From: Effectiveness of nonpharmacological interventions for reducing postpartum fatigue: a meta-analysis
First author (publication year) | Country | Study design | Population | Sample size (intervention/control) | Intervention | Frequency | Intervention start time and duration | Control | Evaluation time points | Fatigue assessment tools | Psychological assessment tools |
---|---|---|---|---|---|---|---|---|---|---|---|
Exercise (n = 5) | |||||||||||
Ashrafinia [22] (2015) | Iran | RCT | Primiparous women, EPDS<10 | 80 (40/40) | Pilates home exercises | 5 times a week (30 min/session) | Intervention was started 72 h after delivery and continued for 8 weeks | Routine care | Baseline, 4 weeks, 8 weeks postpartum | MFI-20 | / |
Dritsa [23] (2008) | Canada | RCT | Women in the postpartum (4–38 weeks), EPDS≧10 | 88 (46/42) | Aerobic exercise, stretching and strength exercises | 60–120 min/week, 4 times | Intervention was started 4–38 weeks (mean: 10.96) postpartum and continued for 12 weeks | Assessing exercise participation once a month | Baseline, post-treatment and 3 months post-treatment | MFI-20 | / |
Ko [24] (2008) | China | A control group pre−/post-program design | Postpartum women who were “doing-the-month” | 61 (31/30) | A low-intensity exercise program | 6 sessions | Intervention was started from the first week postpartum and continued for 3 weeks | Usual care | Before and after the program | FSC | CES-D Scale |
Lee [25] (2016) | UK | RCT | Postnatal women who had given birth between 6 weeks and one year previously | 65 (33/32) | Physical activity consultations and a moderate-intensity walking programme | 30–55 min/time, one session each week | Intervention was started at 6 weeks to one year after delivery and continued for 10 weeks | Received a leaflet with information on physical activity | Baseline, three-month and six-month follow-up. | VAS-F | AGWBI |
Yang [12] (2019) | China | RCT | Postnatal women who had vaginal delivery, EPDS ≦ 10 | 140 (70/70) | Moderate-intensity aerobic exercise | At least 3 times a week (15 min per section) | Intervention was started at 6 weeks after childbirth and continued for 12 weeks | Usual care | Baseline, at 4 weeks and 12 weeks postintervention | PFS | PSS, EPDS |
Psychoeducational intervention (n = 7) | |||||||||||
Doering [15] (2018) | USA | Quasi-experimental | Postpartum women who had a healthy singleton newborn | 27 (15/12) | Helping U Get Sleep. Self-management intervention was offered via home visit and phone calls | A home visit and 4 phone calls | Intervention was started at the third week postpartum and continued for 3 weeks. | Health education related to sleep | Baseline, postpartum weeks 4, 6 and 9 | MFSC | / |
Gholami [26] (2017) | Iran | A control group pre−/post-program design | Women who had given birth | 120 (40/40/40) | Educational behavioural interventions including instructions of the health approaches, relaxation techniques (face-to-face/ e-learning) | 3 times | Intervention was started on 10 days after delivery and continued for 50 days | Usual care | Before and after the intervention | FSS | / |
Giallo [27] (2014) | Australia | RCT | Mothers who had a child younger than the age of 6 months | 202 (63/67/72) | Intervention group 1 (professionally led support): offer workbook, home visit and phone calls; Intervention group 2 (self-directed written): read workbook containing information about fatigue | A workbook, home visit, and 3 telephone support calls; reading the workbook | Intervention was started within 6 months after delivery and continued for 4 weeks | Usual care | Baseline, 6 and 12 weeks after the baseline | FAS, FSS, | DASS-21 |
Milani [28] (2017) | Iran | Clinical trial | Healthy postpartum mothers, EDPS< 10 | 276 (92/184) | A comprehensive postpartum home care program giving instructions of personal hygiene, mental, psychological, and sexual health, oral and dental health and so on | 2 home visits | Intervention was started immediately postpartum care and continued for 60 days | Usual care | Pretest and posttest | Fatigue rate | EPDS |
Ozcan [13] (2020) | Turkey | RCT | Primiparous women | 117 (58/59) | Levin’s conservation model containing instructions of nutrition, sleep, breastfeeding and so on | 8 sessions, each session lasted 60–120 min. | Intervention was started between postpartum 4th and 7th days and continued for 12 weeks | Usual care | Pretest and posttest | VAS-F | / |
Stremler [29] (2013) | Canada | RCT | Primiparous women | 246 (123/123) | Behavioural-educational sleep intervention containing sleep promotion strategies, sleep hygiene and so on | A 45–60 min meeting, a 20 page booklet, and 3 phone contacts. | Intervention was started before mothers’ discharge from hospital and continued for 4 weeks | Usual care | Baseline, 6 and 12 weeks | VAS-F | EPDS |
Troy [30] (2003) | USA | Quasi-experimental | Healthy primiparous postpartum mothers | 68 (32/36) | The Tiredness Management Guide containing a list of several techniques for postpartum fatigue management | Women in the intervention group were asked to use the TMG whenever they felt tired | Intervention was started at 2 weeks after delivery and continued for 4 weeks | Usual care | Fatigue was assessed six times per week, before going to bed and again on rising from Tuesday evening to Friday morning | VAS-F | / |
Drinking tea (n = 2) | |||||||||||
Chang [31] (2015) | China | RCT | Postnatal women with poor sleep quality (PSQS score ≧16) | 80 (40/40) | Drink one cup of chamomile tea | Every day | Intervention was started at 6 weeks after childbirth and continued for 2 weeks | Usual care | Baseline and at 2 and 4 weeks post intervention | PFS | EPDS |
Chen [32] (2015) | China | RCT | Postnatal women with poor sleep quality (PSQS score ≧16) | 80 (40/40) | Drink one cup of Lavender tea | Every day | Intervention was started at 6 weeks after childbirth and continued for 2 weeks | Usual care | Baseline, 2-week posttest and 4-week posttest | PFS | EPDS |
Physical therapy (n = 3) | |||||||||||
Funda [10] (2020) | Turkey | RCT | Primiparous and had a vaginal delivery at the 37th to 40th weeks of gestation | 80 (40/40) | Mother-infant skin-to-skin contact | 1 time | Intervention was started from the first hour following the delivery and continued for 30 min | Usual care | Before and after the intervention | VAS-F | / |
Hsieh [33] (2017) | China | Quasi-experimental | Healthy postpartum women | 356 (94/264) | Take warm showers | 1 time | Intervention was started on the second postpartum day and continued for 20 min | Usual care | The first postpartum day and the second postpartum day | PFS | / |
Vaziri [11] (2017) | Iran | RCT | Primiparous women with normal vaginal delivery | 56 (29/27) | Breathe lavender oil aroma | 3 times, 10–15 min each time | Intervention was started immediately postpartum care and completed in 1 day | Sesame oil used as placebo | Baseline, after the first intervention and the tomorrow morning assessment | VAS-F | VAS for distress, PANAS |