Presence and process of fear of birth during pregnancy—Findings from a longitudinal cohort study. Women and Birth, 30(5), e242-e247. https://doi.org/10.1016/j.wombi.2017.02.003
-
Hildingsson, I., Johansson, M., Fenwick, J., Haines, H., & Rubertsson, C. (2014). Childbirth fear in expectant fathers: Findings from a regional Swedish cohort study. Midwifery, 30(2), 242-247. https://doi.org/10.1016/j.midw.2013.01.001
-
Ip, W., Chung, T. K., & Tang, C. S. (2008). The Chinese childbirth self‐efficacy inventory: the development of a short form. Journal of Clinical Nursing, 17(3), 333-340. https://doi.org/10.1111/j.1365-2702.2006.01919.x
-
Isbir, G., Serçekuş, P., Yenal, K., Okumuş, H., Durgun Ozan, Y., Karabulut, Ö., …Erdoğan, S. (2024). The prevalence and associated factors of fear of childbirth among Turkish pregnant women. Journal of Reproductive and
Infant Psychology, 42(1), 62-77. https://doi.org/10.1080/02646838.2022.2057938
-
Korukcu, O., Bulut, O., & Kukulu, K. (2016). Psychometric Evaluation of the Wijma Delivery Expectancy/Experience Questionnaire Version B. Health Care for Women International, 37(5), 550-567. https://doi.org/10.1080/07399332.2014.943838
-
Korukcu, O., Kukulu, K., & Fırat, M. Z. (2012). The reliability and validity of the Turkish version of the Wijma Delivery Expectancy/Experience Questionnaire (W‐DEQ) with pregnant women. Journal of Psychiatric and Mental Health Nursing, 19(3), 193-202. https://doi.org/10.1111/j.1365-2850.2011.01694.x
-
Lippke, S. (2017). Self-Efficacy Theory. Içinde Encyclopedia of Personality and Individual Differences (ss. 1-6). Springer International Publishing. https://doi.org/10.1007/978-3-319-28099-8_1167-1
-
Long, Q., Kingdon, C., Yang, F., Renecle, M. D., Jahanfar, S., Bohren, M. A., & Betran, A. P. (2018). Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in China: A mixed-methods systematic review. PLOS Medicine, 15(10), e1002672. https://doi.org/10.1371/journal.pmed.1002672
-
O’Connell, M. A., Khashan, A. S., & Leahy-Warren, P. (2021). Women’s experiences of interventions for fear of childbirth in the perinatal period: A meta-synthesis of qualitative research evidence. Women and Birth, 34(3), e309-e321. https://doi.org/10.1016/j.wombi.2020.05.008
-
Opiyo, N., Kingdon, C., Oladapo, O. T., Souza, J. P., Vogel, J. P., Bonet, M., Bucagu, M., Portela, A., McConville, F., Downe, S., Gülmezoglu, A. M., & Betrán, A. P. (2020). Non-clinical interventions to reduce unnecessary caesarean sections: WHO recommendations. Bulletin of the World Health Organization, 98(1), 66-68. https://doi.org/10.2471/BLT.19.236729
-
Organisation for Economic Co-operation and Development. (2023). Health at a Glance 2023. https://data.oecd.org/healthcare/caesarean-sections.htm
-
Republic of Turkey Ministry of Health General Directorate of Health Information Systems. (2023). Sağlık İstatistikleri Yıllığı. https://ohsad.org/wp-content/uploads/2024/10/Saglik-Istatistikleri-Yilligi-2023-Haber-Bulteni.pdf
-
Reyes, E., & Rosenberg, K. (2019). Maternal motives behind elective cesarean sections. American Journal of Human Biology, 31(2). https://doi.org/10.1002/ajhb.23226
-
Ryding, E. L., Lukasse, M., Parys, A. Van, Wangel, A., Karro, H., Kristjansdottir, H., Schroll, A., & Schei, B. (2015). Fear of childbirth and risk of cesarean delivery: A cohort study in six european countries. Birth, 42(1), 48-55. https://doi.org/10.1111/birt.12147
-
Sercekus, P., & Yenal, K. (2015). Doğuma hazırlık sınıflarının Türkiye’deki gelişimi. Turkiye Klinikleri J Obstet Womens Health Dis Nurs-Special Topics, 1(1), 33-35.
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