Journal of Education and Health Promotion

Abstract BACKGROUND: Vaginal childbirth is the most stressful physical and mental event for most women, 
which necessitates the use of coping styles. Furthermore, childbirth self‑efficacy will be one of the 
effective factors to cope with this stressful situation and doing compatible behaviors with childbirth 
pain. Therefore, the aim of this study was to determine the relationship between childbirth self‑efficacy 
and coping styles of problem based and emotive based in nulliparous pregnant women.
MATERIALS AND METHODS: This study is a descriptive‑correlational study that is done over 323 
nulliparous pregnant women attending the health centers in the city of Zahedan in 2020–2021. Data 
were collected by participants’ demographic questionnaire, childbirth self‑efficacy questionnaire 
of Lowe, and coping styles questionnaire of Folkman and Lazarus. The data were analyzed using 
Spearman’s correlation coefficient test, linear regressions model, and multiple regression in SPSS 
software version 22. P < 0.05 was considered statistically significant.
RESULTS: Results of Spearman’s correlation coefficient test showed a significant direct correlation 
between problem‑based coping style and childbirth self‑efficacy (P = 0/017, r = 0.13); but, there was 
no significant direct correlation with emotive‑based coping style (P = 0/782, r = 0.01). According 
to the linear regressions model, just the problem‑based coping style is predicted childbirth 
self‑efficacy (P = 0/006).
CONCLUSIONS: According to the findings, nulliparous pregnant women should be responsible, 
have a positive reassessment of vaginal childbirth, plan to solve their problems, and look for social 
support (all of these are part of a problem‑based coping style) to increase and improve their childbirth 
self‑efficacy. Furthermore, designing appropriate educational interventions based on problem‑based 
coping style is necessary.

Abstract INTRODUCTION: Gestational diabetes is the most common metabolic disorder in pregnancy, and
lack of self‑care is the most important reason for mortality in diabetic patients. Since the glycemic
control is associated with physiological and psychological mechanisms, variables such as health
locus of control can play a role in health behaviors of diabetic patients. Therefore, this study was
aimed to predict self‑care behaviors among women with gestational diabetes based on maternal
health locus of control (MHLC) and fetal health locus of control (FHLC).
METHODS: This study is a descriptive, predictive correlational study that it is conducted on
over 400 women with gestational diabetes attending the health centers and clinic of hospitals
affiliated to Mashhad University of Medical Sciences in 2015. Data were collected using individual
questionnaire, self‑care derived from the summary of diabetes self‑care activities, MHLC, and FHLC
scale. The data were analyzed using Spearman’s correlation coefficient test, linear regressions
model, and multiple regression in SPSS software version 16. P < 0.05 was considered statistically
significant.
RESULTS: Results of Spearman’s correlation coefficient test showed a significant direct linear
relationship between self‑care and internal MHLC (P = 0.027) and internal dimensions (P < 0.0001)
and powerful others (P = 0.012) of FHLC. According to linear regressions model, internal
MHLC (P = 0.027), internal dimensions (P < 0.0001), and powerful others (P = 0.012) of FHLC are
considered as predictor variables of self‑care.
CONCLUSION: Midwives should perform interventions to increase internal locus of control and
encourage more responsibility among women with gestational diabetes to achieve better self‑care.