• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• 대한간호학회지
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• 제50권3호
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• pp.459-473
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• 2020

Purpose: This study was conducted to identify the effects of a lifestyle intervention program on weight gain, dietary habits, fatigue and pregnancy stress, blood pressure, and neonatal birth weight, using Cox's interaction model of client health behavior for overweight and obese women. Methods: This was a quasi-experimental research with a non-equivalent control group pre-post test design. A total of 52 patients who met the selection criteria, including 25 in the experimental group and 27 in the control group, were the subjects of the study; they comprised overweight and obese pregnant women who were receiving prenatal care at A and B women's hospital in J province. The lifestyle intervention program ran for 12 weeks in total and consisted of interactions involving affective support, health information, and professional/technical competencies. The data collection period was from February 1, 2017 to August 31, 2017. Results: This study showed differences in the appropriate weight gain rate (χ²=6.17, p=.013), suppression of an increase in fatigue (t=-2.32, p=.012), and an increase in pregnancy stress (t=-1.87, p=.034). Yet, no differences in physical activity, dietary habits change, blood pressure, and neonatal birth weight (p>.05) were found. Conclusion: The study findings indicate that this program could be an effective intervention for the control of appropriate weight gain, fatigue, and pregnancy stress. Therefore, a lifestyle intervention program based on Cox's interaction model of client health behavior could be an efficient strategy for a positive health outcome of overweight and obesity pregnant women.

• 대한간호학회지
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• 제25권1호
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• pp.17-29
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• 1995

This study was done to analysis data on breastfeeding mothers. This stud was conducted using data from telephone counseling in one metropolitan area. The subjects who had received consultation about breastfeeding were 100 breastfeeding mothers. The period of consultation was from Mar. 9, 1994 to August 23, 1994. Consultants were referred from UNICEF, hospitals, TV, newspapers or magazines. Analysis of the problem patterns resulted in 11 classifications. These were physio -anatomical factors(11 cases) , psychological factors(15 cases), breastfeeding methods(21 cases), breastfeeding intervals and frequency(19 cases) , disease in the breastfeeding mothers(13 cases), disease in the babies (12 cases), lack of support (4 cases), food and drugs while breastfeeding(5 cases), weaning(11 cases), others(27 cases). The highest frequency was for breastfeeding methods (21 cases). When the contents of the counselling were analyzed for the 100 cases, 36 problem patterns were identified. Patterns with over 10 responses were diarrhea, insufficient milk supply, sore and cracked nipples, weaning, inverted nipples and jaundice. The age of infants when mothers were telephoned was as below : 1 week(28 cases), 2 weeks(12 cases), 3-4 weeks(18 cases), 5-8 weeks(7 cases), 9 weeks-3 menths(4 cases), 4 menths-6 months(12 cases), over 6 months(2 cases), and the number of pregnant women was 12. The nursing diagnosis were classified according to problem patterns and each diagnosis was assigned an appropriate Problem Pattern The total number of nursing diagnoses was 22. When clients are referred for counselling nurses need guidelines about problems, possible causes and nursing. In this study, the example of guidelines for sore nipples is suggested. The recommendations based on the telephone counseling results are as follows : Prenatal education about the advantages of breastfeeding and breast care, and home visits after delivery for counseling related to breastfeeding. During the hospital stay, nursing intervention such as education on breastfeeding methods using slides, audio-visual tapes, pamphlets are needed as well as an initial trial of breastfeeding. Further research is indicated on the perceived lack of breast milk and on the effectiveness of nursing interventions to pro-mote breastfeeding.

• 부모자녀건강학회지
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• 제7권2호
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• pp.144-159
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• 2004

Purpose: The purpose of this study is to explore mother's perception and practice of Taegyo. In addition, belief factors toward Taegyo oriented Korean mother-fetus interaction are identified in order to obtain baseline data for the development of Taegyo oriented program enhancing mother-fetus interaction. Method: The sample consisted to 186 pregnant women who visited public health center or hospital for prenatal care. Self-reporting questionnaire devised by investigator was used. Data were analyzed by SPSS win program and contents analysis was used. Result: Although mothers intended to a pregnancy, many of them were perceived negatively toward pregnancy. The study revealed that most of pregnant women continued cultural practices related to Taegyo, they focused on mother-fetus interaction behavior-such as listen to the music, reading a book, talk to fetus, stroke the fetus- with being altered traditional beliefs toward Taegyo or Taemong. Most of pregnant women had Taemong and believed a it's predictive functions. Beliefs toward mother-fetus interaction were classified to 6 factors, pregnancy, Taemong. fetus, practice behavior, infant's abilities and mother-fetus interaction behavior. The scores of belief toward mother-fetus interaction and each factors of pregnancy, fetus, practice behavior, infant's ability were statistically significant different depending upon husbands education. Also pregnancy factor in belief toward mother-fetus interaction was statistically significant different depending upon the number of children, child birth, experience of abortion, premature birth. Conclusion: Developing Taegyo oriented program enhancing the mother-fetus interaction need to include the elements of being facilitated maternal identity formation and maternal confidence for the pregnant women. In addition, it should be developed the program concerning with the characteristics of the pregnant women.

• Nutrition Research and Practice
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• 제4권4호
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• pp.323-331
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• 2010

The aim of this study was to analyse effects that the degree of depression have on the life style variables, nutrient intake, iron indices and pregnancy outcome. Subjects were 114 pregnant women who were receiving prenatal care at a hospital in Seoul. We collected data for general characteristics and lifestyle variables from general survey instrument and for depression score from the questionnaire on depression. Dietary intakes of subjects were estimated by 24 hour dietary recall method. Also we analysed iron indices and pregnancy outcomes. We classified subjects by 10 point, which was the average depression score, into two groups [Low depression score group (LS) : High depression score group (HS)]. As to the intakes of total calcium, plant-calcium, plant-iron, potassium, total folate and dietary folate, LS group was far higher than HS group (P < 0.05, P < 0.05, P < 0.01, P < 0.001, P < 0.05, and P < 0.01, respectively). As to pre-pregnancy alcohol drinking, LS group had 41.9% in non-drinker, which was far higher than 28% in HS group in non-drinker (P < 0.05). As for drinking coffee during pre-pregnancy, pregnant women who don’ drink coffee in LS group took 43.6%, which was higher than 38% in HS group (P < 0.01). Regarding delivery type, the cesarean section in LS group (18%) was significantly lower than that in HS group (45%) (P < 0.01). Bivariate analysis showed that birth weight was significantly associated with the gestational age (P < 0.01). The pregnant women with higher depression score tended to have undesirable life habit, which might affect negative pregnancy outcomes. A better understanding of how depression and intake of nutrients work together to modulate behavior will be benefit nutritional research.

• 한국환경성돌연변이발암원학회지
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• 제23권1호
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• pp.1-6
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• 2003

The purpose of this study was to evaluate whether the MTHFR variants, folate and vitamin $B_{12}$ deficiencies increase the risk of hyperhomocysteinaemia and adverse pregnancy outcome such as short gestational age or reduced birth weight. Healthy pregnant women (n=136; 24-28 gestational weeks; 20-40 years old), who visited Ewha Womans University Hospital for prenatal care, participated in this study. At the time of delivery, trained nurses recorded the pregnancy outcome from medical chart. We determined maternal MTHFR polymorphisms (C to T subsitution at nucleotide 677) and measured serum homocyteine, vitamin $B_{12}$, and folate concentrations. We compared serum homocysteine level by MTHFR genotype, serum folate and serum vitamin B12 levels using ANOVA. To evaluate the association between serum homocysteine level and pregnancy outcome, we compared the gestational age and birth weight by serum homocysteine levels using multiple regression analysis, adjusting for other potential predictors. Mean level of serum homocysteine was highest among pregnant women of the MTHFR variants with low levels of serum folate and vitamin $B_{12}$. Regarding association with birth outcome, we found the relationship between homocysteine levels and increased gestational age (p=0.03) and reduced birth outcome (p>0.05). Our data demonstrates that serum level of folate and vitamin $B_{12}$ among pregnant women affects significantly serum homocysteine levels, and the genetic polymorphism of MTHFR modulates the relationship between them. However, we did not have conclusive evidence of association between high homocysteine level and adverse pregnancy outcome such as preterm or low birth weight.

• Journal of Nutrition and Health
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• 제18권3호
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• pp.194-200
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• 1985

The purpose of this study was to investigate sodium intake and protein metabolism for pregnant women in Korea. The relationship between salt consumption and hypertension, electrolyte changes in pregnancy, and the tendency of weight gain of pregnant women were also examined. The dietary survey and twelve or twenty-four hour's urine collection was performed in this study. The subjects were pregnant women who came to gynecology clinic for prenatal care from July to August in 1984. The results were as follows: 1) Intakes of calorie and iron of Korean pregnant women were 2,036 Kcal and 16mg per day per person. The calorie composition consists of 65% carbohydrate, 16% protein, and 19% lipids. The average level of all nutrients was about 87% of Korean Recommended Dietary Allowances. 2) The sodium intakes in pregnant women estimated by dietary survey was 318.6 mEq Na (7,966 mg Na), which is equivalent to 20.2 g NaCl. 3) Daily sodium excretion was 112.5 mEq per liter, that is equal to 147.4 mEq. Potassium excretion was 24.95 mEq per liter and creatinine excretion was 594.0 mg per day. 4) There were statistically significant correlations between sodium intake and the excretions of sodium, potassium and creatinine. The blood pressure was positively correlated with sodium intakes. As sodium and potassium ratio was increased, systolic blood pressure and diastolic blood pressure were also significantly increased 5) Urinary nitrogen and creatinine ratio known to be reliable index for nutritional status of protein was 5.5 : 1. These values were comparable to the values in American pregnant women. 6) The weight gain during the pregnancy was examined. There was little weight gain during the first trimester, because of nausea, vomit and decrease of appetite. The weight gain during the second trimester was 4.9Kg, and 11.1Kg for third trimester.

• Clinical and Experimental Pediatrics
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• 제60권1호
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• pp.10-16
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• 2017

Purpose: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. Methods: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. Results: Among 292 newborns with a gestational age of $35.2{\pm}3.0$ weeks and a birth weight of $2,428{\pm}643g$, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. Conclusion: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.

• Clinical and Experimental Pediatrics
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• 제48권5호
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• pp.557-560
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• 2005

재태 연령 38주, 출생체중 3,040 g, 제왕절개로 출생하여 단 일제대동맥이 동반되고 첫 울음 없이 전신에 청색증, 심한 호흡 곤란이 발생하여 기관내삽관을 시행하였으나 실패 한 후 후두내시경을 통해 확진된 선천성 후두폐쇄증 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 여성건강간호학회지
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• 제8권3호
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• pp.371-379
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• 2002

The purpose of the present study is to consider its effect on the childbirth of a woman. This is a quasi-experimental study with nonequivalent control group post-test design. The subjects of this study are 60 primiparas (30 in the control, and another 30 in the experimental group) who have had a regular prenatal care from February 5 to March 20, 2002, in an outpatient obstetrics and gynecology of S university medical center located in Seoul. The result is as follows: 1. The hours of labor pains in the entire delivery period: the average hours are 7 hr. 9 min. in the experimental group, and 10 hr. 39 min. in the control group. The hours of labor pains are shorter in the woman with a family delivery experience in LDR. The difference is statistically significant (t=-3.34, p=.001). 2. The degree of pains in the entire delivery period: the average degree is 7.38 in the experimental group, and 7.68 in the control group. The degree of labor pains are lower in the woman with a family delivery experience in LDR. But, the difference is statistically insignificant (t=-0.86, p=.396). 3. The perceptions of the delivery experience: the average score of the perception is 73.63 in the experimental group, and 63.57 in the control group. The women with a family delivery experience in LDR have more positive perception of the delivery procedure, and, the difference is statistically significant (t=4.65, p=.000). In summary of the above result, a family-participated delivery in LDR is proved to be an effective nursing intervention that shortens the hours spent in the delivery procedure and promotes positive perceptions of the delivery experience.