The Effects of Angel Sounds and Guided Imagery Technique Played to Expectant Couples

Not Applicable

Completed

• Conditions: Prenatal Anxiety; Prenatal Attachment; Sleep Quality

• Registration Number: NCT05441033
• Lead Sponsor: Inonu University

Brief Summary

The study sample consisted of 177 pregnant women and their partners who met the inclusion criteria and participated in a prenatal education class. Expectant couples were randomized into three groups: Group 1 (FHS) listened to fetal heartbeat sounds, Group 2 (GIT) received the guided imagery intervention, and Group 3 served as the control group. Each group consisted of 59 couples.

Detailed Description

Aim: This randomized controlled trial aimed to evaluate the effects of listening to angel sounds (fetal heartbeat) and applying the guided imagery technique on prenatal attachment, anxiety, and sleep quality among expectant couples.

Methods: The study included 177 pregnant women and their partners who attended a prenatal education class and met the inclusion criteria. Expectant couples were randomly assigned into three equal groups. In Group 1 (FHS), only fetal heartbeat sounds were listened to. In Group 2 (GIT), the guided imagery technique was applied. Group 3 served as the control group. Each group consisted of 59 couples.

Study Timeline

• Study Start: 2022-04-22
• Study First Submitted: 2022-06-22
• Study First Submitted QC: 2022-06-27
• Study First Posted: 2022-07-01
• Primary Completion: 2022-12-01
• Study Completion: 2023-07-14
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-02
• Last Update Posted: 2025-04-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 354

Inclusion Criteria

• Having basic literacy skills,
• Owning a smartphone and having internet access,
• Having a singleton and viable pregnancy,
• Being between the 27th and 38th weeks of gestation,
• Not having any diagnosed pregnancy-related risks (e.g., preeclampsia, diabetes, placenta previa, oligohydramnios),
• Not having any diagnosed fetal health issues (e.g., fetal anomalies, intrauterine growth restriction),
• Pregnant individuals and their spouses with no current or prior psychiatric diagnoses.

Exclusion Criteria

• Not living with their spouse,
• Spouse working in shifts,
• Pregnancy via assisted reproductive techniques,
• Currently participating in childbirth education programs,
• Presence of communication difficulties or cognitive impairments in either the pregnant individual or the spouse.

Withdrawal Criteria:

• Participated in the intervention for fewer than 3 nights,
• Unable to use the Fetal Heart Rate Monitoring Device (FHRMD),
• Experiencing premature birth or pregnancy loss,
• Incomplete questionnaire data,
• Voluntary withdrawal from the study by the participant or their spouse. -

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
The Paternal Antenatal Attachment Scale	Change in Prenatal Attachment Levels of Expectant Fathers over 4 Days	The Paternal Antenatal Attachment Scale are based on the fathers' experiences in the last two weeks and measure the father's feelings and thoughts towards the developing fetus in the mother's womb. Increasing score indicates higher degree of attachment. The scale is in 5-point Likert type and consists of 16 items and two sub-dimensions. Sub dimensions; "quality of attachment \[2, (3), (7), 9, 11, (12), (15), 16\]" in which the emotional experience of the father is measured while thinking about the baby in the womb, "time spent on attachment \[( 1), 4, (5), (6), (8), 10, (13), 14\]". 9 items are reverse scored in the scale. Cronbach's alpha reliability coefficient of the scale was 0.82; the Cronbach's alpha of the quality of attachment sub-dimension was 0.80; The alpha of the time spent connecting sub-dimension is 0.67.
Richard Campbell Sleep Questionnaire	Change in Couples Sleep Quality over 4 Days	This scale is a 6-item scale that measures the depth of night sleep, the time to fall asleep, the frequency of awakening, the time to stay awake when awakened, the quality of sleep, and the noise level in the environment. Each of the items is evaluated on a chart with numbers from 0 to 100. According to the scale scoring, "0-25" points indicate very bad sleep, while "76-100" points indicate very good sleep. The 6th item, which evaluates the noise level in the environment, is excluded from the scale total score evaluation, and the total score is evaluated over 5 items. As the score of the scale increases, the sleep quality of the patients also increases. The scale's Cronbach α value is 0.91.
State Anxiety Inventory	Change in Couples State Anxiety over 4 Days	The scale is a self-evaluation type scale consisting of short statements. It is used to determine how an individual feels in a certain situation and in a certain area. The emotions or behaviors expressed in the State Anxiety Scale items are answered by marking one of the options such as (1) not at all, (2) a little, (3) a lot, (4) completely, depending on the severity of the emotion or behavior. There are two types of expressions in the scale. These are reversed or straight forward expressions. reversed expressions; positive feelings express, direct expressions express negative feelings. When scoring reverse expressions, those with a weight of 1 are converted to 4, and those with a weight of 4 are converted to 1. In the State Anxiety Scale; There are ten reversed statements, items 1, 2, 5, 8, 10, 11, 15, 16, 19 and 20. When scoring, the reversed and direct statements are summed.
The Maternal Antenatal Attachment Scale	Change in Prenatal Attachment Levels of Expectant Mothers over 4 Days	Each item of The Maternal Antenatal Attachment Scale (MAAS), which has a total of 19 items, focuses on the pregnant woman's feelings, attitudes and behaviors towards the fetus. The scale is likert-type and each item is scored between 1 and 5 (5=represents very strong feelings towards the fetus; 1=represents the absence of feelings towards the fetus). A high score indicates a high degree of attachment. 11 items in the scale are scored in the opposite direction (1, 3, 5, 6, 7, 9, 10, 12, 15, 16, 18).

Trial Locations

Locations (1)

Faculty of Health Science; 🇹🇷 Malatya, Turkey