Abstract：
Women who undergo cesarean delivery have reported experiencing mood distress related to the surgery and postoperative pain. Heart rate variability biofeedback (HRVB) training is known to have positive effects on mental health, but its effects on women undergoing cesarean delivery have not yet been determined. This study evaluated the effects of an HRVB training intervention on stress, anxiety, and depression in women undergoing cesarean delivery. We hypothesized that 10 sessions of HRVB training could cumulatively improve emotion regulation in participants. This study was designed as a double-blinded randomized controlled trial involving a total of 86 enrolled women who were then divided into two groups: intervention and control. During their hospitalization, the intervention group underwent HRVB training daily, while both groups received standard perinatal care. Heart rate variability (HRV) was assessed using root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), high-frequency power (HF) and low-frequency power (LF). HRV parameters, stress, anxiety, and depression were evaluated at baseline and on the fifth day after childbirth. Intention-to-treat (ITT) analyses examined change over time between groups. Although no significant effects were found for the RMSSD and HF, a significant increase was observed in SDNN (F = 13.43, p = < 0.001, ƞ2 = 0.14), and LF at post-assessment (F = 4.26, p = .04, ƞ2 = 0.05) compared to the control group. Except for the depression variable, stress (F = 6.11, p = .02, ƞ2 = 0.07) and anxiety (F = 8.78, p = .004, ƞ2 = 0.10) significantly decreased compared to the control group on the fifth postpartum day. Furthermore, post-hoc analysis showed that HRVB was more effective in decreasing mild to severe depressive symptoms (F = 7.60, p = .001, ƞ2 = 0.27). The intervention program successfully decreased self-perceived stress and anxiety in the postpartum period and relieved symptoms in more severely depressed participants. Our findings suggest that this program is suitable and beneficial for application in women during the early postpartum period following cesarean delivery.
摘要：
接受剖宫产的妇女报告经历了与手术和术后疼痛相关的情绪困扰。已知心率变异性生物反馈（HRVB）训练对心理健康有积极影响，但其对剖宫产妇女的影响尚未确定。这项研究评估了HRVB训练干预对压力的影响，焦虑,剖腹产妇女的抑郁症。我们假设10次HRVB训练可以累积改善参与者的情绪调节。这项研究被设计为一项双盲随机对照试验，涉及总共86名入选妇女，然后将其分为两组：干预和控制。在他们住院期间,干预组每天进行HRVB训练,两组均接受标准围产期护理。心率变异性（HRV）使用连续差的均方根（RMSSD）进行评估，正常到正常间隔的标准偏差(SDNN)，高频电源（HF）和低频电源（LF）。HRV参数,压力，焦虑,在基线和分娩后第5天评估抑郁。意向治疗（ITT）分析检查了组间随时间的变化。尽管对RMSSD和HF没有发现明显的影响，SDNN显著增加(F=13.43,p=<0.001,2=0.14),与对照组相比，评估后的LF（F=4.26，p=.04，2=0.05）。除了抑郁变量，产后第五天与对照组相比，压力（F=6.11，p=.02，2=0.07）和焦虑（F=8.78，p=.004，2=0.10）显着降低。此外，事后分析显示,HRVB在减轻轻度至重度抑郁症状方面更有效(F=7.60,p=.001,2=0.27).干预计划成功地减少了产后自我感知的压力和焦虑，并缓解了更严重的抑郁参与者的症状。我们的发现表明，该计划适用于剖宫产后产后早期的女性。
