A Study to Evaluate the Effectiveness of Music Therapy on Postpartum Blues among Postnatal Mothers Admitted at Selected Hospitals in Kanyakumari District

 

Miss. Blessy Mol.^1*, Dr. S. Reeta Jebakumari Solomon²

¹M.Sc. Nursing, Department of Obstetrics and Gynecologic Nursing, MBA (HR), Thasiah College of Nursing, Marthandam, India

²Principal and Professor, Department of Obstetrics and Gynecologic Nursing, Thasiah College of Nursing, Marthandam, India.

 

ABSTRACT:

Background of the study:  Mood change in the early days of postpartum are particularly common. Postpartum blues are the common mental health problems during the early postpartum period. There are many alternative therapies to treat this. However, Music therapy is easy to perform without any risk and with minimal expenses it decreases the cortisol level in the blood stream which causes stress and leads to decrease in the postpartum blues. The aim of the study is to evaluate the effectiveness of music therapy on postpartum blues among postnatal mothers admitted at selected hospitals in Kanyakumari district. Material and method: The research design adopted for this study is quasi experimental pre-test post-test control group design. The purposive sampling technique was used to select the samples. The tool used for data collection procedure was Am I blues? questionnaire by Skillman, N. (1996). The conceptual frame work of this study is based on sister Callista Roy’s Adaptation model. After the pre-test assessment of postpartum blues, the mother those who had moderate and severe level of postpartum blues were given music therapy given for 20 minutes per day for 5 days. Result: The study revealed that in pre-test most of the women, 53.33% in experimental group had severe postpartum blues and in control group half of them, (50%) had severe postpartum blues and other half of them had moderate postpartum blues. After music therapy it was surprising that 60% of them had low level of postpartum blues in experimental groups and only 40% of mothers had moderate level of postpartum blues. There was a significant reduction in mean post-test postpartum blues scores (MD=41.23., t=35.03., P<0.001) of the experimental group. The mean post-test postpartum blues score in experimental group was 25.26., lesser than that of the control group 64.10., (MD= 30.84., t= 11.70., P<0.001). Conclusion: Music therapy has found to be cost effective, non-invasive, non-pharmacological management used to reduce postpartum blues among postnatal mothers.

 

 

 

 

INTRODUCTION:

Background of the study: A women’s life has different stages, during which she has different roles, positions, responsibilities, expectations, and purposes. Among all these motherhoods is considered to be very important. Because womanhood gets completed through motherhood. Childbirth is a most momentous period in women’s life. Postnatal period is a natural condition with six transformative weeks full of excitement, planning in the unfolding of life. Every woman wants to enjoy with the baby, the joyful experience of the postnatal period but it is not the same for everyone, sometimes it is associated with the minor problems. It is one of the vital events, which needs special care to the postnatal period. Postpartum blues is a most common postpartum mood disorder, which are generally transient and last for about few hours to a week. Postpartum blues are usually characterized by bouts of crying and sadness. Other symptom includes reactivity of mood, generalized anxiety and irritability. These symptoms usually begin about 3-4 days after delivery, peak on the 5th day and most often remit by the 10th postpartum day. There are many therapies reduces postpartum blues. Music therapy has positive influences on decreasing postpartum blues and increasing maternal attachment of puerperal women. There are many studies showings that the postnatal mothers who used the music therapy as a relaxation technique have decreased level of postnatal depression. The nurses have an important enabling and facilitating role to help the women to reduce the postnatal blues. Music therapy is easy to perform without any risk and with minimal expenses. The noticeable substantiation that music therapy reduced the postpartum blues and helps to increase the mother-child bonding.

 

Section II:

Table 1: Distribution of The Level of Postpartum Blues of Mothers in Experimental Group.                                               (n=30)

Level of postpartum blues	Experimental group
	Pre-test		Post-test
	F	%	F	%
Mild	0	0.00	18	60.00
Moderate	14	46.67	12	40.00
Severe	16	53.33	0	0.00

 

Table 1 predicts that 53.33% of post-natal mothers had severe postpartum blues and 46.67% of them had moderate postpartum blues before administering music therapy. After the music therapy the level of postpartum blues was decreased in which majority of them, 60% had mild postpartum blues, only 40% of them had moderate postpartum blues and no one had severe postpartum blues.

 

Table 2: Distribution of The Level of Postpartum Blues of Mothers in Control Group.                              (n=30)

Level of postpartum blues	Control group
	Pre-test		Post-test
	F	%	F	%
Mild	0.00	0.00	0.00	0.00
Moderate	15	50.00	17	56.67
Severe	15	50.00	13	43.33

 

Table 2 summarizes that equal distribution of postnatal mother with postpartum blues. i.e., half of them had severe postpartum blues and other half of them had moderate postpartum blues in pre-test. Whereas in post-test there was not much changes. Majority, 56.67% of post-natal mother had moderate postpartum blues and 43.33% of them had severe postpartum blues. 

Section Comparison of postpartum blues scores of mothers who had postpartum blues in experimental group between pre-test and post-test:

 

Table 3: Comparison of postpartum blues scores of mothers who had postpartum blues in experimental group between pre-test and post-test.                                                                      (n=30)

Group	Test	Mean	SD	Mean difference	‘t’ value	p value
Experimental group	Pre-test	66.40	9.84	41.14	35.03	0.001*
	Post-test	25.26	10.53

*significant at 0.001 level

 

The mean post-test postpartum blues scores in experimental group was 25.26 which was less than the mean pre-test postpartum blues scores 66.40. The obtained ‘t’ value is 35.03 was highly significant at p< 0.001 level. This indicates that the mean difference 41.14 is a true deference and has not occurred by chance. This proves that due to the effect of music therapy the mean post-test postpartum blues scores in mothers who had postpartum blues in experimental group had marked reduction.

 

 

Figure 1: Comparison of postpartum blues scores of mothers who had postpartum blues in experimental group between pre-test and post-test.

 

Comparison of mean post-test scores of mothers who had postpartum blues in experimental group and control group.

Table 3: Comparison of mean post-test scores of mothers who had postpartum blues in experimental group and control group (N=60)

Group	Test	Mean	SD	Mean difference (MD)	‘t’ test	‘p’ value
Experimental group	Post-test	25.26	10.53	38.84	11.70	0.001*
Control group	Post-test	64.10	9.80

*significant at 0.001 level

 

and in the control group was 64.10. The ‘t’ value, 11.70 was highly significant at p< 0.001 level. This shows that marked reduction of postpartum blues in experimental group is due to the effect of music treatment. This indicate the mean difference of 38.84 is a true difference and has not occurred by chance.

 

 

Figure 2: Comparison of post-test scores of mothers who had postpartum blues in experimental group and control group  N = 60

 

Association of level of pre-test postpartum blues among mothers in experimental group with their selected demographical variables:

The above table predicts that the demographic variables such as age (χ² value 6.01 df 2 p<0.005), area of residence (χ² value 6.71 df 2 p<0.005), marital relationship (χ² value4.05 df 1 p<0.005) and family support (χ² value 3.92 df 1 p< 0.005) has significant association with the postpartum blues whereas the other demographic variables have statistically no significant association with postpartum blues.

 

Association of level of pre-test postpartum blues among mothers in experimental group with their selected clinical variables:

The above table predicts that the clinical variables such as stressful events during pregnancy (χ² value 7.23 df 1 p<0.005), family history of depression (χ² value 5.11 df 1 p<0.005) and obstetrical outcome (χ² value7.2 df 2 p<0.005) has significant association with the postpartum blues whereas the other clinical variables have statistically no significant association with postpartum blues.

 

Association of level of pre-test postpartum blues among mothers in control group with their selected demographical variables:

The above table predicts that the demographic variables such as age (χ² value 5.99 df 2 p< 0.005), area of residence (χ² value 6.25 df 2 p<0.005) and family support (χ² value 4.82 df 1 p<0.005) has significant association with the postpartum blues. whereas the other demographic variables have statistically no significant association with postpartum blues. So, the researcher partially rejects the null hypothesis and accepts the research hypothesis for age, area of residence and family support.

 

Association of level of pre-test postpartum blues among mothers in control group with their selected clinical variables:

The above table predicts that the clinical variables such as stressful events during pregnancy (χ² value 5.00 df 1 p<0.005), family history of depression (χ² value 5.11   df 1 p<0.005) and obstetrical outcome (χ² value 9.86 df 2 p<0.005). Whereas the other clinical variables have statistically no significant association with postpartum blues. So, the researcher partially rejects the null hypothesis and accepts the research hypothesis for stressful events during pregnancy, family history of depression and obstetrical outcome.

 

LIMITATIONS:

·       The study was conducted among all postnatal mothers without any complications from selected hospital in Kanyakumari district. So, generalization done with caution.

·       The study was done on sample size of 30 in experimental group and 30 in control group, hence generalization is possible only for the selected participant.

 

RECOMMENDATION:

·       A similar study can be conducted with large sample with large settings.

·       A similar study can be conducted to see the effectiveness of music therapy among antenatal mothers with stress and anxiety.

·       A similar study can be conducted to find out the effectiveness of music therapy on postpartum blues and mother child bonding.

 

REFERENCE:

1.      Basavanthappa, B.T. (2008). Textbook of midwifery and reproductive health. New Delhi: Jaypee Brothers Company.

2.      Denise, F. Polit& Hungler. (2007). Nursing Research. (7^th edition). New Delhi: Lippincott Williams and Wilkins.

3.      Dutta, D. C. (2007). Text book of gynecology. (7^th edition). Kolkata: New central book agency (p) Ltd.

4.      Dutta, D. C. (1998). Text book of obstetrics. (5^th edition). Calcutta: New central book agency.

5.      Jacob Annamma, (2008). A comprehensive text book of midwifery. (2^nd edition). New Delhi: Jaypee publications.

6.      Lowdermilk, Perry, Bobak. (2007). Maternity and woman health. (9^th edition). Missouri: Mosby Elsevier.

 

 

 

 

Received on 22.09.2018         Modified on 14.10.2018

Accepted on 02.11.2018      ©A&V Publications All right reserved