Effect Of A Pregnancy Care Program Based On The COM-B Model For Primiparae With Fear Of Childbirth In Late Pregnancy

Objective:1.To understand the real-life experiences of primiparae with fear of childbirth in late pregnancy on pregnancy care,to distill themes,and to provide input for the development of a pregnancy care program based on the COM-B model.2.To develop a targeted pregnancy care program for primiparae with fear of childbirth in late pregnancy based on the COM-B model,to explore its effects on fear of childbirth,quality of pregnancy care,and birth outcomes.To provide a reference basis for developing a systematic and standardized pregnancy care program for primiparae with fear of childbirth in the future.Methods:1.Qualitative study of primiparae with fear of childbirth in late pregnancy on their experience of pregnancy care under the COM-B model.Using purposive sampling method,semi-structured interviews were conducted with primiparae who met the criteria of nadir and volunteered in the fetal heart monitoring unit of a tertiary care hospital in Taiyuan,Shanxi Province.From April 30 to May 30,2022,and the sample size of the study was subject to data saturation.A total of 20 cases of late pregnancy delivery fear primigravida were finally included.With the help of Nvivo12 software,data analysis was conducted based on Mayring’s theory to understand the real experiences of primiparae with fear of late pregnancy and delivery in order to provide a reference for the development of a COM-B model-based pregnancy care program.2.The effect of the COM-B model-based pregnancy care program on delivery fear primigravida.Using the purposive sampling method,116 pregnant women who met the criteria of nadir were selected from the obstetrics clinic of a tertiary hospital in Taiyuan,Shanxi Province from June 2022 to September 2022 as the study subjects to evaluate the application of the COM-B model-based pregnancy care program for 6 weeks.The results were evaluated.The group was divided into a control group(51 cases)and an intervention group(54 cases)according to the time of enrollment.The control group will be given conventional pregnancy care,while the intervention group will be given the COM-B model-based pregnancy care program on this basis.The Childbirth Attitudes Questionnaire,Quality of Prenatal Care Questionnaire scores,and birth outcomes of the primigravida in the two groups will be compared.Results:1.Qualitative study of primiparae with fear of childbirth in late pregnancy on their experience of pregnancy care under the COM-B model.Pregnancy health careexperiences of primiparae with fear of late pregnancy and childbirth can be categ orized into 3 themes and 9 sub-themes.(1)Competence factors,complex psycholog ical feelings of primiparae in late pregnancy.(1)Primipara’s strangeness to the envir onment of childbirth.(2)Lack of birthing experience and fear of the unknown proce ss of birth.(3)Distrust of midwives and midwifery techniques.(2)Motivational fact ors,limited knowledge of natural childbirth.(1)Insufficient knowledge of the advanta ges and disadvantages of natural childbirth.(2)Misconceptions about knowledge of n atural childbirth.(3)Ineffective transmission of knowledge of maternal health care In effective transmission.(4)Lack of knowledge of existing labor analgesia technology.(3)Opportunity factors,influence of social factors on the first-time mothers.(1)The birth experience of friends and relatives.(2)Ihe influence of social network platformand customs.2.The effect of the COM-B model-based pregnancy care program on delivery fear primigravida.(1)Before the intervention,the differences were no statistically significant difference in general information,CAQ scores and QPCQ scores between the two groups before the intervention(P>0.05).(2)After 6 weeks of intervention,there were statisticallysignificant differences in CAQ scores and QPCQ scores between the two groups after 6 weeks of intervention were compared(P<0.05).(3)After delivery,there were statistically significant differences in CAQ scores and QPCQ scores between the two groups afterdelivery(P<0.05).(4)Multiple comparison before and after intervention,before intervention,after 6 weeks of intervention,and after delivery,there were statistically significant differences in the scores of CAQ and QPCQ between the two groups in time factor,inter-group factor and inter-group interaction factor(P < 0.001).Conclusion:1.Perinatal health care workers should pay more attention to the psychological condition of pregnancy and detect the fear of childbirth in primigravida as early as possible.The traditional model of pregnancy health care can no longer meet the needs of primigravida with fear of childbirth in late pregnancy.Pregnancy health care workers need to improve it according to the needs of primigravida with fear of childbirth,so as to promote maternal psychological health and ensure the health of mothers and newborns.2.The COM-B model-based pregnancy care program can help primigravida rebuild their cognitive system of childbirth and effectively reduce their fear of childbirth,improve the quality of pregnancy care,and promote natural childbirth.