Journal of Education and Health Promotion

Abstract INTRODUCTION: Maternal confidence is an extremely important factor in playing the mother’s role
and her identity formation. Loss of self‑confidence occurs in primiparous women due to the lack of
maternal skills. Obtaining the behaviors of maternal role and self‑confidence, the mother provides
better care for her child. Hence, the aim of this study was to examine the effect of maternal role
training program based on Mercer theory on maternal self‑confidence of primiparous women with
unplanned pregnancy.
METHODOLOGY OF THE RESEARCH: This clinical trial was performed on 67 primiparous
women referring to Mashhad health centers. Individuals were randomly divided into intervention
and control groups. A maternal role training program based on Mercer theory was carried out for
intervention group (three sessions of group training in the 34th, 35th, and 36th weeks of pregnancy
and one individual training session before discharge from the hospital and then, weekly follow‑up
over the phone for 4 weeks). The control group received the normal pregnancy care. The research
tools were questionnaires of demographic characteristics, London, DASS 21, Edinburgh Postnatal
Depression Scale, Parenting Sense of Competence, General Impressions on Infant Temperament
Questionnaire, and Six Simple Questions. Maternal self‑confidence was measured before training,
4 weeks after delivery, and 4 months after delivery. Data analysis was carried out using independent
t‑test, Chi‑square test, paired t‑test, Mann–Whitney test, one‑way ANOVA, and Wilcoxon test. P < 0.05
was considered statistically significant.
RESULTS: There was a significant difference between mean maternal self‑confidence
changes (before training and 4 weeks after delivery (P = 0.003) and before training and 4 months
after delivery (P = 0.001) in both groups. After eliminating the effect of interventional variables, the
mean scores of maternal self‑confidence after training in the intervention group had a statistically
significant difference with that in the control group (P = 0.001).
CONCLUSIONS: Maternal role training program based on Mercer theory increases maternal
self‑confidence in primiparous women with unplanned pregnancy. Teaching maternal role is
recommended to all health‑care providers.

Abstract INTRODUCTION: Using fertility treatment will cause high levels of anxiety and depression. The study
was carried out with the objective of determining the effect of problem‑solving skills (PSS) training on
mental health and the success of treatment of infertile women under intrauterine insemination (IUI)
treatment.
MATERIALS AND METHODS: this randomized clinical trial was carried out on 72 women
referring to Milad Infertility Center in Mashhad. Individuals were randomly assigned into control and
intervention groups. PSS were taught in three sessions in the intervention group, and the control
group received usual care. The success rate of therapy and the mean of anxiety and depression
on the day of IUI operation were compared using the Beck Depression Inventory and Spielberger
Anxiety Inventory in both groups. t‑test, Mann–Whitney, paired t‑test, Wilcoxon, and Chi‑square
tests were used to analyze the data.
RESULTS: on the day of IUI operation, the mean score of state anxiety in the control
group (5 0 . 11 ± 8.51) and PSS (68.12 ± 11.49) was significant (P < 0.001), trait anxiety in the
control group (46.41 ± 8.70) and PSS (44.00 ± 9.92) was significant (P < 0.001), and depression in the
control group (17.44 ± 11.70) and PSS (12.99 ± 8.99) was significant (P < 0.001); however, the success
of treatment in both groups (14.7% and PSS (26.5%) was not significantly different (P = 0.230).
CONCLUSION: Considering the effect of problem‑solving on reducing anxiety and depression, it is
suggested that infertility center of this intervention should be used.

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.

Abstract INTRODUCTION: The maternal role is one of the most basic and important roles played by
women during their lifetime. The process of the maternal role starts during pregnancy and
to continue and develop after postpartum with the growth of suckling. However, unplanned
pregnancy may jeopardize achieving the maternal role and reduce maternal role satisfaction.
Therefore, the researcher conducted the present study to determine the impact of maternal
role training program on attainment of role and role satisfaction in nulliparous women with
unplanned pregnancy.
METHODOLOGY OF THE RESEARCH: In this clinical trial, the researcher divided 67 nulliparous
women with unplanned pregnancies into two groups at random by drawing lots. For the
intervention group, in addition to the usual pregnancy care, the researcher conducted 3 group
training sessions at weeks 34, 35, and 36 of pregnancy and an individual training session in the
1st day after delivery before release; then, during the next 4 weeks, the researcher made follow‑up
phone calls each week. The control group received the usual pregnancy care. The research
tools included London questionnaire to measure unplanned pregnancy, Myself‑As‑Mother
Scale (SD‑Self), My‑Baby Scale (SD‑Baby), Perceived Competence Scale to measure maternal
role attainment, and Parenting Sense of Competence Scale to measure maternal role satisfaction.
The researcher measured the maternal role attainment and maternal role satisfaction before
training and 4 weeks after delivery. The researcher analyzed the data using SPSS software
version 21 and statistical tests such as independent t‑test, Chi‑square, paired sample t‑test,
Mann–Whitney, one‑way analysis of variance, and Wilcoxon. The amount of P was supposed
to be <0.05.
RESULTS: The mean age of research units was 24.10 ± 4.3. Twenty‑one persons (60%) in the
intervention group and ten persons (31.3%) in the control group attained the maternal role (P = 0.019)
and changes to achieve the maternal role in intervention group were significantly more than the control
group (P = 0.002). Changes in the mean scores of maternal role satisfaction in the intervention group
were significantly more than the control group (P = 0.023).
CONCLUSION: Maternal role training for nulliparous women with unplanned pregnancy during
pregnancy and postpartum period can help them in maternal role attainment and maternal role
satisfaction.