• Title/Summary/Keyword: Hospital, maternity

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Development of a Prediction Model for Postpartum Depression: Based on the Mediation Effect of Antepartum Depression (산후우울 예측모형 개발: 산전우울의 매개효과 검증을 중심으로)

  • Lee, Eun Joo;Park, Jeong Sook
    • Journal of Korean Academy of Nursing
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    • v.45 no.2
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    • pp.211-220
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    • 2015
  • Purpose: This study was done to develop a prediction model for postpartum depression by verifying the mediation effect of antepartum depression. A hypothesized model was developed based on literature reviews and predictors of postpartum depression by Beck. Methods: Data were collected from 186 pregnant women who had a gestation period of more than 32 weeks and were patients at a maternity hospital, two obstetrics and gynecology specialized hospitals, or the outpatient clinic of K medical center. Data were analysed with descriptive statistics, correlation and exploratory factor analysis using the SPSS/WIN 18.0 and AMOS 18.0 programs. Results: The final modified model had good fit indices. Parenting stress, antepartum depression and postpartum family support had statistically significant effects on postpartum depression, and defined 74.7% of total explained variance of postpartum depression. Antepartum depression had significant mediation effects on postpartum depression from stress in pregnancy and self-esteem. Conclusion: The results of this study suggest that it is important to develop nursing interventions including strategies to reduce parenting stress and improve postpartum family support in order to prevent postpartum depression. Especially, it is necessary to detect and treat antepartum depression early to prevent postpartum depression as antepartum depression can affect postpartum depression by mediating antepartum factors.

Effect of Discharge Education Program for Mothers of Premature Infants on Maternal Role Confidence and Parenting Stress (퇴원교육 프로그램이 미숙아 어머니의 모성역할 자신감, 양육스트레스에 미치는 효과)

  • Kwon, Hee-Kyung;Kwon, Mi-Kyung
    • Child Health Nursing Research
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    • v.13 no.1
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    • pp.58-65
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    • 2007
  • Purpose: The purpose of this study was to examine the effect of a discharge education program on maternal role confidence and parenting stress of mothers who delivered premature infants. The program provided them with information on childrearing and supportive educational nursing care. Method: This study was based on pretest-posttest nonequivalent nonsynchronized quasi-experimental design. The participants in this study were 30 mothers who delivered premature infants at a general hospital in G city. The instruments used in this study were Maternity Confidence Inventory, Parenting Stress Index(PSI). Results: The first hypothesis that the mothers in the experimental group would undergo changes in maternal role confidence after the intervention was accepted, as there was a statistically significant gap between the two groups(F=9.386, P=.000). The second hypothesis that mothers in the experimental group would undergo change in parenting stress after the intervention was accepted, as there was a statistically significant gap between the two groups(F=4.425, P=.380). Conclusion: The findings suggest that the Discharge Education Program was an efficient intervention method to boost the maternal confidence of mothers with premature infants and to decrease their parenting stress.

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Is Axillary Dissection Necessary for Breast Cancer in Old Women? A Meta-analysis of Randomized Clinical Trials

  • Zhang, Pei-Zhen;Chong, Le;Zhao, Ye;Gu, Jing;Tian, Jin-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.947-950
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    • 2013
  • Background: We performed this meta-analysis to assess the effectiveness and safety of axillary dissection in old women. Methods: The Cochrane Library, PubMed, EMBASE and Chinese Biomedical Literature Database were searched and all randomized controlled trials of axillary dissection in old women (at least 60 years old) were considered. Meta-analyses were completed using RevMan5.1. Results: Three eligible randomized controlled trials (RCTs) including 5,337 patients were considered. There was weak evidence in favour of axillary dissection (AD) in old women. The meta-analysis showed that the overall survival (OS) after 1, 3, 5 and 7 years and the disease free survival (DFS) after 1, 3 and 5 year were not statistically significantly different between AD and no AD groups. However, there was a difference in the 7 year DFS. Conclusions: Axillary dissection did not provide survival benefit to the old women with breast cancer analysed. Therefore, axillary dissection is not well-indicated in old women with breast cancer.

Reconstruction of Professional Identity in Clinical Nurses (내러티브를 통한 임상간호사의 간호 정체성)

  • 강현숙;조결자;최남희;김원옥
    • Journal of Korean Academy of Nursing
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    • v.32 no.4
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    • pp.470-481
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    • 2002
  • This study was carried out to identify and re-establish the professional identity in clinical nurses. Method: From Dec. 1999, for 4 months, the study had been conducted by narrative analysis method based on hermeneutic principles. Subjects were ten nurses with 3-4 years of nursing experience at a university hospital. The data were collected and transcribed through narrative interviews. Result: As a result, the maternal role was identified as the most dominant discourse in which nurses formed their identity. Subjects felt that a maternity is socio-culturally needed in case of nursing. Reconstruction of professional identity consists of 3 stages, Telling, Retelling and Rebuilding. At first, nurses felt confused by skeptism of the profession, interpersonal difficulties, and heavy work loads. However, during the interviews, nurses recognized that nursing is not regarded as significant, effort to make nursing meaningful were small, and there was a lack of understanding others. From this new insight, they re-established a new image of nursing ″through better understanding of others, seeking knowledge, and making positive efforts towards qualified nursing". Conclusion: The above narrative interviews may help nurses reflect and contextually interpret themselves, so that a new identity could be established. Furthermore researchers can obtain new insight from the subjects, while the subjects form a new nursing image from self-reflection.tion.

Correlations among Perceptions and Practice of Taegyo and Maternal-Fetal Attachment in Pregnant Women (일 지역 임부의 태교인식, 태교실천 및 모-태아애착 간의 상관관계)

  • Jang, Sang-Youn;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.25 no.4
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    • pp.398-405
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    • 2019
  • Purpose: This study was conducted to examine the relationships among the perceptions and practice of taegyo (a traditional set of practices and beliefs related to healthy fetal development) and maternal-fetal attachment in pregnant women. Methods: The participants were 136 pregnant women who visited a public health center or maternity hospital for prenatal care. The collected data were analyzed using descriptive statistics, the t-test, analysis of varience, and Pearson correlation coefficients with SPSS version 22.0. Results: The mean age of the pregnant women was $32.24{\pm}3.99$ years. The mean scores for perceptions of taegyo, practice of taegyo, and maternal-fetal attachment were $3.96{\pm}0.53$, $3.74{\pm}0.64$, and $3.94{\pm}0.49$, respectively. Perceptions of taegyo were significantly correlated with the practice of taegyo (r=.72, p<.001), and maternal-fetal attachment (r=.55, p<.001). A significant correlation was also found between the practice of taegyo and maternal-fetal attachment (r=.65, p<.001). Conclusion: Perceptions of taegyo affected the practice of taegyo, and had a positive effect on maternal-fetal attachment. These findings suggest that primary care nurses at hospitals and public health centers should provide nursing intervention programs to improve the perceptions of taegyo, the practice of taegyo, and maternal-fetal attachment.

Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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Texture Analysis of Three-Dimensional MRI Images May Differentiate Borderline and Malignant Epithelial Ovarian Tumors

  • Rongping Ye;Shuping Weng;Yueming Li;Chuan Yan;Jianwei Chen;Yuemin Zhu;Liting Wen
    • Korean Journal of Radiology
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    • v.22 no.1
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    • pp.106-117
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    • 2021
  • Objective: To explore the value of magnetic resonance imaging (MRI)-based whole tumor texture analysis in differentiating borderline epithelial ovarian tumors (BEOTs) from FIGO stage I/II malignant epithelial ovarian tumors (MEOTs). Materials and Methods: A total of 88 patients with histopathologically confirmed ovarian epithelial tumors after surgical resection, including 30 BEOT and 58 MEOT patients, were divided into a training group (n = 62) and a test group (n = 26). The clinical and conventional MRI features were retrospectively reviewed. The texture features of tumors, based on T2-weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging, were extracted using MaZda software and the three top weighted texture features were selected by using the Random Forest algorithm. A non-texture logistic regression model in the training group was built to include those clinical and conventional MRI variables with p value < 0.10. Subsequently, a combined model integrating non-texture information and texture features was built for the training group. The model, evaluated using patients in the training group, was then applied to patients in the test group. Finally, receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of the models. Results: The combined model showed superior performance in categorizing BEOTs and MEOTs (sensitivity, 92.5%; specificity, 86.4%; accuracy, 90.3%; area under the ROC curve [AUC], 0.962) than the non-texture model (sensitivity, 78.3%; specificity, 84.6%; accuracy, 82.3%; AUC, 0.818). The AUCs were statistically different (p value = 0.038). In the test group, the AUCs, sensitivity, specificity, and accuracy were 0.840, 73.3%, 90.1%, and 80.8% when the non-texture model was used and 0.896, 75.0%, 94.0%, and 88.5% when the combined model was used. Conclusion: MRI-based texture features combined with clinical and conventional MRI features may assist in differentitating between BEOT and FIGO stage I/II MEOT patients.

Lack of Effects of HER-2/neu on Prognosis in Colorectal Cancer: a Meta-analysis

  • Han, Jun;Meng, Qing-Yang;Liu, Xiao;Xi, Qiu-Lei;Zhuang, Qiu-Lin;Wu, Guo-Hao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5551-5556
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    • 2014
  • Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.

Changes of Maternal-fetal Attachment and Self Efficacy for Delivery after the Taekyo-perspective Prenatal Class (태교관점 임부교실 참여 전후 임부 태아애착과 분만자신감의 변화)

  • Chang, Soon-Bok;Kim, Ki-Young;Kim, Eun-Sook
    • Women's Health Nursing
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    • v.7 no.1
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    • pp.7-17
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    • 2001
  • The purpose of this study was to evaluate the effects on maternal-fetal attachment and self efficacy for delivery using the Taekyo-oriented prenatal class. This class is for 2 hours/week for 4 weeks. The program covers the contents of fetal growth and development including their responding ability, the importance of the uterine environment, sharing the motive and purpose of pregnancy, sharing experiences about pregnancy, sharing of prejudices against delivery, training of maternal-fetal interaction, understanding delivery, relaxation breathing techniques, maternity exercises, writing letters or prayers to the baby, and declaration of loving the baby. This study took place from March 4th to June 15th, 2000, in a university hospital and community care center, and was done by with a pretest-posttest design, with 55 pregnant women who were within 32-36 weeks pregnant and who agreed to participate in this study. Data was measured twice by self-report by the Cranley's Maternal-fetal Attachment Scale(MFAS, 1981), and the Shin's(1997) Self Efficacy for Delivery Scale at the beginning and at the completion of the class. Data was analyzed by SAS. The study results were: 1. The score of maternal-fetal attachment was significantly increased after the Taekyo perspective prenatal class than before the class. (t=7.389, p=0.000) 2. The score of self efficacy for delivery was significantly increased after the Taekyo perspective prenatal class than before the class. (t=8.885, p=0.000) The above results proved that the present Taekyo perspective prenatal education program was effective in increasing maternal-infant attachment and self efficacy for delivery. Therefore, it is concluded that the existing prenatal class should include Taekyo perspective elements. However, further study is needed to compare the effects with preexisted prenatal class.

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Study of the correlation between postpartum joint symptoms and maternity season within 15 days after giving birth (출산 후 15일 이내에 나타난 관절증상과 출산계절의 상관성 연구)

  • Koo, Jin Suk;Kim, Yun Young;Seo, Bu Il
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.125-133
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    • 2017
  • Objectives: The purpose of this study is to investigate the correlation between postpartium joint diseases and maternal season. So it can prevent postpartum joint diseases and provide fundamental data about postpartum health care. Methods: The subject of the present study was 219 women (142 women who completed vaginal delivery and 77 women who delivered by cesarean section) who completed labor between November 1, 2013 and November 31, 2016, at the clinic of OB&GYN. They have been taking good care of their health at postpartum clinic in Andong Woori Women Hospital. We investigated the various symptoms and situation which occurred from the moment of hospital to postnatal admission health care period and oriental doctor examined the patients. We classified the symptoms by the age of patients, the method of delivery, the term of pregnancy, the body weight of infant, the weight change of mother and the way of feeding. Through data analysis, we investigated the correlation between maternal season and postpartum joint diseases. Results: Postpartum joint diseases were the most common among all symptoms after childbirth. Postpartum joint diseases were classified into shoulder area pain and low back pain. In low back pain, there was no significant difference between maternal season and postpartum joint diseases. In shoulder, wrist and finger pain, pain was the most severe at winter delivery. It was the most painful in winter, followed by autumn, spring and summer. Conclusion: There was a close correlation between postpartum joint disease manifestations and maternal season.