Investigating the effect of mindfulness-based art therapy on self-efficacy of multiparous and nulliparous women: A randomized controlled trial

Background: Labor pain is a common concern among pregnant women, leading to fear and anxiety.Enhancing self-efficacy can play a crucial role in managing these complications.This study aims to evaluate the effect of mindfulness-based art therapy on the self-efficacy of multiparous and nulliparous women. Methods:The present study was a randomized clinical trial with three parallel intervention arms (Multiparous and nulliparous groups) and a control.The statistical population of the study included pregnant women (Multiparous and nulliparous groups) referring to health centers (Public and private) in Bandar Abbas city for prenatal care.A total sample size of 90 participants was determined, with 30 individuals randomly assigned to each group using a block randomization method.Participants were selected based on inclusion and exclusion criteria.Interventions were conducted in eight sessions, with 3 to 15 people in each group, in a face-to-face and coherent manner.Participants in the intervention and control groups were assessed three times: before the intervention, immediately after the intervention, and four weeks after the intervention using the Iranian Childbirth Self-Efficacy Questionnaire and the Five-Factor Mindfulness Questionnaire.The data were then analyzed using SPSS version 26 software, employing ANOVA and repeated measures tests.A significance level of less than 0.05 was considered. Results:The mean self-efficacy scores for expectations during the active stage of labor immediately after the intervention were 162.0711.28(Nulliparous), 163.0712.02(Multiparous), and 145.7727.50(Control group).Four weeks post-intervention, the scores were 162.0711.98(Nulliparous), 163.0712.02(Multiparous), and 145.7727.50(Control group).The mean self-efficacy scores for expectations during the fourth stage of labor immediately after the intervention were 155.2110.80(Nulliparous), 156.2111.12(Multiparous), and 122.7724.96(Control group).Four weeks after the intervention, these scores were 152.4610.29 (Nulliparous), 154.2311.34(Multiparous), and 121.2327.42(Control group).The mean mindfulness scores in both intervention groups (Multiparous and nulliparous) were significantly higher immediately after the intervention (p=0.001) and four weeks later (p=0.001)compared to baseline. Conclusion:The results indicated the effectiveness of mindfulness-based art therapy in enhancing self-efficacy and mindfulness among pregnant women.Thus, it is recommended that this therapeutic method be utilized to manage and reduce the fear of childbirth in pregnant women.