Effectiveness of empathic caring on stress and depression for women with recurrent miscarriage: A randomized controlled trial.

AIM: The purpose of this study was to investigate the effectiveness of empathic caring on sleep quality, depression, stress, and social support in women with recurrent miscarriage. MATERIALS AND METHODS: Sixty-two eligible women were randomly assigned to either the experimental group (n = 31), which received three face-to-face nursing counseling sessions, or the control group (n = 31). Outcome measures included the Pittsburgh Sleep Quality Index, Edinburgh Prenatal Depression Scale, Perceived Stress Scale, and Interpersonal Support Evaluation List. RESULTS: Paired-sample t-tests revealed that, after receiving nursing counseling, the participants in the experimental group showed significant decreases in stress and depression. However, no significant mean differences were found in the control group between the pretest and the 12-week posttest for any of the four outcome measures. CONCLUSION: Clinical healthcare professionals may incorporate empathic caring into health-promotion protocols to assist women with recurrent miscarriage to improve their psychosocial health.

Effects of non-supervised aerobic exercise on sleep quality and maternal-fetal attachment in pregnant women: A randomized controlled trial.

OBJECTIVES: This study was designed to evaluate the effect in pregnant women of a non-supervised aerobic exercise intervention on sleep quality and maternal-fetal attachment. DESIGN: Pretest-posttest randomized controlled trial. SETTING: Prenatal clinic of a medical center in southern Taiwan. PARTICIPANTS: One hundred and forty eligible, pregnant women were assigned systematically, at a random starting point, to either the experimental group (n = 70) or the control group (n = 70). INTERVENTION: Participants in the experimental group received a 20-minute, low-impact aerobic exercise video on DVD and were instructed to exercise at home at least three times per week for a period of three months. Participants in the control group received routine prenatal care only. MAIN OUTCOME MEASURES: The Pittsburgh Sleep Quality Index and Modified Maternal-Fetal Attachment Scale were used to assess outcome measures before the intervention and at four and 12-weeks post-intervention. RESULTS: The paired-sample t-tests revealed a significant improvement in sleep quality in the experimental group at 4-weeks posttest, which persisted through 12-weeks posttest. In addition, the experimental group reported a significantly higher mean score for maternal-fetal attachment at 4-weeks posttest than the control group. CONCLUSION: The results of this study indicate that performing aerobic exercise ameliorates the decline in sleep quality and improves maternal-fetal attachment in women who are pregnant. These findings may be used to encourage pregnant women to regularly perform low-impact aerobic exercise.

Impacts of Fatigue, Stress, and Perceived Health Status on Women With Rheumatic Diseases: A Comparison Study.

BACKGROUND: Rheumatic conditions, which increase in prevalence as populations age, are a growing public health problem that disproportionately affects women. Understanding the influences of rheumatic diseases (RDs) on fatigue, stress, and perceived health status is deemed important to the improvement of physical and mental health for women with RDs. PURPOSE: This study was designed to compare the fatigue, stress, and perceived physical and mental health status of women with RDs (RD group) with those of peers who did not have chronic illnesses (comparison group). METHODS: A cross-sectional, purposive sample and comparative design was used. Four hundred forty-three women with a mean age of 46.2 years participated in this study. Those with physician-diagnosed RDs (n = 212) were enrolled in the RD group, and those without chronic disease were enrolled in the comparison group (n = 231). Measures used included a demographic datasheet, Fatigue Severity Scale, Perceived Stress Scale, and Short Form-12 Items Health Survey. Analysis of covariance was used to examine the intergroup differences for major variables based on demographic covariates. RESULTS: The RD group reported significantly more fatigue and stress than the comparison group. Moreover, the RD group reported significantly poorer perceived physical health status, significantly poorer physical functioning and general health, and greater bodily pain compared with the comparison group. Conversely, the RD group reported significantly better perceived mental health status, significantly lower vitality, and better role emotional status than the comparison group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings support the theory that RDs have a negative impact on perceived stress and fatigue in women. Physical function, bodily pain, and general health may be the most significantly affected domains of perceived physical health in women with RDs. Of note, with the exception of the vitality subscale, RDs did not adversely affect the perceived mental health of participants with RD in this study. Healthcare professionals should cooperate with clinical rheumatologists, psychologists, and physiotherapists to provide comprehensive care that includes long-term education to help patients with RD self-manage stress, restore vitality, relieve pain, and increase physical function.

Music intervention for pain and anxiety management of the primiparous women during labour: A systematic review and meta-analysis.

AIMS: To determine the effect of music on the management of pain and anxiety in primiparous women during labour. BACKGROUND: Music is cost-effective intervention in clinical practice to reduce pain, stress, and anxiety. However, a systematic review with meta-analysis for investigating its effects during labour is still lacking. DESIGN: A systematic review with meta-analysis. DATA SOURCES: MEDLINE, EMBASE, and CINAHL databases. REVIEW METHODS: Randomized controlled trials or quasi-experimental trials concerning the effects of music among primiparous women who were expected to give normal spontaneous delivery were searched and screened up to 31 July 2017. The recruited trials for this review were compliant with the standards of the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: A total of 392 primiparous pregnant women (197 in the music intervention group and 195 in the routine care group) from five studies were included in this review. Music as an intervention seemed to lower the pain scores for primiparous women during labour, but the effect was not statistically significant. However, there was a significant benefit of music intervention compared with routine care for primiparous women during labour. In the sensitivity analysis, music intervention showed significant effect on the improvement of pain and anxiety for primiparous women during labour. CONCLUSION: Music intervention may be an effective intervention for the management of pain and anxiety for primiparous women during labour.

Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial.

AIM: The purpose of this study was to evaluate the effects of chamomile tea on sleep quality, fatigue and depression in postpartum women. BACKGROUND: Sleep quality is a significant issue for postnatal women. Chamomile is widely used as a folk remedy for its presumed sedative-hypnotic effects. DESIGN: A pretest-post-test randomized controlled trial was used. METHODS: A total of 80 Taiwanese postnatal women with poor sleep quality (Postpartum Sleep Quality Scale; PSQS score ≧16) were recruited from November 2012-August 2013. They were systematically assigned, with a random start, to either the experimental group (n = 40) or the control group (n = 40). The participants in the experimental group were instructed to drink chamomile tea for a period of 2 weeks. The participants in the control group received regular postpartum care only. The PSQS, Edinburgh Postnatal Depression Scale, and Postpartum Fatigue Scale were used to assess outcomes. Two-sample t-tests were used to examine the mean differences in outcome variables between the two groups. RESULTS: Compared with the control group, the experimental group demonstrated significantly lower scores of physical-symptoms-related sleep inefficiency (t = -2·482, P = 0·015) and the symptoms of depression (t = -2·372, P = 0·020). However, the scores for all three instruments were similar for both groups at 4-week post-test, suggesting that the positive effects of chamomile tea were limited to the immediate term. CONCLUSION: Chamomile tea may be recommended to postpartum women as a supplementary approach to alleviating depression and sleep quality problems.

Effects of Qigong Exercise on Biomarkers and Mental and Physical Health in Adults With at Least One Risk Factor for Coronary Artery Disease.

Current medical technology permits the early detection of risk factors for coronary artery disease (CAD) in adults, and interventions are available to prevent CAD-related morbidity and mortality. The goal of this study was to determine the effectiveness of a Qigong exercise intervention in improving biomarker levels and mental and physical health outcomes in community-dwelling adults diagnosed with CAD risk factors, in a southern Taiwanese city. Participants were randomly assigned to an experimental (n= 84) group that participated in a 60-min Qigong group session 3 times per week for 3 months or a control (n= 61) group that did not receive the intervention. Self-perceived mental and physical health assessed with the Chinese Health Questionnaire-12, and body fat percentage were measured at baseline and 6, 12, and 16 weeks. Blood samples were collected at baseline and 12 weeks for analysis of lipid profiles, high-sensitivity C-reactive protein (hs-CRP), glycated hemoglobin (HbA1c), and fasting plasma sugar. Linear mixed model analyses revealed that experimental participants had significantly improved perceived mental and physical health and body fat percentage compared to the control group at 6 and 12 weeks but not 16 weeks. The lipid profiles were significantly more improved in the Qigong group than in the control group at 12 weeks. Qigong exercise, however, had no significant effects on hs-CRP, HbA1c, or fasting plasma sugar. Findings suggest that Qigong exercise improves a limited number of CAD risk factors in community-dwelling adults aged 40 years and over.

Effects of music listening on stress, anxiety, and sleep quality for sleep-disturbed pregnant women.

Prenatal sleep disturbance has been associated with undesirable birthing outcomes. To determine the effectiveness of listening to music at home in improving sleep quality, 121 Taiwanese pregnant women with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score > 5) were systematically assigned, with a random start to music listening (n = 61) or control (n = 60) group. Participants in the music listening group self-regulated listening to music in addition to receiving general prenatal care similar to that in the control group for 2 weeks. The PSQI and State-Anxiety Inventory were used to assess outcomes. ANCOVA analyses were used with the pretest scores as covariates and showed significant improvement in sleep quality, stress, and anxiety in the music listening group compared with the control group. The most frequently used music genre by participants in the experimental group was lullabies, followed by classical music and crystal baby music. This study supported the theory that 2-week music listening interventions may reduce stress, anxiety, and yield better sleep quality for sleep-disturbed pregnant women. The analysis of participants' journals also implied that the expectant mothers' choices of musical genres may correlate more with perceived prenatal benefits or the desire to interact with their unborn child.

Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women.

BACKGROUND: Lavender inhalation aromatherapy is widely believed to impart a hypnotic effect, act as a mood stabilizer, and enhance the positive feelings of mothers toward their infants. However, research into these and other potential therapeutic effects of lavender tea has been limited. AIMS: This study was conducted in Taiwan to evaluate the effectiveness of lavender tea in relieving sleep quality, fatigue, and depression; and in improving maternal-infant attachment during the early postpartum period. METHODS: A total of 80 Taiwanese postnatal women with poor sleep quality (Postpartum Sleep Quality Scale; PSQS score ≥16) and with no history of allergy to herbal teas, foods, or medicines were assigned systematically to either the experimental group (n = 40) or the control group (n = 40). The participants in the experimental group were instructed to drink one cup of lavender tea after spending time to appreciate and smell the aroma each day for a period of 2 weeks, whereas their control group peers received regular postpartum care only. The PSQS, Edinburgh Postnatal Depression Scale, Postpartum Fatigue Scale, and Postpartum Bonding Questionnaire were used to assess outcomes. RESULTS: ANCOVA analyses using education level and pretest scores as covariates showed that experimental group participants perceived less fatigue (F = 6.281, p = .014) and depression (F = 4.731, p = .033) and showed greater bonding with their infant (F = 4.022, p = .049) compared with the control group. However, the scores for all four instruments were similar for both groups at the 4-week posttest, suggesting that the positive effects of lavender tea were limited to the immediate term. LINKING EVIDENCE TO ACTION: Healthcare researchers assume accountability for integrating research results into clinical practice. The findings in this study can gain greater attention among healthcare practitioners and encourage the correct and positive use of herbal therapy in postpartum health care.

The effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy.

OBJECTIVE: While music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancy-specific stress relief. This study examines the effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy. DESIGN: A randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n=145) and a control group (n=151). INTERVENTIONS: The experimental group received routine prenatal care and music listening. The control group received routine prenatal care only. MAIN OUTCOME MEASURES: Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal-Fetal Attachment Scale (MFAS). RESULTS: The post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal-fetal attachment were found between the post-test results of the two groups. CONCLUSION: This study provides evidence in support of using of music in interventions designed to relieve psychosocial stress in prenatal women. IRB approval number: ER98223.

The effectiveness of a relaxation training program for women with preterm labour on pregnancy outcomes: a controlled clinical trial.

BACKGROUND: Prenatal maternal stress is associated with adverse birth outcomes. Few studies have been published on the effectiveness of relaxation techniques focusing on women with preterm labour. OBJECTS: The object of this study was to examine the effectiveness of a relaxation training program on pregnancy outcomes in women experiencing preterm labour. DESIGN: A single-blinded, controlled clinical trial was used. SETTINGS: The study was conducted in two hospitals. Both of the study hospitals located in northern Taiwan are also large teaching hospitals and share the same treatment protocols of preterm labour. PARTICIPANTS: Inclusion criteria were being pregnant and diagnosed with preterm labour, singleton, hospitalized at time of entry into the study, at gestation between 20 and 34 weeks, and having a cervical dilatation of less than 3 cm. Exclusion criteria were if they had one or any combination of the following: antepartum hemorrhage, infection, hypertension, gestational diabetes mellitus, or immunologic disease. METHODS: The experimental group (n=68) participants received a mini mp3 player containing a 13-min relaxation audio program, which they were instructed to follow daily, while the control group (n=59) received only routine prenatal care. Pregnancy outcomes were obtained from medical charts after each woman gave birth. RESULTS: Survival analysis demonstrated that the experimental group had a significant pregnancy prolongation compared to the control group (p=0.048). Participants receiving the relaxation training program had a significant lower proportion of extreme preterm birth, a higher rate of not being admitted to a NICU, and a lower rate of stay days within 30 days when compared with the control group. No significant differences were found on pregnancy outcomes in terms of the rate of preterm birth, low birth weight, Apgar score at 1 and 5 min, mode of birth, and perinatal mortality between the two groups. CONCLUSIONS: Relaxation training for women with preterm labour is effective in delaying of delivery and enhancing positive pregnancy outcomes. This relaxation intervention is cost-effective, noninvasive, and easily applicable in women with preterm labour.

Effects of a relaxation training programme on immediate and prolonged stress responses in women with preterm labour.

AIM: This paper is a report of an experimental study of the effects of relaxation-training programme on immediate and prolonged stress responses in women with preterm labour. BACKGROUND: Hospitalized pregnant women with preterm labour experience developmental and situational stress. However, few studies have been performed on stress management in such women. METHODS: An experimental pretest and repeated post-test design was used to compare the outcomes for two groups in northern Taiwan from December 2008, to May 2010. A total of 129 women were randomly assigned to an experimental (n = 68) or control (n = 61) group. The experimental group participants were instructed to listen daily to a 13-minute relaxation programme. Measurements involved the stress visual analogue scale, finger temperatures, State Trait Anxiety Inventory, Perceived Stress Scale and Pregnancy-related Anxiety. Two-way analysis of variance and hierarchical linear modelling were used to analyse the group differences. RESULTS: Compared with those in the control group, participants in the experimental group showed immediate improvements in the stress visual analogue scale scores and finger temperatures. The State Trait Anxiety Inventory-State subscale score for the experimental group was significantly lower than that for the control group (P = 0·03). However, no statistically significant differences for the Perceived Stress Scale and Pregnancy-related Anxiety scores were found between the experimental group and the control group. CONCLUSIONS: The relaxation-training programme could improve the stress responses of women with preterm labour.

[Using alternative therapies in treating sleep disturbance].

Sleep disturbance is a common health problem among adults, and enhancing sleep quality is an issue of significant importance to healthcare providers. As sleep quality worsens into insomnia, individuals may seek assistance from medication. However, sedative hypnotic drugs pose potentially adverse effects. Also, most medical treatments (e.g., positive pressure assistant ventilators) represent invasive interventions that must be prescribed by physicians. Non-pharmacological alternative therapies are commonly recommended and adopted by community nurses. Alternative therapies for sleep disturbance included exercise, cognitive behavior therapy, multiple strategies, music, and acupressure. In general, moderately intensive walking exercise is the intervention most recommended by professionals to help patients deal with sleep disturbance. Therefore, it is suggested that future researchers devise sleep quality promotion strategies that are suitable for home practice in order to apply the findings and spirit of research already done in this area.

Comparison of health-promoting lifestyles between postnatal han taiwanese and indigenous women.

BACKGROUND: The health-promoting lifestyle of postpartum women is an important issue, but few studies have been undertaken to examine the role of cultural difference. PURPOSE: The purpose of this study was to better understand the health-promoting lifestyles of postnatal mothers in Taiwan in terms of differences between ethnic Han Taiwanese and indigenous women and of factors predicting health-promoting lifestyles in the two groups. METHODS: For this cross-sectional comparative study, data on postnatal health-promoting behaviors, as measured using the Health-Promoting Lifestyle Profile (HPLP), were collected from 314 mothers during their sixth postpartum week. HPLP scores of ethnic Han Taiwanese mothers living in Kaohsiung City, and indigenous women living in Pingtung County were then compared. RESULTS: : Han Taiwanese and indigenous mothers differed significantly in terms of age, education, employment status, socioeconomic status, type of family, and primary postnatal helper. Han Taiwanese had better original scores in overall health-promoting lifestyle, self-actualization, stress management, nutrition, and interpersonal support. However, these differences did not achieve statistical significance when subjected to analysis of covariance. Indigenous participants had significantly higher scores in terms of health responsibility and exercise than Han Taiwanese women. Significant predictors of higher HPLP score in the Han Taiwanese group included employment status and breast-feeding, which together accounted for 8.2% of total variance. In the indigenous group, significant predictors of higher HPLP score included more years of education and middle socioeconomic status, which together accounted for 22.0% of total variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Results showed significant differences in the health responsibility and exercise subscales and significant differences in key predictors between the Han Taiwanese and the indigenous groups. Findings support the role of culture as a significant factor affecting the health-promoting lifestyle of postnatal women in Taiwan. Nurses should be aware of cultural mores and influences when delivering healthcare to postpartum mothers of different ethnic groups to maximize postnatal care efficacy.

Effects of acupressure on menstrual distress in adolescent girls: a comparison between Hegu-Sanyinjiao matched points and Hegu, Zusanli single point.

AIM AND OBJECTIVES: To examine a comparison between Hegu and Sanyinjiao matched points and Hegu, Zusanli single point on adolescent girls' menstrual distress, pain and anxiety perception. BACKGROUND: Primary dysmenorrhoea is a major cause of temporary disability, with a prevalence ranging from 60-93%, depending upon the population and study. No one has yet compared the effects of single point and multiple point acupressures. Design. A single blind randomised experimental study was used. METHODS: Adolescents (n = 134) randomly assigned to experimental groups Zusanli (n = 30), Hegu (n = 33) and Hegu-Sanyinjiao Matched Points (n = 36) received acupressure intervention protocol for 20 minutes, while the control group (n = 35) did not receive any acupressure intervention. Four instruments were used to collect data: (1) the Visual Analog Scale for Pain; (2) the Menstrual Distress Questionnaire Short Form; (3) the Short-Form McGill Pain Questionnaire and (4) the Visual Analog Scale for Anxiety. RESULTS: During the six-month follow-up, acupressure at matched points Hegu and Sanyinjiao reduced the pain, distress and anxiety typical of dysmenorrhoea. Acupressure at single point Hegu was found, effectively, to reduce menstrual pain during the follow-up period, but no significant difference for reducing menstrual distress and anxiety perception was found. Zusanli acupressure had no significant effects of reducing menstrual pain, distress and anxiety perception. CONCLUSION: This controlled trial provides preliminary evidence that six-month acupressure therapy provides female adolescents with dysmenorrhoea benefits. RELEVANCE TO CLINICAL PRACTICE: Acupressure is an effective and safe non-pharmacologic strategy for the treatment of primary dysmenorrhoea. We recommend the use of acupressure for self-care of primary dysmenorrhoea at Hegu and Sanyinjiao matched points and single point Hegu, as pressure placement at these points is easy for adolescent girls to learn and practice.

Effects of listening to music on postpartum stress and anxiety levels.

AIM: This Taiwan study investigated what effect listening to specially selected, relaxing music at home, on a self-regulated basis, had on the perceived stress and state anxiety of postpartum women. BACKGROUND: Listening to music has been increasingly used in the perinatal period, but few studies have been undertaken to provide evidence of its effectiveness. DESIGN: A randomised clinical trial. METHODS: Seventy-seven postpartum women were randomly assigned to an experimental group (n = 37) and a control group (n = 40). The experimental group listened to music at home for at least 30 minutes a day over two weeks and received regular postpartum care. The women in the control group received regular postpartum care only. The Perceived Stress Scale and State Anxiety Inventory were used to measure outcomes. RESULTS: After controlling the pretest scores and educational level of mothers, which was a significant covariate, there were no significant differences in the posttest levels of perceived stress and state anxiety between the two groups. CONCLUSIONS: This study does not provide evidence that preselected designer music reduced stress and anxiety levels among postpartum women. RELEVANCE TO CLINICAL PRACTICE: Despite the absence of significant findings, there are lessons that professionals may find useful. It is recommended that future studies take more account of the stress factors that postpartum women are unable to control when they are listening to music at home.

Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers.

AIMS: The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour. BACKGROUND: Music therapy has been used on clinical medicine. Only few scientific studies validate the value on labour women. DESIGN: Randomised controlled trial. METHODS: Sixty primiparas expected to have a normal spontaneous delivery were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received routine care and music therapy, whereas the control group received routine care only. A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain. Anxiety was measured with a visual analogue scale for anxiety and finger temperature. Pain and anxiety between groups were compared during the latent phase (2-4 cm cervical dilation) and active phase (5-7 cm) separately. RESULTS: Our results revealed that compared with the control group, the experimental group had significantly lower pain, anxiety and a higher finger temperature during the latent phase of labour. However, no significant differences were found between the two groups on all outcome measures during the active phase. CONCLUSIONS: This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour. RELEVANCE TO CLINICAL PRACTICE: The findings support that music listening is an acceptable and non-medical coping strategy for labouring women. Especially, apply in reducing the pain and anxiety for women who are at the early phase of labour.

[Evidence-based management of perinatal depression].

Perinatal depression, which may occur from pregnancy to one year after childbirth, is recognized by the World Health Organization as a significant health issue affecting women. Depression during the perinatal period can have enormous consequences, not only affecting the health of the woman herself but also influencing her interaction with her children and other family members. This article introduces several depression screening tools and evidence-based nonpharmacological managements of perinatal depression. There are some fairly valid and feasible screening methods, among which routinely screening perinatal women with EPDS (Edinburgh Perinatal Depression Scale) or BDI (Beck Depression Inventory) in the primary care setting is practicable. A survey of the limited literature available reveals that interpersonal psychotherapy, cognitive behavior therapy and listening to music provide quantifiable depression amelioration effects for perinatal women. More scientific research moderated by women's life experiences and preferences should be conducted, however, and applied to improve women's health.

Effects of music therapy on psychological health of women during pregnancy.

AIMS AND OBJECTIVES: The purpose of this study was to examine the effects of music therapy on stress, anxiety and depression in Taiwanese pregnant women. BACKGROUND: The value of music therapy is slowly being realized by nurses in various clinical areas, including obstetrics. Previous studies have demonstrated a high prevalence of psychological stress during pregnancy. Few studies have examined the effects of music therapy on reducing psychological stress during pregnancy. DESIGN: A randomized experimental study design was developed and implemented. METHODS: Two hundred and thirty-six pregnant women were randomly assigned to music therapy (n = 116) and control (n = 120) groups. The music therapy group received two weeks of music intervention. The control group received only general prenatal care. Psychological health was assessed using three self-report measures: Perceived Stress Scale (PSS), State Scale of the State-Trait Anxiety Inventory (S-STAI) and Edinburgh Postnatal Depression Scale (EPDS). RESULTS: In a paired t-test, the music therapy group showed significant decrease in PSS, S-STAI and EPDS after two weeks. The control group only showed a significant decrease in PSS after two weeks. This decrease was not as substantial as in the experimental group. An ancova test with the pretest scores as the control revealed that the changes in PSS, S-STAI and EPDS after two weeks were significantly decreased in the experimental group compared with the control group. CONCLUSIONS: This controlled trial provides preliminary evidence that two-week music therapy during pregnancy provides quantifiable psychological benefits. RELEVANCE TO CLINICAL PRACTICE: The findings can be used to encourage pregnant women to use this cost-effective method of music in their daily life to reduce their stress, anxiety and depression. Further research is needed to test the long-term benefits.

Experience of Taiwanese women living with nausea and vomiting during pregnancy.

Two common symptoms of pregnancy are nausea and vomiting, which, for some women, cause great discomfort and profoundly impact daily life. A descriptive phenomenological method was used to understand how Taiwanese women deal with nausea and vomiting during pregnancy. A purposive sample of 10 expectant mothers participated in the study. A transcription of each informant's verbal description of her nausea and vomiting experience was made and analyzed using Colaizzi's phenomenological methodology. Four themes emerged from the interview data after inductively analyzing the narrative content concerning nausea and vomiting: 1) understanding nausea and vomiting, 2) finding coping strategies, 3) psychosocial adaptation, and 4) needing support. The results also indicated the importance of social support to pregnant women's health, including instrumental and emotional forms of support. Health professionals, however, were not mentioned in the mothers' narratives as a source of support. The issues of social support, language translation, and western and eastern perspectives on nausea and vomiting and cultural differences in perceptions of their severity are discussed.

A comparison of massage effects on labor pain using the McGill Pain Questionnaire.

The purpose of this study was to describe the characteristics of pain during labor with and without massage. Sixty primiparas in labor were randomly assigned to either a massage or control group and tested using the self-reported Short-Form McGill Pain Questionnaire (SF-MPQ) at 3 phases of cervical dilation: phase 1 dilation (3-4 cm), phase 2 dilation (5-7 cm), and phase 3 dilation (8-10 cm). The massage group received standard nursing care and massage intervention, whereas the control group received standard nursing care only. The results of this study showed: (1) In both groups, as cervical dilation increased, there were significant increases in pain intensity as measured by SF-MPQ; (2) massage lessened pain intensity at phase 1 and phase 2, but there were no significant differences between the groups at phase 3; (3) the most frequently selected five sensory words chosen by both groups were similar at phases 1 and 2- (a) sore, (b) sharp, (c) heavy, (d) throbbing, and (e) cramping, while of the 4 affective classes, "fearful" and "tiring-exhausting" were the most used by participants to describe the affective dimension. The results of this study indicate that, although massage cannot change the characteristics of pain experienced by women in labor, it can effectively decrease labor pain intensity at phase 1 and phase 2 of cervical dilation during labor. Nurses and caregivers could consider using massage to help laboring women through the labor pain.