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A Study on the Perceived Stress of Mothers in Neonatal Intensive Care Unit (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Choi Sung Hee
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.60-75
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    • 1998
  • The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

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Meconium Peritonitis: A Rare Treatable Cause of Non-Immune Hydrops

  • Rajendran, Usha Devi;Govindarajan, Jeyanthi;Balakrishnan, Umamaheswari;Chandrasekaran, Ashok;Amboiram, Prakash
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.576-580
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    • 2019
  • Meconium peritonitis as a cause of non-immune hydrops in neonates is rarely reported. Here we report such a rare occurrence. In our case, a routine antenatal scan at 25 weeks revealed isolated ascites. By 31 weeks of gestation, all features of hydrops were observed in scans. However, antenatal workup for immune and non-immune hydrops was negative. Subsequently, a preterm hydropic female baby was delivered at 32 weeks. She required intubation and ventilator support. An X-ray revealed calcification in the abdomen suggestive of meconium peritonitis. Ultrasound showed gross ascites, a giant cyst compressing the inferior vena cava, and minimal bilateral pleural effusion. Emergency laparotomy revealed meconium pellets and perforation of the ileum. Double-barrel ileostomy was performed, and the edema resolved and activity improved. The baby was discharged after 3 weeks. Ileostomy closure was done at follow-up. The baby is growing well.

States, Behaviors and Cues of Infants (영아의 상태, 행동, 암시)

  • Kim, Tae-Im
    • Korean Parent-Child Health Journal
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    • v.1
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    • pp.56-74
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    • 1998
  • The language of the newborn, like that of adults, is one of gesture, posture, and expression(Lewis, 1980). Helping parents understand and respond to their newborn's cues will make caring for their baby more enjoyable and may well provide the foundation for a communicative bond that will last lifetime. Infant state provides a dynamic pattern reflecting the full behavioral repertoire of the healthy infant(Brazelton, 1973, 1984). States are organized in a predictable emporal sequence and provide a basic classification of conditions that occur over and over again(Wolff, 1987). They are recognized by characteristic behavioral patterns, physiological changes, and infants' level of responsiveness. Most inportantly, however, states provide caregivers a framework for observing and understanding infants' behavior. When parents know how to determine whether their infant is sleep, awake, or drowsy, and they know the implications, recognition of states has for both the infant's behavior and for their caregiving, then a lot of hings about taking care of a newborn become much easier and more rewarding. Most parents have the skills and desire to do what is best for their infant. The skills 7373parents bring to the interaction are: the ability to read their infant's cues: to stimulate the baby through touch, movement, talking, and looking at: and to respond in a contingent manner to the infant's signals. Among the crucial skills infants bring to the interaction are perceptual abilities: hearing and seeing, the capacity to look at another for a period of time, the ability to smile, be consoled, adapt their body to holding or movement, and be regular and predictable in responding. Research demonstrates that the absence of these skills by either partner adversely affects parent-infant interaction and later development. Observing early parent-infant interactions during the hospital stay is important in order to identify parent-infant pairs in need of continued monitoring(Barnard, et al., 1989).

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A Case of Successful Treatment of Congenital Syphilis in an Extremely Preterm Baby With Severe Respiratory Distress

  • Yoon Kyung Cho;Yeon Kyung Lee;Sun Young Ko
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.161-165
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    • 2022
  • We report a case of successful treatment of congenital syphilis in an extremely preterm baby. A 1,395 g female infant was born by emergency Caesarean section due to preterm labor and breech presentation at gestational age at 29 weeks and 3 days with an Apgar score of 2 and 4 at 1 minute and 5 minutes, respectively. The mother of the newborn, an illegal immigrant who did not receive any antenatal care, was diagnosed as active syphilis infection by reactive rapid plasma regain (RPR) (titer 1:128) just before the delivery. Upon birth, the newborn presented with various clinical manifestations, including severe respiratory distress syndrome, persistent pulmonary hypertension of the newborn, disseminated intravascular coagulopathy, desquamation and scaling of the whole body, and osteolytic changes of long bone ends. Results of laboratory tests showed signs of early congenital syphilis, including positive syphilis reagin test (12.7 R.U.), reactive with RPR titer of 1:64, and positive for immunoglobulin (Ig) M and IgG fluorescent treponemal antibody absorption test. However, after completion of penicillin G treatment for two weeks, laboratory results dramatically improved, showing a negative syphilis reagin test (0.5 R.U.) and non-reactive in RPR. In conclusion, the incidence of congenital syphilis is prone to be resurgent in South Korea, neonatologists should be fully aware of the clinical features of congenital syphilis because early diagnosis and prompt treatment are essential in order to reduce the social and economic burden due to congenital syphilis.

A Study of Current Newborn Clothing and Consumer Complaints (신생아복 현황과 소비자 불만사항에 관한 연구)

  • Roh, Eui Kyung;Kwon, Sang-Hee
    • Fashion & Textile Research Journal
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    • v.20 no.2
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    • pp.128-142
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    • 2018
  • This study explores newborn clothing with regard to clothing type, construction, textiles, design, size, and label placement. Related consumer complaints are also analyzed. Analysis of 50 newborn clothing items revealed six types of newborn clothing: baenaet jeogori, baenaet gown, bodysuit, one-piece, shirt and pants set, and pants. The baenaet jeogori was the most common type, and the most commonly used fasteners were ties and snaps. The following characteristics were commonly observed: front opening, long raglan sleeves, mitten cuffs, cotton fabric, white/ivory color, animal print, contrast hem, $appliqu{\acute{e}}$, and size 60. In-depth interviews of 12 mothers with children under 24 months revealed that the baenaet jeogori was the most unsatisfactory type; the shirt and pants set and bodysuit were preferred. Interviewees were dissatisfied with types of openings, expressing a preference for snaps and complaining about ties, too many snaps, metal snaps, and shoulder openings. Overly wide or narrow sleeves resulted in improper fit, and long sleeves made it difficult to dress the baby. Interviewees required diverse sleeve length options. They were dissatisfied with heavy fabric for hot and warm seasons, and with labels attached inside clothing or outside near the neckline. Mothers with particularly small or big babies complained about limited sizes. To improve current newborn clothing, additional items such as shirt and pants sets or individual pants, front opening clothing with few snaps, proper sleeve fit with diverse length options, lightweight fabric for hot and warm seasons, label placement that avoids skin irritation, and size segmentation are recommended.

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

  • Kim, Tae-Im
    • Journal of Haehwa Medicine
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    • v.8 no.1
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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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Clinical Experience of Mediastinal Immature Teratoma in a Newborn (선천성 종격동 기형종(신생아에 발생한 미성숙 기형종) 치험 1례 보고)

  • 정승혁
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.530-532
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    • 1995
  • The teratomas seem to be the most common mediastinal tumor in Korea. However, the immature teratomas are the rarest type of these mediastinal teratomas. A case of immature teratoma of the mediastinum occurring in a newborn male is reported. He suffered from severe dyspnea since birth. Simple chest X-ray and chest sonogram revealed huge mass shadow in fight whole lung field. On 6th day after birth, the operation was done and the mass was completely excised. Biopsy showed elements of mature tissues derived from 3 germ cell layers including immature neuronal components. The baby is well without evidence of disease till now.

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A Comparison of Parent Stress Sick Newborn in NICU (신생아 중환자실에 입원한 중증 신생아의 부모 스트레스의 비교)

  • Oh, Kum-Suk;Lim, Ji-Young;Cho, In-Sook;Ham, Ok-Kyung
    • Journal of Home Health Care Nursing
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    • v.17 no.1
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    • pp.12-20
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    • 2010
  • Purpose: The study examined differences in stress between the parents of sick newborns. Methods: Participants were the mothers (n=57) and fathers (n=57) of newborns in NICU of six university hospitals. An established stress measurement tool (Miles and Carter, 1993) was used. Results: Fathers and mothers displayed the highest stress scores (4.44 and 4.67, respectively) when the baby looked in pain. Maternal overall stress scores were significantly higher than paternal scores. Conclusions: Mothers and fathers experience differing levels of stress concerning their newborn. Further studies are needed to develop customized stress management intervention programs for parents of newborns in the NICU.

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A Study of the Assessing the High Risk Mothers and Influencing to Their Newborn Babies (고 위험 임신과 신생아 상태와의 관계에 관한 연구)

  • 이경혜;이자형
    • Journal of Korean Academy of Nursing
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    • v.9 no.2
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    • pp.7-15
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    • 1979
  • This study was undertaken to determine .the identify the relation between the high risk mother and their baby which then allows the nurse to assess and plen for the delivery of optimal health care to the high risk groups. This study was carried out between January through December 1978. This study sample consisted of 300 pregnant women who visited Ewha womens hospital during this time. The method used to for the collection of data was an“Antepartum High-risk pregnancy scoring form. The questionair included 4 categories: 1) reproductives history 2) Associated conditions 3) pre-sent pregnancy and 4) total risk score . The bind are as follows: 1. The frequency of high risk pregnancy women 149(49.7%) was highest. 2. In the investigation sample high risk factors were related to hypertension and toremia. 3. There was a difference in the high risk scores and newborn babys scores (r = 0.610). 4. Relationship between high risk pregnancy women and least of pregnant women was highest prenatal mortality. Implications of positive assessing of high risk factors by MCH nurse and community health nurses.

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