• Neonatal Medicine
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• v.17 no.2
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• pp.224-231
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• 2010

Purpose: Hospital readmissions have recently increased due to early hospital discharge and increased trends in breast-feeding. Neonatal hyperbilirubinemia can lead to fatal permanent neurological sequelae without appropriate management. Early detection and intervention are critical. We evaluated the clinical features, risk factors, and brain MRI findings of Korean newborns with idiopathic nonhemolytic hyperbilirubinemia to determine the optimal management policy. Methods: A retrospective review of the medical records of 79 newborns with idiopathic nonhemolytic hyperbilirubinemia was performed at the NICU of the Kyungpook National University Hospital from January 2006 to September 2009. All patients were 35 or more weeks of gestation, and their peak level of serum total bilirubin was more than 20 mg/dL. Results: The mean gestational age was $38^{+3}{\pm}1^{+4}$ weeks, and the mean age on admission was 8.8$\pm$4.0 days. The mean body weight (3,105$\pm$479 g) was decreased by 2.8$\pm$6.4 percent compared to the mean birth weight (3,174$\pm$406 g). There were no statistically significant differences for the peak serum bilirubin level or the duration and effects of phototherapy between the patients with and without risk factors, which included: breastfeeding, cephalohematoma, subdural hemorrhage, and/or ABO incompatibility. Patients were grouped according to change of body weight. Group I consisted of patients that gained weight compared to birth weight, and group II of patients that lost weight compared to birth weight. There were significant differences in the peak serum total bilirubin level between the two groups. Thirty nine patients had brain MRI evaluation; 21 patients had bilateral symmetric signal intensity increases in the globus pallidus compared to adjacent corticospinal tract and putamen on T1-weighted images. Conclusion: Bilirubin encephalopathy is preventable with early screening and proper management. Parents require instruction on feeding practices and follow-up to prevent complications from idiopathic nonhemolytic hyperbilirubinemia.

• Journal of Korean Academy of Nursing
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• v.20 no.2
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• pp.153-173
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• 1990

One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p＝0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p＝0.000) but no differences for labor or the bady according to the delivery method(p＝0.096, p＝0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p＝0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p＝0.042), 2nd day (p＝0.009), and the 3rd day(p＝0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F＝.3206, p＝.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r＝.4363, p＝.000, r＝.2881, p＝.012). No correlations between perceptions of labor and maternal-infant interaction were found(p＝0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p＝0.000) and from the fourth to sixth weeks after birth(P＝0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p＝0.002) and breast feeding(p＝0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p＝0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p＝0.010), a wanted pregnancy (P＝0.030) and her confidence in her role as a mother(p＝0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

• Women's Health Nursing
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• v.6 no.1
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• pp.142-152
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• 2000

This study is a descriptive study to offer an actual basic data as Nursing intervention strategy of nurses before delivery in order that pregnant women in Korea may effectively practice Taekyo by examining the relation after apprehending level of recognition and practice of our pregnant women about Taekyo. This study collected questionnaires from 801 pregnant women who visited general hospitals in 10 areas(Seoul, Daejon, chunan, Daegu, Kummi, $Ky{\check{o}}ngju$, $P{\ddot{o}}hang$, Busan, $J{\ddot{o}}nju$, and $Y{\ddot{o}}nkwang$) for prenatal care through an outpatient obstetrics and gynecology from July 15 to August 30, 1999. This study used the tool of lee, Ki Young(1993) revised an complemented by investigator to measure recognition of Taekyo and the tool of Jang, Shun Buk and Park, Young Ju(1996) revised and complemented by investigator to measure practice of Taekyo. The Cronbach's alpha value of each tool was .88 in recognition of Taekyo, while the value was .90 in practice of Taekyo. For data analysis, this study used the descriptive and statistical analysis, Pearson correlation, t-test, ANOVA, Tukey's post hoc contrast, and Stepwise multiple regression in accordance with the purpose of this study with using SPSS Win 7.5 program. The results were as follows ; 1. The practice of Taekyo was low in comparison with recognition of Teakyo by showing average 4.28 points and standard deviation 0.48 at level of recognition of pregnant women about Taekyo on the basis of 5 points and showing to show average 2.81 points and standard deviation 0.36 at practice level on the basis of 4 points. 2. They showed the higher level of recognition on Taekyo at high educational background of pregnant woman(F=3.735, p=.005), Roman catholicism (F=4.570, p=.002), satisfied married life(F=5.448, p=.004), high monthly income(F=6.096, p=.000) and cases of hoping pregnancy(F=2.525, p=.012). 3. They showed the higher level of practice on Taekyo at high educational background of pregnant woman(F=2.883, P=.022), Roman catholicism(F=3.616, p=.032), satisfied married life(F=19.924, p=.000), good health condition(F=2.386, p=.017), cases of hoping pregnancy(F=0.677, p=.000), cases of planning pregnancy with husband(F=3.024, p=.001), cases of regular prenatal care before delivery(F=0.241, p=.005), cases of maternal breast feeding (F=9.132, p=.000), and the number of less children(F=2.763, p=.041). 4. In result of examining correlation between recognition and practice of Taekyo, they showed high level of practice on Taekyo under high level of recognition of pregnant women on Taekyo by showing the statistically significant correlation. 5. In result of examining the related factors that affect recognition and practice of Taekyo y the object, practice of Taekyo had 16.8 percents of explanatory range, purpose of practicing Taekyo 8.5 percents of explanatory range, and monthly income 1.9 percent of explanatory range as variables of affecting recognition of Taekyo. The total explanatory range was 27.2 percents, Recognition of Taekyo had 16.1 percents of explanatory ragne, time of starting Taekyo 3.2 percents, health condition 2.2 percents of explanatory range, condition of hoping pregnancy 1.1 percent of explanatory range, satisfaction of married life 0.8 percent of explanatory range, and religion 0.6 percent of explanatory range as variables of affecting practice of Taekyo. The total explanatory range was 24.0 percents.