Document Type : Original Article



BACKGROUND: Fear of childbirth is a common problem during pregnancy, which can give rise to
sleep disorders and diminish sleep quality. This study aimed to determine the effect of cognitive–
behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers who
visited the slum health centers of Zahedan city, Iran, in 2020.
MATERIALS AND METHODS: This quasi‑experimental study was conducted in 2020 on 100 pregnant
adolescent slum dwellers between 11 and 19 years old at 24–28 weeks pregnant. Multi‑stage sampling
was used and the participants were randomly divided into an intervention and a control group. The
intervention group received four sessions of cognitive–behavioral training at weekly intervals. The
control group only received routine care. The Wijma Delivery Expectancy/Experience Questionnaire
and the Pittsburgh Sleep Quality Index were filled before and 4 weeks after the training course.
The data were analyzed in SPSS 21 using independent t‑test, paired t‑test, Fisher’s exact test, and
Chi‑squared test. and covariance. A P value of < 0.05 was considered significant.
RESULTS: After the intervention, the fear of childbirth significantly decreased (P = 0.004), and sleep
quality significantly improved (P = 0.001) in the intervention group compared with the control group.
The results of analysis of covariance to control the significant effect of pre‑test scores showed that
the mean score of fear of childbirth (P = 0.03) and mean score of sleep quality (P = 0.001) in the
two groups after the intervention was statistically significant.
CONCLUSION: The results showed that in addition to reducing fear of childbirth, cognitive–behavioral
training improved the sleep quality of women in the intervention group. Therefore, this training could
be used as an easy and accessible method without complications to improve women’s health.


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