Effect of Positive Psychology Interventions on the Quality of Prenatal Care Offered by Midwives: A Field Trial

Fatemeh Shaghaghi, Zahra Abedian, Negar Asgharipour, Habibollah Esmaily5, Mohammad Forouhar6


Background: The quality of prenatal care has been recognized as critical to the effectiveness of care in optimizing maternal and child health outcomes. This study examined the effect of positive psychology interventions on the quality of prenatal care offered by midwives.

Materials and Methods: This field trial was conducted on 60 midwives working in community health centers in Mashhad, Iran, from September 23, 2015 to March 20, 2016. Initially, centers No. 1 and No. 3 were selected via cluster sampling from among the five healthcare centers of Mashhad. Then, all subsidiaries of these centers were listed and assigned to intervention and control groups through simple random sampling. Thus, 60 midwives were randomly assigned to two equal intervention and control groups. The intervention, based on Seligman’s Well‑Being Theory, was presented weekly with homework in eight 2‑h sessions. Before the interventions and immediately after the intervention, the Oxford Happiness Questionnaire (OHQ) and Ryff’s Scales of Psychological Well‑Being (SPWB) were completed by the midwives, and the Quality of Prenatal Care Questionnaire (QPCQ) was completed by two pregnant women for each midwife.

Results: After the intervention, the mean [Standard Deviation (SD)] score of the overall quality of prenatal care in the intervention group was significantly higher than that of the control group [mean (SD) = 1.51 (0.49) vs. 0.05 (0.21); t43,12 = 18.7, p < 0.001].

Conclusions: It seems that improving the well‑being of midwives through positive psychology interventions is effective on the quality of prenatal care provided by them.


Iran, mental health, positive psychology interventions, prenatal care, quality of health

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Sword W, Heaman MI, Brooks S, Tough S, Janssen PA, Young D, et al. Women’s and care providers’ perspectives of quality prenatal care: A qualitative descriptive study. BMC Pregnancy Childbirth 2012;12:29.

Jahani Shourab N, Ghaffari Sardasht F, Jafarnejad F, Esmaili H. Assessment of prenatal care process based on Donabedian model in Mashhad health centers. Iran J Obstet Gynecol Infertil 2013;16:7 17.

Maternal mortality World Health Organization (W.H.O.). Available from: https://www.who.int/news room/fact sheets/ detail/maternal mortality. [Last accessed on 2018 Feb 16].

Karimi Mouneghi H, Taheri N, Behnam Vashani HR, Vagheie S. Communication skills training on quality of nursing care. Ir J

Evidence based 2013;2:37 46.

Kandasamy M. Do women’s sociodemographic characteristics or type of prenatal care provider influence quality of prenatal care? 2013. (Doctoral dissertation).

Abedian Z, Attarzadeh Hoseini SR, Mazloum SR. The effectiveness of aerobic training in leisure time on burnout of midwives: A Randomized Clinical Trial. Iran J Obstet Gynecol Infertil 2014;17:16 22.

Hamid N, Dehghanizadeh Z. The relationship between spirituality, organizational commitment and general health with job performance of clinical nurses. Quarterly Journal of Nursing Management 2012;1:20 8.

Hasheminejad N, Moqadam S, Mohammadian M, Amiri F. The relation between mental health and occupational stress in midwives of Kerman Hospitals in year 2011. Iran J Obstet Gynecol Infertil 2013;16:1 9.

Masoumi Z, Mirzaiinajmabadi Kh, Shobeiri F, Khodakarami B, Montazeri A. Quality of Life for Midwives working in Hospitals, Hamedan, Iran. J Iran Institute Health Sci Res 2013;12:283 8.

Golyan Tehrani Sh, Monjamed Z, Mehran A, Hasheminasab L. Mental Health Status among Midwives Working in Tehran’s Public Hospitals. J Hayat 2007;13:73 80.

Hadizadeh Talasaz Z, Noorani Saadoldin S, Shakeri M, Modares Gharavi M. Study the level of happiness in midwives working in maternity and its relationship to their quality of communicative performance in Mashhad in 1392. J Urmia Nurs Midwifery Fac 2015;13:320 7.

Fahami F, Amini Abchuyeh M, Aghaei A. The relationship between psychological wellbeing and body image in pregnant women. Iran J Nurs Midwifery Res 2018;23:167 71.

Forouhar M, Hoveyda R, Ghanenia M. Positivity paradigm at organizations. Tadbir 1986;27:33 8.

Sheppard VB, Zambrana RE, O’Malley AS: Providing health care to low income women: A matter of trust. Fam Pract 2004;21:484 91.

Nebrida JD, Dullas A. I’m perfectly imperfect: Exploring the relationship between PERMA model of wellbeing with self esteem among persons with disabilities. Int J 2018;7:27 44.

Robertson I, Cooper C. Wellbeing: Productivity and Happiness at Work. Basingstoke: Palgrave Macmillan; 2011. 240 p.

Gander F, Proyer RT, Ruch W. Positive psychology interventions addressing pleasure, engagement, meaning, positive relationships, and accomplishment increase well being and ameliorate depressive symptoms: A randomized, placebo controlled online study. Front Psychol 2016;20:686 7.

Luthans F, Luthans BC, Luthans KW. Organizational Behavior: An Evidence Based Approach. IAP; 2015.

Sin NL, Lyubomirsky S. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice-friendly meta-analysis. J Clin Psychol 2009;65:467 87.

Meyers MC, Van Woerkom M, Bakker AB. The added value of the positive: A literature review of positive psychology interventions in organizations. Eur J Work Organ Psychol 2013;22:618 32.

Kaplan S, Bradley JC, Luchman JN, Haynes D. On the role of positive and negative affectivity in job performance: A meta analytic investigation. J Appl Psychol 2009;94:162 76.

Heaman MI, Sword WA, Akhtar Danesh N, Bradford A, Tough S, Janssen PA, et al. Quality of prenatal care questionnaire: Instrument development and testing. BMC Pregnancy Childbirth 2014;14:188.

Hatamloye SM, Hashemi NT. The comparison of psychological well being and marital satisfaction in the fertile and infertile women. Qual J Health Psychol 2012;1:20 31. [In Persian].

Khanjani M, Shahidi SH, Fathabadi G, Mazaheri M, Shokri A. Factor structure and psychometric properties of the Ryff’s scale of Psychological well being, short form (18 item) among male and female students. J Thought Behav Clin Psychol 2014;8:27 36. [In Persian].

Hadinejad H, Zareei F. Reliability, validity and normalization of the oxford happiness questionnaire. Psychol Res 2009;12:62 77. [In Persian].

Feicht T, Wittmann M, Jose G, Mock A, von Hirschhausen E, Esch T. Evaluation of a seven week web based happiness training to improve psychological well being, reduce stress, and enhance mindfulness and flourishing: A randomized controlled occupational health study. Evid-Based Compl Alt 2013. doi: 10.1155/2013/676953.

Ouweneel E, Le Blanc PM, Schaufeli WB. Do it yourself: An online positive psychology intervention to promote positive emotions, self efficacy, and engagement at work. Career Dev Int 2013;18:173 95.

Luthans F, Avey JB, Avolio BJ, Peterson SJ. The development and resulting performance impact of positive psychological capital. Hum Resour Dev Q 2010;21:41 67.

Avey JB, Avolio BJ, Luthans F. Experimentally analyzing the impact of leader positivity on follower positivity and

performance. Leadersh Q 2011;22:282 94.

Kavoosi Z, Ghaderi A, Moeenizadeh M. Psychological well being and job performance of nurses at different wards. Research in Clinical Psychology and Counseling 2015;4:175 94.

Forouhar M, Ghanenia M, Rozegar M. Positive Energy and Job Engagement at Work. Theory, research, Evaluation and Application. Savalan pub; 2017.

Noble T, McGrath H. PROSPER: A new framework for positive education. Psychology of Well-being 2015;5:2.

Cameron K. Positive leadership: Strategies for extraordinary performance. San Francisco: Berrett-Koehler Publishers; 2012.

Handler A, Raube K, Kelley MA, Giachello A. Women’s satisfaction with prenatal care settings: A focus group study. Birth 1996;23:31 7.

Grant AM. Employees without a cause: The motivational effects of prosocial impact in public service. IPMJ 2008;11:48 66.

Wrzesniewski A, Dutton JE. Crafting a job: Previsioning employees as active crafters of their work. Academy of Management Review 2001;26:179 201.

Lewis S. Positive psychology at work: How positive leadership and appreciative inquiry create inspiring organizations. New York: John Wiley & Sons; 2011.


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