- Health Sciences ＞ Development of Pharmaceutical
Volume 4 Issue 1
Jun, Eun-Mi 3
Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.
Lee, Young-Sook 12
This study was done to determine the situations of stress incontinence(SI) and the differences in general characteristics, obstetrical history and SI related variables between women with stress incontinence and normal women. The design for study was a descriptive study. The number of subjects consisted of 156 women who were selected by systematic random sampling in Kwangju city. Data collection was done with the modified Hendrickson's Stress Incontinence Scale(1981) which was analyzed using frequency and percentiles. The results were as follows : 1. The stress incontinence (SI) rate of the sample was 64.1% and the majority of the women(40.9%) had experienced SI for a period of five years(the mean period was 2.7 years) without any treatment or care(83.0%). The amount of SI was from one drop(40.0%) to one teaspoon(16.7%) daily. 2. Items on the SI scale had the scores ranging from 4 to 44 with a mean score of 13.7 which showed mild SI. 3. The priority of provocative factors for SI were abdominal tightening(83%), coughing(58%), laughing(52%), sneezing(40%), steeping(18%), sudden standing(17%), nose blowing(13%), heavy exercise(11%), rapid walking up-stairs(10%) and excitment (9%) in that order. 4. There were no significant differences in age, education, spouse, job and income between the women with SI and the normal women. 5. There were no significant differences in the age at the last delivery, age of last baby. number of vaginal, or cesarean deliveries, or abdominal operations between the women with SI and the normal women. It can be concluded that SI in women has a high incidence nth various provocative factors but it is relatively mild SI on a daily basis and generally there has been no treatment. It is suggested that a descriptive study of emotional problems and precipitating variables in SI women will increase the knowledge of SI.
Park, Hyun-Ae;Song, Kun-Yong 24
본 연구는 국민건강조사의 대상가구 중 0-4세 어린이와 엄마가 있는 3,002가구(1989), 1,623가구(1992)의 모아를 대상으로 의료이용 양상을 비교하였다. 그 결과 엄마의 의료이용이 어린이의 의료이용과 유의한 상관관계를 나타내고 있으며, 특히 건강한 어린이 그룹에서 어머니의 의료이용 수준이 어린이의 의료이용량에 크게 영향을 미치는 것으로 나타났다. 엄마의 의료이용이 엄마와 가족의 특성을 나타내는 대리변수로서 어린이의 의료이용에 영향을 미치는지 알아 보기 위해 엄마와 가족의 특성을 나타내는 가구원 수, 생활수준, 의료보험 종류, 엄마의 교육수준, 엄마의 평소 건강상태를 포함한 모형과 포함하지 않은 모형을 분석하여 비교한 결과 엄마의 의료이용 수준이 어린이의 의료이용에 독자적으로 영향을 미치는 것으로 나타났다.
Differences in Maternal Role Attainment for Breastfeeding and Bottlefeeding Mothers at Four Months after DeliveryLee, Hae-Kyung 33
모유수유 유무와 아기의 신체적, 정서적 발달과의 관계, 모유수유 성공에 영향을 주는 요소, 모유수유를 성공시키기 위한 전략 등 모유수유를 증진시키기 위한 연구는 많이 이루어 졌다. 이에 비하여 모유수유가 어머니의 모성행위, 어머니의 만족에 미치는 영향 등 모유수유 유무가 어머니의 정서에 미치는 영향에 관한 조사는 거의 이루어지지 않은 실정이다. 그러나 많은 모성간호사들은 모유수유 어머니가 인공수유 어머니보다 아기 양육에 더 자신감을 갖고 있고, 어머니로서의 역할에 더 만족한다고 믿고 있다. 또한 피치못할 사정으로 인공수유를 하는 어머니들 스스로도 모유수유를 하지 못함 때문에 아기에 대한 죄의식을 갖고 있을 수 있다. 그래서 생후 4개월된 아기를 갖고 있는 어머니를 대상으로 모유수유 유무와 어머니의 모성역할 긴장과 모성역할 획득 정도에 차이를 연구하였다. 연구결과 모유수유 유무에 따라 모성역할 획득정도에 차이가 없었으며, 모성역할 긴장에도 차이가 없었다. 또한 남편의 지지와 친척 및 친구의 지지를 공변량으로 처리하여 모유수유 유무에 따라 모성역할 획득정도에 차이를 알아 본 결과 모유수유 유무에 따라 모성역할 획득 정도에 차이가 없었고, 모성역할 긴장 역시 차이가 없었다.
Cho, Cheong-Ho 41
The purposes of this study were to identify responses of nursing students following clinical maternity nursing practice, to develop data of further effective clinical maternity nursing practice, to understand nursing students perceive the natural maturation process toward pregnancy delivery and puerperal process, to help the nursing students achieve personality growth and development through clinical maternity nursing practice. The subjects were 35 senior nursing students from the Department of Nursing Science of Chung-Ang University. The data were collected from the 1st semester (Feb.22
$\sim$June 9) to the 2nd semester(Aug.23 $\sim$Nov.10), 1993 through self-reporting using an open ended questionnaire about perception and feelings regarding the normal delivery process. The data analysis used descriptive method. Results of the study were as follows : 1. Following clinical practice in maternity nursing, the responses of the nursing students were collected included both positive and negative aspects. The positive responses were classified in to four categories and each category included subgroups. One group, labelled as $\ulcorner$The birth of noble life $\lrcorner$had a subgroup, (I felt the mystery and wonder of life), another group, $\ulcorner$After delivery, comfort and satisfaction $\lrcorner$with the subgroup (I can bear to see the comfort and relief beyond pain) (C/S is better than vaginal delivery) (Very easy), the 3rd group, $\ulcorner$I realized family friendship and support $\lrcorner$with subgroup (Honorable, Magnificient) (I thank my parents ) (It's good to looking at my husband's support), and the 4th group, $\ulcorner$The birth of a healthy baby $\lrcorner$, with its subgroup, (baby looks pretty and healthy). 2. The negative responses were classified in eight categories and each category included subgroups. One group labelled as $\ulcorner$Fear $\lrcorner$, had subgroups of (Terrible, Horrible) (Shock) (Dread), another group, $\ulcorner$Tension $\lrcorner$, and its subgroup, (I became tense about stories heard before clinical practice), the 3rd group, $\ulcorner$surprise $\lrcorner$and its subgroup (I was surprised at the delivery process), the 4th group, $\ulcorner$Power lessness $\lrcorner$and its subgroup, (I watched the labor pain impatiently), the 5th group $\ulcorner$Apathy $\lrcorner$; and its subgroup, (I didn't feel the empathy for the labor pain of the pregnant women), the 6th group, $\ulcorner$Disgust $\lrcorner$and its subgroup, (Disgust, Embarrassed), the 7th group, $\ulcorner$Inevitable destiny $\lrcorner$and its subgroups (necessity of self-sacrifice and difficulty) (I accepted it as a women's destiny) (I can't do it), the last group, $\ulcorner$There seems to be trouble $\lrcorner$and its subgroup, (It seems to have been a little too hard for mother and baby). Suggestions for further studies are as follows : 1. Nursing students should receive intensive education about $\ulcorner$The birth of noble life $\lrcorner$ $\ulcorner$After delivery, comfort and satisfaction $\lrcorner$ $\ulcorner$I realized family friendship and support $\lrcorner$ $\ulcorner$The birth of a healthy baby $\lrcorner$, so that a more positive attitude can be developed before clinical maternity nursing. 2. Nursing students should be given an orientation which is reality based and related clinical maternity nursing (using for A.V. Materials), so that they will not feel they tension, of the negative categories. 3. Nursing students should be received articles on Pain Relief Method, so that they will be prepared activie and positive in the clinical practice, and therefore they will not feel the powerlessness, of the negative categories. 4. F/U for responses of nursing students should be checked following clinical maternity nursing to evaluate the effects of the instruction.
Byun, Soo-Ja;Han, Kyung-Ja;Lee, Ja-Hyung 52
This study was done to investigate mother's attitude to breast feeding and the type of feeding according to the general characteristics of mother. The study sample consisted of 1696 mothers who had an infant and who were visiting five Hospitals or ten Public Health Centers in Seoul. Data was collected through a question aire from June, 1 to June, 30, 1993. The results are as follows : 1. The types of feeding were artificial feeding 2%), mixed feeding(21.7%) and breast feeding (26.1%). 2. The attitude of mothers to breast feeding was very positive for behavior tendency and cognitive attitude but the emotional attitude was low to moderate. 3. The attitude scores for the mothers were from 27 to 60 and 65% the mothers had scores that were high, 50-60 and mean was 49.86. 4. There was the significance between the general characteristics (type of delivery, obtaining in formation on breast feeding, type of feeding and baby's birth order) and the attitude score of mothers. 5. The attitude scores for the mothers by the general characteristics and type of feeding was not a 2-way interaction but the type of feeding had a main effects.
Oh, Hyun-Ei;Park, Nan-Jun;Im, Eun-Sook 68
This study measured variables influencing the breast feeding patterns of lactating mothers over a 40 day period In 1993 in the Jeonla area. The Methodology used was a questionnaire covering 92 items based on statistical discriminant analysis. The results were as follows : The successful group was measured against the unsuccessful group over a 4month lactation period ; The successful group was measured over a 4month lactation period ; the unsuccessful less than 4month lactation period. Principal factor analysis was used to generate comparative data factors which were ; 1) nonunderstanding of mother's breast feeding, 2) physical and psychological stress, 3) insufficient milk supply, 4) mother's negative acceptance of baby, 5) lack of spousal support, 6) sore nipple and breast pain, 7) baby's negative acceptance, 8) lack of familial support, 9) baby's diarrhea and watery milk. Discriminant statistical analysis of sever factors included ; 1) insufficient milk supply 2) sore nipple and breast pain, 3) pre-natal planning of breast feeding method, 4) mother's occupation 5) breast feeding method of previous infant, 6) nipple type, and 7) infant birth order. This analysis predicted a 78.9% successful breast feeding. Criterion correlation analysis revealed ; D=-1.780+.165
$\times$(Fac3)+.135 $\times$(Fac6)+.927 $\times$(prenatal planning of breast feeding method)+.900 $\times$(mother's occupation)+.675 $\times$(breast feeding method of previous infant)+1.0l4 $\times$(nipple type)+.378 $\times$(infant birth order). We classified the unsuccessful group as more than .63937 and the successful group less than -.82742 of the D value obtained from the above criterion correlation in order to check the success or the non-success of breast feeding mothers. The rate of correct classification of the grouped cases employing a statistical discriminant analysis was significantly improved to 78.9% when these cases were compared with the actual grouped classification.
Koh, Hyo-Jung 80
Concept analysis is a strategy that examines the attributes or characteristics of a concept. It is a formal linguistic exercise to determine those defining attributes. The basic purpose of concept analysis is to clarify ambiguous concepts in theory, and to propose a precise operational definition which reflects the theoretical base of the concept. The concept of maternal role is too broad and variable in expression, therefore there has been no authentic definition nor standard opinion for this concept. The purpose of this study is to clarify the concept of maternal role which in turn will help in the development of a theory of maternal role attainment. In order to analyze the concept of maternal role, much effort was extended to look up "maternal role" in various dictionaries and literature, but only a few cases were found which listed this terminology. Consultation on the meaning of "mother" and "role" separately was then done and consequently a definition of "maternal role" was obtained through concept analysis of these two words independently, finding their attributes and unifying them. The attributes of the concept of maternal role which was analyzed based on the steps of concept analysis by Walker & Avant (1988) are : 1) Women who have pregnancies 2) Women who have a child 3) Women who rear a child 4) Expected behavior according to social status 5) Learning through social cultures 6) Social interrelationships. The antecedents of the maternal role are : 1) women who are pregnant and deliver a baby, must keep in contact with their child. 2) Circumstances for childrearing must be provided. 3) Formation of self-concept as mother should be developed, cognitive activity, which is necessary for the nurturing activity, financial support and preparation of childrearing should be provided. And the consequences of the maternal role are : 1) Improvement 2) Changeability 3) Ambiguity 4) Stability Through this concept analysis, the concept of the maternal role is defined as "expected behavior by social interrelationships and learned nurturing behavior through social cultures."