The mediating role of resilience on the association between self-efficacy and prenatal anxiety among pregnant women: A multi-site smart phone survey in China (Preprint)
BACKGROUND Prenatal anxiety is one of the most prevalent mental disorders in prenatal period. Self-efficacy and resilience, the well-known positive resources, could help prevent the symptoms of anxiety during pregnancy. OBJECTIVE This study assessed the prevalence of prenatal anxiety and examine whether resilience could play a mediating role in the relationship between self-efficacy and prenatal anxiety of Chinese pregnant women. METHODS From July 2018 to July 2019, a multi-site smart phone survey was carried out in three cities (Shenyang in Liaoning province, Zhengzhou in Henan province and Chongqing) in China. A total of 665 pregnant women participated in the study. A hierarchical multiple regression (HMR) model was used to test the predictors and mediators of prenatal anxiety. A structural equation model (SEM) was applied to test the hypothesis that resilience mediates the relationship between self-efficacy and prenatal anxiety. RESULTS The HMR model indicated that self-efficacy contributed most to the variance (11.9%) of prenatal anxiety and had a significant negative correlation with prenatal anxiety (P<0.01) among pregnant women. Resilience had a significant positive correlation with self-efficacy (P<0.01) and was negatively correlated with prenatal anxiety (P<0.01). Resilience served as a mediator between self-efficacy and prenatal anxiety (a*b = -0.198, BCa 95% CI: -0.270, -0.126). CONCLUSIONS Self-efficacy was a negative predictor of prenatal anxiety for pregnant women. Moreover, resilience played a mediating role on the association between self-efficacy and prenatal anxiety among pregnant women in nationwide China. This study suggested that pregnant women might benefit from interventions to relieve prenatal anxiety through improved self-efficacy and the mediating path of resilience.