| Objective:This mixed approach aims to comprehensively explore the current situation of maternal fear of childbirth in the third trimester of pregnancy,analyze the factors that may affect the fear of childbirth,and provide effective guidance for improving the self-efficacy of childbirth in pregnant women with vaginal delivery intention in the third trimester of pregnancy,reducing the fear of childbirth,and ensuring physical and mental health.Methods:This study was divided into two parts:1.In the first part of the study,the mixed method research design of parallel triangular mutual evidence was adopted,and the qualitative and quantitative research was carried out simultaneously.In the analysis,the researchers integrated and compared the results of qualitative and quantitative studied to explore the fear of childbirth in pregnant women with vaginal delivery intention in the third trimester.In the qualitative research part,open questionnaire and semi-structured interview were used.From November to December 2021,a purposive sampling method was used to select 22 pregnant women in the third trimester of pregnancy who were qualified for vaginal delivery and met the inclusion and exclusion criteria in six hospitals in Shandong Province and had the intention of vaginal delivery.The interview data were collected and analyzed through open questionnaire and semi-structured interview.In the quantitative study,cross-sectional design was adopted.From November to December 2021,convenient sampling was used to select pregnant women with intention of vaginal delivery in the third trimester of pregnancy and their spouses who met the inclusion and exclusion criteria in six hospitals in Shandong Province as subjects 2.Demographic data and 16-item Fear of Childbirth scale were used to collect the fear of childbirth of pregnant women with intention of vaginal delivery in the third trimester.Nvivo11.0 software,iFLYTEK software and SPSS 24.0 software complete the data entry and statistical description of research materials.2.The second part of the study was a quantitative study,which used 307 pregnant women and their spouses in the quantitative study part of the first part of the study as the subject of the survey,and the data collection continues on the basis of the first part of the study in the form of a questionnaire.With Pittsburgh sleep quality index scale,self-evaluation of anxiety scale(SAS)and Edinburgh postnatal depression scale(EPDS),the realization social support scale(PSSS),fatigue scale FS-14,self-efficacy scale to collect the pregnancy childbirth intention of pregnant women with vaginal delivery in late sleep,anxiety,depression,social support conditions,the condition of fatigue and childbirth The message of self-efficacy.Through the general demographic data of spouses and expectant fathers’ paternity expectation scale,the basic information and paternity expectation of pregnant women’s spouses were collected.SPSS 24.0 statistical software was used for descriptive statistical analysis,one-way analysis of variance,independent sample t-test,Pearson correlation,and multiple linear regression to explore the influencing factors of fear of childbirth.Outcome:1.In the first part of the study,the qualitative research part obtained three themes about the fear of childbirth of pregnant women with vaginal delivery intention in the third trimester,and some of the themes also included corresponding subthemes.The themes and subthemes extracted are:(1)emotional experience of childbirth fear(① subjective experience,②physiological activation,③ external behavior);(2)the content of fear of childbirth(①fear of fetal health,②fear of loss of control during childbirth,③ fear of Pain in childbirth,④fear of hospital intervention and the environment,⑤ emotional tipping point events);(3)The need to address the fear of childbirth(①medical support,②self-regulation,③family support,④environmental control).In the quantitative study,the score of partial fear of childbirth scale was 34.28±11.57.2.The results of the second part of the study are as follows:(1)The results of the univariate analysis showed that the occupational type of the pregnant woman,whether the pregnant woman had attended the pregnant woman’s school(P>0.050),and the spouse’s education(P=0.016)were the main factors affecting the fear of childbirth of pregnant women with vaginal delivery intentions in the third trimester.(2)Pearson correlation analysis results showed that sleep index(r=0.273,P<0.001),anxiety score(r=0.267,P<0.001),fatigue score(r=0.356,P<0.001),depression score(r=0.158,P=0.006)were positively correlated with the birth fear score of pregnant women with vaginal delivery intention in the third trimester;Social support scores(r=-0.135,P=0.018)and selfefficacy scores(r=-0.138,P=0.015)were inversely correlated with the childbirth fear score of pregnant women with vaginal delivery intentions in the third trimester.(3)Variables with statistically significant results from univariate analysis were included in multiple linear regression equation analyses,which showed that the type of occupation of pregnant women,sleep index scores,fatigue scores,social support scores,and spouse education were the main factors influencing fear of childbirth.Conclusion:1.Pregnant women with the intention of giving birth in the third trimester are at a mild level of fear of childbirth,and the fear of childbirth is more common in the group of pregnant women with vaginal delivery intention in the third trimester.The fear of childbirth requires the attention of clinical care workers.2.Pregnant women whose occupation is farming,pregnant women whose spouses have a junior high school degree or below,as well as the sleep status of pregnant women,the fatigue of pregnant women,the social support score of pregnant women,and the spouse’s academic qualifications have the main impact on the fear of pregnancy in pregnant women with vaginal childbirth intentions in the third trimester,and these groups need the attention of clinical medical personnel. |
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