• 여성건강간호학회지
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• 제21권2호
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• pp.106-114
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• 2015

Purpose: The purpose of this review was to describe a psychoneuroimmunology (PNI) framework for postpartum depression (PPD) and discuss its implications for nursing research and practice for postpartum women. Methods: This study explored the role of hypothalamic-pituitary-adrenal (HPA) axis and inflammation as possible mediators of risk factors for PPD through literature review. Results: From this PNI view, human bodies are designed to respond with the reciprocal interactions among the neuro-endocrine and immune system when they are faced with physical or psychological stressors. Chronic stress induces alterations in the function of HPA axis, and a chronic low-grade inflammatory response is associated with depression. The dysfunctions of cytokines and HPA axis have been observed during the postpartum period. Stress promotes glucocorticoid receptor resistance, which can promote inflammatory responses. This, in turn, can contribute to the pathophysiology of depression. This can especially affect populations at vulnerable time-points, such as women in the postpartum. Conclusion: From a PNI perspective, well-designed prospective research evaluating the role of stress and inflammation as an etiology of PPD and the effect of stress reduction is warranted to prevent PPD.

• 대한간호학회지
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• 제28권3호
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• pp.616-624
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• 1998

The purpose of this study was to contribute to maternal nursing in early postpartum stage and to neonatal nursing. Data were collected through self-report questionnaires which were constructed to include parental role stress scale, state-trait anxiety scale, and perception of the newborn scale. The subjects consisted of 100 mothers in the early postpartum stage at three hospitals in the Kyoung-In area, from November 8 to December 26, 1997. The data were analyzed by an SPSS program. The results are as follows ; 1. The mean of parental role stress of mothers in the early postpartum stage was 10.70$\pm$2.63. The means of state anxiety and trait anxiety of mothers were 36.29$\pm$8.45 and 38.53$\pm$8.36. The mean of perception of the newborn was 2.65$\pm$5.05, and 59% of mothers rated their newborn as better than the average newborn. 2. The level of parental role stress correlated to the level of state anxiety and trait anxiety. The level of state anxiety and trait anxiety were also related. The level of perception of the newborn was related to the level of state anxiety and trait anxiety. 3. Mothers who did not want the pregnancy, whose newborns were girls, and who already had one child had higher state anxiety than those who did not. Mothers who already had one child, and whose newborn had no specific signs had higher trait anxiety than those who did not. Mothers who professed a religions had a higher perception of the newborn than those who did not. The above findings indicate that the levels of parental role stress, state anxiety, trait anxiety and perception of the newborn of mothers in early postpartum stage were correlated. Therefore nursing intervention for reducing stress and anxiety, and improving perception of the newborn should be provided for mothers in early postpartum stage.

• 대한간호학회지
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• 제34권5호
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• pp.722-728
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• 2004

Purpose: This study was designed to determine the predictors of postpartum depression. Method: One hundred-sixty one women within one year after delivery from one public health center located in the northern area of Seoul were used in this study. The instruments were a survey of general characteristics, the Edinburgh Postnatal Depression Scale, recent life events index, perceived social support from family, Quality of marriage index, parenting stress index, and Rosenberg's self-esteem inventory. Data was analysed using descriptive statistics, Pearson correlation coefficients, and logistic regression. Result: The average item score of the EPDS was 6.67. 12.4% of respondents, who scored above a threshold 12, were likely to be suffering from a depression of varying severity. The fitness of the model for explaining postpartum depression from six variables, plan for pregnancy, family support, quality of marital relation, perceived social support, life events, childcare stress, and self-esteem, was statistically significant and the predictive power of these variables was 90.9%. The significant predictors of postpartum depression were family support and child care stress. Conclusion: Further research is needed to identify the prevalence rate of postpartum depression using more reliable sampling methods from a large general population. Nursing interventions need to be developed for promoting family support and reducing childcare stress.

• International Journal of Advanced Culture Technology
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• 제6권4호
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• pp.45-51
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• 2018

The purpose of the study was to examine the effects of family related factors (mothers' self-esteem, mothers' parenting stress, mothers' marital satisfaction, fathers' parenting involvement, and social support) on mothers' postpartum depression. The subjects were 797 households that were extracted from the $1^{st}$ wave of the Panel Study of Korean Children (PSKC). The study variables were measured using the survey questionnaires, and analyses of Pearson's correlation and multiple regression were conducted. Results showed that family related factors significantly predicted mothers' postpartum depression. Moreover, the most significant predictor was mothers' parenting stress, followed by marital satisfaction, self-esteem, fathers' parenting involvement, and social support. Study findings indicate that mothers' postpartum depression is attributed to not only personal but also family related factors. Our results suggest importance of parent education and family support along with social support.

• 대한간호학회지
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• 제41권3호
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• pp.294-301
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• 2011

Purpose: The purpose of this study was to examine the effects of laughter therapy on postpartum fatigue and stress respon-ses of postpartum women. Methods: The research design was a nonequivalent control group non-synchronized design. The participants were 67 postpartum women who agreed to participate in this study, selected by convenience sampling: (experiment group-33 and control group-34). The data were collected from August 5 to September 30, 2010. The experimental group received laughter therapy from a laughter therapy expert for 60 min, twice a week for 2 weeks, a total of 4 sessions. To evaluate the effects of laughter therapy, postpartum fatigue by self-report questionnaire and cortisol concentration in breast milk were measured. The data were analyzed using the SPSS WIN 13.0 Program. Results: The first hypothesis that "the degree of postpartum fatigue in the experimental group participating in laughter therapy would be lower than that of the control group" was accepted. These findings indicate that laughter therapy has a positive effect on decreasing postpartum fatigue. Conclusion: The finding provides evidence for use of complementary and alternative nursing in Sanhujori facilities and obstetric units to reduce postpartum women's fatigue.

• 대한간호학회지
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• 제45권4호
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• pp.587-594
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• 2015

Purpose: To identify the effects of foot reflexology massage on fatigue, stress and depression of postpartum women. Methods: A nonequivalent control group pre-post design was used. A total of 70 women in a postpartum care center were recruited and were assigned to the experimental group (35) or control group (35). Foot reflexology massage was provided to the experimental group once a day for three days. Data were collected before and after the intervention program which was carried out from December, 2013 to February, 2014. Data were analyzed using Chi-square test, Fisher's exact test, and t-test. Results: The level of fatigue in the experimental group was significantly lower than the control group (t= - 2.74, p=.008). The level of cortisol in the urine of women in the experimental group was significantly lower than the control group (t= - 2.19, p=.032). The level of depression in the experimental group was significantly lower than the control group (t= - 3.00, p=.004). Conclusion: The results show that the foot reflexology massage is an effective nursing intervention to relieve fatigue, stress, and depression for postpartum women.

• 여성건강간호학회지
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• 제19권1호
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• pp.48-56
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• 2013

Purpose: The purpose of this study was to identify the influencing factors of mothers' confidence in their maternal role during the early postpartum period. Methods: Participants were 178 postpartum women who delivered at three specialized obstetrics and gynecology facilities and used the postpartum care facility in city B. Data were collected from February to April, 2012 using the scales of measurements of self-confidence in maternal role performance, maternal self-esteem, mother-to-infant attachment, social support, and childcare stress. Descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression were used with the SPSS/WIN 18.0 program to analyze the data. Results: The scores for self-confidence in the maternal role showed significant negative correlations with the scores of childcare stress (r=-.40, p<.001). Parity and maternal attachment were significant predictors and accounted for 97.4% of the variance in self-confidence in the maternal role. Conclusion: To strengthen self-confidence in the maternal role of early postpartum mothers, prenatal class programs need to be complemented in order to reduce childcare stress and promote mother-to-infant attachment.

• 부모자녀건강학회지
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• 제9권2호
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• pp.91-100
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• 2006

Purpose: This study was done to investigate into the relationship between mother's stress in postpartum period and perception of infant in order to provide basic data for developing nursing intervention program. Methods: The data were collected from September 1, 2004 to October 15, from one women's hospital and three facilities for taking care of women's health after delivery located in B metropolitan city, and analyzed by SPSS/12.0 program frequency, percentage rate, mean, standard deviation, average, the maximum value, the minimum value and Person's correlation coefficient. Results: 1. The degree of stress of subjects was $75.6{\pm}38.3$(0-376) in average, and $.8{\pm}\;.4$(0-4) of average point, and the degree of perception of infant was $-5.8{\pm}5.6$(15-75) in average and $-\;.4{\pm}.4$(1-5) of average point. The relationship of degrees between the stress of subject and conception of infants that showed weak reverse relation(r= .210, p= .030). That is, the more the stress of subject was high, the more the perception of infant is relatively indefinite. Conclusion: As a result, The stress of mother in postpartum period was a level to be in need of management and the perception of infant was slightly negative. thus, the introduction of nursing assistance program is necessary to relive the stress of mother in postpartum period to promote the affirmative perception of infant.

• 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.

• 여성건강간호학회지
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• 제15권2호
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• pp.108-120
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• 2009

Purpose: This study aimed to explore the subjective sleep quality of depressed and non-depressed mothers in the late postpartum period and to determine the relationship with their health promoting behaviors, family functioning, parenting stress. Method: A non-probability sample of 128 mothers completed a self-administered questionnaires at 4-6weeks postpartum. The Edinburgh postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index were used to measure mother's experiences of depression symptoms and sleep. Related factors of sleep quality were measured by the Korean Family Functioning Scale, Health Promoting Lifestyle Profile, and Parenting Stress Index. The data was analysed using t-test, one-way ANOVA, and the Pearson's correlation coefficients. Result: The results indicated that the depressed mothers (EPDS$\geq$ 10) had poorer sleep quality than the non-depressed mothers(EPDS < 10), reported shortened sleep duration, and experienced more daytime dysfunctions. Depressed mothers who had no job, did not drink coffee, and were primipara tended to report poorer sleep quality. There were significant correlation between poorer sleep quality and lower health promoting behaviors, higher family intimacy and lower family communication, and higher parenting stress among depressed mothers. Conclusion: Our findings support the view that depressed mothers' experiences of poor sleep are much higher than non-depressed mothers and multi-faced. Nurse professionals should screen for sleep problems in the depressed mothers with a different biopsychosocial and behavioral aspect from the non-depressed mothers in the late postpartum period.