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Current scientific literature on VR details primarily focuses on fear and anxiety during childbirth. Variables such as attachment, fear, and self-efficacy are often considered independently. Therefore, in addition to interventions focused on the prenatal period, a need arose for holistic audiovisual and technologically supported intervention models that simultaneously address multidimensional aspects of life, such as prenatal attachment, fear of childbirth, and perception of childbirth self-efficacy.
This study is a randomized controlled trial conducted to evaluate the effects of digital storytelling applied to primiparous pregnant women via virtual reality glasses on prenatal attachment, fear of childbirth, perception of childbirth self-efficacy, and non-stress test results. The study will consist of two groups: an experimental and a control group. Participants in the experimental group will access a digital storytelling training program via virtual reality glasses and receive information and guidance on topics such as prenatal attachment, fear of childbirth, and perception of childbirth self-efficacy. Participants in the control group will receive standard care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| İntervention Arm | Experimental | Participants in the intervention group will receive digital storytelling modules using virtual reality (VR) headsets once a week for four weeks, starting at 28 weeks of gestation. Each module will include three topics (2-10 minutes). After each topic, there will be a rest period followed by an interactive session. The final two modules will be administered during the NST recording, and mother and baby status will be monitored. Each module, including the interactive session, will last 45-50 minutes. Participants will receive an educational brochure after the module and will be reminded via WhatsApp. Posttests (at the end of 36 weeks of gestation):
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| Control Arm | No Intervention | Participants in the control group will receive routine care. Posttests (at the end of 36 weeks of gestation):
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual Reality Digital Storytelling | Behavioral | Participants in the intervention group will receive digital storytelling modules using virtual reality (VR) headsets once a week for four weeks, starting at 28 weeks of gestation. Each module will include three topics (2-10 minutes). After each topic, there will be a rest period followed by an interactive session. The final two modules will be administered during the NST recording, and mother and baby status will be monitored. Each module, including the interactive session, will last 45-50 minutes. Participants will receive an educational brochure after the module and will be reminded via WhatsApp. |
| Measure | Description | Time Frame |
|---|---|---|
| Prenatal Attachment Inventory | The Prenatal Attachment Inventory (PAI) developed by Muller (1993) is used to assess the thoughts, feelings, and states experienced by women during pregnancy and to determine their attachment to their babies during the prenatal period (Muller, 1993). The Turkish validity and reliability study of the inventory, conducted by Yılmaz and Beji (2013), consists of 21 items. Each item is a four-point Likert-type scale, ranging from 1 to 4. A minimum score of 21 and a maximum score of 84 can be obtained from the scale. Increasing scores indicate increased attachment. The scale's validity and reliability performance was found to be 0.84, with a Cronbach's alpha of 0.10. | Time Frame: Pre-test (before intervention) Time Frame: Post-test (after intervention: 36th week of pregnancy, after the fourth module) |
| Wijma Childbirth Expectation/Experience Questionnaire Version A (W-DEQ-A) | Developed by Wijma et al. (1998) to assess the level of fear of childbirth experienced by pregnant women, the scale was adapted into Turkish by Körükcü (2009). Version A of the W-DEQ is a 33-item scale. Responses are numbered from 0 to 5 and are on a six-point Likert-type scale. The minimum score is 0, and the maximum score is 165. A high total score indicates a high level of fear. In the validity and reliability study of the scale, Cronbach's Alpha was found to be 0.89 (Körükcü, 2009). | Time Frame: Pre-test (before intervention) Time Frame: Post-test (after intervention: 36th week of pregnancy, after the fourth module) |
| Short Version of the Labor Self-Efficacy Scale | The Turkish adaptation of the scale, developed to measure women's self-efficacy for childbirth, was conducted by Ersoy (2011). The scale consists of two sub-dimensions: competence and outcome expectation, and a total of 32 questions. Scores for each sub-dimension range from 16 to 160. As the score on each sub-dimension increases, the competence and outcome expectation for childbirth increases. The Likert-type scale is scored from 1 to 10. In the outcome expectation sub-dimension of the scale, 1 represents "not at all useful," and 10 represents "very useful." In the competence expectation sub-dimension, questions 1 to 13 are scored as 1 "completely confident," 10 represents "not at all confident," and the remaining questions are scored as 1 "not at all confident," and 10 represents "completely confident." The first 13 questions in the competence expectation sub-dimension of the scale are reverse-scored. The total score obtained from the scale ranges from 32 to 320. As the score on the |
| Measure | Description | Time Frame |
|---|---|---|
| NST Follow-up Form | This form consists of sections containing the emotional state and NST findings experienced by pregnant women during the NST procedure. The NST results in the NST Follow-up Form will be evaluated and recorded by the researcher. | Time Frame: 34th weeks of pregnancy (during the last two modules) Time Frame: 36th weeks of pregnancy (during the last two modules) |
| Measure | Description | Time Frame |
|---|---|---|
| Video Immersion Scale (VIS) | The Video Immersion Scale, developed by Visser et al. (2016), was adapted into Turkish by Deryakulu et al. (2019). The scale consists of five factors and a total of 15 items. The Cronbach's alpha internal consistency coefficients calculated for the subfactors and the entirety of the Video Immersion Scale, which is a seven-point Likert-type scale, are as follows: Factor 1 (Attention) 0.57; Factor 2 (Narrative World Immersion) 0.73; Factor 3 (Identity) 0.87; Factor 4 (Empathy) 0.78; Factor 5 (Emotion) 0.69; and for the entire scale, 0.90. In this study, the Cronbach's alpha reliability coefficients for the factors were, respectively, Factor 1 (Attention) 0.57; Factor 2 (Entering the narrative world) was calculated as 0.71; Factor 3 (Identity) as 0.70; Factor 4 (Empathy) as 0.72; Factor 5 (Emotion) as 0.78; and 0.81 for the entire scale. |
Inclusion Criteria:
Exclusion Criteria:
Only individuals who are biologically female and experiencing their first reproduction are eligible to participate.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| RUKİYE DİKMEN, PhD Student | Contact | +905433686510 | rukiye.dikmen@yobu.edu.tr |
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Individual participant data will not be shared to protect participant confidentiality and as data was collected only for this study.
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Arm 1 Intervention Arm: Participants in the intervention group will receive digital storytelling modules using virtual reality (VR) headsets once a week for four weeks, starting at 28 weeks of gestation. Each module will include three topics (2-10 minutes). After each topic, there will be a rest period followed by an interactive session. The final two modules will be administered during the NST recording, and mother and baby status will be monitored. Each module, including the interactive session, will last 45-50 minutes. Participants will receive an educational brochure after the module and will be reminded via WhatsApp.
Arm 2 Control Arm: Participants in the control group will receive routine care.
Posttests (at the end of 36 weeks of gestation):
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There is no other hidden side to this study.
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| Time Frame: Pre-test (before intervention) Time Frame: Post-test (after intervention: 36th week of pregnancy, after the fourth module) |
| Time Frame: Post-intervention (post-intervention: 36th week of pregnancy, after the fourth module) |
| Virtual Reality Glasses Application Satisfaction Level Information Form | This form will include questions prepared by researchers to determine satisfaction with the video watched with virtual reality glasses. | Time Frame: Post-intervention (post-intervention: 36th week of pregnancy, after the fourth module) |