Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants (저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구)
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- Journal of Korean Academic Society of Home Health Care Nursing
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- v.8 no.1
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- pp.5-24
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- 2001
The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.
Compared to the traditional format, the revised IPA is an effective method for selecting a management strategy as compared to the traditional IPA. Comparison between the traditional IPA and revised IPA with a management strategy has been, however, limited. Therefore, the difference between the traditional IPA and revised IPA was compared to select an effective management strategy in the Suncheon Bay Wetland Reserve. First of all, related papers were reviewed to select an appropriate revised IPA. It was found that Deng (2007)'s revised IPA was appropriate for quantifying service quality and a management strategy that affects the measurable satisfaction of visitors in the space. Second, the results of the traditional IPA were compared with the revised IPA in the Suncheon Bay Wetland Reserve and the management strategy of the revised IPA and the changes of management factors were discussed. It was found that some management factors deviated from the order of the quadrant "low priority for managers", "Concentrate management here", "Keep up the good work" were moved to the order of the quadrants "Concentrate management here", "low priority for managers" and "Possible overkill" in the revised IPA grid. The complexity as a management factor resulted in higher demand management than the traditional IPA, which moved from "low priority for managers" to "Concentrate management here". Management factors resulted in lower demand management than the traditional IPA moved from "Concentrate management here" to "low priority for managers"; these consisted of shade trees, exhibition exteriors, programs, and a guided tour. Also, management factors moved from "Keep up the good work" to "Possible overkill" consisted of relaxation facilities, glow of the setting sun, a hedge, and an exhibition interior. Over all, the revised IPA responded properly to changes in the measurable satisfaction of visitors to the Suncheon Bay Wetland Reserve. Therefore, a revised IPA should be provided for accurate and reliable guidelines when decision makers establish management strategies.
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This study aims to understand the process of family reunion of the ex-offenders. To this end, Korea Rehabilitation Agency under Ministry of Justice and Healthy Family Support Center conducted intensive interviews with ex-offenders, their families and with 8 counselors who are in charge of ex-offenders and their families' residential, psychological, and educational support. The data collected through the interviews were analyzed by Consensus Qualitative Research(COR). The followings are the results: the counselors found out that most of ex-offenders had experienced unhappy childhood which was lack of healthy relationship with their parents. Secondly, counselors noticed a common feature among the families of ex-offenders. The common feature was that they keep the fact that one of their parents was imprisoned to their children as a secret. Thirdly, through the data analysis, counselors could understand various factors that affect reunion of ex-offenders' families: the factors that helped successful reunion were ex-offenders' sense of responsibility, open and healthy communication among family members, and mutual understanding of being a good family member, whereas, irresponsible dependance to other family members, denier and avoidance from the family members against ex-offenders, and lost sense of being a family member were the factors that discouraged the reunion. It turned out that the kinds of crime that ex-offenders committed also affected family reunion. The processes of reunion were easier for those who served their time with fraud, embezzlement, whereas, it was much more challenging for those who served their time with rape, violence, or murder. Fourthly, counselors learned that "relaxation" is the key factor in the process of reunion of ex-offenders' families. They also emphasized that there should be thorough monitoring process before the intervention in the reunion process. This study contributes in terms of finding healthy ways of intervention with ex-offenders' families and developing programs that help ex-offenders to recover their relationship with their family.
In this study, the stress characteristics of temporary fixed steel rods were analyzed in the "temporary fixing system using internal prestressing tension", which is mainly applied to the construction of superstructures by FCM. It was difficult to confirm the changes in initial tensile force in this system because the steel rod was internally connected to the pier and the PSC BOX. Therefore, measurement was performed before and after the completion of each segment using an FBG sensor to measure the change in the micro length of the steel rod. The results of the analysis showed that 75% to 90% of the maximum vertical contraction of the steel rod that occurred until the completion of the cantilever segment occurred in the fixing ~ 1segment, and the maximum loss of initial prestressing force was 39%. Such excessive loss of tension force to 1 segment means that tension is needed to improve the precision of construction during the fixation, and re-tension is needed to secure stability for conduction of cantilever segments after the completion of 1segment. In the 2 ~ last segment, the stress of the steel rod decreased gradually, and in the summer, the decrease in stress tended to partially recover due to the increase in the length of the steel rod corresponding to the increase in the vertical volume of PSC BOX. The dominant factor in the stress change in 2~ last segment in this phenomenon is judged to be the change in the length of the steel rod according to the temperature. Unlike the change in length, the relaxation was 1.2-2.7%, which was mostly offset by the opposite stress corresponding to the temperature stress. Therefore, a plan was proposed to improve the internal stress, such as adjusting the fixation time.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70