The effect of a kolcaba's comfort theory–based structured supportive approach applied to primiparous pregnant women on comfort levels in the third trimeste

This study was designed to examine the effect of Kolcaba's Comfort Theory–based structured supportive approach, implemented through breathing awareness exercises, on the overall comfort level of primiparous pregnant women in the third trimester. The research was conducted using a randomized controlled experimental design with a pretest–posttest control group and single-blind procedure. Ethical approval and institutional permissions were obtained prior to data collection. The study was carried out between September 2024 and January 2025 at the antenatal education unit (pregnancy school) of Şanlıurfa Harran University Hospital, Department of Obstetrics and Gynecology. A total of 71 primiparous pregnant women (36 in the control group and 35 in the intervention group) completed the study over an 8-week period, during which the program was implemented 7 days a week, including one face-to-face hospital session. To support participants in performing their daily breathing awareness exercises independently, the booklet titled "Kolcaba Comfort Theory–Based Structured Supportive Approach: Breathing Awareness Exercise Guide for Primiparous Pregnant Women" was provided. In addition, a short reminder message was sent every morning between 10:00–11:00, and participants were contacted by phone between 17:00–18:00 to check whether they experienced any problems. Data were collected using the Descriptive Information Form, vital sign assessment (pulse, respiratory rate, oxygen saturation, and blood pressure), and the General Comfort Questionnaire (GCQ). Statistical analyses were performed using IBM SPSS 25.0. The findings showed that 97.1% of the intervention group and 97.2% of the control group experienced pregnancy-related problems, and these problems had a substantial negative effect on general comfort levels (intervention: 37.1%, control: 44.4%). The breathing awareness intervention led to a significant increase in third-trimester GCQ total scores in the intervention group (posttest = 137.54 ± 8.49) compared to the control group (posttest = 120.03 ± 16.05). In addition, significant improvements were observed in the physical, psychospiritual, and environmental subdimensions of the GCQ. The breathing awareness exercises also produced significant differences in vital signs, specifically pulse, respiratory rate, and oxygen saturation levels (SpO₂) (p < 0.001). In conclusion, breathing awareness exercises administered to primiparous pregnant women during the second trimester resulted in a positive improvement in overall comfort levels in the third trimester. Due to the positive therapeutic effects of breathing awareness exercises on general comfort and vital signs, it is recommended that these practices be used as a complementary intervention for second-trimester pregnant women.