• Child Health Nursing Research
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• v.16 no.4
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• pp.352-359
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• 2010

Purpose: To explore premature infants' pain response to routine procedures in the neonatal intensive care unit (NICU). Methods: The participants were 56 preterm infants who showed 149 pain responses to 8 high frequency routine procedures which were evaluated using the Premature Infant Pain Scale (PIPS). Videotaped recording was used for data collection. Data were analyzed with descriptive analysis, paired t-test, and Pearson's correlation coefficient. Results: PIPS scores for each procedure were as follows; for removal of central catheter dressing, 6.17 (2.04), venous sampling, 6.12 (2.87), intramuscular injection, 6.05 (2.38), insertion of a peripheral line, 5.38 (2.16), insertion of feeding tube, 4.40 (1.34), heel stick, 4.33 (1.23), insertion of central line, 4.00 (2.12), and endotracheal suctioning, 2.90 (1.25). PIPS score was negatively correlated with gestational age (r=-.218, p=.007) and birth weight (r=-.249, p=.002) among general characteristics of the infants. Conclusion: The majority of 8 routine procedures were found to be painful for premature infants in the NICU. Therefore, adequate pain management related to procedures should be provided to premature infant in the NICU.

• Clinical and Experimental Pediatrics
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• v.54 no.12
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• pp.481-488
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• 2011

In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report, I describe the status of neonatal intensive care in Korea, as well as nationwide flow of transfer of high-risk newborn infants and pregnant women, and present a short review of the regionalization of neonatal and perinatal care in the Unites States and Japan. It is necessary not only to increase the number of neonatal intensive care unit (NICU) beds, medical resources and manpower, but also to create a strong network system with appropriate leveling of NICUs and regionalization. A systematic approach toward perinatal care, that includes both high-risk pregnancies and newborns with continuous support from the government, is also needed, which can be spearheaded through the establishment of an integrative advisory board to propel systematic care forward.

• Journal of Korean Academy of Nursing
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• v.35 no.7
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• pp.1401-1409
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• 2005

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

• Korean System Dynamics Review
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• v.6 no.2
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• pp.73-93
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• 2005

This paper on an experiment, using System Dynamics, on the affect of increase in number of beds and medical instruments used for the care of premature infants, which constitute the physical requirements in quality of medical services, on changes in the survival rate of premature in ants that leads to demographic changes of Newborn infants. The model has four sectors: take-in capacity, survival rate of premature infants, demographics without newborn infants and demographics with newborn infants. The model simulates the changes in demographics of the newborn infants from 2002 to 2022. The study results show that the survival rate of premature infants can be increased by improving the physical aspects in the quality of medical services. An average of 1,900 premature infants can survive as a result of the physical quality improvements in medical services, adding up to an increase of 37,300 newborn infants by the year 2022.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.2
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• pp.100-107
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• 2015

Purpose: We investigated the iron status of very low birth weight infants receiving multiple erythrocyte transfusions during hospitalization in the neonatal intensive care unit (NICU). Methods: We enrolled 46 very low birth weight infants who were admitted to the Kyungpook National University Hospital between January 2012 and December 2013. Serum ferritin was measured on their first day of life and weekly thereafter. We collected individual data of the frequency and volume of erythrocyte transfusion and the amount of iron intake. Results: A total of 38 (82.6%) of very low birth weight infants received a mean volume of $99.3{\pm}93.5mL$ of erythrocyte transfusions in NICU. The minimum and maximum serum ferritin levels during hospitalization were $146.2{\pm}114.9ng/mL$ and $456.7{\pm}361.9ng/mL$, respectively. The total volume of erythrocyte transfusion was not correlated to maximum serum ferritin concentrations after controlling for the amount of iron intake (r=0.012, p=0.945). Non-transfused infants took significantly higher iron intake compared to infants receiving ${\geq}100mL/kg$ erythrocyte transfusion (p<0.001). Minimum and maximum serum ferritin levels of non-transfused infants were higher than those of infants receiving <100 mL/kg erythrocyte transfusions (p=0.026 and p=0.022, respectively). Infants with morbidity including bronchopulmonary dysplasia or retinopathy of prematurity received a significantly higher volume of erythrocyte transfusions compared to infants without morbidity (p<0.001). Conclusion: Very low birth weight infants undergoing multiply erythrocyte transfusions had excessive iron stores and non-transfused infants also might had a risk of iron overload during hospitalization in the NICU.

• Journal of Korean Academy of Nursing
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• v.35 no.2
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• pp.262-269
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• 2005

Purpose: The purpose of this study was to develop a health education program for child care workers of infants, toddlers and preschoolers to improve their care ability. The program provided child care teachers and children with information on how to take care of their health. Method: This program development was based on a systematic design of instruction by Dick & Carey(1996). The process included a review of literature, setting an instructional goal, getting advice from various experts, designing instruction and instructional medias, designing formative evaluation, revising the program and making a summative evaluations. Result: The products of this program were the 'Teachers Guide Book & CD-ROM.' The guide book included health education programs for infants, toddlers and preschoolers. The infant program included a basic baby care program for teachers. The toddlers and preschoolers program included basic health promotion, dental health, nutrition management, communicable disease prevention, substance abuse prevention and a safety program. Conclusion: These programs provided a systematic content of health education for children and their teachers, and useful data which can be applied to child care centers.

• Child Health Nursing Research
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• v.22 no.4
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• pp.299-308
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• 2016

Purpose: To investigate the perception and barriers of Kangaroo-Mother Care (KMC) among nurses in Neonatal Intensive Care Units (NICU). Methods: Participants were 131 nurses working in NICU who completed self-report questionnaires which included information regarding perception, barriers, and practice of KMC. Collected data were analyzed using SPSS 18.0 program for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients. Results: Of the participants, 33.6% reported the practice of KMC in their NICU, with 75.6% wanting to receive training in KMC and 31.3% having received KMC education. Most of the participants agreed that KMC enhances attachment, parental confidence, and effective breast feeding but they reported a negative perception in providing KMC for premature infants weighing less than 1000 grams or intubated premature infants. Major barriers to practicing KMC were safety of infants, possible work overload for nurses, as well as absence of consistent guidelines. Barriers to KMC among nurses who received the KMC training were lower than nurses who did not receive the KMC training (t=-2.11, p=.037). Conclusion: Education program and standardized clinical practice protocol should be developed to foster the positive perception and to reduce nurse barriers to KMC.

• Korean Parent-Child Health Journal
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• v.13 no.2
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• pp.78-85
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• 2010

Purpose: The purpose of this study was to examine the pain reducing effects of the dextrose-coated pacifier on venipuncture in premature infants. Methods: The design of this study is a nonequivalent control group pretest-posttest design and a crossover trial. The analysed cases were 40 premature infants (20 in experimental group and 20 in control group) in neonatal intensive care unit of a University Hospital, Gyeongnam Province, Korea. The data were collected from April to October, 2009. The experimental treatment was carried out nursing 20% dextrose-coated pacifier on venipuncture for IV injection. The instruments were $O_2$ saturation and heart rate on pulse oxymeter monitor to measure physiologic pain responses, and NIPS to measure behavioral pain responses. Collected data were analyzed with $x_2$ test, t-test using SPSS program. Results: The effects of the 20% dextrose-coated pacifier were found in the physiologic (only heart rate) and behavioral pain response on venipuncture. Conclusion: These finding is suggested that the dextrose-coated pacifier could be an effective nursing intervention for reducing pain on venipuncture in premature infants.

• The Korean Journal of Community Living Science
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• v.12 no.2
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• pp.15-32
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• 2001

This research was performed to examine the ratio of blindness to the child care environment and compare the evaluation of it among principals, teachers and mothers. Data were collected from questionnaires completed by respondents of this research were 37 principals, 37 teachers and 261 mothers of infants and toddlers at child care centers in Incheon, Korea. Cross tabulation, one-way ANOVA and Duncan's Multiple Range Test were utilized to analyze the data. In almost all of the items about the child care environment, mothers showed higher degrees of blindness than principals and teachers. In most of the items, mothers'evaluations were higher than those of principals and teachers. As a result, the researchers recognize a pressing need far programs far parents to improve the quality of child care.

• Child Health Nursing Research
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• v.10 no.1
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• pp.5-13
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• 2004

Purpose: The aim of this study was to analyze the correlation of gestational age and birth weight with weight gain of very low birth weight infants(VLBWI) during their hospital stay. Method: This is a 5 year retrospective study of which data were collected through review of medical records. Subjects were 124 VLBW infants with a birth weight more than 1000g and less than 1500g who received neonatal intensive care at the university hospital between January 1, 1997 to December 31, 2001. Result: After calculating the z scores of birth weights and discharge weights, z scores of discharge weight and birth weight were compared with the median weight of a fetus of comparable gestational age based on an intrauterine growth reference. There was a significant difference between z scores of birth weight and discharge weight(t=11.60, df=122, p=0.000). Regardless of intensive care during the prolonged hospital stay, VLBW infants showed slow growth rate compared with the median weight of a fetus of comparable gestational age. Conclusion: VLBW infants developed a poor velocity of weight gain during the prolonged hospital stay after birth. The development worsened during the period of physiological weight loss and regain, and they did not reach to comparable growth rate of normal fetus even at the time of discharge. This poor growth velocity of VLBW infants influence negatively for their future growth. Therefore nureses who work at the neonatal intensive care unit must develop an effective nursing intervention protocol to promote the velocity of weight gain and to conduct the parental educational sessions to emphasize the importance of weight gain for VLBW infants at home.