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

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 a 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. Prevalence of low GSE was 12.2%. Multivariable linear regression showed that older age (p=.02), rural area (p=.007), and planned pregnancy (p=.03) were predictors of GSE among pregnant women. Total score of FQOL (p< .001), 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. Conclusion: This magnitude of low GSE in pregnant women was relatively high, especially in those who have at least one child. This study supports researchers and clinicians to develop multidisciplinary prenatal family-oriented programs addressing FQOL, material wellbeing, and parenting accordingly to the family needs.