Discussion
depression, depressed
DISEASES, BLIND
The results of this study showed that the postnatal supportive education program for husbands enhanced the understanding of social support for their primiparous women in the fourth and eighth weeks after delivery. It can be argued that providing education and consultation services to husbands in order to increase their awareness about the characteristics and issues of women in the postpartum period is one of the tools for promoting husbands’ social support to their wives, which has a positive effect on the couple’s knowledge, attitude and practice with respect to postpartum health [To the best of our knowledge, no study has yet been conducted on the effect of husband education or counseling on social support, maternal self-efficacy, and stress in postpartum women. However, previous studies have shown the overall impact of participation and counseling of pregnant women's husbands, primiparous women and couples in this respect. Mohammadpour et al. (2020), for instance, conducted a randomized clinical trial to determine the effect of husband counseling on social support perceived by their pregnant wives. Their intervention involved four 60-min sessions of group counseling (each group consisting of 7 to 10 people) once a week for four consecutive weeks. The results showed that the mean score of social support 4 weeks after the intervention in the intervention group increased significantly compared to the control group [The results of the present study showed that the postnatal supportive education program for husbands of primiparous women promoted maternal self-efficacy in these women in the fourth and eighth weeks after delivery. It can be argued that educating men to promote support for their primiparous wives can play an effective role in reinforcing the mother’s abilities and her interpretation of the competence she has to play the role of a mother, thus increasing her self-efficacy [Salonen et al. (2010) investigated the effect of an online educational intervention on increasing maternal satisfaction and self-efficacy. Mothers in the intervention group had access to an educational website offering infant care training content from the 20th week of pregnancy whereas the control group received only the routine training. No statistically significant difference was observed between the two groups 6 to 8 weeks after delivery in terms of self-efficacy and parental satisfaction compared to before the intervention [In the present study, participants had access to information through education. This useful information helped the men to acquire the right knowledge independently and, by providing support to the mother, they managed to perform the challenging parenting tasks and increase the mother’s self-efficacy. The helpful feedback given to the husbands served as verbal encouragement, thus allaying their concerns and increasing their self-confidence and motivation to promote maternal self-efficacy.The results of the present study showed that the postnatal supportive education program for husbands of primiparous women reduced the perceived stress in these women in the fourth and eighth weeks after delivery. This can be attributed to the fact that educating husbands on providing emotional, informational, and instrumental support to the mother reduces her physical and psychological stress. Therefore, among the available support sources, the support provided by sexual partners is very important [Also, study of Alio et al. (2013) showed that the primary benefits of male partner involved during pregnancy were the reduction of maternal stress levels and the encouragement of positive maternal behaviors [One of the limitations of this study was that women in this study had no neuropsychiatric diseases. This may affect the generalizability of the results to women who are depressed. The second limitation was that data collection was based solely on participants’ own reports, and the researchers did not use other sources of data collection such as observation. The third limitation was that due to the nature of the intervention, the researchers were not blind to data collection after the intervention. Also, no data was collected from husbands. The last limitation was the cultural component. This prevents generalization to other realities. There is no homosexual culture in Iran, and families made up of a man and a woman and who are married. Other family models (single parent, mixed families, not married, formed by people of the same sex), which are not considered here and could be considered in other studies. These limitations notwithstanding, this study is worthwhile considering the following: Random allocation, concealment of allocation, random selection of women from health centers in 4 districts of the city, long-term follow-up, providing telephone numbers to answer participants’ questions, and providing educational content to the control group at the end of the study. Also, the intervention was designed around the planned delivery method. Therefore, we suggest that a similar study be done in women with a history of depression or suffering from that with more sophisticated statistical analysis.