Effect of Aromatherapy on Labor Process, Labor Pain, Labor Stress Response and Neonatal Status of Primipara;Randomized Clinical Trial

아로마테라피가 초산부의 분만과정, 분만동통, 분만스트레스 반응 및 신생아 상태에 미치는 효과

Hur , Myung-Haeng;Park, Mi-Hye
허명행;박미혜

  • Published : 20030400

Abstract

Objects : To relieve stress and pain during labor is most important issue in obstetrical care. The purposes of this study were to verify the effects of aromatherapy on labor process, labor pain, labor stress response and neonatal status of primipara. Methods : This study was a randomized, repeated measures over time, pretest-posttest design. The subjects were forty eight primipara with single gestation, full term, uncomplicated pregnancies. As the treatment, the experimental group took an aromatherapy massage with aromatherapy oil (1.5% dilution essential oil of clary sage, geranium, jasmine, and rose) on the back at every two hours. The control group took general obstetric care. Baseline data including general and obstetric characteristics, plasma $\beta$-endorphin, serum cortisol were obtained at the onset of labor. As resulting variables, length of labor, use of oxytocin, labor pain, use of analgesics, plasma $\beta$-endorphin, serum cortisol, pulse rate, blood pressure, umbilical cord arterial blood pH Apgar score were measured. Collecting Data were analyzed by t-test, $X^2$ test, repeated measures of ANOVA with SPSS program. Results : As a results, the length of decerelation phase of the experimental group was significantly shorter than the control group. No significant group effect were found, but significant time effects were found for labor pain, plasma $\beta$-endorphin, serum cortisol, pulse rate and blood pressure. There were no significant differences in other variables between two groups. Conclusion : These findings indicate that aromatherapy during labor could be effective in decreasing labor length. But , any other effects of aromatherapy did not be verified.

목적 : 분만관리에서 스트레스와 동통을 감소시키는 것은 매우 중요하다. 본 연구는 아로마테라피가 분만과정, 분만동통, 분만스트레스 반응 및 신생아 상태에 미치는 효과를 검증하고자 수행하였다. 연구 방법 : 무작위 반복 측정 전후 실험이며, 대상자는 총 48명이었고, 20대의 정상 초산부로 태아가 단태이며 두정위인 경우였다. 실험처치는 클라리세이지, 제라늄, 로즈, 자스민을 4:4:1:1로 블렌딩한 후 1.5%로 희석한 오일로 아로마테라피 마사지를 잠재기부터 2시간 간격으로 제공하였다. 사전조사로 동질성 확인을 위해 일반적, 산과적 특성, 혈장 베타엔돌핀, 혈청 코티졸 등을 측정하였다. 처치효과로 분만시간, 분만동통, 진통제 사용 빈도, 혈장 베타엔돌핀, 혈청 코티졸, 제대 동맥혈 수소이온농도와 아프가 점수를 측정하였다. 자료는 SPSS 프로그램을 이용하여 t-test, $X^2$-test, 반복 측정 분산분석으로 비교 분석하였다. 결과 : 실험군의 분만시간이 더 짧았으며, 분만 1기의 활성기중 감속기에서는 통계적으로 유의하게 짧았다. 옥시토신 사용빈도나 총 주입량에서 대조군이 더 많았으나, 통계적으로 유의하지 않았다. 분만동통은 분만시기에 따라 유의하게 증가하였으나 두 군간 차이가 없었다. 혈장 베타엔돌핀 및 혈청 코티졸, 제대 동맥혈 수소이온농도지수, 아프가 점수에서 두 군간 차이가 없었다. 결론 : 분만 중 에센셜 오일을 이용한 아로마테라피가 분만과정을 짧게 하는 데에는 효과적이었으나, 분만동통, 분만스트레스 반응, 신생아 상태에 대한 효과는 입증되지 않았다.

Keywords

References

  1. Fox HA. The effects of catecholamines and drug treatment on the fetus and newborn. Birth and the Family Journal 1979; 6(3): 157-65
  2. Schuiling LD, Sampselle CM. Comfort in labor and midwifery art. Image-the Journal of Nursing Scholarship 1999; 31(1): 77-81
  3. Lederman E, Lederman RP, Work B, McCann DS. Maternal psychological and physiological correlates of fetal-newborn health status. American Journal Obstetrics & Gynecology 1981; 139(8): 956-8
  4. Lederman RP, Lederman E, Work B, McCann DS. Anxiety and epinephrine in multiparous women in labor: Relationship to duration of labor and fetal heart rate pattern. American Journal Obstetrics & Gynecology 1985; 153(8): 870-7
  5. Price S. Practical Aromatherapy, 2nd Eds., London: Thorsons; 1987
  6. Cerrato P. Aromatherapy, Is it for real? RN 1998; 61(6): 51-2
  7. Keville K, Green M. Aromatherapy, A Complete guide to the healing art. Freedom: The Crossing Press; 1995
  8. Tisserand M. Aromatherapy for woman, a Practical guide to essential oils for health and beauty. Rochester: Healing Arts Press; 1996
  9. Dye J. Aromatherapy for women & childbirth. Saffron Walden: The C·W·Daniel company; 1997
  10. England A. Aromatherapy for mother & baby. Rochester, Vermont: Healing Arts Press; 1994
  11. Clifford FR. Aromatherapy During Your Pregnancy. Saffron Walden: The C. S. Daniel Company Limited; 1997
  12. Wesson N. Natural mothering a guide to holistic therapies for pregnancy, birth, and early childhood. Rochester, Vermont: Healing Arts Press; 1997
  13. Ronald C, Wayne J. The challenge of complementary and alternative medicine. American Journal of Obstetrics and Gynecology 1997; 177(5): 1156-61
  14. Trevelyan J. Using aromatherapy in childbirth. Nursing Times 1994; 90(9): 54-60
  15. Burns E, Burney C. Soothing scents in childbirth. International journal of Aromatherapy 1994; 6: 24-28. In Buckle J. Clinical aromatherapy in nursing, London: Arnold London. 1997: 174
  16. Burns E, Blamey C, Ersser SJ. Lloyd AJ. Barnetson L. The use of aromatherapy in intrapartum midwifery practice an observational study. Complement Ther Nurs Midwifery 2000; 6(1): 33-4
  17. Buckle J. Clinical Aromatherapy in Nursing, London: Arnold London; 1997
  18. Roach S. Massage for the Doula. International Doula 2001; 9(3): 8-9
  19. Watson F. Aromatherapy Blends and Remedies, Sanfrancisco; Thorsons: 1995
  20. Rose J. 375 essential oils and hydrosols. Califonia: Frog Ltd; 1999
  21. Tiran D. Clinical aromatherapy for pregnancy and childbirth. Edinburgh, London; Churchill livingstone: 2000
  22. 한선희, 허명행, 박진희, 이은진, 박미경. 여성건강과 아로마테라피, 서울: 현문사; 2002
  23. Price S. Aromatherapy for women, London: Lorenze book, 2001: 73
  24. Edwards VH. The aromatherapy companion, North Adams; Storey Books: 1999
  25. Cooksley VG. Aromatherpay: a lifetime guide to healing with essential oils. New Jersey; Prentice Hall: 1996; 282-5
  26. Burns E, Blamey C. Using aromatherapy in childbirth. Nursing Times, 1994; 90(9): 54-60
  27. Reed L, Norfolk L. Trial using lavender(unspecified) during labor. Aromatherapy in midwifery. Aromatherapy world; 1993: 12-15. in Price S, Price L. Aromatherapy for health professionals. London: Churchill livingstone; 2000: 194-5
  28. 허준용. 분만에 따른 임부혈중 Cortisol 및 태아제대혈중 Cortisol과 Prolactin치에 관한 연구. 서울: 고려대학교 1984
  29. Hoffman DI, Abboud TK, Haase HR, Hung TT, Goebelsmann U. Plasma $\beta$-endorphin concentrations prior to and during pregnancy, in labor, and after delivery. American Journal Obstetrics & Gynecology, 1984; 150(5): 492-6
  30. McLachlan E. Recognizing pain. American J of Nursing 1974; 74(3): 496-7
  31. Pagana KD, Pagana YJ. Diagnostic testing and nursing implications a case study approach, 5th ed. St Louis: Mosby; 1999
  32. 대한산부인과학회. 산과학. 서울; 도서출판 칼빈서적: 1997. 621-2
  33. 허명행. 일대일 분만지지간호가 초산모의 분만동통, 분만스트레스 반응, 분만경험 및 신생아 상태에 미치는 효과. 서울: 카톨릭대학교 2000