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산후초기 유두·유륜 신전성과 착유용이도에 따른 유두통증 및 모유수유 실천

Other Titles
 Impact of nipple and areola extensibility and ease of milk extraction during early postpartum period on nipple pain and conti 
Authors
 주진옥 
Issue Date
2008
Description
간호학교육 전공/석사
Abstract
[한글]

본 연구는 초산모의 유방을 사정하여 유두?유륜 신전성과 착유용이도를 조사하여 대상자의 분포를 파악해보고 대상자의 유두·유륜 특성이 유두통증과 모유수유 실천에 미치는 영향을 비교하여 향후 유두·유륜 특성에 따라 간호중재 전략개발의 기초 자료를 제공하고자 시행하였다.

본 연구의 설계는 서술적 조사연구로 대상자는 선정 기준에 적합한 초산모로서 서울지역에 소재한 일개 여성전문 병원에서 분만하고 산후조리장소를 산후조리원을 이용하지 않은 123명을 대상을 하였으며 자료수집기간은 2007년 7월에서 9월까지였다.

연구도구는 일반적 특성 7문항, 모유수유 관련특성 7문항으로 구성된 설문지를 이용하였고, 유두·유륜 신전성과 착유용이도를 측정하였으며 모유수유 실천은 WHO의 모유수유 정도에 따른 영아 영양분류체계(Helsing, 1985)를 이용하여 분만 후 2주와 4주에 연구자와 연구보조자가 전화 조사하여 자료를 수집하였다.

자료분석은 SPSS WIN 15.0 통계프로그램을 이용하여 실수와 백분율, Chi-square 로 분석하였다.



본 연구의 결과는 다음과 같다.

1. 유두·유륜 신전성에 따른 대상자의 분포는 2.5-3.0cm(고려) 그룹이 가장 많 았고(52.8%), 2.5cm 미만(요주의) 그룹은 매우 적었다(7.4%).

2. 착유용이도에 따른 분포는 1.2cm 미만(양호) 그룹이 많았으며(62.4%), 1.2cm 이상(고려) 그룹(37.4%)이 적었다.

3. 모유수유실천은 2주, 4주에 높았으며(70.7%, 61%) 중단율은 기존 연구와 유사하였고 분유수유율 만 비교했을 때는 본 연구가 현격한 차이로 적었다 (3%-7%). 또한 2주와 4주의 모유수유율은 큰 차이가 없어 모유수유 실천에 있어 산후 2주가 중요한 기간임을 알 수 있었다.

4. 유두·유륜 신전성에 따른 모유수유 실천은 2주, 4주에 3.0cm 이상(양호)그 룹에서 가장 높았으며(83.7%, 75.5%) 신전 길이가 짧을수록 모유수유 실천 이 낮아졌고 이는 통계적으로 유의하였다(p=0.033*, p=0.013*).

5. 착유용이도에 따른 모유수유 실천은 2주, 4주에 1.2cm 미만(양호)그룹이 1.2cm 이상(고려)보다 실천이 높았으나(76.7%, 66.2%) 통계적으로 유의 하 지는 않았다.

6. 유두·유륜 신전성과 착유용이도 두 가지 조건을 가진 대상자 분포는 신전 성 3.0cm 이상 & 착유용이도 1.2cm 미만의 양호그룹이 가장 많았으며 (32.5%), 신전성 2.5cm 미만 & 착유용이도 1.2cm 미만그룹의 분포가 가장 적었다(1.6%).

7. 유두·유륜 신전성과 착유용이도를 고려와 양호조건의 두 그룹 으로 세분화 하였을 때 신전성 3.0cm 이상 & 착유용이도 1.2cm 미만(양호) 그룹은 2주, 4주 모유수유율이 높았으나(85%, 75%), 반대로 신전성 3.0cm 미만 & 착유 용이도 1.2cm이상 (고려)그룹은 2주, 4주에 모유수유율이 낮았으며(63.9%, 54.2%) 이는 통계적으로 유의하였다(p=0.016, p=0.027).

8. 유두·유륜 신전성과 착유용이도에 따른 모유수유 시 유두통증 경험은 2주 에 신전 길이가 짧을수록 통증을 많이 경험하고 있었으나 통계적으로 유의 하지는 않았다. 착유용이도는 2주, 4주에 상반된 결과를 보여 유두통증에 영 향요인은 아님을 알 수 있었다.

9. 일반적 특성과 모유수유 관련특성에 따른 모유수유 실천은 2주에 연령 (p=0.016)과 직업(p=0.012), 4주는 모자동실경험에서 높았으며 이는 통계적 으로 유의한 차이가 있었다(p=0.014).

10. 모유수유 중단 요인은 2주, 4주 모두 모유량 부족(57.9%, 65.7%)과 아기가 젖을 빨지 않음(31.5%, 28.3%), 유두 동통과 울혈 순으로 조사되었다.



이상의 연구결과를 종합해 볼 때 산후 초기 유두?유륜 신전성과 착유용이도는 유두통증과 모유수유 실천에 유의한 관계가 있음을 알 수 있었다. 따라서 산후 초기 모유수유 시 산모의 유두·유륜 신전성과 착유용이도는 우선적으로 사정되어져야 하며, 향후 임상에서 쉽게 적용할 수 있는 유두·유륜 신전성과 착유용이도를 증진시킬 수 있는 프로그램이 개발되어져야 할 것이다





[영문]This study was conducted to identify the effects of characteristics of areola and nipple on nipple pain and continuation of breast-feeding and to provide basic data for the development of nursing care strategies according to the characteristics areola and nipple. The breasts of first-time mothers were assessed and the extensibility of the areola and nipple and the ease of breast feeding were examined to determine the distribution and compare the effects between groups.



This study was a descriptive research and the participants were 123 primiparous mothers who had deliveries at one women's specialty hospital in Seoul and did not use a postpartum care institution. The data were collected from July to September 2007.



The mothers were surveyed immediately after delivery using questionnaires for collection of data on general and breast-feeding-related characteristics. Areola and nipple extensibility and ease of milk extraction were measured by a research assistant before the first breast-feeding and data on breast-feeding continuation were collected by telephone interview conducted at 2 weeks and 4 weeks after delivery by the researcher and an assistant.



Collected data were analyzed using SPSS WIN 15.0 and expressed as actual numbers, percentage, Chi-square.



The results are as follows:

The highest level for distribution of areola and nipple extensibility of the mothers was 2.5 cm-3.0 cm (average level, 52.8%) and the lowest less than 2.5 cm (poor, 7.4%).

The highest level for distribution of ease of milk extraction was in the group under 1.2 cm (good, 62.4%) and the lowest in the group above 1.2 cm (average, 37.4%).

The highest rate for continuation of breast-feeding at week 2 was 70.7% and at week 4, 61.0%, and discontinuation rates were similar to existing research. The feeding rates for powdered milk were significantly low in this study (3%-7%). Continuation rates between week 2 and week 4 showed no significant differences and this suggests that 2 weeks after delivery is an important period for continuation of breast-feeding .

Rate for continuation of breast-feeding according to areola and nipple extensibility were the highest in the group above 3.0 cm (good) both at week 2 and week 4 (83.7%, 75.5%, respectively). Shorter extensibility lengths were statistically significantly related to lower rates for continuation of breast-feeding (p=0.033*, p=0.013*)

Rate for continuation of breast-feeding according to ease of milk extraction at week 2 and week 4 were higher in the group under 1.2 cm (good, 76.7%) compared to the group with greater than 1.2 cm (average, 66.2%), but the difference was not significant.

Distribution of the participants based on both areola and nipple extensibility and ease of milk extraction criteria were the highest in the group (good, 32.5%), with 3.0 cm or more of extensibility and 1.2 cm or less of ease of milk extraction and lowest in the group (1.6%) with 2.5 cm or more of extensibility and 1.2 cm or less of ease of milk extraction.

When participants were divided into two groups according to both areola and nipple extensibility and ease of milk extraction criteria, breast-feeding continuation rates were higher in the group with 3.0 cm or more of extensibility and 1.2 cm or less of ease of milk extraction (good) at week 2 and week 4 (85.0%, 75.0%, respectively) compared to their counterparts (average, 63.9%, 54.2%, respectively). The result were statistically significant (p=0.016, p=0.027).

Nipple pain at week 2 and week 4 was more often accompanied by shorter extension lengths, but this results was not statistically significant. However, ease of milk extraction showed the opposite results at week 2 and week 4, therefore ease of milk extraction is not a factor influencing nipple pain.

In terms of general and breast-feeding characteristics, rates for continuation of breast-feeding were high in the lower age group (p=0.016) and in the with an occupation (p=0.012) at week 2. Participants who experienced rooming-in had a significantly higher continuation rate at week 4 (p=0.014).

Factors influencing breast-feeding discontinuation both at week 2 and week 4 were shown to be milk insufficiency (57.9%, 65.7%, respectively), babies not sucking breasts (31.5%, 28.3%, respectively), nipple pain and blood congestion in that order.



In conclusion, areola and nipple extensibility and ease of milk extraction in the early postpartum period were highly related to nipple pain and continuation of breast-feeding. These findings suggest that areola and nipple extensibility and ease of milk extraction in mothers should be assessed immediately after delivery and programs to improve these two factors should be developed
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3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 2. Thesis
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/137161
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