• Child Health Nursing Research
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• 제10권2호
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• pp.180-187
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• 2004

Purpose: This study was designed to investigate effect of sensory stimulation on the mother-infant interaction in premature infants. Method: The subjects of this study consisted of 36 pairs of premature infants and their mothers from NICU of one university hospital located in Taegu, 18 pairs for intervention group and 18 pairs for control group. The data were collected from May, 1999 to October, 2000. For the intervention group Field's sensory stimulation(tactile and kinesthetic stimulation) was applied 2 times a day for 10 days(10:00-11:00 in the morning and 7:00-8:00 in the afternoon by researcher and mother). To determine mother and infant interaction during feeding, tool developed by Kim Mi-Ye(1999) was used. Collected data were analyzed with SAS program using chi-square test and t-test. Result: Significant differences were found in mother-infant interaction between two groups(t=-5.38, p=.00). It indicates that sensory stimulation was effective in improving mother-infant interaction. In the aspects of the quality of mother-infant interaction, sensory stimulation was most effective in improving sensitivity to mother and infant's synchronic behaviors(t=-5.43. p=.00) and followed by growth fostering(t=-5.07, p=.00), sensitivity to infant's cues(t=-4.53, p=.00), clarity of infant's cues(t=-3.03, p=.00) and responsiveness to the mother's behaviors(t=-2.14, p= 0.04). Conclusion: Based on the result of this study, it is suggested that maternally administered sensory stimulation should be applied clinical practice to improve interaction of premature infants and their mothers.

• Neonatal Medicine
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• 제15권2호
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• pp.123-133
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• 2008

Purpose: The purpose of this study was to determine the outcomes of extremely low birth weight infants (ELBWI) who were born at the Asan Medical Center and evaluate the recent status of neonatal intensive care and associated problems. Methods:We retrospectively evaluated 120 inborn ELBWI who were admitted to the NICU of the Asan Medical Center between 2003 and 2006. The survival rate, neurodevelopmental outcomes, maternal and infant factors, and infant mordibities were evaluated and the relationships with survival and catch-up growth were investigated. Results:The survival rate of the ELBWI was 82% at a mean gestational age of 27+2 weeks, and with a mean birth weight of 801.3${\pm}$129.0 g. The duration of hospitalization was 85.7${\pm}$27.2 days, the duration of O2 use was 43.9${\pm}$35.4 days, and the duration of ventilatory support was 20.9${\pm}$20.9 days among the survivors. The incidence of respiratory distress syndrome, chronic lung disease, severe intraventricular hemorrhage, and periventricular leukomalacia were 41.8%, 61.2%, 3%, and 4%, respectively. The mean mental developmental index and psychomotor development index of Bailey Scales of Infant Development (II) at follow-up were 83.4${\pm}$18.2 and 83.3${\pm}$20.3, respectively. Among the infants who had >18 months of follow-up, 50.8% had catch-up growth at 12 months. Conclusion:The survival rate of ELBWI has improved; however, the morbidities remain high, thus indicating further efforts must be implemented to reduce morbidity and improve neurodevelopmental outcomes.

• Child Health Nursing Research
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• 제16권3호
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• pp.211-219
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• 2010

Purpose: The study was done to measure the effects of maternal heart sound on body weight, physiologic reactions (heart rate [HR] and cortisol) and behavioral states of preterm infants. Methods: Thirty-five preterm infants were recruited from a neonatal intensive care unit at a university hospital. Institutional Review Board approval and informed consent were obtained. The infants were assigned to an experimental group (n=18) with an auditory stimulation for 7 days of life, a continuous delivery of maternal heart sound using MP3 attached inside the incubator, or to a control (n=17) without any auditory stimulation. The outcome variables, daily variations in weight, HR and behavioral states, and differences in cortisol were analyzed. Results: There were differences in variations of daily weights (F=3.431, p=.011) and in cortisol (t=3.184, p=.006) between groups, but no difference in variations of daily HR (F=0.331, p=.933) and behavioral states (F=1.842, p=.323). Conclusion: The findings support the safety of continuous maternal heart sound as no changes in HR and behavioral states occurred, and the efficacy as weight increased and cortisol decreased. This auditory simulation may lead to more efficient utilization of energy in preterm infants by consistently providing familiar sounds from intrauterine life and blocking noxious sounds from NICU environments.

• Child Health Nursing Research
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• 제24권2호
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• pp.252-261
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• 2018

Purpose: This study aimed to evaluate the effects of an empowerment program on maternal stress, anxiety, depression and parenting confidence. Methods: A total of 44 mothers of preterm infants were assigned into an experimental or a control group (n=22 each). The experimental group received the usual nursing care and 7 sessions of an empowerment program. The control group only received the usual care. The program was implemented from June to December, 2016 in the neonatal intensive care unit of K university-affiliated hospital in Daegu, Korea. The outcome variables measured were parental stress (PSS: NICU), anxiety (STAI), depression (CES-D) and parenting confidence. Data were analyzed using t-test or repeated measures ANOVA. Results: Scores for both parental stress (t=3.07 p=.004) and depression (F=3.76, p=.26) were significantly lower in the experimental group than in the control group. However, there were no significant differences in anxiety between the groups (F=0.79, p=.505). Parenting confidence scores (F=9.05, p=.001) were significantly higher in the experimental group than in the control group. Conclusion: A maternal empowerment program can be an effective means of reducing parental stress and depression as well as enhancing parenting confidence, for mothers of preterm infants.

• Neonatal Medicine
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• 제17권1호
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• pp.141-146
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• 2010

영양위축성 형성이상은 드물게 발생하는 척추-골단-골중간 형성이상의 일종으로 진행성의 척추측후만증, 운동제한을 동반한 짧은 사지, 비교적 큰 손과 발, 큰 관절들의 비대 등을 특징으로 한다. 이 기형은 특징적인 임상소견과 방사선소견을 통해 진단할 수 있다. 이 기형은 양성 경과를 보인 다수의 증례들이 보고되어 왔고, 소수에서 치명적인 경과를 보이는 증례도 보고되었다. 저자들은 치사성의 영양위축성 형성이상 1례를 경험하였기에 보고하는 바이다.

• 대한간호학회지
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• 제46권6호
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• pp.793-803
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• 2016

Purpose: Developmental care has been recognized as a very important component for the development and health promotion of preterm infants. However, research on how to assess developmental nursing competency has not been studied as expected. This study was done to develop and evaluate a new scale to measure nursing competency for developmental support of preterm infants. Methods: Concept analysis was done with using the Hybrid model of Schwartz-Barcott and Kim (2000), from which a preliminary new scale (30 items) was developed. To test the validity and reliability of the new scale being developed, data were collected from 122 NICU nurses at 4 hospitals in 3 cities in the Republic of Korea, from December, 2014 to March, 2015. Results: The final version of the Developmental Support Competency Scale for Nurses (DSCS-N) caring for premature infants was a 4-point Likert type scale, consisting of 19 items, and categorized as 6 factors, explaining 62.5% of the total variance. Each of the factors were named as follows; 'environmental support' (4 items), 'parental support' (3 items), 'interaction' (3 items), 'critical thinking' (3 items), 'professional development' (3 items), and 'partnership' (3 items). The Cronbach's ${\alpha}$ coefficient for the scale was .83 and the reliability of the subscales ranged from .60~.76. Conclusion: The psychometric evaluation of the new scale demonstrated an acceptable validity and reliability. Findings indicate that the DSCS-N can be used as the tool to test the effect of educational programs for nurses and contribute to advance developmental care for preterm infants.

• Child Health Nursing Research
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• 제5권2호
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• pp.198-210
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• 1999

The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. However, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate En primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals (77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the sub ject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of E% in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.

• 대한간호학회지
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• 제33권4호
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• pp.488-494
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• 2003

Purpose. To examine the effects of body position and time after feeding on gastric residuals in low birth weight infants(LBW). Methods. A repeated measures design was conducted. Twenty LBW infants being fed via indwelling nasogastric tubes were randomly assigned to one of 5 different position orderings. In each position, gastric residuals were measured at 30, 60, 90, 120, 150, and 180 minutes after feeding. Results. In comparisons of gastric residuals with position and time, the main effects of position and time were statistically significant (F=5.038, p=0.001; F=429.763, p < 0.001, respectively), but the interaction between position and time was found not to be significant. In pairwise comparisons, the gastric residuals were more reduced in the right anterior oblique and prone positions compared with the left lateral position (p < 0.05) and the differences across time periods were significant (p < 0.001). Conclusions. The body position after feeding has a significant affect on gastric residuals over time in LBW infants. The right anterior oblique or prone position is recommended rather than left lateral position after feeding. Knowledge of the proper position and the pattern of gastric emptying over time after feeding may lead to the development of evidence-based nursing care.

• Neonatal Medicine
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• 제15권1호
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• pp.54-60
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• 2008

목 적 : 신생아 패혈증의 원인균 및 항생제 감수성의 변화를 조사하여 극소 저출생 체중아 및 미숙아의 이환율 및 사망률 증가와 관련된 패혈증에 대하여 가능한 신속하고 적절한 치료 방침을 세우는데 도움을 주고자 하였다. 방 법 : 2000년 1월부터 2006년 6월까지 을지대학병원 신생아집중치료실에 입원한 출생체중 1,500 g 미만의 극소 저출생 체중아를 대상으로 의무기록을 후향적으로 분석하여 패혈증의 원인균과 항생제 감수성에 대해 조사하여 시기별 분포를 비교하였다. 결 과 : 대상 환아 164명 중 균이 증명된 환아는 19명(11.6%)이었다. 균이 증명된 19명의 환아에서 총 26례의 패혈증 발생을 보였으며, 후기 지발형 패혈증의 발생빈도가 제일 높았다. K. pneumoniae가 가장 흔한 원인균이였으며, 그 뒤로 Streptococcus spp., CNS, Enterobacter spp.의 순으로 배양되었고, 대부분이 경험적 항균제에 내성을 나타내었다. 결 론 : 과거 연구나 타 의료기관에서 증명된 흔한 원인균과 항생제 감수성 결과에 의존하여 광범위 경험적 항생제를 사용하기보다는 주기적으로 원인균 및 항균제 감수성의 변화를 파악하고 적절한 항생제를 사용하는 것이 신생아 패혈증의 치료의 효과뿐만 아니라, 다제내성균의 출현을 막을 수 있을 것으로 사료된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.536-544
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• 2019

Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. Conclusion: The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.