Iranian Red Crescent Medical Journal | Effect of Acceptance and Commitment Therapy (ACT) on Anxiety and Quality of Life During Pregnancy: A Mental Health Clinical Trial Study

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Iranian Red Crescent Medical Journal | Effect of Acceptance and Commitment Therapy (ACT) on Anxiety and Quality of Life During Pregnancy: A Mental Health Clinical Trial Study

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The demographic variables presented in Table 2 show the lack of a significant difference between the ACT (22.6 ± 1.515) and control (22.1 ± 1.383) groups (P = 0.205) in terms of the mean age. For the main outcomes of the study (anxiety and quality of life), the presumption of normality was established using Shapiro-Wilk test for all variables (P > 0.05) (Tables 3 and 4 and Figure 1).

Variable ACT (N = 20) Control (N = 21) P Value
Age 22.6 ± 1.515 22.1 ± 1.383 0.205b
Parity 1.2 ± 0.4 1.4 ± 0.5 0.6b
Number of living children 0.3 ± 0.6 0.4 ± 0.5 0.089b
Spouse’s age 25.3 ± 4.028 25.3 ± 3.805 0.970b
Spouse’s education 0.06c
University 3 (14.3) 8 (40)
Non-university 18 (85.7) 12 (60)
Occupation 0.42c
Housewife 19 (95.5) 20 (95.2)
Employed 0 (0) 1 (4.8)
Self-employed 1 (5) 0 (0)
Education 0.061c
University 8 (40) 4 (19)
Non-university 12 (60) 17 (81)
Spouse’s occupation 0.51c
Worker 8 (40) 12 (57.2)
Employed 4 (20) 2 (9.5)
Self-employed 8 (40) 3 (33.3)
Type of pregnancy 0.738c
Planned 18 (90) 18 (85.7)
Unplanned 2 (10) 3 (14.3)

aValues are expressed as mean ± SD or No. (%).

bt-test.

cFisher exact test.

Pregnancy-Related Anxiety ACT Control P Value Group P Value Time P Value Time × Group
Self-centered fears or fear of changes in the personal life of the mother 0.518 0.055 0.001
Before 52.82 ± 16.993 41.3333 ± 13.16
After 37.52 ± 12.98 48.66 ± 11.20
One month later 41.235 ± 15.50 49.571 ± 12.33
Fear of giving birth to a child with physical or mental health issues 0.491 0.150 0.001
Before 21.90 ± 6.016 14.90 ± 6.72
After 14.15 ± 6.33 19.33 ± 6.11
One month later 14.00 ± 6.21 19.285 ± 6.81
Fear of childbirth 0.108 0.069 0.001
Before 53.45 ± 14.16 43.428 ± 17.20
After 35.640 ± 13.03 53.76 ± 12.81
One month after 41.941 ± 17.76 55.428 ± 13.27
Fear of changes in mood and its consequences for the child 0.081 0.183 0.001
Before 62.70 ± 17.088 49.23 ± 16.67
After 42.60 ± 12.12 61.142 ± 10.34
One month later 47.58 ± 14.13 63.04 ± 11.90
Fear of changes in the marital relationship 0.127 0.294 0.001
Before 28.05 ± 7.52 21.57 ± 9.51
After 18.41 ± 7.25 27.85 ± 9.51
One month later 20.52 ± 7.2 28.04 ± 7.73
Total Anxiety 0.101 0.54 0.001
Before 219.05 ± 51.01 170.47 ± 52.51
After 148.35 ± 42.59 210.76 ± 30.21
One month later 148.35 ± 54.74 215.38 ± 31.17

aValues are expressed as mean ± SD.

bRepeated-measures test.

Quality of Life ACT (N = 20) Control (N = 21) P Value Group P Value Time P Value Time × Group
Physical functioning 0.679 0.013 0.355
Before 70.00 ± 16.543 71.190 ± 18.967
After 66.76 ± 18.10 66.904 ± 19.524
One month later 61.470 ± 19.666 67.381 ± 18.276
Physical role functioning 0.573 0. 012 0.017
Before 45.58 ± 39.76 52.38 ± 38.65
After 58.82 ± 35.29 52.976 ± 39.50
One month later 33.823 ± 35.29 52.381 ± 38.65
Emotional role functioning 0.249 0.494 0.616
Before 35.29 ± 44.83 52.381 ± 35.85
After 42.833 ± 32.86 52.381 ± 32.61
One month later 37.245 ± 38.778 49.206 ± 34.34
Vitality 0.096 0.021 0.002
Before 54.86 ± 24.48 51.50 ± 18.14
After 68.52 ± 12.59 49.250 ± 16.081
One month later 56.470 ± 18.937 50.250 ± 16.895
Mental health 0.094 0.103 0.011
Before 59.76 ± 26.09 55.238 ± 20.223
After 71.76 ± 18.99 51.809 ± 17.0
One month later 58.823 ± 20.72 53.142 ± 19.47
Social role functioning 0.886 0.127 0.191
Before 63.97 ± 22.04 66.071 ± 16.83
After 72.20 ± 15.43 66.071 ± 13.19
One month later 63.236 ± 20.477 65.119 ± 17.59
Bodily pain 0.237 0.467 0.399
Before 60.88 ± 18.02 69.881 ± 20.48
After 67.64 ± 16.38 68.452 ± 14.39
One month later 61.617 ± 18.56 67.261 ± 13.03
General health perceptions 0.614 0.005 0.011
Before 63.60 ± 24.33 69.34 ± 23.37
After 64.550 ± 20.477 55.7 ± 15.714
One month later 60.294 ± 16.05 55.47 ± 19.22
Quality of life 0.994 0.052 026
Before 57.77 ± 17.75 60.07 ± 14.20
After 63.24 ± 15.18 58.182 ± 13.49
One month later 55.47 ± 15.10 58.135 ± 13.86

aValues are expressed as mean ± SD.

bRepeated-measures test.

Mean quality of life before ACT, after ACT, and one month later in the intervention and control groups

The difference between the three measurement times (before ACT, after ACT, and one month later) in fear of changes in the personal life of the mother was not significant (P = 0.055). The interaction of group with time was significant (P = 0.001). In the control group, the mean score of the fear of changes in the personal life of the mother increased during the study period. But in the intervention group, it first decreased and then increased. At both measurement times (after ACT and one month later), the mean score of the first dimension of anxiety was lower in the intervention group than in the control group.

The mean score of the second dimension of anxiety (fear of giving birth to a child with physical or mental health issues) was not significantly different between the three measurement times (before ACT, after ACT, one month later) (P = 0.150). The interaction between group and time was significant (P = 0.001). In the control group, the mean score of the second dimension of anxiety increased during the time. But in the intervention group, it reduced first and then remained constant. At both time points (after ACT and one month later), the mean score of the second dimension of anxiety was lower in the intervention group than in the control group.

The mean score of the third dimension of anxiety (fear of childbirth) was not significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.069). The interaction between group and time was significant (P = 0.001). In the control group, during the period, the mean score of the third dimension of the change was anxiety. But in the intervention group, it first decreased and then increased. At both time points (after ACT and one month later), the mean score of the third dimension of anxiety was lower in the intervention group than in the control group.

The mean score of the fourth dimension of anxiety (fear of changes in mood and its consequences for the child) was not significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.05). The interaction between the group and time was significant (P = 0.05). In the control group, the mean score of the fourth dimension of anxiety increased during the period. But in the intervention group, it first decreased and then increased. At both time points (after ACT and one month later), the mean score of the fourth dimension of anxiety was lower in the intervention group than in the control group.

The mean score of the fifth dimension of anxiety was significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.294). The interaction between group and time was significant (P = 0.001). In the control group, the mean score of the fifth dimension of the variable was anxiety during the time. But in the intervention group, it first decreased and then increased. At both time points (after ACT and one month later), the mean score of the fifth dimension of anxiety was lower in the intervention group than in the control group.

The mean score of total anxiety was not significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.054). The interaction between group and time was significant (P = 0.001). In the control group, the mean score of total anxiety increased during the time, but in the intervention group, it first decreased and then increased. At both time points (after ACT and one month later), the mean score was lower in the intervention group than in the control group.

The mean score of the first dimension of the quality of life (physical functioning) was significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.013). Over time, the mean score of physical functioning decreased. Also, the mean score was not significantly different between the two groups (P = 0.679).

The mean score of the second dimension of quality of life (physical role functioning) had a significant difference between the three measurement times (before ACT, after ACT, and one month later) (P = 0.012). The interaction between group and time was significant (P = 0.017). In the control group, the mean score of physical role functioning was constant during the study period, but in the intervention group, it first increased and then decreased.

The mean score of the third dimension of quality of life (emotional role functioning) was not significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.494). The mean score of emotional role functioning was not significantly different between the two groups (P = 0.249).

The mean score of the fourth dimension of quality of life (vitality) had a significant difference between the three measurement times (before ACT, after ACT, and one month later) (P = 0.021). The interaction between group and time was significant (P = 0.002). In the control group, the mean score of vitality was constant during the time, but in the intervention group, it first increased and then decreased. At all three time points, the mean vitalitywas greater in the intervention group than in the control group.

The mean score of the fifth dimension of quality of life (mental health) had no significant difference between the three measurement times (before ACT, after ACT, and one month later) (P = 0.103). The interaction between group and time was significant (P = 0.011). In the control group, the mean score of mental health was constant during the time, but in the intervention group, it first increased and then decreased. At all three time points, the median mental health was higher in the intervention group than in the control group.

The mean score of the sixth dimension of quality of life (social role functioning) was not significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.127). The mean social role functioning

(SF) was not significantly different between the two groups (P = 0.191).

The mean score of the seventh dimension of quality of life (bodily pain) was not significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.467). Also, the difference was not significant between the two groups (P = 0.399).

The mean general health (GH) had a significant difference between the three measurement times (before ACT, after ACT, and one month later) (P < 0.005). The interaction between group and time was significant (P < 0.011). In the control group, the mean GH initially decreased and then remained constant over time, but in the intervention group, decreased after a primary increase. At both time points (after ACT and one month later), the mean GH was greater in the intervention group than in the control group.

The mean score of the total quality of life was not significantly different between the three measurement times (before ACT, after ACT, and one month later) (P = 0.052). The interaction between group and time was significant (P = 0.026). In the control group, the mean score of total quality of life was constant during the time, but in the intervention group, it first increased and then decreased.

This content was originally published here.

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