Department of Nursing, Taiwan Adventist Hospital, Taipei, Taiwan.
School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Appl Psychophysiol Biofeedback. 2024 Dec;49(4):637-650. doi: 10.1007/s10484-024-09656-z. Epub 2024 Jul 31.
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, ƞ = 0.14), and LF at post-assessment (F = 4.26, p = .04, ƞ = 0.05) compared to the control group. Except for the depression variable, stress (F = 6.11, p = .02, ƞ = 0.07) and anxiety (F = 8.78, p = .004, ƞ = 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, ƞ = 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.
接受剖宫产的女性报告称，手术和术后疼痛与情绪困扰有关。心率变异性生物反馈（HRVB）训练已知对心理健康有积极影响，但尚未确定其对接受剖宫产的女性的影响。本研究评估了 HRVB 训练干预对接受剖宫产的女性的应激、焦虑和抑郁的影响。我们假设 10 次 HRVB 训练可以累积改善参与者的情绪调节。本研究设计为一项双盲随机对照试验，共纳入 86 名符合条件的女性，然后将其分为两组：干预组和对照组。在住院期间，干预组每天接受 HRVB 训练，而两组均接受标准围产期护理。使用均方根差的连续差异（RMSSD）、正常到正常间隔的标准差（SDNN）、高频功率（HF）和低频功率（LF）评估心率变异性（HRV）。在基线和产后第 5 天评估 HRV 参数、应激、焦虑和抑郁。意向治疗（ITT）分析检查了组间随时间的变化。尽管 RMSSD 和 HF 没有显著影响，但 SDNN（F=13.43，p<0.001，η=0.14）和 LF 在评估后（F=4.26，p=0.04，η=0.05）显著增加与对照组相比。除抑郁变量外，与对照组相比，应激（F=6.11，p=0.02，η=0.07）和焦虑（F=8.78，p=0.004，η=0.10）在产后第 5 天显著降低。此外，事后分析显示，HRVB 更有效地降低了轻度至重度抑郁症状（F=7.60，p=0.001，η=0.27）。该干预计划成功降低了产后期间的自我感知压力和焦虑，并缓解了抑郁症状更严重的参与者的症状。我们的研究结果表明，该计划适用于并有益于在剖宫产术后早期的女性应用。
