Effects of Benson Relaxation Technique and Music Therapy on the Anxiety of Primiparous Women Prior to Cesarean Section: A Randomized Controlled Trial

Abstract

Background and Aims. Primiparous women experience high levels of anxiety before cesarean section. Therefore, this research aimed to investigate the effects of the Benson Relaxation Technique (BRT) and Music Therapy (MT) on the anxiety of primiparous women prior to cesarean section. Methods. A randomized controlled trial was carried out on 105 women scheduled for cesarean section. They were randomly assigned into three groups: BRT, MT, and control (n = 35 per group). The women in the BRT and MT groups performed exercises and listened to music, respectively, for 20 minutes prior to cesarean section. The State Anxiety Inventory was used to measure the women’s anxiety in the groups before and after the intervention. Results. Within-group comparisons showed that the women in the BRT (t = 5.61, p < 0.001, effect size (Cohen’s d) = 0.94) and MT (t = 3.83, p = 0.001, d = 0.64) groups had significantly lower anxiety after the interventions compared to before the interventions. Also, between-group comparisons revealed that anxiety after the intervention was significantly lower in the BRT and MT groups compared to the control group ( p = 0.007). Conclusions. Although both of the BRT and MT helped with the reduction of anxiety among primiparous women before cesarean section, the BRT was shown more effective. These nonpharmacologic methods are safe and cost-effective and can improve well-being among women undergoing this invasive procedure. They can be used along with pharmacologic methods for reducing overreliance on medications.

The Effects of Music-Based Interventions for Pain and Anxiety Management during Vaginal Labour and Caesarean Delivery: A Systematic Review and Narrative Synthesis of Randomised Controlled Trials

“…In summary, this review showed that most but not all the included studies found that music was beneficial in reducing pain and anxiety during vaginal labour [3,27,[38][39][40][41][42][43][44][45][46][48][49][50][51][52][53] and C-section [13,14,56,57,[59][60][61], particularly in primiparous women. However, other studies did not find a significant advantage of music over a control condition or a different therapy [47,58,60].…”

“…The application of music as one element of a larger treatment during vaginal labour [27,53], as individually selected music [41,52,54,55], as music combined with another therapy [27,[51][52][53], as instrumental [3,14,40,43,46,48], classical [13,42,53] and relaxing [27,42,45,50,51,57,59,60] styles of music, and as music played via headphones during the caesarean procedure [14,54,57,[59][60][61] all seemed particularly helpful in reducing pain and anxiety in mothers.…”

“…Perioperative anxiety has physiological implications as the sympathetic adrenal-medullary system becomes aroused, which in turn may affect the circulatory system, leading to an increased risk of complications, including constriction of the mother's coronary arteries, greater blood viscosity, and increased risk of a heart attack [13]. It is therefore crucial that heightened anxiety is detected and managed throughout the perioperative period, as an inability to do so may delay recovery, increase hospital admission length, and intensify maternal pain sensitivity, leading to a greater demand for pain-relieving drugs [14,15]. Research by Wyatt et al [16] revealed that a substantial proportion of anxious women took benzodiazepines pre-surgery to manage their anxiety despite knowing the negative side effects associated with the drug, for example, respiratory depression, indicating a need to consider alternative forms of anxiety management with greater risk aversion for women undergoing C-sections.…”

“…Another study of 105 participants examined two presurgical therapies, i.e., MT, namely the composition "weightless" by Macaroni Union and Benson's relaxation technique (BRT) [14]. Both interventions significantly reduced anxiety levels during caesarean deliveries compared with the control group receiving standard nursing care, although BRT was more effective.…”

“…For example, some studies did not state the specific genre/songs or did not give their reasoning for the music chosen. Some participants wore headphones [3,14,40,[48][49][50]52,54,[57][58][59][60] whilst others did not [41,[43][44][45]55,56], which can impact the listening experience, and MT was delivered by a trained music therapist in only two studies [27,45]. Previous research has emphasised the importance of a trained music therapist delivering music interventions for optimal effectiveness [63] as the lack of reported detail and variability in the quality of those delivering music interventions to participants may restrict replicability and the potential of implementing the outcomes in clinical practice.…”