The impact of Swanson’s theory of caring on self-efficacy and pregnancy outcomes of primiparous women

Abstract

Objective: To explore the impact of Swanson’s theory of caring on self-efficacy and pregnancy outcomes in primiparous women.

Methodology: This single-center, retrospective case-control analysis included 130 primiparous women who underwent prenatal check-ups and completed delivery at Suzhou Hospital of Integrated Traditional Chinese and Western Medicine between March 2023 to March 2025. According to the prenatal care received from 28 to 37 weeks of pregnancy, participants were divided into the Swanson group (based on Swanson’s theory of caring in nursing) and the control group (routine nursing). Two groups were matched in a 1:1 ratio, with 65 cases in each group. The primary outcomes were childbirth self-efficacy and childbirth coping ability. The secondary outcomes included the degree of pain during labor, assessed using the Visual Analog Scale (VAS), the total duration of labor, the 1-minute Apgar score of the newborn and pregnancy outcomes.

Results: After intervention, the scores of Self-Efficacy Expectations (EE-16), Outcome Expectations (OE-16) and the Chinese version of the Childbirth Self-Efficacy Inventory (CBSEI-C32) in both groups significantly increased compared to before intervention and were considerably higher in the Swanson group compared to the control group (P<0.05). The delivery VAS, total labor duration, cesarean section rate and incidence of adverse pregnancy outcomes in the Swanson group were significantly lower than those in the control group. Swanson’s theory of caring was associated with a considerably higher one-minute Apgar score than routine nursing (P < 0.05).

Conclusions: Interventions based on Swanson’s care theory can effectively improve the self-efficacy of primiparous women during labor, reduce pain levels, shorten labor duration, promote vaginal delivery and improve maternal and infant outcomes.