The Efficacy of Integrating Spirituality into Prenatal Care on Pregnant Women’s Sleep: A Randomized Controlled Trial

Abstract

Objective. The study is aimed at determining the efficacy of spiritual content counselling on improving the sleep quality and insomnia severity of pregnant women. Methods. This randomized controlled trial was carried out on 40 pregnant women recruited at five health centres of Abhar, Iran, 2020. The eligible women were allocated into two intervention and control groups according to the randomized blocking method. Group counselling with spiritual content was carried out in eight sessions at 16 to 20 weeks of gestation. The control group only received routine care. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) questionnaires in three stages, before the intervention, at 28, and 36 weeks of gestation. Statistical analysis was performed using repeated measure ANOVA test, chi-square, and independent t -tests. P < 0.05 was considered significant statistical level. Results. In the counselling group, the mean (SD) of a total score of sleep quality before the intervention was 9.45 (2.30) which decreased to 5.40 (1.56) in 36 weeks of gestational age, while in the control group was increased from 9.26 (2.15) to 11.47 (1.54). After the intervention based on the repeated measure ANOVA test, the mean total score of the insomnia severity, sleep quality, and its components decreased statistically in the second and third trimesters compared to the first trimester in the intervention group compared to the control group ( P = 0.001 ). Conclusion. The results showed that counselling with spiritual content could effectively ameliorate sleep quality and reduce insomnia severity in pregnant women. It seems that the approach is an acceptable basis to design intervention programs in this field that can be considered by midwives. Clinical Trial Registry and Registration Number. The study was registered at the Iranian Registry of Clinical Trials under the IRCT20150731023423N15.

Efficacy of cognitive behavioural therapy for insomnia or sleep disturbance in pregnant women: A systematic review ad meta‐analysis

“…Eight RCTs (Cain et al, 2020; Felder et al, 2020; Han et al, 2019; Jiang et al, 2021; Kalmbach et al, 2020; Khatibi et al, 2021; Manber et al, 2019; Moradi et al, 2022) were included, involving 743 pregnant women, 373 in experiment groups, and 370 in control groups. Among them, two RCTs were conducted in China (Han et al, 2019; Jiang et al, 2021), four in the USA (Cain et al, 2020; Felder et al, 2020; Kalmbach et al, 2020; Manber et al, 2019), and two in Iran (Khatibi et al, 2021; Moradi et al, 2022). CBT‐I was used in the experimental groups, and sleep education, or conventional obstetric care was used in the control groups.…”

“…Six RCTs (Cain et al, 2020; Felder et al, 2020; Jiang et al, 2021; Kalmbach et al, 2020; Manber et al, 2019; Moradi et al, 2022) included 303 pregnant women in the CBT‐I group and 303 in the control group. Considering the heterogeneity test results ( I 2 = 89%, p < 0.001), the random‐effect model was employed, revealing a significant reduction in the CBT‐I group (MD = −4.25, 95% CI (−6.32, −2.19), p < 0.001) (Figure 3).…”

“…The study included seven RCTs (Cain et al, 2020; Felder et al, 2020; Han et al, 2019; Jiang et al, 2021; Kalmbach et al, 2020; Khatibi et al, 2021; Moradi et al, 2022) with 262 pregnant women in the CBT‐I group and 262 pregnant women in the control group. The PSQI score of the experimental group was lower than that of the control group.…”

“…Four RCTs (Han et al, 2019; Jiang et al, 2021; Khatibi et al, 2021; Moradi et al, 2022), including 206 pregnant women reported sleep onset latency, and 103 were assigned to receive CBT‐I. The random‐effect model showed shorter sleep onset latency in CBT‐I group (SMD = −1.25, 95% CI (−2.01, −0.50), p = 0.001; I 2 = 83%, p < 0.001) (Figure 5).…”

“…The five RCTs (Han et al, 2019; Jiang et al, 2021; Kalmbach et al, 2020; Khatibi et al, 2021; Moradi et al, 2022) focussed on TST with 297 pregnant women, the heterogeneity was high ( I 2 = 92%, p < 0.001), so the random‐effect model was applied. CBT‐I had similar effects to that of the control interventions (SMD = 0.31, 95% CI (−0.54, 1.17), p = 0.47) (Figure 6).…”