title: The relationships of social support, uncertainty, self-efficacy, and commitment to prenatal psychosocial adaptation.
abstract: OBJECTIVE
  To report a study of the relations of prenatal psychosocial adaptation, social support, demographic and obstetric characteristics, uncertainty, information-seeking behaviour, motherhood normalization, self-efficacy, and commitment to pregnancy.
  
  
  BACKGROUND
  Prenatal psychosocial assessment is recommended to identify psychosocial risk factors early to prevent psychiatric morbidities of mothers and children. However, knowledge on psychosocial adaptation and its explanatory variables is inconclusive.
  
  
  METHODS
  This study was non-experimental, with a cross-sectional, correlational, prospective design.
  
  
  METHODS
  The study investigated Hong Kong Chinese women during late pregnancy. Convenience sampling methods were used, with 550 women recruited from the low-risk clinics of three public hospitals. Data was collected between January-April 2007. A self-reported questionnaire was used, consisting of a number of measurements derived from an integrated framework of the Life Transition Theory and Theory of Uncertainty in Illness. Explanatory variables of psychosocial adaptation were identified using a structural equation modelling programme.
  
  
  RESULTS
  The four explanatory variables of the psychosocial adaptation were social support, uncertainty, self-efficacy, and commitment to pregnancy. In the established model, which had good fit indices, greater psychosocial adaptation was associated with higher social support, higher self-efficacy, higher commitment to pregnancy, and lower uncertainty.
  
  
  CONCLUSIONS
  The findings give clinicians and midwives guidance in the aspects to focus on when providing psychosocial assessment in routine prenatal screening. Since there are insufficient reliable screening tools to assist that assessment, midwives should receive adequate training, and effective screening instruments have to be identified. The explanatory role of uncertainty found in this study should encourage inquiries into the relationship between uncertainty and psychosocial adaptation in pregnancy.
authors.affiliation: School of Nursing The University of Hong Kong. whchoi@hku.hk
authors.forename: W H
authors.initials: WH
authors.lastname: Hui Choi
authors.forename: G L
authors.initials: GL
authors.lastname: Lee
authors.forename: Celia H Y
authors.initials: CH
authors.lastname: Chan
authors.forename: Ray Y H
authors.initials: RY
authors.lastname: Cheung
authors.forename: Irene L Y
authors.initials: IL
authors.lastname: Lee
authors.forename: Cecilia L W
authors.initials: CL
authors.lastname: Chan
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006723:Hong Kong; D006801:Humans; D016013:Likelihood Functions; D008960:Models, Psychological; D009042:Motivation; D011247:Pregnancy / Q000523:psychology*; D011295:Prenatal Care; D011446:Prospective Studies; D015203:Reproducibility of Results; D020377:Self Efficacy; D012944:Social Support; D035501:Uncertainty