Assess the Effectiveness of Benson’s Relaxation on stress among antenatal mothers attending outpatient department in selected PHC at Namakkal District.

Prof. P. Padmavathi,

Principal, Dhanvantri College of Nursing, Ganapathypuram, NO – 1 Ranganoor Road, Muniyappan Kovil, Pallakkapalyam (PO), Tiruchengodu (TK), Namakkal District – 637 303

*Corresponding Author Email:

ABSTRACT:

Background: Every pregnant woman experiences stress of some sort, whether it is financial fears or just how to assemble the crib correctly. These sorts of stress are common during pregnancy. But some women suffer extreme stress during pregnancy. Pregnancy is an experience full of growth changes, enrichment and challenges. It is a time of fear and expectation about becoming mother. Around 80% women experience these symptoms.

Objectives: To assess the effectiveness of Benson’s relaxation on stress among antenatal mothers.

Design: Pre experimental one group pre and posttest design was adopted for the study. Setting: VK hospital and TPN hospital, Erode. Participants: 30 antenatal mothers fulfilling the inclusion criteria were selected by convenient sampling.

Methods: A pretest was conducted by using Perceived Stress Scale. Immediately after pretest. Benson’s relaxation was given one time (15 = 20 minutes) a day for 30 days and 31stday post test was conducted to assess the effectiveness of Benson’s relaxation. Collected data was analyzed by using descriptive and inferential statistics.

Results: In pretest, the mean score of the sample was 22.3 (SD= 1.34)) and the posttest mean score was 12.2 (SD = 0.72) with paired ‘t’ value of 10.32. This showed that the Benson’s relaxation was effective on reducing the stress among antenatal mothers. There was a statistically no significant association found between the post test scores of the sample with their demographic variables.

Conclusion: It seems that teaching pregnant women on relaxation could be effective in mother and her children. Therefore, attention should be paid to different methods for reducing stress in this group of mothers. Benson’s relaxation is a non-pharmacological, cost effective and simple intervention without any adverse effects. The results proved that the Benson’s relaxation was effective in reducing the stress among antenatal mothers.

KEYWORDS: Effectiveness, Benson’s relaxation, stress, antenatal mothers.

BACHGROUND OF THE STUDY:

Pregnancy brings both physical and psychological changes in the women. During pregnancy majority of psychological problems is result of hormonal changes. Pregnancy is an experience full of growth changes, enrichment and challenges. It is a time of fear and expectation about becoming mother.

Around 80% women experience these symptoms. First trimester - fear of losing the baby, second trimester- due to increase in weight there is loss of self-esteem and third trimester - fear of baby arrival. (Annamma Jacob. 2008)

A study of association between antenatal stress and low birth weight in developed country. A Total of 143 healthy mothers with stress in third trimester of pregnancy and 143 non stress mother of similar. Gestation was followed from birth infant weight was measured and information collected on socioeconomic status, maternal body mass index and socio demographic factors. The result showed infants of stressed mothers had lower body weight (mean 2910gms) than infant of non stressed mother (mean3022 gms) relative risk for low birth weight(< 2500gms) (Sunder C et.al., 2009)

Every pregnant woman experiences stress of some sort, whether it is financial fears or just how to assemble the crib correctly. These sorts of stress are common during pregnancy. But some women suffer extreme stress during pregnancy. Certain situations such as domestic violence, workload, worries over being a single mother, and medical worries can cause some pregnant women to endanger themselves and their babies. (Vijay P, Sharma, 2008)

In the Nineties, we have begun to understand how the stress and mother's emotional state affects her foetus. Studies proved that, if a mother experience excessive stress or suffers from an emotional trauma, her baby may be born with certain defects, which may persist into adulthood and cause more complications. (Nkanshah, 2009)

Stress is not good for the mother during the term. It can have adverse side effects. It is very important for the mothers to remove anxiety. This is also a part of the stress management process. Anxiety during pregnancy is very harmful. It may result in false labour or premature birth. It can also cause hypertension. The effects can be disastrous for the unborn foetus.

Maternal stress during pregnancy is also found to cause of asymmetry in coordination of ears, fingers, feet, elbows, etc. As a result intelligent quotients of such children are found to be lower. Maternal stress is also linked with imperfections in the developing nervous system which can lead to problems of perception, thinking, and memory.

A study was conducted on effects of maternal stress on low birth weight and preterm birth outcomes across neighborhoods of South Carolina. The result showed that maternal stress was significantly associated with increased risks of low birth weight and preterm deliveries. Neighborhood high poverty and low education (upper quartiles) were independently associated with low birth weight but not preterm deliveries and stress appeared as a partial mediator of contextual effects on birth outcomes. (Silvia R.et.al., 2010)

The study was conducted on maternal stress and preterm birth. A cohort study of 1,962 pregnant women in central North Carolina, in which 12% delivered preterm. There was increased risk of preterm birth among women high counts of pregnancy related anxiety (risk ratio= 2.1, 95% confidence interval: 1.5, 3.0) with life events to which respondent assigned a negative impact weight (RR=1.8, 95% CL: 1.0, 2.0). Preterm birth initiated by labor or ruptured was associated with pre term birth. High level of negative impact weight (RR=3.0, 95% CL: 1.7, 5.3) (Hodnett E.D. Stress., 2010)

OBJECTIVES:

1. To assess the level of stress among antenatal mothers before and after Benson’s Relaxation

2. To determine the effectiveness of Benson’s Relaxation on stress among antenatal mothers

3. To find out the association between post test scores of stress among antenatal mothers with their demographic variables

HYPOTHESIS:

H₁ There will be significant reduction of stress among antenatal mothers before and after Benson’s Relaxation

H₂ There will be significant effectiveness of Benson’s Relaxation on stress among antenatal mothers

H₃ There will be significant association between post test scores of stress among antenatal mothers with their demographic variables

MATERIALS AND METHODS:

Research approach

An evaluative approach was considered as the appropriate measure to evaluate the effectiveness of Benson’s Relaxation on stress among antenatal mothers.

Research design

Pre experimental where one group pre and posttest design was used

Antenatal mothers	Pre test	Intervention	Post test
Experimental group	O₁	X	O₂

Research setting

The study was conducted in Primary Health Center, Elanthakkutti.

Sample

The sample consisted of 30 antenatal mothers

Sampling technique: Non probability convenience sampling technique was used to select the samples

Development of tool

Section A : Socio demographic variables of the samples (age, education, occupation, income, family type, parity, nature of pregnancy (planned or unplanned), occupation of the spouse and previous history of miscarriages.

Section B : Perceived Stress Scale (PSS)

The Perceived Stress Scale (PSS) is a classic stress assessment instrument. Each question choose from the following alternatives:

0 – never; 1 - almost never; 2 – sometimes; 3 - fairly often; 4 - very often

Scoring Procedure

You can determine your PSS score by following these directions: First, reverse your scores for questions 4, 5, 7, and 8. On these 4 questions, change the scores like this: 0 = 4, 1 = 3, 2 = 2, 3 = 1, 4 = 0. Now add up your scores for each item to get total scores. Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress.

1. Scores ranging from 0-13 would be considered low stress.

2. Scores ranging from 14-26 would be considered moderate stress.

3. Scores ranging from 27-40 would be considered high perceived stress.

Data Collection procedure

§ Ethical clearance obtained from PHC Medical Officer. Followed by informed consent of 30 ante natal mothers from 3 – 4 months. Baseline data was obtained from the groups.

§ Pretest was conducted by using Perceived Stress Scale during the month between 3 – 4 months.

§ After immediately pretest Benson’s relaxation response technique (included being in a calm environment, mindfulness meditation, having a passive attitude, experiencing a comfortable situation, deep relaxation of muscles from feet to head) was given 15 to 20 minutes and finally ending relaxation very smoothly for one times day for 30 days

§ Post test was conducted by using Perceived Stress Scale after 30 days month.

Plan for data analysis

The data were analyzed by using both descriptive and inferential statistics

Ø Back ground information of the subject were described by percentage distribution

Ø Mean, standard deviation, Paired’t’ was used to find the relationship between pre-test and post-test assessment scores on stress among antenatal mothers.

Ø Chi square test was used to find out the relationship between selected variables of antenatal mothers with their post test scores.

RESULTS:

Section A: The study findings showed that in majority (74%) of the sample were in the age group of 21 025 years, 60% were secondary education, 83% were coolie workers, 67% of them were below Rs 50000/ income group, 60% of the were nuclear family, 60% of them were primi para, 83% of them were unplanned pregnancy, 90% of their husband was coolie worker and 60% of the were no previous history of miscarriage.

Section B: Assess the stress among antenatal mothers

Frequency and percentage distribution of antenatal mothers level of stress shows that, in pretest assessment, majority 18 (60%) of them had moderate stress and 12 (40%) of them had high stress whereas in posttest assessment majority 22 (73%) of them had low stress and 8 (27%) of them had moderate stress.

Section D:

Chi square was computed to determine the association between post test scores of the respondents with their demographic variables such as age (1= 0.532), education (2 = 0.91), occupation ( 2 = 0.054), income (1 = 0.243), family type (1 = 0.72), parity (1= 0.423), nature of pregnancy (planned or unplanned) (1 = 0.048), occupation of the spouse (1 = 0.074) and previous history of miscarriages (1 = 0.032).

DISCUSSION:

Highly significant difference found between pretest and post test scores of antenatal mothers regarding level of stress. So Benson’s relaxation technique was effective in reducing the stress among antenatal.

According to Toosi M (2013) reported that different Investigations have shown that the effect of Relaxation Training on emotional stress. The results showed a significant difference between the two groups in height, infant reflex and intensive crayning (with better situation in case group). There was no significant difference between the two groups in delivery, Apgar scores, weight and cephalic index, meconium deification and Apgar score in 1-5 minute. It seems that teaching pregnant women on relaxation could be effective in mother and her children.

There is no significant relationship was found between post test scores of the samples with their demographic variables such as age, education, occupation, income, family type, parity, nature of pregnancy (planned or unplanned), occupation of the spouse and previous history of miscarriages.

RECOMMENDATIONS:

On the basis of the findings of the study it is recommended that,

§ The study can be replicated on a larger sample to generalize the results

§ The comparative study can be conducted with more than one intervention

§ The same conducted with primi and multi ante natal mothers

§ The same conduct with control group

§ Non pharmacological stress management should be emphasized in nursing curriculum

§ Training programmes Nurses can be given on complementary therapies

LIMITATIONS:

Ø Intervention was limited to 10 -20 minutes.

Ø Study was conducted only on ante natal mothers.

Ø Relatively small sample size.

CONCLUSION:

Relaxation training during pregnancy has considerable effects on embryonic development. Simple and low-cost trainings can help pregnant mothers give birth to healthier children. Thus we suggest relaxation education as part of a healthcare program for pregnant mothers. It seems that teaching pregnant women on relaxation could be effective in mother and her children. Therefore, attention should be paid to different methods for reducing stress in this group of mothers.

REFERENCE:

1. Annamma Jacob. A comprehensive textbook of midwifery. 2^nd edition.New Delhi. Jaypee Brothers Medical publication (p) ltd; 2008. Page No 116-120.

2. SunderC et.al. Pica epidemiology and association with pregnancy complication:, Janeiro. (2009)

3. Silvia R .et.al .Depression during pregnancy in Brazilian public health care system,: Brazil(2010)

4. Stress during pregnancy: .Available From WWW. Women health care topic .com

5. Hodnett E.D. Stress during pregnancy for women increase risk of low birth weight babies: Canada. (2010),

6. The people’s media company, 2008, stress during pregnancy a breakdown of relaxing ideas, Amberberg publication.

7. Vijay P, Sharma Ph.D, mind publication stress and coping during pregnancy can affect child’s health, 2008, 24-28

8. Nkanshah, Amankra, Luckock J, Hussey TR , Maternal child health 2000 March, 2009-january 28, 14(2), 215-26.

9. Toosi M, Akbarzadeh M, Zare N, Sharif F The role of relaxation training in health index of infants in pregnant mothers, Journal of Jahrom University of Medical Sciences, Vol. 11, No. 1, Spring 2013

Received on 26.04.2014 Modified on 28.05.2014

Int. J. Adv. Nur. Management 2(2): April- June, 2014; Page 86-89