The Effect of Telenursing-Based Five-Finger Hypnosis Therapy on Maternal Stress Among Mothers of Stunted Children: A Quasi-Experimental Study
Abstract
Background: Stunting remains a major public health problem in developing countries, including Indonesia. In addition to nutritional factors, maternal psychological stress may indirectly affect caregiving quality and child well-being.
Objective: This study aimed to examine the effect of telenursing-based five-finger hypnosis therapy on maternal stress levels among mothers of children with stunting.
Methods: A quasi-experimental pretest-posttest control group design was conducted from March to May 2024 in Wanaraja Village, Garut Regency, Indonesia. A total of 34 mothers of children with stunting were recruited using purposive sampling and assigned to an intervention group (n = 17) and a control group (n = 17). The intervention group received telenursing-based five-finger hypnosis therapy for seven sessions over four weeks, while the control group received routine puskesmas services. Maternal stress was measured using 14 items derived from a modified DASS-42 questionnaire. Data were analyzed using the Friedman test and Mann-Whitney test.
Results: Maternal stress in the intervention group decreased progressively from pretest to posttest 1 and posttest 2, with mean scores declining from 18.4 (SD 3.12) to 16.4 (SD 2.50) and 14.5 (SD 2.40), respectively. The control group also showed a slight reduction, from 18.9 (SD 2.29) to 17.9 (SD 2.77) and 17.6 (SD 2.50). However, the reduction in maternal stress was significantly greater in the intervention group than in the control group at week 2 (p = 0.036) and week 4 (p < 0.001), with a larger effect observed at week 4.
Conclusion: Telenursing-based five-finger hypnosis therapy was associated with a greater reduction in maternal stress among mothers of children with stunting than routine care alone. This intervention may serve as a supportive psychosocial strategy in community-based stunting management programs.
Full Text:
PDFReferences
Almaatani, D., Cory, E., Gardner, J., Alexanian-Farr, M., Hulst, J. M., Bandsma, R. H. J., & Van Den Heuvel, M. (2023). Child and Maternal Factors Associated with Feeding Practices in Children with Poor Growth. Nutrients, 15(22), 4850. https://doi.org/10.3390/nu15224850
Cardoso, C., Lumini, M. J., & Martins, T. (2025). Effects of physical exercise in reducing caregivers burden: a systematic review. In Frontiers in Public Health (Vol. 13). Frontiers Media SA. https://doi.org/10.3389/fpubh.2025.1474913
De Benedittis, G. (2024). Hypnotic Modulation of Autonomic Nervous System (ANS) Activity. Brain Sciences, 14(3), 249. https://doi.org/10.3390/brainsci14030249
Emalia, H. F., & Nilasari, P. (2021). Pengaruh Electronic Health Terhadap Penurunan Tingkat Depresi Postpartum: Tinjauan Sistematis. Jurnal Ilmu Keperawatan Maternitas, (2). https://doi.org/10.23284/jikm.v4i2.1271
Febristi, A., Antoni, A., & Baiturrahmah, A. K. (2023). Gambaran Status Psikologis Orang Tua Terhadap Kejadian Stunting Di Wiliyah Kerja Kenagarian Pematang Panjang Kab.Sijunjung Tahun 2022 Description Of The Psychological Status Of Parents On Stunting Incidents In The Working Area Of Pematang Panjang Regency, Sijunjung Regency, 2022. 01.
Fernandez, A., Urwicz, L., Vuilleumier, P., & Berna, C. (2021). Impact of hypnosis on psychophysiological measures: A scoping literature review. American Journal of Clinical Hypnosis, 64(1), 36–52. https://doi.org/10.1080/00029157.2021.1873099
Forslund, M., Mathieson, K., Djibo, Y., Mbindyo, C., Lugangira, N., & Balasubramaniam, P. (2024). Strengthening the evidence base on the use of digital health technologies to accelerate progress towards universal health coverage. Oxford Open Digital Health, 2. https://doi.org/10.1093/oodh/oqae033
Hansen, N. H., Bjerrekaer, L., Pallesen, K. J., & Fjorback, L. O. (2022). The effect of mental health interventions on psychological distress for informal caregivers of people with mental illness: A systematic review and meta-analysis. https://doi.org/DOI10.3389/fpsyt.2022.949066
Kemenkes. (2025, May 26). SSGI 2024: Prevalensi Stunting Nasional. Kementerian Kesehatan Republik Indonesia. https://kemkes.go.id/id/ssgi-2024-prevalensi-stunting-nasional-turun-menjadi-198
Kenwright, M., Fairclough, P., McDonald, J., & Pickford, L. (2024). Effectiveness of community mental health nurses in an integrated primary care service: An observational cohort study. International Journal of Nursing Studies Advances, 6, 100182. https://doi.org/10.1016/j.ijnsa.2024.100182
Leo, D. G., Keller, S. S., & Proietti, R. (2024). “Close your eyes and relax”: the role of hypnosis in reducing anxiety, and its implications for the prevention of cardiovascular diseases. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1411835
Mulyani, A. T., Khairinisa, M. A., Khatib, A., & Chaerunisaa, A. Y. (2025). Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction—A Narrative Review. Nutrients, 17(9), 1493. https://doi.org/10.3390/nu17091493
Muzzamil, M., Khurram, S. S., Aga, I. Z., Karim, M., Fatima, F., & Hashmi, S. (2025). Association between maternal mental health and child nutritional status in rural Sindh: a cross-sectional study using an e-health clinical model. BMJ Paediatrics Open, 9(1), e003972. https://doi.org/10.1136/bmjpo-2025-003972
Nishigaki, K., Yamaji, N., Adachi, N., Kamei, T., Kobayashi, K., Kakazu, S., & Yonekura, Y. (2025). Telenursing on primary family caregivers and children with disabilities: a scoping review. Frontiers in Pediatrics, 12. https://doi.org/10.3389/fped.2024.1374442
O’Dea, G. A., Youssef, G. J., Hagg, L. J., Francis, L. M., Spry, E. A., Rossen, L., Smith, I., Teague, S. J., Mansour, K., Booth, A., Davies, S., Hutchinson, D., & Macdonald, J. A. (2023). Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis. Archives of Women’s Mental Health, 26(4), 441–452. https://doi.org/10.1007/s00737-023-01332-1
Padilla, V. J., Muñiz, V., Scheffrahn, K., & Elkins, G. (2026). Effect of Mindful Hypnotherapy on Psychological Distress: A Systematic Review and Meta-Analysis. Behavioral Sciences, 16(1), 107. https://doi.org/10.3390/bs16010107
Pan, B., Gong, Y., Wang, Y., Miao, J., Zhao, C., & Li, Y. (2025). The impact of maternal parenting stress on early childhood development: the mediating role of maternal depression and the moderating effect of family resilience. BMC Psychology, 13(1), 277. https://doi.org/10.1186/s40359-025-02575-6
Rafi, A., Neshati, A., Falahi, B., & Naeimi, S. (2026). “It’s more than just physical care”: a systematic review and qualitative meta-synthesis of nurses’ evolving role in providing mental health care within primary health care systems. BMC Primary Care, 27(1), 91. https://doi.org/10.1186/s12875-026-03210-y
Rana, R., Sirwani, B., Mohandas, S., Kirubakaran, R., Puthussery, S., Lelijveld, N., & Kerac, M. (2024). Effectiveness of Postnatal Maternal or Caregiver Interventions on Outcomes among Infants under Six Months with Growth Faltering: A Systematic Review. Nutrients, 16(6), 837. https://doi.org/10.3390/nu16060837
Ren, F., Yue, C., Bao, M., Qin, M., Liu, X., Sheng, L., Liu, X., Zhao, J., & Chen, X. (2025). The association of maternal parenting stress, responsive caregiving and social-emotional competence of children aged 12–36 months: Undirected and Bayesian network analyses. Infant Behavior and Development, 81, 102162. https://doi.org/10.1016/j.infbeh.2025.102162
Rosendahl, J., Alldredge, C. T., & Haddenhorst, A. (2024). Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: a 20-year perspective. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1330238
Safitri, A., & Tresya, E. (2023). Five Finger Hypnosis to Reduce Anxiety Levels during the Covid-19 Pandemic. Journal of Complementary Nursing, 2(1), 122–126. https://doi.org/10.53801/jcn.v2i1.81
Saripah, S. (2022). Anak Penderita Stunting dan Psikologis Orang Tua: Kajian di Desa Teluk, Batanghari. JIGC (Journal of Islamic Guidance and Counseling), 6(1), 29–48. https://doi.org/10.30631/jigc.v6i1.63
Soliman, N., Soliman, A., Alyafei, F., Elsiddig, S., Alaaraj, N., Hamed, N., Mohamed, S., & Itani, M. (2024). Persistent Global Burden of Stunting Among Children. European Journal of Medical and Health Sciences, 6(2), 15–20. https://doi.org/10.24018/ejmed.2024.6.2.2080
Sriati, A., Kurniawan, K., Senjaya, S., Khoirunnisa, K., Muslim, R. N. I., Putri, A. M., Aghnia, N., & Fitriani, N. (2024). The Effectiveness of Digital-Based Psychotherapy in Overcoming Psychological Problems in College Students During the COVID-19 Pandemic: A Scoping Review. Journal of Holistic Nursing, 42(2_suppl), S26–S39. https://doi.org/10.1177/08980101231162990
Wang, Y., Wang, Y., Huang, W., Deng, J., & Gu, J. (2024). Association of maternal postpartum depression, anxiety, and stress symptoms: a network analysis. BMC Psychiatry, 24(1), 940. https://doi.org/10.1186/s12888-024-06412-9
Wati, W. S., Jayanti, D. M. ari D., & Arwidiana, D. P. (2021). The The Effect of 5 Finger Hypnosis on Decreasing Stress Levels in the Family of Schizophrenia Patients in Puskesmas II Denpasar Timur. NURSING UPDATE : Jurnal Ilmiah Ilmu Keperawatan P-ISSN : 2085-5931 e-ISSN : 2623-2871, 12(2), 42–50. https://doi.org/10.36089/nu.v12i2.173
WHO. (n.d.). Malnutrition in children. World Health Organization. Retrieved March 31, 2026, from https://www.who.int/data/nutrition/nlis/info/malnutrition-in-children
WHO. (2021, August 18). Global strategy on digital health 2020-2025. World Health Oraganization.
WHO. (2025, July 21). Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group joint child malnutrition estimates: key findings of the 2025 edition. World Health Organization. https://www.who.int/publications/i/item/9789240112308
DOI: http://dx.doi.org/10.30829/contagion.v8i2.29001
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 Iwan Wahyudi, Tanti Suryawantie, Ishmah Hamidah
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
