Document Type : Original Article

Authors

1 Department of Nursing, School of Nursing and Midwifery

2 Department of Nursing, Holistic Research Center, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord

3 Department of Mathematics, School of Basic Sciences, Shahrood University, Shahrood

4 Department of Nursing, School of Nursing and Midwifery, Islamic Azad University, Bojnourd Branch, Bojnourd, Iran

Abstract

Background and Aim: The postpartum period is a critical then effects on the structure of the
family. Most women in the postpartum period may place at risk of undesirable experiences such
as changes in sleep patterns. Therefore, this study aimed to identify the efficacy of the relaxation
program on sleep quality of mothers with premature infants. Materials and Methods: This
study is a clinical trial that 60 mothers with premature infants. The mothers in the intervention
group were trained for muscle progressive relaxation by Jacobson method within 24–72 h
after delivery. Research tool was the Pittsburgh Sleep Quality Index, which was completed by
the mother at the beginning of the study, end of the first and the second 4‑week. Data were
analyzed using parametric statistics tests by SPSS software version 16. Results: No significant
difference was observed between two groups in terms of underlying characteristics (P < 0.05).
The independent t‑test at the beginning of the study showed that the comparison of the mean
scores of mothers’ sleep quality has no significant difference between two groups (P = 0.43).
But, 1‑month after the intervention (P = 0.024) and 2 months after the intervention (P > 0.001),
mean sleep quality score in the intervention group was significantly less than the control group.
Conclusion: Relaxation training can improve mothers’ sleep quality at postpartum period.

Keywords

1. Ko YL, Yang CL, Chiang LC. Effects of postpartum exercise program
on fatigue and depression during “doing‑the‑month” period. J Nurs
Res 2008;16:177‑86.
2. Li CY, Chen SC, Li CY, Gau ML, Huang CM. Randomised controlled
trial of the effectiveness of using foot reflexology to improve
quality of sleep amongst Taiwanese postpartum women. Midwifery
2011;27:181‑6.
3. Shiffman J. Generating political will for safe motherhood in
Indonesia. Social Science and Medicine. 2003;15:1197-207.
4. McGovern P, Dowd B, Gjerdingen D, Moscovice I, Kochevar L,
Lohman W. Time off work and the postpartum health of employed
women. Med Care 1997;35:507‑21.
5. Carter JD, Mulder RT, Darlow BA. Parental stress in the NICU:
The influence of personality, psychological, pregnancy and family
factors. Personal Ment Health 2007;1:40‑50.
6. Younger JB, Kendell MJ, Pickler RH. Mastery of stress in mothers
of preterm infants. J Soc Pediatr Nurs 1997;2:29‑35.
7. Zelkowitz P, Papageorgiou A, Bardin C, Wang T. Persistent maternal
anxiety affects the interaction between mothers and their very low
birthweight children at 24 months. Early Hum Dev 2009;85:51‑8.
8. Trombini E, Surcinelli P, Piccioni A, Alessandroni R, Faldella G.
Environmental factors associated with stress in mothers of preterm
newborns. Acta Paediatr 2008;97:894‑8.
9. Robichaud KP. The effects of an exercise intervention on the
psychological well‑being of postpartum women; Tennessee: Middle
Tennessee State University, 2008.
10. Fathi R, editor. Relaxation Therapy. 1st ed. Tehran: Shahra; 2000.
11. Lee KA, Gay CL. Sleep in late pregnancy predicts length of labor
and type of delivery. Am J Obstet Gynecol 2004;191:2041‑6.
12. HoseinAbadi R, Nourozi K, Pouresmail Z, Karimlu M,
Sadat Maddah SB, Cheraghi MA. The effect of acupressure
on quality of sleep in Iranian elderly nursing home residents.
Complement Ther Clin Pract 2010;16:81‑5.
13. Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III L,
Wenstrom K. Normal labor and delivery. In: Williams Obstetrics.
Cunningham FG, Kenneth KJ, Bloom SL, Hauth JC, Gilstrap LC,
Wenstrom KD, editors. 22nd ed. New York: McGraw‑Hill; 2005.
p. 431.
14. Goyal D, Gay CL, Lee KA. Patterns of sleep disruption and depressive
symptoms in new mothers. J Perinat Neonatal Nurs 2007;21:123‑9.
15. Sahota PK, Jain SS, Dhand R. Sleep disorders in pregnancy. Curr
Opin Pulm Med 2003;9:477‑83.
16. Cunningham FG, Leveno K, Gilstrap LC 3rd, Hauth JC, editors.
Williams’s Obstetrics. 22nd ed. New York: Mc Graw‑Hill; 2005.
17. Lee SH. Effects of aroma inhalation on fatigue and sleep quality of
postpartum mothers. Korean J Women Health Nurs 2004;10:235‑43.
18. Bastable B. In: Nurse as Educator: Principles of Teaching and
Learning for Nursing Practice. Philadelphia: Jones and Bartlet
Publising; 2003. p. 677‑80.
19. Payne RM, editor. Relaxation Techniques. 3rd ed. Newyork:
Edinburg; 2005.
20. Chuang LL, Lin LC, Cheng PJ, Chen CH, Wu SC, Chang CL. Effects
of a relaxation training programme on immediate and prolonged
stress responses in women with preterm labour. J Adv Nurs
2012;68:170‑80.
21. Masoudi R, Faradonbeh AS, Mobasheri M, Moghadasi J. Evaluating
the effectiveness of using a progressive muscle relaxation technique
in reducing the pain of multiple sclerosis patients. J Musculoskelet
Pain 2013;21:350‑7.
22. Hashemzadeh A, Mirtaghi G, Chalabianloo G, Maleki Rad A. The
study of effectiveness of relaxation and distraction techniques
training in anxiety reduction in cardiac patients. Arak University of
Medical Sciences Journal. 2011; 14 (3):97‑105
23. Mousavi Asl A, Kharamin SH, Rakhsha H, Poorsamad A. The effect of
relaxation training for mothers on infant health indicators. Armaghan
Danesh 2009;14:107.
24. Eslami AA, Rabiei L, Khayri F, Rashidi Nooshabadi MR, Masoudi R.
Sleep quality and spiritual well‑being in hemodialysis patients. Iran
Red Crescent Med J 2014;16:e17155.
25. Means MK, Lichstein KL, Epperson MT, Johnson CT. Relaxation
therapy for insomnia: Nighttime and day time effects. Behav Res
Ther 2000;38:665‑78.
26. Morawetz D. Insomnia and depression: Which comes first. Sleep
Res Online 2003;5:77‑81.
27. Hunter LP, Rychnovsky JD, Yount SM. A selective review of maternal
sleep characteristics in the postpartum period. J Obstet Gynecol
Neonatal Nurs 2009;38:60‑8.
28. Malekzadegan A, Moradkhani M, Ashayeri H, Haghani H. Effect
of relaxation on insomnia during third trimester among pregnant
women. Iran J Nurs Midwifery Res 2010;23:52‑8.
29. Pawlow LA, Jones GE. The impact of abbreviated progressive
muscle relaxation on salivary cortisol and salivary immunoglobulin
A (sIgA). Appl Psychophysiol Biofeedback 2005;30:375‑87.
30. Viens M, De Koninck J, Mercier P, St‑Onge M, Lorrain D. Trait anxiety
and sleep‑onset insomnia: Evaluation of treatment using anxiety
management training. J Psychosom Res 2003;54:31‑7.
31. Schaffer L, Jallo N, Howland L, James K, Glaser D, Arnell K. Guided
imagery: An innovative approach to improving maternal sleep
quality. J Perinat Neonatal Nurs 2013;27:151‑9.32. Mirmohammadalii M, Ashrafinia F, Rajabi H, Amelvalizadeh M.
Effects of exercise on sleep quality in women postpartum period.
Hayat. 2012;18:20‑9.
33. Bastani F, Haidarnia A, Vafaei M, Kazemnejad A, Kashanian M. Effect
of Relaxation Training Based on the Synthesizing of the Precede
Model with the Health Belief Model and the Self‑efficacy Theory
on Anxiety and Pregnancy Outcomes Among Pregnant Women:
Theses for PhD Degree of Tarbiat Modares University; 2004.
34. Conrad A, Roth WT. Muscle relaxation therapy for anxiety disorders:
It works but how? J Anxiety Disord 2007;21:243‑64.