In total, we interviewed 104 participants, of which six were eliminated because they did not meet the criteria for inclusion. Another 15 participants were excluded from further analysis because of their unwillingness to participate. There were no statistically significant differences between the ultimate group of participants (n = 83), including the intervention (n = 40) and comparison (n = 43) groups and those subjects that dropped out (n = 15) in terms of age, infant’s gestational age, body weight, education level, census register, marital status, household income, parity, pregnancy method, and pregnancy complications (Table 1, Figure 1).
Table 1 Characteristics of participants
Characteristics
|
All(98)
|
Intervention
group(40)
|
Comparison
group(43)
|
Lost to follow
up(15)
|
Statistics
|
P
|
Age (M ± SD)
|
31.75±3.2
|
31.83±3.5
|
31.51±3
|
32.1±2.5
|
0.29
|
0.75b
|
Gestational age of
infant (M ±SD)
|
26.38±4.0
|
26.23±3.8
|
27±4.1
|
25.2±4.0
|
1.16
|
0.32b
|
Bodyweight(M ±SD)
|
64.1±8.85
|
63.19±8.4
|
6.15±9.15
|
61.8±8.8
|
1.87
|
0.16b
|
Level of education
|
|
|
|
|
1
|
0.61a
|
Junior college or below
|
19
|
7
|
10
|
2
|
|
|
University or above
|
80
|
33
|
33
|
14
|
|
|
Census register
|
|
|
|
|
0.42
|
0.81a
|
Urban
|
61
|
26
|
25
|
10
|
|
|
Rural
|
38
|
14
|
18
|
6
|
|
|
Marital status
|
|
|
|
|
1.23
|
0.56c
|
Married
|
96
|
39
|
42
|
15
|
|
|
Not married
|
3
|
1
|
1
|
1
|
|
|
Income
|
|
|
|
|
5.34
|
0.25a
|
Less than ¥100,000
|
27
|
13
|
11
|
3
|
|
|
¥100,000-¥200,000
|
39
|
15
|
20
|
4
|
|
|
More than ¥200,000
|
33
|
12
|
12
|
9
|
|
|
Parity
|
|
|
|
|
1.95
|
0.38a
|
No prior births
|
75
|
32
|
33
|
10
|
|
|
1 or more prior births
|
24
|
8
|
10
|
6
|
|
|
Pregnancy way
|
|
|
|
|
0.53
|
1c
|
pregnancy by nature
|
94
|
38
|
41
|
14
|
|
|
Pregnancy by medicine
|
5
|
2
|
2
|
1
|
|
|
pregnancy complications
|
|
|
|
|
2.1
|
0.35a
|
No
|
72
|
33
|
30
|
13
|
|
|
Yes
|
27
|
7
|
13
|
3
|
|
|
a Chi-square test, X2; b Analysis of variance, ANOVA; c Fisher’s exact test. Significant at the 0.05 level. |
Table 2 Assessing the effects of depression, anxiety, fear, satisfaction with life, and mindfulness using repeated measures analysis of variance
Variable
|
group
|
T0
|
T1
|
T2
|
T3
|
EPDS
|
intervention group
|
14.1±3.62
|
13.42±3.41
|
12.12±4.38*ab
|
12.2±4.06*a
|
control group
|
13.74±3.44
|
13.79±3.15
|
13.95±4.01
|
14.4±3.86
|
SAS
|
intervention group
|
41.24±8.13
|
40.11±6.35*
|
37.51±5.83*a
|
39.46±9.91
|
control group
|
41.44±6.6
|
45.41±6.99a
|
43.63±10.64
|
43.46±11.09
|
W-DEQ-A/B
|
intervention group
|
72.19±22.15
|
60.79±18.53*a
|
62±24.94*a
|
N/A
|
control group
|
70.78±18.04
|
75.73±17.83
|
72.95±22.49
|
N/A
|
SWLS
|
intervention group
|
25.98±3.98
|
28.35±3.99*a
|
N/A
|
25.58±5.4*b
|
control group
|
24.78±5.48
|
24.47±4.04
|
N/A
|
22.47±5.74ab
|
FFMQ
|
intervention group
|
131±12.16
|
133.22±11.42*
|
N/A
|
131.49±15.75*
|
control group
|
129.77±11.46
|
126.41±12.16
|
N/A
|
122.79±11.9a
|
T0=before the intervention; T1=after the intervention; T2=3 days after delivery; T3=42 days after delivery. |
EPDS, Edinburgh Postnatal Depression Scale; FFMQ, Five Facet Mindfulness Questionnaire; SAS, Self-rating Anxiety Scale; SWLS, Satisfaction with Life Scale; W-DEQ-A/B, Delivery Expectancy/Experience Questionnaire. |
* There was a statistical difference between the intervention and control groups. |
a Compared with T0, there was a statistical difference; b Compared with T1, there was a statistical difference; c Compared with T2, there was a statistical difference. |
The longitudinal data analysis results are presented in Table 2 and Figure2. Regarding depression, the means of the two groups were compared at the same time points. At T0, the average score of the intervention group was 0.36 points higher than the control group, with no statistical significance (p = 0.65). After the intervention, the average score of the intervention group was lower than that of the control group, with a difference of 0.37 points (p = 0.61). The difference between the two groups gradually emerged over time: at T2 and T3, it was 1.83 points (p < 0.05) and 2.21 points (p = 0.01), respectively. A comparison of mean values at different time points within the group showed that there was no statistical significance between the four time points in the control group; however, in the intervention group, the mean scores at T2 and T3 were significantly lower than at T0. Additionally, the mean scores at T2 were significantly lower than at T1.
For anxiety, the comparison of the means of the two groups at the same time indicated that the intervention group's average score was 0.2 points lower than that of the control group at T0, with no statistical significance (p = 0.91). After the intervention, the difference between the two groups widened to 5.31 points (p = 0.001) and 6.12 points (p = 0.003) at T2. However, the difference between the two groups narrowed to 4 points at T3 (p = 0.1). Mean comparisons of within-group scores at different time points indicated that in the control group, the mean scores at T1 were significantly higher than those at T0; however, in the intervention group, the mean scores at T2 were significantly lower than those at T0.
On the W-DEQ-A/B, the mean score for the experimental group was 1.41 points lower than that of the control group at T0 (p =0 .91). The mean score for the experimental group was 14.95 points lower (p < 0.01) than that of the control group at T1; however, the gap between the two groups narrowed at T2, and the mean score for the experimental group was 10.95 points lower (p = 0.04) than that of the control group. The mean comparison of scores with groups at different time points indicated that the difference between the three time points in the control group was not statistically significant; however, in the experimental group, the mean scores at T1 and T2 were significantly lower than those at T0.
Regarding satisfaction with life, the average score of the intervention group at T0 was only 1.2 points lower than that of the control group (p =2.66). After the intervention, the difference between the two groups widened to 3.86 points (p <0 .01). At T3, the difference between the two groups narrowed to 3.1 points (p = 0.015). Mean comparisons of within-group scores at different time points indicated those in the control group, the mean scores at T3 were significantly lower than those at T0 and T1. In contrast, in the intervention group, the mean scores at T1 were significantly higher than those at T0, and the mean scores at T3 were significantly higher than those at T1.
In the mindfulness questionnaire, the mean score of the intervention group at T0 was 1.23 points higher than the control group (p = 0.64). After the intervention, the difference between the two groups widened to 6.81 points (p =0.01), and at T3, the difference widened to 8.7 points (p < 0.01). Within groups, mean comparisons indicated that in the control group, the mean scores at T3 were significantly lower than those at T0, and the difference among the three time points in the intervention group was not significant.