DOI QR코드

DOI QR Code

Effects of Kangaroo Care on Physical Development and Adaptation of External Environment of Prematurity, and Maternal Role Confidence who Delivered Premature Infants

캥거루식 접촉이 미숙아 신체발달과 외부환경 적응 및 어머니의 역할수행 자신감에 미치는 효과

  • Received : 2016.08.23
  • Accepted : 2016.12.08
  • Published : 2016.12.31

Abstract

This study aimed to investigate the effect of kangaroo care on physical development adaptation of external environment of prematurity, and maternal role confidence of those who delivered preterm infants. The subjects were 38 preterm infants and mothers with cesarean section delivery in the hospital, located at B city. Eighteen premature infants were assigned to the kangaroo care (KC) group or the control group (CG). Data were collected between June 2013 and June 2015. KC was given 3 times a day (60 min at a time) and performed a total of 10 times. The physical development indicator (weight, height, and head circumference) as well as the adaptation of external environment (temperature, heart rate, oxygenation) of preterm infants were checked before the start of the program. Following the initial measurement, the program was performed, and measurements were taken again at the end of the program. For measurement of maternal role confidence, structured self-reported questionnaires were performed. The results showed that the KC group had a lower oxygenation compared with the CG (t=2.27, p=.02); however, the physical development indicator (weight t=-0.83, p=.21, height t=-0.34, p=.37, head circumference t=1.29, p=.10) and maternal role confidence (t=-0.41, p=.34) were not significantly compared with the CG. The results of this study suggest that the practice of KC helps the adaptation of external environment of preterm infants

본 연구는 신생아 중환자실에 입원한 미숙아를 대상으로 캥거루식 접촉이 미숙아의 신체발달, 외부환경 적응, 어머니의 역할수행 자신감에 미치는 효과를 파악하기 위해 시도되었다. 연구대상은 B광역시에 소재한 1개 종합병원에서 제왕절개분만을 한 미숙아와 미숙아 어머니로서 캥거루식 접촉을 시행 한 실험군 19명과 캥거루식 접촉을 하지 않은 대조군 19명이다. 자료수집기간은 2013년 6월 1일부터 2015년 6월 30일까지이며, 실험군에게 캥거루식 접촉을 하루 3회(1회 60분), 총 10회를 실시하였다. 미숙아의 신체발달(체중, 신장, 머리둘레)과 외부환경 적응(체온, 심박동수, 산소포화도)을 캥거루식 접촉 전에 측정하였고, 중재를 제공한 후 다시 측정하였다. 어머니 역할수행 자신감은 자가보고식 설문지로 측정하였다. 연구결과 캥거루식 접촉을 시행한 실험군과 접촉을 시행하지 않은 대조군 간의 차이에서 미숙아의 신체발달은 통계적으로 유의한 차이가 없었으며(체중 t=-0.83, p=.21 신장 t=-0.34, p=.37, 머리둘레 t=1.29, p=.10), 외부환경 적응에서 산소포화도가 유의한 차이가 있었다(t=2.27, p=.02). 미숙아 어머니의 역할수행 자신감은 유의한 차이가 없었다(t=-0.41, p=.34). 결론적으로 캥거루식 접촉은 미숙아의 외부환경 적응에 효과가 있는 것으로 나타났다.

Keywords

References

  1. Korea National Statistics Office, Birth certificate data, 2015, Retrieved May 26, 2016, http://kostst.go.kr/portal/korea/kor_nw/3/index.board?bmode=read&aSeq=354078
  2. M. C. Mahoney, M. I. Cohen, "Effectiveness of developmental intervention in the neonatal intensive care unit: implications for neonatal physical therapy", Pediatric Physical Theraphy, 7, 3, pp. 194-208, 2005. DOI: http://dx.doi.org/10.1097/01.pep.0000176574.70254.60
  3. M. S. Kim, "The effect of sensory stimulation on body weight and behavioral states of premature infants", Unpublished master thesis, Yonsei University, Seoul, 2000.
  4. Y. M. Ahan, M. R. Kim, "The relationship between early neonatal exposure, and maternal attachment, maternal self-esteem and postpartum depression in the mothers of NICU infants", Journal of Korean Academy of Nursing, 35, 5, pp. 798-809, 2005. https://doi.org/10.4040/jkan.2005.35.5.798
  5. J. G. Long, A. G. Philip, J. F. Lucey, "Excessive handling as a cause of hypoxemia", Pediatrics, 65, pp. 203-207, 1980.
  6. D. Holditch-Davis, T. R. Bartlett, M. Belyea, "Developmental problems and interaction between mothers and prematurely born children", Journal of Pediatric Nursing, 15, pp. 157-167, 2000. DOI: http://dx.doi.org/10.1016/S0882-5963(00)70004-2
  7. World Health Organization, "Kangaroo mother care: A practical guide", [Internet]. Geneva: Dept. of Reproductive Health Research; 2003 [cited 2012 May 5]. Available from: http://www.who.int/maternal_child_adolescent/documents /9241590351/en/
  8. A. Whitelaw, K. Sleath, "Myth of the marsupial mother: Home care of very low birth weigh babies in Bogota. Columbia", Lancet, 1, pp. 1206-1208, 1985. DOI: http://dx.doi.org/10.1016/S0140-6736(85)92877-6
  9. R. P. Bell, J. McGrath, "Implementing a research-based kangaroo care program in the NICU". Nursing Clinics of North America, 31, 2, pp. 387-403, 1996.
  10. N. Charpak, J. G. Ruiz, J. Zupan, Z. Figueroa, R. Tessier et al, "Kangaroo mother care", Australian Journal of Advanced Nursing, 23, 4, pp. 20-26, 2005.
  11. D. Acolet, K. Sleath,, A. Whitelaw, "Oxegenation, heart rate and temperature in very low birth weight infants during skin to skin contact with their mothers", Acta Paediatrica Scandinavica, 78, pp. 189-193, 1989. DOI: http://dx.doi.org/10.1111/j.1651-2227.1989.tb11055.x
  12. R. Feldman, A. I. Eidelman "Skin-to skin contact (Kangaroo Care) accelerates autonomic and neurobehavioural maturation in preterm infants", Development Medical Child Neurology, 45, pp. 274-281, 2003. DOI: http://dx.doi.org/10.1111/j.1469-8749.2003.tb00343.x
  13. R. Tessier, M. Cristo, S. Velez, M. Giro′n, Z. Calume et al., "Kangaroo mother care and the bonding hypothesis", Pediatrics, 102, 2, p.17, 1998. DOI: http://dx.doi.org/10.1542/peds.102.2.e17
  14. A. J. Engler, S. M. Ludington-Hoe, R. M. Cusson, R. Adams, M. Bahnsen, E. Brumbaugh, P. Coates, J. Grieb, L. McHargue, D. L. Ryan, M. Settle, D. Williams, "Kangaroo care: national survey of practice, knowledge, barriers, and perceptions", Maternal Child Nursing, 27, 3, pp. 146-153, 2002. DOI: http://dx.doi.org/10.1097/00005721-200205000-00004
  15. J. H. Lee, K. S. Bang, "The effects of kangaroo care on maternal self-esteem and premature infants", Korean Journal of Women Health Nursing, 17, 5, pp. 454-462, 2011. DOI: http://dx.doi.org/10.4069/kjwhn.2011.17.5.454
  16. Y. I. Moon, H. Y. Koo, "The effects of Kangaru care on anxiety and confidence and gratification of mothering role in mothers of low birth weight infants", Child Health Nursing Research, 6, 3, pp. 281-290, 2000.
  17. H. J. Shin, I. S. Park, "Effect of kangaroo care on mental and motor developmental in premature infant and maternal role confidence", Journal of Korean Society Maternal Child Health, 17, 2, pp. 215-226, 2013. DOI: http://dx.doi.org/10.21896/jksmch.2013.17.2.215
  18. J. H. Lim, G. U. Kim, Y. H. Shin, "Effects for kangaroo care: systematic review & meta analysis", Journal of the Korea Academia-Industrial cooperation Society, 17, 3, pp. 599-610, 2016. DOI: http://dx.doi.org/10.5762/KAIS.2016.17.3.599
  19. J. Cohen, "Statistical power analysis for the behavioral sciences(2nd ed.).", Hillscale, New York: Erlbaum. 1988.
  20. S. B. Lee, H. S. Shin, "Effects of Kangaroo care on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants", Journal of Korean Academy of Nursing, 37, 6, pp. 949-956, 2007. https://doi.org/10.4040/jkan.2007.37.6.949
  21. R. P. Lederman, C. G. Weigarten, E. Lederman, "Postpartum self-evaluation questionnaire, measures of maternal adaptation", Birth Defects Original Article Service, 17, 6, pp. 201-231, 1981.
  22. Y. E. Lee, "An experimental study of the impact of an agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers and enhance their self-confidence and satisfaction in maternal role performance", Unpublished doctoral dissertation, Ehwa University, Seoul, 1991.
  23. M. Y. Jang, "Effects of Kangaroo care on growth in premature infants and on maternal attachment", Journal of Korean Academy Child Health Nursing, 15, 4, pp. 335-342, 2009. DOI: http://dx.doi.org/10.4094/jkachn.2009.15.4.335
  24. A. Whitelaw, G. Heisterkamp, K. Sleath, D. Acolet, M. Richards, "Skin to skin contact for very low birth weight infants and their mothers", Archives of Disease in Childhood, 63, pp. 1377-1381, 1998. DOI: http://dx.doi.org/10.1136/adc.63.11.1377
  25. M. A. Turley, "A meta-analysis of informing mothers concerning the sensory and perceptual capabilities of their infants; the effects on maternal-infant interaction". Maternal Child Nursing Journal, 14, 3, pp 183-197, 1985.
  26. H. Als, G. L, F. H. Duffy, G. B. Mcanulty, R. Gibes-Grossman, J. G. Blickman, "Individualized developmental care for the very low-birht-weight preterm infant. Medical and neurofunctional effects", Journal of the American Medical Association, 272, 11, pp. 853-858, 1994. DOI: http://dx.doi.org/10.1001/jama.272.11.853
  27. H. S. Kim, "The effect of sensory intergration program for low birth weight infant on growth index, behavioral state and physiologic response change", Unpublished master thesis, Ewha Womans University, Seoul, 1996.
  28. H. S. Lim, "Effects of Yakson therapy on growth and stable state of preterm infants and on maternal attachment", Unpublished doctoral dissertation, Korea University, Seoul, 2005.
  29. R. Mori, R. Khanna, D. Pledge, T. Nakayama, "Meta-analysis of physiological effects of skin-to-skin contact for newborns and mothers", Pediatrics International, 52, pp. 161-170, 2010. DOI: http://dx.doi.org/10.1111/j.1442-200X.2009.02909.x
  30. Y. M. Yan, J. H. Kim, "Comparison of maternal self-esteem, postpartal depression, and family function in mothers of normal and of low birth-weight infants", Journal of Korean Academy of Nursing, 33, 5, pp. 580-590, 2003. https://doi.org/10.4040/jkan.2003.33.5.580
  31. K. S. Bang, "Perception of Nurses and Physicians in Neonatal Intensive Care Units on Kangaroo Care", Journal Academic Child Health Nurses, 17, 4, pp. 230-270, 2011. DOI: http://dx.doi.org/10.4094/jkachn.2011.17.4.230