BackgroundMedication-related adverse events are common in pregnant women, and most are due to misunderstanding medication information. The identification of appropriate medication information sources requires adequate medical information literacy (MIL). It is important for pregnant women to comprehensively evaluate the risk of medication treatment, self-monitor their medication response, and actively participate in decision-making to reduce medication-related adverse events. ObjectiveThis study aims to examine the effectiveness of a medication education course on a web-based platform in improving pregnant women’s MIL and decision self-efficacy. MethodsA randomized controlled trial was conducted. Pregnant women were recruited from January to June 2021 in the Department of Obstetrics and Gynecology of a large hospital in a major city in central China. A total of 108 participants were randomly divided into a control group (CG), which received routine prenatal care from nurses and physicians, and an intervention group (IG), which received an additional 3-week web-based medication education course based on the theory of planned behavior as part of routine prenatal care. Participants completed a Medication Information Literacy Scale and a decision self-efficacy questionnaire at baseline, upon completion of the intervention, and at a 4-week follow-up. Generalized estimation equations (GEE) were used to analyze the main effect (time and grouping) and interaction effect (grouping×time) of the 2 outcomes. The CONSORT-EHEALTH (V 1.6.1) checklist was used to guide the reporting of this randomized controlled trial. ResultsA total of 91 pregnant women (48 in the IG and 43 in the CG) completed the questionnaires at the 3 time points. The results of GEE indicated that there was no statistically significant difference in time×group interactions of MIL between the 2 groups (F2=3.12; P=.21). The results of the main effect analysis showed that there were statistically significant differences in MIL between the 2 groups at T1 and T2 (F1=17.79; P<.001). Moreover, the results of GEE indicated that there was a significant difference in decision self-efficacy regarding the time factor, grouping factor, and time×group interactions (F2=21.98; P<.001). The results of the simple effect analysis indicated a statistically significant difference in decision self-efficacy between the 2 groups at T1 (F1=36.29; P<.001) and T2 (F1=36.27; P<.001) compared to T0. Results showed that MIL and decision self-efficacy in the IG were found to be significantly higher than those in the CG (d=0.81; P<.001 and d=1.26; P<.001, respectively), and they remained significantly improved at the 4-week follow-up (d=0.59; P<.001 and d=1.27; P<.001, respectively). ConclusionsWeb-based medication education courses based on the theory of planned behavior can effectively improve pregnant women’s MIL and decision self-efficacy, and they can be used as supplementary education during routine prenatal care. Trial RegistrationChinese Clinical Trial Registry ChiCTR2100041817; https://www.chictr.org.cn/showproj.html?proj=66685

Purpose: This pilot randomized controlled trial examined the feasibility, acceptability, and preliminary effectiveness of a culturally optimized Interpersonal Psychotherapy (IPT) for perinatal depression among rural women in China. It was hypothesized that the adapted IPT would be feasible to deliver, acceptable to participants, and potentially effective in improving depressive symptoms, social support, and family functioning. Patients and Methods: A pilot randomized controlled trial was conducted with 34 pregnant women recruited from two rural clinics in Hubei, China. Participants were randomized to treatment-as-usual (TAU) or culturally optimized IPT plus TAU. The IPT program comprised three face-to-face sessions and one online follow-up, tailored to rural family and cultural contexts. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess depressive symptoms, with social support and family functioning as secondary outcomes. Results: Compared with TAU, participants receiving the adapted IPT showed suggested reductions in EPDS scores and improvements in social support and family functioning at postpartum follow-ups. Feasibility was demonstrated by high adherence (94.1%), low attrition, and strong satisfaction. Bayesian mixed-effects modeling confirmed the robustness of these trends. Conclusion: Findings indicate that the adapted IPT was both feasible and well accepted within rural maternal care systems, suggesting potential psychosocial benefits aligned with the study's hypotheses. The culturally optimized IPT appears promising as a feasible, acceptable, and potentially effective approach for supporting maternal mental health in rural China. Larger trials with extended follow-up are needed to confirm these preliminary results.

Objectives: This study aims to examine the temporal associations among psychological distress, mindfulness, childbirth trauma, and postpartum post-traumatic stress disorder (PTSD) symptoms across the first three months postpartum and test whether mindfulness mediates these longitudinal pathways. Methods: This prospective longitudinal cohort study followed Chinese postpartum women at one week (T1), one month (T2), and three months (T3) after childbirth. A total of 210 women completed baseline assessments, with 173 and 148 participants retained at T2 and T3, respectively. Psychological distress, mindfulness, childbirth trauma, and postpartum PTSD symptoms were assessed using validated self-report measures. Cross-lagged panel models (CLPM) with bootstrapping were applied to examine temporal associations and the mediating role of mindfulness. Results: Mindfulness demonstrated a complex mediating role across the postpartum period. Psychological distress at T1 showed a significant negative indirect association with childbirth trauma at T3 via mindfulness at T2 (/3 = -0.110, 95% CI [-0.188, -0.037]), while simultaneously exerting a positive direct effect (/3 = 0.151, 95% CI [0.030, 0.272]), resulting in an inconsistent mediation pattern (/3 = 0.041, 95% CI [-0.158, 0.240]). In contrast, psychological distress at T1 showed a significant indirect longitudinal association with postpartum PTSD symptoms at T3 via mindfulness at T2 (/3 = -0.206, 95% CI [-0.310, -0.101]). This pattern was consistent with mediation, although the findings should be interpreted cautiously given the CLPM framework and the modest model fit. Conclusions: Mindfulness functions as a central but non-uniform mechanism in postpartum mental health. These findings underscore both its protective potential and the methodological and conceptual complexity of interpreting mindfulness in longitudinal postpartum research.

Objective To explore the current status of health communication and intentions regarding pre-hospital delay among high-risk groups for stroke, and to analyze the impact of health communication on these intentions.Methods A convenient sampling method was used to collect data using a general information questionnaire, a health communication survey, and the Stroke Pre-hospital Delay Behavior Intention for high-risk stroke populations in three communities in Wuhan.Results A total of 367 valid questionnaires were retrieved. Of 367 valid questionnaires, 50.14% showed a moderate intention for pre-hospital delay behavior, 48.77% of the respondents considered relatives and friends as their main health information disseminators. The primary dissemination channel was the illness experiences of relatives and friends (53.13%). In terms of dissemination content, the majority of participants (98.37%) reported that “failure to receive timely treatment may result in a loss of self-care ability and thus resulting in a heavy family care burden.” 43.87% of respondents received related information less than twice every six months. Multiple linear regression analysis indicated that different types of disseminators, channels of receiving information, media platforms for receiving information, frequency and presentation of receiving information, as well as dissemination content, are influencing factors of the stroke pre-hospital delay behavior intention.Conclusion It’s necessary to improve health communication and reduce the stroke pre-hospital delay behavior intention among high-risk stroke populations. From the perspective of health communication, targeted, differentiated, and effective health communication strategies should be formulated for high-risk stroke populations to lower the intention of pre-hospital delay behaviors, thereby promoting the prevention and control of stroke.

OBJECTIVE:This study aimed to develop a machine learning (ML)-based prediction model for antenatal depression (AND) in Chinese women. Given the significant impact of AND on maternal and infant health, the goal was to create an accurate and interpretable model to identify women at risk early. METHODS:Five ML models were compared, including Extreme Gradient Boosting (XGBoost) and Light Gradient Boosting Machine (LightGBM). The models were evaluated on accuracy, sensitivity, specificity, the area under the receiver operating characteristic curve (AUC), and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) were utilized to improve model interpretability and highlight important predictive features. The training set comprised 442 pregnant women during prenatal visits at the obstetrics clinic of a major hospital in Wuhan, China. In comparison, the external validation set comprised 190 pregnant women at the obstetrics clinic of another major hospital in Wuhan, China. RESULTS:The LightGBM model outperformed the other models in terms of predictive accuracy and generalizability. Key predictors of AND included educational attainment, coping strategies, social support and personality traits. The model demonstrated robust performance in both the training and validation datasets, offering an effective tool for AND prediction. CONCLUSION:This study developed a reliable and interpretable ML-based model for early identification of women at risk for AND. The findings suggest that ML techniques, specifically LightGBM, can be integrated into prenatal care to enhance early screening and provide timely interventions for at-risk women, improving maternal mental health outcomes.

BACKGROUND:Mindfulness-based interventions (MBIs) have shown potential in reducing maternal negative emotions, but their effectiveness for women with fetal loss requires further investigation. This study aimed to evaluate the effects of MBIs on mental health outcomes among these women. METHODS:Randomized controlled trials (RCTs) on MBIs for women with fetal loss were retrieved from eight databases, covering literature from inception to January 21, 2025. Outcomes included depression, anxiety, and post-traumatic growth. Risk of bias was assessed using Cochrane RoB 1.0, and meta-analyses were performed using Review Manager 5.4. RESULTS:Ten RCTs were included. MBIs significantly improve depression (SMD=1.01, 95 %CI (0.60,1.41), p < 0.01), anxiety (SMD=1.24, 95 %CI (0.57, 1.91), p < 0.01), stress (SMD=0.99, 95 %CI (0.11, 1.86), p = 0.03) and post-traumatic growth (MD=19.67, 95 %CI (10.96, 28.38), p < 0.01) in women with fetal loss. Subgroup analyses were feasible only for depression and anxiety. MBIs significantly reduced depressive symptoms in both women with pre-existing psychological symptoms (SMD=0.85, p < 0.01) and those without (SMD=1.07, p < 0.01), with no significant difference by intervention duration (p > 0.05). For anxiety symptoms, MBIs were effective only in women without symptoms (SMD=1.57, p < 0.01). Short-duration MBIs (≤4 weeks, SMD=2.59, p < 0.01) showed greater effects than long-duration MBIs (>4 weeks, SMD=0.74, p < 0.01). LIMITATIONS:There are few high-quality RCTs, small sample sizes, and a lack of long-term follow-up. CONCLUSIONS:MBIs effectively improve mental health in women with fetal loss, with short-duration effects exceeding long-duration ones. These findings support the integration of MBIs into psychosocial care, particularly for women with pre-existing psychological symptoms, and highlight the need to refine intervention strategies.

Objectives: This study aimed to explore the relationship between resilience, infertility self-efficacy, infertility coping strategies, and fertility quality of life (fertility QoL) in women with infertility. Additionally, it sought to examine the mediating roles of self-efficacy and infertility coping strategies in the relationship between resilience and fertility QoL. Methods: A cross-sectional study was conducted on infertile women undergoing assisted reproductive treatment from December 2021 to March 2022 in reproductive centers in Wuhan, China. A total of 314 participants were recruited using convenience sampling to complete a socio-demographic characteristics questionnaire, the 10-item Connor–Davidson Resilience Scale (CD-RISC-10), the Infertility Self-efficacy Scale (ISE), the Copenhagen Multi-Centre Psychosocial Infertility (COMPI) Coping Strategy Scale, and the Fertility QoL Scale. Results: Resilience (r = 0.375, p < 0.01), infertility self-efficacy (r = 0.584, p < 0.01), and meaning-based coping strategy (r = 0.191, p < 0.01) were positively correlated with fertility QoL. The other three infertility coping strategies, including active-avoidance coping (r = −0.367, p < 0.01), active-confronting coping (r = −0.143, p < 0.05), and passive-avoidance coping (r = −0.130, p < 0.05), were negatively correlated. The indirect effect of resilience on fertility QoL through three mediators, including infertility self-efficacy (β = 0.467, p < 0.001), active-confronting coping (β = −0.214, p < 0.001), and meaning-based coping (β = 0.161, p < 0.001), was significant (value of total indirect effect = 0.263, 95% CI, 0.188 to 0.350) with an effect of 71.5%. Conclusions: Resilience may be a psychological resource that promotes adaptive coping strategies. This allows women to be more confident in their management of infertility and treatment-related concerns, which promotes a better fertility QoL.

This preprint has been withdrawn at the request of the authors due to serious scientific errors that cannot be corrected through an update of the paper.

INTRODUCTION:Human milk banks (HMBs) were established to provide safe human milk for infants in need. However, the number and volume of donors are insufficient in China. This study aimed to explore Chinese postpartum mothers perspectives on the use of donor milk and the implementation of HMBs. METHOD:A descriptive phenomenology design with semi-structured interviews was used to collect data involving 18 postpartum mothers from January to June 2021. RESULTS:The study revealed that participants had limited knowledge of donor milk and human milk banks, faced multiple barriers to accessing donor milk, and exhibited diverse motivations for considering its use. Key barriers included misconceptions about the value of donor milk for premature infants, concerns over quality and safety, psychological hesitations, and limited access to human milk banks. However, some participants saw donor milk as a way to support breastfeeding beliefs and alleviate the burdens associated with breastfeeding. DISCUSSION:This study explored challenges in HMBs and donor milk use, emphasizing the necessity for targeted education.

Antenatal depression (AND) is a common complication during pregnancy, particularly in rural China, where access to mental health resources is limited. This study aimed to examine the relationship between positive psychological capital (PsyCap) and AND, and to explore the mediating roles of maternal health literacy (MHL) and social support (SS). A cross-sectional survey was conducted among 1,683 pregnant women from seven rural regions in China. Participants completed validated instruments measuring PsyCap, SS, MHL, and AND. Data were analyzed using Pearson correlations, hierarchical regression, and structural equation modeling. Mediation effects were tested with 5,000 samples bootstrapping. A total of 51.1

Purpose:The study examined the effects of partners' intimacy and disclosure levels on their own and their spouses' experiences of relational uncertainty, changes in interdependence, and relational turbulence. Methods:A total of 201 married couples parenting a child with autism spectrum disorder (ASD) who was beginning school or who had started school in the past 6 months completed three questionnaires and provided demographic information. Result:Only scores for parental disclosure showed no correlation (r = 0.097, P > 0.05), whereas the other variables were correlated. Only parental intimacy demonstrated a correlation (r = 0.154, P < 0.05). Parental dyadic coping was correlated with parental disclosure (mothers: r = 0.448, P < 0.01; fathers: r = 0.445, P < 0.01). The mode Actor-Partner Interdependence Model examined the effect of overall intimacy on dyadic coping and presented a qualified fit: (χ2) =76.466, comparative fit index = 0.99, and root mean square error of approximation = 0.027. The partner effect of fathers' intimacy on mothers' dyadic coping was statistically significant (B = 0.344, P < 0.001), whereas mothers' intimacy was not significantly related to fathers' dyadic coping (B = 0.64, P > 0.24). Conclusion:The findings indicate that parental intimacy and self-disclosure within dyadic coping influence certain relationship qualities. Furthermore, individuals' perceptions of their spouse's dyadic coping abilities were a stronger predictor of relational turbulence than self-reported coping. These results offer important insights into how married couples can safeguard their relationship during their child's health-related transitions.

BackgroundA low breastfeeding rate causes an increased health care burden and negative health outcomes for individuals and society. Coparenting is an essential tactic for encouraging breastfeeding when raising a child. The efficacy of the coparenting interventions in enhancing breastfeeding-related outcomes is controversial. ObjectiveThis study aimed to examine the effects of coparenting interventions on exclusive breastfeeding rates, exclusive breastfeeding duration, breastfeeding knowledge, parenting sense of competence, coparenting relationships, depressive symptoms in new couples at 1 and 6 months post partum, and the BMI of infants 42 days post partum. MethodsThis was a randomized, single-blinded controlled clinical trial. Eligible couples in late pregnancy in a hospital in central China were randomly assigned to 2 groups. While couples in the control group received general care, couples in the intervention group had access to parenting classes, a fathers’ support group, and individual counseling. Data were collected at baseline (T0), 1 month post partum (T1), and 6 months post partum (T2). Data on exclusive breastfeeding rate and exclusive breastfeeding duration were analyzed using the chi-square, Fisher exact, or Mann-Whitney U tests; coparenting relationships and the infant’s BMI were analyzed using an independent samples t test; and breastfeeding knowledge, parenting sense of competence, and depressive symptoms were analyzed using a generalized estimation equation. ResultsA total of 96 couples were recruited, and 79 couples completed the study. The intervention group exhibited significantly higher exclusive breastfeeding rates at T1 (90% vs 65%, P=.02) and T2 (43.6% vs 22.5%, P=.02), compared with the control group. Exclusive breastfeeding duration was extended in the intervention group than in the control group at T1 (30, range 30-30 days vs 30, range 26.5-30 days; P=.01) and T2 (108, range 60-180 days vs 89, range 28-149.3 days; P<.05). The intervention group exhibited greater improvements in maternal breastfeeding knowledge (β=.07, 95% CI 0.006-0.13; P=.03) and maternal parenting sense of competence (β=5.49, 95% CI 2.09-8.87; P<.01) at T1, enhanced coparenting relationships at T1 (P<.001) and T2 (P=.02), paternal breastfeeding knowledge at T2 (β=.25, 95% CI 0.15-0.35, P<.001), paternal parenting sense of competence at T1 (β=5.35, 95% CI 2.23-8.47, P<.01), and reduced paternal depressive symptoms at T2 (β=.25, 95% CI 0.15-0.35, P<.001), and there was a rise in infants’ BMI at 42 days post partum (β=.33, 95% CI 0.01-0.64, P=.04). ConclusionsAn evidence-based breastfeeding coparenting intervention is effective in improving exclusive breastfeeding rate, prolonging exclusive breastfeeding duration within the initial 6 months post partum, enhancing parental breastfeeding knowledge, levels of parenting sense of competence and coparenting relationship, infant’s BMI, and reducing paternal depressive symptoms. Trial RegistrationChinese Clinical Trial Registry ChiCTR2300069648; https://tinyurl.com/2p8st2p8

BACKGROUND:Fear of childbirth is a common concern in pregnant women and their spouses due to the unpredictability of the process and outcome of a delivery, which results in adverse effects on mental health, birth outcomes and family intimacy. However, there is a lack of studies that explore the influencing factors of fear of childbirth among expectant couples from a dyadic perspective. The aim of this study is to explore the correlation of dyadic coping, resilience and fear of childbirth in pregnant couples and to construct an actor-partner interdependence model to verify dyadic effects. METHODS:This cross-sectional survey included 420 couples and was conducted between November 2022 and March 2023 in the obstetric department at two hospitals in China. Convenience sampling and an actor-partner interdependence model was used. FINDINGS:The prevalence of fear of childbirth among pregnant women and their spouses is 37.4 % and 33.1 %, respectively. Women's resilience and dyadic coping had a partner effect on spouses' fear of childbirth, in addition to an actor effect on their own fear of childbirth. Spouses' resilience and dyadic coping had only actor effects on themselves, and no partner effect was found on the pregnant women. CONCLUSION:Women's fear of childbirth was positively associated with spouses' fear of childbirth. Interventions for fear of childbirth should include improving resilience and enhancing dyadic stress support and coping. This study provides empirical evidence for future clinical research and interventions on the psychological status of pregnant women and their partners during pregnancy.

The implementation of early essential newborn care (EENC) is important to maternal and neonatal health. However, few studies have conducted a complete procedure of EENC in cesarean section. This study aimed to systematically evaluate the effects of EENC during and after cesarean section. A randomized controlled trial was conducted at a tertiary hospital in Wuhan, China. Full-term pregnant women who had no comorbidities and underwent elective cesarean section were recruited and received EENC intervention or routine health care. The Infant Breastfeeding Assessment Tool (IBFAT), the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), a questionnaire of the breastfeeding behavior, the Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) were used to collect data. The correlation between EENC implementation and breastfeeding, maternal-infant attachment, postpartum depression, and other maternal and neonatal outcomes was analyzed. Mother-newborn pairs (N = 157) were enrolled in this study, 78 in the EENC group and 79 in the control group. A total of 155 (98.8 www.chictr.org.cn , ChiCTR2300074760, retrospectively registration. Registration Date: August 15, 2023. EENC has been implemented in women who give birth vaginally and has been proven to have numerous benefits in aiding maternal postpartum recovery, increasing breastfeeding rates, and reducing admission rates to NICU. For a long time, China's cesarean section rate has remained high. While EENC has been well-promoted among women undergoing vaginal deliveries, its application in cesarean sections has been limited. Therefore, we conducted a randomized controlled trial, one group received EENC intervention and the other did not receive it. We collected data before and after the intervention to explore the safety and effectiveness of implementing EENC techniques in cesarean sections. The results indicate that the application of EENC in cesarean sections is safe and feasible. It can improve breastfeeding behaviors and mother-infant attachment. This intervention is recommended to be implemented on a larger scale.

Objectives: This study was conducted to investigate the stigma status of infertile women in China and to determine the influencing factors. Methods: 366 infertile women from the gynecological and reproductive departments of two tertiary hospitals completed socio-demographic questionnaires, the Infertility Stigma Scale (ISS) and the Mandarin Fertility Problem Inventory (M-FPI). Results: The scores of stigma and infertility-related stress in infertile women were (52.51 ± 17.74) and (150.03 ± 17.51), respectively. Multiple regression analysis found that location of residence, regarding children as the most important thing in life, talking to others about infertility and infertility-related stress were the main influencing factors of stigma in infertile women, which explained 17.3% of the total variance. Conclusions: In the current study, the level of stigma in women with infertility was at the middle range. Location of residence, regarding children as the most important thing in life, whether to talk with others about infertility and infertility-related stress were the four main influencing factors of stigma.

Objectives The pressure of internal competition at the college level has increased in recent years in China with an impact on nursing students' learning and well-being. This study aimed to investigate the current situation and factors affecting professional identity, learner well-being and self-regulated learning of undergraduate nursing students in the Neijuan ecology of the "double tops" universities, and to explore the relationships between these three variables. Methods A cross-sectional design was adopted to conduct an online survey of 322 Chinese undergraduate nursing students from seven "double tops" universities. The survey included socio-demographics characteristics, students' professional identity, learner well-being, and self-regulated learning. Results Results of Pearson correlation analysis showed that professional identity was significantly and positively correlated with learner well-being (R = 0.795, p < 0.001); professional identity was significantly and positively correlated with self-regulated learning (R = 0.843, p < 0.001); and, self-regulated learning was significantly and positively correlated with learner well-being (R = 0.852, p < 0.001). After mediation effect testing, self-regulated learning had a mediating effect between professional identity and learner well-being (95 % CI 0.366-0.548, p < 0.001). Professional identity had a positive predictive effect on self-regulated learning (a = 0.570, p < 0.001), and self-regulated learning also had a positive predictive effect on learner well-being (b = 0.798, p < 0.001). The direct effect of professional identity on learner well-being (0.225) and its mediating effect (0.455) account for 33.1 % and 66.9 % of the total effect (0.680), respectively. Conclusions The learner well-being of undergraduate Chinese nursing students is in the middle to upper range, and it is crucial to enhance professional identity and develop students' self-regulated learning to improve their learner well-being. This study provides empirical evidence to support the mediating effect of self-regulated learning on the relationship between professional identity and learner well-being among undergraduate nursing students in "double tops" universities. Universities are expected to strengthen career planning guidance and professional competence training for students as early as possible in order to develop quality nursing education programs that produce graduates who enter and remain in the workforce.

PROBLEM AND BACKGROUND:There is a low world rate of exclusive breastfeeding and a short duration of breastfeeding. More studies have constructed interventions to improve breastfeeding behavior, but the actual effect is not significant. AIM:The purpose of this review is identifying the ways that various theories have an influence on theory-based breastfeeding intervention studies. METHODS:A scoping review using Arksey and O'Malley's framework explored breastfeeding promotion practices. PubMed, The Cochrane Library, Web of Science, Embase, and CINAHL databases were searched from database creation to March 9, 2024. Building on previous research, key terms were used to search the literature. Data analysis involved descriptive and interpretive summaries of theories used and the proposed interventions. FINDINGS:An online search yielded 906 articles, with 28 meeting the inclusion criteria for the scoping review, including 5 reviews and 23 articles. Reviews demonstrated that interventions based on theories were more effective. Articles promoting breastfeeding used theories of self-efficacy (n = 9), theory of planned behavior (n = 8), social cognitive theory (n = 5) and individual and family self-management theory (n = 1). These theories were used in developing specific content of the intervention program (n = 20, 86.9%), constructing the framework of the program (n = 10, 43.5%), and evaluating outcomes (n = 19, 82.6%). Most interventions focused on education, professional support, and/or peer support for breastfeeding. CONCLUSION AND DISCUSSION:Theory can guide decisions and play a role in selecting a methodology or lens. Researchers should make deliberate choices in the use of a theory that relates to aspects of breastfeeding behavior. Future interventions based on theories should be more varied and effective and need to consider families' and social factors.

BACKGROUND:Evidence on the mental status of expectant fathers indicates that their fears of childbirth (FOC) are of great concern. In consideration of expectant fathers' increasing involvement during pregnancy and childbirth, it is necessary to provide a reliable instrument to measure the psychometric properties of expectant fathers. The purpose of this study was to revise the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ A) for expectant fathers, analyze the psychometric properties and explore its applicability to the Chinese population. METHODS:The W-DEQ A was revised to apply to Chinese men following the completion of a cross-sectional study. Content validity was assessed by an expert panel of specialists in obstetrics. Construct validity was assessed using exploratory factor analysis and confirmatory factor analysis. Reliability was assessed by the internal consistency coefficient and retest reliability. RESULTS:A total of 741 expectant fathers participated in this study. The item-level content validity index (I-CVI) was greater than 0.8, while the scale-level CVI (S-CVI) was 0.92, indicating satisfactory content validity. Exploratory factor analysis revealed eight factors, accounting for 60.97% of the cumulative variance. Confirmatory factor analysis revealed acceptable structural validity of the father's version of the W-DEQ A (W-DEQ AF), demonstrating a good model fit. The Cronbach's alpha for the W-DEQ AF was 0.843, indicating good reliability of the scale. CONCLUSIONS:The Chinese version of the W-DEQ-AF is reliable and could be considered for use with expectant fathers in China to assess their psychological status and fear of childbirth during pregnancy of their spouse.

Fear of childbirth not only brings negative psychological experiences to expectant fathers and affect their ability to prepare for parenthood but can even affect children's emotional and cognitive development. It is essential to identify men with a more severe fear of birth and its related risk factors for the better transition of fathers' role. The objective of this study was to investigate the prevalence of fear of childbirth among Chinese expectant fathers, identify its contributing factors and explore the association among fear of childbirth, resilience and dyadic coping. A cross-sectional survey was conducted in the obstetric department of two tertiary hospitals in Wuhan, China. The socio-demographic questionnaire, the father's version of the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ A), the Connor-Davidson Resilience Scale-10 (CD-RISC), and the Dyadic Coping Inventory (DCI) were used to explore the correlation of fear of childbirth, resilience and dyadic coping of participants. Ultimately, a total of 1176 expectant fathers were included in this study. The prevalence of fear of childbirth was 32.1%. Gestational weeks of pregnant women, monthly income, adverse birth experience, gravidity and parity of pregnant women were considered risk factors for the expectant fathers with fear of childbirth. Furthermore, there was a weak negative correlation between fear of childbirth and resilience and dyadic coping. In conclusion, the prevalence of fear of childbirth in expectant fathers in China was high. Adequate identification of factors influencing the fear of childbirth among expectant fathers is necessary to reduce the fear of childbirth and to develop appropriate interventions in preparing fathers for their new parenting role.

ObjectiveTo translate, cross-culturally adapt and test the reliability and validity of a Chinese version of the Infertility Self-Efficacy scale.MethodsThe Infertility Self-Efficacy (ISE) scale was translated into Chinese using forward and backward translations, expert consultation, cognitive interviews and a pilot study. To test the scale’s reliability and validity, 515 infertile women in two hospitals were recruited to evaluate the Chinese version of the scale. Content validity was assessed by means of expert consultation. Exploratory factor and confirmatory factor analyses were performed using SPSS 26.0 and Amos 24.0. Reliability tests of the scale included Cronbach’s alpha coefficient, split-half reliability and test-retest reliability.ResultsThe Chinese version of the ISE scale contains 16 items and one dimension. Content validity of the scale was 0.96. Results of exploratory factor analysis suggested that the one factor model was suitable for the scale, and factor loading of all items was greater than 0.4. Model fitting parameters of confirmatory factor analysis of the ISE scale were χ2/df =2.710, Root Mean Square Error Approximation (RMSEA)=0.079, Standardized Root Mean Square Residual (SRMR)=0.042, Comparative Fit Index (CFI)=0.953, and Tucker–Lewis Index (TLI)=0.939. Cronbach’s alpha coefficient of the Chinese ISE was 0.980; split-half coefficient was 0.972 and retest reliability was 0.848 (P<0.01).ConclusionThe Chinese ISE scale is a reliable and valid instrument to evaluate the self-efficacy of infertile Chinese women.