• 대한간호학회지
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• 제43권1호
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• pp.69-80
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• 2013

Purpose: The purpose of the study was to investigate the effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. A total of 55 women with GDM were recruited from Cheil General Hospital, Seoul, Korea and were assigned to an experimental (n=28) or control group (n=27). The participants were 24-30 weeks pregnant women who had been diagnosed with GDM as of July 30, 2010. The program was conducted as a 1 hour small group meeting 3 out of 5 times and by telephone-counseling 2 out of 5 times. The integrated self-management program was verified by an expert panel. Results: Although there was no significant reduction in HbA1c (U= -1.17, p=.238), there were statistically significant increases in self-management (U= -3.80, p<.001) and maternal identity (U= -4.48, p<.001), and decreased 2-h postprandial glucose levels (U= -2.43, p<.015) in the experimental group compared to the control group. Conclusion: These findings suggest that an integrated self-management program for women with GDM improves self-management, maternal identity, and glycemic control. Further studies are needed to identify the effects of an integrated self-management program on pregnancy and neonatal outcomes.

• 부모자녀건강학회지
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• 제7권2호
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• pp.121-132
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• 2004

Purpose: This study aimed to develop a breast feeding program for mothers of premature infants. The program was applied and its effect was evaluated on stress, knowledge and breastfeeding behaviors of premature infant mothers. Method: This study employed a one group pre- and post-test quasi-experimental design. The data were collected from 17 participants from August 15 to October 24, 2004, at a N1CU at D University Medical Center located in Susan, Korea. Data were analyzed by means of frequency, SD, and t-test using SPSS version 10. Result: After the program, participants significantly showed a greater level of knowledge than before the program (t=-5.750, p=.000). No statistically significant differences in stress level scores were found (t=1.453, p=.153). The breastfeeding practice rate was 94.1%: Conclusion: This educational program using a handbook and video had a positive effect on increasing knowledge and practice of breastfeeding among premature infant mothers. It is suggested that this study be replicated with a larger sample size to compare group responses.

• 부모자녀건강학회지
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• 제12권1호
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• pp.46-60
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• 2009

Purpose: The purpose of this study was to explore married immigrant women's child-rearing experiences including parenting stress and parenting efficacy using parallel/simultaneous mixed method design. Method: Participants of this quantitative study were 53 immigrant women in G City. Data was collected from May 1 to July 31 and analyzed using the SPSS 14 program. Qualitative data was collected from 8 immigrant women through focus group discussions from April, 22 to August 5, 2008 in G City and G Province. The data was analyzed using a content analysis method. Results: The mean score of parenting stress scale and parenting efficacy were 63.49 and 43.11 respectively. Significant differences were found in parenting stress according to nationality, length of stay, religion, economic status, education level, Korean language skill, number of children, and program participation. Significant differences were found in the Parenting efficacy according to the nation, length of stay, economic status, education level, Korean language skill, children's health status, and program participation. Three themes emerged through this analysis: 1) Isolation from the maternal parent, 2) Insufficient support system, 3) Conflicts and Compromise of child-rearing practices. Conclusion: Married immigrant women experience double burdens of mothering. There is a need to develop educational and support programs for them.

• Child Health Nursing Research
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• 제5권1호
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• pp.70-83
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• 1999

The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

• 보건행정학회지
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• 제6권1호
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• pp.29-58
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• 1996

This study was conducted to identify the factors that affect the output of health conters. An analystical model employed in this study was developed by modifying 'input-output model' and 'organizational behavior model'. Data were collected form two source; the 1995 report of thealth center which was submitted to the Ministry of Health and Welfare and a mail survey questionary of officers at health center, including 66 directors and 1,768 staffs of the health centers in southern region. The major findings are as follows: That analysis has identified the factors associated with dependent variables: medical services provided by the health center and health program performance(HPP). The number of primary medical facilities was negatively associated with health center performance while the number of staffs, job satisfaction, and professional background of health center directors were positively associated. These independent variables accounted for 40.1% of the variance of dependent variables. The variance of HPP was significantly explained by the number of health subcenter and primary health post, priority level of public health program by hief executive officers(CEOs) and legislator. A significant relationship was found between leadership types of health center directors and the performance of maternal and child health program. Considering these results, the authors suggested that the role in medical care service of health center in the should be rearranged at local level because medical care service of the health center is competing with primary medical facilities in the same region. It is also suggested that educational efforts be made to improve leadership of the health center directors and concern with public health program by the CEOs and legislators of local governments.

• 부모자녀건강학회지
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• 제9권2호
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• pp.150-160
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• 2006

Purpose: This study was to examine how an invasive procedures education program affected the anxiety and supportive behavior of mothers with hospitalized children, and to help provide an efficient to improve their maternal role performance by boosting their supportive behavior. Method: To evaluate their anxiety, Spilberger(1972)'s Anxiety Inventory that was translated by Kim Jeong-taek, et al.(1978) was employed, and Weon Dae-yeoung(1999)'s modified version of Melnyx(1994)'s Index of Parent Support During Instructive Procedure was utilized to assess their supportive behavior. The collected data were analyzed with SPSS program. Statistical data on real number and percentage were acquired, and $x^2$-test and t-test were conducted. Result: There was a more favorable change in the anxiety(trait anxiety and state anxiety) of the experimental group that participated in an invasive procedures education program(a mean of -0.14) than in that of the control group that didn't(a mean of 0.16). The experimental group(an average of 4..65) outstripped the control group(a mean of 3.42) in that regard. Conclusions: The invasive procedures education program that catered to the mothers with hospitalized children turned out to be effective in easing their anxiety and enhancing their supportive behavior.

• Journal of Preventive Medicine and Public Health
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• 제16권1호
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

• Child Health Nursing Research
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• 제10권2호
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• pp.153-164
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• 2004

The purpose of this study is to investigate the effect on mother-fetus attachment through mother-fetus interaction promotion program of talking and tactual stimulation aimed at enhancing sensitivity of primipara Non-equivalent control group posttest design was used. Fifty primiparas (26 mothers for intervention group and 24 mothers for control group) were recruited from three general hospital and an OBGY clinic located in Gang Nung city. Data was collected from January 30th to December 20th in 2001. For the intervention group, programed education which focused on mother-fetus interaction promotion of talking and tactile stimulation in the 1st trimester. Telephone counselling was provided with interval of two weeks. For two groups, home visiting for data collection of mother-fetus attachment was conducted at 36 to 38 weeks of gestational age. The data were analyzed using chi-square test and Fisher' Exact test to test the equivalence of two groups, and the effect of intervention program was determined with t- test. The result was as follow: The significant difference was found in mother-fetus attachment between two groups(t= 2.772, P= 0.0079). It indicated that intervention program was effective in improving mother-fetus attachment. In conclusion, this study has shown that the applied nursing intervention aimed at enhancing sensitivity of primiparas to fetus's movement promoted mother-fetus attachment. Therefore, this study suggests that this nursing intervention to increase maternal sensitivity to the fetus's movement should be broadly applied to primiparas, which can be beneficial for formation of mother-infant relationship, and for promotion of the social, affective, and cognitive developments of their children.

• 대한간호학회지
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• 제37권6호
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• pp.914-923
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• 2007

Purpose: This qualitative study aimed to identify the common, lived experiences of grandmothers who cared for their grandchildren as the primary caregivers. Methods: This study was based on the phenomenological method described by Colaizzi (1978). Results: Seven theme clusters emerged from the data as follows: "grandmother caregivers accept the parenting role of the incessant responsibilities and the distrust of non-kin caregivers.", "grandmother caregivers have a double maternal roles; an instrument-oriented maternal role to their own child and relationship-oriented maternal role to their grandchild.", "grandmother caregivers are partially authorized to make decisions in the matters of their grandchild.", "grandmother caregivers suffer a deterioration in their health by an acceleration of the aging process.", "caregiving causes grandmother caregivers to feel a sense of social isolation, and persue various coping strategies to control this feeling.", "grandmother caregivers have a greater feeling of self-esteem, but they often conflict with their adult children if they don't feel appreciated by them.", "grandmother caregivers have limited social support and their health issues are often overlooked in the family context.' Conclusion: The results of this study can guide nurses and health care workers to understand the experiences of grandmother caregivers and to implement individualized nursing interventions suited for them.

• Child Health Nursing Research
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• 제13권2호
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• pp.191-200
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• 2007

Purpose: This study was conducted to develop a mother-fetus interaction promotion program aimed at enhancing the sensitivity of primiparas, and to evaluate the effects of a mother-infant play interaction. Method: Participants were recruited from OB-GY clinic with postpartum take-care center (17 mother-infant dyads for intervention group and 17 dyads for control group). Data were collected from January 18 to August 5, 2005. For the intervention group, programmed education which focused on mother-fetus interaction in the 3rd trimester was given. For the two groups, home visiting or a postpartum care center was used for data collection of the mother-infant interaction which was conducted at postpartum 1 week and 1 month. Also mother-infant interactions during feeding were videotaped and two trained observers analyzed the tapes. Results: A significant difference was found in mother-infant interaction between the two groups (postpartum 1 week, t=6.10, P=0.000, 1 month t=6.69, p=.000). For variations in mother-infant interaction in the control group, a significant difference was found in between postpartum 1 week and 1 month (t=-2.564, p=.021). In subscale analysis, interactional behavior of the infant significantly increased in both groups. Conclusion: This study showed that the mother-fetus interaction promotion program aimed at promoting mother-infant interaction increase maternal sensitivity. Therefore, this study suggests that this nursing intervention to increase maternal sensitivity to the fetus should be broadly applied with primiparas, as it can be beneficial for formation of the mother-infant relationship, and for promotion of the social, emotional, and cognitive developments of the children.