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Moderating Effect of General Self-Efficacy on the Relationship between Pregnancy Stress, Daily Hassles Stress, and Preterm Birth Risk in Women Experiencing Preterm Labor: A Cross-Sectional Study

  • Cho, Hyun-Jeong (Department of Nursing, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Jeung-Im (School of Nursing, College of Medicine, Soonchunhyang University)
  • Received : 2024.01.16
  • Accepted : 2024.05.10
  • Published : 2024.08.31

Abstract

Purpose: This study investigated the moderating role of general self-efficacy (GSE) on how stress caused by pregnancy and daily hassle affect the risk of preterm birth (PTB) in women experiencing preterm labor. Methods: This cross-sectional study included 196 pregnant women experiencing preterm labor before 37 weeks of gestation. We used IBM SPSS Statistics 27 and employed Hayes process macro version 4 (model 1) and hierarchical regression to analyze the moderating effect of GSE on the relationship between pregnancy stress, daily hassle stress, and PTB risk. Results: Stress caused by pregnancy and daily hassle was positively correlated to PTB risk (r = .54, p < .001; r = .25, p < .001, respectively). While GSE did not significantly correlate with pregnancy stress, it negatively correlated with daily hassle stress (r = - .19, p = .009). GSE significantly moderated the relationship between combined stressors and PTB risk. As GSE levels increased, escalation in PTB risk in response to increasing stress levels was a more pronounced, highlighting a complex interaction between higher GSE levels and response to escalating stress levels. This model accounted for 39.5% of the variance in the PTB risk. Conclusion: Higher GSE may amplify the impact of stress on PTB risk, rather than mitigate it, which suggests a more nuanced role of GSE in the stress response of pregnant women at risk of preterm labor. GSE should be considered in care strategies, and managing its impact on stress perception and responses in pregnant women is crucial.

Keywords

Acknowledgement

We appreciate all women who participated in this study. For written English check, we used OpenAI. (2024). ChatGPT (4) [Large language model]. https://chat.openai.com.

References

  1. World Health Organization (WHO). Preterm birth [Internet]. WHO; c2023 [cited 2024 Mar 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/preterm-birth. 
  2. Statistics Korea. Birth statistics for 2022 [Internet]. Statistics Korea; c2023 [cited 2024 Mar 28]. Available from: https://kostat.go.kr/board.es?mid=a10301010000&bid=204&list_no=426806&act=view&mainXml=Y. 
  3. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75-84. https://doi.org/10.1016/s0140-6736(08)60074-4 
  4. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Obstetrics. Practice bulletin No. 171: Management of preterm labor. Obstetrics and Gynecology. 2016;128(4):e155-e164. https://doi.org/10.1097/aog.0000000000001711 
  5. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS. Williams obstetrics. 24th ed. McGraw-Hill; 2014. 
  6. Traylor CS, Johnson JD, Kimmel MC, Manuck TA. Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: An expert review. American Journal of Obstetrics & Gynecology MFM. 2020;2(4):100229. https://doi.org/10.1016/j.ajogmf.2020.100229 
  7. Upchurch Sweeney CR. Daily stress. In: Gellman MD, Turner JR, editors. Encyclopedia of Behavioral Medicine. Springer; 2013. p. 537-538. 
  8. Patel I, Dev A. What is prenatal stress? A scoping review of how prenatal stress is defined and measured within the context of food insecurity, housing instability, and immigration in the United States. Women's Health. 2023;19:1745505723119 1091. https://doi.org/10.1177/17455057231191091 
  9. McDonald SW, Kingston D, Bayrampour H, Dolan SM, Tough SC. Cumulative psychosocial stress, coping resources, and preterm birth. Archives of Women's Mental Health. 2014;17(6):559-568. https://doi.org/10.1007/s00737-014-0436-5 
  10. Hoffman MC, Mazzoni SE, Wagner BD, Laudenslager ML, Ross RG. Measures of maternal stress and mood in relation to preterm birth. Obstetrics and Gynecology. 2016;127(3):545-552. https://doi.org/10.1097/aog.0000000000001287 
  11. Tanpradit K, Kaewkiattikun K. The effect of perceived stress during pregnancy on preterm birth. International Journal of Women's Health. 2020;12:287-293. https://doi.org/10.2147/ijwh.s239138 
  12. Phillips AC. Perceived stress. In: Gellman MD, Turner JR, editors. Encyclopedia of Behavioral Medicine. Springer; 2013. p. 1453-1454. 
  13. Sanchez SE, Puente GC, Atencio G, Qiu C, Yanez D, Gelaye B, et al. Risk of spontaneous preterm birth in relation to maternal depressive, anxiety, and stress symptoms. The Journal of Reproductive Medicine. 2013;58(1-2):25-33. 
  14. Cha S, Masho SW. Preterm birth and stressful life events. In: Erez O, editor. Preterm birth [Internet]. IntechOpen; 2013 [cited 2023 Dec 10]. Available from: https://www.intechopen.com/chapters/42170. 
  15. Piggott JJ, Townsend CR, Matthaei CD. Reconceptualizing synergism and antagonism among multiple stressors. Ecology and Evolution. 2015;5(7):1538-1547. https://doi.org/10.1002/ece3.1465 
  16. Orr JA, Vinebrooke RD, Jackson MC, Kroeker KJ, Kordas RL, Mantyka-Pringle C, et al. Towards a unified study of multiple stressors: Divisions and common goals across research disciplines. Proceedings. Biological Sciences. 2020; 287(1926):20200421. https://doi.org/10.1098/rspb.2020.0421 
  17. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977;84(2):191-215. https://doi.org/10.1037//0033-295x.84.2.191 
  18. Sebastian V. A theoretical approach to stress and self-efficacy. Procedia - Social and Behavioral Sciences. 2013;78:556-561. https://doi.org/10.1016/j.sbspro.2013.04.350 
  19. Tsai YJ, Hsu YY, Hou TW, Chang CH. Effects of a webbased antenatal care system on maternal stress and self-efficacy during pregnancy: A study in Taiwan. Journal of Midwifery & Women's Health. 2018;63(2):205-213. https://doi.org/10.1111/jmwh.12685 
  20. Ngai FW, Chan SW. Stress, maternal role competence, and satisfaction among Chinese women in the perinatal period. Research in Nursing & Health. 2012;35(1):30-39. https://doi.org/10.1002/nur.20464 
  21. Reece SM, Harkless G. Self-efficacy, stress, and parental adaptation: Applications to the care of childbearing families. Journal of Family Nursing. 1998;4(2):198-215. https://doi.org/10.1177/107484079800400206 
  22. Pasha H, Faramarzi M, Chehrazi M, Esfandyari M, Shafierizi S. Role of social capital and self-efficacy as determinants of stress in pregnancy. Tzu Chi Medical Journal. 2021;33(3): 301-306. https://doi.org/10.4103/tcmj.tcmj_156_20 
  23. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39(2):175-191. https://doi.org/10.3758/bf03193146 
  24. Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression/correlation analysis for the behavioral sciences. 3rd ed. Routledge; 2002. 
  25. Kim Y, Chung CW. Development of the Korean pregnancy stress scale. Japan Journal of Nursing Science. 2018;15(2): 113-124. https://doi.org/10.1111/jjns.12175 
  26. Kim CH. Relationship of the daily hassles, stress appraisal and coping strategies with emotional experiences. Korean Journal of Counseling and Psychotherapy. 1995;7(1):44-69. 
  27. DeLongis A, Folkman S, Lazarus RS. The impact of daily stress on health and mood: Psychological and social resources as mediators. Journal of Personality and Social Psychology. 1988;54(3):486-495. https://doi.org/10.1037//0022-3514.54.3.486 
  28. Lee YM, Schwarzer R, Jerusalem M. Korean adaptation of the general self-efficacy scale [Internet]. Freie Universitat Berlin; c1994 [cited 2021 Nov 20]. Available from: http://userpage.fu-berlin.de/~health/korean.htm. 
  29. Schwarzer R, Jerusalem M. The general self-efficacy scale (GSE) [Internet]. Freie Universitat Berlin; c1995 [cited 2021 Nov 20]. Available from: http://userpage.fu-berlin.de/~health/engscal.htm. 
  30. Kim JI. Development and validation of the 23-item preterm birth risk assessment scale-Korean version. BMC Pregnancy and Childbirth. 2023;23(1):668. https://doi.org/10.1186/s12884-023-05975-x 
  31. Ju KS, Kim HS. Association between maternal age and complications of pregnancy in primipara. Journal of Health Informatics and Statistics. 2022;47(4):349-356. https://doi.org/10.21032/jhis.2022.47.4.349 
  32. Dolatian M, Mirabzadeh A, Forouzan AS, Sajjadi H, Alavimajd H, Mahmoodi Z, et al. Relationship between structural and intermediary determinants of health and preterm delivery. Journal of Reproduction & Infertility. 2014;15(2):78-86. 
  33. Jerusalem M, Schwarzer R. Self-efficacy as a resource factor in stress appraisal processes. In: Schwarzer R, editor. Self-Efficacy: Thought Control of Action. Taylor & Francis; 1992. p. 195-213. 
  34. Ryu Y. Korean adult women's mindfulness effect on daily hassles: Verification of the intermediate effect of self-compassion and anger expression [master's thesis]. Hwaseong: Neungin Graduate School; 2020. p. 1-69. 
  35. Ma D, Li B, Liu X, Sun Y, Sun J. The moderating effect of self-efficacy on pregnancy stress and smartphone addiction of pregnant women in late pregnancy: A longitudinal study. Risk Management and Healthcare Policy. 2024;17:41-48. https://doi.org/10.2147/rmhp.s445581 
  36. Beebe KR, Lee KA, Carrieri-Kohlman V, Humphreys J. The effects of childbirth self-efficacy and anxiety during pregnancy on prehospitalization labor. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2007;36(5):410-418. https://doi.org/10.1111/j.1552-6909.2007.00170.x