This study was designed to compare the effects of a prenatal education program based on the Indivisible Self Model with those of a needs-based prenatal education program on psychosocial outcomes among pregnant women.
This study is designed as a single-blind randomized controlled trial to compare the effects of an Indivisible Self Model-based prenatal education program with those of a needs-based prenatal education program on psychosocial outcomes among pregnant women residing in Aksaray, Türkiye, between December 2025 and November 2026. Eligible pregnant women who meet the inclusion criteria will be informed about the study objectives and procedures, and written informed consent will be obtained prior to participation. Participants will be randomly allocated to one of two intervention groups. The intervention group will receive a prenatal education program based on the Indivisible Self Model. Training will be delivered by a researcher-midwife in face-to-face group sessions consisting of 7-8 participants, with a total of five groups. The program will comprise 10 sessions delivered over two consecutive days, with five 45-minute sessions scheduled each day and a 15-minute break between sessions. The curriculum will be structured around the five dimensions of the Indivisible Self Model (Creative Self, Coping Self, Social Self, Essential Self, and Physical Self). Each dimension will include an interactive theoretical component followed by practical activities designed to enhance participants' knowledge, skills, and psychosocial well-being. The control group will receive a needs-based prenatal education program developed according to participants' identified educational needs and the Turkish Ministry of Health's Standard Training Content for Pregnant Information Classes. Training will likewise be delivered face-to-face by the researcher-midwife to groups of 7-8 participants, with five groups in total. The program will consist of 10 sessions conducted over two consecutive days, following the same schedule as the intervention group. The curriculum will focus on pregnancy, childbirth, breastfeeding, postpartum care, and newborn care, aiming to improve participants' knowledge and practical skills. Educational sessions will incorporate interactive teaching strategies, including open-ended questioning, reflective listening, affirmations, and communication techniques appropriate to the learning objectives. Delivery of both educational programs is expected to be completed within a 10-week period. Outcome measures and study questionnaires will be administered in person at three time points: baseline (before the first training session), immediately after completion of the education program, and during the early postpartum period (12-24 hours after birth). The study protocol has been developed and will be conducted in accordance with the CONSORT guidelines.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
76
The Indivisible Self Model-based prenatal education program consists of 10 face-to-face group sessions delivered over 2 days. The program is structured around the five components of the Indivisible Self Model (Primary Self, Coping Self, Social Self, Creative Self, and Physical Self) and includes an interactive theoretical presentation and a practical application session for each component. Each training day comprises five 45-minute sessions with a 15-minute break between sessions. The program is designed to promote psychosocial well-being and enhance coping skills among pregnant women.
The needs-based prenatal education program consists of 10 face-to-face group sessions delivered over 2 days. Developed according to the Republic of Türkiye Ministry of Health's antenatal education guidelines (updated from 2024 onward), the program is tailored to participants' educational needs and covers pregnancy, childbirth, breastfeeding, postpartum, and newborn care. Each day includes five 45-minute sessions with 15-minute breaks. The program is designed to improve participants' knowledge, skills, and preparedness for childbirth and the postpartum period.
Psychological Well-Being Scale
Participants' current levels of psychological well-being will be assessed using the "Psychological Well-Being Scale" developed by Diener et al. (2009-2010). This scale is a measurement tool developed to complement existing well-being measures and aims to assess individuals' socio-psychological well-being levels. The scale has a 7-point Likert-type response format and consists of a total of 8 items, each rated from "1 = Strongly disagree" to "7 = Strongly agree". All items consist of positive statements, and the possible scores on the scale range from 8 to 56. Higher scores indicate a higher level of psychological well-being. The internal consistency of the scale was found to be α = .87 using Cronbach's alpha coefficient.
Time frame: Baseline: Within 24 hours before the education program. Post-intervention: Within 24 hours after completion of the education program. Postpartum follow-up: Within 12-24 hours after childbirth.
Revised Emotional Consistency Scale
Participants' levels of sense of coherence will be assessed using the Revised Emotional Coherence Scale, developed by Bachem and Maercker in 2016 to improve upon Antonovsky's original model. Based on Antonovsky's "Sense of Coherence" theory, this scale aims to assess individuals' perceptions of their life experiences as meaningful, comprehensible, and manageable. The scale uses a five-point Likert-type response format, with items rated from "1 = Not true at all" to "5 = Very true". The minimum possible score is 13, and the maximum is 65. Higher scores indicate that individuals perceive their lives as more meaningful, comprehensible, and manageable, thus indicating a higher level of emotional coherence. In the Turkish validity and reliability study of the scale, the Cronbach's alpha coefficient for overall internal consistency was determined as α = 0.82. The alpha values for the sub-dimensions are α = 0.77 for significance, α = 0.77 for compr
Time frame: Baseline: Within 24 hours before the education program. Post-intervention: Within 24 hours after completion of the education program. Postpartum follow-up: Within 12-24 hours after childbirth.
Self-Efficacy Scale for Normal Birth
Participants' perceptions of control and support during childbirth will be assessed using the Perceived Control and Support During Childbirth Scale developed by Ford, Ayers, and Wright in 2009. The Perceived Control and Support During Childbirth Scale is a scale developed to assess women's perceptions of control and support during childbirth in the postpartum period.The scale consists of three sub-dimensions: internal control, external control, and perceived support, and contains a total of 33 items. The PCS, which has a five-point Likert scale, is rated from "1 = Strongly disagree" to "5 = Strongly agree". The minimum possible score on the scale is 33, and the maximum score is 165. Higher scores indicate that the individual felt more control and perceived more support during childbirth. In the Turkish reliability and validity study of the scale, the Cronbach's alpha coefficient was reported as 0.95.
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Time frame: Baseline: Within 24 hours before the education program. Post-intervention: Within 24 hours after completion of the education program.
Perceived Control and Support in Childbirth Scale
Participants' self-efficacy levels will be assessed using the Self-Efficacy Scale for Normal Delivery, developed by Chu et al. in 2017. This scale is an important assessment tool, particularly for determining women's attitudes towards normal delivery and their level of self-confidence during the prenatal period. The scale consists of 9 items, each scored from 0 (no confidence at all) to 10 (very confident). Thus, the scale offers 11 different score options for each item. The total scores that can be obtained from the scale range from 0 to 90, with higher scores indicating a high level of self-efficacy belief in normal delivery. Cronbach's alpha coefficient was reported as 0.994 for the 2nd trimester; 0.956 for the 3rd trimester; and 0.980 for the entire scale. The Turkish adaptation, validity, and reliability study of the Self-Efficacy Scale for Normal Birth was carried out by Kahraman and Alparslan in 2022.
Time frame: Postpartum follow-up: Within 12-24 hours after childbirth.