Effects of solution-oriented approach applied to primigravidas on psychosocial health, fear of childbirth and postnatal senses of security: A randomized controlled study

The study was conducted as a randomized, post-test-control group, parallel group experimental study in order to determine the effect of the solution-oriented approach applied to primigravidas on psychosocial health, fear of childbirth and postnatal security feelings. The study was carried out in a university hospital located in the city center of Konya, between 20 September 2021 and 27 May 2022, with 96 primigravidas (intervention group: 48, control group: 48) who met the inclusion criteria of the study. Primigravidas included in the study group were assigned to the intervention and control groups by the block randomization method. A total of four sessions of Solution-Focused Approach Program were applied to the pregnant women in the intervention group, once a week, starting at the 32nd gestational week. After the program was completed, a training booklet prepared by the researcher was given to the pregnant women in the intervention group. No intervention was made to the pregnant women in the control group other than routine hospital practices. Pregnant women in the intervention and control groups were re-evaluated at the end of the 35th week of pregnancy, 37-40 in the gestational week, within the first 24 hours postpartum and at the end of the first postpartum week. Information Form, Pregnancy Psychosocial Health Assessment Scale (PPHAS), Wijma Birth Expectancy/Experience Scale (W-DEQ) A and B versions and Mothers' Postnatal Sense of Security Scale were used to collect data. In the analysis of the data, number, percentage, mean, standard deviation, chi-square test, t-test for independent groups, one-way and mixed-pattern ANOVA test were used for repeated measurements. It was determined that the pregnant women in the intervention and control groups had similar socio-demographic and obstetric characteristics and there was no statistical difference between the groups (p>0.05). While the mean PPHAS scores of the pregnant women in the intervention and control groups were similar before the education (p>0.05), the mean scores of the pregnant women in the intervention group after the education were significantly higher (p<0.05) and the effect size (d=0.445) was determined to be moderate. While the mean W-DEQ (A) scores of the pregnant women in the intervention and control groups were similar before the education (p>0.05), the pregnant women in the intervention group were post-training and 37-40 week of gestation W-DEQ (A) mean scores were significantly lower than the control group (p<0.01) and the effect sizes (d=-3.051; d=-3.052, respectively) were found to be high. W-DEQ (B) total mean scores of the mothers in the intervention group were significantly lower than the mean score of the mothers in the control group (p<0.01) and the effect size (d=-3,051) was found to be high. Postnatal Sense of Security Scale mean scores of the mothers in the intervention group were significantly higher than the mean scores of the mothers in the control group (p<0,01) and the effect size (d=1,852) was found to be high. In conclusion; It was determined that the Solution-Focused Approach applied to primigravidas increased the psychosocial health level and decreased the fear of childbirth. It was determined that strengthening psychosocial health and managing the fear of childbirth during pregnancy have a positive effect on the postpartum period and increase the postnatal security feelings of mothers. According to the research results; It is recommended that a counseling program based on the Solution-Focused Approach should be integrated into the planned interventions in order to strengthen the psychosocial health of pregnant women, reduce their fear of childbirth and increase their postnatal security feelings.