• Child Health Nursing Research
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• v.16 no.4
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• pp.239-248
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• 2010

Purpose: This study was done to evaluate effects of a mother-fetus interaction promotion program on maternal and infant sleep/activity regulation, and examine the correlation between maternal and infant sleep/activity. Methods: Thirty-four mother-infant dyads were recruited from an OB-GY clinic with postpartum care center, and assigned to the intervention group (17) or control group (17). Data were collected from January 18 to August 5 2005. A programmed education focused on mother-fetus interaction was provided to the intervention group in the 3rd trimester. Maternal sleep/activity record was completed at 32-36 weeks gestation and infant sleep/activity record was completed for one month after birth. Results: During the 3rd trimester, there were no significant differences in maternal sleep/activity between the groups, except for frequency of mothers' night awakening and urination at night. There were no significant differences in infant sleep, but significant difference was found in feeding times between the groups. Correlation of maternal sleep in the 3rd trimester and infant waking times was significant. Conclusion: The results of this study indicate that maternal sleep/activity during pregnancy influences infant sleep/activity at 3-4 weeks, and that nursing interventions to regulate maternal sleep/activity provided to primiparas can be beneficial to the regularity of infant sleep/activity patterns.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.46-59
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• 2000

The purpose of this study is to determine whether the NCASA (Nursing Child Assessment Sleep/Activity Record) would be suitable to evaluate and to provide the basic resources for a Korean model of sleep/activity patterns during the first 6 months Korean infants' lives and to provide a basis for nursing intervention for mothers of early infants. The subjects of this study were 94 normal infants from birth to 6 months of age who visited the postpartum care center and two general hospitals located in Pusan from February 1 to April 28, 2000. The method of data collection was through convenient sampling. The instrument of this study was the NCASA translated by the Korean parent Child Health Academic Association. The collected data were analysed by mean, standard deviation, frequency percentage and ANOVA, Post Hoc test by use of SPSS/PC. The conclusions obtained from this study are summarized as follows: 1. The mean amount of daytime sleep was 8.06 hours. The mean amount of nighttime sleep was 6.31 hours. The mean amount of total daily sleep was 14.37 hours. The mean of the longest sleep period was 5.20 hours. The mean regularity of daytime sleep was 25.84%. The mean regularity of nighttime sleep was 77.69%. The mean regularity of total daily sleep was 42.60%. The mean frequency of nighttime wakenings was 2.33 times. 2. The mean amount of daytime activity was 8.25 hours. The mean amount of nighttime activity was 1.39 hours. The mean amount of daily total activity was 9.64 hours. The mean of the longest activity period was 3.80 hours The mean frequency of daytime feeding was 5.69 times. The mean frequency of nighttime feeding was 2.08 times. The mean frequency of total daily feeding was 7.74 times. The mean frequency regularity of feeding was 54.62%. The mean frequency of wakenings was 5.14 times. The mean frequency of crying was 1.90 times. 3. According to an analysis of sleep patterns based on an infant's age, there were some significant differences in the following factors: amount of daytime sleep(p<.001), amount of night time sleep(p<.05), amount of total daily sleep (p<.001), longest sleep period(p<.001), regularity of daytime sleep(p<.001), regularity of nighttime sleep(p<.01), regularity of total daily sleep(p<.001), frequency of nighttime wakenings(p<.001). 4. According to an analysis of activity patterns based on an infant's age, there were some significant differences in the following factors: amount of daytime activity(p<.001), amount of nighttime activity(p<.01), amount of total daily activity(p<.001), longest activity period(p<.05), frequency of nighttime feeding(p<.01), frequency of wakenings(p<.001). 5. The mean amount of a mother's day time was 16.30 hours. The mean amount of a mother's night time was 7.70 hours. In conclusion, the initial irregular sleeping and activity patterns of the early infant became regurized as the infant grew older and estabilished firmer patterns of sleeping and of activity.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.60-72
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• 2000

Studies are needed to determine the standard norms for sleep/activity patterns in new born baby and there have been no established reports of discrepancy of sleep/activity patterns in new born baby among various races. The purpose of this study is to determine whether the NCASA(Nursing Child Assessment Sleep Activity Record) would be suitable to evaluate and to provide the basic resources for a Korean model of sleep/activity patterns during the new born baby, and to provide a basis for nursing intervention for mothers of new born baby. The subjects of this study were 38 normal new born baby who visited the postpartum care center and two general hospitals located in pusan from January 1 to April 28, 2000. They all agreed to participate in this study. The method of data collection was through convenient sampling. Data were collected through questionnaires including demographic data, birth hi story, and general informations concerning the infant, mother and family. The instrument of this study was the NCASA translated by the Korean parent Child Health Academic Association. The collected data were analysed by mean. standard deviation, frequency, and percentage by use of SPSS/PC. The conclusions obtained from this study are summarized as follows: 1. The mean amount of daytime sleep was 10.23 hours. The mean amount of nighttime sleep was 5.53 hours. The mean amount of total daily sleep was 15.77 hours. The mean of the longest sleep period was 4.49 hours. The mean regularity of daytime sleep was 49.69%. The mean regularity of nighttime sleep was 66.98%. The mean regularity of total daily sleep was 55.81%. The mean frequency of nighttime wakenings was 3.09 times. 2. The mean amount of daytime awake periods was 6.12 hours. The mean amount of nighttime awake periods was 2.11 hours. The mean amount of daily total awake periods was 8.23 hours. The mean of the longest awake periods was 3.76 hours. 3. The mean frequency of daytime feeding was 5.71 times. The mean frequency of nighttime feeding was 2.65 times. The mean frequency of total daily feeding was 8.36 times. The mean frequency regularity of feeding was 62.50%. 4. The mean amount of a mother's day time was 16.36 hours. The mean amount of a mother's night time was 7.64 hours. In conclusion, The new born baby slept more during the daytime compare than nighttime and more active during the daytime. On the other hand. although nighttime sleeping the length of the mother was normal, but sleep was interrupted by the infant over 3 times on average. Therefore this research study will contribute to nursing practice and nursing research by its implication through postnatal educational nursing programs at hospital and nursing intervention programs that would help individual caring of early infant mothers at home.

• Korean Parent-Child Health Journal
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• v.2
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• pp.83-110
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• 1999

The purpose of this study was to identify the sleep/activity patterns of neonates and to provide a baseline data for the development effective mother-infant relationship. Subjects of this study were 36 newborns aged 1-21 days and stayed in Postpartum Care Center in Taejon during the period of October 28th, 1999 to February 10th, 2000. The data were collected using NCASA developed by Barnard et al. and were analyzed with SPSS 7.5 for window program. The results of this study were as follows: 1. An average day sleep of neonates was 8.0 hours, night sleep was 3.6 hours, and total sleep was 11.6 hours. A longest period of day sleep was 3.8 hours and a longest period of night sleep was 3.4 hours. The regularity of day sleep was 22.1%, night sleep was 23.3%, and total was 22.1%. 2. The frequency of daytime feeding was 6.9, nighttime fee ding was 3.4, resulting in total of 10.3. The regularity of feeding was 37.4%, and the frequency of night awakening was 2.4. 3. Associations among variables related to neonate's sleep/activity records were as follows : - The regularity of total sleep was positively correlated with the frequencies of day sleep(r=.57, P=.00), night sleep (r=.40, P=.01), and total sleep(r=.65, P=.00). - The frequency of total feeding was negatively correlated with the frequencies of day sleep(r=-.29, P=.04), night sleep(r=-.39, P=.02), and total sleep(r=-.42, P=.00), as well as longest day sleep(r=-.50, P=.00). - The regularity of feeding was negatively correlated with the frequency of night sleep(r=-.35, P=.02), longest period of day sleep(r=-.32, P=.04), and longest period of night sleep(r=-.30. P=.04), whereas positively correlated with frequencies of daytime feeding (r=.29, P=.02) and nighttime feeding (r=.32, P=.05). - The frequency of night awakening was negatively correlated with amount of night sleep(r=-.39, P=.02) and frequency of daytime feeding(r=-.42, P=.01) while positively correlated with frequencies of nighttime feeding(r=.68, P=.00) and total feeding(r=.50, P=.00). 4. Although there was no statistical significant difference between sleep pattern and infant's age, following tendency was noted: - As baby gets older, total amount of sleep and longest period of day sleep decreased while longest period of night sleep increased. - As baby gets older, the regularity of day sleep decreased while the regularity of night sleep and total sleep slightly increased. - The frequencies of daytime and total feedings increased while the frequency of nighttime feeding decreased. In conclusion, the author found that the neonates of this study showed less amount of sleep, more night awakening, and more night time feedings than NCAST sample. There was a certain sleep/activity pattern existed: If babies were fed more frequently, daytime or nighttime sleeping hours became shorter, and if babies had longer daytime sleep, frequent nighttime awakenings were noted. This pattern illustrated the significant influence of feeding and sleep periods on each other. Awakening in the night is natural and normal patterns in the newborn period. The result of this study will provide information to parents about what to expect their infants.

• Korean Parent-Child Health Journal
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• v.3 no.2
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• pp.1-17
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• 2000

The purpose of this study was to recognized the sleep activity patterns of the normal infants in Korea. The subject were 41 normal infants who were below 8 weeks old and were born in Taegu city and Kyungbuk province. The measuring instrument the sleep activity was NCASA translated by the Korean-parent-child Health Academic Association. The data that were collected from April, 18 1999 to January 1, 2000 were analysed by the SPSS 7.5 program. The results of the study was summarized as follow; 1) The mean amount of total sleeping hours per day was decreased from $16.27{\pm}1.96$ hr at the 1st week, to $15.19{\pm}2.39$ hr at the 2nd week, to $13.66{\pm}2.40$ hr at the 3 week but increased to $16.55{\pm}5.77$ hr at the 4-8 week after birth. 2) The mean frequency of feeding was increased to $9.43{\pm}2.79$ times at the 3rd week but decreased to $7.55{\pm}1.23$ times at the 4-8th week after birth. 3) The regularity of day time sleep was decreased from 50.00% to 19.79% and that of night time sleep was increased from 51.79% to 72.92%. 4) The regularity of feeding was increased from 30.42% at the 1st week to 50.07% at the 2nd week but decreased 26.34% at the 4-8th week after birth. 5) The longest period of day time sleep was decreased to $2.39{\pm}0.42$ hr at the 3rd week but increased $2.47{\pm}0.69$ hr at the 4-8th week after birth. The longest period of night time sleep was decreased to $2.58{\pm}0.67$ hr at the 2nd week but increased to $3.00{\pm}1.32$ at the 3rd week and $4.30{\pm}1.16$ hr at the 4-8th week after birth. 6) At the 1st week, the 2nd week, the 3rd week after birth, the frequency of day time feeding was positively correlated with the frequency of night time feeding($R_{1week}=0.948^{**}$, $R_{2week}=0.927^{**}$, $R_{3week}=0.779^{**})$. At the 4-8th week after birth, the frequency of night time feeding was negatively correlated with the amount of night time sleep ($R_{4week-8week}=0.875^{*}$). On the basis of above findings, the following is suggested; It is need a longitudinal and transcultural study which are designed for children's sleep and feeding.

• Journal of Korean Academy of Nursing
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• v.13 no.3
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• pp.119-126
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• 1983

Early extra-uterine development of the newborn infant has the potential for clarifying important questions of nature and care taking environment. In this study, tactile and auditory stimulation is used on .a group of infants to determine the effects of their response. Infants were tested by EKG at 24∼48 hrs after birth ana all they are free from complication. Stimuli presented were-touch and sound (40dB, 70dB and 40∼70dB). The result of the study were as follows: 1) The heart rate was seen to depend on their sleep-wake state. (light sleep ; 125/min, eyes: open & motor activity increase ； 151/min crying ; 185/min). 2) The heart rate affected by tactile & auditory stimulus. The heart rate response was acceleration above the prestimulus level. (tactile, 231min increase, auditory ; 16∼21/min increase), and heart rate change was seen to depend on prestimulus rate. (γ=.73) 3) There was a decrease in heart rate when they were soothe. (touch ; 24.8sec, 21/min decrease, pacifier ; 14.5sec, 26/min decrease) and significant difference in time between touch and pacifier (t= 1.76, p<0.05). This result support the evaluation of newborn infant's sensory abilitics, and has even begin to influence changes in nursing care. But systemic monitoring of newborn infants response would. further define.

• Child Health Nursing Research
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• v.18 no.2
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• pp.85-94
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• 2012

Purpose: Instead of a chaotic non circadian environmental approach, continuing regular day-night rhythm in neonatal nurseries may benefit the development of preterm infants. The purpose of this study was to define the effects of cycled lighting on circadian rhythms of premature infants. Methods: The experimental group included 15 preterm infants, and the control group, 15 premature infants in the NICU of a general hospital in Seoul. All infants were between 32 and 37 weeks' postconceptional age. The experimental group infants were provided with cycled lighting before discharge. The incubator or bassinet cover of the experimental group was off between 7 AM and 7 PM, and was covered between 7 PM and 7 AM. Results: There were significant differences in the NNNS score ($p$=.039), and some significant differences in the sleep-activity pattern between the experimental group and the control group, but distinct differences in sleep-activity patterns between the two groups could not be defined. Conclusion: The results of this study suggest that cycled lighting can be helpful in the neurobehavioral development of preterm infants. By modifying the NICU environment to provide a more developmentally supportive milieu, nursing professionals can better meet the infants' physiologic and neurobehavioral needs.

• Women's Health Nursing
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• v.8 no.2
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• pp.301-313
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• 2002

The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.1
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• pp.135-146
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• 2000

The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.