This Study Aimed to Examine the Effects of Individualized Care and Counseling Given to Mothers in the First Trimester of Pregnancy on Maternal Attachment, Maternal Self-efficacy and Maternal Function.

The Effect of Individualized Care and Counseling Given to Primiparous Mothers in the Postpartum Period on Maternal Attachment, Maternal Self-Efficacy and Maternal Function: Randomized Controlled Trial

Purpose of the research:

This study aimed to examine the effects of individualized care and counseling given to mothers in the first trimester after birth on maternal attachment, maternal self-efficacy and maternal function.

In this context, the hypotheses of the research are as follows:

1. Individualized care and counseling does not have a significant effect on the level of maternal attachment.
2. Individualized care and counseling does not have a positive effect on mothers' self-efficacy perceptions.
3. Individualized care and counseling does not have a significant effect on the gain of maternal function.

The study consists of experimental and control groups. The mothers of the experimental group will be interviewed in the 2nd, 4th, 6th, 8th and 12th postpartum weeks, and various surveys will be administered through counseling.

Control group mothers will not be given any training or counseling by the researcher other than the standard care and services offered in the hospital. The measurement tools applied to the experimental group mothers will be simultaneously applied to the control group mothers.

Data Collection Tools: In this study, Introductory Information Form, Mother-Infant Attachment Scale, Maternal Attachment Scale (MAS), Parent Self-Efficacy Scale (PSS) and Barkin Maternal Functioning Scale (MFFS) were used as data collection tools.

Introductory Information Form: It is a form consisting of a total of 12 questions, prepared by the researcher as a result of literature review, to be applied to pregnant women and evaluating the socio-demographic (7 questions) and obstetric characteristics (5 questions) of pregnant women.

Mother-to-Infant Bonding Scale (Mother-to-Infant Bonding Scale): The scale, which allows the mother to express the feelings she feels towards her baby with a single word, was developed by Taylor et al. in 2005. The original name of the scale is Mother-Infant Attachment Scale. The scale was adapted into Turkish by Karakulak Aydemir in 2009. Mother-Baby Attachment Scale is a 4-point Likert type scale consisting of 8 items. According to the results of the guidance, the items Loving, Neutral/feeling nothing, Joyful, Dislike and Protective are placed under the first factor, and the items Angry, Disappointment and Anger are placed under the second factor. Responses consisting of four options are scored between 0-3. The lowest score that can be obtained from the scale is 0, while the highest score is 24. The responses to the items in the scale are as follows; 0 = A lot, 1 = A lot, 2 = A little, 3 = Not at all. In the evaluation, items 1, 4 and 6 express positive emotional expressions, while items 2, 3, 5 and 7 express negative emotional expressions and are scored reversely. An increase in the score obtained from the scale indicates a mother-infant attachment problem.

Maternal Attachment Scale (MBS): The scale measuring maternal feelings and behaviors that show love was developed by Muller in 1994. The scale was first applied to mothers at 30-40 days postpartum, and then in the fourth and eighth months. The scale, adapted to Turkish society as a result of the study of Kavlak and Şirin in 2009, was tested on mothers with one- and four-month-old babies. The expressions of the one-dimensional scale, consisting of a total of 26 items in the four-point likert type, were determined as always=a (4 points), often=b (3 points), sometimes=c (2 points) and never=d (1 point).The lowest score to be obtained from the scale is 26 and the highest score is 104. A high score indicates high maternal attachment. Muller found the Cronbach Alpha coefficient of the scale to be 0.85, 0.76 and 0.85, respectively, and Şirin and Kavlak found it to be 0.77 in mothers with one-month-old babies and 0.82 in mothers with four-month-old babies.

Parental Self-Efficacy Scale (EÖS): The scale was developed by Kılıçaslan in 2007 to determine the personal judgments of parents of their first babies aged 3-6 months regarding their competence in the parental role.It is a 5-point likert-type scale consisting of 18 items. The scale has 5 sub-dimensions. Items 11, 12, 13, 16, 18 indicate baby's needs, items 1, 5, 6, 9 indicate parenting skills, items 2, 4, 10, 17 indicate baby's mental state, items 7, 8, 15 indicate baby's disorders, and items 3 and 14 indicate baby's emotions. The responses to the items in the scale are listed as strongly agree, agree, undecided, disagree and strongly disagree. The scale is scored on a scale from 1 to 5. In case of opposite statements, the scores will be reversed and the calculation will be made. The Cronbach Alpha value of the scale was found to be 0.852.

Barkin Maternal Function Scale (BAFÖ): The Turkish validity and reliability of the scale developed by Barkin in 2009 to evaluate the functional status of the mother after birth was conducted by Aydın in2016. The seven-point likert type scale consists of a total of 16 questions. The responses on the scale are numbered between 0 and 6. 0 means strongly disagree, 1 means disagree, 2 means slightly disagree, 3 means undecided, 4 means slightly agree, 5 means agree, 6 means strongly agree.The lowest score that can be obtained from the scale is 0 and the highest score is 96. Evaluation is made based on the total score. A high score means that the maternal function is high. The Barkin Maternal Function Scale, which is recommended to be used starting from 6-10 weeks postpartum and up to two years, includes five subscales: self-care, maternal psychology, baby care, social support and adaptation to motherhood. Barkin found the Cronbach Alpha value of the scale to be 0.87, and Aydın found it to be 0.73.

Inclusion Criteria:

• Being primiparous
• Having a vaginal birth
• Having given birth at term
• Being 18 years or older
• Having a single, healthy baby
• Must be at least a primary school graduate
• The mother does not have a diagnosed chronic or psychiatric disease.
• Volunteering to participate in the study

Exclusion Criteria:

• • Having a history of risky pregnancy

  • Participated in any birth preparation training program
  • The mother shows signs of mental or physical illness (self-report/clinical diagnosis).
  • Inability to communicate effectively with the mother
  • The baby has a health problem