• Neonatal Medicine
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• 제25권1호
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• pp.1-6
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• 2018

Extremely low birth weight infants remain at increased risk of intraventricular hemorrhage from the fragile vascular bed of the germinal matrix; the roles of hypotension (ischemia) and reperfusion (hyperemia) in the development of intraventricular hemorrhage are still debated. Cerebrovascular pressure autoregulation protects the brain by maintaining constant cerebral blood flow despite changes in blood pressure. The ontogeny of cerebrovascular pressure autoregulation has not been well established and uncertainty remains about the optimal arterial blood pressure required to support brain perfusion. Another important aspect of premature cerebral hemodynamics is the critical closing pressure--the arterial blood pressure at which cerebral blood flow ceases. Interestingly, in premature infants, the critical closing pressure approximates the mean arterial blood pressure. Often in this unique population, cerebral blood flow occurs only during systole when the diastolic arterial blood pressure is equal to the critical closing pressure. Moreover, the diastolic closing margin, a metric of cerebral perfusion that normalizes diastolic arterial blood pressure to the critical closing pressure, may be a better measure than arterial blood pressure for defining cerebral perfusion in premature infants. Elevated diastolic closing margin has been associated with intraventricular hemorrhage. This review summarizes the current state of understanding of cerebral hemodynamics in premature infants.

• Child Health Nursing Research
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• 제15권4호
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• pp.335-342
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• 2009

Purpose: This study, using a pre-post test design of non-equivalence comparative group, was done to determine effects of Kangaroo care (KC) on growth in premature infants and on maternal attachment (MA). Methods: Fifty-three premature infants were assigned to the KC (24) or control group (CG) (29). Data were collected from July 2007 to June 2008. KC was given for 60 min at a time, Monday, Wednesday, and Friday for 10 times. Weight, height, and head circumference (HC) of premature infants were checked before the program started. Following the initial measurement, the program was given and measurements were taken again at the end of the program. For measurement of attachment between mother and infant, data collection was done using structured self-reported questionnaires. Results: KC group had a higher weight (t=2.565, p=.013), height (t=2.182, p=.034) and HC (t=2.468, p=.017) than the CG. Compared to the CG, the KC had significantly higher scores in MA (t=2.026, p=.048). Conclusion: The results of this study suggest that the practice of KC in the nursing environment might actively promote attachment between mother and infant as well as acceleration of growth for premature infants as one of the most efficient nursing intervention.

• 여성건강간호학회지
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• 제23권3호
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• pp.191-200
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• 2017

Purpose: The purpose of this study was to determine the factors that may affect quality of life of mothers who delivered premature infants. Methods: With survey design, data were collected from 145 mothers of premature infants with corrected age of 2 months to 12 months from January 9 to February 2, 2017. Quality of life was assessed with two measures of direct survey in the selected hospital and online survey. A self-report questionnaire was administered regarding personality of the mothers and the infants, postpartum depression, parenting stress, social support, and the quality of life. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The quality of life of the mothers of the premature infants was influenced by postpartum depression, parenting stress, parents-infant dysfunctional interactions, and social support accounted for 65% of the variance. Conclusion: These results indicate that early screening and continuous management of postpartum depression during postpartum period are important to improve the quality of life of the mothers of the premature infants. Education program and information and social support systems need to be developed to monitor mother-infant interaction and their role development.

• Child Health Nursing Research
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• 제23권4호
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• pp.407-415
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• 2017

Purpose: The purpose of this study was to examine how child development knowledge, child rearing knowledge, and use of healthcare services after discharge affect maternal confidence among mothers of premature infants. Methods: Participants in this study were 55 mothers who were involved in internet communities for mothers with premature infants and 30 mothers who visited hospitals for follow up care after having their babies discharged from Neonatal Intensive Care Units (NICU) in South Korea. Results: Presence of operation history, child development and rearing knowledge, and use of healthcare service explained 12.2% of maternal confidence. Presence of operation history (${\beta}=.32$, p<.05) and child development knowledge (${\beta}=.52$, p<.05) were significant predictors for maternal confidence. Conclusion: The results of this study suggest that mothers with premature infants need further education especially on motor development, developmental knowledge, and knowledge related to operations for mothers whose child had surgery in the NICU. Also information about services provided from community health services for premature infants need to be advertised and distributed.

• Child Health Nursing Research
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• 제11권4호
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• pp.381-389
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• 2005

Purpose: This study was done to investigate the effects of a massage program on the growth of premature infants and on the mothers' confidence and satisfaction in the mothering role. Methods: The participants were 29 mothers of premature infants hospitalized in a neonatal intensive care unit at CNU Hospital (14 in the massage program group and 15 in control group). Massage was done for 10-15 minutes, 2-3 times a day for 4 weeks. The data were using the SAS PC+ program. Result: Significant differences were found in the ratios of weight gain (Z=2.24, p=.013), grow in length (Z=2.50, p=.006) and increase in head circumference (Z=1.91, p=.028) between the massage program group and the control group. Confidence in the mothering role was significantly higher for mothers in the massage program group compared to those in the control group (Z=2.69, p=.004), but there was no significant difference in satisfaction with the mothering role between the two groups (Z=.88, p=.191). Conclusion: These results suggest that the massage program enhances growth of premature infants as well as enhancing the mother's confidence in her role as mother. Therefore, the massage program for premature infants can be use as an effective nursing intervention.

• 대한간호학회지
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• 제43권6호
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• pp.704-713
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• 2013

Purpose: This study was done to identify the parenting experience of mothers of premature infants in order to provide basic data for educational solutions and desirable directions. Methods: Q-methodology was used as it provides a method of analyzing the subjectivity of each item. The participants were 33 mothers of premature infants who sorted 34 selected Q-statements which were then classified into the shape of a normal distribution using a 9-point scale. Subjectivity on parenting experience among the mothers was analyzed using the pc-QUANAL program. Results: Four types of parenting experience were identified. Type I was named 'struggling', type II, 'self blame', type III, 'information collecting', and type IV, 'self-introspection'. Conclusion: The results of this study indicate that different approaches to educational programs are needed for mothers of premature infants based on the four types of parenting experience.

• Clinical and Experimental Pediatrics
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• 제54권9호
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• pp.359-362
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• 2011

There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation ($SpO_2$) is 90 to 93% with an intermittent review of the correlation between $SpO_2$ and the partial pressure of arterial oxygen tension ($PaO_2$). Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.

• 대한간호학회지
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• 제34권6호
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• pp.1129-1142
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• 2004

Purpose: This research was conducted to evaluate the effects of asystemic follow-up care program on health promotion and risk reduction in 64 high-risk infants(HRI) including premature infants and their mothers. Method: The intervention consisted of systemic NICU education, tele-counseling and 3 home visits in 6 months. The subjects were divided into either the intervention group or the control group receiving the conventional NICU education without the tele-counseling and home visiting. Infant health promotion was measured using physical assessment, types of health problems, reflexes, OPD visiting history, DDST, immunization, feeding assessment, Infant death rate, etc. Maternal self-esteem, postpartum depression and family function were measured using the maternal self-report inventory(MRI), EPDS, and family apgar score(Fapgar), retrospectively. Result: All premature infants in the intervention group were in the normal range of growth and development, and the regular vaccination schedule. The health problems in the intervention group were addressed early so not to develop into adverse effects. The follow-up program for 6 months showed beneficial effects on MRI, EPDS, and Fapgar. Conclusion: A systemic follow-up health care program is beneficial on health promotion and risk reduction in 64 HRI including premature infants and their mothers.

• Neonatal Medicine
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• 제28권1호
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• pp.22-28
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• 2021

Purpose: Meconium obstruction of prematurity (MOP) predisposes premature infants to intestinal perforation and prolonged hospitalization if not diagnosed and treated promptly. A standard contrast enema is less effective to treat infants with distal ileal obstructions because the contrast may not reach the obstructed areas. In an effort to avoid risky surgery, we administered oral contrast media to seven clinically diagnosed patients with MOP whose obstructions were not relieved via conventional sonography-guided contrast enema. We retrospectively evaluated whether oral nonionic water-soluble contrast media relieves MOP. Methods: Seven of 67 premature infants with MOP were administered oral contrast media from June 2015 to January 2019. Patients were followed-up radiographically for bowel distention and evacuation of contrast media after oral administration. We recorded radiographic improvements, meconium evacuation, time to first feeding after oral contrast media administration, maternal history, and neonatal clinical factors. Results: We evaluated five male and two female infants. The median gestational ages and body weights at birth were 27⁺⁵ weeks and 890 g, respectively. Radiography in five infants revealed multiple distended intestinal loops without air-fluid interfaces. Two infants had gasless abdomens, in which only stomach gas was visible. Oral contrast media (median, 2.5 mL) were administered at a median age of 7 days; five infants (5/7, 71.4%) responded to this treatment. The remaining two infants, who had ileal stenosis and hypoganglionosis, were surgically managed. Five infants (5/7, 71.4%) had maternal risk factors, and two (28.6%) were small for gestational age. Conclusion: Nonionic oral water-soluble contrast medium can serve as a valuable adjunct treatment in premature infants with meconium obstruction.

• Child Health Nursing Research
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• 제24권3호
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• pp.298-309
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• 2018

Purpose: The purpose of this study was to explore and develop a deeper understanding of the experiences of mothers of premature children receiving rehabilitation therapy. Methods: The participants were 12 mothers with premature children who had received rehabilitation therapy for over 1 year. Individual in-depth interviews were conducted from July to August 2017. The data were analyzed through the phenomenological research method. Results: The participants' experience was structured into five thematic clusters: 'Regret and guilt that premature birth led to rehabilitation therapy', 'Burden of life in an endless tunnel', 'Changes in personal relationships surrounding me and my child', 'Meaning of new life through my child', and 'Desire to expand the rehabilitation of premature infants'. Conclusion: The results of this study will be helpful for developing family-centered care programs for premature infants at high risk of developmental disorders.