The Effects of Instrumental Marching and Cheerful Music on ...

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ดนตรีจังหวะมาร์ชและจังหวะรื่นเริงในระยะคลอด ศศิธร พุมดวง และคณะstage <strong>of</strong> labor. 21-23 It can reduce fear, increase asense <strong>of</strong> calm, decrease stress, <strong>and</strong> increase theself-control <strong>of</strong> those who hear it. 24 One studyshowed that elderly women in Taiwan who listenedto music for one hour per day for three months,<strong>and</strong> thereafter once every two weeks for a year,reported that the music made them feel stronger,increased their energy level, reduced their feelings<strong>of</strong> suffering, gave them greater motivationto exercise, confirmed their personal feelings <strong>of</strong>worth, <strong>and</strong> gave them greater life satisfaction. 25It is important to study which methodscan be used to reduce a woman’s fear, increaseher sense <strong>of</strong> power, <strong>and</strong> aid her in relaxingduring second-stage labor. Lessening the time<strong>of</strong> second-stage labor is also a goal. From aliterature review on such methods used duringsecond-stage labor <strong>and</strong> in other settings, it wasfound that no studies have been conducted inwhich music has been used in an attempt toincrease a laboring woman’s sense <strong>of</strong> power <strong>and</strong>self-control, <strong>and</strong> lower her fear <strong>of</strong> childbirth.Thus, a pilot study was conducted in whichseven women in second-stage labor listened toinstrumental music-mainly marching songs <strong>and</strong>cheerful melodies. <strong>The</strong> results showed that thewomen had a greater sense <strong>of</strong> power (71.4%), hadmore power in bearing down (71.4%), <strong>and</strong> had alower fear <strong>of</strong> childbirth. <strong>The</strong>se women reportedthat the music was useful <strong>and</strong> helped them torelax. Thus, it is important to study the effects <strong>of</strong>marching songs <strong>and</strong> cheerful music on both theduration <strong>of</strong> second-stage labor <strong>and</strong> on the sense<strong>of</strong> power, self-control, <strong>and</strong> fear <strong>of</strong> childbirththat women in the second stage <strong>of</strong> labor have.Material <strong>and</strong> methodsDesignThis r<strong>and</strong>omized, controlled trial examinedthe effects <strong>of</strong> marching songs <strong>and</strong> cheerful musicon second-stage labor duration <strong>and</strong> on thewomen’s sense <strong>of</strong> power, self-control, <strong>and</strong> fear <strong>of</strong>childbirth.Instruments<strong>Music</strong><strong>The</strong> first set <strong>of</strong> music consisted <strong>of</strong>instrumental marching music: 1) the U.S.national anthem, “<strong>The</strong> Star-Spangled Banner”(114 beats/min); 2) the “Marines’ Hymn” (106beats/min); 3) “<strong>The</strong> U.S. Field Artillery March”(119 beats/min); <strong>and</strong> 4) “<strong>The</strong> Stars <strong>and</strong> StripesForever” (113 beats/min). <strong>The</strong> latter two werecomposed by John Phillip Sousa. This wasfollowed by cheerful instrumental music from“<strong>The</strong> Four Seasons” <strong>and</strong> other works byVivaldi: 1) Spring Concerto No. 1 in E major(109 beats /min); 2) Summer Concerto No. 2 inG minor (107 beats/min); 3) Oboe Concerto inC major (100 beats/min); <strong>and</strong> 4) Piano Concertoin C Major (78 beats/min). It was hypothesizedthat initially the marching rhythm would helpto stimulate the laboring women; this was tobe followed by cheerful music which wouldhelp the mother to relax after giving birth. <strong>The</strong>duration <strong>of</strong> the music was 30 minutes <strong>and</strong> had torepeat after using for 30 minutes if the womenwere still in second-stage labor. <strong>The</strong> music waschosen by the principal investigator <strong>and</strong> themusician, <strong>and</strong> was pre-tested in a pilot studybefore being employed in the present study.166ส§¢ÅÒ¹¤ÃÔ¹·Ã์àÇªสÒÃ »‚·Õè 29 ฉบับที่ 4 ก.ค.-ส.ค. 2554
<strong>Marching</strong> <strong>Music</strong> <strong>and</strong> <strong>Cheerful</strong> <strong>Music</strong> During ChildbirthPhumdoung S, et al.Sample <strong>and</strong> data collectionSample<strong>The</strong> sample was comprised <strong>of</strong> bothprimiparous <strong>and</strong> multiparous women in aregional hospital. Because <strong>of</strong> the positive results<strong>of</strong> the pilot study, a high effect size wasexpected; thus, an effect size <strong>of</strong> 0.60-0.70, with apower <strong>of</strong> 0.80, was used to calculate the samplesize, based on a table (page 91) in Lipsey. 26<strong>The</strong> calculated sample size was 25-35 subjectsin each group. However, this study involved67 primiparous women (music 32, control 35)<strong>and</strong> 78 multiparous women (music 38, control40). <strong>The</strong> inclusion criteria for the sample werethe following: being female, married, <strong>and</strong> aged18-35 years; having a gestational age <strong>of</strong> 38-42weeks; having a fetus with a heart rate rangingfrom 120-160 beats/min; having a fetus with anestimated weight <strong>of</strong> 2,500-4,000 grams; beingin the latent phase for no more than 20 hours;having no health complications; <strong>and</strong> havingbegun to receive antenatal care no later thansometime during the second trimester. Amongthe multiparous women, the maximum parity(number <strong>of</strong> births) was three. Purposive samplingwas initially used to recruit the subjects; thenurse screened for laboring women who metthe criteria, <strong>and</strong> then asked them for permissionto let a research assistant ask them to participatein the study. <strong>The</strong> assistant informed them aboutthe study <strong>and</strong> their rights as human subjects.<strong>The</strong>n, subjects were assigned into groups bymeans <strong>of</strong> a r<strong>and</strong>om block design: 1) primiparouswomen were assigned to the music group,2) primiparous women were assigned to thecontrol group, 3) multiparous women wereassigned to the music group, <strong>and</strong> 4) multiparouswomen were assigned to the control group.<strong>The</strong> study was conducted during thewomen’s second stage <strong>of</strong> labor. <strong>The</strong> researchassistant arranged for the participants in themusic group to listen to music in the laborroom throughout their second-stage labor. <strong>The</strong>research assistant stayed with each wom<strong>and</strong>uring labor to control for social desirability.Data collectionDemographic, obstetric, <strong>and</strong> infant datawere collected from the participants’ charts. <strong>The</strong>duration <strong>of</strong> each woman’s second-stage labor wascollected from the labor records <strong>of</strong> the nurses.<strong>The</strong> women’s sense <strong>of</strong> power, self-control, <strong>and</strong>fear <strong>of</strong> childbirth was measured by the researchassistant, using 100 mm visual analogue scales.<strong>The</strong> VAS consisted <strong>of</strong> horizontal lines, each 100mm in length. <strong>The</strong> line measuring sense <strong>of</strong> powerwas anchored on the left side with the mostnegative phrase, “Not having power at all.” Onthe right was the most positive phrase, “Havingthe most power.” For self-control, the left sidehad the phrase, “Not having self-control at all,”<strong>and</strong> the phrase on the right side was, “Havingthe most self-control.” For fear <strong>of</strong> childbirth, theleft phrase read, “No fear <strong>of</strong> childbirth at all,”<strong>and</strong> the right phrase read, “<strong>The</strong> most fear <strong>of</strong>childbirth.” Each participant was asked to place aslash mark (/) on the perspective line indicatingher perception. <strong>The</strong> visual analogue scale is asingle item which has a high validity <strong>and</strong> reliability,similar to multiple-item measurement. 27 <strong>The</strong>Songkla Med J Vol. 29 No. 4 Jul-Aug 2011 167
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