• Child Health Nursing Research
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• v.4 no.2
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• pp.305-313
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• 1998

The purpose of study was to examine the effect of nonnutritive sucking(NNS) on behavioral state in preform infants. Fourteen infants (gestational age 28-35 weeks, M=31.86 ; birth weights 1095-2275g, M=1694g) admitted to NICU, serving as their controls were randomly administered 5 min of nonnutritive sucking and a control condition. Behavioral state was measured using the Anderson Behavioral State Scale(ABSS). Heart rates were obtained for each infant before and during NNS and bottle feeding. Data collecction was done by 3 experienced nurses in NICU 2 times a day for conseculive 4 days for each subject. Interrater reliability were .80-.90. The findings were as follows : 1. Preform infants averaged active restless states 58.93% in the prointervention phase and 27.32% in the NNS phase. Inactive awake states were 3.57% in the preintervention phase and 34.64% in the NNS phase. 2. There were significantly more positive changes to inactive awake states for the NNS intervention, Z=-2.35, p=.01. 3. There was no statistically significant difference in heart rate change between NNS intervention and control condition, z=-1.15, p=.24. 4. The rates of feeding success determined by finishing prescribed amount of milk by bottle feeding within 15 minutes were 83.94% in NNS intervention and 89.29% in control condition. The findings from this study confirmed that NNS is effective for behavioral state modulation and inducing optimal state for feeding in preform infant. The NNS intervention in nursing practice may help the transition of preform infants for nipple feeding.

• Journal of Korean Academy of Nursing
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• v.36 no.2
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• pp.255-264
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• 2006

Purpose: This study is aimed to confirm the effects of Yakson therapy on the growth and physical response of preform infants, and maternal attachment to them compared with GHT therapy. Method: The design of this study is nonequivalent control group with repeated measuring by quasi experimental study. The subjects are preterm infants in 26 - 34 gestational age hospitalized in the NICU of 4 university hospitals with an experimental group of 15 and a control group of 14. Yakson therapy consists of three phases: laying a hand, caressing by hand, and laying a hand again taking 5 minutes for each phase. Result: As a result of administering Yakson therapy to preform infants; the average weight gain of the Yakson group was higher than that of the GHT group, but there is no significant difference between groups. The oxygen saturation and maternal attachment difference between the Yakson and the GHT group were not significant. Significant differences in the average daily increase of oral intake and apical pulse rate were observed between the Yakson group and GHT group. Conclusion: These data suggested that Yakson therapy may be an effective nursing intervention which can facilitate growth and physical response of preform infants.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.11 no.2
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• pp.203-212
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• 2004

Purpose: This study was done to determine whether providing auditory and vestibular stimulation to preform infants would have an effect on stress hormones. Methods: The design was a nonequivalent control group protest-posttest design in a quasi-experimental study Seventy-nine preform infants were assigned either one of two experimental groups or to a control group: 27 in the auditory stimulation group, 25 in the vestibular stimulation group and 27 in the control group. The criteria for inclusion in this study were 1) gestational age of less than 37 weeks, 2) birth weight of less than 2,500g, 3) the absence of congenital anomalies or specific diseases, 4) recovering physiological weight loss, and 5) weaned from ventilatory assistance or oxygen. The data were collected from March 2002 to May 2003. The auditory stimulation, a music audiotape, was provided 20 minutes twice a day for 10 days and the vestibular stimulation, an infant waterbed, was provided for 10 days. On day 1 and day 10 of the study, 24 hour urine sample was collected for norepinephrine, epinephrine, and cortisol assays. In the data analysis SPSSWIN 10.0 program was utilized for descriptive statistics, ANOVA and t-test. Results: General characteristics of the three groups showed no significant differences, thus three groups were found to be homogenous. The 24 hour urine cortisol for the auditory (t=3.489, p=.001) and for the vestibular (t=2.638, p=.013) stimulation group were significantly reduced compared to the control group after 10 days. Conclusions: The results suggest that auditory and vestibular stimulation can be used to reduce 24 hour urine cortisol in preform infants. Therefore, music audiotapes and waterbeds provided in incubator are be recommended for reduction of the stress in preform infants who are hospitalized in neonatal intensive care units.

• Korean Journal of Community Nutrition
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• v.8 no.4
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• pp.584-594
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• 2003

The lactose, total nitrogen and total lipid contents of human breast milk were determined longitudinally after protein and term deliveries. Milk samples were obtained from day 2 to 5, on weeks 1, 2, 4, and 6 after preform (PM : n = 24) and term (TM : n = 22) deliveries. The lactose contents of PM and TM increased from 5.28 g/dl and 5.93 g/dl at days 2 to 5, to 7.95 g/dl,7.87 g/dl at 6 weeks, respectively. The total nitrogen contents of PM and TM decreased significantly during the first 6 weeks after birth (from 374 to 220 mg/dl versus 382 to 220 mg/dl respectively). However the total lipid contents of the PM and TM increased during the same periods. Significant differences in the total lipid contents between the PM and TM were 2.15 versus 3.27 g/dl at 2 weeks, and 3.26 versus 2.52 g/dl at 6 weeks, respectively. The energy intakes of preform infants was 134.8 ㎉/kg/d during the 6 weeks of lactation, which satisfied with energy requirements (85-130 ㎉/kg/d) of the preform infants. (Korean J Community Nutrition 8(4) : 584-594, 2003)

• Child Health Nursing Research
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• v.11 no.4
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• pp.481-489
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• 2005

Purpose: The purpose of this study was to investigate the effects on weight of premature infants when Yakson therapy was conducted by mothers and also to measure role confidence and role satisfaction of the mothers. Method: A non-equivalent control group non-synchronized design was used. The data were collected from January to July, 2005. Thirty preform infants and mothers were assigned to either an experimental (15) or a control group (15). Yakson therapy consists of three phases: laying on of hands, caressing by hands, and laying on of hands again, each phase taking 5 minutes. Yakson therapy was provided to infants in the experimental group for 15-minutes 5 times a day far 15 days. Infant weight, mothers' role confidence and satisfaction with role were measured for both groups. Results: Compared to the control group, weight gain of infants in the experimental group (t=2.05, p=.049) was significantly increased after 15 days. The experimental group also had significantly higher scores in mothers'.ole confidence (t=1.98, p=.038). Conclusion: The results suggest that Yakson therapy can be used to increase weight gain in preform infants and improve the role confidence of mothers.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.3
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• pp.510-519
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• 2006

Purpose: To develop and validate a scale suitable and efficient scale for use in clinical practice as to assess pain in premature infants. Method: Pain indicators identified by observation of preform infants. A cohort of preform infants was studied prospectively to determine the construct validity, inter-rater reliability, and internal consistency of the scale. The PIPS uses four indicators of pain: corrected gestational age, heart rate, oxygen saturation, behavioral state. The validation study included 45 premature infants with gestational age of 37 weeks or less. Results: The inter-rater reliability of the PIPS was acceptable, with Pearson correlations ranging from.720 to.970. Internal consistency was high: Cronbach's alpha coefficients ranged from.551 to.653. There was a strong correlation between the PIPS and PIPP scores (each researcher's r=.743, each indicator's r=.914). Although gestational age showed no association between these factors and the sum, the other variables were positively associated with the sum. Time needed to calculate PIPS scores is was less than Premature Infant Pain Profile (PIPP) scores(p<.000). Conclusion: The validation data suggest that the PIPS is appropriate and efficient for assessing pain in premature infants. Further studies are required about to determine appropriate interventions for each pain score on the PIPS.

• Child Health Nursing Research
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• v.4 no.2
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• pp.159-176
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• 1998

In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

• Journal of Nutrition and Health
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• v.37 no.9
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• pp.817-824
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• 2004

The purpose of this study was to analyze the intake of antioxidant vitamins and plasma TRAP concentrations of 60 maternal-infant pairs (30 in normal term delivery group, NT; 30 in preform group, PT) We also investigated the relationship between plasma TRAP levels of maternal-umbilical cord blood and pregnancy outcomes. Mean energy intakes of NT and PT pregnant women were 93.2% and 85.4% and their protein intakes were 113.3% and 110.9% of the recommended dietary allowance (RDA), respectively. The vitamin A intakes of NT and W pregnant women were 559.7 RE and 497.8 RE, which were less than RDA. While the vitamin E and C intakes of both NT and PT pregnant women were more than RDA. The maternal plasma TRAP level of PT was 1.41 mmol/l and that of was 1.50 mmol/l, which was significantly higher than TRAP level of PT (p < 0.05) . The umblical cord plasma TRAP levels of NT and PT were 1.44 mmol/l and 1.23 mmol/l, which indicates the significant difference between those two groups (p < 0.001) . In case of comparing the TRAP level of maternal and umbilical cord blood, there was no significant difference in NT pregnant women, however, in PT group maternal the TRAP level significant higher than that of umbilical cord (p < 0.001). The length of gestation and plasma TRAP level of maternal and umbilical cord showed a positive correlation. However, other parameters of pregnancy outcomes such as birth weight, weight gain, and Apgar score were not affected by the plasma TRAP levels. Based on these results, preform infants could have a risk of oxidative stress because of low plasma TRAP level.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.10-20
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• 1988

This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.1
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• pp.33-45
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• 1998

The aim of this study was to investigate what is the most accurate and quick temperature measurement among rectal, auxiliary and tympanic routes. The body temperatures of 86 preform infants in incubators, a controlled environment, were measured at three different sites. The measurements were taken to examine the accuracy of the temperatures, proper nursing time for measuring the temperatures and the validity of fever detection. The results were as follows : 1. The mean temperature was significantly lower in the auxiliary site($36.71^{\circ}C$) and higher in the tympanic site($37.27^{\circ}C$) than in the rectal site($37.03^{\circ}C$). 2. The mean nursing time for measuring body temperature was significantly longer in the auxiliary site(171.65 seconds) and shorter in the tympanic site(17.70 seconds) than in the rectal site(83.33 seconds). 3. The nursing time for measuring body temperature included the time needed for preparation, measuring, as well as the post-measuring time. It was found that the time required to prepare for measuring the temperature of the rectal site was significantly longer than for other sites. In addition, the time needed to measure the temperature of the auxiliary site was significantly longer than in the other sites. Finally, the nursing time needed for measuring the auxiliary temperature(171.65 seconds) was the longest among the three sites whereas the nursing time for the tympanic site was the shortest(17.70 seconds). 4. Rectal temperature was significantly correlated to the tympanic(r=0.67) and auxiliary temperatures(r=0.69). Tympanic temperature was also significantly correlated to the auxiliary temperature(r=0.74). 5. The sensitivity, specificity, positive and negative predictive values of tympanic temperatures for detecting fever were 1.00, 0.80, 0.24, and 1.00, respectively. Those for the auxiliary temperatures were 0.00, 0.99, 0.00, and 0.94, respectively. Thus the level of fever detection was lower in the auxiliary temperatures than in tympanic temperatures. The above findings indicate that the tympanic method of temperature measurement offers a useful alternative to conventional methods.