The Effect of Expressive Writing on Postpartum Depression and Stress of Mothers with a Preterm Infant in NICU
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The Effect of Expressive Writing on Postpartum Depression and Stress of Mothers with a Preterm Infant in NICU Soheila Rabiepoor1 · Naemeh Vatankhah‑Alamdary2 · Hamid Reza Khalkhali3
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract This study was conducted to investigate the effects of expressive writing on postpartum depression and stress of mothers with a preterm infant in NICU. This clinical trial was carried out on 91 mothers whose infants were in NICU. Subjects were assigned to intervention and control groups. In the intervention group, subjects were asked to start expressive writing from the third day of hospitalization in NICU and continue it until the tenth day. EPDS, PSS: NICU, and PSS-14 COHEN were completed by all the mothers on days 3 and 10, and 1–3 months after the admittance. Mean EPDS score was obtained as 9.65 ± 5.28, 9.23 ± 5.41, 8.19 ± 4.45, and 7.60 ± 4.65, respectively, for control group at days 3 and 10, and 1–3 months after hospitalization, and it was also obtained as 9.62 ± 5.89, 6.04 ± 3.39, 2.95 ± 2.41, and 2.44 ± 2.01, respectively, for the intervention group at days 3 and 10, and 1–3 months after hospitalization (p 0.4 (Montazeri, Torkan, & Omidvari, 2007). PSS: NICU PSS: NICU was designed by Miles–Funk–Carlson in 1993 to measure parental perception of stressors arising from physical and psychosocial environment of NICU. It includes 22 items scored on a 5-point Likert scale from 0 (no experience at all) to 5 (extremely stressful), with a total score ranging from 22 to 110. Higher scores indicate greater perceived stressor. PSS: NICU consists of three subscales measuring stress related to sights and sounds of the unit (six items), infant appearance and behaviors (eight items), parental role and their relationship with their baby and communication with the staff (eight items). Validity of the Persian edition of the questionnaire was confirmed in the study conducted by Kadivar et al. (2015). Internal consistency reliability was also confirmed. Cronbach’s alpha coefficient was obtained as 0.87 (Kadivar & Mozafarinia, 2013; Kadivar, et al., 2015). PSS‑14’COHEN PSS-14’COHEN was developed by Cohen et al. to measure perceived stress during the last month (Cohen, Kamarck,
& Mermelstein, 1983). It asks about feelings and thoughts related to stressful events, and controlling or coping with stressors. Content validity of this scale assessed by simple correlation coefficient was reported as 0.63 (Moghadam, Rashidzadeh, Shamsalizadeh, & Fallahi, 2014). Reliability of the Persian edition of PSS-14′COHEN was confirmed in the studies conducted by Bastani et al. and Mohammadi et al., and Cronbach’s alpha coefficient was reported as 0.74 (Bastani, Rahmatnejad, Jahdi, & Haghani, 2008). Items are rated on a 5-point Likert scale (0 never; 1 almost never; 2 sometimes; 3 fairly often; 4 very often) with a total score ranging from 0 to 56. Items 4–7, 9, 10, and 13 are reverse scored. Higher score implies a higher level of perceived stress (Katsarou et al., 2012).
Ethical Consid
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