Does a nurse-led postpartum self-care program for first-time mothers in Bangladesh improve postpartum fatigue, depressive mood, and maternal functioning?: a non-synchronized quasi-experimental study

Abstract

Purpose: This study aimed to test the efficacy of a nurse-led postpartum self-care (NL-PPSC) intervention at reducing postpartum fatigue (PPF) and depressive mood and promoting maternal functioning among first-time mothers in Bangladesh.Methods: A non-synchronized quasi-experimental design was used. First-time mothers were recruited during postpartum (PP) and assigned to the experimental or control group (34 each). The experimental group attended the NL-PPSC—a 1-day intervention that focused on increasing self-efficacy—at a hospital in person. The control group received usual care. Data on PPF, depressive mood, maternal functioning, self-care behaviors, PP self-efficacy, and self-care knowledge were collected at 2 weeks PP (attrition 23.5%) and 6 weeks PP (attrition 16.1%). Data were analyzed using descriptive statistics, bivariate statistics, and linear mixed model analysis.Results: One-third (33.3%) of new mothers experienced depressive mood (Edinburgh Postnatal Depression Scale scores of ≥13 points). The NL-PPSC intervention statistically significantly decreased PPF (β=–6.17, SE=1.81, t=–3.39, p<.01) and increased maternal functioning at 6 weeks PP in the experimental group (β=13.72, t=3.73, p<.01) as opposed to the control group. Knowledge was also statistically significant for increased maternal functioning over time (β=.37, SE=.18, t=2.03, p<.05). However, no statistically significant differences in PP depressive mood were observed over time.Conclusion: The NL-PPSC intervention was feasible and effective at improving fatigue and maternal functioning in Bangladeshi mothers at 6 weeks PP. PP care knowledge was effective at improving maternal functioning; this finding supports the implementation of the NL-PPSC intervention for new mothers after childbirth.

Effect of Maternal and Newborn Care Intervention on Maternal Functioning of Primiparous Mothers

“…However, comparing postpartum self-care knowledge mean scores at postpartum six weeks revealed that the intervention group had significantly higher than the control group (t = -6.61, p < 0.001). The result obtained from the current study was consistent with the study done in Indonesia (Khatun et al, 2021). That study used "Nurse-led postpartum self-care (NLPPSC)" intervention which included two sessions of postpartum education and two phone calls in which each lasted three to five minutes for reinforcement at postpartum two and six weeks.…”

“…The result of RCT conducted in Iran which involved 68 postpartum women showed that four sessions of counseling using the "Skills Training Approach" were effective in increasing the maternal functioning of postpartum women (Chamgurdani et al, 2020) that was alike with the finding of the current study. Finding of the current study was supported by another study done in Indonesia which showed that NLPPSC program was effective in enhancing the maternal functioning of first-time mothers (Khatun et al, 2021). In accordance with the above reviewed studies, maternal functioning of mothers can be promoted by provision of the intervention.…”

“…However, only 23.2%, 29.5% and 34.1% of postpartum mothers had high level of social support from their husband, parents and their friends in Myanmar (Myo, Hong, Thepthien, & Hongkrailert, 2021). According to finding of previous studies, telephonebased intervention (Khatun et al, 2021) and peer support (Shorey et al, 2019) were effective in supporting mothers and using these kinds of support are relevant in the improvement in digital socialization.…”

“…To be a healthy mother both physically and emotionally, mothers need to have adequate self-care knowledge. Khatun et al (2021) proved that improving maternal functioning was significantly associated with increased postpartum self-care knowledge. Newborn care knowledge is also necessary for mothers to take care of their babies.…”

“…If maternal functioning can be improved, positive health outcomes of primiparous mothers and newborns can be attained and other undesirable burdens can be minimized. Maternal functioning is affected by self-care knowledge (Khatun et al, 2021), newborn care knowledge (Albanese, Geller, Steinkamp, & Barkin, 2020), social support (Shamasbi et al, 2020), and self-efficacy of mothers (Mirghafourvand & Bagherinia, 2018). Therefore, an effective nursing intervention program for improving maternal functioning should be developed.…”