• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.201-208
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• 2022

Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

• Journal of Digital Convergence
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• v.11 no.5
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• pp.371-384
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• 2013

The purpose of this study was to develop the risk-adjusted mortality model using Korean Hospital Discharge Injury data and US National Hospital Discharge Survey data and to suggest some ways to manage hospital mortality rates through comparison of Korea and United States Hospital Standardized Mortality Ratios(HSMR). This study used data mining techniques, decision tree and logistic regression, for developing Korea and United States risk-adjustment model of in-hospital mortality. By comparing Hospital Standardized Mortality Ratio(HSMR) with standardized variables, analysis shows the concrete differences between the two countries. While Korean Hospital Standardized Mortality Ratio(HSMR) is increasing every year(101.0 in 2006, 101.3 in 2007, 103.3 in 2008), HSMR appeared to be reduced in the United States(102.3 in 2006, 100.7 in 2007, 95.9 in 2008). Korean Hospital Standardized Mortality Ratios(HSMR) by hospital beds were higher than that of the United States. A two-aspect approach to management of hospital mortality rates is suggested; national and hospital levels. The government is to release Hospital Standardized Mortality Ratio(HSMR) of large hospitals and to offer consulting on effective hospital mortality management to small and medium hospitals.

• Journal of Korean Academy of Nursing
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• v.35 no.5
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• pp.842-849
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• 2005

Purpose: The main purpose of this study was to establish a nursing intervention data base to improve maternal attachment. Method: The first group of mothers( control group), experienced their first physical contact with their infants after being discharged from the hospital. The second group (experimental group) practiced early initial mother-infant postpartum contact known as the most sensitive period for founding maternal-infancy attachment. The subjects of this study gave birth to normal infants at M hospital from Aug.25 to Sept.30, 2004. During the same time, data was collected through direct observation, with instruments designed by Cropley et al., to assess the behaviors of normal attachment. The statistical methods for data analysis were percentage, mean, standard deviation and t-test with an SPSS program. Result: The group practicing initial mother-infant contact, showed a higher degree of physical and functional bonding than the group experiencing the first contact after discharge from the :10spital (control group)(p<.0l). The group practicing initial mother-infant contact, showed higher degrees of bonding attachment assessments than the group experiencing their first initial contact after their discharge from the hospital(p<.01). Conclusion: The group practicing early mother-infant contact, showed more maternal-infant interaction than the group experiencing their initial contact after their discharge from the hospital. These results show that maternal attachment behavior increases according with an early initial mother-infant contact.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.201-212
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• 2002

This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.287-295
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• 2011

Purpose: This study was done to compare educational needs for discharge after thyroid cancer surgery between patients and nurses. Methods: The participants were 107 patients who had thyroid cancer surgery and 70 nurses who have had experience of taking care of patients with thyroid cancer surgery at P hospital in Busan. The researcher reviewed the literature and conducted a preliminary survey to develop a questionnaire. Results: Although there was no significant difference in total perceived nursing discharge educational needs after thyroid cancer surgery between patients and nurses, both had a high level of nursing educational needs for discharge. The degree of patients' needs was higher than nurses in areas of dietary management after discharge and the degree of nurses' needs was higher than patients in the other areas. Although the first ranking area of educational needs was medication management for both patients and nurses, dietary management after discharge was the second ranking for patients and operation site and complication management was those for nurses. Conclusions: As the patients had different educational needs from the nurses, nurses need to focus on the patient's educational needs and provide relevant information. Educational programs should be developed and applied to post-surgical thyroid cancer patients.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.168-178
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• 2004

The purposes of this paper were to investigate the effect of active treatment compared with a conservative treatment and to provide the information for physical therapy in patients suffering from chronic neck pain. Forty female subjects who were diagnosed with cervical radiculopathy participated in this study and were divided into the conservative and active treatment groups. The active treatment group consisted of 20 patients who were treated with therapeutic modalities and active neck exercise program during the admission (15 days) and one month after discharge. The conservative treatment group consisted of 20 patients who were not received with active neck exercise program. The assessment tools were made using visual analogue scale(VAS), neck disability index(NDI) and modified Zung depression scale(MZDS). All subjects were measured three times: before the admission, at discharge, and at one month after discharge. Data were compared by groups using independent t-test. VAS, NDI and MZDS scores measured at admission and discharge were not significantly different between the groups. On the assessment performed one month after discharge, VAS and NDI scores were significantly lower for the active treatment group compared with those of the conservative treatment group(p<0.05), but MZDS score was not significantly different between the groups. In the comparison of two treatment methods for chronic neck pain, active treatment was more effective than conservative treatment. The findings of the study indicate that active treatment in chronic neck pain has a positive effect in relieving pain and restoring neck function.

• Korea Journal of Hospital Management
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• v.19 no.4
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• pp.21-33
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• 2014

This study was conducted to propose an insight into the appropriateness of hospital length of stay(LOS) by developing a severity-adjusted LOS model for patients with pneumonia, organism unspecified. The pneumonia risk-adjustment model developed in this paper is based upon the 2006-2010 the Korean National Hospital Discharge in-depth Injury Survey. Decision tree analysis revealed that age, admission type, insurance type, and the presence of additional disorders(pleural effusion, respiratory failure, sepsis, congestive heart failure etc.) were major factors affecting the severity-adjusted model using the Clinical Classifications Software(CCS). Also there was a difference in LOS among the regional hospitals, especially the hospital LOS has not been efficiently managed in Gyeongsangbuk-do, Jeollanam-do, Jeollabuk-do, Daejeon, and Busan. To appropriately manage hospital LOS, reliable statistical information about severity-adjusted LOS should be generated on a national level to make sure that hospitals voluntarily reduce excessive LOS and manage main causes of delayed discharge.

• Quality Improvement in Health Care
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• v.8 no.2
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• pp.160-171
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• 2001

Background : This study was conducted to compare the level of satisfaction between mothers who were educated on the care of newborns by video-taped method and those by verbal one before discharge. Methods : Fifty-two mother (verbal method group) from a free standing OB & GY hospital in Wonju City and forty-seven mothers (videotaped method group) from the OB & GY section of Wonju Christian Hospital(WCH) were selected for a study sample. The knowledge and understanding of newborn care and the degree of maternal satisfaction were assessed after the education by self-administered questionnaires. The opinions of the 11 nurses of WCH who were involved in the education were also collected by a questionnaire. Results : With respect of the level of understanding and satisfaction with the discharge education on newborn care, there is no significant difference between the videotaped educated group and verbal educated one. The correlation analysis of the video education group revealed a strong correlation between the score of understanding and satisfaction with the discharge preparation(r=0.409, p=0.01), and between the satisfaction scores for discharge preparation and discharge education(r=0.844, p=0.001). As for the verbal education group, the score of understanding also correlated significantly with both the score of satisfaction with the discharge education(r=0.272, p=0.001) and the discharge preparation(r=.680, p=0.001). Conclusions : This study showed that the discharge education to mothers regarding newborn care by a videotaped method does not improve the understanding or satisfaction of the mothers. However, the response to the mode of discharge education varies by the characteristics of the mothers. In conclusion, the characteristics of the mother should be considered in order to improve the understanding and knowledge of newborn care when the mode discharge education is chosen.

• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.157-170
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• 2009

Purpose: This quasi-experimental study was conducted to investigate the effects of supportive nursing management on postpartum depression in the mothers with premature infants. Methods: The subjects were 21 mothers who delivered premature babies in a university hospital. The experimental group of 10 mothers was provided with supportive nursing management program by nurses in neonatal ICU and the control group of 11 mothers was provided with usual management only. The designed programs were given 4 times to the experimental group while their babies were hospitalized, and telephone consultation was provided 3 times after discharge. The stress, anxiety, identity, support from their husbands & family members, and postpartum depression were measured 3 times using Edinburgh Postnatal Depression Scale (the 4th day of premature's hospitalization, the day of discharge and the day of 4 weeks after discharge). Results: There was no significant difference in general characteristics and the influential factors of postpartum depression between the two groups, so they were homogeneous. There was no significant difference in depression (F=0.01, p=.917). However there was significant difference over time (F=6.74, p=.003) and the interaction between measurement time and treatment (F=3.59, p=.037). Conclusion: The supportive nursing management on postpartum depression of mothers with premature infants is considered effective and useful in reducing postpartum depression. Further research is warranted to investigate paternal depression and the program's long-term effects.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.246-255
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• 2017

Purpose: This study was designed to identify factors affecting depression among hospitalized older adults prior to discharge from an acute care hospital. Methods: This descriptive study included adults aged 65 or older who were hospitalized in a general hospital in Seoul, Korea. Depression was measured by the Short Form Geriatric Depression Scale and illness perception was evaluated by the Brief Illness Perception Questionnaire. Social support was examined using the Perceived Geriatric Social Support Scale. Data were collected from August 25 to October 12, 2015. Data analysis included descriptive statistics, independent t-test, Kruskal-Wallis test, Pearson's correlation coefficient, and hierarchical multiple regression. Results: Among a total of 120 participants, 57 patients (47.5%) experienced depression. Mean depression score was $7.37{\pm}3.67$. Depression was associated with illness perception (r=.53, p<.001), social support (r=-.19, p=.043), number of admission due to the recurrence (r=.31, p=.001), and time to recognize discharge plan (r=.25, p=.044). In hierarchical multiple regression, illness perception (${\beta}=.45$, p<.001) and time to recognize discharge plan (${\beta}=.21$, p=.039) were predictors of depression (F=7.68, p<.001, Adjusted $R^2=.38$). Conclusion: The findings of this study suggest that management of illness perception and timely notice of discharge are important to reduce depression in hospitalized elderly patients.