Effectiveness of solution-focused counseling therapy on pregnancy anxiety and fear of childbirth: A randomized clinical trial
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Abstract
Background & Aim: Fear of childbirth and pregnancy anxiety may affect the desire for normal delivery. No study has investigated the effectiveness of solution-focused counseling on either pregnancy anxiety or all factors comprising fear of childbirth. We aimed to investigate the effects of solution-focused counseling in reducing pregnancy anxiety and fear of childbirth.
Methods & Materials: This randomized clinical trial study was conducted on 132 nulliparous women in 2019. Participants with moderate to a severe fear of childbirth were randomly divided into the intervention and control groups. The intervention group participated in five solution-focused counseling sessions. Before and after the intervention, women filled the anxiety scale for pregnancy and the Wijma Delivery Expectancy Questionnaire (W-DEQ). Data were analyzed using t-test, paired t-test, and analysis of covariance (ANCOVA).
Results: The two groups did not differ in terms of demographic and obstetric variables and pregnancy anxiety pre-test scores (P>0.05). The means of the post-test total scores and the means of scores for all five factors of the ASP were significantly lower in the intervention group than in the control group (p<0.001). The adjusted means of total scores and the adjusted means of scores for all six factors of the WDE-Q were significantly lower in the intervention group than in the control group (p<0.001).
Conclusion: The solution-focused counseling reduced pregnancy anxiety and fear of childbirth in women participating in counseling sessions compared to the controls. Solution-focused counseling therapy sessions should be held for women with pregnancy anxiety and fear of childbirth.
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2. Ghelichi F, Roshan R, Khodabakhshi Kolaee A. Comparing of maternal-fetal attachment and pregnancy anxiety in surrogate women and normal pregnancy. The Iranian Journal of Obstetrics, Gynecology, and Infertility. 2017;19(39):46-53. [Persian]
3. Mortazavi F, Agah J. Childbirth fear and associated factors in a sample of pregnant Iranian women. Oman Medical Journal. 2018 Nov;33(6):497.
4. Brunton R, Dryer R, Saliba A, Kohlhoff J. Pregnancy anxiety: A systematic review of current scales. Journal of Affective Disorders. 2015;176:24-34
5. Nasreen HE, Pasi HB, Rifin SM, Aris MAM, Rahman JA, Rus RM, et al. Impact of maternal antepartum depressive and anxiety symptoms on birth outcomes and mode of delivery: a prospective cohort study in east and west coasts of Malaysia. BMC Pregnancy and Childbirth. 2019;19(1):201.
6. Martini J, Knappe S, Beesdo-Baum K, Lieb R, Wittchen HU. Anxiety disorders before birth and self-perceived distress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev. 2010;86(5):305-10
7. Najafi F, Abouzari-Gazafroodi K, Jafarzadeh-Kenarsari F, Rahnama P, Gholami Chaboki B. Relationship between attendance at childbirth preparation classes and fear of childbirth and type of delivery. Hayat. 2016;21(4):30-40.
8. Gurung RAR, Dunkel-Schetter C, Collins N, Rini C, Hobel CJ. Psychosocial predictors of prenatal anxiety. Journal of Social and Clinical Psychology. 2005;24(4):497-519.
9. Madhavanprabhakaran GK, D’Souza MS, Nairy KS. Prevalence of pregnancy anxiety and associated factors. International Journal of Africa Nursing Sciences. 2015;3:1-7.
10. Ding X, Mao L, Ge X, Xu S, Pan W, Yan S, et al. Course and risk factors of maternal pregnancy-related anxiety across pregnancy in Ma' anshan city. Wei sheng yan jiu = Journal of Hygiene Research. 2015;44(3):371-5.
11. Arch JJ. Pregnancy-specific anxiety: which women are highest and what are the alcohol-related risks? Compr Psychiatry. 2013;54(3):217-28.
12. Bayrampour H, Ali E, McNeil DA, Benzies K, MacQueen G, Tough S. Pregnancy-related anxiety: A concept analysis. Int J Nurs Stud. 2016;55:115-30
13. Delaram M, Soltanpour F. The effect of counseling in third trimester on anxiety of nulliparous women at the time of admission for labor. ZJRMS. 2012;14(2):61-5.
14. De Shazer S, Berg I. What works?’Remarks on research aspects of solution-focused brief therapy Journal of Family Therapy. 1997;19(2):121-4.
15. De Castro S, Guterman J. Solution-focused therapy for families coping with suicide. Journal of Marital and Family Therapy. 2008;34(1):93-106.
16. Nazari A, Rasouli M, Davarniya R, Hosseini A, Babaei Gharmkhani M. Effectiveness of focused- solution brief therapy(SFBT) on couple burnout and divorce tendency in married women. Iranian Journal of Psychiatric Nursing. 2016;3(3):41-52.
17. Parsa P, Ahangpour P, Shobeiri F, Soltanian A, Rahimi A. The effect of group counseling based on problem solving on postpartum depression in mothers attending to health care centers in Hamadan city UNMF. 2017;15(6):440-8.
18. Karrabi R, Farjamfar M, Mortazavi F, Nazari AM, Goli S. The effect of solution-focused group counseling on pregnant women’s worries: A randomized clinical trial. Hayat. 2019;25(1):81-94.
19. Moradi-Lakeh M, Vosoogh-Moghaddam A. Health sector evolution plan in Iran; equity and sustainability concerns. Int J Health Policy Manag. 2015;4(10):637-40.
20. Mehrabadi M, Masoudifar M, Parvizi A, Rakhshani MH, Mortazavi F. Effects of childbirth preparation classes program based on national guideline on fear of childbirth in pregnant women: a randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2020;23(1):58-68.
21. Fontein K, Nieuwenhuijze M, Ausems M, Bude L, de Vries R. Antenatal interventions to reduce maternal distress: A systematic review and meta-analysis of randomised trials. BJOG 2014;121:389-97.
22. Larsson B, Karlström A, Rubertsson C, Hildingsson I. The effects of counseling on fear of childbirth. Acta Obstetricia et Gynecologica Scandinavica. 2015;94(6):629-36.
23. Toohill J, Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E, et al. A randomized controlled trial of a psycho‐education intervention by midwives in reducing childbirth fear in pregnant women. Birth. 2014;41(4):384-94.
24. Doyle-Waters MM, Kishor N, Doyle-Baker PK. Development and validation of an anxiety scale for pregnancy. Medicine and Science in Sports and Exercise. 2001;33(5).
25. Mortazavi F, Akaberi A. Validation of the Anxiety Scale for Pregnancy in a Sample of Iranian Women. IJWHR 2018;6(1):67-74.
26. Ghezi S , Eftekhariyazdi M , Mortazavi F. Pregnancy Anxiety and Associated Factors in Pregnant Women, Zahedan J Res Med Sci. 2021;23(1):e99953.
27. Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ: A new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynecol 1998;19(2):84-97.
28. Zar M, Wijma K, Wijma B. Pre- and postpartum fear of childbirth in nulliparous and parous women. Scandinavian Journal of Behaviour Therapy. 2001;30(2):75-84.
29. Mortazavi F. Validity and reliability of the Farsi version of Wijma delivery expectancy questionnaire: an exploratory and confirmatory factor analysis. Electronic Physician. 2017;9(6): 4606-15.
30. Sharifzadeh M, Bolbol Haghighi N, Keramat A, Goli M, Motaghi Z. Effectiveness of midwifery counseling based on solution-focused approaches on fear of childbirth. Koomesh. 2018;20(2):375-83.
31. Nilsson L, Thorsell T, Hertfelt Wahn E, Ekström A. Factors influencing positive birth experiences of first-time mothers. Nursing Research and Practice. 2013;2013:349124.
32. Funke J. How much knowledge is necessary for action? InKnowledge and action. Cham: Springer International Publishing; 2017. p. 99-111.
33. Haghighat M, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Malakouti J, Erfani M. The effect of spiritual counseling on stress and anxiety in pregnancy: A randomized controlled clinical trial. Iran Red Crescent Med J. 2018;20(4):e64094.
2. Ghelichi F, Roshan R, Khodabakhshi Kolaee A. Comparing of maternal-fetal attachment and pregnancy anxiety in surrogate women and normal pregnancy. The Iranian Journal of Obstetrics, Gynecology, and Infertility. 2017;19(39):46-53. [Persian]
3. Mortazavi F, Agah J. Childbirth fear and associated factors in a sample of pregnant Iranian women. Oman Medical Journal. 2018 Nov;33(6):497.
4. Brunton R, Dryer R, Saliba A, Kohlhoff J. Pregnancy anxiety: A systematic review of current scales. Journal of Affective Disorders. 2015;176:24-34
5. Nasreen HE, Pasi HB, Rifin SM, Aris MAM, Rahman JA, Rus RM, et al. Impact of maternal antepartum depressive and anxiety symptoms on birth outcomes and mode of delivery: a prospective cohort study in east and west coasts of Malaysia. BMC Pregnancy and Childbirth. 2019;19(1):201.
6. Martini J, Knappe S, Beesdo-Baum K, Lieb R, Wittchen HU. Anxiety disorders before birth and self-perceived distress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev. 2010;86(5):305-10
7. Najafi F, Abouzari-Gazafroodi K, Jafarzadeh-Kenarsari F, Rahnama P, Gholami Chaboki B. Relationship between attendance at childbirth preparation classes and fear of childbirth and type of delivery. Hayat. 2016;21(4):30-40.
8. Gurung RAR, Dunkel-Schetter C, Collins N, Rini C, Hobel CJ. Psychosocial predictors of prenatal anxiety. Journal of Social and Clinical Psychology. 2005;24(4):497-519.
9. Madhavanprabhakaran GK, D’Souza MS, Nairy KS. Prevalence of pregnancy anxiety and associated factors. International Journal of Africa Nursing Sciences. 2015;3:1-7.
10. Ding X, Mao L, Ge X, Xu S, Pan W, Yan S, et al. Course and risk factors of maternal pregnancy-related anxiety across pregnancy in Ma' anshan city. Wei sheng yan jiu = Journal of Hygiene Research. 2015;44(3):371-5.
11. Arch JJ. Pregnancy-specific anxiety: which women are highest and what are the alcohol-related risks? Compr Psychiatry. 2013;54(3):217-28.
12. Bayrampour H, Ali E, McNeil DA, Benzies K, MacQueen G, Tough S. Pregnancy-related anxiety: A concept analysis. Int J Nurs Stud. 2016;55:115-30
13. Delaram M, Soltanpour F. The effect of counseling in third trimester on anxiety of nulliparous women at the time of admission for labor. ZJRMS. 2012;14(2):61-5.
14. De Shazer S, Berg I. What works?’Remarks on research aspects of solution-focused brief therapy Journal of Family Therapy. 1997;19(2):121-4.
15. De Castro S, Guterman J. Solution-focused therapy for families coping with suicide. Journal of Marital and Family Therapy. 2008;34(1):93-106.
16. Nazari A, Rasouli M, Davarniya R, Hosseini A, Babaei Gharmkhani M. Effectiveness of focused- solution brief therapy(SFBT) on couple burnout and divorce tendency in married women. Iranian Journal of Psychiatric Nursing. 2016;3(3):41-52.
17. Parsa P, Ahangpour P, Shobeiri F, Soltanian A, Rahimi A. The effect of group counseling based on problem solving on postpartum depression in mothers attending to health care centers in Hamadan city UNMF. 2017;15(6):440-8.
18. Karrabi R, Farjamfar M, Mortazavi F, Nazari AM, Goli S. The effect of solution-focused group counseling on pregnant women’s worries: A randomized clinical trial. Hayat. 2019;25(1):81-94.
19. Moradi-Lakeh M, Vosoogh-Moghaddam A. Health sector evolution plan in Iran; equity and sustainability concerns. Int J Health Policy Manag. 2015;4(10):637-40.
20. Mehrabadi M, Masoudifar M, Parvizi A, Rakhshani MH, Mortazavi F. Effects of childbirth preparation classes program based on national guideline on fear of childbirth in pregnant women: a randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2020;23(1):58-68.
21. Fontein K, Nieuwenhuijze M, Ausems M, Bude L, de Vries R. Antenatal interventions to reduce maternal distress: A systematic review and meta-analysis of randomised trials. BJOG 2014;121:389-97.
22. Larsson B, Karlström A, Rubertsson C, Hildingsson I. The effects of counseling on fear of childbirth. Acta Obstetricia et Gynecologica Scandinavica. 2015;94(6):629-36.
23. Toohill J, Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E, et al. A randomized controlled trial of a psycho‐education intervention by midwives in reducing childbirth fear in pregnant women. Birth. 2014;41(4):384-94.
24. Doyle-Waters MM, Kishor N, Doyle-Baker PK. Development and validation of an anxiety scale for pregnancy. Medicine and Science in Sports and Exercise. 2001;33(5).
25. Mortazavi F, Akaberi A. Validation of the Anxiety Scale for Pregnancy in a Sample of Iranian Women. IJWHR 2018;6(1):67-74.
26. Ghezi S , Eftekhariyazdi M , Mortazavi F. Pregnancy Anxiety and Associated Factors in Pregnant Women, Zahedan J Res Med Sci. 2021;23(1):e99953.
27. Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ: A new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynecol 1998;19(2):84-97.
28. Zar M, Wijma K, Wijma B. Pre- and postpartum fear of childbirth in nulliparous and parous women. Scandinavian Journal of Behaviour Therapy. 2001;30(2):75-84.
29. Mortazavi F. Validity and reliability of the Farsi version of Wijma delivery expectancy questionnaire: an exploratory and confirmatory factor analysis. Electronic Physician. 2017;9(6): 4606-15.
30. Sharifzadeh M, Bolbol Haghighi N, Keramat A, Goli M, Motaghi Z. Effectiveness of midwifery counseling based on solution-focused approaches on fear of childbirth. Koomesh. 2018;20(2):375-83.
31. Nilsson L, Thorsell T, Hertfelt Wahn E, Ekström A. Factors influencing positive birth experiences of first-time mothers. Nursing Research and Practice. 2013;2013:349124.
32. Funke J. How much knowledge is necessary for action? InKnowledge and action. Cham: Springer International Publishing; 2017. p. 99-111.
33. Haghighat M, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Malakouti J, Erfani M. The effect of spiritual counseling on stress and anxiety in pregnancy: A randomized controlled clinical trial. Iran Red Crescent Med J. 2018;20(4):e64094.
| Files | ||
| Issue | Vol 8 No 3 (2021): Summer | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v8i3.5939 | |
| Keywords | ||
| anxiety; pregnancy; counseling; women; fear; normal childbirth | ||
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How to Cite
1.
Mortazavi F, Mehrabadi M, Karrabi R. Effectiveness of solution-focused counseling therapy on pregnancy anxiety and fear of childbirth: A randomized clinical trial. NPT. 2021;8(3):244-254.
