The Effects of Effleurage as a Nursing Intervention to Promote Prenatal Attachment

Abstract

The purpose of this study was to examine the effects of effleurage on prenatal attachment. A quasi-experimental research design was used for the study. A group of 49 pregnant women who attended childbirth education classes at a medical center in the Midwest participated in the study. The experimental group consisted of 16 pregnant women who were taught the intervention of effleurage. The control group consisted of 33 pregnant women who were not taught the intervention. Three research hypotheses were posed for the study. The first research hypothesis was: Pregnant women in the experimental group who use the intervention of massage will demonstrate a significantly greater increase between pretest/posttest PAI scores than pregnant women in the control group. With an alpha set at .05, an independent t-test of the mean differences between the pretest/posttest scores for the experimental and control groups revealed t = 1.634, p = 0.056. This hypothesis was not supported. The second research hypothesis was: Pregnant women in the experimental group who use the intervention of massage will have significantly higher posttest scores than women in the control group. With an alpha set at .05, an independent t-test revealed t = 1.11, p = 0.14. There was no significant difference between the posttest PAI scores of the experimental and control groups. The third hypothesis was: There is no relationship among the demographic variables of maternal age, marital status, education level, perceived social support, number of other living children, and race/ethnicity and PAI scores. Social support was the only moderate correlation noted (r = 0.311). There was no statistically significant relationship between PAI scores and the demographic variables of maternal age (r= -0.105), marital status (r= -0.006), educational level (r= -0.015), number of children (r= -0.113), race/ethnicity (r= -0.008), or gestational age (r = 0.028) . The literature revealed a lack of prenatal attachment intervention studies and conflicting results of studies correlating prenatal attachment and demographic variables. Recommendations were made for more studies that test a variety of nursing interventions that promote prenatal attachment. Conceptual clarification is needed, which would enhance both tool refinement and prenatal attachment theory development. Implications of the study for advanced nursing practice include incorporating emerging prenatal attachment interventions into general nursing practice, nursing education, and childbirth education. Intervening through social support as a way to promote prenatal attachment was discussed. Supportive care during pregnancy and beyond is best accomplished with the help of an advanced practice maternal-child nurse. With a focus on the developing attachments throughout pregnancy, the nurse can "mother the mother" throughout her pregnancy and significant contributions can be made to the health of society by strengthening families.