Complementary therapies to reduce physiological stress in pregnancy

Effect of Salvia officinalis scent on postmenopausal women's sexual function and satisfaction: a randomized controlled trial

INTRODUCTION

Sexual function is one of the important aspects of quality of life which is often impaired after menopause. Given the side effects of hormone therapy on postmenopausal women, alternative treatments such as aromatherapy have won popularity. The aim of this study was to investigate the effect of aromatherapy using Salvia officinalis on the sexual function and satisfaction of postmenopausal women.

METHODS

This was a double-blind randomized controlled trial conducted on postmenopausal women referring to health centers in Kermanshah, Iran, in 2018. The participants were randomly divided into two groups: Salvia officinalis (n = 32) and control (n = 32). Women in the intervention group received 2 drops of Salvia officinalis essential oil by inhalation twice a day for 5 consecutive days of a week continued for 6 weeks. The control group received almond oil in the same dosage and frequency. Sexual function and satisfaction were evaluated using the Lindberg sexual satisfaction questionnaire and the female sexual function index, respectively before the intervention and 6 weeks after it.

RESULTS

After 6 weeks of intervention, the total mean scores of sexual function (28.8 ± 2.13 vs.17.9 ± 1.59 P < 0.001) and sexual satisfaction (71.53 ± 5.86 vs. 50.44 ± 10.41) were significantly higher in the Salvia officinalis group compared with the control group, respectively.

CONCLUSION

The findings showed that aromatherapy using Salvia officinalis has a significant effect on improving sexual function and satisfaction in postmenopausal women. Therefore, given the prevalence of sexual disorders in postmenopausal women, aromatherapy using Salvia officinalis is recommended to be used for improving these disorders.

CLINICAL TRIAL REGISTRATION

Iranian Registry of Clinical Trials; https://en.irct.ir/user/trial/50212/view (IRCT20160427027633N6), registered (12/08/2020).

The Relationship between Bullshit Receptivity and Willingness to Share Misinformation about Climate Change: The Moderating Role of Pregnancy

Widespread dissemination of misinformation about climate change has seriously harmed the health of future generations and the world. Moreover, misinformation-sharing behaviors exhibit strong individual characteristics. However, research is limited on the antecedents of and mechanism underlying the willingness to share misinformation about climate change in terms of individual personalities and physiological states. Accordingly, we surveyed 582 women (224 pregnant) using a questionnaire and constructed a moderated mediation model to explore the relationships among individuals' bullshit receptivity, belief in misinformation about climate change, willingness to share misinformation about climate change, and pregnancy. The results showed that: (1) bullshit receptivity is positively related to the willingness to share misinformation about climate change; (2) belief in misinformation about climate change mediates the relationship between bullshit receptivity and willingness to share misinformation about climate change; and (3) for individuals with higher bullshit receptivity, pregnancy exacerbates the detrimental effects of bullshit receptivity on belief in misinformation about climate change.

Combination of 3-Dimensional Virtual Reality and Hands-On Aromatherapy in Improving Institutionalized Older Adults' Psychological Health: Quasi-Experimental Study

Background

In Taiwan, which has one of the most rapidly aging populations in the world, it is becoming increasingly critical to promote successful aging strategies that are effective, easily usable, and acceptable to institutionalized older adults. Although many practitioners and professionals have explored aromatherapy and identified its psychological benefits, the effectiveness of combining 3-dimensional (3D) virtual reality and hands-on aromatherapy remains unknown.

Objective

A quasi-experimental trial was designed to evaluate the effectiveness of this combination in lowering perceived stress and promoting happiness, sleep quality, meditation experience, and life satisfaction among institutionalized older adults in Taiwan.

Methods

A total of 60 institutionalized elderly participants either received the combined intervention or were in a control group. Weekly 2-hour sessions were implemented over 9 weeks. The outcome variables were happiness, perceived stress, sleep quality, meditation experience, and life satisfaction, which were assessed at baseline and after the intervention.

Results

Generalized estimating equation (GEE) analyses indicated that the experimental group showed significant post-intervention improvements in terms of scores for happiness, perceived stress, sleep quality, meditation experience, and life satisfaction (n=48; all P<.001). Another GEE analysis showed that the significant improvements in the 5 outcome variables persisted in participants aged 80 years and older (n=35; all P<.001).

Conclusions

This is the first trial to explore the effectiveness of a combination of 3D virtual reality and hands-on aromatherapy in improving older adults’ psychological health. The results are promising for the promotion of psychological health in institutionalized older adults.

Trial Registration

ClinicalTrials.gov NCT04324216; https://clinicaltrials.gov/ct2/show/NCT04324216.

Efficacy of Progressive Muscle Relaxation on Pregnancy Outcome among Anxious Indian Primi Mothers

Background:

Progressive Muscle Relaxation (PMR) helps to improve the emotional state of antenatal mothers with stress and anxiety, which is necessary to keep the fetus healthy inside the womb. This study assesses the efficacy of progressive muscle repose on stress and anxiety among primigravidae.

Materials and Methods:

A randomized controlled study was conducted from May 2015 to June 2017 with 250 primigravidae. The women were assigned using a lottery method to intervention and control groups, 125 in each group. Information on background variables, pregnancy outcome, maternal complications, fetal complications, and postpartum depression was collected during the interval following delivery. PMR was the intervention (video) installed on one-to-one basis for two consecutive days. Pearson correlation, ANOVA, and regression analysis were used to evaluate the data to determine pregnancy outcome and performance of PMR.

Results:

There was a significant reduction ((F₃ = 24.81, p < 0.001) in all aspects of stress among the intervention and control groups during the posttest. The mean gestational age at birth was significantly different (F₂ = 6.08, p = 0.014) in the control group. There was significant increase in the occurrence of fetal complications such as birth asphyxia (F₂ = 5.67, p < 0.050), respiratory distress (F₂ = 8.68, p < 0.050), and jaundice (F₂ = 3.91, p < 0.050) in the control group. There was a negative correlation between PMR and stress (r = −0.22, p < 0.001), and PMR and state anxiety (r = −0.26, p < 0.001). There was an increased occurrence of maternal complications among the control group in comparison with the intervention group.

Conclusions:

The study suggests that PMR practice is useful during pregnancy to decrease stress, anxiety, and for reducing the occurrence of postpartum complications.

Effects of Support Interventions in Women Hospitalized With Preterm Labor

This study was to examine the effects of support interventions on anxiety, depression, and quality of life in women hospitalized with preterm labor. A randomized, single-blind experimental design was used. Participants were recruited from maternity wards of one medical center in Taiwan. The control group ( n = 103) received routine nursing care, and intervention group ( n = 140) received interventional support during hospitalization. The Beck Anxiety Inventory, Edinburgh Postnatal Depression Scale, and Quality of Life Enjoyment and Satisfaction Questionnaire were used at admission and 2 weeks of hospitalization. For the control group, anxiety and depression scores increased significantly and quality of life decreased 2 weeks after hospitalization. Participants who received 2 weeks of support intervention had significantly lower anxiety and depression scores than controls. Thus, clinical nurses can offer support interventions to improve anxiety and depression for women with preterm labor during hospitalization.

Nurses' views on workplace wellbeing programmes

Workplace stress is prevalent among nurses. Healthcare employers have implemented complementary and alternative therapies (CATs) for relaxation and stress management within workplace wellbeing programmes. In-depth interviews were conducted with 12 registered nurses to explore the perceptions and experiences of nurses towards accessing CATs in and outside the workplace. Interviews were audio recorded and transcribed verbatim. Data were analysed using conventional, qualitative thematic techniques. Themes identified were 'perceptions of complementary and alternative therapies for stress management' and 'engagement with workplace wellness schemes'. CATs have a role within workplace wellbeing programmes and nurses are not averse to accessing them, although there are barriers to access that need to be addressed.

Effect of Acupressure on Maternal Anxiety in Women With Gestational Diabetes Mellitus: A Randomized Clinical Trial

Women with diabetes often experience a higher level of anxiety. The aim of the study was to evaluate the effect of acupressure on relieving anxiety of women with gestational diabetes mellitus (GDM). A randomized clinical trial was conducted on 60 women with GDM at a university hospital. The participants were allocated to an experimental and a placebo group (30 women per group). The experimental group received a nurse-provided acupressure at the true point, and the placebo group received pressure (touching) at a sham (false) point. Anxiety was measured immediately in the groups prior to and after a 2-day intervention by a questionnaire and the Visual Analogue Scale. The data were analyzed using descriptive and inferential statistics. Results indicated that the acupressure group had significantly lower anxiety than the placebo group (p ≤ .0001). In conclusion, the effects of acupressure appeared to be effective in reducing anxiety in diabetic pregnant women.

Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: a cross-sectional survey

Background

Maternal health is a public health priority in many African countries, but little is known about herbal medicine use in pregnancy. This study aimed to determine the pattern of use of herbal medicine in an urban setting, where women have relatively high access to public healthcare.

Methods

This cross-sectional study included 333 women attending a childcare clinic in a district public health hospital in Nairobi, Kenya, during January and February, 2012, and who had delivered a baby within the past 9 months. Qualitative and quantitative data on herbal medicine use during their latest pregnancy were collected through an interviewer-administered questionnaire. Data was analysed descriptively and the Chi square test and Fishers’ exact test used to analyse relationships among variables.

Results

About 12% of women used herbal medicine during their most recent pregnancy. The use of herbal medicine was associated with a lower level of education (p = 0.007) and use before the index pregnancy (p <0.001). Only 12.5% of users disclosed such use to healthcare professionals, and about 20% used herbal medicine concomitantly with Western medicine for the same illness/condition. Women used herbal medicine for back pain, toothache, indigestion and infectious diseases, such as respiratory tract infections and malaria. A proportion of users took herbal medicine only to boost or maintain health. There were high rates of self-prescribing, as well as sourcing from family and friends. Beliefs about safety and efficacy were consistent with patterns of use or non-use, although both users and non-users were unsure about the safety and contraindications of Western medicine during pregnancy compared with that of herbal medicine.

Conclusion

Herbal medicine is used by 12% of pregnant women with access to healthcare in an urban context in Kenya, and often occurs without the knowledge of healthcare practitioners. Healthcare professionals should play a role in rational use of both herbal and Western medicine, by discussing contraindications and the potential for drug-herb interactions with patients. More studies are needed into the use of herbal medicines during pregnancy, labour and the postpartum period in different geographical areas, and into the health outcomes associated with their use.

Antenatal stress: an Irish case study

BACKGROUND

stress in pregnancy is common and impacts negatively on women, infants and families. A number of factors contribute to high levels of stress in pregnancy, including financial concerns, marital discord, low support systems and low socio-economic status.

OBJECTIVES

the aim of this study was to evaluate stress anxiety levels and depressive symptoms among low risk women in an area in Ireland that was particularly impacted by the 2008 economic crisis.

DESIGN

a quantitative descriptive cross-sectional design was used. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale and the State Trait Anxiety Inventory (STAI). Data was collected at a single time during the second trimester.

SETTING

this paper reports a case study of one maternity service in Ireland. Participants included low risk pregnant women who were attending the hospital clinic for routine antenatal care.

RESULTS

of 150 questionnaires distributed, 74 completed questionnaires were returned indicating a 49.3% return rate. Findings indicated high levels of stress, anxiety and depressive symptomatology among participants. There were no significant difference in mean EPDS score for different age groups (F4,69=2.48, P=0.052), living arrangements (F4,68=0.90, P=0.5) or usual occupation (F4,69=1.45, P=0.2). A score of ≥ 12 was taken as indicative of probable antenatal depression and 86.5% of participants responded with a score of 12 or above. PSS scores were also high and more than three quarters of respondents scored ≥ 15 (75.6%) and more than a third had scores ≥ 20 (35.1%), out of a total score of 40. There was a significant difference in mean PSS score between the different age groups (F4,69=3.60, P=0.010) but not for living arrangements or usual occupation. A STAI score of ≥ 39 was taken as indicative of antenatal anxiety, and 74.3% of participants responded with a score of 39 or above. There were no significant differences in mean STAI score between the different age groups (F4,68=1.68, P=0.16), living arrangements (F4,67=2.30, P=0.068) or usual occupations (F4,68=1.25, P=0.3).

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

this study found high levels of antenatal stress, anxiety, and depressive symptoms in a low risk pregnant population, in an economically impacted region in Ireland. These findings have implications for fetal development and maternal health during pregnancy and in the post partum. Further studies are important to confirm rates and should be conducted over a longer time frame with data collected at more than one point in time, such as mid and late pregnancy. If findings are confirmed, early recognition and treatment of stress, anxiety and depressive symptoms is important to ameliorate some of the harmful effects of these conditions.

The effect of aromatherapy massage on the psychological symptoms of postmenopausal Iranian women

BACKGROUND

Menopausal symptoms experienced by women vary widely, and while many women transition through menopause with manageable symptoms, others experience severe symptoms, which may impair their quality of life.

OBJECTIVES

A randomized clinical trial was conducted to determine the effect of aromatherapy massage on psychological symptoms during menopause.

METHODS

The study population comprised 90 women. Each subject in the aromatherapy massage group received 30 min aromatherapy sessions with aroma oil, twice a week, for four weeks; each subject in the massage therapy group received the same treatment with odorless oil, while no treatment was provided to subjects in the control group. The outcome measures were psychological symptoms, as obtained through the psychological subscale of the Menopause Rating Scale.

RESULTS

A total of 87 women were evaluated. A statistically significant difference was found between the participants' pre- and post-application psychological score in intervention groups, whereas the score in the control group did not differ significantly. Aromatherapy massage decreased the psychological score MD: -3.49 (95% Confidence Interval of Difference: -4.52 to -2.47). Massage therapy also decreased the psychological score MD: -1.20 (95% Confidence Interval of Difference: -2.19 to -0.08). To distinguish the effect of aromatherapy from massage separately, we compared the reduction in the psychological score. Aromatherapy massage decreased the psychological score more than massage therapy MD: -2.29 (95% Confidence Interval of Difference: -3.01 to -0.47).

CONCLUSION

Both aromatherapy massage and massage were effective in reducing psychological symptoms, but, the effect of aromatherapy massage was higher than massage.

Use of and attitudes toward complementary and alternative medicine among midwives in Turkey

OBJECTIVE

The objective of the study was to evaluate the use of and attitudes toward complementary and alternative medicine (CAM) among midwives in Turkey.

STUDY DESIGN

Information was requested from 129 midwives at family health centers in Samsun concerning their suggestions for the use of complementary and alternative medicine for pregnant women.

RESULTS

58.9% of the midwives in this study had suggested CAM methods to pregnant women. It was found that, among CAM methods, the midwives studied made use of herbal treatment, diets and exercises the most (32.6%, 27.9% and 28.7%, respectively) and acupuncture, relaxation techniques and fast walking the least (1.6%, 6.2%, and 7.0%, respectively). It was found that the CAM method most suggested by the midwives studied was herbal therapy, and this therapy was suggested for nausea-vomiting, anemia, gastralgic complaints, constipation, sore throat, insomnia, hypertension, sinusitis, cough, the common cold, stress, hemorrhoids and asthenia-fatigue.

CONCLUSION

Complementary and alternative medicine, especially herbal therapy, is commonly suggested to pregnant women by those midwives studied in Samsun.

Complementary and alternative medicine in obstetrics: a survey from Iran

PURPOSE

This survey assessed the use of complementary and alternative medicine (CAM) methods by obstetricians in the Islamic Republic of Iran.

METHODS

Obstetricians in the province of Tehran were identified using the "Ketabe 118 Mashaghel" (2008), a source of medical department information. A survey on the use of CAM methods during childbirth and the reasons behind their application was conducted on site.

RESULTS

CAM methods are by in 37.3% (62/166) of the obstetricians. Acupressure, massage, and phytotherapy were found to be the most frequently used methods. Use of CAM was influenced by the employment status of the midwives and inversely correlated with the number of deliveries in the hospital.

CONCLUSIONS

CAM methods are used in Iran to some extent. With evidence-based medicine in mind it is interesting to note that in Iran mainly CAM methods which already have some proven benefit are used.

Manipulative therapy for pregnancy and related conditions: a systematic review

OBJECTIVE

The objective of this review is to evaluate the evidence on the effects of Spinal Manipulative Therapy (SMT) on back pain and other related symptoms during pregnancy.

DATA SOURCES

A literature search was conducted using Pubmed, Manual, Alternative and Natural Therapy Index System, Cumulated Index to Nursing and Allied Health, Index to Chiropractic Literature, the Cochrane Library, and Google Scholar. In addition hand searches and reference tracking were also performed, and the citation list was assessed for comprehensiveness by content experts.

METHODS OF STUDY SELECTION

This review was limited to peer-reviewed manuscripts published in English from 1966 until September 2008. The initial search strategy yielded 140 citations of which 12 studies were reviewed for quality.

TABULATION, INTEGRATION, AND RESULTS

The methodological quality of the included studies was assessed independently using quality checklists of the Scottish Intercollegiate Guidelines Network and Council on Chiropractic Guidelines and Practice Parameters. The review indicates that the use of SMT during pregnancy to reduce back pain and other related symptoms is supported by limited evidence.

CONCLUSION

Overall, this body of evidence is best described as emergent. However, since effective treatments for pregnancy-related back pain are limited, clinicians may want to consider SMT as a treatment option, if no contraindications are present.

TARGET AUDIENCE

Obstetricians & Gynecologists, Family Physicians

LEARNING OBJECTIVES

After completion of this article, the reader should be able to describe the concepts of spinal manipulative therapy and types of symptoms for which it might be considered in pregnancy, explain the quality of available research on the use of spinal manipulative therapy, and plan to discuss this therapy with interested pregnant patients.

The interaction between chronic stress and pregnancy: preterm birth from a biobehavioral perspective

Women's health care providers are increasingly aware that chronic stressors--such as poverty, ongoing perceived stress and anxiety, intimate partner violence, and experiences of racism--are associated with an increased incidence of preterm birth in the United States. It is important to increase our understanding of the explanatory pathways involved in these associations. This article discusses the concepts of stress, chronic stress response, allostatic load, the physiology of labor initiation, and the pathophysiologic interactions that may contribute to the occurrence of chronic stress-related preterm birth. Implications for future research and interventions are explored.

Women's experiences of using a Snoezelen room during labour in Western Australia

OBJECTIVE

to explore women's experience of using a Snoezelen room during their labour.

DESIGN

a qualitative exploratory design was conducted to provide insight into the phenomenon of using a Snoezelen room for labouring women and to identify factors that could facilitate or inhibit use of this environment. The constant comparison method modified from the grounded theory methodology was used to analyse data from in-depth interviews.

SETTING

Osborne Park Hospital, the second largest public provider of obstetric services in Western Australia, was the study setting.

PARTICIPANTS

sixteen women, recruited from July 2005 to June 2006, agreed to participate in an in-depth interview and share their experience of using the Snoezelen room during a recent labour.

FINDINGS

six themes were extracted from the data providing insight into what a Snoezelen environment can offer a labouring woman: distraction; relaxation; comfort; environmental control; choice of complementary therapies; and safety in a home-like atmosphere. Additional categories revealed factors that facilitated and/or detracted use of the room such as familiarity with features, being offered information and choice, timing in labour, the support person's response and working order of the room's features.

IMPLICATIONS FOR PRACTICE

when sharing their experience, women focused upon the process of their labour and how they managed this process rather than specific outcomes such as analgesic used or type of birth. Although outcomes such as type of birth may not have been their preferred choice, these women were able to achieve satisfaction with how they managed their labour while in the Snoezelen room. This midwifery-led initiative contributed to these women's labour experiences, by offering a combination of complementary therapies within the safety of a hospital environment.

Fetal responses to induced maternal relaxation during pregnancy

Fetal responses to induced maternal relaxation during the 32nd week of pregnancy were recorded in 100 maternal-fetal pairs using a digitized data collection system. The 18-min guided imagery relaxation manipulation generated significant changes in maternal heart rate, skin conductance, respiration period, and respiratory sinus arrhythmia. Significant alterations in fetal neurobehavior were observed, including decreased fetal heart rate (FHR), increased FHR variability, suppression of fetal motor activity (FM), and increased FM-FHR coupling. Attribution of the two fetal cardiac responses to the guided imagery procedure itself, as opposed to simple rest or recumbency, is tempered by the observed pattern of response. Evaluation of correspondence between changes within individual maternal-fetal pairs revealed significant associations between maternal autonomic measures and fetal cardiac patterns, lower umbilical and uterine artery resistance and increased FHR variability, and declining salivary cortisol and FM activity. Potential mechanisms that may mediate the observed results are discussed.

Prophylactic role for complementary and alternative medicine in perinatal programming of adult health

BACKGROUND

The health status of an individual in adulthood is proposed to be determined by events occurring in the prenatal and early postnatal period. A common early life event proven to have long lasting effects on the developing fetus is stress, including pain. Exposure of fetal and neonatal infants to repetitive psychological (e.g., maternal stress) or physiological (e.g., pain, infection, and noise) stress during this period is proposed to alter mechanisms involved in the regulation of stress, immunological maturation, pain perception, and cognition. Such changes, which persist into adulthood, may occur via alterations in the development of the hypothalamic-pituitary-adrenal (HPA) axis. This process is typically referred to as 'perinatal programming'. Ontogenic alterations in the development of the HPA-axis have been related to a number of adult pathologies such as cardiovascular disease, type 2 diabetes, asthma, as well as psychopathologies such as anxiety and depression.

OBJECTIVE

In this review, the effectiveness of complementary and alternative medicine (CAM), such as music, dietary supplements, massage and aromatherapy, in reducing perinatal stress in mothers and infants is examined. An emphasis is placed on these therapies as preventative measures which may be of value to individuals at risk of developing disease profiles associated with the consequences of adverse perinatal programming. The widening interest in perinatal programming and CAM suggests the potential for CAM to become a valuable tool in offsetting negative adult health outcomes resulting from perinatal programming associated with adverse gestational early life environments.

Allostasis: A Theoretical Framework for Understanding and Evaluating Perinatal Health Outcomes

OBJECTIVE

To explore the theory of allostasis within the context of childbearing women's perceptions or experiences of stress and perinatal health outcomes.

DATA SOURCES

Articles published in refereed journals and selected chapters from published books that addressed physiological and psychological effects of perceived or actual stress experiences, or both, including the theory of allostasis, on health outcomes.

STUDY SELECTION

Qualitative, quantitative, and review articles that focused on psychoneurohormonal responses to physical and psychological stress in pregnant and nonpregnant human cohorts and the theory of allostasis.

DATA EXTRACTION AND SYNTHESIS

The impact of abnormal allostatic states in childbearing women in response to physiological and psychological perceptions or experiences of stress, or both was analyzed. There is a growing body of epidemiologic evidence to support the relationship between maternal stress and adverse pregnancy outcomes.

CONCLUSIONS

The theory of allostasis provides a framework for understanding and evaluating the complex elements of stress, coping, and adaptation during childbearing on perinatal health outcomes and has the potential to provide new insight into previously unexplained adverse perinatal events.

Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes?: a randomized controlled trial

Maternal anxiety and stress are found to be predictors of adverse pregnancy outcomes, including low birth weight and prematurity.

OBJECTIVE

The aim of the study was to determine whether relaxation education in anxious pregnant Iranian women in their first pregnancy affects selected pregnancy outcomes, including birth weight, preterm birth, and surgical delivery rate.

SUBJECTS

A total of 110 obstetrically and medically low-risk primigravid women in Iran with a high anxiety level demonstrated by Spielberger's State-Trait Anxiety Inventory were randomly assigned into experimental and control groups.

METHOD

In this randomized controlled trial, the experimental group received routine prenatal care along with 7-week applied relaxation training sessions, while the control group received only routine prenatal care. Anxiety and perceived stress were measured by pre-educational and post-educational intervention. Data related to pregnancy outcomes include birth weight, gestational age at birth, and type of delivery.

RESULTS

Significant reductions in low birth weight, cesarean section, and/or instrumental extraction were found in the experimental group compared with the control group. No significant differences were found in the rate of preterm birth.

CONCLUSION

The findings suggest beneficial effects of nurse-led relaxation education sessions during the prenatal period. This intervention could serve as a resource for improving pregnancy outcomes in women with high anxiety.