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Self-efficacy in pregnant women with severe fear of childbirth
Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-1588-135X
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
2013 (English)In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 42, no 2, 191-202 p.Article in journal (Other academic) Published
Abstract [en]

Objective: To apply and test the concept of childbirth self-efficacy to expectations of the upcoming birth in the context of severe fear of childbirth (SFOC).

Design: Qualitative study using semi-structured interviews.

Setting: A region in the southeast of Sweden

Participants: Nulliparous pregnant women (n=17) with SFOC.

Method: The interviews were analysed according to content analysis, using deductive and inductive approaches. The seven domains of the childbirth self-efficacy inventory (CBSEI) made up the matrix for the deductive analysis.

Results: Behaviours for coping with labour and childbirth were related to six domains of childbirth self-efficacy; “concentration”, “support”, “control”, “ motor/relaxation”, “selfencouragement” and “breathing”. Most of these behaviours referred to capabilities to carry out (self-efficacy expectancy) rather than to beliefs in effectiveness (outcome expectancy). Five additional sub-domains representing defined childbirth self-efficacy were identified; “guidance”, “the body controls”, “the professionals´ control”, “reliance” and ‘fatalism’.

Conclusion: The domains of childbirth self-efficacy have been deepened and expanded in relation to SFOC. It is imperative to identify pregnant women with SFOC and their efficacy beliefs in order to help them find appropriate coping behaviours prior to the onset of labour, and furthermore these behaviours must be supported by healthcare professionals during labour and childbirth. Support in the form of verbal persuasion emanating from the subdomains of childbirth self-efficacy ought to be added.

Place, publisher, year, edition, pages
John Wiley & Sons , 2013. Vol. 42, no 2, 191-202 p.
Keyword [en]
CBSEI, content analysis, fear of childbirth, qualitative study, self-efficacy
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-85649DOI: 10.1111/1552-6909.12024ISI: 000316279500010OAI: oai:DiVA.org:liu-85649DiVA: diva2:572237
Available from: 2013-04-12 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Fear is in the air: Midwives´ perspectives of fear of childbirth and childbirth self-efficacy and fear of childbirth in nulliparous pregnant women
Open this publication in new window or tab >>Fear is in the air: Midwives´ perspectives of fear of childbirth and childbirth self-efficacy and fear of childbirth in nulliparous pregnant women
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: In Western countries, about one pregnant woman in five experiences a considerable fear of childbirth (FOC). Consequently FOC is an important topic for midwives, being pregnant women’s main care givers. Also, although many aspects of FOC have been studied, almost no studies have into detail applied a theoretical frame of reference for studying pregnant women’s expectations for their upcoming labour and delivery. Therefore, the theory of self-efficacy, here regarding pregnant women’s belief in own capability to cope with labour and delivery, has been applied with the aim to better understand the phenomenon of FOC.

Aim: The overall aims of the thesis were to describe midwives´ perceptions and views on FOC and to expand the current knowledge about expectations for the forthcoming birth in nulliparous women in the context of FOC.

Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed.

Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed.

Conclusions: Swedish midwives regard severe FOC as a serious problem that influences pregnant women’s view on the forthcoming labour and delivery. Midwives at antenatal care clinics, compared to colleagues working at labour wards, experience a greater need for training in care of pregnant women with severe FOC. Self-efficacy is a useful construct and the self-efficacy theory an applicable way of thinking in analysing fear of childbirth. The self-efficacy concept might be appropriate in midwives’ care for women with severe FOC.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 75 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1334
Keyword
Anxiety; Childbirth; Content analysis; Fear; Focus-group interview; Midwives; Self-efficacy; Phenomenography; W-DEQ; CBSEI
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-85650 (URN)978-91-7519-780-7 (ISBN)
Public defence
2012-12-14, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-11-27 Created: 2012-11-27 Last updated: 2012-11-27Bibliographically approved

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Salomonsson, BirgittaBerterö, CarinaAlehagen, Siw

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