• 제목/요약/키워드: NICU

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통합적 NICU입원교육이 고위험신생아 어머니의 모아애착, 모성자존감, 산후우울에 미치는 영향 (The Effects of the Integrated NICU Hospitalization Education on Maternal Attachment, Maternal Self-Esteem, and Postpartum Depression in the Mothers of High-Risk Infants)

  • 안영미;이상미
    • Child Health Nursing Research
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    • 제10권3호
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    • pp.340-349
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    • 2004
  • Purpose: The quasi-experimental study was conducted to investigate the effects of the integrated NICU hospitalization education on maternal attachment, maternal self-esteem, and EPDS in the 26 mothers of high-risk infants(HRI). Method: The subjects were divided into the experimental group to received the integrated NICU hospitalization education included the enforced direct education of NICU and HRI to the mothers using a booklet and the provision of the neomaternal exposure as soon as possible after delivery. The control group received the routine education of the NICU hospitalization, mostly including the admission process and the NICU rules delivering to the husband. The research variables were maternal attachment, maternal self-esteem, and EPDS. Result: The results showed the increases in these variables after the integrated education in experimental group compared to the control group. Conclusion: It supports the benefits of the early direct NICU education and the neomaternal exposures on maternal adaptation process in the mothers of HRI.

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신생아 중환자실에 입원한 환아 어머니의 스트레스 (A Study on the Perceived Stress Level of Mothers in the Neonatal Intensive Care Unit Patients)

  • 김태임
    • Child Health Nursing Research
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    • 제6권2호
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    • pp.224-239
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    • 2000
  • This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales : NICU(PSS:NICU) developed by Miles et al. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from (1) to (5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's α coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers was slightly high(3.6±.7). The highest scored dimension was 'appearance and behavior of the baby'(3.9±1.5), and next were 'relationship with their baby and parental role change'(3.5±1.4), 'communication with health team'(3.4±.9), 'sight and sounds of NICU'(3.2±.8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

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신생아중환자실 의료기구의 소독방법, 소독주기, 교환주기에 대한 감염관리 표준화를 위한 연구 (A Study for Infection Control Standards for Medical Devices in NICU)

  • 김희영;이은정;장은경;박영애
    • 임상간호연구
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    • 제16권2호
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    • pp.69-84
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    • 2010
  • Purpose: The purpose of this study was to identify the state of infection control in neonatal intensive care units (NICUs) including disinfection methods, disinfection cycles, and exchange cycles for medical devices and to suggest a basic framework which would help develop standardized infection control guidelines. Methods: From a list of NICU equipment developed from the NICUs in 4 tertiary hospitals, a structured questionnaire on 74 types of medical equipment was developed and sent to 31 hospitals by mail. The results were reviewed by panel of experts (56 persons), and analyzed for internal validity by a focus group (4 persons) using guidelines from the Centers for Disease Control and the Korean Hospital Nurses Association. Results: The results showed various methods, cycles, disinfectant levels for the disinfectants and exchange cycles in the medical equipment infection control of the 31 hospitals. The focus group developed a 66-item basic framework based on validity testing. Conclusion: From the results of this study, a framework of infection control standards for 66 types of medical equipment in the NICU was developed. It is suggested that further study be done to more precisely establish standard infection control guidelines for NICU medical equipment.

미숙아의 성장과 관련 요인 연구 (Factors associated with the growth of preterm infants)

  • 전지수;서원희;정상진
    • Journal of Nutrition and Health
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    • 제55권5호
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    • pp.572-586
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    • 2022
  • 본 연구는 미숙아의 체중을 추적 조사하여 성장곡선 체중 z-score 값으로 성장 상태를 확인하고 관련 요인을 탐색하기 위한 종단적 연구이다. 출생 체중, 재태연령, 출생 시 NICU에서의 의료적 처치 (CPR, 산소치료, 위장관 삽관), NICU 입원 기간 및 퇴원연령, 수유 문제, 일일 추정 수유량이 체중 성장에 유의하게 영향을 가지는 것이 확인되었다. 출생 체중과 연령이 적은 그룹이 유의하게 초기 성장 정도가 더 낮았으나 교정연령 3개월 이후부터 12개월까지의 체중에 차이가 없었다. 하지만 재태연령 40주 이후의 연령-체중 z-score가 평균 이하인 그룹이 출생 체중이 유의하게 낮은 것으로 보아 장기적인 성장에 출생체중이 영향을 미치는 것으로 보인다. 또한 NICU에서 의료적 처치를 받고 NICU 입원 기간이 긴 경우 성장곡선의 50 백분율 이하로 성장에 유의한 차이가 있었고, 퇴원 후 2개월간 수유과정 중 문제가 없으며 더 많은 양을 섭취한 그룹이 성장곡선에서 더 상위에 있었으며 더 잘 자랐다. 또한 NICU 퇴원 후 가정에서 자녀가 초기보다 하향 성장을 하고 있을 때, 외부의 도움 및 커뮤니티 케어를 필요로 하므로 미숙아 성장 지원을 위하여 커뮤니티 케어 도입의 필요성을 시사하였다. 본 연구 결과를 통하여 미숙아의 출생 체중 및 연령, NICU에서의 처치는 초기의 체중 성장에 영향을 끼치며, 재태연령 40주 이후의 성장 증진과 성장지연 위험을 감소시키기 위해서 올바른 섭취를 통한 원활한 영양공급이 중요함을 알 수 있다. 미숙아 성장 추적은 NICU 퇴원 후에도 지속되어야 하며 성장 증진 관련 변수, 특히 영양 지원에 적극적인 개입과 지지가 필요하다.

2009년 한국 시도별 미숙아, 저체중출생아의 빈도 및 신생아중환자실의 현황 (Regional Analysis on the Incidence of Preterm and Low Birth Weight Infant and the Current Situation on the Neonatal Intensive Care Units in Korea, 2009)

  • 강병호;정경아;한원호;심계식;장지영;배종우
    • Neonatal Medicine
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    • 제18권1호
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    • pp.70-75
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    • 2011
  • 목적: 한국에서는 최근 저 출산율의 지속과 더불어 미숙아 및 저체중출생아의 출생 빈도가 증가하는 경향을 보인다. 이러한 변화에도 불구하고 지속적으로 신생아중환자실의 병상수가 부족한 상태이다. 이 연구의 목적은 2009년 국가통계포털의 통계청 자료에 의거한 총 출생아 수, 미숙아, 저출생체중아 수 NICU 등록 병상 수를 행정지역별로 검토하여 보다 나은 NICU 운영 및 미숙아 신생아의 생존 향상에 도움을 주고자 하였다. 방법: 한국통계포탈에 공개된 2009년도 인구통계 중 미숙아수, LBWI, 출생통계부분, 총 출생 수, 미숙아 수, LBWI 수, VLBWI 수를 얻었고, 전국 및 지역별 NICU 병상 수의 자료는 한국 건강보험심사평가원에서 획득하였다. 한국의 행정구역 지역별, 미숙아 수, LBWI 수, VLBWI수에 따른 병상수의 비와 각 평균에 대한 부족 지역 등을 조사하였다. 결과: 2009년 전체 출생 수 444,849명 중 미숙아 25,374명(5.7%), LBWI 21,954명(4.9%) 이었으며 미숙아나 LBWI 의 빈도가 평균보다 높은 지역은 부산, 인천, 광주였다. 2009년 NICU 총 병상 수는 1,284병상 이었으며 1병상 당 미숙아나 LBWI의 비율이 평균보다 높은 지역은 인천, 대구, 울산 이었다. 2009년 조사된 NICU 병상보유율은 87.5% (1,284/1,486)로 2005년보다는 증가하였으나 12.5%인 184병상이 여전히 부족하다. 특히 경기도는 159병상이 부족하였다. 결론: 신생아는 환자의 특성상 출생 후 이동의 어려움이 있어 즉각적이고 지속적인 처치가 중요하다. 이를 위해 전국적으로 균형 잡힌 NICU의 지역화가 필수적이다. 본 연구를 통해 NICU의 현황 및 시도별 단위에 대한 부족 병상 수에 대한 기본 자료를 제시하는 바이다.

신생아 중환자실에서의 초기 모아상호노출과 모아애착, 모성자존감 및 산후우울간의 관계분석 (The Relationship between Early Neo-maternal Exposure, and Maternal Attachment, Maternal Self-esteem and Postpartum Depression in the Mothers of NICU Infants)

  • 안영미;김미란
    • 대한간호학회지
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    • 제35권5호
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    • pp.798-809
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    • 2005
  • Purpose: This study was performed to investigate the quantities of three neo-maternal exposures; visiting frequency, auditory contact and physical contact, and to examine the relationship between the quantities of each exposure and maternal attachment, maternal self-esteem and postpartum depression in 40 mothers of NICU babies during the first week in the NICU. Method: Each neo-maternal exposure was counted at every mother's visit to the newborn and maternal attachment, maternal self-esteem and postpartum depression were measured using the maternal attachment inventory, the maternal self-report inventory and Edinburgh Postpartum Depression Scale (EPDS) on the first and seventh day in the NICU. Result: The Mean of each neo-maternal exposure was 8.77(2.81) for the visiting frequency, 5.82(3.66) for the auditory contact and 5.60(2.89) for the physical contact during 7 days in the NICU. No significant changes were found in the scores of maternal attachment, maternal self-esteem and postpartum depression between the first and the seventh day in the NICU. The quantities of neo-maternal exposures were positively related to the scores of maternal attachment and maternal self-esteem but not related to postpartum depression. Conclusion: The results of the study suggest the lack of early neo-maternal exposure in cases of NICU hospitalization negate its beneficial effects on maternal psychological well-being in increasing maternal attachment and self-esteem. More efforts are neededfor the neo-maternal interaction and the reevaluation of NICU visitation hours in order to promote maternal-infant interaction.

신생아중환자 분류도구 개발을 위한 간호활동 규명 및 표준간호시간 조사연구 (A Study on Identifying Nursing Activities and Standard Nursing Practice Time for Developing a Neonatal Patient Classification System in Neonatal Intensive Care Unit)

  • 고범자;유미;강진선;김동연;복정희;장은경;박선자;오순자;최윤진
    • 임상간호연구
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    • 제18권2호
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    • pp.251-263
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    • 2012
  • Purpose: It was necessary for developing a neonatal classification system based on nursing needs and direct care time. This study was, thus, aimed at identifying nursing activities and measuring the standard nursing practice time for developing a neonatal patient classification system in Neonatal Intensive Care Unit (NICU). Methods: The study was taken place in 8 general hospitals located in Seoul and Kyungi province, South Korea from Dec, 2009 to Jan, 2010. By using 'the modified Workload Management System for critical care Nurses' (WMSN), nursing categories, activities, standard time, and task frequencies were measured with direct observation. The data were analyzed by using descriptive statistics. Results: Neonatal nursing activities were categorized into 8 areas: vital signs (manual), monitoring, activity of daily living (ADL), feeding, medication, treatment and procedure, respiratory therapy, and education-emotional support. The most frequent and time-consuming area was an ADL, unlike that of adult patients. Conclusion: The findings of the study provide a foundation for developing a neonatal patient classification system in NICU. Further research is warranted to verify the reliability and validity of the instrument.

NICU에 입원한 미숙아 어머니의 스트레스 (Study on the Perceived Stress Level of Mothers in Neonatal Intensive Care Unit)

  • 김태임
    • 혜화의학회지
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    • 제8권1호
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    • pp.865-878
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    • 1999
  • With advances in neonatal medicine, smaller and sicker infants are surviving premature birth. As these tiny patients battle for their lives, their parents also struggle with psychological consequences of an unexpected role. The birth of a sick infants has long been documented as stressful events for the parents. High stress levels may alter parents' interaction with their baby and impair their communication with health professionals, which can in turn affect parents' participation in care planning and decision making. Nursing interventions aimed at reducing the parental stress and anxiety levels during this crisis may have a positive impact on their ability to form an attatchment to their baby and make prudent decisions about his care. The planning of such interventions would be inhanced if the contributions of various factors to increased parental stress levels were identified. This descriptive study was conducted to understand the contents and degree of parental stress in the NICU during their premature's hospitalization, and to give a baseline data in developing nursing intervention program. Subjects were the 60 mother of hospitalized newborn in NICU of 2 University Hospital in Taejon City from April 1st, 1999 to June 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales:NICU(PSS:NICU) developed by Miles et al.. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from "not stressful" (1) to "extremely stressfu1"(5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's ${\alpha}$ coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers of premature baby was slightly high($3.66{\pm}1.1$). The highest scored dimension was 'relationship with their baby and parental role change'($4.21{\pm}0.9$), and next were 'appearance and behavior of the baby'($3.92{\pm}1.1$), 'communication with health team'($3.32{\pm}1.3$), 'sight and sounds of NICU'($3.30{\pm}1.1$). 2. There were statistically significant correlation noted ; mother's perceived severity of the baby's condition(F=8.0012, P= .0125) and baby's gestational age(r = -.4724, P = .0500). In summary, information about physical environment of NICU, the mother's perceived severity of premature baby's state, maternal role change related variables and the knowledge of characteristics of premature baby must be included in nursing intervention program of mother's of premature baby in reducing the parental stress and anxiety level. It is suggested that each NICU needs to develop a nurse managed supportive care program for parents of premature baby. Also, it is suggested that there need to investigate the coping mechanism of mother of premature baby.

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초극소 저출생체중아의 고농도 가습환경 유지를 위한 근거중심 프로토콜 개발 (Development of evidence-based protocol to maintain high humidity of incubator in Extremely Low Birth Weight Infant)

  • 유미;최윤진;한리라;윤영미;배근하;이지은;박지선;박의
    • 중환자간호학회지
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    • 제2권2호
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    • pp.5-17
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    • 2009
  • Purpose: The purpose of this study was to investigate the current humidification state of incubator, the factors disturbing high humidification and to establish the evidence-based nursing protocol to maintain it. Methods: The subjects were 15 infants who were born with extremely low birth weight (ELBW) from May to October, 2007, and data were collected during the first 3 days and analyzed with SPSS WIN program. Results: The goal of humidity level in incubator was 95%, but mean humidity levels were 89.7%(1st day), 91.9%(2nd day), and 91.8%(3rd day)(p<0.001). The disturbing factors were opening frequency and duration of incubator door and window by caregivers. The handling of infants by nurses and doctors happened more frequently during the first day. Especially, nurses handled them more often than others, but the duration of opening during the invasive procedures by doctors was longer than others. The opening frequency had negative correlation with duration(r=-.779, p<.01). Conclusion: So the evidence-based protocol for maintaining high humidity in incubator for ELBW infants during the first 3 days and next 2 days was made. Furthermore we need to educate NICU nurses and doctors about minimal handling.

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국내 대학병원 신생아중환자실 작업치료의 현황 (Current Status of Occupational Therapy in Korean University Hospital NICUs)

  • 김선미;박서희;안선정
    • 대한통합의학회지
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    • 제2권4호
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    • pp.19-27
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    • 2014
  • Purpose : The purpose of this study was to provide some basic information about current status of occupational therapy in Korean University Hospital NICUs. Method : This study was conducted by mail and by analyzing 61 survey questionnaires sent out pediatric occupational therapist in 39 university hospitals. Result : 23 people of the current pediatric occupational therapists worked in NICU under many constraints. Some reasons for not providing occupational therapy services in the NICU were lack of pediatric occupational therapists(55.3%), funding difficulties(42.1%) and problem in the hospital system(42.1%). Conclusion : The results of this study can be used as a basis to increase the provision of occupational therapy in the NICU. Further research is needed to improve the role of occupational therapy in the NICU.