• 제목/요약/키워드: Immediate postpartum period

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Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period

  • Kim, Ju-Ree;Lee, Sang-Hoon
    • Radiation Oncology Journal
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    • 제30권2호
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    • pp.49-52
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    • 2012
  • Purpose: To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. Materials and Methods: A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the final Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. Results: In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. Conclusion: When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

산욕초기 어머니 됨과 돌봄 자신감 (Motherhood and Role Confidence in the Immediate Postpartum Period)

  • 방미란;이정희;이지애;정지윤;박세영;안옥심;박숙희;김영희
    • 여성건강간호학회지
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    • 제6권2호
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    • pp.291-304
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    • 2000
  • Being a mother is motherhood which means maternal role attainment and has to meet maternal identity and role confidence of caring infant. This study was designed to examine maternal identity as a motherhood and role confidence in the immediate postpartum period, and then explain the correlations of them. Data were collected for 2 months by questionnaires from 64 mothers in the hospital. The scales were to measure motherhood questionnaire which consisted of 11 items and role confidence questionnaire which consisted of 13 items. The analysis of data was done with SPSSWIN program for descriptive statistics and t-test, chi-square, ANOVA, Multiple Regression Analysis. The results were as follows: 1. Mean score of maternal identity of primipara was 55.41 and multipara was 53.81. In this outcome primipara's score was higher than multipara's. 2. Mean score of role confidence of primipara was 44.0 and multipara was 46.81. Multipara's score was higher than primipara's. 3. Correlation between maternal identity and role confidence was r=0.29(P=0.03). This was a interesting result. Because many studies reported that primipara had a lower score of maternal identity and role confidence than multipara's. But this study showed that primipara's score of maternal identity was higher than multipara's. So nurse has to support primipara's identity as a mother, taking advantage of nursing intervention from prenatal to postnatal periods. Also nurse has to offer many opportunities to experience premiparas and multiparas how to care their infants.

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영아기 어머니의 산후 우울 정도와 모성역할 자신감, 양육 스트레스, 영아기질에 관한 연구 (Postpartum Depression and Maternal Role Confidence, Parenting Stress, and Infant Temperament in Mothers of Young Infants)

  • 권미경;김혜원;김남선;장정애
    • Child Health Nursing Research
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    • 제12권3호
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    • pp.314-321
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    • 2006
  • Purpose: The purposes of this descriptive survey study were to describe postpartum depression level and to identify the influence of postpartum depression on maternal role confidence, parenting stress and infant temperament, in order to develop a base for nursing intervention programs for mothers who have postpartum depression. Method: Data were collected from 183 mothers of infants who visited one public health center in Goyang city. The instrument used for this study was a self-report questionnaire to identify the postpartum depression (BDI), maternal role confidence, parenting stress (PSI) and infant temperament (WBL). Results: Of the mothers 42.1% were in the normal range for postpartum depression, 33.3% in the mild group and 24.6% were in the moderate to severe group. There were significant differences in parenting stress, and infant temperament according to level of postpartum depression. There were correlations between maternal role confidence (r=-0.13), infant temperament (r=-0.20), parenting stress (r=0.51) and postpartum depression, and weak negative correlation between parenting stress and infant temperament (r=-0.30). Conclusion: Postpartum depression in the infant period when the mother's role is very important and the effect is not only on the mother's role but also on the infant's growth. It is essential to assess and provide immediate care to mothers who have postpartum depression.

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초기 산욕부의 간호요구도와 만족도에 관한 연구 (A Study on the Nursing Needs and Satisfactions of Early Postpartum Women)

  • 유연자;이은주
    • 여성건강간호학회지
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    • 제5권3호
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    • pp.389-409
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    • 1999
  • This study was carried out to identify the differences between nursing needs and levels of satisfaction of postpartum women during the early postpartum period. The goal of this study was to obtain needed to develope the nursing quality for postpartum women. The subjects were 87 postpartum women who had vaginal delivery at 2 general hospital and 2 maternity hospital in the Ulsan City. The period for the data collection was from June 1 to 29, 1999. The data was gathered using an 98 items questionnaire which was a modified version of a questionnaire the developed by Y. J. Chun. Results found are as follows : 1. The general characteristics of the subjects : The majority of subjects were 25-29 yrs. (57.5%), high school and college graduates(96.5%), unemployed(75.9%), middle ranged economics(93.1%), had no religion(43.7%), male baby(52.9%), birth weight 3-3.5Kg(49.4%), wanted pregnancy(96.6%), no abortion history(50.6%), had antenatal care(89.7%), had prenatal education(32.2%), postnatal education(42.5%), intended breast feeding (46.0%), had resonable self confidence about self(20.7%), infant care(36.8%) and nuclear family pattern(82.3%). 2. The level of nursing needs of overall nursing care(3.93) and the levels of satisfaction(3.86) was relatively high. The nursing needs by category of nursing care, the highest need was in the emotional and psychological care(4.09), and the lowest need was in physical need(3.73). The satisfactions by category of nursing care, the highest satisfaction was in emotional and psychological care(4.11) and the lowest satisfaction was in education in self care(3.64). The significant differences between nursing needs and satisfactions were found on education in infant care(p=.005), and education in self care(p=.020). 3. Among items of physical care, 'accurate medication and treatment(4.21)', 'control of postpartum hemorrhage(4.13)', 'pain control and care of episiotomy wound (4.12)' and 'regular observation of postpartum conditions(4.09)' showed high nursing needs. 'Accurate medication and treatment(4.31)', 'regular observation of postpartum condition(4.24)', 'control of postpartum hemorrhage(4.22)' and 'pain control and care of episiotomy wound(4.12)' showed high satisfaction levels. 4. Among items of emotional and psychological care, 'personal treatment(4.32)', kind and faithful care(4.30)', 'detailed explanation on the treatment or nursing care(4.25)', 'adequate draping during the care and treatment(4.23)' and detailed explanation on a doubt(4.13)', showed high nursing needs, 'personal treatment(4.52)', 'kind and faithful care(4.45)', 'detailed explanation on a doubt(4.24)', 'detailed explanation on the treatment or nursing care(4.21)' and 'adequate draping during the care and treatment(4.18)' showed high satisfaction of nursing care. Difference between the level of nursing needs and satisfaction was significant except item of 'early contacts with their baby and breast feeding'. 5. Among items of environmental care, the highest level of need and satisfaction were on the items of 'neat bedding and clothes(4.05, 4.21)' and 'room cleansing or care of room(4.01, 4.28)'. Differences between the level of nursing care and satisfaction were 'room cleansing of care of room'. 6. Among items of educational needs on self care, 'sitz bath method(4.22)', 'high risk symptoms to immediate clinic visits(4.13)', 'the timing of tub bath(4.05)' and 'good secretion of breast milk(4.03)', showed high nursing needs, 'sitz bath method(4.22)' showed high satisfaction of nursing care. Differences between the level of nursing care and satisfaction were 'the timing of hair shampoo', 'the timing of tub bath', ' the method of pad change', 'postpartum exercise', 'good secretion of breast milk', 'maintenance of breast figure', 'contraindicated drugs in postpartum women', 'kegel exercise' and 'breast self examination'. 7. Among items of educational needs on infant care, 'immunization of infants(4.36)', 'symptoms of sickness to immediate clinic visits(4.28)'. 'safety and emergency care(4.28)', 'umbilical care(4.26)', 'feeding times and intervals(4.24)', 'normal growth and development of infant(4.24)' and 'infection control(4.22)', showed high level of nursing care, 'immunization of infants(4.21)', 'feeding times and intervals(4.17)', were high satisfaction items showed significant differences between the level of nursing care and satisfaction. 8. Relationship between nursing needs and levels of satisfaction among postpartum women were as follows : 1) Physical area : There were no significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'working mothers', 'baby's weights', 'baby's sex', 'planning of feeding' and 'routes of receiving postpartum informations'. 2) Emotional and psychological area : The level of nursing needs were significantly different in the area of 'confidence in self care'. Satisfaction levels were significantly different among 'baby's sex', 'baby's weights', 'the confidence of infant care' and 'working mother'. 3) Environment area : There were on significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'maternal age' and 'baby's weights'. 4) Education in self care : The level of nursing needs were significantly different among 'parity history' and 'type of family formation'. Satisfaction levels were significantly different among 'working mother', 'baby's sex', 'antenatal care', 'postpartum education', 'planning of feeding', 'routes of receiving postpartum informations'. 5) Education in infant care area : The level of nursing needs were significantly different among 'parity history'. Satisfaction levels were significantly different among 'baby's sex', 'receiving postpartum education or not' and 'working mother'.

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산후 경과별 모유수유실태 (The present status of breast feeding practice according to the postpartum period)

  • 박옥희;권인수
    • 모자간호학회지
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    • 제1권
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    • pp.45-58
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    • 1991
  • The purpose of this descriptive study was to investigate the determinants of mother's choice of infant feeding method on immediate postpartum period & the breast feeding practice after 1, 2, 3, 4, 5months. The subjects were 170 mothers who were delivered at 2 hospital, 2 OBGY clinics, 1 midwifery in Jinju, the data were collected from Jan. 1 to Feb. 20 of 1991, form each subject at two periods of time ; postpartum 2 or 3 days via interview, 5months via telephone interview. The results were as fellows : 1. The propotion of mother planned exclusive breast-feeding was 66.5%, milk feeding 17.6%, mixed feeding 15.9%, End 38.9% of mothers planned to breast-feed their infants for 4-6moths, 25.7% for more than 12 months. The major reasons for selection of milk feeding method were the presence of mother's job(26.7%), the conditions of breast & milk production(23.7%). 2. There were significant relations between the choice of feeding method & the presence of s job(p<.01), & parity(p<.01). 3. The percentages of subjects that were received education about the advantages & method of breast feeding were 63.5%, 38.2%, respectively, & the informants were mass media, 89.8%, 81.5%. 4. The most of mothers had the knowledge about the advantages of breast feeding. 5. The percentage of mothers that practiced breast feeding on postpartum were 75.9%. 6. The rates of breast feeding practice by duration were more than 5months, 60.5%, 1 month, 27.1%, 2-4 months. 12.3%. 7. The reasons for the stop of breast feeding were the decrease of milk volume(22.9%), the presence of mother's job(17.4%). 8. The duration of breast feeding practice were differed significantly by the presence of mother's job, type of delivery, rooming-in, planned duration of breast feeding, the first feeding time.

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산욕초기 초산모의 모성 정체성과 영아돌보기 활동 자신감에 관한 연구 (Primipara's maternal Identity & Self Confidence for Caring the Baby During the Immediate Postpartum Period)

  • 김혜원;황문숙;홍경자
    • 여성건강간호학회지
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    • 제4권1호
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    • pp.84-102
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    • 1998
  • In this study the levels and influencing characteristics of maternal identity and self confidence for caring the baby were identified during the immediate postpartum period. 114 primiparous women who delivered vaginally normal baby participated in the survey from August 1 to October 31, 1996. SD scale was to measure maternal identity which consisted of 11 items for mother and 6 items for baby. Likert scale was to measure self confidence for caring the baby (38 items). Cronbach's alphas for evaluating internal consistency as follows : .86 for maternal identity and .96 for self confidence scale for caring the baby. The study showed these results : 1. Mean score of maternal identity(82.03 : 52.65 for mother, 29.38 for baby) was considered relatively low. 2. Mean score of self confidence for caring the baby(113.91) was considered relatively low. 3. There were significant influencing characteristics of primiparous to maternal identity : age(total ; F=3.53, p=.0329, for mother ; F=2.60, p=.0719, for baby ; F=3.12, p=.0481), prenatal infant care preparation(total ; t=2.31, p=.0306, for mother ; F=2.62, p=.0160), knowledge about infant care during the hospitalization(for baby ; F=3.94, p=.02222), colostrum feeding(total ; t=1.95, p=.0541, for baby ; t=2.71, p=.0080), frequency of breast feeding during the hospitalization(for baby ; F=3.91, p=.0228)and feeding type after discharge(for baby ; F=3.18, p=.0456). 4. There were significant influencing characteristics of primiparous to self confidence for caring the baby : routine husband support(F=6.09, p=.0031), prenatal infant care preparation(t=2.04, p=.0574), knowledge about infant care during the hospitalization(F=3.15, p=.0467), education of breast feeding during the hospitalization(t=-1.79, p=.0850). 5. Correlation between maternal identity and self confidence for caring the baby was r=.37608(p=.0001). This study implies that special education programs for primipara are needed. For the future, this study suggest that maternal role variables need to be monitored through the home visiting follow up. Also intervention programs related to prenatal care, discharge education, home visiting follow up need to be developed and then evaluated their effectiveness.

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한국의 산후 문화와 여성이 경험한 산후병에 관한 일상생활기술적 연구 (An Ethnographic Study of Sanhubyung experienced by Women in Korean Postpartal Culture)

  • 유은광
    • 대한간호학회지
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    • 제25권4호
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    • pp.825-836
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    • 1995
  • This ethnogrphic exploratory study sought to de-fine the meaning of Sanhubyung, as consequence from the perspective of the women who experienced it. A convenience sample of 9 elderly women in San Francisco. and 20 postpartal women and their 20 non-professional helpers during postpartum in Seoul, Korea were observed and interviewed for 23 months from January 1991 to December 1992 at the Human Development Center in San Francisco and at the hospital and their homes in Seoul, Korea. Sanhubyung was regarded as the consequence of "Doing a Sanhujori Wrongly," as a group of symptoms or sequelae which have two types of characteristics of symptoms . chronic and acute. It can be called a culture bound syndrome in the cultural context re-lated to childbearing phenomenon in Korea. If women violate the principles of Sanhujori, such symptoms can appear at various times : during the period of postpartum itself, at any time, periodically, especially at the anniversary of the child's birth, late forties, and in old age. Acute symptoms that can be classified into immediate and late types include painful and edematous gingiva, sensitive teeth, strange sensation and pain in the knees or backache. Besides, there is a localized sense of soreness and pain ; sense of being in a draft and cold, stomach upset, GI irritation, chilling, shivering, and tiredness, pain and dazzling in the eyes. Chronic symptoms occur in the head, neck, teeth, back, hands, knees, hands and feet, arms and legs, eyes, sinews and joints, bones, and in the body or as a whole. Generally these symptoms are pain, often accompanying a feeling of being cold and in a draft, regardless of actual weather conditions. In conclusion, this findings reflect the Oriental way of thought of causal relationship of women's health and illness based on the wholistic paradigm of harmony and balance of two forces, Yin(cold) -Yang(hot). It provides a challenge to the professional sector to rethink the effect of culture on health and illness. Finally, it suggests care providers use cultural assessment for the appropriateness of the intervention and quality of care for desirable health outcomes.

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