Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial
Background: Fear of childbirth significantly affects nulliparous women and can have repercussions for both mothers and children. Drawing on evidence, the salutogenic theory has been proposed as a framework to address and manage this fear. Aim: Thia study aimed to assess the efficacy of an educationa...
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Elsevier
2025-07-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844025018341 |
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| author | Safieh Kananikandeh Farkhondeh Amin Shokravi Mojgan Mirghafourvand Shayesteh Jahanfar |
| author_facet | Safieh Kananikandeh Farkhondeh Amin Shokravi Mojgan Mirghafourvand Shayesteh Jahanfar |
| author_sort | Safieh Kananikandeh |
| collection | DOAJ |
| description | Background: Fear of childbirth significantly affects nulliparous women and can have repercussions for both mothers and children. Drawing on evidence, the salutogenic theory has been proposed as a framework to address and manage this fear. Aim: Thia study aimed to assess the efficacy of an educational program grounded in the salutogenic theory in mitigating fear of childbirth and influencing the choice of birth method among nulliparous women. Design: A randomized clinical trial was used. Participant/setting: This study involved 63 nulliparous women attending health centers in Bostanabad city in East Azerbaijan Province, Iran. Methods: This intervention comprised four group sessions lasting 30–45 min each, guided by the principles of the salutogenic theory. Participants were randomly assigned to either the intervention or control group. Data were collected through self-reports using the Wijma Delivery Expectancy/Experience Questionnaire, Antonovsky's Sense of Coherence scale, and a birth method choice checklist. The analysis involved independent sample t-tests, ANCOVA, repeated measures tests, chi-square tests, Cochran's Q tests, and SPSS 27 software. Results: In the intervention group, the mean score for childbirth fear significantly decreased (MD= 10.10, 95 % CI= 1.88–18.31), and the sense of coherence mean score was higher compared to the control group (MD= 9.10, 95 % CI= 1.71–16.49). However, the frequency of choosing vaginal birth remained consistent post-intervention. Conclusions: An intervention grounded in the salutogenic theory proved effective in assisting nulliparous women in realizing their chosen birth method by addressing fear and enhancing their sense of coherence. Trial registration: IRCT20210506051202N1. The trial registration date was 22/08/2021. |
| format | Article |
| id | doaj-art-96e9c5c7506b4e7a835b4d25f058171e |
| institution | OA Journals |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-96e9c5c7506b4e7a835b4d25f058171e2025-08-20T02:37:02ZengElsevierHeliyon2405-84402025-07-011112e4344810.1016/j.heliyon.2025.e43448Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trialSafieh Kananikandeh0Farkhondeh Amin Shokravi1Mojgan Mirghafourvand2Shayesteh Jahanfar3Health Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranHealth Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Corresponding author.Reproductive Health, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IranMPH Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, United StatesBackground: Fear of childbirth significantly affects nulliparous women and can have repercussions for both mothers and children. Drawing on evidence, the salutogenic theory has been proposed as a framework to address and manage this fear. Aim: Thia study aimed to assess the efficacy of an educational program grounded in the salutogenic theory in mitigating fear of childbirth and influencing the choice of birth method among nulliparous women. Design: A randomized clinical trial was used. Participant/setting: This study involved 63 nulliparous women attending health centers in Bostanabad city in East Azerbaijan Province, Iran. Methods: This intervention comprised four group sessions lasting 30–45 min each, guided by the principles of the salutogenic theory. Participants were randomly assigned to either the intervention or control group. Data were collected through self-reports using the Wijma Delivery Expectancy/Experience Questionnaire, Antonovsky's Sense of Coherence scale, and a birth method choice checklist. The analysis involved independent sample t-tests, ANCOVA, repeated measures tests, chi-square tests, Cochran's Q tests, and SPSS 27 software. Results: In the intervention group, the mean score for childbirth fear significantly decreased (MD= 10.10, 95 % CI= 1.88–18.31), and the sense of coherence mean score was higher compared to the control group (MD= 9.10, 95 % CI= 1.71–16.49). However, the frequency of choosing vaginal birth remained consistent post-intervention. Conclusions: An intervention grounded in the salutogenic theory proved effective in assisting nulliparous women in realizing their chosen birth method by addressing fear and enhancing their sense of coherence. Trial registration: IRCT20210506051202N1. The trial registration date was 22/08/2021.http://www.sciencedirect.com/science/article/pii/S2405844025018341FearChildbirthEducationSense of coherencePregnancy |
| spellingShingle | Safieh Kananikandeh Farkhondeh Amin Shokravi Mojgan Mirghafourvand Shayesteh Jahanfar Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial Heliyon Fear Childbirth Education Sense of coherence Pregnancy |
| title | Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial |
| title_full | Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial |
| title_fullStr | Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial |
| title_full_unstemmed | Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial |
| title_short | Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial |
| title_sort | assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women a randomized controlled trial |
| topic | Fear Childbirth Education Sense of coherence Pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S2405844025018341 |
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