Journal of Health, Medicine and Nursing www.iiste.org ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN Vol.59, 2019 46 Factors Affecting Perceived Stress and Self-Care Agency Pregnant Women Hafize Ozturk Can 1* Zehra Baykal Akmese 1 Yeliz Cakir Kocak 1 Dilek Ocalan 2 Nursel Alp Dal 3 Umran Sevil 4 1. Ege University Faculty of Health Sciences, Midwifery Department, Bornova/Izmir, Turkey 2. Afyonkarahisar Health Sciences University, Faculty of Health Sciences, Nursing Department, Afyon, Turkey 3. Munzur University School of Health, Tunceli, Turkey 4.Ege University Faculty of Nursing, Bornova/Izmir, Turkey Abstract Studies have been conducted to investigate the factors affecting perceived stress in pregnancy and to identify attempts to reduce it. However, it has been determined that there is a gap in the literature on the studies conducted to determine the effects of stress on the ability to use self-care.Aim:This study was to assess the effect of the developmental stress perceived by pregnant admitted to outpatient clinics on their “self-care agency”. Sample: The data were collected from the pregnant women who presented to the pregnancy outpatient clinics of three hospitals in Turkey. The study sample included 1022 pregnant women. Tools:The data were collected with the Socio- demographic Questionnaire, Perceived Stress Scale and Exercise of Self-Care Agency Scale. In the analysis of the data, the SPSS program. Permissions needed to perform the study were obtained. Results:The mean total score from the Perceived Stress Scale was 25.89±6.70 and from the Exercise of Self-Care Agency Scale was 103.57±19.35. There was a significant negative difference between the mean total Perceived Stress Scale score and the mean total Exercises of Self-Care Agency Scale score. Conclusion: It was determined that the perceived stress of the pregnant women affected their self-care agency and that the self-care agency decreased as stress increased. Recommendation: Clinical nurses should support pregnant women to reduce perceived stress and increase self-care. Obstetric and psychiatric nurses should cooperate in the care of pregnant patients Keywords: Perceived developmental stress, perceived stress, self-care agency, pregnancy. DOI: 10.7176/JHMN/59-07 1. Introduction The period of pregnancy is a developmental phase. Pregnancy and childbirth are physiological events in which endocrine changes occur, factors such as changes in the family life cycle, personal experiences, educational level, life philosophy of the woman, intra-family relationships, family members’ attitudes towards pregnancy, the socioeconomic status of the family, and whether the pregnancy is intended or unintended can cause pregnancy to become a major stressful life event for the pregnant woman (Ayoubi, Bostan, Sharifipour, 2017; Bussières et al., 2015; Cardwell, 2013; Guardino & Schetter; 2014; Hundley et al., 1998; World Health Organization, 2014). The psychological state and lifestyle of the woman affects not only the pregnancy but also her psychological and emotional state during pregnancy and the postpartum period. Risks that may adversely affect her for the sake of both her own health and that of her baby (Barua, Junaid, 2015; Eryılmaz, Erci, Engin, 1999; Hart, 1995; Saydam et al., 2007). It has also been reported that stress and anxiety in pregnancy adversely affects maternal and neonatal health, and even the behavioral and cognitive development of the child (Cardwell, 2013; Entringer, Buss & Wadhwa, 2015; Glover, 2014; Khashan et al., 2012; Krabbendam et al., 2005; Salacz et al., 2012; Staneva et al., 2015). The life cycle is caused by pregnancy-induced stress, premature birth, low birth weight fetus and with a smaller head circumference. This situation is negatively affects cognitive development (Glover, 2014; Huizink et al.,2003; Staneva, et.al., 2015). Also, a prospective epidemiological study found that prenatal maternal anxiety predicted behavioral and emotional problems in children at 4 years (O’Connor et al., 2002). A stressful event or situation is only a problem when it is perceived as a threat by an individual. For this reason, the stress perceived by the individual is important (Lobel et al., 2008). There are several factors leading to stress. The stressors may be physiological (trauma, excessive heat and cold), psychological (emotional tensions, internal and external conflicts, problems with the spouse), social (environmental factors, cultural change etc.) and socioeconomic (Guardino & Schetter, 2014; Lobel et al., 2008). The developmental state of an individual (pregnancy, childbirth, menopause etc.) also causes developmental stresses. It is known that stress in pregnancy is mainly caused by psychosocial stressors. Pregnancy-related risk factors and the personality traits of the pregnant woman also affect stress in pregnancy (Ayoubi, Bostan, Sharifipour, 2017; Krabbendam et al., 2005; Orem, 2001). As a result of the physiological changes that occur in pregnancy, a pregnant woman’s healthcare needs increase and she is thus required to take greater care of herself (Eryılmaz, Erci, Engin, 1999). In recent years, the concept of self-care has come to the forefront in the philosophy of primary health care for pregnancy. While the protection and maintenance of health refer to the avoidance of attitudes and behaviors that adversely affect health, improvement of health refers to an individual's ability to use his/her potential and energy in order to lead a