The effect of counseling based on health promotion awareness on mental health and self-esteem in women with ectopic pregnancy: a randomized controlled clinical trial
Abstract
Objectives In all types of pregnancies women experienced changes in their mental health and self-esteem condition. The aim of this study was to determine the effect of counseling on mental health and self-esteem following an ectopic pregnancy (EP).Study design This was a randomized controlled clinical trial on 68 pregnant women with EP referring to Al-Zahra hospital in Tabriz, Iran in 2018. The participants randomly allocated to counseling and control groups. Intervention group received four sessions of counseling including 1) providing medical information about EP and its physical and psychological complications; 2) explaining the syndrome of sadness after losing a pregnancy; 3) mental health and ways to improve it after pregnancy loss; and 4) self-esteem and how to increase it after losing a pregnancy and control group received only routine care. Before and 2 weeks after the end of the intervention, data were collected by the General Health Questionnaire-28 and Rosenberg self-esteem questionnaires. Data were analyzed using SPSS software. The registration number was IRCT20100109003027N41.Results There was no significant difference between the two groups in terms of sociodemographic characteristics and the scores of mental health and self-esteem before the intervention. Two weeks after the end of the intervention, the mean (SD) total score of mental health of women in counseling and control groups were 20.1 (5.0) and 32.9 (9.8), respectively. When compared with the control group, a significant reduction in the total score of mental health (adjusted difference = −11.27; 95% confidence interval: −15.19 to −7.34; p < .001) was observed in the counseling group. In counseling group compared with the control group, a significant increase in the total score of self-esteem (adjusted difference = 4.79; 95% confidence interval: 3.07–6.51; p < .001) was observed.Conclusions Providing counseling based on health promotion awareness by the midwife can help reduce mental health problems and increase self-esteem. For this reason, counseling should be considered as part of care after losing a pregnancy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Individual counselling is effective in alleviating symptoms of grief and post-traumatic stress disorder in parents following perinatal loss.
“Individual counselling has been shown to be effective in alleviating symptoms of grief and post-traumatic stress disorder of parents (Haghighi et al., 2022; Hasani et al., 2021; Navidian et al., 2017).”
From Nurses' and midwives' experiences of supporting parents following perinatal bereavement: A qualitative systematic review (2026) · cites this paper as Hasani et al., 2021
Cites
Self-esteem in a broad-spectrum approach for mental health promotion
Mann, M. (2004) · Health Education Research · doi:10.1093/her/cyg041 · Cited by 1,096 · see citing works
Bouyer, J. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwf190 · Cited by 528 · see citing works
Risk factors for ectopic pregnancy: a meta-analysis
Ankum, W. M., Mol, B. W., van der Veen, F., & Bossuyt, P. M. (1996) · Fertility and Sterility · doi:10.1016/s0015-0282(16)58320-4 · Cited by 490 · see citing works
Farren, J. A., Jalmbrant, M., Ameye, L., Joash, K., Mitchell‐Jones, N., Tapp, S., Timmerman, D., & Bourne, T. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011864 · Cited by 220 · see citing works
McKee, M. D. (2001) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(01)01377-1 · Cited by 211 · see citing works
Depression and emotional stress is highly prevalent among women with recurrent pregnancy loss
Kolte, A. M., Olsen, L. R., Mikkelsen, E. M., Christiansen, O. B., & Nielsen, H. S. (2015) · Human Reproduction · doi:10.1093/humrep/dev014 · Cited by 207 · see citing works
Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009
Coleman, P. K. (2011) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.110.077230 · Cited by 198 · see citing works
Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies
Barnhart, K. T., Sammel, M. D., Gracia, C. R., Chittams, J. L., Hummel, A. C., & Shaunik, A. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.12.023 · Cited by 196 · see citing works
Risk factors for ectopic pregnancy: a multi-center case-control study
Li, C., Zhao, W., Zhu, Q., et al. (2015) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-015-0613-1 · Cited by 174 · see citing works
Kamwendo, F. (2000) · Sexually Transmitted Infections · doi:10.1136/sti.76.1.28 · Cited by 137 · see citing works
Davies, V., Gledhill, J. A., McFadyen, A., Whitlow, B., & Economides, D. L. (2005) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.1854 · Cited by 136 · see citing works
Coste, J., Job-Spira, N., Fernandez, H., Papiemik, E., & Spira, A. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115964 · Cited by 118 · see citing works
Miscarriage and mental health: results of two population-based studies
Toffol, E., Koponen, P., & Partonen, T. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2012.08.029 · Cited by 99 · see citing works
Risk factors for ectopic pregnancy: A case-control study.
Moini, A., Hosseini, R., Jahangiri, N., et al. (2014) · PubMed · Cited by 97 · see citing works
Factor structure and scoring of the SKT test battery
Kim, Y. S., Nibbelink, D. W., & Overall, J. E. (1993) · Journal of Clinical Psychology · doi:10.1002/1097-4679(199301)49:1 · Cited by 78 · see citing works
Gender comparison of psychological reaction after miscarriage—a 1‐year longitudinal study
Kong, G., Chung, T., Lai, B., & Lok, I. (2010) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2010.02653.x · Cited by 72 · see citing works
Psychiatric outcome of termination of pregnancy for foetal abnormality
Iles, S., & Gath, D. (1993) · Psychological Medicine · doi:10.1017/s0033291700028506 · Cited by 62 · see citing works
The loss of self: The effect of miscarriage, stillbirth, and child death on maternal self-esteem
Hill, P. W., Cacciatore, J., Shreffler, K. M., & Pritchard, K. M. (2016) · Death Studies · doi:10.1080/07481187.2016.1261204 · Cited by 53 · see citing works
Main risk factors for ectopic pregnancy: a case-control study in a sample of Iranian women.
Parashi, S., Moukhah, S., & Ashrafi, M. (2014) · PubMed · Cited by 38 · see citing works
Association between socioeconomic status and ectopic pregnancy rate in the Republic of Korea
Yuk, J., Kim, Y. J., Hur, J., et al. (2013) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2013.03.015 · Cited by 31 · see citing works
Maternity nursing: An introductory text
Levine, M. A. (1993) · Midwifery · doi:10.1016/0266-6138(93)90044-s · Cited by 23 · see citing works
Trend of ectopic pregnancy and its main determinants in Hamadan province, Iran (2000-2010)
Shobeiri, F., Tehranian, N., & Nazari, M. (2014) · BMC Research Notes · doi:10.1186/1756-0500-7-733 · Cited by 21 · see citing works
van Mello, N. M., Mol, F., Hajenius, P. J., et al. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.06.007 · Cited by 13 · see citing works
Hood, C. L. (1983) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1983.tb136153.x · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Shaohua, L., & Shorey, S. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.103871 · Cited by 91 · see citing works
Xie, J., Hunter, A., Biesty, L., & Grealish, A. (2024) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2024.104814 · Cited by 21 · see citing works
Gao, H., Iwunze, C. J., An, X., Zhou, T., & Curtin, M. (2026) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2026.100538 · Cited by 2 · see citing works
“Individual counselling has been shown to be effective in alleviating symptoms of grief and post-traumatic stress disorder of parents (Haghighi et al., 2022; Hasani et al., 2021; Navidian et al., 2017).”
- Authors
- Hasani, S., Mirghafourvand, M., Esmaeilpour, K., & Sehhatie Shafaie, F.
- Affiliations
- Tabriz University of Medical Sciences (IR)
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Iran
- University of Tabriz (IR)
- Venue
- The Journal of Maternal-Fetal & Neonatal Medicine
- Publisher
- Informa UK Limited
- Published
- 2019-08-19
- Volume
- 34
- Issue
- 11
- Pages
- 1687-1694
- ISSN
- 1476-4954 (ISSN-L)
- 1476-7058
- OpenAlex
- W2961773981
- Cited by
- 19
- References
- 24
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 6 · 2022: 3 · 2021: 3
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Maternal-Fetal & Neonatal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Tabriz University of Medical Sciences
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Keywords
- ectopic pregnancy, counseling, health promotion, mental health, self-esteem, miscarriage, midwifery care
- MeSH terms
- Counseling, Female, Health Promotion, Humans, Iran, Mental Health, Pregnancy, Pregnancy, Ectopic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
