Effectiveness of a Nurse-led Program to Enhance Self-efficacy of Pregnant Adolescents and Reduce their Fear of Childbirth: A Randomized Controlled Trial

Abstract

Fear of childbirth is a common feeling experienced by pregnant women, and it can occur before, during, or after childbirth. Intense fear has a detrimental effect on physical and psychological statuses of the pregnant women. The aim of this randomized controlled trial was to examine the effectiveness of a nurse-led program together with the mobile phone application to enhance pregnant adolescents’ childbirth self-efficacy and reduce their fear of childbirth. The sample was pregnant adolescents receiving antenatal care in a regional hospital in Southern Thailand. Using the minimization procedure, pregnant adolescents were assigned to either an experimental group receiving the program (n = 64) or a control group receiving routine care (n = 64). The instruments used for data collection consisted of a demographic characteristics form, the Fear of Childbirth in the Third Trimester Questionnaire, and the Thai Childbirth Self-Efficacy Inventory. Data were analyzed using descriptive statistics, paired t-test, and independent t-test. The results showed that after completion of the intervention program, the participants in the experimental group had a significantly higher mean score on childbirth self-efficacy and lower fear of childbirth than before the intervention. When comparing the two groups after completion of the program, results showed a significantly higher childbirth self-efficacy mean score, and lower fear of childbirth mean score in the experimental group than those in the control group. The results indicate that application of childbirth self-efficacy enhancement program can increase self-efficacy and reduce fear of childbirth in pregnant adolescents. Therefore, it is a promising program for caring pregnant adolescents but needs to be tested with other samples before implementation in practice.