The Effect of Psychological Interventions on the Anxiety and Breastfeeding Self-Efficacy: A Systematic Review and Meta-Analysis
-
Roghaiyeh Nourizadeh
,
Shiva Shamsdanesh
,
Esmat Mehrabi
,
Fatemeh Ranjbar
,
Sevil Hakimi
,
Hanieh Salehi pourmehr
Abstract
Background: Maternal anxiety has been accompanied by many unfavorable effects on breastfeeding in the postpartum period. We aimed to provide scientific evidence in identifying effective interventions for anxiety and breastfeeding self-efficacy (BSE) in a systematic review and meta-analysis.
Methods: All published studies with inclusion criteria by 2022 were searched in Embase, Cochrane library, Web of Sciences, Google Scholar, PubMed, Scopus, SID and Magiran. The literature search was performed using PRISMA instructions. Further, 20 eligible interventional studies (RCT and pre-posttest) and one case study were included in this systematic review and meta-analysis. Publication bias was checked with Eggers test and funnel plot methods. The collected data were analyzed using stata version16.
Results: It is not possible to provide an explicit and accurate conclusion about the effective intervention method in reducing anxiety and increasing BSE among lactating women during the covid19 pandemic. The results indicated a significant increase in BSE among lactating women after educational and psychological interventions (4.20, 95% CI: 3.61 to 4.80, I2 = 26.38%).
Conclusion: It is recommended to conduct further studies with a strong methodology and based on intervention methods during the postpartum period, especially in the first month of birth to reduce the symptoms of stress and anxiety in the mother, establish better mother-child attachment, and improve BSE and maternal performance during the Covid-19 pandemic.
1. Rahmani F, Seyedfatemi N, Asadollahi M, et al (2011). Predisposing factors of postpartum depression. Iran Journal of Nursing, 24 (72): 78-87.
2. Nagel EM, Howland MA, Pando C, et al(2022). Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review. Clin Ther, 44(2):215-27.
3. Borra C, Iacovou M, Sevilla A (2015). New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Matern Child Health J, 19 (4): 897-907.
4. Bastani F, Rahmatnejad L, Jahdi F, et al (2008). Breastfeeding self efficacy and perceived stress in primiparous mothers. Iran Journal of Nursing, 21 (54): 9-23.(In Persian)
5. Fawcett EJ, Fairbrother N, Cox ML, et al (2019). The prevalence of anxiety disorders during pregnancy and the postpartum period: a multivariate Bayesian meta-analysis. J Clin Psychiatry, 80(4): 18r12527.
6. Alshikh Ahmad H, Alkhatib A, Luo J (2021). Prevalence and risk factors of postpartum depression in the Middle East: a systematic review and meta–analysis. BMC Pregnancy Childbirth, 21:542.
7. Liu Y, Zhang L, Guo N, Jiang H (2021). Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors. BMC Psychiatry, 21(1):487.
8. Cheng CY, Chou YH, Chang CH, Liou SR (2021). Trends of perinatal stress, anxiety, and depression and their prediction on postpartum depression. Int J Environ Res Public Health, 18(17):9307.
9. Makwana N (2019). Disaster and its impact on mental health: A narrative review. J Family Med Prim Care, 8 (10): 3090-3095.
10. Kontoangelos K, Economou M, Papageorgiou C (2020). Mental health effects of COVID-19 pandemia: a review of clinical and psychological traits. Psychiatry Investig,17(6):491-505.
11. Chen Q, Li W, Xiong J, et al (2022). Prevalence and risk factors associated with postpartum depression during the COVID-19 pandemic: A literature review and meta-analysis. Int J Environ Res Public Health, 19 (4): 2219.
12. Wu Y, Zhang C, Liu H, Duan C, et al (2020). Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol, 223(2):240.e1-240.e9.
13. Yasemi M, Razjooyan K (2001). Relationship of mental disorder anxiety and depression with cessation of breastfeeding. Journal of Guilan University of Medical Sciences, 10(39): 1-7.
14. Fajardo M, Florido J, Villaverde C, et al (1994). Plasma levels of β-endorphin and ACTH during labor and immediate puerperium. Eur J Obstet Gynecol Reprod Biol, 55(2): 105-8.
15. Oyetunji A, Chandra P(2020). Postpartum stress and infant outcome: A review of current literature. Psychiatry Res, 284:112769.
16. Gila-Díaz A, Carrillo GH, López de Pablo ÁL, et al (2020). Association between maternal postpartum depression, stress, optimism, and breastfeeding pattern in the first six months. Int J Environ Res Public Health,17(19):7153.
17. Shamsdanesh S, Nourizadeh R, Hakimi S, et al (2023). The effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy during COVID-19 pandemic: a ramdomized controlled trial. BMC Pregnancy Childbirth, 23(1): 26.
18. Cullen W, Gulati G, Kelly BD (2020). Mental health in the COVID-19 pandemic. QJM,113(5):311-2.
19. Soklaridis S, Lin E, Lalani Y, Rodak T, Sockalingam S (2020). Mental health interventions and supports during COVID-19 and other medical pandemics: A rapid systematic review of the evidence. Gen Hosp Psychiatry, 66:133-46.
20. Schmidt B, Crepaldi MA, Bolze SD, Neiva-Silva L, Demenech LM (2020). Mental health and psychological interventions during the new coronavirus pandemic (COVID-19). Estudos de Psicologia (Campinas), 37: e200063
21. Liberati A, Altman DG, Tetzlaff J, et al (2009). The PRISMA statement for re-porting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elabo-ration. PLoS Med, 6(7):e1000100.
22. DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7(3):177-188.
23. Egger M, Smith GD, Schneider M, et al (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315 (7109): 629-34.
24. Begg CB, Mazumdar M (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50(4):1088-1101.
25. Huang JW, Zhou XY, Lu SJ, et al (2020). Dialectical behavior therapy-based psychological intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report. J Zhejiang Univ Sci B, 21(5): 394-9.
26. Mannan I, Rahman SM, Sania A, et al (2008). Can early postpartum home visits by trained community health workers improve breastfeeding of newborns? J Perinatol, 28 (9): 632-40.
27. Sikander S, Maselko J, Zafar S, et al (2015). Cognitive-behavioral counseling for exclusive breastfeeding in rural pediatrics: a cluster RCT. Pediatrics, 135 (2): e424-e31.
28. Parsa p, Boojar A, Roshanaei G, et al (2016). The Effect breastfeeding counseling on self-efficacy and continuation breastfeeding among primiparous mothers: a randomised clinical trial. Avicenna J Nurs Midwifery Care, 24 (2): 98-104.
29. Fauzia F, Fudholi A (2020). The influence of participative counseling approach on improving breastfeeding self-efficacy to pregnant women in Indonesia. Asian J Pharm Clin Res, 13 (1): 85-88.
30. Azizi E, Maleki A, Mazloomzadeh S, et al (2020). Effect of stress management counseling on self-efficacy and continuity of exclusive breastfeeding. Breastfeed Med, 15 (8): 501-8.
31. Farasati M, Nourizadeh R, Sattarzadeh-Jahdi N, et al (2022). The Effect of In-Home Supportive Counseling on Breastfeeding Self-Efficacy and Breastfeeding Performance Following Cesarean Section Among Primiparous Women. International Journal of Women's Health and Reproduction Sciences. Accepted article. (In press).
32. Farasati M, Nourizadeh R, Sattarzadeh-Jahdi N, et al (2022). The effect of in-home supportive counseling on maternal functioning and self-efficacy following cesarean section among primiparous women. Journal of Education and Health Promotion. Accepted article. (In press).
33. Hashemzadeh M (2014). Effect of educational package on breastfeeding self-efficacy in postpartum period. Payesh, 13 (2): 221-8.
34. Mohseni H, Jahanbin I, Sekhavati E, et al (2018). An investigation into the effects of prenatal care instruction at home on breast-feeding self-efficacy of first-time pregnant women referred to shiraz clinics. Iran. International Journal of Women's Health and Reproduction Sciences, 6 (1): 41-46.
35. Saljughi F, Savabi Esfahani M, Kohan S, et al (2016). Promoting breastfeeding self-efficacy through role-playing in pregnant women. Int J Pediatr, 4 (7): 2061-8.
36. Merdasi F, Araban M, Saki MA (2017). The effect of message-framing on breastfeeding self-efficacy among nulliparous women in Shushtar, Iran. Electron Physician, 9 (1): 3554-60.
37. Dol J, Aston M, Grant A, et al (2022). Implementing Essential Coaching for Every Mother during COVID-19: A Pilot Pre-Post Intervention Study. Birth, 49 (2): 273-280.
38. Liu L, Zhu J, Yang J, et al (2017). The effect of a perinatal breastfeeding support program on breastfeeding outcomes in primiparous mothers. West J Nurs Res, 39 (7): 906-23.
39. Abdollahipour F, Nougjah S, Latifi SM, et al (2017). The impact of applying the breast crawl (TBC) with other educational strategies on breastfeeding self-efficacy after the first breastfeeding among primiparous women in Dezful. Iran J Health Educ Health Promot, 5(1): 20-32
40. Karimi A, Bagheri S, Tara F, Khadivzadeh T, Mousavi Bazaz SM (2014). Effect of Kangaroo Mother Care on breastfeeding self-efficacy in primiparous women, 3 month after child birth. The Iranian Journal of Obstetrics, Gynecology and Infertility, 17 (120): 1-8.
41. Karimi A, Khadivzadeh T, Bagheri S (2014). Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: a randomised control trial. Women Birth, 27 (1): 37-40.
42. Naroee H, Rakhshkhorshid M, Shakiba M, et al (2020). The effect of motivational interviewing on self-efficacy and continuation of exclusive breastfeeding rates: a quasi-experimental study. Breastfeed Med, 15 (8): 522-7.
43. Salehi F, Motaghi Z, Keramat A, et al (2019). Comparing the effect of talks and motivational interviews on self-efficacy of exclusive maternal breastfeeding in primiparous women. J Mazandaran Univ Med Sci, 29 (171): 45-57.
44. Pugh LC, Serwint JR, Frick KD, et al (2010). A randomized controlled community-based trial to improve breastfeeding rates among urban low-income mothers. Acad Pediatr, 10 (1): 14-20.
45. Procelli DE. Effects of music therapy and relaxation prior to breastfeeding on the anxiety of new mothers and the behavior state of their infants during feeding [Master thesis]. College of music, The Florida State University, USA; 2005.
2. Nagel EM, Howland MA, Pando C, et al(2022). Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review. Clin Ther, 44(2):215-27.
3. Borra C, Iacovou M, Sevilla A (2015). New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Matern Child Health J, 19 (4): 897-907.
4. Bastani F, Rahmatnejad L, Jahdi F, et al (2008). Breastfeeding self efficacy and perceived stress in primiparous mothers. Iran Journal of Nursing, 21 (54): 9-23.(In Persian)
5. Fawcett EJ, Fairbrother N, Cox ML, et al (2019). The prevalence of anxiety disorders during pregnancy and the postpartum period: a multivariate Bayesian meta-analysis. J Clin Psychiatry, 80(4): 18r12527.
6. Alshikh Ahmad H, Alkhatib A, Luo J (2021). Prevalence and risk factors of postpartum depression in the Middle East: a systematic review and meta–analysis. BMC Pregnancy Childbirth, 21:542.
7. Liu Y, Zhang L, Guo N, Jiang H (2021). Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors. BMC Psychiatry, 21(1):487.
8. Cheng CY, Chou YH, Chang CH, Liou SR (2021). Trends of perinatal stress, anxiety, and depression and their prediction on postpartum depression. Int J Environ Res Public Health, 18(17):9307.
9. Makwana N (2019). Disaster and its impact on mental health: A narrative review. J Family Med Prim Care, 8 (10): 3090-3095.
10. Kontoangelos K, Economou M, Papageorgiou C (2020). Mental health effects of COVID-19 pandemia: a review of clinical and psychological traits. Psychiatry Investig,17(6):491-505.
11. Chen Q, Li W, Xiong J, et al (2022). Prevalence and risk factors associated with postpartum depression during the COVID-19 pandemic: A literature review and meta-analysis. Int J Environ Res Public Health, 19 (4): 2219.
12. Wu Y, Zhang C, Liu H, Duan C, et al (2020). Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol, 223(2):240.e1-240.e9.
13. Yasemi M, Razjooyan K (2001). Relationship of mental disorder anxiety and depression with cessation of breastfeeding. Journal of Guilan University of Medical Sciences, 10(39): 1-7.
14. Fajardo M, Florido J, Villaverde C, et al (1994). Plasma levels of β-endorphin and ACTH during labor and immediate puerperium. Eur J Obstet Gynecol Reprod Biol, 55(2): 105-8.
15. Oyetunji A, Chandra P(2020). Postpartum stress and infant outcome: A review of current literature. Psychiatry Res, 284:112769.
16. Gila-Díaz A, Carrillo GH, López de Pablo ÁL, et al (2020). Association between maternal postpartum depression, stress, optimism, and breastfeeding pattern in the first six months. Int J Environ Res Public Health,17(19):7153.
17. Shamsdanesh S, Nourizadeh R, Hakimi S, et al (2023). The effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy during COVID-19 pandemic: a ramdomized controlled trial. BMC Pregnancy Childbirth, 23(1): 26.
18. Cullen W, Gulati G, Kelly BD (2020). Mental health in the COVID-19 pandemic. QJM,113(5):311-2.
19. Soklaridis S, Lin E, Lalani Y, Rodak T, Sockalingam S (2020). Mental health interventions and supports during COVID-19 and other medical pandemics: A rapid systematic review of the evidence. Gen Hosp Psychiatry, 66:133-46.
20. Schmidt B, Crepaldi MA, Bolze SD, Neiva-Silva L, Demenech LM (2020). Mental health and psychological interventions during the new coronavirus pandemic (COVID-19). Estudos de Psicologia (Campinas), 37: e200063
21. Liberati A, Altman DG, Tetzlaff J, et al (2009). The PRISMA statement for re-porting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elabo-ration. PLoS Med, 6(7):e1000100.
22. DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7(3):177-188.
23. Egger M, Smith GD, Schneider M, et al (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315 (7109): 629-34.
24. Begg CB, Mazumdar M (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50(4):1088-1101.
25. Huang JW, Zhou XY, Lu SJ, et al (2020). Dialectical behavior therapy-based psychological intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report. J Zhejiang Univ Sci B, 21(5): 394-9.
26. Mannan I, Rahman SM, Sania A, et al (2008). Can early postpartum home visits by trained community health workers improve breastfeeding of newborns? J Perinatol, 28 (9): 632-40.
27. Sikander S, Maselko J, Zafar S, et al (2015). Cognitive-behavioral counseling for exclusive breastfeeding in rural pediatrics: a cluster RCT. Pediatrics, 135 (2): e424-e31.
28. Parsa p, Boojar A, Roshanaei G, et al (2016). The Effect breastfeeding counseling on self-efficacy and continuation breastfeeding among primiparous mothers: a randomised clinical trial. Avicenna J Nurs Midwifery Care, 24 (2): 98-104.
29. Fauzia F, Fudholi A (2020). The influence of participative counseling approach on improving breastfeeding self-efficacy to pregnant women in Indonesia. Asian J Pharm Clin Res, 13 (1): 85-88.
30. Azizi E, Maleki A, Mazloomzadeh S, et al (2020). Effect of stress management counseling on self-efficacy and continuity of exclusive breastfeeding. Breastfeed Med, 15 (8): 501-8.
31. Farasati M, Nourizadeh R, Sattarzadeh-Jahdi N, et al (2022). The Effect of In-Home Supportive Counseling on Breastfeeding Self-Efficacy and Breastfeeding Performance Following Cesarean Section Among Primiparous Women. International Journal of Women's Health and Reproduction Sciences. Accepted article. (In press).
32. Farasati M, Nourizadeh R, Sattarzadeh-Jahdi N, et al (2022). The effect of in-home supportive counseling on maternal functioning and self-efficacy following cesarean section among primiparous women. Journal of Education and Health Promotion. Accepted article. (In press).
33. Hashemzadeh M (2014). Effect of educational package on breastfeeding self-efficacy in postpartum period. Payesh, 13 (2): 221-8.
34. Mohseni H, Jahanbin I, Sekhavati E, et al (2018). An investigation into the effects of prenatal care instruction at home on breast-feeding self-efficacy of first-time pregnant women referred to shiraz clinics. Iran. International Journal of Women's Health and Reproduction Sciences, 6 (1): 41-46.
35. Saljughi F, Savabi Esfahani M, Kohan S, et al (2016). Promoting breastfeeding self-efficacy through role-playing in pregnant women. Int J Pediatr, 4 (7): 2061-8.
36. Merdasi F, Araban M, Saki MA (2017). The effect of message-framing on breastfeeding self-efficacy among nulliparous women in Shushtar, Iran. Electron Physician, 9 (1): 3554-60.
37. Dol J, Aston M, Grant A, et al (2022). Implementing Essential Coaching for Every Mother during COVID-19: A Pilot Pre-Post Intervention Study. Birth, 49 (2): 273-280.
38. Liu L, Zhu J, Yang J, et al (2017). The effect of a perinatal breastfeeding support program on breastfeeding outcomes in primiparous mothers. West J Nurs Res, 39 (7): 906-23.
39. Abdollahipour F, Nougjah S, Latifi SM, et al (2017). The impact of applying the breast crawl (TBC) with other educational strategies on breastfeeding self-efficacy after the first breastfeeding among primiparous women in Dezful. Iran J Health Educ Health Promot, 5(1): 20-32
40. Karimi A, Bagheri S, Tara F, Khadivzadeh T, Mousavi Bazaz SM (2014). Effect of Kangaroo Mother Care on breastfeeding self-efficacy in primiparous women, 3 month after child birth. The Iranian Journal of Obstetrics, Gynecology and Infertility, 17 (120): 1-8.
41. Karimi A, Khadivzadeh T, Bagheri S (2014). Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: a randomised control trial. Women Birth, 27 (1): 37-40.
42. Naroee H, Rakhshkhorshid M, Shakiba M, et al (2020). The effect of motivational interviewing on self-efficacy and continuation of exclusive breastfeeding rates: a quasi-experimental study. Breastfeed Med, 15 (8): 522-7.
43. Salehi F, Motaghi Z, Keramat A, et al (2019). Comparing the effect of talks and motivational interviews on self-efficacy of exclusive maternal breastfeeding in primiparous women. J Mazandaran Univ Med Sci, 29 (171): 45-57.
44. Pugh LC, Serwint JR, Frick KD, et al (2010). A randomized controlled community-based trial to improve breastfeeding rates among urban low-income mothers. Acad Pediatr, 10 (1): 14-20.
45. Procelli DE. Effects of music therapy and relaxation prior to breastfeeding on the anxiety of new mothers and the behavior state of their infants during feeding [Master thesis]. College of music, The Florida State University, USA; 2005.
| Files | ||
| Issue | Vol 52 No 5 (2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i5.12710 | |
| Keywords | ||
| Anxiety Breastfeeding self-efficacy Exclusive breastfeeding Psychological interventions | ||
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How to Cite
1.
Nourizadeh R, Shamsdanesh S, Mehrabi E, Ranjbar F, Hakimi S, Salehi pourmehr H. The Effect of Psychological Interventions on the Anxiety and Breastfeeding Self-Efficacy: A Systematic Review and Meta-Analysis. Iran J Public Health. 2023;52(5):937-949.
