Yan Xi Soh1, Nurul Khairani Binte Abdul Razak2, Ling Jie Cheng3, Ying Lau4. 1. Staff nurse, Division of Nursing, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore. Electronic address: soh.yan.xi@kkh.com.sg. 2. Senior Staff nurse, Division of Nursing, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore. Electronic address: nurul.khairani@kkh.com.sg. 3. MPH (Candidate), RN, Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore 117549, Singapore. Electronic address: chenglingjie@u.nus.edu. 4. Associate Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore. Electronic address: nurly@nus.edu.sg.
Abstract
OBJECTIVE: This study aims to examine the relationships among sociodemographic and obstetric factors, fear of childbirth, psychosocial well-being and childbirth self-efficacy using a structural equation modelling approach. DESIGN: It adopted an exploratory cross-sectional study among 205 multi-ethnic pregnant women in Singapore. We used structural equation modelling to examine our hypothetical model, which integrates the concepts of Bandura's self-efficacy theory and previous literature reviews. The Childbirth Self-Efficacy Inventory, the Childbirth Attitudes Questionnaire and the World Health Organisation (Five) Well-Being Index were employed to measure childbirth self-efficacy, fear of childbirth and psychological well-being, respectively. FINDINGS: The structural equation model showed that multiparous women (β = 0. 24, P < 0.01), with better psychological well-being (β = 0.26, P < 0.001) were more likely to have higher childbirth self-efficacy; whereas Chinese women (β = -0.32, P < 0.01) with previous caesarean section (β = -0.17, P < 0.05) and higher fear of childbirth (β = -0.30, P < 0.001) were more likely to have lower childbirth self-efficacy. The structural equation model had good fit with the data (incremental fit index = 0.925, Tucker-Lewis index = 0.911, comparative fit index = 0.923, and root means square error of approximation = 0.048). CONCLUSION: Findings of this study highlight that ethnic Chinese, multiparous women, previous caesarean section, psychological well-being and fear of childbirth were determinants of childbirth self-efficacy among pregnant women in Singapore. Enhancement of self-efficacy can increase coping ability and reduce fear of childbirth and thus promote normal childbirth. Future self-efficacy enhancing interventions among pregnant women should be tailored by age, ethnicity, parity and prior modes of birth.
OBJECTIVE: This study aims to examine the relationships among sociodemographic and obstetric factors, fear of childbirth, psychosocial well-being and childbirth self-efficacy using a structural equation modelling approach. DESIGN: It adopted an exploratory cross-sectional study among 205 multi-ethnic pregnant women in Singapore. We used structural equation modelling to examine our hypothetical model, which integrates the concepts of Bandura's self-efficacy theory and previous literature reviews. The Childbirth Self-Efficacy Inventory, the Childbirth Attitudes Questionnaire and the World Health Organisation (Five) Well-Being Index were employed to measure childbirth self-efficacy, fear of childbirth and psychological well-being, respectively. FINDINGS: The structural equation model showed that multiparous women (β = 0. 24, P < 0.01), with better psychological well-being (β = 0.26, P < 0.001) were more likely to have higher childbirth self-efficacy; whereas Chinese women (β = -0.32, P < 0.01) with previous caesarean section (β = -0.17, P < 0.05) and higher fear of childbirth (β = -0.30, P < 0.001) were more likely to have lower childbirth self-efficacy. The structural equation model had good fit with the data (incremental fit index = 0.925, Tucker-Lewis index = 0.911, comparative fit index = 0.923, and root means square error of approximation = 0.048). CONCLUSION: Findings of this study highlight that ethnic Chinese, multiparous women, previous caesarean section, psychological well-being and fear of childbirth were determinants of childbirth self-efficacy among pregnant women in Singapore. Enhancement of self-efficacy can increase coping ability and reduce fear of childbirth and thus promote normal childbirth. Future self-efficacy enhancing interventions among pregnant women should be tailored by age, ethnicity, parity and prior modes of birth.
Authors: Agustín Ramiro Miranda; Ana Veronica Scotta; Ana Lucía Méndez; Silvana Valeria Serra; Elio Andrés Soria Journal: J Prev Med Public Health Date: 2020-10-05