• Women's Health Nursing
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• v.19 no.2
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• pp.75-87
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• 2013

Purpose: In this study effects of a paternal participation program during cesarean section on paternal infant attachment were investigate. The experimental treatment was an integrative nursing intervention to promote father to infant attachment. Methods: Study design was a non-equivalent control group posttest design. The program consisted of emotional support to spouse and father towards infant attachment immediately following cesarean birth. Participants were 66 men, partners of women with normal full term pregnancy having a cesarean section with spinal or epidural anesthesia, (experimental group, 34; control group, 32). The experiment was carried out from August 1 to October 30, 2010. Control group data were obtained from May 1 to June 30, 2012. Posttest was performed 72 hours after cesarean birth. A self-report questionnaire including a paternal attachment instrument was used. Data were analyzed using t-test, propensity score matching, and analysis of covariance with the SPSS/WIN 18.0 program. Results: Total score for paternal infant attachment in the experimental group was significantly higher than the control group (p<.001). After matching, significant differences were found between the two groups through all subcategories. Adjusted mean score for paternal infant attachment verified experimental effects. Conclusion: Results indicate that this paternal participation program during cesarean section is effective in improving paternal infant attachment.

• Women's Health Nursing
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• v.17 no.4
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• pp.359-368
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• 2011

Purpose: To examine delivery type of mother who have had a previous cesarean and identify maternal factors related to type of delivery. Methods: The study sample included 60,504 mothers who had delivered through cesarean section. Related variables were categorized as sociodemographic factors (age, residence, health insurance type, income level) and clinical characteristics (14 maternal factor, 4 fetal factor and pre-term). For data analysis, $x^2$ and multivariate logistic regression were conducted. Results: Among the 60,504mothers, 3,075 were delivered through Vaginal Birth After C-Section (VBAC) and the VBAC rate was 5.1%. Underage 34, the VBAC rate increased according to age increases up to 3%. Mothers residing in urban areas had VBAC more frequently than mothers in rural area. Mothers in the high and middle income levels had a greater possibility of having VBAC than mothers in lower income levels. A greater likelihood of increase in repeated cesarean section were found in mothers with maternal and fetal factors. Conclusion: Evidence based nursing practice guidelines and education programs for previous cesarean section mothers and health policy are needed to increase VBAC.

• The Journal of Korean Physical Therapy
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• v.36 no.1
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• pp.1-8
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• 2024

Purpose: The purpose of this study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) abdominal muscle strengthening exercise on the activity, posture, and body function of clients with abdominal muscle weakness after cesarean section. Methods: PNF abdominal muscle strengthening exercise was applied to one patient with abdominal muscle weakness after cesarean section. PNF abdominal muscle strengthening exercise was applied five times a week for four weeks. The 5-time supine-to-long sitting test (5-TSLST) and supine-to-stand test (SST) were used to measure activity, and the pelvis tilt angle test (PTAT) and anterior head translation test (AHTT) were used to measure posture. Body function was assessed using the transverse abdominis muscle strength test (TAMST), the internal oblique and external oblique muscle strength test (IOEOMST), and the rectus abdominis muscle strength test (RAMST). Results: Activity, posture, and body function were improved post-intervention. Conclusion: The study verified that PNF abdominal muscle strengthening exercises are effective when applied to patients with abdominal muscle weakness after cesarean section. The findings of this study provide useful data for future interventions in patients with abdominal muscle weakness after cesarean section.

• 모자간호학회지
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• v.1
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• pp.23-33
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• 1991

Recently, Cesarean Section has been revealed as major events in maternity nursing, because it has influence on tile formatter of the self concept of cesarean section mothers as well as later coping mechanism and mother-child relationship including the mothering role. The study is conducted to clarify the relationships between the perceired family support and the self concept of cesarean section mothers, and to find out other Influencing factors on the formation of the self concept. Measuring instrument used in this study was Lee's scale to measure the self concept and the degree of perceived family support of the cesarean section mothers, The subject were 155 cesarean section mothers who were selected conveniently. Volunteers answered self reporting questionnaires which asked about their self concept. Data was analyzed as follows using SAS. The relationship between scores of the self concept and degree of the perceived family support was analyzed by Pearson's product moment correlation. In order to identify the influencing effects of demographic variables on the formation of self concept & F test were used. Result were summarized as follows : 1. Scores of self concept of cesarean section mothers were significantly correlated with scores of the perceived family support (r=0.3438, p<0.01) These results show that the family support is closely related to the self concept of cesarean mothers and has positive effects on their coping capacity. 2. Scores of self-concept of those who have lower ducation background and are multipara were significantly higher than those who have higher education background and are primipara(M=29.90$\pm$9.37, 27.69$\pm$3.89, t=2.006, df=105.8, p=0.0480: M=27.75$\pm$3.49. 29.46$\pm$8.68, t=-1.7183, 2. p=0.08).

• Women's Health Nursing
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• v.5 no.1
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• pp.5-20
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• 1999

This study was conducted to examine primiparas' perception of delivery experience and identity as the mother("Myself as the Mother" and "My Baby") according to delivery methods such as normal delivery and cesarean section. The result of this study summarized as follows. 1. The primiparas' perception of delivery experience according to delivery methods showed that the primipars who had normally delivered perceives the delivery experience more positively than those by cesarean section(t=4.88, p=0.000). This fact supported hypothesis 1 that "the primiparas group by normal delivery should perceive the delivery experience more positively that by cesarean section." 2. The primiparas who had delivered by cesarean section were more positive in the SD-Self score than those who had normally delivered at the time when four weeks passed after delivered, and there was a significant difference(t=-4.21, p\0.000). Therefore, hypothesis 2-1 that "the primiparas group who had normally delivered should be more positive in the SD-Self 1-2 days and 4 weeks after delivery than one who delivered by cesarean section" was rejected. 3. It was shown that the primiparas who had delivered normally were more positive in the SD-Baby 1-2 days 4 weeks after delivery than those who delivered by cesarean section(after-delivery 1-2 days : t=3.10, p=0.002 and after-delivery 4 weeks : t=2.15, p=0.034). Based on this fact, hypothesis 2-2 that "the primiparas group who had delivered normally should be more positive in the SD-Baby 1-2days and 4 weeks after delivery than those who had delivered by cesarean section"was supported. 4. Primiparas who had delivered by cesarean section appeared to have a positive identity as the mother by showing a more significant difference (t=7.96, p=0.000) 4 weeks after delivery than 1-2 days after delivery. In conclusion, we see that primiparas' perception of delivery experience and identity as the mother were different according to delivery methods. Thus, it is required to devise a nursing in tervention strategy to expand support from the health care system and opportunities to provide pre. post-delivery programs so that primiparas can have a positive perception of delivery experience and a positive identity as the mother. Based on conclusion stated above, the following suggestions are made. 1. As this study compared the perception of delivery experience and identity as the mother between prmiparas who had delivered normally and ones who had delivered by cesarean section, the further study on comparison between multiparas who had delivered normally and ones who had delivered by cesarean section is needed. 2. According to the results of this study, longitudinal study is needed to examine the difference and change in the formation of maternal identity. 3. According to the result of this study, a study is also needed to determine interaction between time for maternal identity and delivery methods.

• Health Policy and Management
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• v.11 no.3
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• pp.121-150
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• 2001

This study was conducted to investigate provider's behavior change after releasing the information on the Cesarean section rate. Claims data filed at the National Health Insurance Corporation was used for this analysis and the focus of this study was the change of cesarean rate after the public disclosure of information. Average rates of the year 1999 and 2000 were compared, on the institutional basis, and range and coefficient of variation were estimated. For the last decade, Cesarean section rate has been increased dramatically. Clinical or demographic factors could not adequately explain the increase. Instead, nonclinical factors, such as financial incentive, physician's convenience, practice characteristics, etc., were more significant in explaining the increasing rate. Providers' behavior was significantly affected by the public release of information: after the release, average rate was decreased by 10.2%, and variations were also decreased. In particular, the extent of decrease was explained mainly by nonclinical factor rather than clinical ones. The results suggest that disseminating practice information to providers and consumers could contribute to reducing unnecessary medical service.

• Journal of Korean Academy of Nursing
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• v.5 no.2
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• pp.23-28
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• 1975

One hundred and fifty seven cesarean sectioned patients among 2010 deliveries, were reviewed with the following clinical charts from January, 1973 to December, 1974 at Taegu Presby-terian medical Center. The results are as follows; 1) The section rate was 7.8% 2) In age distribution, the most frequent age was 26~30ys and it~s rate was 37%, and others were as follows : 31~35ys 24.2%, 21~25ys 21%, 36~40ys 10.8%, 41~45ys 7% respective]y- 3) In indication, the cephalopelvic disproportion was the most prevalent and it's rate was 29.3%, and others were as follows : malpresentation 14% previous cesarean section 10.8% uttering dysfunction 9.6%, totemic 4%, elderly primigravida 4%, fetal distress 2.5% post maturity 3.2%, wanted cesarean section 1, 9%, pelvic deformity 1.2% twin 1.9%, abruptio placenta 1.2%, Vaginal stricture 1.2%, and others 2.5%. 4) In type of operation, tower cervical transverse type was 82.1%, classical type 17%, ana cesarean hysterectomy was 0.9% respectively. 5) General Anesthesia was major type and it's rate was 63%, and spinal anesthesia 17.2%, epidermal anesthesia 14% and other combined type was 5.8%. 6) Percental mortality was 11.4%. 7) There was no maternal death. 8) Among the cesarean section complications, wound infection was 8,4%, headache 4.4%, urinary tract infection 1.2% and one case in endometritis. 9) In combined surgery, tubal legation was 31.2%, appenectomy 7.6%, posterior repair 1.2%, salpingoop-horectomy 1.9%, and one case in resection of uttering septum. 10) Cesarean section was performed 61.3% in multipara and 38.2% in primipara. 11) 47 (30%) had received artificial abortions. 12) 28 (17.8%) had previously experienced cesarean section.

• Journal of Korean Academy of Nursing
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• v.21 no.1
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• pp.41-49
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• 1991

From of old, labor has been accompanied by pain and much effort has been mode to eliminate or diminish the amounts of pain during labor. Little concern has yet been given to the subjective meaning of pain in labor. Recently, rates of cesarean section in Korea and in some other nations have increased rapidly and some investigators are reporting negative reactions such as anger, disappointment and feeling of loss due to lack of control over labor and its pain. These findings are thought to suggest that control of labor and its pain gives some meaning to the laboring woman. Thus the investigators sought to discover the meaning of pain during labor for Korean women. Specific objectives of this study were to explore the meaning of pain in labor to the mothers, their reactions to the experience of labor add their preference for delivery method. The subjects of this study were 95 mothers who delivered their babies in hospital from September 989 to May 1990 : 45 gave birth by vaginal delivery, and 50 by cesarean section. Data were gathered through direct interviews by the investigators, and questions were focused on five areas i.e. mothers' feelings about delivery and their babies, their feelings about of having more children, the most difficult aspect about this labor and delivery, and what they thought the differences were between vaginal delivery and cesarean section. After interview, mothers' answers were summarized, and classified according to the degree of positive or negative attitude. To ascertain the difference in meaning of labor pains and reaction to delivery experience between mothers delivered vaginally and by cesarean section a Median test was done using an SAS. Results were as follows. 1. More mothers who had delivered vaginally realized that they “have became a mother” than those who had a cesarean section(X$^2$＝8.409, df＝3, p＝0.038). 2. Immediate reaction to their delivery experience was more positive for mothers who had a cesarean section. 3. These Korean mothers expressed preference for vaginal delivery. Suggestions for further research on the meaning for mothers of their experience of labor, and on the meaning of pain for mothers who have a cesarean section were made.

• Journal of Korean Academy of Nursing
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• v.20 no.2
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• pp.131-141
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• 1990

Recently, the rate of cesarean section in Korea has been increasing. The results of several previous studies in foreign countries on the emotional responses of cesarean section mothers showed that they might experience difficulties in the mother- infant interaction due to fatigue, lack of early mother - infant interaction, disappointments, anger, feelings of loss of control, and other factors. Human behavior is said to be determined by one's self concept, and self concept is influenced by both internal and external environmental factors. A scale to measure the self concept of cesarean section mothers was needed in order to identify those who might have difficulties in the mother- infant interactions in future. The purposes of this study were to develop a measuring scale, and to test its reliability and validity. The process of this study was as follows. A structured interview was done with 50 cesarean section and vaginal delivery mothers to find their state of emotional reaction after giving birth to their babies. Based on the results of the interviews, a 50 items Likert scale was developed. The self concept of 268 cesarean section and vaginal delivery mothers who were hospitalized at six hospital in seoul were measured, during the period between Feb. 1 and April 30. Reviewing the discriminating power of each item by means of crosstabulation, ten items were selected for the final scale. The reliability and validity of this ten item scale were tested by Cronbach's alpha and t-test, using spss pc＋package. The results of this study and recommendation are as follows. 1. The ten selected items were as follows. I feel pains in my breast. (－) I have a good appetite now. (＋) I feel pains in my flank. (－) I feel fine now. (＋) My body seems to have returned to its prepregnant state. (＋) Thinking of the delivery process, I feel sorry. (－) I want to hold my baby in my arms. (＋) I want to keep my own life, even if I became a mother. (－) I want to delegate the care of the baby to my mother / mother in law. (－) I think baby is my alter ego. (＋) 2. The reliability of this scale was tested by Cronbach's alpha, and the coefficient of this scale was .8066. 3. The construct validity of this scale was tested by means of known group methods. The value of self concept for cesarean section mother was significantly lower than for vaginal delivery mothers(t＝-5.51, df＝266, p＝0.007). 4. The criterion validity of this scale was tested indirectly. Though this scale could discriminate the differences in the self concept between cesarean section and vaginal delivery mothers, the five items on the personal self concept scale didn's show any differences between cesarean section and vaginal delivery mothers. Therefore, the study indicates that those who shows lower values in the personal self concept measurement, that is, lower than 12.03 points, could be regaled as “risk mothers” 5. Further studies using this scale to clarify the influencing factors on negative self concept are strongly recommended.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.337-346
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• 2001

Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.