Women's Health Nursing (여성건강간호학회지)

Korean Society of Women Health Nursing (한국여성건강간호학회)
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The effects of music therapy on labor pain, childbirth experience, and self-esteem during epidural labor analgesia in primiparas: a non-randomized experimental study

음악요법이 초산부의 경막하 무통 분만 중 분만통증, 분만경험, 자아존중감에 미치는 효과: 유사실험 연구

  • Seong Yeon An (Delivery Room, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Eun Ji Park (Delivery Room, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Yu Ri Moon (Delivery Room, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Bo Young Lee (Delivery Room, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Eunbyul Lee (Delivery Room, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Dong Yeon Kim (Nursing Innovation Unit, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Seong Hee Jeong (Delivery Room, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Jin Kyung Kim (Obstetrics Ward, The Catholic University of Korea, Seoul St. Mary's Hospital)
  • 안성연 (가톨릭대학교 서울성모병원 분만실) ;
  • 박은지 (가톨릭대학교 서울성모병원 분만실) ;
  • 문유리 (가톨릭대학교 서울성모병원 분만실) ;
  • 이보영 (가톨릭대학교 서울성모병원 분만실) ;
  • 이은별 (가톨릭대학교 서울성모병원 분만실) ;
  • 김동연 (가톨릭대학교 서울성모병원 간호혁신 unit) ;
  • 정성희 (가톨릭대학교 서울성모병원 분만실) ;
  • 김진경 (가톨릭대학교 서울성모병원 산과병동)
  • Received : 2023.03.25
  • Accepted : 2023.06.21
  • Published : 2023.06.30
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Abstract

Purpose: This non-randomized study was performed to evaluate the effects of music therapy on labor pain, the childbirth experience, and self-esteem in women during vaginal delivery. Methods: In total, 136 primiparous women over 37 weeks of gestation receiving epidural analgesia during vaginal delivery were recruited via convenience sampling. To minimize diffusion effects, data from the control group (n=71) were collected first (April 2020 to March 2021), followed by data from the music group (n=65; April 2021 to May 2022). Participants in the music group listened to classical music during labor, while the control group was offered usual care (no music). Labor pain was measured using a numeric rating scale (NRS), and self-esteem and childbirth experience were collected using self-report questionnaires. Data were analyzed using the independent t-test, chi-square test and Cronbach's α coefficients. Results: The overall pain level (NRS) at baseline was 0 in both groups. Mothers in the music therapy group had lower levels of latent pain (t=1.95, p=.005), active pain (t=3.69, p<.001) and transition-phase pain (t=7.07, p<.001) than the control group. A significant difference was observed between the two groups, and the music therapy group expressed more positive perceptions of the childbirth experience (t=-1.36, p=.018). For self-esteem, the experimental group's score was slightly higher, but without a statistically significant difference from the control group. Conclusion: Using music therapy during labor decreased labor pain and improved the childbirth experience. Music therapy can be clinically recommended as a non-pharmacological, safe, and easy method for nursing care in labor.

Keywords

Acknowledgement

This study was supported by the research fund of Seoul St. Mary's Hospital and the Catholic University of Korea in 2021.

References

  1. Corbijn van Willenswaard K, Lynn F, McNeill J, McQueen K, Dennis CL, Lobel M, Alderdice F. Music interventions to reduce stress and anxiety in pregnancy: a systematic review and meta-analysis. BMC Psychiatry. 2017;17(1):271. https://doi.org/10.1186/s12888-017-1432-x
  2. Jiang J, Rickson D, Jiang C. The mechanism of music for reducing psychological stress: music preference as a mediator. Arts Psychother. 2016;48:62-68. https://doi.org/10.1016/j.aip.2016.02.002
  3. Dehcheshmeh FS, Rafiei H. Complementary and alternative therapies to relieve labor pain: a comparative study between music therapy and Hoku point ice massage. Complement Ther Clin Pract. 2015;21(4):229-232. https://doi.org/10.1016/j.ctcp.2015.09.002
  4. Simavli S, Kaygusuz I, Gumus I, Usluogullari B, Yildirim M, Kafali H. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. J Affect Disord. 2014;156:194-199. https://doi.org/10.1016/j.jad.2013.12.027
  5. Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-463. https://doi.org/10.1016/j.midw.2014.12.012
  6. Gokyildiz Surucu S, Ozturk M, Avcibay Vurgec B, Alan S, Akbas M. The effect of music on pain and anxiety of women during labour on first time pregnancy: a study from Turkey. Complement Ther Clin Pract. 2018;30:96-102. https://doi.org/10.1016/j.ctcp.2017.12.015
  7. Ji ES, Han HR. The effects of Qi exercise on maternal/fetal interaction and maternal well-being during pregnancy. J Obstet Gynecol Neonatal Nurs. 2010;39(3):310-318. https://doi.org/10.1111/j.1552-6909.2010.01135.x
  8. Park HJ, Sung MH. Effects of music therapy on stress of preterm labor and uterine contraction in pregnant women with preterm labor. Korean J Women Health Nurs. 2017;23 (2):109-116. https://doi.org/10.4069/kjwhn.2017.23.2.109
  9. Kim YS, Lee YJ, Park GH. The effects of maternal health care program on depression, maternal role self-confidence and delivery self-efficacy in pregnant women. J East-West Nurs Res. 2017;23(2):134-141. https://doi.org/10.14370/jewnr.2017.23.2.134
  10. Kim JS. Non-pharmacological interventions to relieve labor pain: a literature review. Korean Parent Child Health J. 2011;14(1):28-35.
  11. Han SJ, Kim JI, Kim MJ. Comparison of obstetric pain, anxiety, and cervical dilatation between epidural analgesia and no analgesia group during labor stage I. Korean J Women Health Nurs. 2012;18(2):126-134. https://doi.org/10.4069/kjwhn.2012.18.2.126
  12. Kim Y, Lee H, Park GS. Experience of Korean primipara women's induction of labor. J Qual Res. 2017;18(2):209-219. https://doi.org/10.22284/qr.2017.18.2.209
  13. Liu YH, Chang MY, Chen CH. Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers. J Clin Nurs. 2010;19(7-8):1065-1072. https://doi.org/10.1111/j.1365-2702.2009.03028.x
  14. Kim EM, Hong S. Impact of uncertainty on the anxiety of hospitalized pregnant women diagnosed with preterm labor: focusing on mediating effect of uncertainty appraisal and coping style. J Korean Acad Nurs. 2018;48(4):485-496. https://doi.org/10.4040/jkan.2018.48.4.485
  15. Lee EJ, Lee JY, Lee SJ, Yu SE. Influence of self-esteem and spouse support on prenatal depression in pregnant women. J Korean Soc Matern Child Health. 2020;24(4):212-220. https://doi.org/10.21896/jksmch.2020.24.4.212
  16. Kim YL, Chung CW. Factors of prenatal depression by stress-vulnerability and stress-coping models. Korean J Women Health Nurs. 2014;20(1):38-47. https://doi.org/10.4069/kjwhn.2014.20.1.38
  17. Lee ME, Kweon YR. Psycho-social factors associated with depression in pregnant women. J Korean Acad Psychiatr Ment Health Nurs. 2011;20(3):252-260. https://doi.org/10.12934/jkpmhn.2011.20.3.252
  18. Hwang RH. Self-esteem, body image and factors influencing on maternal fetal attachment behavior of pregnant women. J Digit Converg. 2018;16(9):197-206. https://doi.org/10.14400/JDC.2018.16.9.197
  19. Yeo JH. Childbirth experience of participants in Lamaze childbirth education. Korean J Women Health Nurs. 2010;16(3):215-223. https://doi.org/10.4069/kjwhn.2010.16.3.215
  20. Kim GJ. The effects of Doula touch delivery education on self-confidence delivery, knowledge of childbirth, couple satisfaction. J Korea Acad-Ind Coop Soc. 2013;14(6):2880-2888. https://doi.org/10.5762/kais.2013.14.6.2880
  21. Jeon SI, Park MK. Effects of a spouse's hand massage on anxiety, spouse support and the perception on childbirth experience of a primipara with analgesia for vaginal delivery. J Korean Soc Matern Child Health. 2015;19(2):233-242. https://doi.org/10.21896/jksmch.2015.19.2.233
  22. Kwon JY, Park YW, Kim Y, Kim DW, Ahn EH. The effect of SP-6 acupressure on labor pain and patternof uterine contraction. Korean J Obstet Gynecol. 2005;48(8):1897-1904.
  23. Hollins Martin CJ. A narrative literature review of the therapeutic effects of music upon childbearing women and neonates. Complement Ther Clin Pract. 2014;20(4):262-267. https://doi.org/10.1016/j.ctcp.2014.07.011
  24. McCaffrey T, Cheung PS, Barry M, Punch P, Dore L. The role and outcomes of music listening for women in childbirth: an integrative review. Midwifery. 2020;83:102627. https://doi.org/10.1016/j.midw.2020.102627
  25. Chang MY, Chen CH, Huang KF. Effects of music therapy on psychological health of women during pregnancy. J Clin Nurs. 2008;17(19):2580-2587. https://doi.org/10.1111/j.1365-2702.2007.02064.x
  26. Des Jarlais DC, Lyles C, Crepaz N; TREND Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health. 2004;94(3):361-366. https://doi.org/10.2105/ajph.94.3.361
  27. Farrar JT, Troxel AB, Stott C, Duncombe P, Jensen MP. Validity, reliability, and clinical importance of change in a 0-10 numeric rating scale measure of spasticity: a post hoc analysis of a randomized, double-blind, placebo-controlled trial. Clin Ther. 2008;30(5):974-985. https://doi.org/10.1016/j.clinthera.2008.05.011
  28. Marut JS, Mercer RT. Comparison of primiparas' perceptions of vaginal and cesarean births. Nurs Res. 1979;28(5):260-266. https://doi.org/10.1097/00006199-197909000-00002
  29. Kim OK. The effect of back massage on labor pain , labor duration and childbirth experience in women during labor [master's thesis]. Suwon: Ajou University; 2007. 58 p.
  30. Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965. p. 305.
  31. Kwon HS. The impact of prenatal yoga on women's labor pain, labor self-confidence, anxiety, stress and self-esteem [master's thesis]. Daejeon: Daejeon University; 2014. 129 p.
  32. Arya R, Chansoria M, Konanki R, Tiwari DK. Maternal music exposure during pregnancy influences neonatal behaviour: an open-label randomized controlled trial. Int J Pediatr. 2012;2012:901812. https://doi.org/10.1155/2012/901812
  33. Solt Kirca A, Kanza Gul D. The effect of music and skin contact with the newborn on pain and anxiety during episiotomy repair in primiparous women: a double-blind randomized controlled study. Explore (NY). 2022;18(2):210-216. https://doi.org/10.1016/j.explore.2020.11.007
  34. Guo H, Que M, Shen J, Nie Q, Chen Y, Huang Q, Jin A. Effect of music therapy combined with free position delivery on labor pain and birth outcomes. Appl Bionics Biomech. 2022;2022:8963656. https://doi.org/10.1155/2022/8963656
  35. Lee SM. The effects of music therapy on postpartum blues and maternal attachment of puerperal women. J Korean Acad Nurs. 2010;40(1):60-8. https://doi.org/10.4040/jkan.2010.40.1.60
  36. Moon YK. The effect on the mother of holistic eurhythmics music parental education. J holist Converg Edu. 2012;16(1):173-189.
  37. Choi YR. The effects of musical activities on decreasing in anxiety an increasing in self-esteem in unmarried mothers. Korean J Music Ther. 2002;4(2):61-72.