어머니-영아 안정애착 형성을 위한 예방부모교육프로그램 실시 효과
Effect of Preventive Parenting Program for Mother-Infant secure attachment
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본 연구는 산모들을 대상으로 출산 후 자녀들이 생애 초기의 중요한 발달 과업인 안정애착을 형성하도록 도와주고 애착 문제가 발생하는 것을 예방해줄 수 있는 예방부모교육 프로그램을 산모들에게 실시하고 그 효과를 검증하는 데 목적이 있다. 어머니-영아 안정 애착 형성을 위한 예방 부모교육 프로그램은 임상 장면에서 애착 장애 및 애착 장해 아동들의 어머니들을 대상으로 사용 중인 부모 교육프로그램을 수정, 보완하였다. 이 예방 부모교육 프로그램을 위험군의 산모들을 대상으로 8회기에 걸쳐 실시하였다. 프로그램의 효과를 알아보기 위한 사후 평가는 산모들이 출산 후 자녀가 생후 6개월 되었을 때 이루어졌으며, 예방부모교육 참여집단과 비참여집단 간의 어머니의 영아에 대한 내적표상, 어머니-영아 상호작용에서의 민감성, 어머니의 우울, 불안, 결혼 만족도, 양육 스트레스, 영아의 기질, 영아의 발달 수준을 비교하였다. 결과를 살펴보면 첫째, 예방 부모교육에 참여한 어머니들의 경우 비참여 어머니들에 비해 영아에 대한 내적표상이 유의하게 더 긍정적인 것으로 나타났다. 내적표상의 유형에서도 참여군의 경우 6명의 어머니가 모두 영아에 대해 균형된 표상을 보이는 반면, 비 참여집단 어머니들의 경우 균형된 표상 3명, 비개입된 표상 1명, 왜곡된 표상 1명으로 나타났다. 둘째, 참여집단의 어머니들이 비 참여집단의 어머니들에 비해 영아와 긍정적인 상호작용을 보였는데 내용면에서 침해성이 적었고, 발달적 민감성, 반응성, 민감성 영역에서 비 참여 어머니들에 비해 높게 나타났다. 셋째, 영아들의 기질에서 참여집단 어머니의 영아들이 비 참여집단 어머니의 영아들에 비해 적응성과 주의력이 더 높은 것으로 나타났다. 넷째, 영아의 발달수준을 평가한 결과 참가 집단의 어머니의 영아들이 참가하지 않은 어머니의 영아들에 비해 정신발달이 유의미하게 빠른 것으로 나타났다.
Abstract
This study was to examine the effect of a preventive parenting education program for pregnant women who were at risk for maltreatment. This program is consisted of four parts; 1)education of infant development, 2)improvement of maternal sensitivity in interaction with children, 3)examination of mother's own attachment representation, and 4)establishment of social support to prevent negative effect to parenting. Risk pregnant women were screened by depression, anxiety, marital discord and psychological stress scores. Six women were enrolled in the parenting program which consisted of eight sessions(two hours weekly for 8weeks) of treatment sessions and five women were enrolled as the controls. The post-assessment was performed 6months after the child's birth. The scores of mother's working models of child and the maternal sensitivity were significantly higher in the educated group than the controls. The interaction scores of participant group was significantly higher than that of controls in developmental sensitivity and responsiveness, and lower in intrusiveness. However, there were no significant difference between the participant and control group in the Depression, Marital Adjustment and the Maternal Stress. Infants of participant group showed significantly higher developmental level in Bayley Scale compare to infants of control group. Finally, infants of participant group scored significantly higher in adjustment and attention in temperament scale than the control group. These results supported the effectiveness of the Parenting Education Program in preventing maltreatment and in improving secure attachment.
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