The effect of a theory-based intervention on promoting self -efficacy for childbirth among pregnant women in Hong Kon

The aim of this study was to test the effectiveness of an educational intervention, based on Self-efficacy theory (Bandura, 1989); to promote women's self-efficacy for childbirth and their coping ability for reducing anxiety and pain during labour. The study consisted of two phases: the 1st phase was to establish the validity and reliability of the primary outcome measure of the phase 2 study: a short form of the Chinese version of the Childbirth Self-efficacy Inventory (CBSEI-C32). The confirmatory factor analysis (CFA) was used to establish the construct validity of the CBSEI-C32. In the 2nd phase, the focus was to test the effectiveness of educational intervention to promote women's self-efficacy for childbirth and their coping behaviour during labour. The researcher used an experimental design with random assignment of eligible participants into experimental (n = 54) or control (n = 62) group that completed one pre-test (baseline at 32--34 weeks of gestation) and three posttest surveys (post-intervention at 37 weeks of gestation and within 48 hours and 6 weeks after delivery). The experimental group received two 90-minute sessions of an educational program offered at 33--35 weeks of gestation based on Bandura's (1986) self-efficacy theory. The primary outcome measures were the two subscales of the CBSEI-C32: outcome expectancy (OE-16) and efficacy expectancy (EE-16). The secondary measures included psychological morbidity (GHQ12), pain and anxiety during labour (VAS) and performance of coping behaviour during labour (CCB). Physiological labour outcomes in terms of mode of delivery, length of labour, types of analgesia used, Apgar scores of newborn and neonatal admission were also extracted from the participants' medical record.;Confirmatory factor analysis provided empirical support for the existence of the hypothesized constructs assessed by the CBSEI-C32. Doubly MANOVA indicated that the experimental group was significantly more likely than the control group to demonstrate higher self-efficacy for childbirth and lower perceived anxiety and pain in the early and middle phase of labour. The effects of the programe on anxiety and pain during labour differed according to different phase of labour. Independent samples t test also demonstrated a significantly higher level of coping behaviour performed by the experimental group as compared with the control group. (Abstract shortened by UMI.).