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Assessment of self-management empowerment program on sense of coherence, self-‌efficacy and postpartum anxiety in cesarean mothers randomized trial
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  • Published: 09 February 2026

Assessment of self-management empowerment program on sense of coherence, self-‌efficacy and postpartum anxiety in cesarean mothers randomized trial

  • Fariba Najafi ShahaliBegloo1,
  • Farahnaz Kamali2,
  • Sudabeh Mohamadi3 &
  • …
  • Maryam Ravanipour  ORCID: orcid.org/0000-0002-3421-45124,5 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Health care
  • Medical research
  • Psychology

Abstract

Conflicting study outcomes on women undergoing cesarean sections underscore the complex relationship between repeated cesarean deliveries and factors such as sense of coherence, self-efficacy, and anxiety, highlighting the need for empowerment-based interventions to improve mothers’ mental health and parenting outcomes. This randomized controlled trial aimed to evaluate an educational program based on the self-management empowerment model on sense of coherence, self-efficacy, and postpartum anxiety in cesarean mothers. In 2024, 98 women scheduled for cesarean delivery at Shohada-ye-Khalij-e-Fars Hospital, Bushehr, Iran, were selected by convenience sampling and randomly assigned via block randomization to intervention (n = 49) or control (n = 49) groups. The intervention group received a five-step education program over two months. Antonovsky’s Sense of Coherence Questionnaire, Sherer’s Self-Efficacy Scale, and Spielberger Anxiety Questionnaire were administered pre- and post-intervention. Data were analyzed using SPSS version 27 with descriptive/inferential statistics (p < 0.05). Mean changes showed significant intervention effects: self-efficacy − 1.58 ± 7.31 (control) versus 2.79 ± 6.42 (intervention, ŋ2 = 0.151, p < 0.001); sense of coherence 2.67 ± 8.36 (control) versus 4.81 ± 6.58 (intervention, ŋ2 = 0.073, p = 0.018); anxiety 0.02 ± 15.99 (control) versus − 13.07 ± 13.7 (intervention, ŋ2 = 0.224, p < 0.001). The self-management empowerment model significantly improved sense of coherence and self-efficacy while reducing postpartum anxiety, recommending its integration into postpartum care programs.

Trial Registration http://www.irct.ir/, IRCTID: IRCT20130422013092N12 registered July 11, 2024.

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Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Abbreviations

CS:

Cesarean section

CONSORT:

Consolidated standards of reporting trials

PTSD:

Post-traumatic stress disorder

RCT:

Randomized controlled trial

SOC:

Sense of coherence

SES:

Socioeconomic status

WHO:

World Health Organization

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Acknowledgements

The present manuscript was extracted from the Master’s thesis by Fariba Najafi ShahaliBegloo, Faculty of Nursing and Midwifery of Bushehr University of Medical Sciences, Bushehr, Iran. The study was approved by the Research Council and the Research Ethics Committee (code: (IR.BPUMS.REC.1403.102)) of Bushehr University of Medical Sciences, Bushehr, Iran. The study protocol was registered at the Iranian Registry of Clinical Trials (registration number: IRCT20130422013092N12). We would like to thank the Deputy of Research at Bushehr University of Medical Sciences for the financial support. We would like to express our gratitude to the local authorities for their support and all mothers who participated in this study for their active participation in the study.

Funding

This work was supported by the Research Council of Bushehr University of Medical Sciences (Grant Number: IR.BPUMS.REC.1403.102). The Research Council of Bushehr University of Medical Sciences had no role in conducting the study, data analysis or interpretation, writing the manuscript, or decisions about submitting the script for publication.

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Authors and Affiliations

  1. Department of Nursing, Faculty of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran

    Fariba Najafi ShahaliBegloo

  2. Department of Midwifery, Faculty of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran

    Farahnaz Kamali

  3. Department of Community Medicine, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran

    Sudabeh Mohamadi

  4. The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran

    Maryam Ravanipour

  5. Department of Nursing, Faculty of Nursing and Midwifery, Bushehr University of Medical Sciences, Rishehr Street, Bushehr, P.O.Box: 7518759577, Iran

    Maryam Ravanipour

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  1. Fariba Najafi ShahaliBegloo
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  4. Maryam Ravanipour
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The contribution of the authors to the research was as follows: Research design by MR, FK, SM, FN; data collection by FN; research execution by MR, FK, SM, FN; data analysis by SM; documentation by MR, FK, SM, FN; and primary responsibility for the final content by MR, FK, SM, FN. All authors were major contributions in writing the manuscript and approved the final version.

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Correspondence to Farahnaz Kamali or Maryam Ravanipour.

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Najafi ShahaliBegloo, F., Kamali, F., Mohamadi, S. et al. Assessment of self-management empowerment program on sense of coherence, self-‌efficacy and postpartum anxiety in cesarean mothers randomized trial. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37944-7

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  • Received: 03 July 2025

  • Accepted: 28 January 2026

  • Published: 09 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-37944-7

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Keywords

  • Anxiety
  • Cesarean section
  • Empowerment
  • Self-efficacy
  • Postnatal care
  • Sense of coherence
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