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1 Vol.9, No.2, , :,,,, (S P 6), 1 ). 1..,. (Green, 1993).,,. Dick- Rea d - -(fear- t ension- pain cycle) (B ob ak, Lowdermilk & J ensen. 1995)...,. (, 2002 ; Lowdermilk, P erry & Bobak, 1999).. (,,,, 2002 ;,,, 1992 ;, 1988 ; 1987 ;,,,, 2002), (, 1999 ;,,,, 2002 ;, 2003), (, 2001 ;, 1995 ;, 2000) Doula (, 2001), (, 1998), (, 1995), (, 1988). 1)

2 9 2.. (acupoint acupressure) (acu point ),, (, 2003) (, 200 1). (helper ) (support er ) (, 1999). (acu point ),,,. opioid (Sh er, 1996). 30 (Chauh an, Gasser & Chauhan, 1998) (ripening),, (SP6) (Cook & Wilcox, 1997). (, 1999 ;,,,,, 2001 ;, 2002 ;, 2002)., (2002).. (2002).,., cm 30,.. 1) 1:. 2) 2:. 3) 3:. 3-1 :. 3-2 : Apga r

3 O3 : O5 : 60 O4 : 30 O6 : 1) ( ) 3 ( ) (, 2001 ;,, 1991 ;, 1993) ( (,, 1997). ) 3cm 30. Ext er nal t ocodynamom et er (durat ion ) 2 :3 (J imenez, 1995). 2) Spielberger (1978) 20, , (graphic r ating scale) 20cm 10, (randomized cont rolled clinical t rial). R O1 O2 X1 O3 O4 O5 O6 R O1 O2 X2 O3 O4 O5 O6 <1> R : matched random assign X1 : 3 cm X2 : 3 cm O1 : O2 : 2. C,,,, cm 5. (oxyt ocin )30 ( 3cm ). 3. 1) Spielberger (1978) 20, Chr onbach ' s = (gr aphic r at ing scale). 20cm 10, 10. Spielberger Spielberger. Spielberger

4 9 2 1 ( ) 2 ( ) ++ 3 ( ) 4 (30 ) 5 (60 ) 6 ( ) ph Apgar ++ ph Apgar <2 > (gr aphic r at ing scale) 1% (r = 0.582, p = 0.000). 2),, 30, 60. 3) Apgar., Apgar 1, 5. 4 ). 4. (1), 3cm(2), (), (3, 4, 5, 6) <2>. 1) <3>. 30. (Lowdermilk, 1999 ; Jimenez, 1995) (J imenez, 1995). :. :. 2) :, : ( ) ( ) <3 >

5 (double- blinded meth od). 3,. (inform ed consent ) (mat ching) ( 3cm ) (oxyt ocin) SPSS Win progr am. 1),,. t-t est, 2 - t est. 2) t-t est, ANCOVA, 2 - t est. 3) Chr onbach ' s. 4) Spielberger Pearson correlation coefficient ) < 1> (n = 36) (n = 39) n(%) ( ) n (%) ( ) t or 2 p (27.8) 8(20.5) 7(19.4) 19(52.8) 9(23.1) 22(56.4) (58.3) 15(41.7) 29(80.6) 7(19.4) 19(48.7) 20(51.3) 26(66.7) 13(33.3) (66.7) 12(33.3) 24(61.5) 15(38.5) (61.1) 11(30.6) 3( 8.3) 19(48.7) 17(43.6) 3( 7.7)

6 9 2 < 2 > (n = 36) (n = 39) n (%) ( ) n (%) ( ) 26(72.2) 31(79.5) 10(27.8) 8(20.5) t or 2 p wk oxytocin 20(55.6) 16(44.4) 16(44.4) 20(55.6) 22(56.4) 17(43.6) (46.2) 21(53.8) / hr gm < 1>. (p = 0.342), (p = 0.500), (p = 0.540). 2) < 2>. 26 (72.2%), 31 (79.5%) 20 (55.6%), 22 (56.4 %) , (p = 0.338) ) 1 :. < 3> (t = , p = 0.999). 4.94, 6.28 (t = , p = 0.030). 0.35, 1.83 (t = , p = 0.019).,. < 3 > (0-10) (n = 36) (n = 39) ( ) ( ) t p

7 ) 2 :. 2 < 4 >. 3cm 75.25, (t = 1.064, p = ) , , , 74.03, , ANCOVA (F = 0.139, p = ; F = , p = ; F = , p = 0.108). 2.. < 4 > (n=36) (n = 39) ANCOVA ( ) ( ) F p ) 3 :. 3-1 :. 3-2 : Apgar. 3 < 5>. ph ph (p = 0.124) Apgar 7.92, 7.97 (p = 0.387), 5 Apgar 8.97 (p = 0.979). 3-2 Apgar < 5 > A pg a r (n = 36) (n = 39) t p ( ) ( ) ph Apgar <4 > 4), < 6>. 5 (13.9%), 10 (25.6%). 4.00cm 3.10cm

8 9 2 < 6 > (n = 36) (n = 39) n (%) ( ) n (%) ( ) 5(13.9) 31(86.1) 10(25.6) 29(74.4) t or 2 p cm (8.3) 33(91.7) 7(17.9) 32(82.1) (p = 0.204). ( 10mg)., 3 (8.3%) 7 (17.9%) (p = 0.313).... () () (SP6).,. (sedatives) (analgesia ) (Lowdermilk, 1999). (Melzack & Wall, 1965), (Bobak, 1995) (Prit char d & Macdonald, 1996)., (2001) Doula - (p = ) (1998) (p = 0.009). (1995) 5. (1988) (p = 0.002). (2002) (p = ) (p = 0.008)

9 opiat e (Lo & Chung, 1979). opioid opioid (Sh er, 1996). enkeph alins (Maxwell, 1997). Lo Chung(1979) 8 6, Hyde (1989) (P 6).,,, (1999), Lyr enas, Lut sch, Hett a Lindber g(1987)--. (p = 0.030) (p = ). (2002)., (Sher, 1996). (Budd, Yelland & Maciocia, 1998)., McLachlan (1974 ). (1980) 100,, 1. (2000) (1988)., Wang J in (1989) 98.9%,,, Dunn, Rogers Halfor d (1989) (LV3) TENS TENS. Yanai, Sh aley, Yagu din Zuckerman (1987) 1 (LI4 ) (He7) 20, Apgar. Yip, P ang Sung(1976) 31.,

10 ,, Suth erland (2000)., ph 7.20 (, 1997 ;, 1999). (acidemia), (199 1). 1, 5 Apgar., 1, 5 Apgar. 43% (, 1999). 44 (58.7%), 40 (53.3%). Florido (1997) - ACTH... placebo contr ol grou p...,... 1.,. 75 (informed consent ) (double- blinded m eth od)

11 : 3,. 30. SPSS Win 10.0 program t -t est, 2 - t est t-t est, ANCOVA, 2 - t est. 1 ) (p = 0.019) 1. 2) 75.58, , , 74.03, , ANCOVA (p = ; p = ; p = 0.108) ) ph ph (p = 0.124) 1 Apgar 7.92, 7.97 (p = 0.387), 5 Apgar 8.97 (p = 0.979) ,. 2. 1). 2). 3) (ripening). 4). 5) placebo acupoint. Re f e re n c e s, (1997).. :.,,,, (1999).., 15 (2), (1980).,,.. (1978)... (1999)...,,,, (200 1).., 7 (3), ,,, (2002). (SP6) (LI4 )., 8 (2),

12 9 2 (200 1).. :. (200 1).., 7 (3), (1995).., 1 (1), (1999).., 5 (2), (1997).. :.,, (1992).., 16 (2), (2002).. - (1994 ).,.. (1988)... (1987). Lam aze..,,, (2002).,,., 8 (4), (2003). (SP6),, -..,,, (2002)., - -., 8 (4 ), (2001).. :. (2000).., 30 (2), (1998)... (1995).,.. 8 (1999).. :., (199 1).. : 10 (1993).. :. (1988)... (2001). Doula, - -., 7 (1), (2000).,,.. (199 1). A pgar Score ph Gas.. Bobak, I. M., Lowdermilk, D. L., J ensen M. D.. Mat ernity nursing. Mosby Bu dd, S., Yelland, S., Maciocia, G. (1998). A cupu nct ure and herbal treatm ent in m idwifery. In : Maciocia G, edit or. Obst et rics and Gy necology in Chinese Medicine. London : Chur chill Livingst one, Ch auh an, P. A., Gasser, F. J., Chauh an, A. M. (1998). Clinical invest igation on th e u se of acupunct ur e for tr eatment of placent al ret ent ion. A m erica J ournal of A cupuncture, 26 (1), Cook, A., Wilcox, G. (1997). Pr essuring pain : alt ernat ive th erapies for labor pain management. A W HON N Lifelines, 1 (2), Du nn, P., Rogers, D., & Halford, K. (1989). Transelect rical st imulat ion at acupunct ur e point s in th e Induction ut erine contr act ions. Obst etrics & Gy necology, 73, F lorido, J., Oltr a s, C. M., F aj ardo, M. C., Gonzalens- Esca nu ela, E., Villaver de, C., Gonzalez- Gomez, F. (1997). Plasma concent - r at ions of bet a- endor phin and adr enocorticot ropic h orm one in wom en wirh and wit h out ch ildbir t h pr epa rt ion. E u rop ean J. of Obst et rics & Gy necology and R eprodu ct iv e

13 Biology, 73, Green, J. M. (1993). Expect ations and experiences of pain in labor : findings fr om a lar ge pr ospect ive st udy. Birth, 20 (2), 65. Hyde, E. (1989). Acupressure t her apy for m orning sickness. Journal of N ursing- Midwifery, 34 (4 ), J imenez, S. (1995). Acupressur e : P ain relief at your fingertips. Int ernational Journal of Childbirth Educat ion, 10 (4), Lo, C. W., Chung, Q. T. (1979). The sedat ive effect of acupunct ur e. A m erican Journal of Chinese Medicine, 7 (3), Lowdermilk, D. L., P erry, S. E. and Bobak, I. M. (1999). Mat ernity N ursing(5th ed.) Mosby. Lyr enas, S., Lut sch, H., Hett a, J., Lindberg, B. (1987). Acupuncture befor e delivery : Effect on labor. Gy necologic and Obst et ric Investigat ion, 24, Maxwell, J. (1997). Th e gentle power of acu pr essur e. RN, 60 (4), McLachlan, E. (1974 ). Recognizing pain. A m erica Journal of N urses, 74 (3), Melzack, R., Wall, P. D. (1965). Pain M echanism s. A New th eory, Science. 150, 971. Prit chard, T., Macdonald, P. C. (1996). Obst etrics (20t h ed). New York ; Applet on Century Cr oft. Sher, L. (1996). Th e r ole of t he endogenou s opioid syst em in th e effect of acupunct ur e on m ood and behavior : Th eor etical and pract ical consider ation. A m erica J ournal of A cupuncture, 24 (4 ), Sut herland, J. A. (2000). Gett ing t o t he point : Meridian t her apy is m aking it s way int o nur sing practice. A m erica Journal of N ursing, 100 (9), Wang, D. W., Jin, Y. H. (1989). Present status of cesarean sect ion u nder acu pu ncture anesth esia in China. Fuk ushim a J Med Sci, 35, Yanai, N., Shaley, E., Yagudin, E., Zuckerman, H. (1987). The use of elect roacupuncture during labor. A m erica Journal of A cupu nct ure, 15 (4), Yip, S. K., P ang, J. C. K., Sung, M. L. (1976). Induction of labor by acupuncture elect rostimulation. A m erica Journal of Chinese Medicine, 4 (3), Ab s t ra ct - Effe ct s of Sa n - Yin - J ia o (SP6 ) Acu p r es s u r e on An x iet y, Pu ls e a n d Ne on a t a l St a t u s in Wom en d u r in g Lab or Lee, Mi Ky eong 1 ) Pu rpos e : In th e st udy effect s of San-Yin-J iao (SP6) acu pr essure on anxiety and pulse during labor, and on neonat al st at us wer e examined. Met h od : Th e design was a r andomized cont rolled clinical trial with a double-blind m eth od. Dat a wer e collect ed before (pre) and aft er (post ) tr eatment using st ru ct ur ed quest ionnair e, anxiet y scale, pulse rat e, umbilical vein ph and Apgar scores. Th e experiment al grou p r eceived SP6 acupressur e for t he dur ation of each ut erine cont ract ion over period of 30 minut es, but t he cont rol gr oup r eceived SP 6 t ouch. Res u lt s : Th e anxiet y scores between t he two groups increased, but th e incr ease was less in t he SP 6 acu pr essur e gr oup and th e difference was st atistically significant (p = ). Mat er nal pulse rat e was not significant ly differ ent immediat ely aft er t reat ment (p = 0.711), at 30 a 1) Inst ructor, Dept. of Nursing, Dankook University

14 9 2 and at 60 minut es (p = ; p = 0.108), but while t he SP6 acu pr essure gr oup h ad a st able pulse, t he SP6 t ouch group showed an increased rat e. Ther e was no significant differ ence between th e t wo grou ps for umbilical vein ph (p = 0.124), and neonat al Apgar score at one and five minut es (p = ; p = 0.979) Con clu si on : These findings str ength en th e belief th at SP- 6 acu pr essure can be u sed t o r elieve anxiety during labor wit h no side effect s t o eit her mot her or baby. Key w o rds : SP6 acupressure, Wom en in labor, Anxiety, Pulse, Neonat al st atu s

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