General Self-Efficacy Among Pregnant Women Attending Antenatal Care Units in Tunisia and Its Association with Family Quality of Life: A Multicenter Cross-Sectional Study

Abstract

Highlights: What are the main findings? The prevalence of low general self-efficacy (GSE) among pregnant women was notably high, particularly among those with at least one child. Age, rural area, planned pregnancy, family quality of life, parenting, and family material well-being were predictors of GSE among pregnant women. What are the implications of the main findings? Investment in multidisciplinary, family-centered care teams is essential to address the complex psychosocial needs of expectant families. Midwifery-led interventions should be designed to assess and respond to family and community-level determinants, fostering a shared understanding of pregnancy and parenting between partners. Background/Objectives: General-self efficacy (GSE) is a substantial element during pregnancy that promotes healthy decision-making and prevents complications. Information on predictive factors of GSE among pregnant women is limited. This study aimed to assess the GSE among pregnant women and identify its relationship with family quality of life (FQOL) domains in a lower-middle-income community. Methods: This cross-sectional analytical study was conducted in nine antenatal care centers from July 2024 to March 2025. Pregnant women were enrolled through the multiple stage sampling method. GSE in pregnant women was assessed using the General Self-efficacy Scale. FQOL was assessed using the Beach Center Family Quality of Life Scale. Univariable and multivariable linear regression analyses were performed to assess predictors of GSE among pregnant women. Results: A total of 417 pregnant women participated in the study. The prevalence of low GSE was 12.2%. Multivariable linear regression showed that older age (p = 0.02), rural area (p = 0.007), and planned pregnancy (p = 0.03) were predictors of GSE among pregnant women. The total score of FQOL (p = 0.0001), parenting (p = 0.004), and material well-being (p = 0.043) were positive determinant factors of GSE in pregnant women who have at least one child. Conclusions: The prevalence of low general self-efficacy (GSE) among pregnant women was notably high, particularly among those with at least one child. Education regarding family planning, parenting, and financial management through multidisciplinary, family-centered care teams is essential to address the complex needs of expectant families.