산욕기 산모의 신체적?심리적 산후회복을 위한 림프마사지 프로그램 효과성 검증 = Verification of the Effectiveness of the Lymphatic Massage Program for Physical and Psychological Postpartum Recovery of Postpartum Mothers

다국어 초록 (Multilingual Abstract)

Pregnant mothers go through physical changes due to pregnancy, on top of a variety of physical and psychological changes due to pain in labor and childcare responsibilities after birth, etc. The purpose of this study is to design a lymphatic massage program to facilitate postpartum recovery of mothers and verify the impact of such a program on edema, stress, depressed mood, and fatigue after its execution. For this study, 27 postpartum mothers up to the fourth week after delivery were enrolled, to be grouped into the test group (lymphatic massage) of 14 and the control group (Swedish massage) and receive massage sessions four times a week, for two weeks, with a total of eight sessions of 90 minutes each. The massage programs applied to the test group and the control group were compared for their effects on edema (body weight, extracellular fluid, albumin, and BUN), autonomic nervous systems (sympathetic nervous system activation, parasympathetic nervous system activation, and stress resistance), depression, and fatigue.
The results of this study are as follows:
1. As for the verification of the difference in edema, which is a physical factor of postpartum mothers, before and after applying a lymphatic massage program, a partially significant result was obtained.
1-1. A two-way ANOVA analysis of repeated measurements of the body weight showed only a significant main effect at the time of measurement, while there were no significant differences or interactions between groups. Both the lymphatic massage group and the Swedish massage group lost body weight, but the extent of such a decrease did not differ significantly between the two methods.
1-2. While the main effect on extracellular fluid was not significant in both groups, the interaction effect between the two groups for the time of measurement and the time of measurement*groups was significant. The secretion of extracellular fluid decreased over time in both the lymphatic massage group and the Swedish massage group, but the extent of such a decrease was greater in the lymphatic massage group.
1-3. No significant main effect was observed in either of the two groups in terms of albumin. But the main effect at the time of measurement was significant, indicating a temporary boosting of intravascular circulation volume due to lymphatic massage.
1-4. As for BUN, there was no significant difference between the groups or between the time of measurements. And, none of the interaction effects between the time of measurements and the groups were significant, as well.
2. An analysis of the differences after the lymphatic massage program in terms of the autonomic nervous system, which is a physical factor in postpartum mothers, showed a partially significant result.
2-1. The LF decreased significantly in both the lymphatic massage group and the Swedish massage group after the massages. However, no differences between the groups were observed, and the interaction effect between the time of measurements and groups was not significant, either.
2-2. As for the HF, both groups showed an increase in HF depending on the time of measurement. However, there were no significant differences between the groups, and the interaction effect between the time of measurements and groups was not significant, either.
2-3. In terms of stress resistance (SDNN), the main effect was significant at the time of measurements before and after the massage, and the interaction between the time of measurement and the groups was significant, as well.
3. Depressed mood decreased significantly after the massage, while there were no significant differences between the lymphatic massage group and the Swedish massage group. The interaction effect between the time of measurements and the groups was confirmed to be without statistically significance.
4. As for fatigue, both the lymphatic massage group and the Swedish massage group saw a significant decrease in fatigue levels, but the difference between the groups was not significant. And the interaction between the time of measurements and the groups was not statistically significant.
The findings of this study showed that lymphatic massage could have a more positive effect on the physical factors of postpartum mothers, namely edema and the autonomic nervous system, and the psychological factors of depressed moods and fatigue, compared to Swedish massage, confirming the effectiveness of the lymphatic massage program that could contribute to the health and improvement of the quality of life of postpartum mothers.

Key words: postpartum mother, lymphatic massage, edema, autonomic nervous system, depressed mood, fatigue

목차 (Table of Contents)

• 목 차 ⅰ
• 표 목 차 ⅳ
• 그림목차 ⅵ
• Ⅰ. 서 론 1
• 1. 연구 필요성 1
• 2. 연구의 목적 5
• 3. 연구의 가설 6
• 4. 연구의 제한점 7
• Ⅱ. 이론적 배경 8
• 1. 산욕기 산모의 신체적･심리적 변화와 산후회복 8
• 1) 산욕기와 산후회복의 개념 8
• 2) 산욕기 산모의 신체적 변화와 산후회복 10
• 3) 산욕기 산모의 심리적 변화와 산후회복 12
• 2. 마사지의 개념 및 유형 14
• 1) 림프마사지 14
• 2) 스웨디시 마사지 16
• 3. 마사지와 산후회복의 선행연구 19
• Ⅲ. 연구 방법 21
• 1. 연구절차 및 기간 21
• 2. 연구대상 23
• 3. 측정도구 24
• 1) 부종 24
• 2) 자율신경계 25
• 3) 우울감 26
• 4) 피로도 26
• 4. 신뢰도 검증 28
• 5. 처치 프로그램 29
• 6. 자료 분석 42
• Ⅳ. 연구 결과 43
• 1. 연구대상자의 일반적 특성 43
• 2. 집단간 사전 동질성 검증 45
• 3. 부종에 대한 효과 검증 50
• 4. 자율신경계에 대한 효과 검증 57
• 5. 우울감 및 피로도에 대한 효과 검증 62
• 6. 주요 변인의 변화량 간 상관관계 66
• 7. 가설 검증 68
• Ⅴ. 고 찰 69
• Ⅵ. 결론 및 제언 77
• 1. 결 론 77
• 2. 제 언 80
• 참 고 문 헌 81
• ABSTRACT 95
• 부 록 99
• 감사의 글 104