The Effects of a Childbirth Psychoeducation Programme on Learned Resourcefulness, Maternal Role Competence and Satisfaction, and Depressive Symptoms in Chinese Childbearing Women.

摘要

The crisis nature of early motherhood, the frequent feeling of incompetence in the maternal role, the increasing evidence of postpartum depression in the Chinese population, coupled with the changing nature of socio-cultural environment challenge midwives to make continued refinement of childbirth education to enhance women's adjustment during the transition to motherhood. Learned resourcefulness has been identified as an important coping repertoire that promotes healthy adjustment in the perinatal period. The aim of this study was to determine the effectiveness of a childbirth psychoeducation programme based on the concept of learned resourcefulness.;The study had two phases. The first phase aimed at establishing the psychometric properties of the Chinese versions of Self-Control Schedule (C-SCS) and Parenting Sense of Competence Scale (C-PSOC), which were used as outcome measures in the second phase. The second phase adopted a pretest-posttest, control group quasi-experimental design to examine the effects of a childbirth psychoeducation programme on learned resourcefulness, maternal role competence and satisfaction, and perinatal depression.;A convenience sample of 184 first-time childbearing women was recruited from two public hospitals with one hospital randomly selected as the experimental group. The experimental group (n = 92) received the childbirth psychoeducation programme and routine childbirth education. The comparison group (n = 92) received the routine childbirth education only.;Outcomes on learned resourcefulness, maternal role competence and perinatal depression were measured by C-SCS, C-PSOC (Efficacy Subscale) and Edinburgh Postnatal Depression Scale (EPDS), respectively, at baseline, immediately post-intervention, six weeks and six months postpartum. Maternal role satisfaction was assessed at six weeks and six months postpartum using C-PSOC (Satisfaction Subscale). Doubly multivariate analysis of covariance was performed to compare the effects of childbirth psychoeducation programme between the experimental and comparison groups. In addition, 16 participants in the experimental group were interviewed at six weeks postpartum to explore their perceived impacts of childbirth psychoeducation programme in helping them cope with the experience of new motherhood. Content analysis was used to analyze the interview data.;Results of the phase I study indicated good psychometric properties of C-SCS and C-PSOC in Chinese childbearing women. Results in the phase II study revealed significant improvement in learned resourcefulness at six weeks postpartum (p = 0.004), and overall reduction in depressive symptoms (p = 0.01) for women receiving the childbirth psychoeducation programme compared with the routine childbirth education group after adjusting for baseline group differences on age and social support. No significant change was detected on maternal role competence. However, women receiving the childbirth psychoeducation programl1'l;e had significantly higher level of satisfaction in the maternal role at six weeks postpartum (p = 0.01).;The qualitative interviews revealed that the experimental group perceived the childbirth psychoeducation programme to be helpful in increasing their confidence in the maternal role, improving their emotional well-being and fostering the development of learned resourcefulness skills. The findings of this study support the effectiveness of childbirth psychoeducation programme based on the concept of learned resourcefulness for reducing depressive symptoms in first-time Chinese childbearing women, and highlight the contributions midwives can make to continue improving the quality of childbirth education in Chinese society.