• Title/Summary/Keyword: maternal stress

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Spiritual Care Training for Mothers of Children with Cancer: Effects on Quality of Care and Mental Health of Caregivers

  • Borjalilu, Somaieh;Shahidi, Shahriar;Mazaheri, Mohammad Ali;Emami, Amir Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.545-552
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    • 2016
  • Background: The purpose of this study was to explore the effectiveness of a spiritual care training package in maternal caregivers of children with cancer. Materials and Methods: This study was a quasi-experimental study with pretest and posttest design consisting of a sample of 42 mothers of children diagnosed as having cancer. Participants were randomly assigned to either an experimental or a control group. The training package consisted of seven group training sessions offered in a children's hospital in Tehran. All mothers completed the Spirituality & Spiritual Care Rating Scale (SSCRS) and the Depression, Anxiety and Stress Scale (DASS-21) at pre and post test and after a three month follow up. Results: There was significant difference between anxiety and spiritual, religious, Personalized care and total scores spiritual care between the intervention and control groups at follow-up (P<0.001).There was no statistically significant difference in stress and depression scores between the intervention and the control groups at follow-up. Conclusions: Findings show that spiritual care training program promotes spirituality, personalized care, religiosity and spiritual care as well as decreasing anxiety in mothers of children with cancer and decreases anxiety. It may be concluded that spiritual care training could be used effectively in reducing distressful spiritual challenges in mothers of children with cancer.

조기진통 임부의 조산 발생 영향요인: 전향적 코호트 연구 (Risk Factors for Premature Birth among Premature Obstetric Labor Women: A Prospective Cohort Study)

  • 김윤경;임경희
    • 여성건강간호학회지
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    • 제24권3호
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    • pp.233-242
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    • 2018
  • Purpose: To identify risk factors for premature birth among premature obstetric labor women. Methods: Participants were 129 hospitalized women who were diagnosed with potential premature obstetric labor with 20 weeks to 37 weeks of gestation. Data were analyzed using descriptive statistics, $x^2$ test, t-test, and binary logistic regression. Results: Of 129 women, 78(60.5%) gave premature birth and 51 (39.5%) gave full-term birth. Risk factors for premature birth were education level (${\leq}$bachelor's degree), abnormal bowel condition (constipation or diarrhea), time firstly diagnosed with a premature obstetric labor (below 28 weeks of pregnancy), and multiple pregnancy. There were also increased risks of premature birth for participants with high level of anxiety and high level of prenatal stress. In social support, there was an increased risk of premature birth for participants with low level of social support. Conclusion: Prenatal nursing programs should consider not only psychosocial factors such as anxiety, prenatal stress, and social support, but also some general and obstetric factors such as education level, abnormal bowel condition, time firstly diagnosed with a premature obstetric labor, and multiple pregnancy to increase maternal and child health.

제대혈 갑상선 자극호르몬과 갑상선 호르몬 농도에 영향을 주는 주산기 인자들 (Perinatal Factors Affecting Thyroid Stimulating Hormone(TSH) and Thyroid Hormone Levels in Cord Blood)

  • 김은영;박상기;송창훈;임성철
    • Clinical and Experimental Pediatrics
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    • 제48권2호
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    • pp.143-147
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    • 2005
  • 목 적 : 갑상선 기능은 여러 질환이나 스트레스에 의해서 영향을 받는 것으로 알려져 있다. 저자들은 분만 전과 분만 동안의 여러 인자와 제대혈 갑상선자극호르몬 및 갑상선호르몬 농도와의 상관관계를 알아보고자 본 연구를 시행하였다. 방 법 : 총 130명의 신생아를 대상으로 분만 즉시 제대혈을 10 mL 채취하여 갑상선자극호르몬, $T_3$와 유리 $T_4$ 농도를 방사면역학적 방법(CIS bio international kit, Germany)으로 측정하였다. 재태연령, 출생체중, 가사, 분만방식, 산모의 당뇨병 유무, 산모의 전자간증 유무 등에 따라 갑상선자극호르몬과 갑상선 호르몬 농도를 비교하였다. 결 과 : 1) 제대혈 갑상선자극호르몬 농도는 재태연령 34주 이하 $1.73{\pm}0.48{\mu}IU/mL$, 34주-37주 $2.60{\pm}0.51{\mu}IU/mL$, 38주 이상 $4.26{\pm}0.40{\mu}IU/mL$으로 재태연령의 증가에 따라 증가하였다(P<0.05). 2) 분만형태를 비교하면 질식 분만 군 $4.42{\pm}0.66{\mu}IU/mL$, 제왕절개 분만 군 $3.31{\pm}0.33{\mu}IU/mL$로 질식 분만 군에서 높았다(P<0.05). 3) 가사에 따른 갑상선자극호르몬 농도는 가사가 있는 군 $5.18{\pm}0.93{\mu}IU/mL$로 가사가 없는 군 $2.97{\pm}0.84{\mu}IU/mL$에 비해 유의하게 높았다(P<0.05). 4) 산모의 당뇨병에 따른 갑상선자극호르몬 농도는 당뇨병 군 $8.91{\pm}1.25{\mu}IU/mL$, 없는 군 $4.32{\pm}0.42{\mu}IU/mL$으로 산모 당뇨병 동반시 유의하게 높았다(P<0.05). 5) 산모에게 전자간증이 있는 군의 갑상선자극호르몬 농도는 $5.28{\pm}0.42{\mu}IU/mL$, 없는 군 $3.65{\pm}0.46{\mu}IU/mL$에 비해 유의하게 높았다(P<0.05). 6) $T_3$와 유리 $T_4$ 농도는 가사 군에서 없는 군보다 유의하게 낮았다(P<0.05). 7) 각 변수 간의 영향을 배제하였을때 임신주수, 1분 Apgar 점수, 산모의 당뇨병만이 독립적으로 제대혈의 갑상선자극호르몬 농도에 영향을 미치는 것으로 나타났다. 결 론 : 제대혈 갑상선자극호르몬 및 갑상선호르몬 농도는 산모의 당뇨병이나 산모 전자간증과 같은 분만 전 요인과 태아에게 저산소증을 초래할 수 있는 분만시 스트레스와 밀접한 연관이 있다.

NICU에 입원한 미숙아 어머니의 스트레스 (Study on the Perceived Stress Level of Mothers in Neonatal Intensive Care Unit)

  • 김태임
    • 혜화의학회지
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    • 제8권1호
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    • pp.865-878
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    • 1999
  • With advances in neonatal medicine, smaller and sicker infants are surviving premature birth. As these tiny patients battle for their lives, their parents also struggle with psychological consequences of an unexpected role. The birth of a sick infants has long been documented as stressful events for the parents. High stress levels may alter parents' interaction with their baby and impair their communication with health professionals, which can in turn affect parents' participation in care planning and decision making. Nursing interventions aimed at reducing the parental stress and anxiety levels during this crisis may have a positive impact on their ability to form an attatchment to their baby and make prudent decisions about his care. The planning of such interventions would be inhanced if the contributions of various factors to increased parental stress levels were identified. This descriptive study was conducted to understand the contents and degree of parental stress in the NICU during their premature's hospitalization, and to give a baseline data in developing nursing intervention program. Subjects were the 60 mother of hospitalized newborn in NICU of 2 University Hospital in Taejon City from April 1st, 1999 to June 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales:NICU(PSS:NICU) developed by Miles et al.. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from "not stressful" (1) to "extremely stressfu1"(5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's ${\alpha}$ coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers of premature baby was slightly high($3.66{\pm}1.1$). The highest scored dimension was 'relationship with their baby and parental role change'($4.21{\pm}0.9$), and next were 'appearance and behavior of the baby'($3.92{\pm}1.1$), 'communication with health team'($3.32{\pm}1.3$), 'sight and sounds of NICU'($3.30{\pm}1.1$). 2. There were statistically significant correlation noted ; mother's perceived severity of the baby's condition(F=8.0012, P= .0125) and baby's gestational age(r = -.4724, P = .0500). In summary, information about physical environment of NICU, the mother's perceived severity of premature baby's state, maternal role change related variables and the knowledge of characteristics of premature baby must be included in nursing intervention program of mother's of premature baby in reducing the parental stress and anxiety level. It is suggested that each NICU needs to develop a nurse managed supportive care program for parents of premature baby. Also, it is suggested that there need to investigate the coping mechanism of mother of premature baby.

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일개 보건소의 소프롤로지 식 분만교육의 효과 (The Effects of Sophrologic Prenatal Education Program in Community Health Centers)

  • 김정순;김윤희;김영선;김복자;이정희;김명수
    • 지역사회간호학회지
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    • 제14권4호
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    • pp.598-607
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    • 2003
  • Purpose: The purpose of this study was to identify the effects of the Sophrologic Prenatal Education Program. Method: The subjects of this study were 16 antepartum women who had been registered at community health centers at S-gu in Pusan. Data were collected from women who visited for antenatal care during the period from the 7th of May to 28th of June in 2003. Participants were evaluated before and on completion of the 8 weeks' educational program using 3 instruments: Breast-feeding knowlege, Maternal-fetal attachment and Antenatal stress. The Wilcoxon Signed-Ranks Test was conducted for data analysis using SPSS/WIN 10.0. Results: Statistically significant difference was found between the pretest and posttest in the mean score of the Breast-feeding knowledge. The mean scores of the experiment group and the control group were $31.44{\pm}5.51\;and\;37.06{\pm}4.27$ respectively (p=.001). No statistically significant difference was found between the pretest and posttest in the mean score of the Maternal-fetal attachment (p=.315, p=.578). Conclusions: Community health care providers must consider the emotional needs of Korean people and make efforts to adapt the Sophrologie Prenatal Education Program for a larger number of antepartum women in community.

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어머니의 우울과 양육행동이 유아의 문제행동에 미치는 영향 (The Effect of Mother's Depression and Parenting Behavior on Children's Problem Behavior)

  • 이소현
    • 한국보육학회지
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    • 제18권2호
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    • pp.117-127
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    • 2018
  • 본 연구는 유아의 문제행동에 대한 어머니의 우울과 어머니의 양육행동 유형의 상대적 영향력을 살펴보고자 하였다. 연구대상은 서울특별시와 경기도 유치원과 어린이집의 만 3~5세 유아와 그들의 어머니 203명이며, 우울증 척도(Beck Depression Inventory: BDI), 어머니 양육행동 척도(Maternal Behavior Research Instrument), 한국판 유아행동평가 척도 부모용(K-CBCL)을 통해 자료를 수집하였다. 수집된 자료는 SPSS 18.0 통계프로그램을 활용하여 Pearson 적률상관분석을 하였고, 단계적 중다회귀(Stepwise Multi-Regression)을 통해 검증하였다. 연구결과, 유아의 내재화 문제행동 및 외현화 문제행동은 어머니의 우울, 거부적, 통제적 양육행동과는 정적 상관을 보였으며, 어머니의 애정적, 자율적 양육행동과는 부적 상관을 보였다. 또한 유아의 내재화, 외현화 문제행동에 대한 어머니의 우울과 양육행동 유형별 상대적 영향력을 살펴본 결과, 어머니의 우울이 가장 강력한 예측변인이라는 연구결과가 나타났으며, 어머니의 양육행동 중 거부적 양육행동이 추가적인 예측변인으로 밝혀졌다. 이러한 연구결과는 유아의 문제행동에 대한 어머니의 우울 감소 프로그램 및 거부적 양육행동과 같은 부정적 양육행동의 감소를 위한 부모교육의 필요성을 시사한다.

Epithelial to mesenchymal transition (EMT) of feto-maternal reproductive tissues generates inflammation: a detrimental factor for preterm birth

  • Menon, Ramkumar
    • BMB Reports
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    • 제55권8호
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    • pp.370-379
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    • 2022
  • Human pregnancy is a delicate and complex process where multiorgan interactions between two independent systems, the mother, and her fetus, maintain pregnancy. Intercellular interactions that can define homeostasis at the various cellular level between the two systems allow uninterrupted fetal growth and development until delivery. Interactions are needed for tissue remodeling during pregnancy at both fetal and maternal tissue layers. One of the mechanisms that help tissue remodeling is via cellular transitions where epithelial cells undergo a cyclic transition from epithelial to mesenchymal (EMT) and back from mesenchymal to epithelial (MET). Two major pregnancy-associated tissue systems that use EMT, and MET are the fetal membrane (amniochorion) amnion epithelial layer and cervical epithelial cells and will be reviewed here. EMT is often associated with localized inflammation, and it is a well-balanced process to facilitate tissue remodeling. Cyclic transition processes are important because a terminal state or the static state of EMT can cause accumulation of proinflammatory mesenchymal cells in the matrix regions of these tissues and increase localized inflammation that can cause tissue damage. Interactions that determine homeostasis are often controlled by both endocrine and paracrine mediators. Pregnancy maintenance hormone progesterone and its receptors are critical for maintaining the balance between EMT and MET. Increased intrauterine oxidative stress at term can force a static (terminal) EMT and increase inflammation that are physiologic processes that destabilize homeostasis that maintain pregnancy to promote labor and delivery of the fetus. However, conditions that can produce an untimely increase in EMT and inflammation can be pathologic. These tissue damages are often associated with adverse pregnancy complications such as preterm prelabor rupture of the membranes (pPROM) and spontaneous preterm birth (PTB). Therefore, an understanding of the biomolecular processes that maintain cyclic EMT-MET is critical to reducing the risk of pPROM and PTB. Extracellular vesicles (exosomes of 40-160 nm) that can carry various cargo are involved in cellular transitions as paracrine mediators. Exosomes can carry a variety of biomolecules as cargo. Studies specifically using exosomes from cells undergone EMT can carry a pro-inflammatory cargo and in a paracrine fashion can modify the neighboring tissue environment to cause enhancement of uterine inflammation.

Adrenal and thyroid function in the fetus and preterm infant

  • Chung, Hye Rim
    • Clinical and Experimental Pediatrics
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    • 제57권10호
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    • pp.425-433
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    • 2014
  • Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

일하는 어머니의 취업특성에 따른 부모역할만족 (Parental Satisfaction and Employment Characteristics of Working Mother)

  • 양연숙
    • 대한가정학회지
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    • 제35권3호
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    • pp.139-150
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    • 1997
  • The purpose of this study was (1) to explore the difference in parental satisfaction regarding personal/family, work, and psychological variables of employment characteristics, and (2) to investigate the most effecting variables on the parental satisfaction. For this study, the working mother with children aged under 10 year were surveyed. The results of this study were as follow; (1) There were significant differences in the parental satisfaction according to work time, job preference, income, the difficulty of work life. However, working mother's personal and family variable were not found as the related variable. Psychological variables were correlated with parental satisfaction. (2) Maternal role efficiency, dual role conflict, flexibility of work, marriage year, income, psychological stress, expanded family, durations of occupation, spouse support significantly predicted parental satisfaction. Psychological variables were important in parental satisfaction of working mothers.

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