• 제목/요약/키워드: Premature Infants

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미숙아 발달지지를 위한 간호역량 측정도구 개발 (Development of the Developmental Support Competency Scale for Nurses Caring for Preterm Infants)

  • 김정순;신희선
    • 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.

기관 삽관을 시행한 조산아에서 발생한 상악 유전치의 발육이상 : 증례보고 (DEVELOPMENTAL DISTURBANCE OF PRIMARY INCISORS IN PRETERM INFANTS WITH ENDOTRACHEAL INTUBATION : A CASE REPORT)

  • 임소영;김성오;이제호;김익환
    • 대한장애인치과학회지
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    • 제15권1호
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    • pp.89-93
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    • 2019
  • 본 증례 보고는 기관 삽관 경험이 있는 조산아에서 상악 유전치의 발육장애가 나타난 증례이다. 본 증례들에서는 기관 삽관으로 인해 치관 형태 이상, 법랑질 결함, 맹출 지연이 나타났다. 또한 치배의 변위로 인한 맹출 경로 이상, 치근 만곡, 후속 영구치의 비정상적인 치근 형성도 나타났다. 이환 치아에 대해서는 예방적 수복치료 및 관리, 적절한 시기에 발치를 고려해야 한다. 소아치과의사는 삽관 경험이 있는 조산아에서 나타날 수 있는 상황에 대해 이해하고, 적절한 개입을 통해 구강 건강 증진을 도모해야 한다.

호흡곤란 증후군 미숙아에서 혈중 L-arginine 농도와 Oxygenation Index 및 폐동맥압과의 관계 (Plasma L-Arginine Concentration, Oxygenation Index and Pulmonary Artery Pressure in Premature Infants with Respiratory Distress Syndrome)

  • 정경아;이순주;성인경;전정식
    • Clinical and Experimental Pediatrics
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    • 제46권12호
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    • pp.1207-1211
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    • 2003
  • 목 적 : RDS가 있는 미숙아에서 질병의 심한 정도와 폐동맥압 및 혈중 L-arginine 농도와는 어떤 연관이 있는지 알아보고자 하였다. 방 법 : RDS로 인공 환기요법을 시행 받은 재태기간 37주 미만 미숙아 21명을 대상으로 하여 제 1병일, 제 3병일, 제 7병일에 혈액을 채취하여 혈중 L-arginine 농도를 측정하였다. 혈액채취와 동일한 시기에 호흡곤란 증후군의 중등도를 나타내는 지수로서 OI를 산출하였고, 도플러 심초음파를 이용하여 RVSTI를 측정하여 폐동맥압의 지표로 삼았다. OI와 혈중 L-arginine 농도 및 RVSTI 간의 상관관계를 알아보았다. 결 과 : 1) OI가 클수록 RDS 미숙아의 혈중 L-arginine 농도는 낮았다(r=-0.346, P<0.01). 2) OI가 클수록 RVSTI도 증가되었다(r=0.772, P<0.01). 3) RVSTI가 커지면 RDS 증후군 미숙아의 혈중 L-arginine 농도는 낮았다(r=-0.416, P<0.01). 결 론 : RDS가 있는 미숙아에서 질병이 심할수록 혈중 L-arginine 농도는 낮고, 폐동맥압은 높았으며, 폐동맥압이 높을수록 혈중 L-arginine 농도는 낮은 관계를 보였다.

미숙아 어머니를 위한 체계적인 정보제공이 모아애착, 양육스트레스, 양육자신감에 미치는 효과 (Effects on Maternal Attachment, Parenting Stress, and Maternal Confidence of Systematic Information for Mothers of Premature Infants)

  • 최효신;신영희
    • Child Health Nursing Research
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    • 제19권3호
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    • pp.207-215
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    • 2013
  • 목적 본 연구는 미숙아어머니를 위한 체계적인 정보제공이 모아애착, 양육스트레스, 양육자신감에 미치는 효과를 확인하고자 시도되었다. 방법 D시 소재 K상급종합병원에 입원한 미숙아 어머니를 대상으로 본 연구에 참여를 동의한 실험군 20명과 대조군 22명을 대상으로 하였으며 비동등성 대조군 전후 시차 유사실험 설계를 사용하였다. 실험군에게는 퇴원 일주일 전부터 4번에 걸쳐 체계적인 정보를 제공하였고, 대조군은 통상적인 퇴원교육만 제공하였다. 성과변수로서 모아애착, 양육스트레스, 양육자신감을 측정하였다. 결과 실험군이 대조군에 비해 모아애착점수(F=6.16, p=.005)와 양육자신감 점수(F=16.50, p<.001)가 유의하게 높았고, 양육스트레스 점수는 낮았다(F=5.56, p=.004). 이런 경향은 퇴원 2주후에도 지속되었다. 결론 체계적인 정보제공이 퇴원을 앞둔 미숙아들의 어머니에게 모아애착을 증진시키고, 양육스트레스를 줄이며, 양육자신감을 증진시키는 데 효과적이었다.

ICT 의료시설 기반에서 미숙아 어머니의 퇴원 교육 요구도와 간호사의 교육수행 정도 (The Needs for Discharge Education and Educational Performance of Nurses Perceived by Premature Infants Mothers In the ICT Medical Service)

  • 김수희;최성우;류소연;한미아
    • 한국전자통신학회논문지
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    • 제11권7호
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    • pp.707-716
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    • 2016
  • 본 연구는 ICT 시대에서 미숙아 어머니의 퇴원 교육 요구도와 미숙아 어머니가 인지한 간호사의 교육수행 정도를 알아보고 관련 있는 요인들을 파악하고자 실시되었다. 대상자는 G광역시 2차 진료기관인 K종합병원의 신생아 중환자실에 입원한 미숙아 어머니 중에서 연구에 동의한 54명이며, 자기 기입식 설문을 통해 조사하였다. 퇴원 교육 요구도와 간호사의 교육수행 정도에 유의한 차이를 보인 영역은 '이상증상 확인과 관리'($0.55{\pm}0.97$, p=0.001), '배설관리'($0.45{\pm}1.11$, p=0.004), '성장발달'($0.41{\pm}1.08$, p=0.007)이었다. 퇴원교육 요구도는 분만형태(질식분만: $4.41{\pm}0.47$, 제왕절개: $4.03{\pm}0.47$, p=0.040)와 출생순위(첫째: $4.37{\pm}0.53$, 둘째: $4.25{\pm}0.51$, 셋째이상: $3.75{\pm}0.72$, p=0.031)에 따라 유의한 차이를 보였다. 미숙아 어머니가 인지한 간호사의 교육수행도는 조력자의 유무(있음: $4.15{\pm}0.66$, 없음: $3.48{\pm}0.67$, p=0.002)에 따라 유의한 차이를 보였다. 그러므로 이런한 결과를 기반으로 미숙아 어머니의 퇴원 교육 요구도에 근거한 실질적으로 도움이 되는 ICT 기반하의 퇴원교육 프로그램 개발 연구를 제안한다.

Bronchopulmonary dysplasia: how can we improve its outcomes?

  • Sung, Tae-Jung
    • Clinical and Experimental Pediatrics
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    • 제62권10호
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    • pp.367-373
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    • 2019
  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease of preterm infants with multiple factors affected from prenatal to postnatal periods. Despite significant advances in neonatal care over almost 50 years, BPD rates have not decreased; in fact, they may have even increased. Since more preterm infants, even at periviable gestational age, survive today, different stages of lung development affect the pathogenesis of BPD. Hence, the definition of BPD has changed from "old" to "new." In this review, we discuss the various definitions of BPD, risk factors from the prenatal to postnatal periods, management strategies by phase, and future directions for research.

동맥관으로 오인된 좌폐동맥 결찰에 대한 재수술 치험 (LPA Occulusion Due to the Erroneous Ligature of Patent Ductus Arteriosus; a report of 3 cases)

  • 송태승;윤태진;민경석;서동만
    • Journal of Chest Surgery
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    • 제33권5호
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    • pp.422-427
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    • 2000
  • Confusion of a patent ductus arteriosus (PDA) for the descending thoracic aorta is a fatal error occurring occasionally in infants or neonates. As a result, the left pulmonary artery (LPA) may be misconceived as the PDA, and ligated. This surgical mishap of other hospital leads to serious congestive heart failure and loss of left lung function due to the underdevelopment in the peripheral vascular and alveolar structures in neonates and premature infants. In this report, 3 cases of LPA ligation and subsequent treatment are presented.

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NICU에 입원한 미숙아 어머니의 스트레스 (Study on the Perceived Stress Level of Mothers in Neonatal Intensive Care Unit)

  • 김태임
    • 혜화의학회지
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    • 제8권1호
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    • pp.865-878
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    • 1999
  • With advances in neonatal medicine, smaller and sicker infants are surviving premature birth. As these tiny patients battle for their lives, their parents also struggle with psychological consequences of an unexpected role. The birth of a sick infants has long been documented as stressful events for the parents. High stress levels may alter parents' interaction with their baby and impair their communication with health professionals, which can in turn affect parents' participation in care planning and decision making. Nursing interventions aimed at reducing the parental stress and anxiety levels during this crisis may have a positive impact on their ability to form an attatchment to their baby and make prudent decisions about his care. The planning of such interventions would be inhanced if the contributions of various factors to increased parental stress levels were identified. This descriptive study was conducted to understand the contents and degree of parental stress in the NICU during their premature's hospitalization, and to give a baseline data in developing nursing intervention program. Subjects were the 60 mother of hospitalized newborn in NICU of 2 University Hospital in Taejon City from April 1st, 1999 to June 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales:NICU(PSS:NICU) developed by Miles et al.. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from "not stressful" (1) to "extremely stressfu1"(5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's ${\alpha}$ coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers of premature baby was slightly high($3.66{\pm}1.1$). The highest scored dimension was 'relationship with their baby and parental role change'($4.21{\pm}0.9$), and next were 'appearance and behavior of the baby'($3.92{\pm}1.1$), 'communication with health team'($3.32{\pm}1.3$), 'sight and sounds of NICU'($3.30{\pm}1.1$). 2. There were statistically significant correlation noted ; mother's perceived severity of the baby's condition(F=8.0012, P= .0125) and baby's gestational age(r = -.4724, P = .0500). In summary, information about physical environment of NICU, the mother's perceived severity of premature baby's state, maternal role change related variables and the knowledge of characteristics of premature baby must be included in nursing intervention program of mother's of premature baby in reducing the parental stress and anxiety level. It is suggested that each NICU needs to develop a nurse managed supportive care program for parents of premature baby. Also, it is suggested that there need to investigate the coping mechanism of mother of premature baby.

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Adrenal and thyroid function in the fetus and preterm infant

  • Chung, Hye Rim
    • Clinical and Experimental Pediatrics
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    • 제57권10호
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    • pp.425-433
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    • 2014
  • Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

Effects of an Infant Care Education Program for Mothers of Late-preterm Infants on Parenting Confidence, Breastfeeding Rates, and Infants' Growth and Readmission Rates

  • Jang, Eun Hye;Ju, Hyeon Ok
    • Child Health Nursing Research
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    • 제26권1호
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    • pp.11-22
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effects of an education program for mothers of late-preterm infants on parenting confidence, breastfeeding rate, and infants' growth and readmission rate. Methods: The participants were 53 mothers of late-preterm infants (26 in the experimental group and 27 in the control group). The experimental group was administered the late-preterm care education program while the control group received standard care. The program consisted of two sessions during hospitalization after birth, one session at the time of discharge, and telephone and social networking service consultations at weekly intervals for the month following discharge. The collected data were analyzed using the t-test, x2 test, and repeated-measures analysis of variance. Results: Parenting confidence and the breastfeeding rate were significantly higher in the experimental group than in the control group. However, there was no significant difference in the late-preterm infants' growth and readmission rates between the experimental and control groups. Conclusion: A care education program for mothers of late-preterm infants can be a useful nursing intervention in clinical practice.