The Effect of Psychodramatic Role-Playing on Postpartum Depression, Self-Efficacy, and Perceived Social Support

The Effect of Psychodramatic Role-Playing Used in Childbirth Preparation Classes on Postpartum Depression, Self-Efficacy, and Perceived Social Support

This research was conducted to examine the effect of psychodramatic role-playing in childbirth preparation courses on postpartum depression, self-efficacy, and perception of social support. The study was conducted using a randomized controlled experimental design between October 31, 2025, and February 25, 2026. The study population consisted of pregnant women who applied to the Antenatal School of Zeynep Kamil Women and Children's Diseases Training and Research Hospital. The sample size was calculated as 57 pregnant women (control: 29, intervention: 28). While the control group received standard childbirth preparation education, the intervention group received standard childbirth preparation education as well as psychodramatic role-playing. The Demographic Information Form, General Self-Efficacy Scale, Multidimensional Perceived Social Support Scale, and Edinburgh Postnatal Depression Scale were used to collect research data. The study findings revealed no significant differences between the control and intervention groups in terms of sociodemographic and obstetric characteristics. Furthermore, no significant differences were found between the control and intervention groups in pre-test and post-test scores on the General Self-Efficacy Scale, Multidimensional Perceived Social Support Scale, and Edinburgh Postnatal Depression Scale.

Study Overview

• Status: Completed
• Conditions: Postpartum Depression; Pregnancy; Perceived Social Support; Maternal Self-Efficacy
• Intervention / Treatment: Behavioral: Psychodramatic Role-Playing Childbirth Education; Behavioral: Standard Childbirth Education

Detailed Description

Childbirth preparation education plays a crucial role in reducing anxiety, increasing maternal self-efficacy, and enhancing perceived social support during pregnancy and the postpartum period. Innovative educational approaches, such as psychodramatic role-playing, may strengthen coping skills and emotional preparedness for childbirth. This randomized controlled trial was conducted to evaluate the effectiveness of psychodramatic role-playing integrated into childbirth preparation classes provided in a maternity education program.

The study included pregnant women between 32 and 36 weeks of gestation who voluntarily participated in the childbirth education program. Participants were randomly allocated into intervention and control groups. The intervention group received structured childbirth preparation education sessions enriched with psychodramatic role-playing techniques designed to improve emotional expression, coping strategies, and social interaction. The control group received the standard childbirth preparation education program.

Data were collected at baseline and during the postpartum period using standardized measurement tools including the Edinburgh Postnatal Depression Scale (EPDS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the General Self-Efficacy Scale. The primary outcomes of the study were postpartum depression, maternal self-efficacy, and perceived social support. This study aims to provide evidence on the effectiveness of psychosocial and interactive educational interventions in childbirth education programs and to support the development of evidence-based maternal care practices.

• Study Type: Interventional
• Enrollment (Actual): 57
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye), 34668
    • Zeynep Kamil Women and Children's Diseases Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Agree to participate in the study and be able to speak and understand Turkish,

  • Be 18 years of age or older,
  • Be at least literate,
  • Be a primiparous pregnant woman,
  • Be at least 32 weeks and no more than 36 weeks pregnant,
  • Have no psychological disorders or chronic illnesses.

Exclusion Criteria:

• Being multiparous,

  • Being less than 32 weeks pregnant,
  • Being in the high-risk pregnancy category,
  • Having received childbirth preparation training from another institution or individual,
  • Not having completed the training program.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Psychodramatic Role-Playing Childbirth Education; Participants in the intervention group received childbirth preparation education integrated with psychodramatic role-playing techniques. The sessions included interactive role-playing activities aimed at enhancing emotional expression, coping skills, self-efficacy, and perceived social support during pregnancy and the postpartum period.	Behavioral: Psychodramatic Role-Playing Childbirth Education; Psychodramatic role-playing integrated into childbirth preparation education was administered to the intervention group. The program included structured educational sessions combined with interactive role-playing activities aimed at improving emotional expression, coping skills, maternal self-efficacy, and perceived social support during pregnancy and the postpartum period.
Active Comparator: Standard Childbirth Education; Participants in the control group received the standard childbirth preparation education program routinely provided in the childbirth education classes without psychodramatic role-playing components.	Behavioral: Standard Childbirth Education; The control group received the standard childbirth preparation education routinely provided in childbirth education classes without psychodramatic role-playing components.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postpartum Depression	Edinburgh Postpartum Depression Scale will be applied to examine the effect of home visits and prenatal education on postpartum depression. Edinburgh Postpartum Depression Scale (EPDS); EPDS is a 4-point Likert style self-report scale consisting of 10 items. PRES was adapted to Turkish by Engindeniz. In Engindeniz's validity and reliability study, this scale had an internal consistency coefficient of 0.79, a split-half reliability, a cut-off of 0.80 of 12/13, a sensitivity of 0.84, a specificity of 0.88, a positive predictive value of 0.69, and a negative predictive value of 0.94. The Edinburgh Postnatal Depression Scale is a 10-item self-report scale assessing the common symptoms of depression. Each item is scored on a 4 point scale (O-3), the minimum and maximum total score ranging from O-30, respec- tively. The highest score is 30 points. If it is less than 9 points, there is no risk for depression, if it is 13 and above, there is a high risk for depression.	Postpartum week 1 and postpartum week 8

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maternal Self-Efficacy	Maternal self-efficacy levels measured using the General Self-Efficacy Scale. The General Self-Efficacy Scale was developed by Ralf Schwarzer and Matthias Jerusalem to assess individuals' general perceptions of self-efficacy in coping with stressful situations and managing challenging life events. The scale is a self-report measure consisting of 10 items on a 4-point Likert scale (1 = not at all true, 4 = completely true). The total score obtainable from the scale ranges from 10 to 40, with higher scores indicating a higher level of self-efficacy.	Postpartum week 1 and postpartum week 8
Perceived Social Support	Perceived social support levels assessed using the Multidimensional Scale of Perceived Social Support. The Multidimensional Scale of Perceived Social Support was developed by Gregory D. Zimet and colleagues to assess the level of social support individuals perceive from their family, friends and a specific person. The scale consists of a total of 12 items and uses a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). The scale comprises three sub-dimensions: family support, friend support and support from a significant other. Each sub-dimension consists of 4 items. The total score obtained from the scale ranges from 12 to 84, with higher scores indicating a higher level of perceived social support.	Postpartum week 1 and postpartum week 8

Collaborators and Investigators

• Sponsor: Istanbul University - Cerrahpasa
• Collaborators: Uskudar University

Study record dates

Study Major Dates

• Study Start (Actual): October 31, 2025
• Primary Completion (Actual): January 15, 2026
• Study Completion (Actual): January 15, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: March 28, 2026
• First Posted (Actual): April 2, 2026

Study Record Updates

• Last Update Posted (Actual): April 2, 2026
• Last Update Submitted That Met QC Criteria: March 28, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Postpartum Depression; Randomized Controlled Trial; Pregnant Women; Perceived Social Support; Childbirth Preparation Education; Maternal Self-Efficacy; Psychodramatic Role-Playing
• Additional Relevant MeSH Terms: Urogenital Diseases; Mental Disorders; Female Urogenital Diseases and Pregnancy Complications; Pregnancy Complications; Mood Disorders; Puerperal Disorders; Depressive Disorder; Depression, Postpartum
• Other Study ID Numbers: Ü. Ü. Ebe Feyza KALE

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No