:,, (D oula ) * * *. 1.,., (, 1982 ; F itzpatric, Reeder & M astroianni, 1976 ; Reeder & M artin, 1987). (Klu sman,1975), - - (Read, 1947).,.,. (,1992),., (Doula ) (Klau s & Kn enn ell,1993),. 2. (therapeutic tou ch ).. : 1.. 2..
3.. 4.. 5. (, ). 3.. ( ), ( ),. 1 :,,. 2 :,,. 3 :,,. 4 :,,. 5 :,, (, ). 4. 1) Doula ( ).,,,, 5. 2)..(, 1986 :, 1980).,,,,,, 5. 3) (therapeutic touth ) tou chare, (Ujhely, 1979). T RI.. 1. Lam aze (psy choprophylatic meth od ). V elv ov sky, Platinov Plotitcher 1950 P avlovian
, 1951 7. F erdin and Lam aze 1951,,, (, 1986)., Apgar.,, (M elzack,, 1983 ),.,.. (,1990;, 1986; Genest, 1981). (Gollober, 1976; Miller, 1964), - (Candy, 1979; T aub enh eim, 1981; T oney, 1983). 2. (tou ch ). (Krierer & Peper, 1979). touch are, (Ujhely, 1979).,.,,.(Sandroff, 1980; Vice, 1979; W eiss, 1979). T ry on (, 1980 ) (comfort m ethod ),,. Lerth Blis s (1978), W iedenbach (1967)
, Rubin (1963). M oore (1983) 1,.,,,,,, (F ield, 1993),.,,,,. (, 1992 ; M ontagu, 1971). (Klau s, Kenn ell, Klau s, 1993), (M eehan, 1998). 3. (,,,,, 1982)., (Spielb er, 1970). 50%,. (, 1998; Reeder & M artin, 1987). Ledetm an (1984),,,,. Klu sm an (1975), Read (1979) - -,. 3,, (Cardon, 1976),. (Pritchard, 1980).
.,. T RI(T ou ch Research In stitute) (F ield, 1986).. 1. (nonequiv alent control group posttest only design ). 1),,,, ( 1 ). < 1> T A RO SA 1,2 LPA 1, LPA 2, LPA3 T A L1 - L5 SA 1,2 LPA 1, LPA 2, LPA3 PL T A L1T 3 - L5T 5 SA 1,2 LPA 1, LPA 2, LPA3 PLT L1- L5 : (1-5 ) L1T 3 - L5T 5 : + (3-5 ) RO : Routin e Only T A : SA : (1 :, 2 : ) PL : PLT : + LPA 1 - LPA3 : (LPA 1 = 0-4 ; LPA 2 = 5-7 ; LPA 3 = 8-10 ) 2) (1996) 5.. 3) (therapeutic touch protocol) T RI 1998 8 1 8 30 ( ) 10 2, 2,
2, 2, 2, 10. 3 20 4, 5 20. 10-15.,. 2. 1998 6 13-1999 5 13 C 1998 9 20 99 3 13 5 ( ), (th erapeutic tou ch ) ( ) ( ). 50, 44, 46 140, 4 49, 43, 44, 136. Spielberg et (1970) (1978).,, ( ) 1 F riedm an 0-4. 5-7, 8-10. M elzack (1975) visual an alogu e 5.. M ccaffery (1972) M crachlan (1974) (1983),,,, 4. 5,. ( ) (interv al) (duration ), (intra uterin e pressure) (fetal heart ton e) T ocodyn am om eter. 3. SP SS,,M ean, Chi- square test, Paired t - test, on e w ay Anov a, T ukey H SD, Sch effe test. 4. 1). 2). 3)
. 4)..,,,,,,,,,,.. 1. 1) 1,,.., < 2> 4 5-7, 8-10 5% (F =4.16 p 0.05)., 1. < 2 > F 48 3.0 1.1 1.16 4 42 2.7 1.1 44 2.8 0.9 45 4.2 0.5 1.38 5-7 41 4.0 0.6 44 4.1 0.6 38 4.6 0.6 * 4.16 * 8-10 38 4.2 0.1 * 43 4.2 0.7 * *p< 0.05, *Scheffe< 0.05 2) 2,,. < 3-1>, < 3-2>. (F =0.14 p 0.05),. 1% ( F =6.23, p 0.05).
< 3-2> P aired t - test 2. < 3-1> F 40 63.58 6.12 0.14 42 63.19 8.86 40 64.10 7.90 43 54.09 10.62 2.36 42 58.86 9.57 40 58.13 12.34 42 46.21 10.28 * 6.23 ** 38 54.58 9.37 * 43 52.47 13.30 * *p< 0.01, **Scheffe< 0.05 < 3-2 > t * 54.76 10.22 46.68 10.46 5.93 ** 59.70 9.06 54.73 9.45 3.76 ** 58.46 12.52 52.09 12.84 2.99 ** **p< 0.001, *P aired t - test 3) 3,,,.. < 4-1>,< 4-2> [ 1}. < 4-1> : F 36 568.31 217.14 * 9.46 *** 41 449.34 173.89 * 43 397.79 135.38 * 1 36 518.19 217.98 * 9.36 *** 41 403.07 171.31 * 43 351.67 126.05 * 2 36 50.11 41.92 0.19 41 46.26 22.80 43 46.12 28.76 ***p < 0.001, *T ukey < 0.05 1 2 397.79, 449.34, 568.31 0.1%.(F =9.46, p< 0.05). 1 351.67, 403.07, 518.19 0.1%.(F =9.32, p < 0.001)., 1,
, 2 46.12, 46.26, 50.11. 3-4 7-8 7-8 48.31, 44.48, 76.88 5%.(F =4.33, p =0.05).,.. 1 1 1. m ean 600 500 400 300 200 100 2 0 1 < 1> ( : ) < 4-2 > F 27 170.74 121.22 9.46 3-4 29 209.83 189.42 7-10 34 181.76 140.74 26 76.88 67.42 * 4.33 * 7-10 29 44.48 28.53 * 35 48.31 32.75 * ***p < 0.001, *T ukey < 0.05 4) 4
,,,. < 5> [ 2]. < 5 > (N =136) (% ) (% ) (% ) 2 36 (26.7) 38 (28.1) 42(31.1) 11.41 * * 13 (9.6) 5(3.7) 1(0.7) **p< 0.01 42(31.1% ), 38 (28.1% ), 36 (26.7% ), 1%.( 2 =11.41, p< 0.01). 1(0.7% ), 5 (3.7% ), 13 (9.6% ) 1%. count 50 40 30 20 10 0 N SVD C/ S < 2 > ( : ) 5) 5,,, (, ). [ 3] [ 4]. 36(26.5% ), 36 (25.57% ), 34 (256% ), 8(5.97% ), 7 (5.17% ), 15 (11% ). 4 (8.2% ),
. count 40 30 20 10 0 < 3 > ( : ) count 50 40 30 20 10 0 < 4 > ( : ) 5.
. 1.. 1998 6 13 1999 5 13 C 136,,. 5. M elzack (1975) M ccaffery (1972) M crachlan (1974), Spielberger (1975). SPSS/ PC,,, Chi- square test, t - test, Paired t - test, onew au An ov a, T uk ey HSD, Sch effe test., 1. 1,,.. 2. 2,,.. 3. 3,,.. 4. 4,,.. 5. 5,, (, )..,.,, (interv al)..,.,
. 2.., ( ).,.,.,.,,.,., (1985).. : (1990)...,,,, (1982).. : (1986). (Py choprophylaxis in ob stetrics : Lam aze m ethod)., 25 (3). 54-61. (1992).,. (1980)... 19(3), 41-43. (1980)... (1983)... (1988)... Can dy, M. M. (1979). Birth of acompreh en siv e family centerm n eonates. JOGN Nur sing, 8 (2), 80-84. F ield, T. M., Schanberg, S. M., & Scsfidi, F. (1986). T actile/ kin esthetic stimulation effect s on preterm neonates, Pediatrics, 77 (5), 654-658. F itzpatrick, E., Reeder, S. R., M a stroanni, L. (1976). Loc. cit. Genest, M. (1981). Preparation for childbirth eviden ce for efficacy.jogn Nur sing, 10(3). 82-85.
Gollob er, M. (1976). A comm ent on the need for frather - infant postpartal interaction. JOGN Nur sin g, 5 (5). 17-20. Klau s, M. H., Kenn ell, L. H., & Klau s, P. H.(1993). T he ben efit s of doula support. In M. H. Klau s, J. H., Kenn ell., & P. H. Klau s (Eds ). M otherin g the m oth er (pp. 32-51). NY : A ddison - W esley. Klu sm an, L. E. (1975). Reduction of pain in child birth by alleviation of anx iety during pregran cy. Journal of Con sulting and Clinical P sy chology, 43 (2), 162-165. Krieger, D., & peper, E. (1979). T h erapeutic touch : Cearchin g for eviden ce of logical chan ge. Am erican Journ al of Nur sing, 56 (4), 660-665. Lederm an R. P. (1984). P sy chosocial A daptation in Pregnan cy. En glew ood Cliffs. NJ : Prentice - H all, Inc. Lerch, V., & Bliss, J. (1978). M aternity nur sing (3th ed.). St. Louis : M osby Co. M clach an, E. (1974). Reconizin g pain, Am erican Journ al of Nur sing, 74 (3), 496-498. M ccaffery, M. (1980). W h en y our patient ' s still in pain, don 't ju st do som ething :Sit there. Nur sin g, 81, 58-60. M elzsck, R. (1975). T h e M cgill pain qu estionnaire : M ajor properties an d M ethods. Pain, 1, 277-299. Miller, J. (1964). F ather s in the deliv ery, th e preqm ent couple an d their m arriag e. Joirn al of Nur se- Midw ifery, 22, 18-26. Pritchard, J. A. & M acdonald, P. C. (1985). W illiam s ' ob stetrics (17th ed.) Norw alk : A ppleton - Century - Croft s. Read, G. D. (1979). Childbirth w ithout fear : T he principle an d pr actice of n ational childbirth. New York : H arper & Row. Reeder, S. J., & M artin, L. L. (1987). M aternity nur sin g : F amily, new born, and W om en ' s H ealth Care (16th ed.) Philadelphia : J. B. Lippincott Co. Robert s, J. E. (1976). Priorities in prenatal edu cation. JOGN nur sin g, 5 (3), 17-19. Rubin, R. (1963). T h e matern al tou ch. Nur s Outlook, 11, 828-831. Sandroff, R. (1980). A skeptic ' s guide to T. T. RN. 43 (1), 24-30. Spielberg er, C. D., Gorsuch. R. L., & Lu shen e, R. E. (1970). M anu al for the state - trait anx iety inv entory. CA : California Con sultin g P w y ch ologist pr es s. T aybenheim, A. H. (1981). Paternal- infant bondin g in th e fir st - tin e father. JOGN nur sin g, 10(4), 261-264. T on ey, L. (1983). T h e effests of h olding th e new b orn at deliv ery on paternal bon din g. Nur sing Research, 32(1), 16-19. Ujhely G. B. (1979). T ou ch : Reflection and percoption, Nursin g forum, 18 (1), 18-32. Vice, J. L. (1979). T ou ching th e high risk ob stetrical parient. JOGN Nursin g, 9, 294-295. W eis s, J. S. (1979). T h e lan gu age of touch. Nur sin g Rearch, 28 (2), 76-80. W iedenbach, E. (1976). F amily - centered m aternity nur sing. N. Y.: Purm an, Co. - A b s t rac t - A S tudy on the Effect of
D oula 's Role s including T herapeutic T ouch on Labor and D eliv ery Proc e s s K im, Gum Juin g Y o o, E un K w an g T he purpose of this study is to defin e the effect s of th e roles play ed by th e Doulas : one group educated on th e conv ention al Lam aze m ethod kn ow n to hav e effect s on birth pang durin g deliv ery proces s and th e other group educated both on Lam aze and therapeutic tou ch. On the v ariou s factor s of deliv ery, and thereby, provide for som e b asic dat a to dev elop an effectiv e nur sing int erv ention to reliev e w om en of their birth pang. 136 mother s w ho w ere h ospitalized in a general h ospital from Jun e 13, 1998 to M ay 13, 1998 to M ay 13, 1999 to deliv er their fir st babies w ere sampled to be divided into control group, test group I and test group II and thu s be subject to interv iew s an d ob serv ation s. A s for the tool of stu dy, m elzack ' s (1975) 'pain scale ', M ccaffery ' s (1972) and M crachlan ' s (1974) 'pain ex pression scales ' an d Spielberg er ' s (1975) 'anxiety scale ' w ere u sed. T h e preparatory edu cational program s con sisted of 5w eek Lam aze meth od and th erapeutic tou ch. T he research, design w as qu asi- ex perim ental, n on equiv alent, posttest only control group design. T h e collected data w ere processed u sin g the SPSS/ PC statistics softw are for frequencies, m ean s an d one - w ay Anov a as w ell as T ukey H SD an d Scheffe test as post h oc for in dividu al comparison. M oreov er, chi- square test w as u sed to test the differen ces betw een groups, w hile Pear son ' s correlation coefficient s w ere analy zed to det erm in e th e corr elation s betw een anxiety and v ariables. T he fin ding s are as follow s ; 1. T h e birth pain of th e mother s deliv erin g fir st babies scored in a subjectiv e and objectiv e pain scale ; 1) T here w a s a significant difference of subjectiv e birth pain at 8 10 opening of cervix betw een control group and tw o test groups. 2) T h er e w as n o significant differ ence of objectiv e birth pain as per openin g of cerv ex among three group s in term s of sw eating, facial m ov ement, bodily posture an d v ocal chan ges. 2. T here w as n o significant differen ce of trait anx iety among three groups. how ev er, there w as a significant difference of st at e anx iety durin g labor pr ocess betw een control group and tw o test group s. On the oth er h and, all the three group s show ed a significantly low er lev el of anx iety during lab or pr ocess th an w h en they w ere carried t o the h ospital. 3. T here w as a significant difference of the time of total and fir st - stage labor among
thr ee gr oups, w hile there w as a significant but sm all difference of the tim e elap sed fr om 8 10 cervix open to th e full am on g three group s. 4. T w o t est group s sh ow ed a higher frequ en cy of natur al deliv eries than the contr ol group. 5. T w o test groups w ere subject to these dru g s th an the control group. In con clu sion, it w as found th at the t est gr oup I an d II show ed a sh ort er deliv ery tim e than the control group, a higher frequen cy of natural deliv ery an d a lesser u se of anodyn e or epidur al. In particular, this study is significant t o dev elop a nur sin g interv ention service or a therapeutic touch w hich th e nur sin g administrators can apply to their hospitals in m arketin g program s.