| Learning Objective #1: Describe three factors influencing expectant women's appraisal of their pregnancy risk status | |||
| Learning Objective #2: Describe the effect of expectant women's appraisal of their pregnancy risk status on their emotions, coping behaviors and attachment |
Objective: To test a structural equation model of the effect of expectant women's appraisal of pregnancy risk on maternal-fetal attachment.
Design: Nonexperimental, survey design.
Population, Sample, Setting, Years: 174 expectant women diagnosed with hypertension, diabetes, or preterm labor were recruited from three high-risk maternity units in a large midwestern hospital during 1999-2001.
Concepts Studied Together: Uncertainty in illness and perceived control over health were proposed to be antecedents to women's appraisal of pregnancy risk. Pregnancy risk appraisal was proposed to affect emotions, coping behaviors, and maternal-fetal attachment.
Methods: Following human subjects guidelines, women were asked to complete the survey packet while waiting for their appointment or during their hospital stay. The packet consisted of Mishel's (1990) Uncertainty in Illness Scale; Wallston, Stein, and Smith's (1994) Multidimensional Health Locus of Control–Form C; Smith, Wallston, and Smith's (1995) Perceived Health Competency Scale; Gray's (2001) Pregnancy Risk Appraisal Form; Stewart, Ware, Sherbourne, and Wells (1991) Medical Outcomes Study Psychological Distress/Well-Being Battery; Vitaliano, Russo, Carr, Maiuro, and Becker's (1985) Revised Ways of Coping Checklist; Cranley's (1981) Maternal-Fetal Attachment Scale.
Findings: AMOS 4 analysis revealed the fit of the proposed model was poor, chi square (54, N=174)=2476.41, p<.001. The respecified model had an acceptable fit, chi square (58, N=174)=59.32, p=.43 with a significant positive direct effect of uncertainty on emotions, a direct negative effect of efficacy on both emotions and risk appraisal.
Conclusions: Both uncertainty and self-efficacy affect risk appraisal. Emotions were impacted more by uncertainty than the appraised risk. Pregnancy risk had no significant impact on maternal-fetal attachment.
Implications: Efforts to keep women informed to decrease uncertainty and support their self-efficacy may impact emotional response to high-risk pregnancy. Concerns regarding maternal-fetal attachment should be based on issues other than pregnancy risk status.
Back to Family Health
Back to 14th International Nursing Research Congress
Sigma Theta Tau International
10-12 July 2003