• 가정간호학회지
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• 제8권1호
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• pp.5-24
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• 2001

The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

• 대한간호학회지
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• 제22권3호
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• pp.237-388
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• 1992

This study was done to identify the degree of congruence between nurses and patients on patients' health problems. The purposes of this study were 1. To compare the health problems of parturient women as identified by interview and in the nursing record. 2. To compare the health problems of patients who have had gynecological surgery as identified by interview and in the nursing record. 3. To compare the health problems of chemotherapy patients as identified by interview and in the nursing record. The design of this study was a comparative descriptive design. The subjects were 205 Obstetric-Gynecologic patients. The tool for this study was an 11 item questionnaire, including one open ended question on the patient's problem during the past one day. Data was collected through interviews and an audit of the nursing records during the period from March 22, 1992 to April 29, 1992. Data was analyzed using by frequencies and percentiles. The result of this study were summarized as follows : Pain was the most prevalent complaint for parturient women by interview(60.3% ) and from the nursing records(83.2%). There was no record in the nursing records about the complaints of lack of information and emotional problems even though there were complaints of communication problems (17.6%) and of emotional problems(3.5%) identified in the interviews but there were more records of cardiopulmonary problems in nurses record(9.1%) than the patient interviews (3.3%). In the nursing records 25.9% of the identified records identified pain problems compared with 23.3% in the interviews. In the nursing records, 22.3% of the records identified nutrition problem as compared with 18.2% in the interview. There were only a very few emotional problem identified in the nursing records (3.7%) as compared to 18.2% in the interviews. There were no comments about communication problems in the nursing records but 5.2% of the subjects mentioned of communication problems in the patient interview. There were problems in five categories for the parturient women ; comfort, communication, activity and rest, elimination, emotions, and there were problems in ten categories for the surgery patients : comfort, elimination, communication, emotions, nutrition, cardiopulmonary, thermoregulation, physical integrity, host defense and activity /rest. There were also problems in the same ten categories for chemotherapy Patients. On the other hand, in the nursing records, only comfort activity /rest, and elimination problems were identified for the parturient women, there were only seven categories of problems : comfort, elimination, cardiopulmonary, activity /rest, and nutrition for the gynecology surgical patients, and for the chemotherapy Patients, comfort, nutrition, physical integrity, cardiopulmonary, activity /rest, thermoregulation, emotion and elimination were the categories identified, and no communication problems were identified. It was found that there was low congruence between the patients' problems as identified through patient interview and as recorded in the nursing records. Therefore it can be concluded that the main content of the nursing records is the physical problems of the patients and this is not in congruence with the patients' reported problems in the emotional and communication domain.

• Child Health Nursing Research
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• 제5권1호
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• pp.70-83
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• 1999

The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

• Child Health Nursing Research
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• 제16권2호
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• pp.144-155
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• 2010

Purpose: This study was done to develop and test a home-based discharge program. Methods: The study design was a pretest-posttest nonequivalent nonsynchronized quasi-experimental design. Participants were mothers of premature infants on oxygen therapy at home. The participants, 49 mothers, were assigned to either the experimental group (24) or control group (25). Data collection was conducted from September, 2008 through February, 2009. Maternal confidence and anxiety were measured using a questionnaire. Chi-square test, t-test and Repeated Measures ANOVA were used to analysis the data. Results: Two hypotheses, "Maternal confidence in the experimental group will be higher than that of the control group" and "Perceived anxiety level in the experimental group will be lower than that of the control group", were set up and both hypotheses were supported as there was a statistically significant difference between the two groups. Conclusion: It suggests that the discharge program developed in this study is an efficient intervention method to boost maternal confidence of the mothers with premature infants and to decrease their anxiety; therefore, this program is expected to be of use in nursing interventions.

• Perspectives in Nursing Science
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• 제11권1호
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• pp.63-73
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• 2014

Purpose: This study examine the effects of music therapy and phone counseling on postpartum depression and maternal identity in high risk women. Methods: A nonequivalent control group time series research design was employed. Eighteen women comprised the experimental group and seventeen women, the control group. Experimental group received 4 weeks of music therapy and phone counseling. Postpartum depression and maternal identity were measured prior to intervention and on the 1st, 2nd, and 4th weeks after its introduction. Results: The first hypothesis (i.e., "the degree of postpartum depression would be lower in the experimental group than in the control group in a month's time") was not supported (z=-0.47, p=.641). The second hypothesis (i.e., "the degree of maternal identity would be lower in the experimental group than in the control group in a month") was not supported as well (z=1.08, p=.285). Conclusion: There is the need to monitor long-term effects of music therapy and phone counseling on high risk postpartum women, beyond 4 weeks observed in this study. Additionally, the development of music therapy tailored to high risk individuals and systematic phone counseling protocols for postpartum depression is required.

• 한국콘텐츠학회논문지
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• 제19권3호
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• pp.649-658
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• 2019

본 연구의 목적은 국내에서 수행된 산후우울 중재프로그램의 현황을 파악하고 효과를 알아보기 위함이다. 2018년 11월까지 보고된 국내 학술지 논문 중, 13편의 실험연구를 선별하여 최종 분석에 사용하였다. 연구대상자의 평균 연령은 26.9~34.4세로, 산모 또는 산모와 배우자를 대상으로 하였다. 표본크기는 실험군 6~39명 (평균 20.4), 대조군 5~40명 (평균 20.0)이었고, 중재프로그램의 구성은 0.5~12주/2~14회기/1회 당10~120분으로 이루어졌다. 모든 연구의 설계는 비동등성 대조군전후실험설계였다. 주요 종속변수인 산후우울, 피로도, 모성역할자신감은 메타분석 결과 모두 통계적으로 유의미한 중간 수준 이상의 효과크기를 가지는 것으로 확인되었다. 본 연구는 국내에서 산후우울을 중재하기 사용되는 다양한 실험연구들의 구성과 효과를 확인하였다. 이는 최적의 산후우울 중재프로그램을 구성하기 위한 구체적인 근거기반자료로 활용될 수 있을 것이다.

• 농촌의학ㆍ지역보건
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• 제37권2호
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• pp.67-75
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• 2012

최근, 정부차원의 공공보건의료 개선을 위한 노력이 진행 중이지만 실제 의사, 간호사, 보건직등 의료기관 종사자들의 공공보건의료에 대한 역할의 필요성에 대한 인식과 책임감에 대한 조사는 부족한 실정이며 성공적인 공공보건의료의 역할 수행을 위해서는 모든 의료 종사자들의 역할 인식과 직종간의 유기적인 협력이 필요하다. 이에 일개 국립병원 의료 종사자들을 대상으로 공공보건의료에 대한 역할 인식과 기능수행에 대한 조사를 시행하였다. 일개 국립대학병원 직원을 직종별로 20%를 무작위 추출하여 323명을 대상으로 설문 조사를 시행하였다. 의사직 103명(38.9%), 간호직 98명(37.0%), 기타직 64명(24.1%) 등 총 265명(80.2%)이 참여하였다. 의료 종사자들은 공공보건의료시책의 수립 시행 및 평가 지원사업, 국가 또는 지방자치단체의 보건의료 활동에의 참여 및 지원사업, 민간보건의료기관에 대한 기술지원 및 교육사업, 취약계층에 대한 보건의료, 노인, 장애인, 정신 질환자 등 타 분야와의 연계가 필수적인 보건의료, 아동과 모성에 대한 보건의료 등 공공보건의료의 필수적인 6가지 항목에 대하여 공공보건의료 기관으로서의 역할 인식이 부족하였다. 반면 주요 질병관리사업, 공공보건의료에 관한 전문적인 연구 및 검사사업, 보건의료인의 교육훈련사업, 전염병 예방 및 관리, 응급환자의 진료, 민간보건의료기관이 담당하기 어려운 예방보건의료 등 6 가지 항목에 대해서는 중요하게 인식하고 있었다. 대체적으로 보건의료기관 종사자의 공공보건의료기관으로서 역할과 책임의식에 대한 인식이 부족하며 앞으로 공공병원의 공공성 강화를 위하여 공공보건의료 전담인력 확보와 계획적인 공공보건사업에 대한 교육이 필요할 것으로 사료된다.