Mental distress during pregnancy is very common, and it might lead to a wide range of negative consequences for women and their children. It gives rise to a major healthcare problem that has not been solved yet. Developing evidence-based approaches that combine different methods to reduce maternal stress might have a significant positive effect on the psychological condition of women during pregnancy and postnatal, leading to better birth outcomes. The purpose of this paper is to discuss different aspects of an evidence-based stress reduction program that can be designed and implemented at a middle-sided hospital.
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Pregnancy is a difficult experience, and it is associated with increased levels of stress. Most women suffer from some form of psychological distress before giving birth to a child. This mental state is characterized by symptoms of depression and anxiety. Research has shown that a high level of perceived maternal stress contributes to the development of multiple health problems for the child and the mother, and is a predictor of preterm birth (Lilliecreutz, Larén, Sydsjö, & Josefsson, 2016).
An increased possibility of such adverse birth outcomes makes maternal stress a significant issue that requires more attention of the scientific and medical community. Recent studies provide evidence that supports the effectiveness and show the positive effect of maternal stress reduction programs, but most hospitals do not use complex evidence-based approaches to address this issue yet. Further research is required to fully investigate the subject and develop multifaceted methods and programs that will utilize recent findings to help solve the problem.
This paper investigates the following PICOT question: In first-time pregnant women, how do evidence-based stress reduction programs affect the psychological state of patients compared to regular treatment during pregnancy and the postpartum period?
The population of interest is first-time pregnant women who report high levels of stress. Treatment of such patients has its limitations and requires special approaches. The use of pharmaceutical drugs such as antidepressants, stimulants, mood stabilizers, and anti-anxiety medication is risky and may have many negative side-effects, leading to a number of adverse birth outcomes. Thus, stress reduction programs for pregnant women should focus on non-pharmacological forms of intervention.
The intervention will be a complex evidence-based program to reduce maternity stress. The program will include psychological counseling, education about pregnancy and childbirth, group activities, and listening to music. Research has shown a significant positive effect of mindfulness-based programs and specially designed exercise on perceived stress among pregnant women (Shahtaheri, Hosseinian, Ebrahimi, Jalilabadi, & Mirderikvand, 2016).
The participants of such programs are better at managing their negative emotions, and they learn to adapt and cope with difficult situations. It has also been shown that listening to music helps alleviate depression and anxiety symptoms during pregnancy, allowing its use as a complementary therapy (Chang, Yu, Chen & Chen, 2015). It is also critical to educate women about various health issues and other aspects regarding raising a child.
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The research will use self-reports via questioners to measure the results. The participants will be asked to fill out forms that are designed to assess the stress level. Combining different evidence-based methods to create a complex program allows to make full use of recent findings and might help maximize the positive effect of such programs on the mental condition of women.
The participants will need to complete depression questionnaires and perceived stress scale at the beginning, during, and after taking the course. To measure the effectiveness of the course, researchers can compare the mental condition of women before and after the program. It is also important to investigate how dynamics in the group are different from what is observed in patients who do not receive any special treatment to reduce stress.
The outcome of interest for the research is the change in the perceived stress of the participants. It is measured using self-reports of the women, the patients then are put on the scale, where a level of stress corresponds to a number. The information is studied using the methods of statistical analysis to find the relationship between stress level and participation in the project. Such methods are a reliable and valid tool, and they provide objective and quantifiable data that can be used by other researchers. The program will be considered effective if the research shows the statistically significant positive effect of the course on the mental condition of the patients.
The project in question is a 60-days program that allows participation of 30 pregnant women. The duration is chosen to provide the optimal amount of time to properly investigate the dynamics in the focus group. A smaller-scale study would not allow collecting enough information for the research, whereas much longer project might be excessively complex, making it unnecessarily expensive and difficult to implement and run.
The success of the program will require effective cooperation of medical personnel and non-hospital employees. Work of experienced psychologists and obstetricians will be necessary to develop a well-structured evidence-based course and carefully select the kinds of treatment and exercise for it. The curriculum of the program and educational materials will also be chosen during the planning phase, making it especially important. The implementation of the project will involve the participation of a nurse-midwife, a counseling psychologist, and a yoga instructor.
The project in question is feasible, and it can be successfully implemented at relatively low cost. The implementation of the program does not require any expensive materials or equipment, and the timeframe is reasonably short. Given the importance of the study for public health and potential benefits for the society, it might be justified to expect government support and funding of the project to help overcome potential financial barriers. The main limitation is the necessity of the participation of highly professional medical personnel, and a possible strategy to handle it is to implement the program at a medical clinic that allows part-time involvement of its doctors in the study. Thus, considering the characteristics of the program, it can be executed at a middle-scale hospital on a limited budget.
The implementation of the project will require rooms that are suitable for counseling and group activities, providing enough space to perform the exercise. The place should also be equipped with audio and video systems that can be used to play music and show educational videos. Printed materials need to be created in sufficient amounts and distributed among the participants of the course. The pamphlets should contain schemes and pictures and be easy to read and comprehend for all women regardless of the level of their education. In human resources, the program will mostly rely on personnel of the hospital. The external recruitment will be limited to hiring a yoga instructor.
The program of interest uses counseling, physical exercise, educational activities, and listening to music to help reduce stress and provide support for pregnant women. The effectiveness of this approach to the problem of maternal stress has been shown in a number of studies. The methods that are used in the program are cost-effective and do not rely on medication, which makes them safe. The data collected during the program and the results of the study will make a significant contribution to the discussion, providing additional evidence of the effectiveness of stress reduction programs. Thus, the potential benefits outweigh the cost and limitations of the project.
Chang, H. C., Yu, C. H., Chen, S. Y., & Chen, C. H. (2015). The effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy. Complementary Therapies in Medicine, 23(4), 509-515.
Lilliecreutz, C., Larén, J., Sydsjö, G., & Josefsson, A. (2016). Effect of maternal stress during pregnancy on the risk for preterm birth. BMC Pregnancy and Childbirth, 16(1), 5.
Shahtaheri, E., Hosseinian, S., Ebrahimi, M., Jalilabadi, Z., & Mirderikvand, F. (2016). The impact of stress reduction program based on mindfulness and conscious yoga on depression, perceived stress and quality of life in pregnant women. Acta Medica Mediterranea, 32(5), 2047-2050.