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

• Child Health Nursing Research
• /
• 제24권4호
• /
• pp.407-419
• /
• 2018

Purpose: The purpose of this study was to explore and describe the meaning and essence of a mother's experience of hospitalization of her newborn in the neonatal intensive care unit (NICU). Methods: This study employed a qualitative research design. An interview was conducted with a mother whose newborn was hospitalized in the NICU, and the data were analyzed using Giorgi's phenomenological method. Results: Five main themes and 19 formulated meanings were indentified. The 5 themes were 'drowning in pain', 'just look outside the glass door', 'being a pillar', 'a deepening attachment', and 'prepare for nurturing with hope'. Conclusion: The results of this study provided an in-depth understanding of the experience of a mother with a newborn in the NICU. These results can be used in the development of a nursing intervention program that provides psychological and emotional support to the mother and family.

• 한국의료질향상학회지
• /
• 제8권2호
• /
• pp.160-171
• /
• 2001

Background : This study was conducted to compare the level of satisfaction between mothers who were educated on the care of newborns by video-taped method and those by verbal one before discharge. Methods : Fifty-two mother (verbal method group) from a free standing OB & GY hospital in Wonju City and forty-seven mothers (videotaped method group) from the OB & GY section of Wonju Christian Hospital(WCH) were selected for a study sample. The knowledge and understanding of newborn care and the degree of maternal satisfaction were assessed after the education by self-administered questionnaires. The opinions of the 11 nurses of WCH who were involved in the education were also collected by a questionnaire. Results : With respect of the level of understanding and satisfaction with the discharge education on newborn care, there is no significant difference between the videotaped educated group and verbal educated one. The correlation analysis of the video education group revealed a strong correlation between the score of understanding and satisfaction with the discharge preparation(r=0.409, p=0.01), and between the satisfaction scores for discharge preparation and discharge education(r=0.844, p=0.001). As for the verbal education group, the score of understanding also correlated significantly with both the score of satisfaction with the discharge education(r=0.272, p=0.001) and the discharge preparation(r=.680, p=0.001). Conclusions : This study showed that the discharge education to mothers regarding newborn care by a videotaped method does not improve the understanding or satisfaction of the mothers. However, the response to the mode of discharge education varies by the characteristics of the mothers. In conclusion, the characteristics of the mother should be considered in order to improve the understanding and knowledge of newborn care when the mode discharge education is chosen.

• Child Health Nursing Research
• /
• 제18권4호
• /
• pp.177-183
• /
• 2012

Purpose: This study was done to examine the incidence of pressure ulcers and associated factors, by inspecting the skin of newborn babies in a newborn unit or newborn intensive care unit (NICU). Methods: The participants were 101 newborn babies in either a newborn unit or NICU in D general hospital. The incidence of pressure ulcer was measured using the skin inspection tool for pressure ulcer, suggested by Agency for Health Care Policy and Research. Results: Incidence rate of pressure ulcer was 19.8%, and 80% of the newborns with pressure ulcers were premature babies. The commonest region of onset was the ear (36.8%), followed by the foot (31.6%), occipital region (15.8%) and knee (15.8%). Those are the regions related to external medical devices like nasal Continuous Positive Airway Pressure and Pulse Oximetry. Factors related to pressure ulcers were gestational period of 37 weeks or less, hospitalization for 7 days or more, birth weight under 2,500 g and a low level of serum albumin. Conclusion: The results of the study show that the skin and underlying tissues of premature infants is at risk for pressure-related skin breakdown. As most pressure ulcers are caused by medical devices, nursing interventions are required to prevent further aggravation of the lesions.

• 여성건강간호학회지
• /
• 제8권3호
• /
• pp.345-357
• /
• 2002

The purpose of this study is to find out how the Father Class, which is being practiced at a hospital located in Seoul, influences on fathers' level of knowledge and confidence of postpartal mother and newborn care. Research design was quasi-experimental study using non equivalent experiment and control group. The data, questionaires, were collected from Sep. 13, 2001 to Oct. 31, 2001 through e-mail, telephone and mail, after discharge from S hospital located in Seoul, where the experimental group was educated at the Father Class and control group didn't take part in the class. The objects were the fathers who have the first baby through normal delivery or C-sec delivery including experimental group 48 persons and control group 52 persons. Four instruments were the revised ones of Lee Mi Kyoung's(1990) and Kwak Yon Hee's tool based on the resources of direct interviews of fathers and one expert, professor. The reliability of four instruments were Cronbach's $\alpha$ scores .85 -93. Data were analyzed by SPSS 10.0 program using $x^2$-test, and t-test and, One- way ANOVA, and Pearson correlation, etc. The results of this study are as follows; 1.The two groups were confirmed as a homogeneous group by showing no significant difference statistically at the level of 5%. 2.The results of proving the hypothesis are followings: 1)The first hypothesis, "the fathers who participated in the Father Class will have the higher level of knowledge about postpartal mother care than the fathers who didn't" was accepted by significant difference statistically (p=0.000). 2)The second hypothesis, "the fathers who took part in the class will have the higher confidence in postpartal mother care than the fathers who didn't", was supported by significant difference statistically (p=0.000). 3) The third hypothesis, "the fathers who attended the class will have the better knowledge about taking care of newborn than the others", was accepted by significant difference statistically (p=0.000). 4)The fourth hypothesis, "the fathers who participated in the class will have the higher confidence in newborn care than others," was supported by significant difference statistically (p=0.000). 3.The further analysis showed whether they participated in Prenatal Birth Preparing Class influenced on the father's level of knowledge and confidence in postpartal mother and newborn care. In conclusion, the Father Class is the effective nursing intervention strategy that can help new fathers attain father and husband roles by enhancing the level of confidence in and knowledge of the postpartal mother and newborn care.

• 가정간호학회지
• /
• 제10권2호
• /
• pp.148-157
• /
• 2003

The purpose of this study was to provide the basic data for developing a program for effective intervention for home health care need of postpartum mothers and newborn babies. The subjects were 104 women. The data were collected from march, 2003 to June, using a 81 item questionnaire and analyzed by SPSS program for frequency, Mean, ANOVA. The results were as follow. 1. The mean of care needs of newborn babies was higher than that of physical demand of Postpartum mothers. The mean of physical demand of Postpartum mothers was $3.99\pm.42$. The mean of care needs of newborn babies was $4.11\pm.50$. 2. The most highest mean of physical demand of Postpartum mothers was wound care for caesarean section and episiotomy($4.53\pm.66$), and then breast engorgement care($4.38\pm.71$). The most highest mean of care needs of newborn babies was emergency care methods($4.58\pm.52$), and then infection control $4.51\pm.56$). 3. 66.3% of postpartum mothers positively desired consultation hospitals centered home care need during postpartial periods. 4. Influential variables of home health care need was postpartial periods. they wanted the first week after delivery, more freqently visiting of home care nurse. 37.5% of postpatial mothers wanted visiting within 1 weeks after delivery. 31.7% wanted 2 times/week. In conclusion, it is necessary to study to make a program in nursing of home health care for postpartum mothers, and to keep on studying repeatedly in order to raise the number of objects and to find related variables.

• 부모자녀건강학회지
• /
• 제9권2호
• /
• pp.116-127
• /
• 2006

Purpose: Assessment of mothers' neonatal perception is important in understanding early mothering experiences and in planning future care. The purpose of this study was to identify the differences of mothers' perception and caring-confidence between normal and high-risk newborn during the early postpartum period. The ultimate goal was to contribute to healthy mother-infant relationship and development of infants. Method: The data was collected for this study at one university hospital in Daejeon from May 13, 2005 to December 20, 2005. The subjects were 53 of mothers who had normal newborn and 46 of mothers who had high-risk newborn. The instrument was the 'Neonatal Perception Inventory' by revised Ja-Hyung, Lee (1986), and the 'Caring-Confidence Scale' by revised Hyun-Joo, Oh(2000). The data were statistically analyzed by using an SPSS program and include percentage, mean, SD, t-test. Result: There were significant differences in the perception of the newborn between the mothers of normal newborn and the mothers of high-risk newborn (p<.05). There were no significant differences in the perception pattern of the newborn between the mothers of normal newborn and the mothers of high-risk newborn. There were no significant differences in the caring-confidence between the mothers of normal newborn and the mothers of high-risk newborn. Conclusion: The nursing care in the nursery have needed to various interventions for normal and high-risk newborn mothers in order to improve the interaction and caring-confidence between mother and newborn.

• 대한간호학회지
• /
• 제43권4호
• /
• pp.468-477
• /
• 2013

Purpose: This study was conducted to develop a simulation-based education program for newborn emergency care based on most needed topics found from the needs assessment. This study consisted of two phases: developing the program and evaluating its effectiveness. Methods: The effectiveness of the program was tested in July, 2012, with 49 junior nursing students from C Nursing College in Seoul, who did not have any clinical experience in newborn care. The experimental group was given a three-hour lecture, three hours of clinical training, and a two-hour simulation program, whereas the control group only had the three-hour lecture. Results: There was significant improvement in knowledge in both groups, but no significant differences according to educational methods. The experiment group was more confident of their care ($4.32{\pm}.29$) than the control group ($3.60{\pm}.29$) with the difference being significant (t=8.85, p<.001), and the experimental group was also more satisfied with the program (${\chi}^2$=4.60, p=.032). Conclusion: As the results indicate 'the neonatal emergency care program' increased learners' knowledge, confidence and satisfaction with the program, it should be integrated into clinical training in pediatric nursing curriculum and in-service programs for nurses. To increase generalization further verification studies with various learner groups are needed.

• Child Health Nursing Research
• /
• 제27권1호
• /
• pp.3-12
• /
• 2021

Purpose: While clinical practice is crucial for nursing students to acquire the skills needed to provide professional, high-quality nursing care, further studies on improving undergraduate nursing programs are needed to provide a supportive clinical learning environment for student nurses. This study aimed to understand nursing students' clinical experiences in newborn nurseries and neonatal intensive care units and to provide basic data for the establishment of strategies to promote effective clinical education. Methods: Interviews were held with 15 nursing students at J University who had clinical practice experience in the newborn nursery and neonatal intensive care unit. The collected data were analyzed using the phenomenological analysis method developed by Colaizzi (1978). Results: The nursing students' experiences were grouped into four categories: "expectations for and anxiety about clinical practice", "acquisition of a wide range of knowledge regarding neonatal nursing", "challenges faced in clinical practice", and "experiencing interpersonal changes". Conclusion: The current neonatal practice nursing education system provides students with positive learning experiences. However, the lack of practice opportunities, insufficient instruction, and the theory-practice gap were identified as major issues hindering students' learning needs. These study results are expected to provide basic data for curriculum development to improve undergraduate nursing education.

• 한국융합학회논문지
• /
• 제8권4호
• /
• pp.59-65
• /
• 2017

본 연구의 목적은 간호대학생의 임상융합 신생아마사지 프로그램 전 후에 신생아돌보기 활동 자신감의 차이를 비교분석하기 위하여 실시되었다. 연구대상은 충남지역에 위치한 B대학 간호학과 3학년 학생 50명이었고, 2016년 3월 1일에서 3월 25일까지 1일 2시간씩 4차례에 걸쳐 계획된 교육프로그램을 진행하였다. 대상자에게 신생아돌보기 활동 자신감 정도를 교육 프로그램 전 후에 각각 1회씩 측정하였고, 수집된 자료는 SPSS 21.0 프로그램을 이용하여 paired t-test로 분석하였다. 연구결과로는 교육 전 후에 신생아돌보기 활동 자신감 총점(t=-7.209, p<.001)과 세부영역인 수유관리(t=-6.025, p<.001), 트림시키기(t=-3.870, p<.001), 목욕시키기(t=-7.432, p<.001), 목욕 후 위생관리(t=-5.892, p<.001), 제대관리(t=-3.843, p<.001), 아기 상태 파악 및 아기 간호활동(t=-6.113, p<.001)에서 통계적으로 유의하였다. 이는 임상에서 필요한 지식과 술기에 바탕을 둔 신생아마사지 프로그램이 간호대학생의 신생아돌보기 활동자신감 향상에 긍정적인 효과 및 임상 실습과 졸업 후 임상 간호 수행에 큰 도움이 될 것이라 사료된다.