The effect of individual counseling based on the GATHER principles on perceived stress and empowerment of the mothers with high-risk pregnancies: an experimental study

Empowering women with fetal malpositions: enhancing childbirth experience and empowerment through educational interventions: a randomized controlled clinical trial

BACKGROUND

This study aims to determine the impact of a childbirth educational intervention, based on empowerment theory, on childbirth experience and empowerment in women with fetal occiput posterior and occiput transverse malpositions.

METHODS

A randomized controlled trial was conducted from February 2022 to December 2022 involving pregnant women with fetal occiput posterior and occiput transverse malpositions. Eligible women were randomly assigned to either the control or study group. The control group received routine care during childbirth, while the study group received routine care and a childbirth-empowering educational intervention delivered by midwives. Primary outcomes assessed were childbirth experience and patient perceptions of patient-empowering nurse behaviors in pregnant women. Secondary outcomes included pregnancy outcomes, delivery support and control, maternal coping behavior during delivery, maternal participation in delivery decisions, and perception of empowerment.

RESULTS

A total of 137 pregnant women were enrolled, with 69 and 68 in the control and study groups, respectively. The study group showed significantly higher levels of childbirth experience and reported better patient perceptions of patient-empowering nurse behaviors than the control group. Additionally, the study group demonstrated higher levels of delivery support and control, maternal coping behavior, and specific aspects of perceived participation and patient perception of empowerment compared to the control group. There were no statistically significant differences in pregnancy outcomes between the two groups.

CONCLUSION

The childbirth empowering educational intervention effectively improved the childbirth experience and empowerment of women with fetal occiput posterior and occiput transverse malpositions. However, further studies are required to investigate its impact on pregnancy outcomes.

TRIAL REGISTRATION

The study protocol was approved by the hospital ethics committee (approval number:2020140A01) and registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2300070915; date of first registration: 26/04/2023).

Cross-cultural adaptation of the empowerment scale of pregnant women in China context: An integrative method of translation and linguistic validation

AIM

To translate the Empowerment Scale for Pregnant Women (ESPW) into Chinese and to assess its linguistic validity.

METHODS

The integrative method of the translation process, the Delphi technique, and cognitive interviews were used to implement cross-cultural adaptation and enhance comprehensibility and linguistic validation. This study recruited 14 experts in the expert review and cognitively reviewed 15 pregnant women.

RESULTS

The two-round Delphi method created agreement on cultural applicability. The results of content validity achieved good levels: The item-level content validity index (CVI) ranged from 0.78 to 1.00, and the scale-level content validity index, calculated using two different formulas, were 0.97 and 0.81, respectively. Kappa values ranged from 0.74 to 1.00. Pregnant women could understand most of the items and response options in the cognitive interview. The revisions to the wording were made based on suggestions from experts and pregnant women.

CONCLUSION

The prefinal simplified Chinese ESPW was semantically and conceptually equivalent to the English version, which was well prepared for further psychometric tests in the next stage of cross-cultural adaptation.

PATIENT OR PUBLIC CONTRIBUTION

This comprehensive method successfully developed a Chinese tool to measure the empowerment of pregnant women, indicating the international applicability of this tool and the methodological scientific nature. The simplified Chinese ESPW has the potential to support the identification of empowerment levels of pregnant women and the evaluation of the effectiveness of health education and promotion programmes.

Measuring empowerment in pregnant women: A scoping review of progress in instruments

BACKGROUND

The empowerment of pregnant women is a meaningful strategy that profoundly impacts the health of women and their children. Despite a significant increase in the empowerment of pregnant women and its measurement, little attention was given to a consensus on the selection and application of assessment instruments used for pregnant women.

OBJECTIVE

To identify the available assessment instruments for measuring the empowerment of pregnant women and to describe the appraisal content and their psychometric properties.

METHODS

We searched nine bibliographic databases for original studies that focus on the measurement of empowerment in pregnant women. Arksey and O'Malley's methodology and PRISMA-ScR were selected to guide the implementation of this scoping review. The COSMIN criteria was employed to assess the methodological quality and the quality of psychometric properties.

RESULTS

A total of 23 studies were included and 13 instruments were extracted. Given comprehensive considerations, Kameda's prenatal empowerment scale may be deemed suitable. The included instruments comprehensively measured the attributes of empowerment, with a particular focus on facilitating women's choice and decision-making. Except for the four most recent self-designed questionnaires, the remaining instruments had been tested for reliability and/or validity.

CONCLUSION

There were heterogeneous results regarding the included instruments' appraisal content and psychometric properties. Future studies focusing on the development or validation of measurement instruments should be guided by influential and identical standards.

Prevention of Pregnancy Loss: Combining Progestogen Treatment and Psychological Support

Pregnancy loss can be defined as a loss before either 20 or 24 weeks of gestation (based on the first day of the last menstrual period) or the loss of an embryo or fetus less than 400 g in weight if the gestation age is unknown. Approximately 23 million pregnancy losses occur worldwide every year, equating to 15-20% of all clinically recognized pregnancies. A pregnancy loss is usually associated with physical consequences, such as early pregnancy bleeding ranging in severity from spotting to hemorrhage. However, it can also be associated with profound psychological distress, which can be felt by both partners and may include feelings of denial, shock, anxiety, depression, post-traumatic stress disorder, and suicide. Progesterone plays a key part in the maintenance of a pregnancy, and progesterone supplementation has been assessed as a preventative measure in patients at increased risk of experiencing a pregnancy loss. The primary objective of this piece is to assess the evidence for various progestogen formulations in the treatment of threatened and recurrent pregnancy loss, postulating that an optimal treatment plan would preferably include a validated psychological support tool as an adjunct to appropriate pharmacological treatment.