• 정신신체의학
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• 제28권2호
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• pp.177-184
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• 2020

연구목적 산후우울증은 일반적으로 산모의 10~15%에서 발병하는 질환으로 그 원인으로는 정신사회적인 요인과 산과적인 요인이 모두 관계 있다고 알려져 있다. 감염, 손상, 악성종양, 자가면역질환, 스트레스에 의해 면역체계가 자극되면 proinflammatory cytokine과 anti-inflammatory cytokine이 생성되고 분비된다고 알려져 있다. 본 연구에서는 산후우울증이 있는 경우 산후우울증이 없는 군에 비해 혈중 Transforming growth factor-β1(TGF-β1), Insulin-like growth factor-1 (IGF-1), β-Nerve growth factor (β-NGF), Interleukin-2 (IL-2), IL-4, IL-6, Tumor necrosis factor-α (TNF-α), Interferon-γ (IFN-γ)의 농도가 상승되어 있을 것이라 가정하고, 임산부에서의 우울증의 경과에 따라 cytokine의 농도의 변화를 알아보고자 한다. 방 법 본 연구는 총 104 명의 임산부와 60명의 임신을 하지 않은 정상 대조군을 대상으로 하였다. 우울 증상은 임신 24주, 출산 1주, 출산 6주에 에딘버러 산후 우울 척도(EPDS)를 사용하여 평가하였다. EPDS의 총 점수가 10 이상인 경우, 우울증상이 있는 것으로 판단하였으며 EPDS 점수 변화에 따라 임산부 정상대조군, 출산 후 우울-회복군, 출산 후 우울군 세 그룹으로 나누었다. 결 과 임신군과 비임신 정상대조군을 비교하였을 때 TGF-β1, IGF-1의 혈장 농도는 임신군에서 비임신 정상대조군보다 더 높았다(TGF-β1 ; p<0.01, IGF-1 ; p=0.026). 그러나 β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α는 비임신 여성대조군에 비해 임산부 정상대조군에서 그 농도가 낮게 측정되었다(β-NGF ; p=0.001, IL-2 ; p<0.01, IL-4 ; p<0.01, IL-6 ; p<0.01, IFN-γ ; p<0.01, TNF-α ; p<0.01) 임신 24주에 TGF-β1, IGF-1, β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α의 농도를 살펴보면 임산부 정상대조군, 출산 후 우울-회복군, 출산 후 우울군 세 군간에 유의한 차이가 없었으며 출산 6주에도 역시 유의한 차이가 관찰되지 않았다. 또한 임신 24주, 출산 6주에 시간에 따른 농도 차이를 비교해 보았을 때 세 군에서 모두 그 통계적으로 유의한 차이는 없었다. 결 론 본 연구는 비임신 정상대조군과 임신군간의 혈장 cytokine 농도에서 유의한 차이를 발견했으나 산후우울증군과 정상 임신대조군간의 혈장 cytokine 농도는 유의한 차이를 밝혀내지는 못했다.

• Child Health Nursing Research
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• 제17권2호
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• pp.69-73
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• 2011

Purpose: This study was designed to identify mother and infant related factors that influence child-care stress among the mother of newborn infants. Methods: Data were collected through self-administered questionnaires and descriptive statistics, correlation and multiple regression were used to analyze the data. The data survey was conducted with 957 conveniently selected mothers of infants when they visited a public health center in Seoul to have their children immunized. Results: The average item score for the Childcare Stress Inventory was 38.03, for the Edinburgh Postnatal Depression Scale, 9.31 and for the Degree of Bother Inventory, 23.42. The CSI was positively correlated to EPDS (r=.44, p<.001) and DBI (r=.40, p<.001). Also these two variables explained 30.0% of CSI in infants' mothers. Conclusion: These findings are expected to expand the understanding about postpartum mothers' child-care stress and can contribute to the development of comprehensive interventions based on community health nursing.

• 대한한방부인과학회지
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• 제25권4호
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• pp.125-133
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• 2012

Objectives: Postpartum thyroiditis patient's symptoms are very similar to symptoms of postpartum disease which can be called sanhupung. This study is to report the effect of herbal medicine on sanhupung patient diagnosed of postpartum thyroiditis. Methods: We treated a 32-year-old female patient who had symptoms of postpartum thyroiditis and sanhupung with Jaeumganghwa-tang and Jayumkeonbi-tang. Results: After herbal medicine treatment the symptoms of postpartum thyroiditis such as general weakness, hot flush on the palms and soles of the feet, fever pattern of malaria and symptoms of sanhupung such as arthralgia, depression, imsomnia, sweating were improved. Conclusions: This case report shows that herbal medicine can be used to treat patient with postpartum thyroiditis and Jaeumganghwa-tang, Jayumkeonbi-tang is effective for mitigating the symptoms of postpartum thyroiditis. However, patient is still in thyroxine treatment, and additional care is required.

• 대한한방부인과학회지
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• 제35권1호
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• pp.34-58
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• 2022

Objectives: This study was performed to analyze the interventions of Oriental Medicine which had been commonly used for postpartum disease and postpartum care. Methods: We searched research on the interventions for postpartum disease and postpartum care in 4 domestic search engines. After that, we conducted eligibility screening based on inclusion and exclusion criteria. Results: 1. We selected total 50 studies. There were 2 randomized controlled trial (RCT), 5 non-RCT, 35 case reports, 8 case series within the 6~8 weeks after childbirth. 2. Of the 35 case reports, several interventions were used : acupuncture (22), moxibustion (11), cupping therapy (7), pharmacopuncture (5), chuna manipulation (4), herbal medicine (34). The most common symptoms were musculoskeletal symptoms (8), followed by postpartum depression (7). Various prescriptions and acupoints of oriental medicine were used depending on the diseases or symptoms. 3. Of the 8 case series, 382 subjects in 5 case series had taken Saenghwa-tang-gagam. And Acupuncture, moxibustion, cupping therapy (5), pharmacopuncture (1) were used as an intervention. 4. The most commonly used acupoint is 腎兪 (BL23) in the pain including postpartum back pain and 三陰交 (SP6), 關元 (CV4) in the postpartum care. 關元 (CV4) is the most commomly used moxibustion point not only the postpartum disease but also the postpartum care. Conclusions: In clinical studies of oriental medicine related to postpartum disease and postpartum care, pain-related clinical studies that belong to or progress to Sanhupung were the most common (30%), and among them, postpartum low back pain studies were the most common (20%). Based on this, we believe that large-scale clinical studies with high quality using oriental interventions including chuna and pharmacopuncture are needed to establish guidelines for the management of pain treatment including postpartum back pain.

• 여성건강간호학회지
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• 제10권1호
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• pp.15-22
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• 2004

Purpose: This study was to examine the effect of postpartum exercise on mental health. Mental health comprises a 9 symptom dimension of Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid Ideation, and Psychoticism. Method: A non-equivalent pre-test, post-test control group study was conducted. Fifty-two puerperal women who were admitted to a postpartum ward of a mother-baby clinic in Pusan were recruited; 26 women were assigned to the experimental group and 26 women to the control group. Postpartum exercise was applied to the experimental group from postpartum day 3 for a period of 8 weeks while no exercise program was applied to the control group. Mental health with SCL-90-R was measured before and after exercise. Data was analyzed using mean, $x^2$-test, t-test, and ANOVA by SPSS 10.0. Result: The mental health status in the exercise group did not show a statistically significant decrease when compared to that of the control group. Conclusion: There is no effect of postpartum exercise on women's mental health during the first 8 weeks of the postpartum period. Further studies are needed for randomized clinical trials with a larger sample size.

• 임상간호연구
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• 제15권2호
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• pp.77-89
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• 2009

Purpose: The purpose of this study was to compare maternal perceptions between two groups of postpartum women, women who chose to have their babies room-in and women who did not (non rooming-in group). Methods: Data collection was conducted in 37 hospitals from August 10 to September 20, 2008. The participants were 209 mothers opting for rooming-in and 128 mothers for non rooming-in. The women completed a questionnaire which included the Edinburgh postpartum depression scale, maternal attachment inventory, and postpartum self-evaluation questionnaire. Results: There were significant differences in education level, income and antenatal education between the rooming-in and non rooming-in groups. The rooming-in group also showed higher levels of satisfaction with medical services. More important, the rate of breast feeding for the rooming-in group was higher than for the non rooming-in group. There was no difference between the two groups for postpartum depression, maternal attachment and mothers' confidence with infant care tasks. Conclusion: These findings suggest that rooming-in system has more advantages compared to non rooming-in and that it can help to promote breast feeding. The authors recommend that the rooming-in system be expanded nationwide. The results of this research can be used to assist the development of future rooming-in system expansion strategy.

• 대한간호학회지
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• 제40권4호
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• pp.503-514
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• 2010

Purpose: The purpose of this study was to compare levels of postpartum fatigue, depression, childcare stress, and maternal identity according to postpartum period between primiparas who used Sanhujori facilities and those who did not. Methods: The research design was a longitudinal descriptive study using self-report questionnaires. Participants were 55 healthy primiparas who delivered at one of 3 hospitals in Chungnam, 21 using Sanhujori facilities and 34 not using these facilities during the first three weeks after childbirth. Data were collected from October 2008 to April 2009 at three measurement points, 2-4 days after childbirth (T1), 4-6 weeks (T2), and 12-14 weeks (T3). Data were analyzed using the SPSS 17.0 WIN program. Results: There was a significant difference in childcare stress between the two groups at 4-6 weeks after childbirth. Postpartum depression and childcare stress at 4-6 weeks were significantly higher than those of the other postpartum periods, while maternal identity was significantly lower. Conclusion: Child care stress is the most important issue among women who use Sanhujori facilities and the 4-6 week period after childbirth is very difficult to primiparas. These results indicate that nursing interventions for primiparas in Sanhujori facilities should focus on reducing childcare stress. Furthermore proper follow-up programs at 4-6 weeks are needed to decrease the difficulties in adjustment by new mothers.

• 지역사회간호학회지
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• 제32권1호
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• pp.116-129
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• 2021

Purpose: This study aimed to investigate the maternal health effects of internet-based education interventions on parturients during the postpartum period through a systematic review of randomized controlled trials. Methods: An electronic literature search of the Cochrane Library, CINAHL, EMBASE, Eric, PsycINFO, PubMed, RISS, and KISS databases was performed, using the combination of keywords such as 'parenthood education', '*natal education', '*birth intervention', 'internet-based intervention', 'randomized controlled trial'. The inclusion criteria were peer-reviewed papers in English regarding randomized controlled trials of internet-based postnatal education interventions. Educational interventions were delivered through any web, mobile, eHealth, mHealth, virtual reality, short message service, or social networking service platform. Quality appraisal was performed using the Risk of Bias 2 (RoB 2) for randomized controlled trials. Nine articles were yielded, and the intervention effects were analyzed. Results: Internet-based education interventions during the postpartum period affect maternal self-efficacy, postpartum depression, and successive breastfeeding; however, they do not affect maternal satisfaction and parenting confidence. Conclusion: This study demonstrated that internet-based education interventions affect maternal health status in terms of psychological, emotional, and physical wellness. Therefore, maternal health care professionals can utilize remote education using the internet or mobile-based interventions during the postpartum period.

• 정신신체의학
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• 제17권1호
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• pp.15-22
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• 2009

연구목적 : 산후 우울증은 10~15%의 산모가 경험하는 흔한 질환이다. 본 예비적 연구의 목적은 산후 우울증과 산전 위험요인으로 가족 적응력 및 응집성과의 관계를 알아보기 위함이다. 방법 : 24명의 산모를 대상으로 출산 전후의 시기에 전향적으로 연구하였다. 임신 36~40주에 산전 위험요인에 대한 질문지, Edinburgh 산후 우울증 척도(EPDS), 가족 적응력-응집성 평가 척도(FACES), Beck 불안 척도(BAI) 등을 시행하였다. 출산 후 4~6주에 구조적 면담으로 미니 국제신경정신인터뷰를 시행하여 산후 우울증을 진단하였으며 산후 위험요인에 대한 질문지, EPDS, BAI 등을 시행하였다. 결과 : 산후 우울증 군과 비 산후 우울증 군을 비교한 결과, 여러 v위험 요인 중 가족 적응력 및 응집성, 산전 우울증상 및 임신 중 기분 변화가 유의한 차이를 보였다. 로지스틱 회귀분석 상 임신 중 기분변화, 낮은 가족 적응력-응집성 평가 척도 총점 및 각 하위 척도 점수가 산후 우울증의 유의한 연관 요인으로 나타났다. 결론 : 본 연구의 결과는 산후 우울증에 있어 낮은 가족 적응력 및 응집성이 유의한 연관성을 가진 요인일 수 있음을 시사한다. 그러나 본 연구는 예비적 연구로 연구 대상 수가 적어 상기 결과가 지지되기 위해서는 대규모 연구가 필요하다.

• 한국지역사회생활과학회지
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• 제17권3호
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• pp.109-121
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• 2006

This study examines the relationship between mother's stress and cortisol level during late pregnancy and how it changes into postpartum periods. Thirty one families were recruited from Daejeon and Incheon in South Korea. The major findings were as follows: (1) The level of mothers' cortisol followed the typical diurnal pattern of decline throughout the day. Further longitudinal analysis revealed that the level of Korean mothers' cortisol steadily lowered from the 8th prenatal month to the 6th postnatal month. (2) During pregnancy, mothers reported to experience changes in physical activities, daily routines, eating habits, types or amount of social activities and sleeping habits. Among these they were stressed the most by changes in physical activities and social activities. (3) The results of postpartum depression tests conducted at two months after giving birth showed mothers at this time were mostly stressed from difficulty sleeping and unnecessary self criticism. (4) The level of psycho social stress in mothers at six months after giving birth was mainly on social roles and the questions about self reliance marked the highest points. (5) Overall, there was a tendency for the level of maternal stress to decrease definitely from before and after the delivery and even though the level of stress was steadily decreasing up to 6th postpartum month it was not as sharp as those of before and after the birth of the babies. The level of cortisol analysis also showed the same obvious tendency.