Psychoeducation Dhikr Increases Spiritual Responses of Primiparous
Women
Sri Wahyuni
1
, Anies
2
, Ariawan Soejoenoes
2,3
and Suhartono Taat Putra
4
1
Midwifery Department, Health Polytechnic of Surakarta, Klaten, Central Java, Indonesia
2
Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
3
Department of Obstetrics/ Gynaecology, Dr. Kariadi Hospital, Central Java, Indonesia.
4
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Keywords: Dhikr, Postpartum, Pregnancy, Primiparous, Spiritual.
Abstract: The transition period in the primiparous women requires not only the physical, psychological and social
readiness but also an attitude of willingness in adaptation during perinatal period. The adding a spiritual aspect
is required to facilitate the mother to accept changes after giving birth. This study aims to explore effect of
psychoeducation dhikr for spiritual responses on primiparous women. This study used the randomized pre-
test post-test control group design. A number of 47 participants completed up to the analysis. Variables that
included patience, gratitude, willingness and wisdom examined 4 times. Statistical analysis saw the difference
within and between groups. There was difference of mean score of patience, gratitude, willingness and
wisdom before and after (p <0.001) in intervention group. There was a difference of mean score of patience,
gratitude and willingness (p <0.05) but there was no difference in wisdom (p = 0.35) in the control group.
There was a mean difference (Δ) before and after intervention between groups (p <0.05). Routine midwifery
care plus psychoeducation dhikr further increases spiritual responses based on patience, gratitude, willingness
and wisdom compared with a routine midwifery care on primiparous women.
1 BACKGROUND
The transition period in the primiparous women
requires not only the physical, psychological and
social readiness but also an attitude of willingness to
accept changes after giving birth. The available
maternal health programs generally do not facilitate
the emotional preparedness of mothers (Hung et al.
2011; Care Quality Commission 2010; Care Quality
Commission & NHS 2015), the provision of services
is still related to physical health, treatment, infant care
and family planning (Khalaf et al. 2007).
The literatures on the spirituality around childbirth
are concern to human well-being, although they do not
seem to recognize the experience of labor as
spiritually meaningful (Crowther & Hall 2015).
However, several strategies have been undertaken to
improve interventions such as adding the spiritual
aspects and integrating religious elements into
interventions (Hefti 2011), which the approaches
using belief and spirituality are identified as relevant
sources during the pregnancy and childbirth in dealing
with stress, difficult situations and insecurities
(Büssing et al. 2017). Research suggested that the
period of pregnancy, childbirth and motherhood were
condition to be closer to the God and made life more
meaningful with the use of religious beliefs as a
powerful coping mechanism (Callister & Khalaf
2010), the mother in the period of childbirth has
development of transcendental, spiritual,
psychological experience and positive inner feelings
as self-actualization in the natural life cycle as a
woman (Taghizdeh et al. 2017). Some studies have
concluded that the religious instruction increased
religious knowledge and attitudes and reduced the
postpartum blues (Akbarzadeh et al. 2015), and
helped to deal with the early stress during motherhood
(Mann et al. 2008) and up to the next year (Cheadle et
al. 2015).
In term, dhikr means to remember. In the context
of spirituality, dhikr (remembering) means
remembering God (Allah SWT). By definition, dhikr
is the consciousness of beings in a unified relationship
of their whole life with the God. Dhikr as the ritual
and meditation of Muslims is closely related to the
affective and cognitive conditions of the individual
22
Wahyuni, S., Anies, ., Soejoenoes, A. and Putra, S.
Psychoeducation Dhikr Increases Spiritual Responses of Primiparous Women.
DOI: 10.5220/0008319800220028
In Proceedings of the 9th International Nursing Conference (INC 2018), pages 22-28
ISBN: 978-989-758-336-0
Copyright
c
2018 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
(Hamsyah & Subandi 2017). The dhikr is practice;
where short phrases or prayers are repeated through
oral or inner speech, body movement or the heart with
resignation and meaningfulness, prayer, praise,
thanksgiving, not limited to time and certain readings.
Some of the main purposes of the dhikr are to get
closer to the God through surrender or sincerity, guard
against self-destruction of demons, as tranquilizer,
make peace of the heart and causing salvation from
adversity, find humility, tranquility, peace, and divine
love in this noble exercise (Husain 1998). Dhikr is
also used as a treatment for spiritual illness, which is
not always a separate disease category but can be
incorporated into current diagnostic and classification
systems (Laher 2014).
Several studies of the dhikr have been done, with
the results of relaxation training with the dhikr could
reduce anxiety and improve controlled feelings in
patients with Acute Myocardial Infarction treated by
Intensive Cardiac Care Unit (Mardiyono 2012), as an
important strategy for coping against cancer and
contributes to spiritual care (Mesquita et al. 2013), the
spiritual activities such as repentance and the dhikr
increased the psycho-physiology changes to the
positive ways (Nubli et al. 2013).
There are no research on the psychoeducation
dhikr on the effects for the perceived spiritual on the
primiparous women. The psychoeducation dhikr in
this study was the use of dhikr to deal with the
emotional condition, which begins with the relaxation
and continued with spoken utterance, the body
movements or vibration of the heart in order to get
closer to Allah Subhanahu wa Ta’ala, by reading
some verses, praying and mentioning some names of
Allah Subhanahu wa Ta’ala, done with a soft voice,
with the present heart and mind. The number of
interventions was 5 times @ 45-60 minutes, two times
in T III of pregnancy and on the 3rd, 7th and 10th day
of postpartum. The sequence of activities undertaken
in accordance with the protocol.
The psychoeducation dhikr was chosen by
considering to utilize the provision of beliefs and
knowledge possessed by the respondents. Another
reason was that the dhikr was an easy practice to do
and not limited to reading and time, so the mother
abled to perform during the perinatal period. In
addition, the dhikr could increase the faith and
devotion of the pregnant women to postpartum along
with the increasing need of the additional spiritual
aspect in health services especially the midwifery
care.
Therefore, the psychoeducation dhikr became an
option in order to develop and optimize the mother's
spiritual and the sustainability of that as an effort to
achieve and improve the spiritual health of the
perinatal mother is possible.
The results of this study were expected to be the
scientific basis for the application of the spiritual
intervention dhikr from the TM III of pregnancy up to
postpartum period and suggested the intervention into
the perinatal service program for improvement of the
perceived stress and prevention of the PDS.
This study aims to explore effect of the
psychoeducation dhikr for the spiritual responses on
the primiparous women. The hypothesis of the study
were the routine midwifery care plus psychoeducation
dhikr are more increased the spiritual responses
compared with the routine midwifery care.
2 METHODS
2.1 Study Design
This study used experimental with the randomized
pre-test post-test control group design to explore two
independent groups mean of spiritual responses. The
study done in the six health centers in Klaten,
Indonesia 2017, by doing a pretest by measuring the
spiritual responses (patience, gratitude, willingness
and wisdom). The treatment group received routine
obstetric care plus psychoeducation of dhikr and the
control group only received routine obstetric care, and
then performed posttests.
2.2 Sampling
The permission was asked to the health centers, and
then, based on the recommendation of midwives, the
participant recruitment was conducted. The
researchers explained the research objectives, benefits
and consequences orally and written to the
participants and to provide participants the
opportunity to decide on participation in the study.
We applied the following inclusion criteria:
normal third-trimester (26 36 weeks of gestation)
pregnant women who wish to give birth vaginally and
can read and write in Bahasa. Eligible participants of
78 the pregnant women in the TM III of pregnancy
met the inclusion criteria, randomly allocated to either
an intervention or a control group. Random allocation;
used close envelope; had been done only to the level
of the health centers, to avoid the occurrence of gaps
and conflicts between respondents if in one health
center there were different treatments. The number of
respondents who completed until the end of the study
period and up to the analysis were 47, consisted of 24
for intervention group and 23 for control group.
Psychoeducation Dhikr Increases Spiritual Responses of Primiparous Women
23
2.3 Measurement
Spiritual perception has been examined relatively four
times, ie in the TM III of pregnancy, one week before
due date of birth, day 3 and 11 after childbirth. The
spiritual response questionnaire consists of indicators
of patience, gratitude and willingness of heart, as well
as the wisdom, to measure the spiritual response in
pregnancy to postpartum. Items are based on
theoretical sources and expert judgments. Each item
with four choices of answers: very unsuitable,
mismatch, accordant, very match, on a scale of 3
ranging from highly unsuitable (0) to very appropriate
(3). The spiritual response questionnaire shows the
value of Cronbach Alpha, on the impatient indicator
of 0.772, the gratitude of 0.730, the willingness of the
heart of 0.756, the intelligence of taking 0.768
wisdom.
2.4 Procedures
Pregnant women who have fulfilled inclusion and
exclusion were invited to participate in this study and
for accessibility reasons, pregnant women were
invited to the nearest health center. After signing
informed consent the respondents were asked to fill
out the questionnaire.
The tools and materials used in the study include
the Spiritual Psychoeducation Dhikr (SPD) module,
which has been compiled and reviewed by Islamic
religious expert. The SPD module was then tested and
refined before testing is used. The SPD module was
used 5 times in the same sequence of activities,
beginning with a relaxation activity with deep breath,
followed by reading some Al-Qu'ran letters, Sholawat
Prophet Muhammad, some Asmaul Husna, Toyyibah
sentences, Istighfar, Tauhid sentences and end with a
deep breath.
Interventions were administered five times twice
in the TM III of pregnancy, on the 3
rd
, 7
th
and 10
th
postpartum days, each for 45-60 minutes.
Interventions were conducted by researchers who
were assisted by six midwife instructors, each of
which was owned by a selected community health
center that had been subjected to a perception
equation and was given special training three times.
2.5 Ethical Consideration
Ethical permission was obtained from Research
Ethics Committee at Faculty of Medicine Diponegoro
University, number 80 / EC / FK-RSDK / III / 2017,
March 3, 2017. All respondents signed Informed
Consent in Bahasa Indonesia.
2.6 Data Analysis
Data were primary data obtained directly from the
respondents, tested to test the difference of mean score
of the variable before and after intervention in the
intervention group and control group using Paired
sample t-Test.
Difference test of mean score difference between
intervention group and group using Independent
Sample t-Test. Difference test of mean difference
every time measurement of variable score using
ANOVA with post hoc Bonferroni.
3 RESULTS
Table 1 shows that the age categories of respondents
were mostly low risk (95.8%) in the intervention
group and (87%) in the control group. Based on Mann
Whitney U test that found characteristics of
respondents be based on age category, education
category, occupation, family income, breastfeeding
status and family support were obtained p> 0, 05, so
it can be concluded that the respondent characteristic
data in two groups was homogeneous.
Different test results based on Mann Whitney U
Test on the score of patience, gratitude, willingness
and wisdom on before the intervention obtained p
value > 0,05, so it can be concluded that there was no
initial difference of intervention in two groups. Table
2 shows there were significant difference of mean
score of patience, gratitude, willingness and wisdom
before and after the intervention, in groups who get
additional psychoeducation of dhikr (p <0.001).
Respondents in the group who only received
routine midwifery care there were differences before
and after on patience, gratitude and willingness (p
<0.005), while there was no difference of mean score
of the wisdom (p= 0.350).
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
24
Table 1: Characteristics of primiparous women.
Characteristics
Intervention Group (n=24)
Control Group (23)
p*
n (%)
mean+SD
n (%)
mean+SD
Age (years)
23,96±3,30
22,83±3,92
0.294
Age category:
0,281
High risk
1 (4,2)
3 (13)
Low risk
23 (95,8)
20 (87)
Educational:
0,733
Primary
3 (12,5)
3 (13)
Secondary
19 (79,2)
19 (82,6)
Tertiary
2 (8,3)
1 (4,3)
Occupation:
0,591
Employed
8 (33,3)
6 (26,1)
Unemployed
16 (66,7)
17 (73,9)
Household Income:
0,691
< Regional Min. Wage
14 (58,3)
15 (65,2)
>Regional Min. Wage
10 (41,7)
8 (34,8)
Breastfeeding:
1,000
Yes
24 (100)
23 (100)
No
0 (0)
0 (0)
Family support:
0,435
Often
4 (16,7)
6 (26,1)
Always
20 (83,3)
17 (73,9)
*Mann Whitney U test
3.1 Patience
The first indicator was patience, in table 3 that the
analysis using repeated ANOVA test showed mean
score in TM III of pregnancy with one week before
due date (p=0,019), TM III pregnancy with three days
postpartum (p=0,079) and TM III pregnancy with
eleven postpartum days (p=0.905). The analysis with
post hoc Bonferroni showed no interaction between
measurement time and group (p = 0.173).
However, the independent t test analysis on the
mean difference (Δ) indicated p = 0.002 (table 4), so
it can be concluded that there was difference of
patience before and after intervention between groups
who got additional psychoeducation dhikr and who
only get routines midwifery care.
3.2 Gratitude
The test analysis of gratitude (table 3) obtained mean
score of measurement result at TM III of pregnancy
with one week before due date of childbirth (p =
0,183), TM III pregnancy with three postpartum days
(p = 0,794) and TM III pregnancy with eleven
postpartum days (0,137).
The next analysis showed no interaction between
measurement time and group (p = 0.158). However,
table 4 shown that the mean difference analysis (Δ)
before and after the between group indicated p value
0.012, so it is concluded that there was a difference in
gratitude score before and after the intervention
between groups.
3.3 Willingness
The third indicator was willingness, the analysis
obtained mean scores of willingness in TM III with
one week before due date (p = 0.169), with three
postpartum days (p = 0.952) and with eleven
postpartum days (0.646 ). There was no interaction
between measurement time and group (p = 0.351).
The result of independent t test analysis on the
mean difference (Δ) between groups showed p value
0.026 (table 4), so it can be concluded that there was
difference of willingness score before and after
intervention between group.
Psychoeducation Dhikr Increases Spiritual Responses of Primiparous Women
25
Table 2: Difference scores before and after the intervention based on group
Intervention group (Mean± SD)
p*
Control group (Mean± SD)
P*
Before
After
Before
After
1.767±0.26
2.43±0.28
<0.001
2.12±0.13
2.43±0.27
<0.001
1.86±0.19
2.38±0.27
<0.001
2.00±0.36
2.23±0.39
0.030
1.93±0.26
2.45±0.29
<0.001
2.12±0.21
2.41±0.32
0.004
1.92±0.28
2.41±0.25
<0.001
1.93±0.34
2.05±0.49
0.350
*Before vs after: paired t test.
Table 3: The spiritual responses score pre and post intervention within and between groups.
Variable
Time
Intervention
group
Control
group
Difference (∆ )
(CI 95%)
p*
p**
(Mean± SD)
(Mean± SD)
Patience
1st
1,77±0,26
2,12±0,13
-
-
0,173
2nd
2,05±0,31
2,28±0,33
-0,23 (-0,42[-0,04])
0,019
3rd
2,06±0,35
2,25±0,39
-0,19 (-0,41 - 0,02)
0,079
4th
2,43±0,28
2,43±0,27
-0,01 (-0,17 - 0,15)
0,905
Gratitude
1st
1,86±0,19
2,01±0,36
-
-
0,158
2nd
1,97±0,30
2,10±0,39
-0,14 (-0,34 - 0,07)
0,183
3rd
2,07±0,36
2,10±0,39
-0,03 (-0,25 - 0,19
0,794
4th
2,38±0,27
2,23±0,39
0,15 (-0,05 - 0,35)
0,137
Willingness
1st
1,93±0,26
2,12±0,21
-
-
0,351
2nd
2,14±0,40
2,28±0,25
-0,14 (-0,33 - 0,06)
0,169
3rd
2,26±0,37
2,25±0,32
0,01 (-0,20 - 0,21)
0,952
4th
2,45±0,29
2,41±0,32
0,04 (-0,14 - 0,22)
0,646
Wisdom
1st
1,92±0,28
1,93±0,34
-
-
0,017
2nd
2,05±0,30
2,01±0,50
0,04 (-0,20 - 0,28)
0,730
3rd
1,91±0,38
2,02±0,46
-0,11 (-0,36 - 0,14)
0,382
4th
2,41±0,25
2,05±0,50
0,36 (0,13 - 0,59)
0,003
* Repeated ANOVA test, **post hoc Bonferroni. 1
st
: measurement on TM III of pregnancy,
2nd: measurement on one week before due date of childbirth, 3
rd
: measurement on 3 days after birth,
4th: measurement on 11 days after birth.
3.4 Wisdom
The fourth indicator was that wisdom, by using
ANOVA repeated test showed the measurement
result at TM III of pregnancy with one week before
due date (p = 0,730), TM III pregnancy with three
postpartum days (p = 0,382) and TM III pregnancy
with eleven days postpartum (0.003). Based on the
analysis result (table 3) there was interaction between
measurement time and group (p = 0.017).
The results of the analysis using independent t
test showed the difference of the mean difference
(delta) of the wisdom before and after the intervention
between groups showed the value p = 0.013 (table 4),
so it can be concluded that there was a difference in
the score of wisdom before and after intervention
between groups who received additional
psychoeducation of dhikr and who only received
routine midwifery care.
4 DISCUSSION
The hypothesis of research that psychoeducation of
dhikr increases the spiritual response of primiparous
mother is acceptable, as illustrated by the increase of
mean score of patience, gratitude, willingness and
wisdom. Further described below.
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
26
Table 4. Difference (Δ) before and after intervention between groups
Score
Difference ∆ ± SD
t
CI (95%)
p*
Intervention
Control
Patience
-0.658 ± 0.402
-0.313 ± 0.323
-3.234
-0.560 (-0.130)
0.002
Gratitude
-0.525 ± 0.282
-0.226 ± 0.468
-2.665
-0.524 (-0.131)
0.012
Willingness
-0.525 ± 0.262
-0.287 ± 0.430
-2.302
-0.450 (-0.030)
0.026
Wisdom
-0.492 ± 0.295
-0.122 ± 0.611
-2.661
-0.657 (-0.083)
0.013
*Intervention group vs Control group: Independent t test.
First indicator was the patience. Based on this
study result obtained that psychoeducation dhikr
increases the respondents’ patience in accepting
pregnancy and childbirth along with consequences.
Intervention in this study involved an element of
beliefs held by respondents; shaped dhikr and written
in a module containing dhikr reading and meaning
and meaning. The previous the study revealed that
the guidance of religious belief was effective in
increasing the religious knowledge and attitudes
(Akbarzadeh et al. 2015), and the religious women
supported in coping with the stress of early
motherhood (Mann et al. 2008). When respondents
got guidance and do dhikr, it is interpreted as an
attempt to recall and get closer to add and strengthen
the knowledge of respondents that the conditions,
trials or pressures faced today are in accordance with
the limits of ability and can be faced with the help of
the God.
Second indicator was the gratitude. This study
showed that psychoeducation dhikr increases the
respondents’ gratitude during pregnancy and
childbirth. The previous studies stated that the
spiritual activities such as repentance and the dhikr
increased the psycho-physiology changes to the
positive ways (Nubli et al. 2013). Based on the
literature, it stated that Islam offers a comprehensive
methodology to solve mankind's spiritual,
intellectual and nothing happens without His
permission (Husain 1998). Peoples deed their lives
through the understanding of the faith of a particular
religious that it can direct how an individual will cope
with life stress (Gall et al. 2005).
Another study shown that dhikr creates positive
influences and eliminates negative influences and life
satisfaction can also be achieved immediately when
one performs dhikr, for in dhikr there is humility, fear
of His power, and helplessness before Him, therefore
developed gratitude, making it easy to achieve life
satisfaction (Hamsyah & Subandi 2017). In this
study, through stimulus of the psychoeducation dhikr
which is accompanied by understanding the meaning
of the reading so that happening strengthening and
increase of knowledge, thus giving gratitude to the
favors, fortune and grace in the form of pregnancy
and childbirth.
Third indicator was the willingness. The
psychoeducation dhikr facilitates the willingness of
the respondent's heart in accepting pregnancy,
childbirth and childbirth with all its consequences.
Recurrent pronunciation and hearing, such as those
characterized by dhikr have the ability to obtain a
state of consciousness, because there is
synchronization between the frontal cortex and the
limbic system, and then the parasympathetic nerves
coordinate relaxation, decrease stress hormones and
stimulate serotonergic function to enhance calmness
and increase response immune (Saniotis 2015).
However, another study found that dhikr has a
substantial immediate short-term effect in reducing
depression, anxiety and stress in mothers with
children suffering from Congenital Heart Disease
(Mirzaei et al. 2015). In this study, dhikr interpreted
as a means in increasing the understanding that
everything that happens is the will and has been
arranged by Allah SWT and it reinforces the
understanding and beliefs of pregnancy and
childbirth are the nature of women in continuous
descent.
Fourth indicator was the wisdom. The
psychoeducation of dhikr increases the wisdom on
the events of pregnancy, childbirth and childbirth.
Dhikr lowers perceived stress with improvement the
respondent's knowledge through comprehension and
comprehension of the meaning of reading so that
formed belief that behind condition of pregnancy,
childbirth and childbirth there is a useful wisdom to
be used as base in leading the life forward.
The previous study showed that cultural,
contextual and religious factors affect the experience
and positive attitude toward the pain during labor
(Taghizdeh et al. 2017). Psychoeducation of dhikr
awakens maturity thinking, confidence, and memory
to always be grateful for all the gifts of Allah SWT,
as well as new understanding and knowledge in the
face of pregnancy, childbirth and childbirth, so in the
end pregnant women have better mental health.
Although the respondents did dhikr
Psychoeducation Dhikr Increases Spiritual Responses of Primiparous Women
27
independently, beyond programmed time could not
be controlled, however, psychoeducation dhikr
increases the spiritual response of primiparous
mother, which was reflected from the increase of
mean score of patient indicator, gratitude,
willingness and wisdom.
5 CONCLUSIONS
Based on this study results, the psychoeducation
dhikr increased the patience, gratitude, willingness
and wisdom of the primiparous women, and it can be
concluded that the routine midwifery care plus
psychoeducation dhikr are more increased the
spiritual responses compared with the routine
midwifery care only.
Psychoeducation of dhikr becomes an option in
order to develop and optimize the mother's spiritual
aspect. By adding psychoeducation dhikr on the
routine midwifery care further increases spiritual
responses based on patience, gratitude, willingness
and wisdom on primiparous women.
ACKNOWLEDGEMENTS
The authors would like to thank to the primiparous
women as participants and the midwives as
facilitators in this research. There is no conflict of
interest.
REFERENCES
Akbarzadeh, M. et al., 2015. Investigation of the effect of
religious doctrines on religious knowledge and attitude
and postpartum blues in primiparous women. Iranian
journal of nursing and midwifery research, 20(5),
pp.5706.
Büssing, A. et al., 2017. Spiritual needs of mothers with
sick new born or premature infants A cross sectional
survey among German mothers. Women and Birth.
Callister, L.C. & Khalaf, I., 2010. Spirituality in
childbearing women. The Journal of perinatal
education, 19(2), pp.1624.
Care Quality Commission, 2010. Women’s experiences of
maternity care in England: Key findings from the 2010
NHS trust survey,
Care Quality Commission & NHS, 2015. 2015 survey of
women ’ s experiences of maternity care:Statistical
release,
Cheadle, A.C.. et al., 2015. Spiritual and Religious
Resources in African American Women: Protection
from Depressive Symptoms Following Birth. Clin
Psychol Sci, 3(2), pp.283291.
Crowther, S. & Hall, J., 2015. Spirituality and spiritual care
in and around childbirth. Women and Birth, 28(2),
pp.173178.
Gall, T.L. et al., 2005. Understanding the Nature and Role
of Spirituality in Relation to Coping and Health: A
Conceptual Framework. Canadian
Psychology/Psychologie Canadienne, 46(2), pp.88
104.
Hamsyah, F. & Subandi, 2017. Dzikir and Happiness: A
Mental Health Study on An Indonesian Muslim Sufi
Group. Journal of Spirituality in Mental Health, 19(1),
pp.8094.
Hefti, R., 2011. Integrating Religion and Spirituality into
Mental Health Care, Psychiatry and Psychotherapy.
Religions, 2, pp.611627.
Hung, C.-H. et al., 2011. Postpartum Psychosocial Changes
Among Experienced and Inexperienced Mothers in
Taiwan. Journal Transcult Nursing, 22(3), pp.217
224.
Husain, S.A., 1998. Religion and Mental Health From The
Muslim Perspective. In H. G. Koenig, ed. Handbook of
Religion and Mental Health. California: Academic
press, pp. 279290.
Khalaf, I.A. et al., 2007. Jordanian women’s perceptions of
post-partum health care. Int Nurs Rev, 54(3), pp.288
294.
Laher, S., 2014. An overview of illness conceptualizations
in African, Hindu, and Islamic traditions: Towards
cultural competence. South African Journal of
Psychology, 44(2), pp.191204.
Mann, J.R. et al., 2008. Do antenatal religious and spiritual
factors impact the risk of postpartum depressive
symptoms? Journal of women’s health (2002), 17(5),
pp.745755.
Mardiyono, 2012. The Effects on the Nursing-Based
Intervention Integrating Islamic Relaxation on Anxiety
and Percieved Control in Indonesian Patients with
Acut Myocardial Infarction Admitted in ICCU. Prince
of Songka University.
Mesquita, A.C. et al., 2013. The use of religious/spiritual
coping among patients with cancer undergoing
chemotherapy treatment. Revista latino-americana de
enfermagem, 21(2), pp.53945.
Mirzaei, T. et al., 2015. Short Term Effects of Islamic Zikr
on Anxiety, Stress, and Depression in Mothers of
Children with Congenital Heart Disease. British
Journal of Medicine and Medical Research, 10(4),
pp.15.
Nubli, M., Wahab, A. & Salam, U.B., 2013. The Effects of
Islamic Spiritual Activities on Psycho-Physiological
Performance. Journal of Educational, Health and
Community Psychology, 2(2), pp.5967.
Saniotis, A., 2015. Understanding Mind/Body Medicine
from Muslim Religious Practices of Salat and Dhikr.
Journal of Religion and Health, (May).
Taghizdeh, Z. et al., 2017. A time for psycho-spiritual
transcendence: The experiences of Iranian women of
pain during childbirth. Women and Birth.
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
28