• Journal of Preventive Medicine and Public Health
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• 제16권1호
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

• 한국보건간호학회지
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• 제16권2호
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• pp.315-324
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• 2002

Objectives : This study was conducted to explore the relating factors with the delivery of low-birth-weight infants in Pyungtaek city. Methods : A questionnaire survey was obtained from 51 mothers with low-birth-weight babies and 90 mothers with full-term normal babies from April to October in 2001. Questionnaire consisted of demographic characteristics, dietary habits including alcohol. drugging, and smoking, past and present disease, prenatal risk factors and prenatal check-up, and complications related to labor and delivery. Results : 1. In the low-birth-weight infants group, father's education level and mother's height were significantly lower, and proportion of old age mothers was significantly higher than those of the normal infant group. 2. Mothers with low-birth-weight infants experienced more premature rupture of membrane, placenta previa, ecclampsia, and twin pregnancy than mothers with normal infants. Gestational period of mothers with low-birth-weight infants was significantly shorter than that of mothers with normal infants. 3. No differences were found in eating habit, alcohol and drug ingestion, smoking, exposing to dangerous materials in two groups, but both groups were highly exposed to indirect smoking, although mothers rarely smoke. Conclusion : The findings of this study indicate that high risk group such as less educated, or older mothers need more prenatal health assessment and support from public health services. Addition to determine the risk factors related to the delivery of low-birth-weight infants, public health nurses pay more attention and develop efficient management system for vulnerable women and infants.

• Journal of Chest Surgery
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• 제34권12호
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• pp.909-916
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• 2001

배경 : 하지정맥류는 주변에서 흔히 볼수 있는 혈관 질환으로 흉부외과 영역에서도 최근 관심의 대상이 되고있다. 대상 및 방법 : 본 연구는 1999년 4월부터 2000년 12월까지 본원에서 치료한 하지정맥류 환자 209명 혹은 269족의 임상기록을 후향적으로 연구 관찰하였다. 결과 : 남자는 52명, 여자는 157명으로 1:3의 비율이었고, 연령은 평균 42.2$\pm$9.7세 이었으며, 평균 발생기간은 12.2$\pm$9.7년이었고, 평균 추적간은 2001년 7월을 기준하여 평균 14.8$\pm$6.1개월이었다. 증상은 하지 통증이 122례(58.4%)로 가장 많았다. 장시간 서있는 직업(44명), 임신(37명), 가족력이 있는 경우(7명) 및 이들의 조합이 주원인으로 전체의 79.9%를 차지하였다. 주병소는 대복제정맥까지 침범한 경우가 126례, 소복제 정맥까지 침범한 경우가 18례, 망상혈관 및 모세혈관확장증만 있었던 경우가 65례 있었다. 치료는 대복제정맥 발거,분절 절제술, 대복재정맥-대퇴정맥 연결부위 결찰, 혈관 경화요법 및 보존적 치료를 시행하였다. 대복재정맥을 침범한 경우 발거를 시행한 군(A군)과 혈관경화요법을 시행한 군(B군)을 비교했을때, 시술후 합병증은 A군에서 많았고(p 0.05), 재발은 B군에서 많았다(p 0.05). 소복재정맥까지 침범한 경우 stab avulsion을 시행한 경우(C군)와 혈관 경화요법을 시행한 경우(D군)의 비교시 D군에서 2례의 재발이 있었으나 합병증 및 재발에서 통계적 차이는 없었다. 혈관 경화요법에서 대복재정맥을 침범한 경우(B군)와 망상정맥 및 모세혈관확장증이 있는 경우(E군)의 비교시 합병증은 차이가없었으나(p 0.05), 재발률은 B군에서 높았다(p 0.05). 발거후 합병증으로는 발목 무감각 및 저린 느낌(2례), 발목 통증(2례), 족부부종(2례),창상감염(1례)등이 있었고, 혈관 경화요법의 경우 정맥혈전염(1례), 피부궤양(1례)등이 있었다. 결론 : 대복재정맥의 혈관경화요법은 발거술 보다 재발률이 높았지만. 망상정맥 및 모세혈관확장증에서의 혈관경화요법은 대복재정맥을 침범한 정맥류의 혈관 경화요법을 시행한 경우보다 재발률이 낮았다. 하지만, 혈관경화요법은 수술 및 입원이 필요없는 간편한 치료이기에 대복재정맥의 경우에도 더욱 연구 보완하여 적용하는 것이 필요하리라 생각된다.

• 한국수정란이식학회지
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• 제13권2호
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• pp.89-96
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• 1998

Anti-phospholipid antihodies (aPL) have important roles in various pregnancy complications such as recurrent miscarrige, growth retardation, placental abruption and stillbirth. However, their biological actions on preimplantation development of oocytes are still unclear. In this study, we investigated whether either aPL containing sera or phospholipids could affect in vitro fertilization and development of mouse oocytes. Sera used in this study were collected from three patients and the presence of aPL in the sera was confirmed by enzymatic-linked immunosorbent assay. When mouse oocytes were cultured in a serum-free, Chatot, Ziomek and Bavister (CZB) medium (Experiment 1), addition of aPL-containing sera (10%) to CZB medium did not. significantly (P>0.05) influence sperm penetration of oocytes. However, development to the blastocyst stage was significantly (P<0.05) inhibited by serum addition, and formation of morulae (16-23% vs. 58%) and blastocysts (0-4% vs. 21%) was markedly reduced compared with no addition (Experiment 2). In Experiment 3, pronuclear stage embryos were cultured for 96 h in GZB medium supplemented with 1 $\mu$g /ml phosphatidyl ethanolamine, 1 $\mu$g/ml phosphatidyl inositol or 1 $\mu$g /ml phosphatidyl choline. No increase in embryo development was found after addition of the phospholipids to CZB medium. These results suggest that 1) aPL have an inhibitory role in preimplantation development of mouse embryos, and that 2) the action of aPL may be related to a specific phospholid (s) rather than the tested phospholipids in the present study.

• 농촌의학ㆍ지역보건
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• 제44권2호
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• pp.73-81
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• 2019

목적 : 이 연구는 네팔의 마호타리 지방에 거주하고 있는 사춘기 소녀들의 낙태에 대한 인식 수준을 평가하기 위해 수행하였다. 방법 : 이 연구는 지역사회 기반 단면연구로서 2019년 1월부터 3월까지 네팔의 마호타리 지역의 농촌 마을 사춘기 소녀 412명 대상으로 실시하였다. 대상자는 10세에서 19세까지의 사춘기 소녀로서 다단계집락추출 방법으로 선정하였고, 사춘기 소녀의 낙태에 대한 인식 수준에 미치는 요인을 알기위해다변량로지스틱회귀을 시행하였다. 결과 : 조사 결과 사춘기 소녀의 45.6%가 안전한 낙태에 대해 높은 인식도를 가지고 있었다. 결혼한 청소년의 인식도는 미혼의 청소년보다 높았고(OR = 2.16, 95 % CI : 1.01-4.87), 중등교육 이상을 받은 청소년의 인식도가 높았다(OR = 2.21, 95 % CI : 1.13-3.04). 또한 월 소득이 10,000 ~ 20,000 루피(NRs)와 그 이상이 되는 경우 10,000 루피에 비해 각각 2.33 배(OR=2.33, 95 % CI : 1.07-3.55), 3.17 배(OR=3.17, 95 % CI : 2.19-8.94)더 높았다. 결론 : 이 연구를 통해 낙태에 대한 전반적인 지식 수준은 낮았다. 결혼상태, 교육수준, 가족수입과 같은 사회 경제적 요인이 낙태에 대한 인식수준과 관련이 있어, 이를 통해 원치 않는 임신, 낙태 및 그로 인한 합병증을 줄이기 위해 낙태에 대한 인식 수준을 높일 수 있도록 노력하여야 한다.

• 대한간호학회지
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• 제20권2호
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• pp.153-173
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• 1990

One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p＝0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p＝0.000) but no differences for labor or the bady according to the delivery method(p＝0.096, p＝0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p＝0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p＝0.042), 2nd day (p＝0.009), and the 3rd day(p＝0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F＝.3206, p＝.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r＝.4363, p＝.000, r＝.2881, p＝.012). No correlations between perceptions of labor and maternal-infant interaction were found(p＝0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p＝0.000) and from the fourth to sixth weeks after birth(P＝0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p＝0.002) and breast feeding(p＝0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p＝0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p＝0.010), a wanted pregnancy (P＝0.030) and her confidence in her role as a mother(p＝0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

• 여성건강간호학회지
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• 제7권3호
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• pp.331-347
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• 2001

The purpose of this study was to compare the effects on labor pain and duration of delivery time for primipara women treated by Hob-Gog (LI-4) pressure. 1. The proposed hypothesis was that 'the score of labor pain could be lower in the group which had LI-4 pressure applied than in the control group'. 1-1. The sub hypothesis was that the score of subjective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 1-2. Another sub hypothesis was that the score of objective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 2. The proposed hypothesis was that 'the score of duration of delivery time could be shorter in the group which had LI-4 pressure applied than in the control group'. The design of this study was a nonequivalent control group non-synchronized post test only design to verify the effect on labor pain for primipara women treated by LI-4 pressure and to evaluate the benefits of using LI-4 pressure on some women and judging the degree of their labor pains in comparison with other primipara women not treated with LI-4 pressure. The subjects included 63 primipara women who underwent vaginal delivery, who were between 38-41 weeks intra uterine pregnancy; who did not have any complications; and who were under pitocin augmentation or induction. They were recruited with informed consent; 34 were in the control group and 29 were in the experimental group. The study was measured with a structured questionnaire consisting of general characteristics, knowledge related to delivery, subjective (Johnson, 1974) and objective(McLachlan, 1974) labor pain scale, data collection was done by research during the period from April, 2000 to July, 2000 and data was analyzed by descriptive statistics, $x^2$-test, and t-test. The results were as follows: 1. The scores of total labor pain in the group which had LI-4 pressure applied were lower($347.62{\pm}49.84$) than in the group($411.02{\pm}55.79$) which did not have LI-4 pressure applied; And these differences were statistically significant(t=4.7193, p=.000). 1-1. The scores of subjective labor pain in the group which had LI-4 pressure applied were lower($203.44${\pm}33.88$)$ than in the group ($$233.82{\pm}31.31$$) which did not have LI-4 pressure applied(t=3.6953, p=.000). 1-2. The scores of objective pain in the group which had LI-4 pressure applied were lower ($144.18{\pm}29.12$) than in the group which did not have LI-4 pressure applied($177.20{\pm}35.01$). but there were no statistically significant differences found in regard to the scores of objective pain(t=4.0271, p=.000). 3. The duration of delivery time in the group which had LI-4 pressure applied was shorter ($390.51min{\pm}111.91$) than in the group ($460.44min{\pm}190.78$)which did not have LI-4 pressure applied and the duration of delivery time in the experimental group was statistically more significant than that in the control group. therefore this thesis was adapted(t=1.734, p=.0879). It could be concluded that LI-4 pressure is effective in relation to labor pain and duration of delivery time for primipara women. Therefore it is necessary to increase the number of subjects to generalize this result.