• 제목/요약/키워드: early postpartum

검색결과 134건 처리시간 0.02초

모유영양아와 인공영양아의 1~3개월의 성장발육 상태 평가-한국 표준치와 NCHS Reference간의 비교- (Evaluation of Growth between Breast-Fed and Formula-Fed Korean Infants from 1 to 3 Postpartum Months -Compared with the Korean Standard and NCHS Reference-)

  • 최경숙;구재옥
    • 대한지역사회영양학회지
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    • 제3권4호
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    • pp.533-541
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    • 1998
  • This study compares the growth performance(weight-for-age Z-score, height-for-age Z-score, weight-for-height Z-score) of one- to three- month-old Korean infants(n=232) with the Korean standard(1994) and NCHS reference(1983). The weight-for-age Z-scores(WAZ) by the Korean standard were -2∼1,5 for males and -3∼1 for females. The NCHS reference, WAZ results were -1∼2.5 and -2.5∼3.5 for males and females, respectively. The WAZ compared Korean standard showed no subjects with overnutrition. But 1.3% of the infants showed signs of malnutrition. Comparison with NCHS reference revealed that 0.4% of the infants were malnourished and 7.0% of the infants were overnourished. The WAZ of formula-fed infants were distributed higher than breast-fed infants, but that was not significant. The height-for-age Z-score(HAZ) by the Korean standard were -4.5%∼1.5% for males and -4∼1.5% for females. According to the NCHS reference, HAZ were -2.5%∼2.5% and -3∼3 for males and females, respectively. When the WAZ was compared with the Korean standard, there was no overnutrition but 16% of the infants showed signs of malnutrition. The NCHS reference, revealed that 6.9% of the infants were malnourished and 1.8% of the infants were ovemourished. The weight-for-height Z-scores(WHZ) by the Korean standard were -2∼5 for males and -2.5∼5 for females. The NCHS reference WAZ scores were -1∼4 and -1.5∼4.5 for males and females, respectively. When the WHZ was compared with the Korean standard, 2.2% of infants were malnourished and 19.5% were overnourished. There were no malnourished subjects according to the NCHS reference and 19.1% of the infants were overnourished. When the three Z-scores are considered together, 92.0% of the infants should a normal growth status, there was no malnutrition, and 8.0% of the infants were overnourished. The growth performance was evaluated differently according to the type of standards. Thus, it is necessary to set proper growth standards for infants, according to which classification of feeding methods is chosen. A longterm and careful assessment of infants's growth performances to develop any group of standards.

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가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구 (Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants)

  • 한경자
    • 가정간호학회지
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    • 제8권1호
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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.

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한국인 수유부의 수유초기 이행유의 모유성분 분석과 영아의 섭취량 추정 연구 (Studies of nutrient composition of transitional human milk and estimated intake of nutrients by breast-fed infants in Korean mothers)

  • 최윤경;김나영;김지명;조미숙;강봉수;김유리
    • Journal of Nutrition and Health
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    • 제48권6호
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    • pp.476-487
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    • 2015
  • 본 연구는 분만 후 5일에서 15일 사이에 분비되는 이행유의 성분을 분석하여 모유의 전반적인 영양소의 함량을 측정하고, 모유영양아의 하루 섭취량을 추정하여 2010년 한국인 영양섭취기준과 비교함으로써 국내 모유영양아의 영양 섭취의 적절성을 파악하고자 하였다. 연구 대상은 정상 만삭아를 출산하고 서울경기 지역 소재 산후조리원에서 회복중인 100명의 산모들이었다. 이들은 연구의 취지를 이해하고 참여 동의한 뒤 개인의 특성에 관한 설문지를 작성하고 모유 샘플을 제공하였다. 수유부들의 나이는 평균 $32.01{\pm}4.08$세였고, 신장은 평균 $161.93{\pm}4.79cm$, 만삭 체중은 $65.92{\pm}8.10kg$이었다. 모유 성분 분석 결과 모유 내 에너지 농도는 $59.99{\pm}8.01kcal/dL$, 단백질의 농도는 $1.47{\pm}0.27g/dL$, 지방의 농도는 $2.88{\pm}0.89g/dL$, 탄수화물의 농도는 $6.72{\pm}0.22g/dL$이었다. 지방산의 경우 ${\omega}-6$ 계열의 리놀레산과 아라키돈산의 모유 속 농도는 각각 $181.44{\pm}96.41mg/dL$, $28.15{\pm}8.89mg/dL$이었고, ${\omega}-3$ 계열의 리놀렌산, DHA의 모유 속 농도는 각각 $5.67{\pm}1.86mg/dL$, $5.74{\pm}2.57mg/dL$ 로 나타났다. 모유 속 비타민 A, 비타민 D, 비타민 E의 농도는 각각 $28.95{\pm}17.50{\mu}g/L$, $23.09{\pm}11.16ng/mL$, $7.37{\pm}15.43mg/L$이었으며, 비타민 C, 비타민 $B_1$, 비타민 $B_2$, 비타민 $B_{12}$, 그리고 엽산의 모유 속 농도는 $30.22{\pm}18.43mg/L$, $75.14{\pm}209.61{\mu}g/L$, $617.82{\pm}267.79{\mu}g/L$, $637.74{\pm}271.92pg/mL$, $5.16{\pm}2.58ng/mL$이었다. 무기질 중 칼슘의 모유 속 농도는 $20.71{\pm}3.34mg/dL$, 철의 모유 속 농도는 $5.86{\pm}8.61mg/L$, 칼륨의 모유 속 농도는 $66.71{\pm}10.35mg/dL$, 나트륨의 모유 속 농도는 $27.72{\pm}10.16mg/dL$이었으며, 아연과 구리는 모유 속에 각 $0.44{\pm}0.41mg/dL$, $70.48{\pm}30.41{\mu}g/dL$의 농도로 함유되어 있었다. 면역성분인 IgA의 모유 속 농도는 $61.85{\pm}31.97mg/dL$, total IgE의 모유 속 농도는 $2.35{\pm}0.93IU/mL$이었다. 영아의 하루 섭취량을 추정한 결과에 의하면 에너지 지방, 탄수화물, 비타민 A, 비타민 C, 비타민 $B_1$, 엽산, 칼슘의 하루 섭취 추정량은 이행유 섭취량으로 조정된 2010년 한국인 영양섭취기준의 충분섭취량에 미치지 못하였으나, 단백질, 비타민 D, 비타민 E, 비타민 $B_2$, 비타민 $B_{12}$, 철, 칼륨, 나트륨, 아연, 구리 등은 이행유 섭취량으로 조정된 2010년 한국인 영양섭취기준의 충분 섭취량을 충족하였다. 대부분의 영양소는 추정 섭취량이 이행유 섭취량으로 조정된 2010년 한국인 영양섭취기준과 비교하여 대체적으로 비슷하였으나 비타민 $B_1$, 엽산, 칼슘, 비타민 D, 구리 등의 영양소는 이행유 섭취량으로 조정된 2010년 한국인 영양섭취기준과 다소 차이가 있었다. 이러한 결과는 한국인 모유의 영양성분과 관련 있는 요소를 파악하는 후속 연구의 필요성을 시사하며, 한국인 모유의 성분함량과 섭취량에 관한 지속적인 연구는 모유의 질적 향상을 꾀하고 영아의 성장발달을 도모하기 위한 방안을 마련하는 기초자료로 활용될 수 있을 것이다.