Analysis of Activities and Services of Delivery Room Nurses Based on DACUM Technique

Purpose: The aim of this study was to analyze various nursing services of delivery room nurses by hospital level,and identify importance and frequency to provide baseline data to establish delivery room nurses`` roles.Methods: Through DACUM analysis technique, service descriptions, duties, and tasks were derived from the literature. A survey was done of 242 nurses from delivery rooms of hospitals, general hospitals, superior general hospitals, and special hospitals. Importance and frequency of each service were measured using a 4point scale,and results were analyzed using SPSS. Results: Nursing services for delivery room nurses consisted of 18 duties and 86 tasks. Duties with the highest importance were ``labor support`` and ``infection management``, and those with lowest importance were ``collaborative care`` and ``communication``. The duty with the highest frequency was ``labor support``, and lowest frequency was ``communication``. There were differences between importance and frequency depending on the size of hospitals. Conclusion: Results of this first study on nursing services of delivery room nurses. delivery room nurses are performing a wide range of nursing services and the various types are clarified including importance and frequency.ope

Effects of abdomianl breathing on labor anxiety level and cervix dilatation time in primipara women

간호학교육 전공/석사[한글] 본 연구설계는 복식호흡이 분만과정에 있는 초산부의 진통 중 불안과 분만소요시간 감소에 효과가 있는지를 검정하기 위한 비 동등성 대조군 유사실험 설계이다. 연구 기간은 2007년 10월 11일~12월 4일까지였고, 대상자는 서울 소재 Y의료원 분만실에 입원하여 분만 1기에 pitocin을 사용한 산부 중 편의추출된 36명 이었다. 복식호흡 실험처치는 예비실험을 통해 심정언(2005)이 제시한 호흡법 중 '참기'를 생략하고 '4초 흡기, 6초 호기법'으로 수정하여, 자궁경부 3~4cm, 5~6cm 개대시에 각각 30회씩 실시하였다. 심리적 불안은 각각의 복식호흡 전후에 VAS-A로 측정하였다. 자료분석은 SPSS/PC+ WIN 12.0 program으로 서술통계, x2-test, t-test, Mann-Whitney test, Wilcoxon signed rank test를 이용하였다. 연구결과는 다음과 같다. 1. 심리적 불안 점수의 변화는 자궁경부 3~4cm 개대시 가능점수의 범위 0 ~ 10 점 중에서, 대조군은 5.27에서 5.67으로 0.40점 증가되었고, 복식호흡을 시행한 군은 3.67 에서 2.90으로 -0.76점으로 감소되어 유의한 차이를 보였다 (z=-3.05, p=.002). 또한 자궁경부 5~6cm개대시, 대조군은 6.13에서 6.27로 0.13점 증가되 었고, 실험군은 4.33에서 3.90로 -0.43점으로 감소되어, 통계적으로 유의한 차이 를 보였다(z=-2.04, p=.042) 그러므로 ‘자궁경부 3~4cm 개대 시 복식호흡을 시행한 초산부군의 심리적 불 안 정도는 대조군 보다 낮을 것이다’라는 가설 1-1과 ‘자궁경부 5~6cm개대 시 복식호흡을 시행한 초산부군의 심리적 불안 정도는 대조군 보다 낮을 것이다’라는 가설 1-2는 지지되었다. 2. 분만활성기 소요시간은 대조군은 평균 206.67분, 실험군은 평균 150.48분으로 서 실험군이 대조군에 비해 56.19분 더 짧았으나 이는 통계적으로 유의한 차이는 아니었다. 따라서 ‘복식호흡을 시행한 초산부군의 분만활성기 소요시간은 대조군 보다 짧을 것이다.’라는 가설2는 기각되었다. 이상의 연구결과를 종합해 볼 때 분만중의 산부에게 30회의 복식호흡 실시는 경부개대 3~4cm 시와 경부개대 5~6cm 시에 각각 심리적 불안을 감소시키는 효과가 있었으나 분만시간 단축효과는 규명되지 않았다. 결론적으로 30회의 복식호흡은 진통 중 불안감소에는 유용하다고 결론지을 수 있으므로, 반복연구를 통해 불안감소를 위한 가장 효과적인 최소한의 복식호흡량을 규명하는 것이 요구된다 [영문]This study is a clinical test experiment to examine the effects on labor anxiety and duration of delivery time for primipara women treated by abdominal breathing. It has a non-equivalent comparison group quasi-experimental design. The research period was from October 11, 2007 to December 4, 2007 and 36 subjects who used pitocin and met the selection standards were chosen through convenience sampling from the subjects hospitalized in the labor room of Y hospital located in Seoul. The abdominal breathing experiment measures were modified to ‘four seconds inhale, six seconds exhale breathing method’ by adjusting the breathing method indicated by Shim, Joung Un (2005) and omitting ‘enduring’ through preliminary tests. The abdominal breathing for the treatment group was carried out 30 times each when the uterine cervix was dilated 3~4cm and 5~6cm. Psychological anxiety was measured by VAS-A before and after dilation to 3~4cm, 5~6cm of the uterine cervix. The gathered data were analyzed by descriptive statistics, x2-test, t-test, Mann-Whitney test, and Wilcoxon signed rank test through SPSS/PC+ WIN 12.0 program. The experimental results are as follows. 1. Out of the possible score range of 0 to 10 for the change in psychological anxiety score measured through VAS-A when the uterine cervix was dilated to 3~4 cm, the control group increased by 0.40 from 5.27 to 5.67 and the group that carried out abdominal breathing decreased by -0.76 from 3.67 to 2.90. This showed a statistically significant difference (z=-3.05, p=.002). Therefore, the hypothesis 1-1 which stated that ‘the score of anxiety in cervix dilatation 3~4cm could be lower in the group which had abdominal breathing than in the control group’ was supported. 2. For the change in psychological anxiety score measured by VAS-A in cervix dilatation 5~6 cm, the control group increased by 0.13 from 6.13 to 6.27 while the treatment group decreased by -0.43 from 4.33 to 3.90. This showed a statistically significant difference (z=-2.04, p=.042). Therefore, the hypothesis 1-2 of ‘the score of anxiety in cervix dilatation 5~6cm could be lower in the group which had abdominal breathing than in the control group’ was supported. 3. The duration of delivery time in active phase for the control group was 206.67 minutes on average and 150.48 minutes on average for the treatment group. This shows the treatment group required 56.19 minutes less compared to the control group, but it is not a statistically significant difference. Thus, hypothesis 2 which stated that ‘the score of duration of delivery time could shorter in the group which had abdominal breathing than in the control group’ was rejected. When integrating the experimental results mentioned above, carrying out abdominal breathing 30 times to a woman in labor was effective in decreasing the psychological anxiety in labor and the duration of delivery time for the cervix dilatation of 3~4 cm and 5~6 cm, but a difference was not discovered between their effect in decreasing delivery time. As it can be concluded that abdominal breathing of 30 times is useful during the labor anxiety of childbirth, the development of mediating methods that achieve a minimum of efficiency for decreasing labor anxiety is requiredope