Impact of Affirmation Relaxation and Back Massage on Depression, Anxiety, and Stress in Mothers Who Have Undergone Caesarean Section

肯定放松和背部按摩对剖腹产母亲抑郁、焦虑和压力的影响

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Abstract

Introduction The postpartum psychological well-being and quality of life of mothers after caesarean section are poor when compared to mothers following vaginal delivery. Therefore, the study aimed to evaluate the impact of a combination of back massage and affirmation relaxation technique on depression, anxiety, and stress experienced by mothers who had undergone caesarean section. Methodology This interventional study used a pretest-posttest control group design and was quantitative in nature. Twenty-four caesarean section mothers, with 12 in the experimental group and 12 in the control group, were chosen by a purposive sampling technique at Fatima Hospital, Mau, Uttar Pradesh, India, from July 1, 2022, to August 14, 2022. A structured questionnaire on sociodemographic data and a standardised tool, DASS-21 (Depression, Anxiety and Stress Scale, 21 items), were used to gather the data. Data collection was done from the experimental and control groups on the 3rd and 6th post-operative days. The experimental group was given a back massage and affirmation relaxation four times a day for 10 minutes each on the 4th, 5th, and 6th post-operative days. The control group mothers received routine health assessment and health education on postnatal care and breastfeeding. Descriptive and inferential statistics were used to analyse the data using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York). The analysis of categorical data was done using frequency and percentage distribution, whereas the analysis of continuous variables was done using mean and standard deviation. The Wilcoxon signed rank test and the Mann-Whitney U test were employed to evaluate the intervention's efficacy. The significance level was set at p < 0.05. Results A total of 24 mothers who have undergone caesarean section participated in the study. Baseline characteristics such as age, type of family, education, parity, type of LSCS, gender of the newborn, birthweight of the newborn, and timing of initiation of breastfeeding were homogeneously distributed in both experimental and control groups. Before intervention, the mean depression score of both the experimental group (8 ± 2.09) and the control group (8.50 ± 2.28), the mean anxiety score of the experimental group (11.67 ± 3.06) and the control group (11.50 ± 2.97), and the mean stress score of the experimental group (10.33 ± 3.17) and the control group (11.00 ± 2.63) were comparable. After intervention, there was a significant reduction in the maternal stress score in the experimental group (6 ± 2.83) compared to the control group (8.67 ± 2.31), which was statistically significant at p < 0.05. The anxiety score was also reduced after intervention in the experimental group (6.50 ± 3.53) compared to the control group (9.17 ± 1.99), which was nearly significant (p = 0.052). The mean depression score between the experimental group (6.50 ± 1.93) and the control group (7 ± 2.49) was not statistically significant (p > 0.05). Conclusion The study findings highlight the potential benefits of affirmation relaxation and back massage for improving the psychological well-being of postpartum women who have had caesarean sections. The advantages of this mother-friendly, cost-effective method should prompt hospitals and health centres to incorporate it into standard postpartum care. Nursing students should also be taught about it as part of their midwifery education.

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