The Effect of Counseling based on Health Promotion Awareness on Mental Health and Self-esteem in Women with Ectopic Pregnancy: A Randomized Controlled Clinical Trial

Abstract

Abstract Objectives: In all types of pregnancies women experience changes in their mental health and self-esteem condition. The aim of the present study was to determine the effect of counseling on mental health and self-esteem following an ectopic pregnancy. Study design: This was a randomized controlled clinical trial on 68 pregnant women with ectopic pregnancy referring to Al-Zahra hospital in Tabriz, Iran in 2018. The participants randomly allocated to counseling and control groups. Intervention group received 4 sessions of counseling including 1) providing medical information about ectopic pregnancy and its physical and psychological complications; 2) explaining the syndrome of sadness after losing a pregnancy; 3) mental health and ways to improve it after pregnancy loss, 4) self-esteem and how to increase it after losing a pregnancy, and control group received only routine care. Before and two weeks after the end of the intervention, data were collected by the General Health Questionnaire-28 and Rosenberg self-esteem and social-demografic and obstetrics characteristics questionnaires. Data were analyzed using SPSS 24 software. The registration number was IRCT20100109003027N41. Results: There was no significant difference between the two groups in terms of socio-demographic characteristics and the scores of mental health and self-esteem before the intervention. Two weeks after the end of the intervention, the mean (SD) total score of mental health of women in counseling and control groups were 20.1 (5.0) and 32.9 (9.8), respectively. When compared with the control group, a significant reduction in the total score of mental health (adjusted difference= -11.27; 95% Confidence Interval: -15.19 to -7.34; P<0.001) was observed in the counseling group. In counseling group compared with the control group, a significant increase in the total score of self-esteem (adjusted difference= 4.79; 95% Confidence Interval: 3.07 to 6.51; P<0.001) was observed. Conclusion: Providing counseling based on health promotion awareness by the midwife can help reduce mental health problems and increase self-esteem. For this reason, counseling should be considered as part of care after losing a pregnancy.