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伊朗乌尔米亚健康中心的青少年和成年孕妇的分娩自我效能感、分娩恐惧及其预测因素:一项横断面研究。

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.

机构信息

Midwifery Department, Urmia University of Medical Sciences, Urmia, Iran (the Islamic Republic of).

Midwifery Department, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).

出版信息

BMJ Open. 2023 Oct 17;13(10):e077043. doi: 10.1136/bmjopen-2023-077043.

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.

摘要

目的

青少年妊娠作为世界上一个日益增长的现象,已经从不同的角度进行了研究。然而,对分娩恐惧和自我效能的研究关注较少。因此,本研究旨在比较青少年和成年孕妇的自我效能感和分娩恐惧,并确定其预测因素。

设计

在这项比较性横断面研究中,参与者通过两阶段聚类抽样法选择。使用分娩自我效能感量表和 Wijma 分娩期望/体验问卷收集数据。采用 Pearson 相关检验、独立 t 检验和一般线性模型进行数据分析。

地点

伊朗乌尔米亚健康中心,2020 年。

参与者

360 名成年和青少年孕妇。

结果

青少年和成年孕妇的分娩恐惧均值(SD)分别为 114.7(14.1)和 108.1(23.1)。青少年孕妇在活跃期和第二产程的分娩自我效能均值(SD)分别为 208.8(28.6)和 203.5(32.1),成年孕妇分别为 213.8(25.7)和 212.0(26.5)。青少年和成年孕妇在第二产程的分娩恐惧(p=0.001)、自我效能期望(p=0.003)和总分娩自我效能(p=0.008)方面存在显著差异。调整社会人口学特征后,青少年孕妇的分娩恐惧得分显著高于成年孕妇,而青少年孕妇在第二产程的总自我效能得分显著低于成年孕妇。

结论

本研究表明,青少年孕妇比成年孕妇更害怕分娩,自我效能感更低,而且分娩恐惧和自我效能之间存在关系。卫生服务提供者更加关注分娩恐惧和自我效能及其预测因素,可以改善妊娠和分娩结局。

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本文引用的文献

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Prevalence and factors affecting the negative childbirth experiences: a systematic review.影响负面分娩经历的患病率及因素:一项系统综述。
J Matern Fetal Neonatal Med. 2020 Nov;33(22):3849-3856. doi: 10.1080/14767058.2019.1583740. Epub 2019 Mar 12.
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Psychological perspectives on fear of childbirth.生育恐惧的心理学观点。
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