• 대한간호학회지
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• 제45권2호
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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.

• Child Health Nursing Research
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• 제13권1호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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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.

• 대한간호학회지
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• 제32권4호
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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.

• Child Health Nursing Research
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• 제25권4호
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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.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.531-548
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• 1991

신생아의 질적 관리를 위해 신생아실 의료인력과 의료수가의 타당성을 파악하고자 영남지역내 24개 소아과 수련병원 가운데 신설병원과 모(母)병원의 수련프로그램에 의존해 있는 병원을 제외한 20개 병원의 신생아실을 대상으로 1991년 7월 29일에서 8월 14일 사이에 각 병원을 방문하여 자료를 수집하였다. 자료는 신생아실 대장에서 1991년 6월 한달동안 입.퇴원한 정상 및 환아수를 조사하고 신생아실 수간호사와 소아과 의사를 면담하여 정상신생아 관리에 소요되는 최소한의 간호시간, 인력현황, 인력의 적정성, 그리고 인력확보의 문제점을 조사하였고 자 병원 보험심사과에서 정상 질분만시와 제왕절개분만시 산모 1인당 평균 산모 및 신생아관리분의 의료비를 조사하였다. 정상신생아 1명당 하루에 필요한 최소한의 간호시간은 평균 179.5분(${\pm}58.6$)이었고 대학병원은 202.3분(${\pm}50.7$), 종합병원은 164.2분(${\pm}60.5$)이었다. 최소한의 간호 요구시간 대 제공가능한 간호시간 비는 평균 1.42였고 환아에 대한 간호 요구량을 감안했을 때는 평균 비가 2.06으로 간호인력이 매우 부족하였다. 미국 소아과학회가 권장한 신생아실 간호인력을 기준으로 할 경우 간호사는 31%, 간호조무사는 17%가 충원된 상태였다. 신생아실 수간호사의 90%와 소아과 의사의 85%가 간호사가 부족하다고 했고 간호조무사는 각각 75%가 부족하다고 했다. 간호인력 보충이 안 되는 주된 이유는 재정사정이라고 하였다. 간호조무사의 경우는 인력구하기 힘든 것이 재정사정 다음으로 중요한 이유였다. 그러나 국립대학병원의 경우는 의사와 간호사는 T.O.의 제한이 주된 이유라고 했다. 정상 질분만으로 2박 3일만에 퇴원하는 경우 총 의료비는 평균 219,430원이었고 이 중 신생아분은 20,323원(9.3%)이었으며, 제왕절개분만으로 6박 7일만에 퇴원할 경우 평균 732,578원이었고 이 중 신생아분은 76,937원(12.0%)이었다. 원가계산방식에 의한 신생아관리에 대한 최소한의 원가는 3차진료기관의 경우 1일 16,141원, 기타 종합병원은 14,576원으로 원가가 의료보험수가의 각각 5.0배, 4.9배나 되었다. 오늘날의 의료인력의 인건비 수준과 병원시설 및 관리비를 감안할 때 현행 의료수가로 양질의 신생아관리를 기대하기 어려운 것으로 생각된다.

• Korean Journal of Radiology
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• 제22권1호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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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.

• 여성건강간호학회지
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• 제7권1호
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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.

• 대한한의학회지
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• 제38권1호
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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.