Effect of Progressive Muscle Relaxation Exercises on Pregnancy Distress Level and Pregnancy Perception

Öz

Background: Pregnancy, though a physiological process for women, is a period in which some critical biological and psychosocial changes are experienced and there is a high risk of encountering stress and anxiety-inducing factors. Objectives: The objective of this study is to assess the effect of progressive muscle relaxation exercises on the level of distress experienced by pregnant women and the maternal and body perception in pregnancy. Methods: The study was a randomized controlled study. A total of 83 pregnant women, 42 in the relaxation group and 41 in the control group, participated in the study. Data were collected using a personal information form, the Pregnancy Self-Perception Scale, and the Tilburg Pregnancy Distress Scale between 16.04.2018-20.06.2018. The pregnant women in relaxation group were first given relaxation training for three days and then they were asked to carry it on at home for four weeks. The measurement tools in the experimental and control groups were administered three times, the first at the outset, and at the end of the 2nd and 4th weeks respectively. Results: The median age of the pregnant women participating in the study was 25 (19-40). After interventions, the difference between group Tilburg Distress Scale, negative affect, co-participation subscales (p < .001), the Pregnancy Self-Perception Scale (p = .001) and body image subscale scores (p < .001) were statistically significant. Conclusion: It has been concluded that progressive muscle relaxation exercises reduce the distress level of pregnant women, while pregnant women do not change the perception of maternity and positively affect their body perception.

Anahtar Kelimeler

• Body Perception,Distress,Pregnancy,Prenatal,Progressive Relaxation

Progresif Kas Gevşeme Egzersizlerinin Gebelerin Distres Düzeyi ve Gebelik Algısına Etkisi

Öz

Giriş: Gebelik, kadınlar için fizyolojik bir süreç olmakla birlikte, önemli biyolojik ve psikososyal değişimlerin yaşandığı, stres ve anksiyete oluşturabilecek etkenlerle karşılaşma riskinin yüksek olduğu bir dönemdir. Amaç: Çalışmanın amacı; progresif kas gevşeme egzersizlerinin gebelerin yaşadıkları distres düzeyi, gebelikte annelik ve beden algısı üzerine etkisinin değerlendirilmesidir. Yöntem: Araştırma, randomize kontrollü müdahale çalışmasıdır. Progresif kas gevşeme grubunda 42, kontrol grubunda 41 gebe olmak üzere toplam 83 gebe ile çalışma tamamlanmıştır. Kişisel Bilgi Formu, Gebelerin Kendilerini Algılama Ölçeği ve Tilburg Gebelikte Distres Ölçeği aracılığı ile 16.04.2018-20.06.2018 tarihleri arasında veriler toplanmıştır. Deney grubundaki gebelere üç gün hastanede gevşeme eğitimi verildikten sonra 4 hafta evlerinde egzersizlere devam etmeleri istenmiştir. Deney ve kontrol gruplarından veriler, ilk görüşme, 2. ve 4. haftanın sonunda olmak üzere 3 kez toplanmıştır. Bulgular: Çalışmaya katılan gebelerin yaş ortancası 25 (19-40)’dir. Müdahaleler sonrasında gruplararası Tilburg Gebelikte Distres Ölçeği, olumsuz duygulanım, eş katılımı alt boyutları (p < .001) ile Gebelerin Kendilerini Algılama Ölçeği (p = .001) ve beden algısı alt boyutu puan ortalamaları (p < .001) arasındaki fark istatistiksel olarak anlamlıdır. Sonuç: Progresif kas gevşeme egzersizlerinin, gebelerin yaşadıkları distres düzeyini azalttığı, gebelerin annelik algısını değiştirmezken, beden algılarını olumlu yönde etkilediği sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Beden Algısı,Distres,Gebelik,Prenatal,Progresif Gevşeme

Kaynakça

1. 1. Taşkın L. Doğum ve Kadın Sağlığı Hemşireliği. 13. Basım. Ankara Sistem Ofset Matbaacılık; 2012: 413-427.
2. 2. Alipour Z, Lamyian M, Hajizadeh E, Vafaei MA. The association between antenatal anxiety and fear of childbirth in nulliparous women: a prospective study. IJNMR 2011; 16(2): 169-173.
3. 3. Çalık KY, Aktas S. Gebelikte depresyon: siklik, risk faktörleri ve tedavisi. Psikiyatride Güncel Yaklaşımlar 2011; 3(1): 142-162.
4. 4. Yıldız H. Gebelikte psikososyal sağlığı değerlendirme ölçeği geliştirme çalışması. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi 2011; 4(1): 63-74.
5. 5. Çapık A, Ejder Apay S, Sakar T. Gebelerde distres düzeyinin belirlenmesi. Journal of Anatolia Nursing and Health Sciences 2015; 18(3): 196-203.
6. 6. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: A systematic review of prevalence and incidence. Obstet Gynecol 2005; 106(5): 1071-1083.
7. 7. Richter J, Bittner A, Petrowski K, Junge-Hoffmeister J, Bergmann S, Joraschky P et al. Effects of an early intervention on perceived stress and diurnal cortisol in pregnant women with elevated stress, anxiety, and depressive symptomatology. J Psychosom Obstet Gynaecol 2012; 33(4): 162-170.
8. 8. Van Bussel JC, Spitz B, Demyttenaere, K. Women’s mental health before, during and after pregnancy. A population-based controlled cohort study. Birth 2006; 33(4): 297-302.

9. 9. Bacacı H, Ejder Apay S. Gebelerde beden imajı algısı ve distres arasındaki ilişki. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2018; 8(2): 76-82.
10. 10. Furber CM, Garrod D, Maloney E, Lovell K, McGowan LA. Qualitative study of mild to moderate psychological distress during pregnancy. Int J Nurs Stud 2009; 46(5): 669-677.
11. 11. Lobel M, Cannella DL, Graham EJ, Devincent C, Schneider J, Meyer AB. Pregnancy-specific stress, prenatal health behaviors, and birth outcomes. Health Psychol 2008; 27(5): 604-615.
12. 12. Schuurmans C, Kurrasch DM. Neuro developmental consequences of maternal distress: what do we really know? Clinical Genetics 2013; 83(2): 108-117.
13. 13. Kumcağiz H. Gebe kadınlarda beden algısı ve benlik saygısının bazı değişkenlere göre incelenmesi. International Journal of Human Sciences 2012; 9(2): 691-703.
14. 14. Skouteris H, Carr R, Wertheim EH, Paxton SJ, Duncombe D. A prospective study of factors that lead to body dissatisfaction during pregnancy. Body Image 2005; 2(4): 347-361.
15. 15. Wingood GM, DiClemente RJ, Harrington K, Davies SL. Body image and African American females' sexual health. Journal of Women's Health & Gender-Based Medicine 2002; 11(5): 433-439.
16. 16. Boscaglia N, Skouteris H, Wertheim EH. Changes in body image satisfaction during pregnancy: A comparison of high exercising and low exercising women. Aust N Z J Obstet Gynaecol 2003; 43(1): 41-45.
17. 17. Chang SR, Chao YM, Kenney NJ. I am a woman and I’m pregnant: body image of women in Taiwan during the third trimester of pregnancy. Birth 2006; 33(2): 147-153.
18. 18. Okanli A, Tortumluoglu G, Kirpinar I. Gebe kadinlarin ailelerinden algiladiklari sosyal destek ile problem çözme becerileri arasindaki iliski. Anadolu Psikiyatri Derg 2003; 4(2): 98-105.
19. 19. Yanıkkerem E, Altıparmak S, Karadeniz G. Gebelikte yaşanan fiziksel sağlık sorunlarının incelenmesi, Aile ve Toplum 2006; 3(10): 35-42.
20. 20. Kamysheva E, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. Examination of a multi-factorial model of body-related experiences during pregnancy: The relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes. Body Image 2008; 5(2): 152-163.
21. 21. Dayan J, Creveuil C, Herlicoviez M, Herbel C, Baranger E, Savoye C, Thouin A. Role of anxiety and depression in the onset of spontaneous preterm labor. American Journal of Epidemiology 2002; 155(4): 293-301.
22. 22. Rondó PH, Ferreira RF, Nogueira F, Ribeiro MCN, Lobert H, Artes R. Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. European Journal of Clinical Nutrition 2003; 57(2): 266-272.
23. 23. Berle JØ, Mykletun A, Daltveit AK, Rasmussen S, Holsten F, Dahl AA. Neonatal outcomes in offspring of women with anxiety and depression during pregnancy. Arch Womens Ment Health 8(3): 181-189.
24. 24. Lee AM, Lam SK, Lau M, Chong CSY, Chui HW, Fong DYT. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 2007; 110(5): 1102-1112.
25. 25. Huizink AC, Robles de Medina PG, Mulder EJ, Visser GH, Buitelaar JK. Stress during pregnancy is associated with developmental outcome in infancy. Journal of Child Psychology and Psychiatry 2003; 44(6): 810-818.
26. 26. Urech C, Fink NS, Hoesli I, Wilhelm FH, Bitzer J, Alder J. Effects of relaxation on psychobiological wellbeing during pregnancy: a randomized controlled trial. Psychoneuroendocrinology 2010; 35(9): 1348-1355.
27. 27. Isa MR, Moy FM, Razack AHA, Zulkifli Z, Zainal NZ. Impact of applied progressive deep muscle relaxation training on the level of depression, anxiety and stress among prostate cancer patients: a quasi-experimental study. Asian Pac J Cancer Prev 2013; 14(4): 2237-2242.
28. 28. Varvogli L, Darviri C. Stress management techniques: evidence-based procedures that reduce stress and promote health. Health Science Journal 2011; 5(2): 74-89.
29. 29. Dehdari T, Heidarnia A, Ramezankhani A, Sadeghian S, Ghofranipour F. Effects of progressive muscular relaxation training on quality of life in anxious patients after coronary artery bypass graft surgery. Indian J Med Res 2009; 129: 603-608.
30. 30. Demiralp M, Oflaz F. Bilişsel davranışçı terapi teknikleri ve psikiyatri hemşireliği uygulaması. Anadolu Psikiyatri Dergisi 2007; 8: 132-139.
31. 31. Bastani F, Hidarnia A, Montgomery KS, Aguilar-Vafaei ME, Kazemnejad A. Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes?: a randomized controlled trial. J Perinat Neonatal Nurs 2006; 20(2): 138-146.
32. 32. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175–191.
33. 33. Pop VJ, Pommer AM, Pop-Purceleanu M, Wijnen HA, Bergink V, Pouwer F. Development of the Tilburg pregnancy distress scale: the TPDS. BMC Pregnancy Childbirth 2011; 11(1): 1-8.
34. 34. Çapık A, Pasinlioglu T. Validity and reliability study of the Tilburg pregnancy distress scale into Turkish. J Psychiatr Ment Health Nurs 2015; 22(4): 260-269.
35. 35. Kumcağız H, Ersanlı E, Murat N. Gebelerin Kendilerini Algılama Ölçeği’nin geliştirilmesi ve psikometrik özellikleri. Psikiyatri Hemşireliği Dergisi 2017; 8(1): 23-31.
36. 36. Chan CWH, Richardson A, Richardson J. Managing symptoms in patients with advanced lung cancer during radiotherapy: results of a psychoeducational randomized controlled trial. J Pain Symptom Manage 2011; 41(29): 347-357.
37. 37. Kwekkeboom KL, Hau H, Wanta B, Bumpus M. Patients’ perceptions of the effectiveness of guied imagery and progressive muscle relaxation interventions used for cancer pain. Complement Ther Clin Pract 2008; 14(19): 185-194.
38. 38. Kartal M. Nefes Alma Sanatı. 1. Basım. İstanbul Sistem Yayıncılık; 2011. 37,43,48.
39. 39. Mackereth PA, Booth K, Hillier VF, Caress AL. Reflexology and progressive muscle relaxation training for people with multiple sclerosis: a crossover trial. Complement Ther Clin Pract 2009; 15(1): 14-21.
40. 40. Yali M, Lobel M. Stress-resistance resources and coping in pregnancy. Anxiety Stress Coping 2009; 15(3): 289-309.
41. 41. Diego MA, Jones NA, Field T, Hernandez-Reif M, Schanberg S, Kuh C et al. C, Maternal psychological distress, prenatal cortisol, and fetal weight. Psychosomatic Medicine 2006; 68(5): 747-753.
42. 42. Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P. Maternal stress and preterm birth. Am J Epidemiol 2003; 157(1): 14-24.
43. 43. Zhu P, Tao F, Hao J, Sun Y, Jiang X. Prenatal life events stress: implications for preterm birth and infant birthweight. Am J Obstet Gynecol 2010; 203(1): 34-41.
44. 44. Bergman K, Sarkar P, O'connor TG, Modi N, Glover V. Maternal stress during pregnancy predicts cognitive ability and fearfulness in infancy. J Am Acad Child Adolesc Psychiatry 2007; 46(11): 1454-1463.
45. 45. Davis EP, Sandman CA. The timing of prenatal exposure to maternal cortisol and psychosocial stress is associated with human infant cognitive development. Child Dev 2010; 81(1): 131-148.
46. 46. O'connor TG, Heron J, Golding J, Glover V, AL Spac Study Team. Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. Journal of Child Psychology and Psychiatry 2003; 44(7): 1025-1036.
47. 47. Bastani F, Hidarnia A, Kazemnejad A, Vafaei M, Kashanian MA. Randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery Womens Health 2005; 50(4): 36-40.
48. 48. Field T, Diego MA, Hernandez-Reif M, Schanberg S, Kuhn C. Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol 2004; 25(2): 115-122.
49. 49. Nickel C, Lahmann C, Muehlbacher M, Gil FP, Kaplan P, Buschmann W et al. Pregnant women with bronchial asthma benefit from progressive muscle relaxation: a randomized, prospective, controlled trial. Psychother Psychosom 2006; 75(4): 237-243.
50. 50. Teixeira J, Martin D, Prendiville O, Glover V. The effects of acute relaxation on indices of anxiety during pregnancy. J Psychosom Obstet Gynaecol 2005; 26(4): 271-276.
51. 51. Urizar JrGG, Milazzo M, Le HN, Delucchi K, Sotelo R, Muñoz RF. Impact of stress reduction instructions on stress and cortisol levels during pregnancy. Biol Psychol 2004; 67(3): 275-282.
52. 52. Beydağ KD. Doğum sonu dönemde anneliğe uyum ve hemşirenin rolü. TSK Koruyucu Hekimlik Bülteni 2007; 6(6): 479-484.
53. 53. Mckinney ES, Ashwill JW, Murray S, James S. Maternal-child Nursing; Postpartum Adaptations. Second Edition. Philadelphia W.B. Sounders Company; 2005: 465-507.
54. 54. Özkan H, Polat S. Annelik davranışını öğrenme süreci ve hemşirelik desteği. Bozok Tıp Dergisi 2011; 1(3): 35-39.
55. 55. Babacan Gümüş A, Çevik N, Hataf Hyusni S, Biçen Ş, Keskin G, Tuna Malak A. Gebelikte benlik saygısı ve beden imajı ile ilişkili özellikler. Anatolian Journal of Clinical Investigation 2011; 5(1): 7-14.
56. 56. Çırak R, Özdemir F. Adölesan gebelerde beden imajı algısının belirlenmesi. Journal of Anatolia Nursing and Health Sciences 2015; 18(3): 214-221.