A mixed methods study protocol to develop an educational program based on salutogenesis theory to improve the postpartum quality of life among nulliparous women.

Research on postpartum quality of life (QoL) often focuses on preventing adverse health outcomes rather than promoting positive health and well-being (salutogenesis). While Salutogenesis theory (ST) has been shown to enhance the sense of coherence (SOC), its application in pregnancy and childbirth is limited. This paper presents a mixed-methods protocol for developing a salutogenic educational program to improve postpartum QoL and maternal health outcomes. Data will gather from healthcare centres in Ahvaz city, Khuzestan province, Iran. In the first phase (qualitative approach), nulliparous women's experiences of determinants of postpartum QoL will be explored by semi-structured in-depth interviews. In the second phase literature review will be conducted to identify factors which affected postpartum QoL. In the third phase, the content of the educational program will be developed. In the fourth phase (a Randomized Controlled Trial), 110 nulliparous women will be randomly allocated to intervention and control groups using blocked randomization. Two groups will be compared in terms of primary and secondary outcomes by validated instruments at baseline, immediately after the intervention, 4 weeks, and 8 weeks after delivery.