{"title":"心率变异生物反馈训练可降低剖宫产产妇的早期产妇压力、焦虑和抑郁：随机对照试验","authors":"Shu-Fang Chen, Wan-Lin Pan, Meei-Ling Gau, Tzu-Chuan Hsu, Shu-Chiao Shen","doi":"10.1007/s10484-024-09656-z","DOIUrl":null,"url":null,"abstract":"<div><p>Women who undergo cesarean delivery have reported experiencing mood distress related to the surgery and postoperative pain. Heart rate variability biofeedback (HRVB) training is known to have positive effects on mental health, but its effects on women undergoing cesarean delivery have not yet been determined. This study evaluated the effects of an HRVB training intervention on stress, anxiety, and depression in women undergoing cesarean delivery. We hypothesized that 10 sessions of HRVB training could cumulatively improve emotion regulation in participants. This study was designed as a double-blinded randomized controlled trial involving a total of 86 enrolled women who were then divided into two groups: intervention and control. During their hospitalization, the intervention group underwent HRVB training daily, while both groups received standard perinatal care. Heart rate variability (HRV) was assessed using root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), high-frequency power (HF) and low-frequency power (LF). HRV parameters, stress, anxiety, and depression were evaluated at baseline and on the fifth day after childbirth. Intention-to-treat (ITT) analyses examined change over time between groups. Although no significant effects were found for the RMSSD and HF, a significant increase was observed in SDNN (<i>F</i> = 13.43, <i>p</i> = < 0.001, ƞ<sup>2</sup> = 0.14), and LF at post-assessment (<i>F</i> = 4.26, <i>p</i> = .04, ƞ<sup>2</sup> = 0.05) compared to the control group. Except for the depression variable, stress (<i>F</i> = 6.11, <i>p</i> = .02, ƞ<sup>2</sup> = 0.07) and anxiety (<i>F</i> = 8.78, <i>p</i> = .004, ƞ<sup>2</sup> = 0.10) significantly decreased compared to the control group on the fifth postpartum day. Furthermore, post-hoc analysis showed that HRVB was more effective in decreasing mild to severe depressive symptoms (<i>F</i> = 7.60, <i>p</i> = .001, ƞ<sup>2</sup> = 0.27). The intervention program successfully decreased self-perceived stress and anxiety in the postpartum period and relieved symptoms in more severely depressed participants. Our findings suggest that this program is suitable and beneficial for application in women during the early postpartum period following cesarean delivery.</p></div>","PeriodicalId":47506,"journal":{"name":"Applied Psychophysiology and Biofeedback","volume":"49 4","pages":"637 - 650"},"PeriodicalIF":2.2000,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Heart Rate Variability Biofeedback Training Reduces Early Maternal Stress, Anxiety, and Depression in Women Undergoing Cesarean Delivery: A Randomized Controlled Trial\",\"authors\":\"Shu-Fang Chen, Wan-Lin Pan, Meei-Ling Gau, Tzu-Chuan Hsu, Shu-Chiao Shen\",\"doi\":\"10.1007/s10484-024-09656-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Women who undergo cesarean delivery have reported experiencing mood distress related to the surgery and postoperative pain. Heart rate variability biofeedback (HRVB) training is known to have positive effects on mental health, but its effects on women undergoing cesarean delivery have not yet been determined. This study evaluated the effects of an HRVB training intervention on stress, anxiety, and depression in women undergoing cesarean delivery. We hypothesized that 10 sessions of HRVB training could cumulatively improve emotion regulation in participants. This study was designed as a double-blinded randomized controlled trial involving a total of 86 enrolled women who were then divided into two groups: intervention and control. During their hospitalization, the intervention group underwent HRVB training daily, while both groups received standard perinatal care. Heart rate variability (HRV) was assessed using root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), high-frequency power (HF) and low-frequency power (LF). HRV parameters, stress, anxiety, and depression were evaluated at baseline and on the fifth day after childbirth. Intention-to-treat (ITT) analyses examined change over time between groups. Although no significant effects were found for the RMSSD and HF, a significant increase was observed in SDNN (<i>F</i> = 13.43, <i>p</i> = < 0.001, ƞ<sup>2</sup> = 0.14), and LF at post-assessment (<i>F</i> = 4.26, <i>p</i> = .04, ƞ<sup>2</sup> = 0.05) compared to the control group. Except for the depression variable, stress (<i>F</i> = 6.11, <i>p</i> = .02, ƞ<sup>2</sup> = 0.07) and anxiety (<i>F</i> = 8.78, <i>p</i> = .004, ƞ<sup>2</sup> = 0.10) significantly decreased compared to the control group on the fifth postpartum day. Furthermore, post-hoc analysis showed that HRVB was more effective in decreasing mild to severe depressive symptoms (<i>F</i> = 7.60, <i>p</i> = .001, ƞ<sup>2</sup> = 0.27). The intervention program successfully decreased self-perceived stress and anxiety in the postpartum period and relieved symptoms in more severely depressed participants. Our findings suggest that this program is suitable and beneficial for application in women during the early postpartum period following cesarean delivery.</p></div>\",\"PeriodicalId\":47506,\"journal\":{\"name\":\"Applied Psychophysiology and Biofeedback\",\"volume\":\"49 4\",\"pages\":\"637 - 650\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-07-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Applied Psychophysiology and Biofeedback\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s10484-024-09656-z\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Applied Psychophysiology and Biofeedback","FirstCategoryId":"102","ListUrlMain":"https://link.springer.com/article/10.1007/s10484-024-09656-z","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
Heart Rate Variability Biofeedback Training Reduces Early Maternal Stress, Anxiety, and Depression in Women Undergoing Cesarean Delivery: A Randomized Controlled Trial
Women who undergo cesarean delivery have reported experiencing mood distress related to the surgery and postoperative pain. Heart rate variability biofeedback (HRVB) training is known to have positive effects on mental health, but its effects on women undergoing cesarean delivery have not yet been determined. This study evaluated the effects of an HRVB training intervention on stress, anxiety, and depression in women undergoing cesarean delivery. We hypothesized that 10 sessions of HRVB training could cumulatively improve emotion regulation in participants. This study was designed as a double-blinded randomized controlled trial involving a total of 86 enrolled women who were then divided into two groups: intervention and control. During their hospitalization, the intervention group underwent HRVB training daily, while both groups received standard perinatal care. Heart rate variability (HRV) was assessed using root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), high-frequency power (HF) and low-frequency power (LF). HRV parameters, stress, anxiety, and depression were evaluated at baseline and on the fifth day after childbirth. Intention-to-treat (ITT) analyses examined change over time between groups. Although no significant effects were found for the RMSSD and HF, a significant increase was observed in SDNN (F = 13.43, p = < 0.001, ƞ2 = 0.14), and LF at post-assessment (F = 4.26, p = .04, ƞ2 = 0.05) compared to the control group. Except for the depression variable, stress (F = 6.11, p = .02, ƞ2 = 0.07) and anxiety (F = 8.78, p = .004, ƞ2 = 0.10) significantly decreased compared to the control group on the fifth postpartum day. Furthermore, post-hoc analysis showed that HRVB was more effective in decreasing mild to severe depressive symptoms (F = 7.60, p = .001, ƞ2 = 0.27). The intervention program successfully decreased self-perceived stress and anxiety in the postpartum period and relieved symptoms in more severely depressed participants. Our findings suggest that this program is suitable and beneficial for application in women during the early postpartum period following cesarean delivery.
期刊介绍：
Applied Psychophysiology and Biofeedback is an international, interdisciplinary journal devoted to study of the interrelationship of physiological systems, cognition, social and environmental parameters, and health. Priority is given to original research, basic and applied, which contributes to the theory, practice, and evaluation of applied psychophysiology and biofeedback. Submissions are also welcomed for consideration in several additional sections that appear in the journal. They consist of conceptual and theoretical articles; evaluative reviews; the Clinical Forum, which includes separate categories for innovative case studies, clinical replication series, extended treatment protocols, and clinical notes and observations; the Discussion Forum, which includes a series of papers centered around a topic of importance to the field; Innovations in Instrumentation; Letters to the Editor, commenting on issues raised in articles previously published in the journal; and select book reviews. Applied Psychophysiology and Biofeedback is the official publication of the Association for Applied Psychophysiology and Biofeedback.
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