The effect of Progressive Muscle Relaxation on anxiety of primiparous mothers with premature newborns in the neonatal intensive care unit: a randomized controlled clinical trial

Abstract

Introduction Anxiety is one of the most prevalent psychological disorders among primiparous mothers of premature newborns, which has serious complications and consequences on the mother's health. The present study aimed to evaluate the efficacy of Jacobson's Progressive Muscle Relaxation technique on the anxiety levels among primiparous mothers with premature newborns admitted to the Neonatal Intensive Care Unit. Methods This study was conducted From December 2024 to February 2025 at Amir Kabir Hospital, affiliated with Arak University of Medical Sciences Arak, Iran. A total of N = 66 primiparous mothers of premature infants hospitalized in the neonatal intensive care unit were included in the study and randomly allocated to the intervention and control groups through block randomization.The intervention group received Jacobson's Progressive Muscle Relaxation technique twice daily for three consecutive days, with each session lasting 20–30 min. The control group received routine care. Demographic information and the Spielberger State-Trait Anxiety (STAI) were completed in both groups, pre-intervention and post-completion. Descriptive statistics (mean, standard deviation, frequency, and percentage) were calculated.In inferential statistics, the Independent t -test, the chi-square test, the Fisher exact test, and the U Mann-Whitney test were used to compare differences between groups, and the Wilcoxon test was used to analyze intra-group differences. Collected data were analyzed using SPSS software (V24). Results The mean age of the mothers included in the study was 30.77 ± 6.21 years. However, there was a statistically significant difference in the method of delivery between the two groups; most mothers in the control group had cesarean section, while in the intervention group most deliveries were performed vaginally ( P = 0.048). The assessment of changes in anxiety scores demonstrated that the mean state anxiety score in the intervention group significantly decreased from 53.51 ± 9.66 at baseline to 43.48 ± 12.02 after the intervention ( P = 0.0001). In the control group, the mean state anxiety score also decreased from 53.81 ± 10.23 before the study to 48.78 ± 11.22 after the study; however, this reduction was not considered statistically significant ( P = 0.01). Moreover, comparisons between the intervention and control groups showed no statistically significant differences in state anxiety scores at either baseline or post-intervention assessments ( P > 0.05).Regarding trait anxiety, the mean score in the intervention group decreased significantly from 50.69 ± 8.75 at baseline to 41.81 ± 11.43 after the intervention ( P = 0.0001). In contrast, the mean trait anxiety score in the control group decreased from 51.18 ± 11.10 before the study to 48.24 ± 11.05 after the study, but this change did not reach statistical significance ( P > 0.05). Additionally, no significant differences were observed in trait anxiety scores between the intervention and control groups at either the pre-intervention or post-intervention stages ( P > 0.05).The results of the study showed that on the third day, the level of anxiety in the intervention group had decreased significantly, so that the reduction in state and trait anxiety scores was 1.9 and 3 times greater in the intervention group than in the control group. Conclusion The results of the study showed that the Jacobson relaxation technique can reduce the anxiety of these mothers; therefore, this technique can be used in the hospital in addition to conventional therapeutic and pharmacological method as a complementary and non-pharmacological method to control the anxiety of mothers with premature newborns hospitalized in the intensive care unit.