The effect of counseling with a stress management approach on anxiety and distress and breastfeeding self-efficacy in the corona pandemic: an experimental study

Abstract

Abstract Title: The effect of counseling based on stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy in the corona pandemic: an experimental study Background: Successful breastfeeding is related to the psycho-social conditions of the mother. The covid-19 pandemic led to psychological consequences in women during the postpartum period. Anxiety and discomfort of the mother reduces the chance of exclusive breastfeeding. The present study aimed to investigate the effect of stress management counseling on postpartum anxiety and distress and breastfeeding self-efficacy (BSE) during the COVID-19 pandemic. Materials and methods: In this experimental study, 64 lactating mothers were assigned into two intervention and control groups using a random block of 4 and 6 with a ratio of 1:1. The intervention group participated in 6 individual sessions of 60 to 90 minutes. The control group also received a counseling session about contraceptive methods for an average duration of 60-90 minutes. Spielberger manifest anxiety, postpartum distress and breastfeeding self-efficacy questionnaires were completed before and 4 weeks after the intervention by both control and intervention groups. Finally, the normality of the distributions was determined by the Kolmogorov-Smirnov test. After collecting the data by SPSS24 software and checking the frequency, central and dispersion indices, the data were analyzed by chi-square, independent t and ANCOVA tests. p > 0.05 was considered as a significant level. Results: The findings showed that based on the results of ANCOVA with controlled baseline values, after the intervention, the average anxiety score in the intervention group was lower compared to the control group (mean difference: -13.82 with 95% confidence interval: 15.29) - to 12/35-, (p>0.001)). Also, the average postpartum distress score after the intervention was lower in the intervention group compared to the control group (mean difference with 95% confidence interval: -6.37 to -3.00, (p<0.001)) and the average Breastfeeding self-efficacy score after the intervention was significantly higher in the intervention group compared to the control group (mean difference: 25.57, 95% confidence interval: 28.29 to 22.85, (p<0.001)). Conclusion: Counseling based on stress management could improve postpartum anxiety and distress and breastfeeding self-efficacy during the stressful period of the Corona pandemic. Therefore, it is recommended to provide stress management approach for pregnant and lactating women, especially in similar crises.