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Table 1 Study characteristics (n = 17)

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), EPDS10

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

  1. Notes: RCT Randomized clinical trial, MFI-20 Multidimensional Fatigue Inventory, PFS Postpartum Fatigue Scale, VAS-F Visual analogue scale for fatigue, FAS Fatigue Assessment Scale, MFSC Modified Fatigue Symptoms Checklist, FSC Fatigue Symptom Checklist, EDPS Edinburgh Postnatal Depression Scale, DASS-21 Depression, Anxiety and Stress Scale-21, CES-D Scale Chinese version of the Center for Epidemiologic Studies Depression Scale, PANAS Positive and Negative Affect Schedule, PSS Perceived Stress Scale, AGWBI Adapted General Well-Being Index