Effects of Benson Relaxation Technique on the Anxiety and Hemodynamic Parameters in Women before Cesarean Section: Randomized Controlled Trial
Authors
-
Mansoure Kheiri
1 School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0002-9228-3006
-
Hale Jafari
Ph.D. Candidate of Nursing. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
https://orcid.org/0000-0001-7519-4485
-
Leila Dehghankar
Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
https://orcid.org/0000-0003-2924-6023
-
Mohadese Mohammadi
Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0009-0009-5610-2528
-
Faeza Aashouri Faeza
Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran, Shahroud University of Medical Sciences, Shahroud, Iran..
https://orcid.org/0009-0006-0585-8489
-
Shahrbanoo Goli
Assistant Professor of Biostatistics, Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0003-4066-6627
-
Malihe imeni
Medical Surgical Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
https://orcid.org/0000-0003-0240-1433
-
Zahra Ashrafi
Assistant Professor, Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0001-8661-1221
DOI:
https://doi.org/10.22100/ijhs.v10i2.1127Keywords:
Anxiety, Muscle relaxation, HemodynamicAbstract
Background: Cesarean section (CS) as a delivery method is commonly used in Iran and other countries. Many women experience anxiety before CS. This study aimed to determine the effects of the Benson relaxation on the anxiety and hemodynamic parameters of women before CS.
Methods: A two-group clinical trial was conducted with a study population consisted of 108 women waiting for CS in educational hospitals in Shahroud City, Iran. The participants were randomly allocated to two groups of control and intervention each with 31 participants. After receiving a face-to-face relaxation method by the researcher, the intervention group listened to a relaxation training audio file three to five hours before CS and exercised Benson muscle relaxation at least three times. Data were collected using a demographic characteristics questionnaire, Standard Hospital Anxiety and Depression Scale, and Hemodynamic Parameters questionnaire. The collected data were analyzed in SPSS v23 using descriptive and inferential tests.
Results: The results showed that the mean and standard deviation of the anxiety score in the intervention group before the intervention was 10±2.43, which was significantly higher than that after the intervention (6.86 ± 1.45). On the other hand, the mean and standard deviation of the anxiety score in the control group before the intervention was 10±3.08 and increased to 10.19 ±3.19 after the intervention. There was also a significant difference between the intervention and control groups in terms of the mean and standard deviation of the hemodynamic parameters scores, including systolic blood pressure index (p =0.021), diastolic blood pressure index (p = 0.010), respiratory index (p= 0.037), and heart rate index (p= 0.042) after the intervention.
Conclusion: Based on the results of this study, Benson muscle relaxation significantly reduced the anxiety and hemodynamic parameters scores in the intervention group. Given that this method is uncomplicated, non-pharmacological, and inexpensive, it can be useful for pregnant women in the stressful conditions before CS.
References
Tadevosyan M, Ghazaryan A, Harutyunyan A, Petrosyan V, Atherly A, Hekimian K. Factors contributing to rapidly increasing rates of cesarean section in Armenia: a partially mixed concurrent quantitative-qualitative equal status study. BMC pregnancy and childbirth. 2019;19(2):1-10. doi: 10.1186/s12884-018-2158-6
Jafarzadeh A, Hadavi M, Hasanshahi G, Rezaeian M, Vazirinejad R, Aminzadeh F, et al. Cesarean or cesarean epidemic? Archives of Iranian medicine. 2019;22(11):663-70.
Lupu V, Miron I, Raileanu A, Starcea I, Lupu A, Tarca E, et al. Difficulties in Adaptation of the Mother and Newborn via Cesarean Section versus Natural Birth-A Narrative Review. Life. 2023;13(2):300. doi: 10.3390/life13020300
Yoshida T, Matsumura K, Hatakeyama T, al e. Association between Cesarean section and neurodevelopmental disorders in a Japanese birth cohort: the Japan Environment and Children's Study. BMC Pediatr 2023;23(1):306. doi: 10.1186/s12887-023-04128-5
Abdulla F, Hossain MM, Rahman MM, Rahman MS, Rahman A. Risk factors of caesarean deliveries in urban-rural areas of Bangladesh. Frontiers in Reproductive Health. 2023;5(2023):1101400. doi: 10.3389/frph.2023.1101400
Xie W, Ye F, Yan X, Cao M, Ho MH, Kwok JYY, et al. Acupressure can reduce preoperative anxiety in adults with elective surgery: A systematic review and meta-analysis of randomised controlled trials. International Journal of Nursing Studies. 2023;145:104531. doi: 10.1016/j.ijnurstu.2023.104531
Ferede YA, Bizuneh, Y. B., Workie, M. M., & Admass, B. A. "Prevalence and associated factors of preoperative anxiety among obstetric patients who underwent cesarean section": A cross-sectional study. Annals of Medicine and Surgery. 2022;74:103272. doi: 10.1016/j.amsu.2022.103272
Fentie Y, Yetneberk T, Gelaw M. Preoperative anxiety and its associated factors among women Undergoing elective caesarean delivery: a cross-sectional study BMC Pregnancy and Childbirth 22. 2022;22(648). doi: 10.1186/s12884-022-04979-3
Hinds JA, Sanchez ER. The role of the hypothalamus-pituitary-adrenal (HPA) axis in test-induced anxiety: assessments, physiological responses, and molecular details. Stresses. 2022;2(1):146-55. doi: 10.3390/stresses2010011
Ali NN. Assessment of preoperative anxiety, its contributing factors, and impact on immediate postoperative outcomes among cardiac surgery patients - A cross-sectional study (Unpublished master's dissertation). Aga Khan University, Karachi, Pakistan. 2023.
Abarghoee SN, Mardani A, Baha R, Fadaee Aghdam N, Khajeh M, Eskandari F, et al. Effects of benson relaxation technique and music therapy on the anxiety of primiparous women prior to cesarean section: A randomized controlled trial. Anesthesiology research and practice. 2022;1:9986587. doi: 10.1155/2022/9986587
Rooeintan F ABP, Yazdanpanah A. The impact of healthcare reform plan on the rate of vaginal delivery and cesarean section in Shiraz (Iran) in 2015. Electron Physician. 2016;8(10):3076- 80. doi: 10.19082/3076
Salmanzadeh A RA, Fallahi-Khoshknab A, Mohammadi-Shahbelaghi F, Rahgozar M. The Effect of Benson's relaxation on pre-operative anxiety in Cesarean section in Nulliparus Women. J Adv Pharm Edu Res 2018;8(S2):194-200.
Bernad B-C, Tomescu M-C, Hogea L, Velimirovici DE, Andor M, Lungeanu D, et al. Effects of Stress and Anxiety on Pregnant Women's Cardiovascular Health: A Narrative Review. Preprints. 2024;2024031067. doi: 10.20944/preprints202403.1067.v1
Oliveira P, Pires R, Silva R, Sequeira C. Design of a nursing psychoeducation program to reduce preoperative anxiety in adults. Front Public Health 2024;12:1391764. doi: 10.3389/fpubh.2024.1391764
Jatmiko A. The Effectiveness of Preoperative Nursing Visitation in Reducing the Level of Preoperative Anxiety and Postoperative Pain in Elective Surgery Patients: A Systematic Literature Review. Journal of Global Research in Public Health 2023;8(2):159-69. doi: 10.30994/jgrph.v8i2.474
Yanchi W, Kai M, Minjie C, Xiaopeng LW. Perinatal maternal factors influencing postpartum feeding practices at six weeks. BMC Pregnancy and Childbirth. 2024;24:514. doi: 10.1186/s12884-024-06711-9
Daneshpajooh L NGT, Haghani H. Comparison of the effects of inhalation aromatherapy using Damask Rose aroma and the Benson relaxation technique in burn patients: A randomized clinical trial. Burns. 2019;45(5):1205-1214. doi: 10.1016/j.burns.2019.03.001
Volpato E BP, Rogers SM, Pagnini F. Relaxation techniques for people with chronic obstructive pulmonary disease: a systematic review and a meta-analysis. Evidence-Based Complementary and Alternative Medicine 2015;2015. doi: 10.1155/2015/628365
Xie LQ, Deng YL, Zhang JP, Richmond CJ, Tang Y, Zhou J. Effects of Progressive Muscle Relaxation Intervention in Extremity Fracture Surgery Patients. Western Journal of Nursing Research. 2016;38(2):155-68. doi: 10.1177/0193945914551509
Nooner AK DK, DeShea L, Yeo TP. Using Relaxation and Guided Imagery to Address Pain, Fatigue, and Sleep Disturbances: A Pilot Study. Clinical journal of oncology nursing. 2016 ;20(5): 547-552. doi: 10.1188/16.CJON.547-552
Nejad SA SF, Golmakani N, Shakeri MT. Effect of progressive muscle relaxation on depression, anxiety, and stress of primigravid women. Evidence based care 2015;5(1):67-76. doi: 10.1155/2015/792895
Benson H BJ, Carol MP. The relaxation response. Psychiatry 1974;37:37-46. doi: 10.1080/00332747.1974.11023785
Fateme B FM, Vahid M, Arezou NJ, Manizhe N, Zahra M. The effect of Benson's muscle relaxation technique on severity of pregnancy nausea. Electron J Gen Med 2019;16(2):em125. doi: 10.29333/ejgm/93480
Jasour A, Afrasiabifar A, Zoladl M. A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi- experimental study. BMC Geriatr 2023;23:692. doi: 10.1186/s12877-023-04378-z
Harorani M DF, Farahani Z, Hezave AK, Rafiei F. The effect of Benson's relaxation response on sleep quality and anorexia in cancer patients Undergoing chemotherapy: A randomized controlled trial. Complement Ther Med. 2020;50:102344. doi: 10.1016/j.ctim.2020.102344
Pardede JA, Tarigan I. The Anxiety Level of Mother Presectio Caesarn with Benson's Relaxation Therapy .Jendela nursing journal 2020; 4 (1): 20-28. doi: 10.31983/jnj.v4i1.5801
Anisa Nuri Kurniasari AK, Harmilah. The Effect Benson Relaxation Technique with Anxiety In Hemodyalisis Patients In Yogyakarta. Nursing practice 2016;1. doi: 10.18196/ijnp.1149
Poorolajal J, Ashtarani F, Alimohammadi N. Effect of Benson relaxation technique on the preoperative anxiety and hemodynamic status: A single blind randomized clinical trial. Artery Res 2017;17:33-8. doi: 10.1016/j.artres.2017.01.002
Hanifi N AF, Memarian R, Khani M. The Effect of Benson Relaxation Technique and Premedication on Systolic, Diastolic, LV & Aorta Pressure in Patients under Coronary Artery Angiography . RJMS 2005; 12 (46) :287-294. (Persian).
Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes. 2003;1:14. doi: 10.1186/1477-7525-1-14
Nazari AM, Zare-Kaseb A, Arbabi Z, al e. The effect of Benson relaxation technique on cancer patients: a systematic review. Support Care Cancer 2023;31:681. doi: 10.1007/s00520-023-08142-2
Hassanzadeh M, Kiani F, Bouya S, Zarei M. Comparing the effects of relaxation technique and inhalation aromatherapy on fatigue in patients Undergoing hemodialysis. Complement Ther Clin Pract. 2018;31:210-4. doi: 10.1016/j.ctcp.2018.02.019
Abd ElAziz ElShora SN, Elsayed HEM, El-Feshawy NI, Abd Elaziz Hassen HAE. The Effect of Benson's Relaxation Therapy on Pre-Cesarean Section Fear and Anxiety among Nulliparous Women. Assiut Scientific Nursing Journal. 2024;12(41):75-83. doi: 10.21608/asnj.2024.259888.1746
S H, Thurkkadayil AP. Effectiveness of Benson relaxation therapy on prenatal anxiety among mothers in a tertiary care hospital, Kochi. International Journal of Reproduction Contraception Obstetrics and Gynecology 12(10):12(0):3149-53. doi: 10.18203/2320-1770.ijrcog20232963
Zenouzi A, Moghadam ZB, Babayanzad S, Asghari M, Rezaei E. The effect of benson relaxation technique on stress, anxiety, and depression in pregnant women. Holistic Nursing Practice. Holistic Nursing Practice. 2022;38(4):227-37. doi: 10.1097/HNP.0000000000000463
Mohammadi M, Parandin S. Effect of the combination of Benson's relaxation technique and brief psychoeducational intervention on multidimensional pain and negative psychological symptoms of pregnant women: A randomized controlled trial. J Educ Health Promot. 2019;8(1):91. doi: 10.4103/jehp.jehp_286_18
Eng HS YL, Das S, Letchmi S, Yee KS, Bakar RA, Et al. Anxiety and depression in patients with coronary heart disease: a study in a tertiary hospital. Iran J Med Sci 2011;36(3):201-206.
Mulugeta H, Ayana M, Sintayehu M, Dessie G, Zewdu T. Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC anesthesiology. 2018;18:1-9. doi: 10.1186/s12871-018-0619-0
Qaddumi J, Arda A, Alkhawaldeh A, al. e. Preoperative anxiety, postoperative pain tolerance and analgesia consumption: A prospective cohort study. Journal of Perioperative Practice. 2024;0(0). doi: 10.1177/17504589241253489
Abu Maloh H, Soh K, Chong S, al. e. The Effectiveness of Benson's Relaxation Technique on Pain and Perceived Stress Among Patients Undergoing Hemodialysis: A Double-Blind, Cluster-Randomized, Active Control Clinical Trial. Clinical Nursing Research. 2023;23(2):288-97. doi: 10.1177/10547738221112759
Abu Maloh H, Soh K, AbuRuz M, al. e. Clinical Nursing Research. Efficacy of Benson's Relaxation Technique on Anxiety and Depression among Patients Undergoing Hemodialysis: A Systematic Review 2022;31(1):122-35. doi: 10.1177/10547738211024797
Mohamady SH, Elmoniem SOA, Araby OA-WA, Elrefaeys SR, Nageeb SM. Effect Of Benson Relaxation Technique On Reducing Pain And Stress Among Post Cesarean Section Mothers. Journal of Positive School Psychology. 2022;6(8):6820-68481.
Parsa Yekta ZP SF, Taghavi Larijani TP, Mehran AM. The Comparison of Two Types of Relaxation Techniques on Postoperative State Anxiety in Candidates for The Mastectomy Surgery: A Randomized Controlled Clinical Trial. International journal of community based nursing and midwifery 2017; 5 (1): 61-69.
Udupa K, Bhavanani AB, Ramanathan M. Stress and the Autonomic Nervous System: Implication of Yoga. The Principles and Practice of Yoga in Cardiovascular Medicine Springer, Singapore. 2022:105-15. doi: 10.1007/978-981-16-6913-2_9
Najafi Ghezelcheh T, Sadeghian H, Muhaddith Ardabili F. The effect of Benson relaxation method on anxiety in intensive care unit nurses. Cardiovascular Nursing. 2016;5(3):26-33. (Persian).
Orbach-Zinger S GY, Elliston J, Fadon C, Abu-Lil M, Raz A, et al. Influence of preoperative anxiety on hypotension after spinal anaesthesia in women Undergoing Caesarean delivery. Br J Anaesth 2012;109(6):943-9. doi: 10.1093/bja/aes313
Cho M-Y ME, Hur MH, Lee MS. Effects of Aromatherapy on the Anxiety, Vital Signs, and Sleep Quality of Percutaneous Coronary Intervention Patients in Intensive Care Units. Evid Based Complement Alternat Med. 2013; 2013: 381381. doi: 10.1155/2013/381381
Vahedparast H, Samsami K, Hajinezhad F, Tavallali F, Bagherzadeh R. Comparing the Efficacy of Foot Reflexology and Benson's Relaxation on Anxiety and Physiologic Parameters After Cesarean Surgery. Nursing for Women's Health. 2024;28(4):e1-e12. doi: 10.1016/j.nwh.2024.02.008
Kim WS BG, Song BJ, Lee HJ. Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia. Korean J Anesthesiol 2010;58(4):328-33. doi: 10.4097/kjae.2010.58.4.328
Hu PH PY, Lin YT, Chang CS, Ou MC. Aromatherapy for reducing colonoscopy related procedural anxiety and physiological parameters: a randomized controlled study. Hepatogastroenterology 2010;57(102-103):1082-1086.
Tahmasbi H, Hasani S. Effect of Bensons' relaxation technique on the anxiety of patients Undergoing coronary angiography. j of Nursing and Midwifery 2016;3 (1):8-14. doi: 10.18869/acadpub.jnms.3.1.8
Najafi Ghezelcheh T SH, Muhaddith Ardabili F. The effect of Benson relaxation method on anxiety in intensive care unit nurses. Cardiovascular Nursing 2016; 5(3):26-33. (Persian).
Fayazi S SAAA, Momeni M. The efficacy of bensons relaxation technique on postoperative pain in coronary artery bypases graft. Jundishapur scientific medical journal winter 2010;8(4) (63): 479 - 489.
Torabi M SM, Ghahri Sarabi A.R, Effect of Foot Reflexology Massage and Benson Relaxation Techniques on Anxiety and Physiological Indexes of Patients Undergoing Coronary Heart Angiography. Avicenna J Nurs Midwifery care 2012; 20 (1) :63-73. (Persian).
Mahmoudirad G HM, Nasirizade M, Biabani F. The Effects of Benson's Relaxation Response on Fatigue During Pregnancy: A Two-Group Randomized Controlled Field Trial, Mod Care J. 2017 ; 14(3):e66965. doi: 10.5812/modernc.66965
Published
Issue
Section
License
The Copyright Form should be downloaded and signed by corresponding author in the fourth step "upload supplementary files" during submission process.
After acceptance, copyright form should be downloaded and signed by all authors one by one ( "summery --> supp. file" part and click on "add a supplementary file" link).
