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Babos CI, Zucchi G, Filimberti AE, Leucuta DC, Dumitrascu DL. Meditation and Compassion Therapy in Psychiatric Disorders: A Pilot Study. Cureus 2024; 16:e65678. [PMID: 39077673 PMCID: PMC11286201 DOI: 10.7759/cureus.65678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction Our study aimed to compare meditation and compassion-based group therapy with the standard of care in patients with eating disorders, drug addiction, alcohol addiction, and depression, concerning acceptance, mindfulness awareness, self-compassion, and psychological distress. Methods A controlled designed study was performed, comparing meditation and compassion-focused group therapy added to the standard of care with the standard of care alone, on patients with eating disorders, drug addiction, alcohol addiction, and mood disorders. Four validated questionnaires were administered: the Acceptance and Action Questionnaire-II (AAQ-II), which assesses the ability to be fully in touch with the present moment; the Mindful Attention Awareness Scale (MAAS), which assesses the ability to experience consciously what is happening in the present moment; the Self-Compassion Scale (SCS), which assesses self-compassion characteristics, including loving-kindness; and the Symptom Checklist-90 (SCL-90), which measures psychological distress (anxiety, depression, psychotic behavior, etc.). Results There was a total of 75 subjects, out of which 48 represented the experimental group, and 27 represented the control group. The overall mean age of the subjects was 44.8 ± 13.2 years. There were statistically significant increases in the experimental group (baseline vs. end of study) for the AAQ-II, MAAS, and SCS scores, and a statistically significant decrease in the SCL-90 score. In the control group, there was a statistically significant decrease in the SCL-90 score, but no significant differences for other measurements. The comparisons between the two groups at the end of the study were as follows: AAQ-II: 0.7 (-5.74 to 7.15), p = 0.827; MAAS: 4.78 (-3.19 to 12.75), p = 0.233; SCS: 5.89 (-3.18 to 14.96), p = 0.199; SCL-90: -0.26 (-0.62 to 0.1), p = 0.157. Conclusion Within the experimental group, all scales improved statistically significantly. There were no statistically significant differences at the end of the study concerning the four scales between the groups. The comparison between groups was limited by data availability.
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Affiliation(s)
- Cristian I Babos
- Second Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, ROU
| | - Giovanni Zucchi
- Alcoholic Rehabilitation, Ospedale Maria Luigia, Monticelli Terme, ITA
| | | | - Daniel C Leucuta
- Medical Informatics and Biostatistics Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, ROU
| | - Dan L Dumitrascu
- Second Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, ROU
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Torres-Giménez A, Sureda B, Roca-Lecumberri A, Andrés-Perpiñá S, Solé E, Gelabert E. Efficacy of contextual therapies in perinatal depression and anxiety: A systematic review and meta-analysis. J Psychiatr Res 2024; 169:209-223. [PMID: 38043257 DOI: 10.1016/j.jpsychires.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/14/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND There are previous meta-analyses on the efficacy of cognitive behavioral therapy or mindfulness-based therapies in the perinatal period, but no previous review has focused on contextual therapies as a whole. The aim of this study was to carry out a systematic review and meta-analysis of the efficacy of contextual therapies on depressive and anxious symptoms in women in the perinatal period. METHODS A systematic search for randomized clinical trials has been carried out in the PUBMED, CINAHL, Psyc-INFO and Cochrane Library search engines. For the quantitative synthesis, the Morris effect size measure has been used. RESULTS A total of 34 RCTs have been found, of which 30 have been used for meta-analysis. The mean effect size of the studies on depression scores was dppc2 = -0.81 (95% CI = -1.12 to -0.50), while it was dppc2 = -1.04 (95% CI = -1.54 to -0.53) in the case of studies on anxiety scores. These effect sizes decreased to medium effect sizes when corrected for publication bias. LIMITATIONS The main limitations are the quality of the included studies, publication bias, and the limited number of studies on contextual therapies other than mindfulness-based therapies. CONCLUSIONS In conclusion, this systematic review found a large number of efficacy studies on mindfulness-based therapies and a small number of studies on the other contextual therapies. The effect sizes found are consistent with previous meta-analyses in the perinatal period.
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Affiliation(s)
- Anna Torres-Giménez
- Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Bàrbara Sureda
- Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain
| | - Alba Roca-Lecumberri
- Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Susana Andrés-Perpiñá
- Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eva Solé
- Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Estel Gelabert
- Departament of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
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Sari YP, Hsu YY, Nguyen TTB. The Effects of a Mindfulness-Based Intervention on Mental Health Outcomes in Pregnant Woman: A Systematic Review and Meta-Analysis. J Nurs Res 2023; 31:e306. [PMID: 38036493 DOI: 10.1097/jnr.0000000000000586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Pregnancy stress, anxiety, and depression increase the risk of short-term and long-term health problems for the mother and fetus. Mindfulness-based intervention (MBI) is one of the most popular, nonpharmacological interventions used to treat mental health problems. The results of prior research indicate MBI has a less consistent effect on mental health problems in pregnant women. PURPOSE The purpose of this systematic review and meta-analysis was to clarify and determine the effect of MBI on mental health outcomes in pregnant women. METHODS Six databases, including Embase, Ovid MEDLINE, CINAHL, EBSCOhost, Cochrane Library, and ScienceDirect, were searched from their dates of inception to November 2021. Google Scholar was also used for the literature inquiry. The inclusion criteria followed the PICO (Patient/Problem, Intervention, Comparison, and Outcome) model in terms of only including studies that used mindfulness therapy, reported mental health outcomes, and applied randomized controlled trial and quasi-experimental approaches. The Cochrane risk of bias tool was applied to evaluate the quality of the studies. Review Manager 5 software with random effect with a standardized mean difference (SMD) was used to analyze level of effect. RESULTS Thirteen studies (10 randomized controlled trials and three quasi-experimental studies) were included. MBI was found to have a small effect on mental health outcomes in pregnant women (p < .0001, SMDs = -0.48, 95% CI [-0.74, -0.22], I2 = 87%). Specifically, MBI had moderate effects on stress and anxiety (SMDs = -0.59, 95% CI [-1.09, -0.09], and SMDs = -0.55, 95% CI [-1.00, -0.10], respectively) and no significant effect on depression (SMDs = -0.33, 95% CI [-0.74, 0.08]). CONCLUSIONS MBIs have a small but notable effect on mental health in pregnant women. The high heterogeneity found in this review may reflect the different types and durations of interventions used. Notably, none of the studies in the review examined intervention effects by trimester. Future research should use larger sample sizes and assess the effects of therapy for each trimester of pregnancy.
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Affiliation(s)
- Yanti Puspita Sari
- MSN, RN, Doctoral Candidate, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; and Assistant Professor, Maternity and Child Health Nursing Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Yu-Yun Hsu
- PhD, RN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
| | - Tram Thi Bich Nguyen
- MS, RN, Doctoral Student, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; and Lecturer, Medical Simulation Center, Duy Tan University, Vietnam
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Zeinabeh MZ, Atefeh A, Masumeh GHP, Tania D, Mojgan S, Katayoun A. The Effect of Mindfulness-Based Stress Reduction Counseling on Blood Glucose and Perceived Stress in Women with Gestational Diabetes. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:e517-e523. [PMID: 37846184 PMCID: PMC10579914 DOI: 10.1055/s-0043-1775810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/01/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE Gestational diabetes can cause maternal and neonatal morbidity. Psychological factors, especially stress, play a meaningful role in diabetes management. Therefore, the present study aimed to investigate the effect of Mindfulness-Based Stress Reduction counseling on blood sugar and perceived stress in women with gestational diabetes. METHODS The present quasi-experimental interventional study was performed on 78 women with gestational diabetes. In the intervention group, a Mindfulness-Based Stress Reduction counseling program was conducted by the researcher in 8 sessions of 90 minutes twice a week. The Cohen stress questionnaire was filled in both groups. Also, fasting blood sugar and 2-hour blood sugar levels were measured in both groups. Statistical analysis was performed using the independent T-Test, the paired T-Test, the Mann-Whitney and Wilcoxon Tests using IBM SPSS Statistics for Windows version 20 version (IBM Corp., Armonk, NY, USA). RESULTS The mean age of pregnant women in the intervention group was 28.84 ± 6.20 years old and 29.03 ± 5.42 years old in the control group. There was a significant mean difference between the fasting blood sugar score (p = 0.02; - 6.01; and - 11.46) and the 2-hour fasting blood sugar score (p < 0.001;12.35; and - 5.3) and the perceived stress score (p < 0.001; 35.57; and - 49.19) existed between the intervention and control groups after the intervention. CONCLUSION The results of the present study showed that mindfulness-based stress reduction counseling is effective in reducing blood sugar levels and reducing perceived stress in women with gestational diabetes treated with diet.
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Affiliation(s)
| | | | | | - Dehesh Tania
- Kerman University of Medical Sciences, Kerman, Iran
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Moore N, Abouhala S, Maleki P, Kheyfets A, Carvalho K, Amutah-Onukagha N. The Efficacy of Provider-Based Prenatal Interventions to Reduce Maternal Stress: A Systematic Review. Womens Health Issues 2023; 33:300-311. [PMID: 37019762 DOI: 10.1016/j.whi.2023.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/08/2023] [Accepted: 02/24/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE Exposure to stress during the prenatal period is often associated with adverse maternal and neonatal health outcomes and is increasing in prevalence in the United States. Health care providers play a crucial role in addressing and mitigating this stress, but there is a lack of consensus in effective interventions. This review evaluates the effectiveness of prenatal provider-based interventions that reduce stress for pregnant people, especially those who are disproportionately affected by stress. METHODS A search of relevant English-language literature was conducted using PubMed, CINAHL, Web of Science, Embase, and PyscInfo. Inclusion criteria were 1) the target population was pregnant people, 2) the intervention was delivered within the U.S. health care system, and 3) the study intervention had the goal of reducing stress (stress-reducing intervention). RESULTS A total of 3,562 records were identified in the search and 23 were included in analysis. The four identified categories for provider-led stress-reducing prenatal interventions included in the review are 1) skills-building, 2) mindfulness, 3) behavioral therapy, and 4) group support. Findings suggest an increased overall likelihood of mood and maternal stress improvement among pregnant people who complete provider-based stress-reducing interventions, especially group-based therapies that integrated resource allocation, skills-building, mindfulness, and/or behavioral therapy into an intersectional program. However, the efficacy of each type of intervention varies by category and type of maternal stress targeted. CONCLUSIONS Although few studies demonstrated a significant reduction in stress for pregnant people, this review highlights the critical need for increased research and attention to stress-reducing interventions in the prenatal period, especially as it pertains to minoritized populations.
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Affiliation(s)
- Nichole Moore
- Tufts University School of Medicine, Boston, Massachusetts.
| | | | - Pegah Maleki
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anna Kheyfets
- Tufts University School of Medicine, Boston, Massachusetts
| | - Keri Carvalho
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Ndidiamaka Amutah-Onukagha
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
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Leng LL, Yin XC, Ng SM. Mindfulness-based intervention for clinical and subthreshold perinatal depression and anxiety: A systematic review and meta-analysis of randomized controlled trial. Compr Psychiatry 2023; 122:152375. [PMID: 36841089 DOI: 10.1016/j.comppsych.2023.152375] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/21/2023] [Accepted: 01/28/2023] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES About one in four mothers will experience depression and anxiety during pregnancy and within their first year following childbirth. The meta-analysis aggregated the findings of randomized controlled trials (RCTs) evaluating the immediate post-intervention and maintenance effects of MBI on perinatal depression and anxiety. METHODS A systematic search was conducted in PubMed, PsycINFO, Medline, Scopus, and Web of Science for English-language journal articles from the first available date until Oct 27th, 2022. RESULTS Twenty-five published RCTs were identified and reviewed, with a total of 2495 perinatal women. MBI was superior to controls for clinical and subthreshold perinatal depression and anxiety. The benefit for depression reduction was stable over time and sustained to the postpartum period, but the maintenance effect on perinatal anxiety was less conclusive. Moreover, MBI's post-intervention effects on depression and anxiety were moderated by perinatal women's symptom severity. The post intervention effects were significantly greater among women in Low- and Middle-Income countries, where perinatal mental health care is less available and accessible. Greater improvement in mindfulness was also associated with a significantly larger post-intervention effect on perinatal depression. CONCLUSIONS This meta-analysis suggests that MBIs may complement and extend the available range of effective interventions for clinical and subthreshold perinatal depression and anxiety.
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Affiliation(s)
- Ling Li Leng
- The Department of Sociology, Zhejiang University, Hangzhou, China.
| | - Xi Can Yin
- School of Humanities, Southeast University, Nanjing, China
| | - Siu Man Ng
- Social Work and Social Administration Department, The University of Hong Kong, China
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Bublitz MH, Salmoirago-Blotcher E, Sanapo L, Ayala N, Mehta N, Bourjeily G. Feasibility, acceptability, and preliminary effects of mindfulness training on antenatal blood pressure. J Psychosom Res 2023; 165:111146. [PMID: 36621212 PMCID: PMC10288303 DOI: 10.1016/j.jpsychores.2023.111146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/03/2023] [Accepted: 01/03/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are one of the greatest causes of perinatal morbidity and mortality. Mindfulness training (MT) significantly reduces blood pressure in non-pregnant adults, yet MT has not been tested to reduce blood pressure in the prenatal period. OBJECTIVES The objectives of this pilot randomized clinical trial were to test the feasibility, acceptability, and effects of MT on rates of HDP among pregnant participants at risk for HDP. Exploratory analyses examined effects of MT on antenatal blood pressure. STUDY DESIGN Participants were randomized to an 8-week phone-delivered MT intervention or usual care. Feasibility was defined by MT completion. Acceptability was defined by participants' satisfaction with the intervention. HDP outcomes were collected by medical chart review. Antenatal blood pressure values were extracted from medical records. RESULTS Twenty-nine participants were randomized to phone-based MT (N = 15) or usual care (N = 14). 73% participants completed >5 MT sessions, indicating that MT was feasible. One hundred percent of participants indicated they were "satisfied" or "very satisfied" with the intervention, suggesting the intervention was acceptable. Rates of HDP were lower in the MT vs. usual care condition (9% vs. 29%; OR: 0.25, 95% C.I.: 0.02-2.65) although this did not reach statistical significance. Systolic and diastolic blood pressure levels were significantly lower at follow up among those randomized to MT vs. usual care. CONCLUSIONS Results from this pilot trial suggest that prenatal MT is feasible and acceptable and may be a useful adjunctive preventative treatment for HDP among at-risk pregnant patients. CLINICALTRIALS gov identifier is NCT03679117.
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Affiliation(s)
- Margaret H Bublitz
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Elena Salmoirago-Blotcher
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Laura Sanapo
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Nina Ayala
- Division of Maternal Fetal Medicine, Women and Infant's Hospital of Rhode Island, Providence, RI, USA; Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Niharika Mehta
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ghada Bourjeily
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Wang S, Zhang C, Sun M, Zhang D, Luo Y, Liang K, Xu T, Pan X, Zheng R, Shangguan F, Wang J. Effectiveness of mindfulness training on pregnancy stress and the hypothalamic-pituitary-adrenal axis in women in China: A multicenter randomized controlled trial. Front Psychol 2023; 14:1073494. [PMID: 36935954 PMCID: PMC10018028 DOI: 10.3389/fpsyg.2023.1073494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction In the past two decades, mindfulness-based intervention programs have gradually become popular.Many studies have confirmed that these programs can effectively alleviate prenatal stress and negative emotion.The mindfulness-based stress-buffering hypothesis suggests that mindfulness training can induce changes in the levels of the cortisol secreted by the HPA axis, thereby reducing stress susceptibility. However, to date, only a few high-quality evidence-based medical studies have analyzed the effect of the mindfulness-based intervention in a maternal population.Thus, this study investigated the effects of a mindfulness-based psychosomatic intervention on pregnancy stress and the HYPERLINK "javascript:;" hypothalamic-pituitary-adrenal (HPA) axis of pregnant Chinese women. Methods Women experiencing first-time pregnancy (n = 117) were randomly allocated to the intervention group or parallel active control group, and data were collected at baseline and post-intervention periods. The participants completed questionnaires regarding mindfulness and pregnancy stress. Saliva samples was collected at the time of waking up, and 30, 45, and 60 min after waking up for analyzing the salivary cortisol levels. We analyzed differences between the two groups and changes within the same group before and after the intervention. Results and discussion A total of 95 participants completed the trial. Compared with the parallel active control group, the intervention group exhibited lower levels of stress after the intervention (P = 0.047). For HPA-axis-related indicators after the intervention, Delta value (P = 0.01) and AUCM value (P = 0.031) of the intervention group were significantly higher than that of the control group. Mindfulness-based interventions effectively reduced the level of pregnancy stress and adjusted the HPA axis function in pregnant women in China. Clinical Trial Registration https://www.chictr.org.cn, identifier ChiCTR 2000033149.
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Affiliation(s)
- Shulei Wang
- National Center for Women and Children’s Health, China CDC, Beijing, China
- Yantai Center for Disease Control and Prevention, Yantai, Shandong, China
| | - Chen Zhang
- Fengtai Mental Health Center, Beijing, China
- School of Psychology, Capital Normal University, Beijing, China
| | - Mengyun Sun
- National Center for Women and Children’s Health, China CDC, Beijing, China
| | - Daming Zhang
- Shanxi Maternal and Child Health Hospital, Taiyuan, Shanxi, China
| | - Ying Luo
- Shandong Maternal and Child Health Hospital, Jinan, Shandong, China
| | - Kairu Liang
- Sichuan Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Tao Xu
- National Center for Women and Children’s Health, China CDC, Beijing, China
| | - XiaoPing Pan
- National Center for Women and Children’s Health, China CDC, Beijing, China
| | - Ruimin Zheng
- National Center for Women and Children’s Health, China CDC, Beijing, China
- *Correspondence: Ruimin Zheng,
| | - Fangfang Shangguan
- School of Psychology, Capital Normal University, Beijing, China
- Fangfang Shangguan,
| | - Jia Wang
- Shandong Provincial Hospital, Jinan, Shandong, China
- Jia Wang,
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Kuo TC, Au HK, Chen SR, Chipojola R, Lee GT, Lee PH, Kuo SY. Effects of an integrated childbirth education program to reduce fear of childbirth, anxiety, and depression, and improve dispositional mindfulness: A single-blind randomised controlled trial. Midwifery 2022; 113:103438. [DOI: 10.1016/j.midw.2022.103438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
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Yang M, Zhou X, Ye C, Li J, Sun S, Yu X. Emphasizing mindfulness training in acceptance relieves anxiety and depression during pregnancy. Psychiatry Res 2022; 312:114540. [PMID: 35413533 DOI: 10.1016/j.psychres.2022.114540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
Mindfulness intervention, which trains participants to monitor momentary experiences with an accepting attitude, is effective for reducing maternal anxiety and depression. Monitoring and acceptance are two central components of mindfulness training. The aim of the study is to clarify whether adding acceptance component to monitoring training can help improve the mental health of pregnant people by comparing the effects between mindfulness training on monitoring with an emphasis on acceptance training and training on monitoring alone. Pregnant people with depressive or anxious symptoms (N = 149) were randomized to either a 4-week online intervention of (1) monitoring training (MT), (2) monitoring with an emphasis on acceptance training (MAT), or (3) emotional regulation course conditions as an active control group. All mindfulness training was based on the WeChat platform. We used the Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), Five Facets of Mindfulness Questionnaire (FFMQ), and Regulatory Emotional Self-Efficacy Scale (RESE) to evaluate symptoms of anxiety and depression, mindfulness monitoring and acceptance skills, and the self-efficacy of emotional regulation pre-and postintervention. Of the 149 people enrolled in this study, 10 in the MT training group, 9 in the MAT group, and 15 in the control group did not complete the intervention. Monitoring with an emphasis on acceptance training significantly reduced symptoms of anxiety and depression and improved perceived self-efficacy in managing depression/distress compared with the monitoring training alone and the control group. In addition, participants in the monitoring group showed a downward trend in GAD-7 scores and an upward trend in scores of perceived self-efficacy in managing anger/irritation. This study not only shows that the 4-week online mindfulness training could be a promising technique to help people improve mental health; moreover, it provides evidence that emphasizing acceptance skills on mindfulness training may play a critical role because of its positive effects. We suggest that the online mindfulness intervention should be added as part of psychological care and recommend emphasizing acceptance training during pregnancy.
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Affiliation(s)
- Mengye Yang
- A Nurse Of Department of Obstetrics and Gynecology, Suzhou Municipal Hospital, Suzhou, China
| | - Xiaoli Zhou
- Student of Medical college of Zhejiang University, Zhejiang, China
| | - Cuiwei Ye
- Associate Chief Physician of Department of Psychiatry, Women's Hospital School of Medicine, Zhejiang University, Zhejiang, China
| | - Junqin Li
- Midwifery of Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Zhejiang, China
| | - Shiwen Sun
- A Nurse of Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Zhejiang, China
| | - Xiaoyan Yu
- State Consultant Psychologist Grade 2, is Clinical Psychologist and office Administrator of Women's Hospital School of Medicine, Zhejiang University, Address: 1st Xueshi Road, Hangzhou, Zhejiang 310006, China.
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Yan H, Wu Y, Li H. Effect of mindfulness-based interventions on mental health of perinatal women with or without current mental health issues: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord 2022; 305:102-114. [PMID: 35257692 DOI: 10.1016/j.jad.2022.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 01/16/2023]
Abstract
BACKGROUND The effectiveness of mindfulness-based interventions (MBIs) on the mental health of perinatal women with or without current mental health issues remains unclear. METHODS Four electronic databases were searched from inception to October 1, 2021. Data synthesis, sensitivity analysis, subgroup analysis, and quality assessment were performed on the included studies. I2 and Q tests were applied to evaluate heterogeneity across studies. The risk of publication bias was assessed and visualized using a funnel plot. RESULTS A total of 21 RCTs with 1765 perinatal women were enrolled in the meta-analysis. We found MBIs were effective in reducing depression, anxiety, and stress, as well as increasing mindfulness in perinatal women with current mental health issues. However, MBIs were not prior to controls in reducing depression and stress, and increasing mindfulness in perinatal women without current mental health issues. The effectiveness of MBIs on reducing anxiety in perinatal women without current mental health issues was unclear. LIMITATIONS Considerable heterogeneity was found in the pooled analyses of the RCTs in depression and anxiety in perinatal women with mental health issues and stress in perinatal women without mental health issues. CONCLUSION MBIs could serve as a useful addition to existing support for perinatal women with current mental health issues. However, further studies were needed to explore and prove the effectiveness of MBIs on the mental health of perinatal women without current mental health.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yali Wu
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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Chen Z, Jiang J, Hu T, Luo L, Chen C, Xiang W. The effect of mindfulness-based stress reduction therapy on maternal anxiety, depression, and sleep quality: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28849. [PMID: 35212284 PMCID: PMC8878624 DOI: 10.1097/md.0000000000028849] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 01/28/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Depression and anxiety are common in the prenatal and postnatal periods, which significantly influence pregnant women and their unborn babies. Pharmacological interventions can negatively affect maternal and infant health outcomes, while psychotherapy can avoid adverse events of medication and improve maternal depression and anxiety. Whether mindfulness-based stress reduction (MBSR) can alleviate maternal anxiety and depression and improve sleep quality is still controversial. Therefore, we aim to conduct a meta-analysis by collecting randomized controlled trials (RCTs) reporting the effects of MBSR on maternal anxiety, depression, and sleep quality, thus providing evidence-based medical evidence for non-pharmacological interventions. METHODS RCTs reporting the effect of MBSR on maternal anxiety, depression, and sleep quality versus conventional obstetric care will be searched in online databases, including the Cochrane Central Register of Controlled Trials Repositories, PubMed, Embase, Web of Science, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan Fang Database. Literature selection, data extraction, risk of bias assessment, and meta-analyses will be independently completed by 2 researchers. Meta-analysis will be performed by using RevMan5.4. RESULTS The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This study will provide reliable evidence-based evidences for the effects of MBSR on improving maternal anxiety, depression, and sleep quality.
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Mennitto S, Ditto B, Da Costa D. The relationship of trait mindfulness to physical and psychological health during pregnancy. J Psychosom Obstet Gynaecol 2021; 42:313-319. [PMID: 32400252 DOI: 10.1080/0167482x.2020.1761320] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Research on mindfulness has extended to the prevention of psychopathology and physical conditions during pregnancy. The purpose of this study was to investigate the relationship between trait mindfulness assessed in the first or early second trimester to health outcomes throughout pregnancy. METHODS A total of 510 women were recruited at McGill University-affiliated obstetrics clinics (average gestational age: 13.43 weeks, sd = 1.2). The Mindful Awareness and Attention Scale (MAAS) was administered at baseline. At three timepoints during pregnancy, participants completed the Perceived Stress Scale (PSS-10), the Edinburgh Postnatal Depression Scale (EPDS), the Prenatal Distress Questionnaire-revised (PDQR) and a measure of pregnancy symptom intensity and indicated whether they had been diagnosed with gestational diabetes or high blood pressure. RESULTS Higher MAAS scores predicted lower PSS, EPDS and PDQR scores and less severe physical discomforts throughout pregnancy. MAAS scores were a stronger predictor of PSS scores earlier in pregnancy. Logistic regressions found that trait mindfulness did not predict the presence of physical discomforts, diabetes or high blood pressure. CONCLUSIONS These results indicate that trait mindfulness is an important predictor of subjective stress, depression, anxiety and the severity of physical discomforts during pregnancy. These findings suggest that interventions earlier in pregnancy may increase the impact of mindfulness on maternal health.
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Affiliation(s)
- Serena Mennitto
- Department of Psychology, Faculty of Science, McGill University, Montreal, Canada
| | - Blaine Ditto
- Department of Psychology, Faculty of Science, McGill University, Montreal, Canada
| | - Deborah Da Costa
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Canada
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14
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Babbar S, Oyarzabal AJ, Oyarzabal EA. Meditation and Mindfulness in Pregnancy and Postpartum: A Review of the Evidence. Clin Obstet Gynecol 2021; 64:661-682. [PMID: 34162788 DOI: 10.1097/grf.0000000000000640] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Given their growing popularity, mindfulness practices including meditation are actively being studied in clinical trials to assess their efficacy at improving health outcomes during pregnancy and the postpartum period. We conducted a literature review to compile these studies and assessed their findings. There is sufficient evidence to support the practice of mindfulness practices in pregnancy to reduce anxiety, depression, and stress during pregnancy, which may continue to have beneficial effects through the postpartum period. There is limited evidence on the benefits of mindfulness and meditation for other aspects of pregnancy. However, due to the low-risk nature of these techniques, all women should be encouraged to engage in mindfulness practices during pregnancy.
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Affiliation(s)
- Shilpa Babbar
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Missouri-Kansas City, Children's Mercy Kansas City, Kansas City, Missouri
| | | | - Esteban A Oyarzabal
- Department of Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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15
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Domínguez-Solís E, Lima-Serrano M, Lima-Rodríguez JS. Non-pharmacological interventions to reduce anxiety in pregnancy, labour and postpartum: A systematic review. Midwifery 2021; 102:103126. [PMID: 34464836 DOI: 10.1016/j.midw.2021.103126] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/01/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The anxiety mothers experience during pregnancy is well known and may have negative consequences for the emotional, psychological, and social development of newborns. Anxiety must therefore be reduced using different strategies. OBJECTIVE To determine published non-pharmacological interventions to reduce anxiety during pregnancy, childbirth and postpartum. METHODS A systematic peer-review of experimental and quasi-experimental studies was conducted using the PubMed, Scopus, Web of Science (WOS), and CINAHL databases. The quality of the studies was assessed using the Spanish version of the PEDro scale. Two researchers participated independently in the data selection and extraction process. FINDINGS 587 articles were identified, of which 21 met the eligibility criteria. In eleven studies the intervention was performed during pregnancy, in three of them during labour, in four of them during the postpartum period, and in three of them during pregnancy and postpartum. During pregnancy, the most effective interventions were behavioural activation, cognitive behavioural therapy, yoga, music therapy, and relaxation; during childbirth: aromatherapy; during pregnancy and postpartum: antenatal training, massage by partners, and self-guided book reading with professional telephone assistance. CONCLUSION AND IMPLICATIONS The most effective interventions to reduce anxiety were performed either during pregnancy or during the postpartum period, not during labour. Most of the interventions were performed on the women, with few of them being performed on both partners. Non-pharmacological interventions may be applied by nurses and midwives to reduce anxiety during pregnancy, labour and postpartum.
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Affiliation(s)
- Esther Domínguez-Solís
- Nurse specialist in gynecology and obstetrics. PhD student of the University of Seville, Seville, Spain
| | - Marta Lima-Serrano
- Department of Nursing, Doctor from the University of Seville, Seville, Spain.
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16
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McCabe R, Day E. Counsellors' experiences of the use of mindfulness in the treatment of depression and anxiety: An interpretative phenomenological analysis. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Rebecca McCabe
- Australian College of Applied Psychology ‐ Melbourne Campus Melbourne Vic. Australia
| | - Elizabeth Day
- Auckland University of Technology Auckland New Zealand
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17
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Jensen KHK, Krog MC, Koert E, Hedegaard S, Chonovitsch M, Schmidt L, Kolte AM, Nielsen HS. Meditation and mindfulness reduce perceived stress in women with recurrent pregnancy loss: a randomized controlled trial. Reprod Biomed Online 2021; 43:246-256. [PMID: 34112605 DOI: 10.1016/j.rbmo.2021.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022]
Abstract
RESEARCH QUESTION Can participating in a tailored 7-week meditation and mindfulness programme with additional standard supportive care versus standard supportive care only reduce perceived stress for women with recurrent pregnancy loss (RPL)? DESIGN A two-armed randomized controlled trial (RCT) with 12-month follow-up. In total 76 patients were enrolled and randomly assigned to either standard supportive care or to a 7-week meditation and mindfulness programme led by an instructor in addition to standard supportive care. RESULTS At intervention completion (after 7 weeks), perceived stress decreased significantly both in the intervention group (P = 0.001) and in the control group (P = 0.006). The decrease in perceived stress in the intervention group was significantly larger (P = 0.027) compared with the control group. At the 12-month follow-up perceived stress was still significantly decreased in both groups compared with baseline (P < 0.0001 in the intervention group and P = 0.002 in the control group). CONCLUSION This first RCT of a tailored meditation and mindfulness intervention for women with RPL documents that a 7-week daily at-home meditation and mindfulness programme combined with group sessions reduced perceived stress significantly more than a standard supportive care programme. Future studies should address the most effective format and the 'dose' needed for an impact on perceived stress levels.
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Affiliation(s)
- Karen Henriette Kirchheiner Jensen
- Recurrent Pregnancy Loss Unit, Copenhagen University Hospitals, Rigshospitalet, Fertility Clinic 4071, Copenhagen Ø, Denmark and Hvidovre Hospital, Department of Obstetrics and Gynaecology, Hvidovre, Denmark.
| | - Maria Christine Krog
- Recurrent Pregnancy Loss Unit, Copenhagen University Hospitals, Rigshospitalet, Fertility Clinic 4071, Copenhagen Ø, Denmark and Hvidovre Hospital, Department of Obstetrics and Gynaecology, Hvidovre, Denmark; Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Emily Koert
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen Ø, Denmark
| | - Signe Hedegaard
- Recurrent Pregnancy Loss Unit, Copenhagen University Hospitals, Rigshospitalet, Fertility Clinic 4071, Copenhagen Ø, Denmark and Hvidovre Hospital, Department of Obstetrics and Gynaecology, Hvidovre, Denmark
| | - Marie Chonovitsch
- Recurrent Pregnancy Loss Unit, Copenhagen University Hospitals, Rigshospitalet, Fertility Clinic 4071, Copenhagen Ø, Denmark and Hvidovre Hospital, Department of Obstetrics and Gynaecology, Hvidovre, Denmark
| | - Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen Ø, Denmark
| | - Astrid Marie Kolte
- Recurrent Pregnancy Loss Unit, Copenhagen University Hospitals, Rigshospitalet, Fertility Clinic 4071, Copenhagen Ø, Denmark and Hvidovre Hospital, Department of Obstetrics and Gynaecology, Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark
| | - Henriette Svarre Nielsen
- Recurrent Pregnancy Loss Unit, Copenhagen University Hospitals, Rigshospitalet, Fertility Clinic 4071, Copenhagen Ø, Denmark and Hvidovre Hospital, Department of Obstetrics and Gynaecology, Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark
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18
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Missler M, Donker T, Beijers R, Ciharova M, Moyse C, de Vries R, Denissen J, van Straten A. Universal prevention of distress aimed at pregnant women: a systematic review and meta-analysis of psychological interventions. BMC Pregnancy Childbirth 2021; 21:276. [PMID: 33794828 PMCID: PMC8017784 DOI: 10.1186/s12884-021-03752-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is sufficient meta-analytic evidence that antenatal interventions for women at risk (selective prevention) or for women with severe psychological symptoms (indicated prevention) are effective in reducing postpartum distress. However, women without risk or severe psychological symptoms might also experience distress. This meta-analysis focused on the effectiveness of preventive psychological interventions offered to universal populations of pregnant women on symptoms of depression, anxiety, and general stress. Paternal and infant outcomes were also included. METHOD We included 12 universal prevention studies in the meta-analysis, incorporating a total of 2559 pregnant women. RESULTS Overall, ten studies included depression as an outcome measure, five studies included stress, and four studies anxiety. There was a moderate effect of preventive interventions implemented during pregnancy on the combined measure of maternal distress (d = .52), on depressive symptoms (d = .50), and on stress (d = .52). The effect on anxiety (d = .30) was smaller. The effects were not associated with intervention timing, intervention type, intervention delivery mode, timing of post-test, and methodological quality. The number of studies including partner and/or infant outcomes was too low to assess their effectiveness. CONCLUSIONS This meta-analysis suggests that universal prevention during pregnancy is effective on decreasing symptoms of maternal distress compared to routine care, at least with regard to depression. While promising, the results with regard to anxiety and stress are based on a considerably lower number of studies, and should thus be interpreted with caution. More research is needed on preventing other types of maternal distress beyond depression. Furthermore, there is a lack of research with regard to paternal distress. Also, given the large variety in interventions, more research is needed on which elements of universal prevention work. Finally, as maternal distress symptoms can affect infant development, it is important to investigate whether the positive effects of the preventive interventions extend from mother to infant. SYSTEMATIC REVIEW REGISTRATION NUMBER International prospective register of systematic reviews (PROSPERO) registration number: CRD42018098861.
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Affiliation(s)
- Marjolein Missler
- Department of Clinical, Neuro and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands. .,Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525, HR, Nijmegen, The Netherlands.
| | - Tara Donker
- Department of Clinical, Neuro and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.,Department of Psychology Laboratory for Biological and Personality Psychology, Albert-Ludwigs-University of Freiburg, Stefan-Meier-Straße 8, D-79104, Freiburg i.. Br, Germany
| | - Roseriet Beijers
- Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525, HR, Nijmegen, The Netherlands.,Radboud University Medical Center, Donders Institute for Brain, Cognition & Behavior, Heyendaalseweg 135, 6525, AJ, Nijmegen, The Netherlands
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Charlotte Moyse
- Department of Clinical, Neuro and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Ralph de Vries
- Vrije Universiteit Amsterdam, Medical Library, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands
| | - Jaap Denissen
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
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19
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Galante J, Friedrich C, Dawson AF, Modrego-Alarcón M, Gebbing P, Delgado-Suárez I, Gupta R, Dean L, Dalgleish T, White IR, Jones PB. Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. PLoS Med 2021; 18:e1003481. [PMID: 33428616 PMCID: PMC7799763 DOI: 10.1371/journal.pmed.1003481] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is an urgent need for mental health promotion in nonclinical settings. Mindfulness-based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions. METHODS AND FINDINGS Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in-person, expert-defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk-of-Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well-being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta-regression and sensitivity analyses were prespecified. Pairwise random-effects multivariate meta-analyses and prediction intervals (PIs) were calculated. A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = -0.56; 95% confidence interval (CI) -0.80 to -0.33; p-value < 0.001; 95% PI -1.19 to 0.06), depression (14 trials; SMD = -0.53; 95% CI -0.72 to -0.34; p-value < 0.001; 95% PI -1.14 to 0.07), distress (27 trials; SMD = -0.45; 95% CI -0.58 to -0.31; p-value < 0.001; 95% PI -1.04 to 0.14), and well-being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p-value = 0.003; 95% PI -0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = -0.46; 95% CI -0.81 to -0.10; p-value = 0.012, 95% PI -1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well-being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs' superiority. Only effects on distress remained when higher-risk trials were excluded. USA-based trials reported smaller effects. MBPs targeted at higher-risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials. CONCLUSIONS Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.
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Affiliation(s)
- Julieta Galante
- University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, United Kingdom
| | | | | | - Marta Modrego-Alarcón
- University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | | | - Irene Delgado-Suárez
- University of Zaragoza, Zaragoza, Spain
- Institute of Medical Research Aragón, Zaragoza, Spain
| | | | - Lydia Dean
- University of Cambridge, Cambridge, United Kingdom
| | - Tim Dalgleish
- University of Cambridge, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Ian R White
- University College London, London, United Kingdom
| | - Peter B Jones
- University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
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20
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Gorman G, Toomey E, Flannery C, Redsell S, Hayes C, Huizink A, Kearney PM, Matvienko-Sikar K. Fidelity of Interventions to Reduce or Prevent Stress and/or Anxiety from Pregnancy up to Two Years Postpartum: A Systematic Review. Matern Child Health J 2020; 25:230-256. [PMID: 33237506 DOI: 10.1007/s10995-020-03093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Intervention fidelity refers to whether an intervention is delivered as intended and can enhance interpretation of trial outcomes. Fidelity of interventions to reduce or prevent stress and anxiety during pregnancy and postpartum has yet to be examined despite inconsistent findings for intervention effects. This study systematically reviews use and/or reporting of intervention fidelity strategies in trials of interventions, delivered to (expectant) parents during pregnancy and postpartum, to reduce or prevent stress and/or anxiety. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Studies were included if they were randomised controlled trials including pregnant women, expectant fathers and/or partners during pregnancy, and/ or parents within the first two years postpartum. The National Institutes of Health Behavior Change Consortium checklist was used to assess fidelity across five domains (study design, provider training, delivery, receipt, enactment). RESULTS Sixteen papers (14 interventions) were identified. Average reported use of fidelity strategies was 'low' (45%), ranging from 17.5 to 76%. Fidelity ratings ranged from 22% for provider training to 54% for study design. CONCLUSIONS Low levels of intervention fidelity may explain previous inconsistent effects of stress and anxiety reduction interventions. Important methodological areas for improvement include intervention provider training, fidelity of comparator conditions, and consideration of non-specific treatment effects. Increased methodological rigour in fidelity enhancement and assessment will improve intervention implementation and enhance examination of stress and anxiety reduction and prevention interventions delivered during pregnancy and the postpartum.
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Affiliation(s)
- Gregory Gorman
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Sarah Redsell
- School of Medicine, University of Nottingham, Nottingham, England
| | | | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Patricia M Kearney
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland
| | - Karen Matvienko-Sikar
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland. .,School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
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21
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Guo P, Zhang X, Liu N, Wang J, Chen D, Sun W, Li P, Zhang W. Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2020; 77:125-146. [PMID: 33048358 DOI: 10.1111/jan.14588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
AIM To quantify the effect of mind-body interventions on stress in pregnant women. DESIGN A systematic review and meta-analysis of randomized controlled trials was performed. DATA SOURCES PubMed, Embase, CENTRAL, Web of Science and PsycINFO were searched from each database inception to January 2020. REVIEW METHODS Randomized controlled trials regarding mind-body interventions for stress in pregnant women were included. Methodological quality was evaluated using the Cochrane Collaboration 'Risk of Bias' tool and meta-analysis was performed via RevMan 5.3. Subgroup analysis and publication bias assessment were conducted. Post hoc sensitivity analysis was performed to investigate the source of heterogeneity. RESULTS In total, 28 studies comprising 1944 participants were included. The overall meta-analysis showed that antenatal stress of pregnant women in the mind-body interventions groups showed significant high improvements (SMD=-0.94; 95% CI [-1.25, -0.63]; p < .00001) compared with the control groups. Results of subgroup analyses indicated that all types of mind-body interventions including mindfulness intervention, cognitive behavioural therapy, relaxation techniques and yoga were beneficial to antenatal stress. Both groups and individual formats mind-body interventions were effective. 4-8 weeks mind-body interventions were seemed as the optimal choice. Moreover, mind-body interventions were concomitant with reducing antenatal anxiety and depression. CONCLUSION Mind-body interventions are promising approaches for stress reduction in pregnant women. Nevertheless, the results should be interpreted with caution because of high heterogeneity and publication bias. Further high-quality studies are needed to verify the findings. IMPACT Mind-body interventions have been widely implemented to ameliorate antenatal stress, but conflicting results were found across studies. This systematic review and meta-analysis suggested that mind-body interventions are relatively safe and convenient and can successfully promote antenatal stress. The suggestions proposed in this review may be useful for developing a scientific mind-body interventions regimen and encouraging the application of mind-body interventions in pregnant women, thereby managing antenatal stress effectively.
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Affiliation(s)
- Pingping Guo
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xuehui Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Na Liu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jie Wang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Dandan Chen
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Weijia Sun
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Ping Li
- Department of Developmental Pediatrics, Second Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
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22
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Olsson Mägi CA, Bjerg Bäcklund A, Lødrup Carlsen K, Almqvist C, Carlsen KH, Granum B, Haugen G, Hilde K, Lødrup Carlsen OC, Jonassen CM, Rehbinder EM, Sjøborg KD, Skjerven H, Staff AC, Vettukattil R, Söderhäll C, Nordlund B. Allergic disease and risk of stress in pregnant women: a PreventADALL study. ERJ Open Res 2020; 6:00175-2020. [PMID: 33083440 PMCID: PMC7553112 DOI: 10.1183/23120541.00175-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/23/2020] [Indexed: 11/05/2022] Open
Abstract
Background Maternal stress during pregnancy may negatively affect the health of mother and child. We therefore aimed to identify the proportion of women reporting high maternal stress in mid and late pregnancy and explore whether symptoms of maternal allergic disease are associated with perceived maternal stress in late pregnancy. Method The population-based Preventing Atopic Dermatitis and Allergy in Children (PreventADALL) study enrolled 2697 pregnant women at their 18-week routine ultrasound examination in Norway and Sweden. Information about sociodemographic factors, symptoms and doctor-diagnosed asthma, allergic rhinitis, atopic dermatitis, food allergy, and anaphylaxis and stress using the 14-item perceived stress scale (PSS) was collected at 18 weeks (mid) and 34 weeks (late) pregnancy. High stress was defined as a PSS score ≥29. Scores were analysed using multivariate logistic and linear regression. Results Among the 2164 women with complete PSS data, 17% reported asthma, 20% atopic dermatitis, 23% allergic rhinitis, 12% food allergy and 2% anaphylaxis. The proportion of women reporting high stress decreased from 15% at mid to 13% at late pregnancy (p<0.01). The adjusted odds ratio for high stress in late pregnancy was 2.25 (95% CI 1.41-3.58) for self-reported symptoms of asthma, 1.46 (95% CI 1.02-2.10) for allergic rhinitis and 2.25 (95% CI 1.32-3.82) for food allergy. A multivariate linear regression model confirmed that symptoms of asthma (β coefficient 2.11; 0.71-3.51), atopic dermatitis (β coefficient 1.76; 0.62-2.89) and food allergy (β coefficient 2.24; 0.63-3.84) were independently associated with increased PSS score. Conclusion Allergic disease symptoms in pregnancy were associated with increased stress, highlighting the importance of optimal disease control in pregnancy.
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Affiliation(s)
- Caroline-Aleksi Olsson Mägi
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Bjerg Bäcklund
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Catarina Almqvist
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Kai-Håkon Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Katarina Hilde
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Oda C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christine Monceyron Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Katrine D Sjøborg
- Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Björn Nordlund
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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23
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Han Q, Guo M, Ren F, Duan D, Xu X. Role of midwife-supported psychotherapy on antenatal depression, anxiety and maternal health: A meta-analysis and literature review. Exp Ther Med 2020; 20:2599-2610. [PMID: 32765754 PMCID: PMC7401497 DOI: 10.3892/etm.2020.9011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/14/2020] [Indexed: 12/17/2022] Open
Abstract
The onset of depression and anxiety during the antenatal stage of pregnancy is common. Despite the conception of numerous interventions in the past decades, studies show no signs of decline in the prevalence of antenatal depression and anxiety. Recently, the use of midwife-supported psychotherapy to treat these psychosomatic disorders has garnered a lot of attention. However, no attempt to date has been made to synthesize the evidence evaluating the influence of midwife-supported psychotherapy on antenatal depression, anxiety, and overall maternal health-status. The aim of the present meta-analysis was to demonstrate the effectiveness of midwife-supported psychotherapy on depression, anxiety, and maternal health-status outcome during the antenatal stage of pregnancy. A systematic identification of literature was performed according to PRISMA guidelines on four academic databases: MEDLINE, Scopus, EMBASE and CENTRAL. A meta-analysis evaluated the influence of midwife-supported psychotherapy on depression, anxiety, and maternal health-status outcome as compared to conventional obstetric care. Of the 1,011 records, 17 articles, including 6,193 pregnant women (mean age: 28.9±2.2 years) were included in this meta-analysis. Eleven studies compared the effects of midwife-supported therapy on depression, 14 compared its effects on anxiety and 2 compared its effects on maternal health-status outcome. The meta-analysis reveals the beneficial effects of midwife-supported psychotherapy for reducing depression (Hedge's g: -0.9), anxiety (-0.8) and enhancing maternal health-status outcome (0.1), as compared to conventional obstetric care. The current systematic review and meta-analysis recommend the use of midwife-supported psychotherapy for the reduction of depression, anxiety and enhancing maternal health-status during the antenatal stage of pregnancy.
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Affiliation(s)
- Qing Han
- Department of Obstetrics, Zaozhuang Hospital of Maternal and Child Health, Zaozhuang, Shandong 277100, P.R. China
| | - Min Guo
- Department of Obstetrics, Zaozhuang Hospital of Maternal and Child Health, Zaozhuang, Shandong 277100, P.R. China
| | - Fenfen Ren
- Department of Obstetrics, Zaozhuang Hospital of Maternal and Child Health, Zaozhuang, Shandong 277100, P.R. China
| | - Dongyun Duan
- Department of Obstetrics, Zaozhuang Hospital of Maternal and Child Health, Zaozhuang, Shandong 277100, P.R. China
| | - Xiufeng Xu
- Department of Obstetrics, Zaozhuang Hospital of Maternal and Child Health, Zaozhuang, Shandong 277100, P.R. China
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24
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Gheibi Z, Abbaspour Z, Haghighyzadeh MH, Javadifar N. Effects of a mindfulness-based childbirth and parenting program on maternal-fetal attachment: A randomized controlled trial among Iranian pregnant women. Complement Ther Clin Pract 2020; 41:101226. [PMID: 32853900 DOI: 10.1016/j.ctcp.2020.101226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 07/22/2020] [Accepted: 07/30/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Although mindfulness-based childbirth and parenting is suggested to promote maternal-fetal attachment, no study has yet addressed its potential effects. This study aimed to determine the effects of a mindfulness-based childbirth and parenting program on maternal-fetal attachment among Iranian pregnant women. MATERIALS AND METHODS This study was conducted on pregnant women, who were divided into two groups to either receive routine care plus mindfulness training for childbirth and parenting (i.e., eight 2-h group sessions once a week and one 3-h session of silent meditation) or receive routine care alone. Maternal-fetal attachment was evaluated by the Cranley's Maternal-Fetal Attachment Scale. RESULTS After the intervention, the total score of maternal-fetal attachment was significantly higher in the experimental group (P < 0.001; effect size = 0.640). In the intervention group, all dimensions of maternal-fetal attachment significantly improved, except the dimension of "differentiation of self from the fetus", whereas in the control group, only the dimension of "attributing characteristics to the fetus" improved. CONCLUSION The implemented program in this study was potentially effective in promoting maternal-fetal attachment.
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Affiliation(s)
- Zeinab Gheibi
- Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zabihollah Abbaspour
- Department of Psychology, School of Education and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
| | | | - Nahid Javadifar
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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25
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Lucena L, Frange C, Pinto ACA, Andersen ML, Tufik S, Hachul H. Mindfulness interventions during pregnancy: A narrative review. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2020; 18:470-477. [PMID: 32798196 DOI: 10.1016/j.joim.2020.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022]
Abstract
Pregnancy is a period of major transformations in a woman's life; increased stress, and mood and sleep disorders are frequent. This review evaluates mindfulness interventions during pregnancy and their ability to help manage stress, anxiety, depression, emotional regulation, level of mindfulness and sleep quality. A search of English language scientific literature relevant to mindfulness interventions for pregnant women was conducted using PubMed, Scopus and Web of Science, without restriction on publication date. Inclusion criteria were randomized clinical trials with pregnant women, using mindfulness as an intervention for at least three weeks, in one of our main areas of interest, and using only validated scales to measure outcomes. Two hundred and thirty studies were identified in our searches of research databases, and thirteen were included in our analysis. We found a large diversity of mindfulness programs, heterogeneity among the instruments used to evaluate outcomes, and inconsistency in the gestational periods used in the studies. Mindfulness interventions were beneficial for stress, anxiety and depression. Mindfulness was also effective when applied in pregnant women with a history of depression or experiencing depression. Considering emotional regulation and the level of mindfulness, there were signs of improvement, but more studies are needed. None of the studies evaluated sleep quality. Our review provides information about current mindfulness programs, an overview of the effects of mindfulness interventions, a description of the measurements used so far, and recommendations for developing high-quality mindfulness protocols for pregnant women.
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Affiliation(s)
- Leandro Lucena
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Cristina Frange
- Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo 04039002, Brazil
| | - Ana Claudia Amorim Pinto
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Monica Levy Andersen
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Helena Hachul
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil; Department of Gynecology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04024002, Brazil.
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26
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Kazemi F, Masoumi SZ, Soltani F, Oshvandi K, Ghelichkhani S, Niazy Z. Postpartum women's perception of stressors in the delivery ward: a qualitative study. BMC Res Notes 2020; 13:335. [PMID: 32660523 PMCID: PMC7359504 DOI: 10.1186/s13104-020-05176-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/07/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Delivery is a challenging event in women's lives. What happens during childbirth is stressful for most women. Regarding the short and long-term effects of stressors of the delivery ward on childbirth and neonatal outcomes, and given that understanding the stressors are influenced by existing social culture and factors, the present qualitative study was conducted to investigate women's perception of stressors in the delivery ward. Participants were 13 newly delivered women who were monitored in the recovery room at the Fatemieh Hospital of Hamadan, Iran. Purposive sampling was performed and continued until data saturation. The data collection method was in-depth and semi-structured. RESULTS The content analysis of qualitative data led to the emergence of two themes of human stressors and environmental stressors as well as four categories; i.e., personal factors, care staff-related factors, environmental factors, and equipment-related factors. The research findings indicated that several personal, environmental, staff-related, and equipment-related factors could lead to stress in the labor and delivery ward. Although ignoring them and increasing stress during childbirth may jeopardize the childbirth consequences, most of them are ignored and overlooked. It is necessary to consider measures to control these factors as much as possible.
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Affiliation(s)
- Farideh Kazemi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Farzaneh Soltani
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samereh Ghelichkhani
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ziba Niazy
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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27
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Yang M, Jia G, Sun S, Ye C, Zhang R, Yu X. Effects of an Online Mindfulness Intervention Focusing on Attention Monitoring and Acceptance in Pregnant Women: A Randomized Controlled Trial. J Midwifery Womens Health 2020; 64:68-77. [PMID: 30695166 DOI: 10.1111/jmwh.12944] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 11/12/2018] [Accepted: 11/17/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Attention monitoring and acceptance underlie the effects of mindfulness meditation. This study tested the feasibility and acceptability of an online mindfulness intervention for pregnant women as an approach to reduce depressive and anxious symptoms. METHOD We developed an 8-week mindfulness intervention program that trained participants to monitor their internal and external experiences in an accepting way. The mindfulness course was based on the Wechat platform. This study was conducted in a women's hospital in China. A total of 123 women with scores on the Generalized Anxiety Disorder Scale and Patient Health Questionnaire suggesting mild or moderate symptoms of depression and anxiety were recruited from the outpatient department between April and June 2018. The participants were randomized to receive the mindfulness intervention or routine prenatal care. The Generalized Anxiety Disorder Scale, the Patient Health Questionnaire, and the Five Facets of Mindfulness Questionnaire were used to evaluate the levels of anxiety, depression, and mindfulness, respectively, before and after the intervention. RESULTS Of the 123 women enrolled in this study, 10 in the intervention group and 11 in the control group did not complete the intervention. The retention rate and feedback suggested that the mindfulness intervention was feasible and acceptable among pregnant women. Participants in the intervention group showed greater declines in depressive and anxious symptoms compared with those in the control group, as well a significant improvement in mindfulness skills (eg, attention monitoring and acceptance). DISCUSSION These results suggest that an online mindfulness intervention may be a promising technique to help women use mindfulness skills to reduce depressive and anxious symptoms. The mindfulness intervention could constitute part of the psychological care provided to pregnant women.
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28
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Matvienko-Sikar K, Flannery C, Redsell S, Hayes C, Kearney PM, Huizink A. Effects of interventions for women and their partners to reduce or prevent stress and anxiety: A systematic review. Women Birth 2020; 34:e97-e117. [PMID: 32107141 DOI: 10.1016/j.wombi.2020.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/09/2020] [Accepted: 02/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The period from conception to two years postpartum (the first 1000 days) represents a normative transitional period, which can be potentially stressful for some parents. Parental stress and anxiety adversely impacts psychological and physical health for parents and children. AIM The aim of this review is to systematically examine effects of interventions for women and their partners to reduce or prevent stress and/or anxiety during the first 1000 days. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Randomised controlled trials examining intervention effects on parental stress and/or anxiety during first 1000 days were eligible for inclusion. Data were independently extracted by two reviewers and narratively synthesised. FINDINGS Fifteen interventions, reported in 16 studies, met inclusion criteria (n=1911 participants). Overall, findings were inconsistent and the majority of trials demonstrated high risk of bias. Interventions were predominantly delivered to women during pregnancy and only two studies included fathers. There was some evidence that adapting interventions to the pre and postnatal periods provided benefits for stress and anxiety reduction, however there was limited evidence for individual intervention types or approaches. CONCLUSIONS There is currently inconsistent evidence of what interventions are most effective for women during the first 1000 days and there is insufficient evidence for any interventions for male partners during this period. There is a clear need for rigorous development and examination of interventions developed specifically to reduce or prevent stress and/or anxiety across the first 1000 days.
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Affiliation(s)
| | | | - Sarah Redsell
- School of Medicine, University of Nottingham, United Kingdom
| | | | | | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
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29
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Bublitz MH, Nillni Y, Livingston Z, Carpenter M, Salmoirago-Blotcher E. Phone-Delivered Mindfulness Training for Pregnant Women at Risk for Preterm Birth. J Altern Complement Med 2019; 25:444-445. [PMID: 30789281 DOI: 10.1089/acm.2018.0331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Margaret H Bublitz
- 1 Department of Psychiatry and Human Behavior and Alpert Medical School of Brown University, Providence, RI.,2 Department of Medicine, Alpert Medical School of Brown University, Providence, RI.,3 Women's Medicine Collaborative, The Miriam Hospital, Providence, RI
| | - Yael Nillni
- 4 Department of Psychiatry, Boston University School of Medicine, Boston, MA
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30
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Agampodi T, Katumuluwa S, Pattiyakumbura T, Rankaduwa N, Dissanayaka T, Agampodi S. Feasibility of incorporating mindfulness based mental health promotion to the pregnancy care program in Sri Lanka: a pilot study. F1000Res 2018; 7:1850. [PMID: 32226605 PMCID: PMC7096187 DOI: 10.12688/f1000research.17049.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Though widely discussed, mindfulness-based interventions (MBI) to improve maternal mental health is limited by lack of studies with system incorporation. We evaluate the feasibility of incorporating a MBI program into routine antenatal care (ANC) in Sri Lanka. Methods: MBI included learning mindfulness concepts, practicing mindfulness sitting/reclining meditation, performing mindful movements and practicing mindfulness in daily life. Feedback from the participants were obtained through an anonymous, self-administered, semi-structured questionnaire to determine the program’s cultural appropriateness, usefulness, and feasibility. Results: Participants reported that the training reduced the stress of their daily life, brought a sense of calmness to their mind and body, and improved their anger management. Participants felt strongly that this training would be very useful and a shortened version be included in the national ANC program. Conclusions: This pilot study suggests that an interventional study to evaluate system incorporation of a MBI to improve maternal mental health is feasible.
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Affiliation(s)
- Thilini Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
| | - Subhashini Katumuluwa
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
| | - Thulani Pattiyakumbura
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
| | - Nilupulee Rankaduwa
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
| | - Thushari Dissanayaka
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
| | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
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