• Title/Summary/Keyword: Family-Support

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Indigenous psychological analysis of delinquency among Korean adolescents: Comparison of adolescents under probation and high school students (한국 일탈 청소년의 토착심리 탐구: 보호관찰 청소년과 일반 청소년의 부모자녀관계에 대한 비교를 중심으로)

  • Young-Shin Park ;Uichol Kim ;Soo Yeon Tak
    • Korean Journal of Culture and Social Issue
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    • v.10 no.1
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    • pp.107-145
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    • 2004
  • This study examines factors that influence delinquency among adolescents under probation using indigenous psychological analysis, focusing specifically on parent-child relationship. A total 268 adolescents under probation and their parents and 251 high school students and their parents participated in the two studies. In the first study, qualitative results indicate that both groups of adolescents were most likely to trust their parents than any other person and reason for their trust is reported to be based on blood relationship. Similarly, majority of parents of both groups reported trusting their children because of the blood relationship. Parents hope that their children will be sincere a person and will be able to maintain harmonious social relationship. Parents of adolescents under probation were more likely to report disobedience as being most problematic, whereas parents of high school students were more likely report providing social and financial support for their children's education as being the most difficult. In the second study, structured questionnaires were administered to the four groups and the following set of results were obtained. First, in terms of family background, the socio-economic status of adolescents under probation was lower, they are less likely to live with both parents or natural parents, and more likely to have ran away from home than high school students. Second, adolescents under probation are less likely to trust their parents and more likely to view their parents as being hostile. Third, parents of adolescents under probation were less likely to trust their children, more likely to view their relationship as being conflictual and hostile, and feel that they had to sacrifice for their children when compared with parents of high school students. Implications of these results for parent-child relationship and delinquency are discussed.

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Estimation Analysis of the Value of Welfare Facilities for the Aged Management (노인복지시설의 경영가치 추정 분석)

  • Kim, Keum Hwan;Pak, Ae Kyung;Joe, Soon Joem
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.1
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    • pp.193-203
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    • 2013
  • The social welfare service is expanding to different field as the social welfare budget is increasing. By this opportunity, it needs to make clear of the basis of argument that the necessity of development of korean government's support and aid by social policy should be worked. Welfare economics perspective, this study used by the operating expenditure in welfare facilities for the elderly old people to effect social benefits to be gained, in other words, business value analysis. Local elderly people, provide opportunities to participate in the economic activities of the family welfare services offered to attainment of the elderly welfare policy, and provide disease prevention and health promotion opportunities, to enhance the satisfaction of life, including a wide range of impact will cause. In this study, elderly people use the welfare facilities for the elderly when they get the benefits by applying the AHP analysis techniques operating value was calculated. Elderly Welfare Center operated by the result of applying P senior welfare center Case of the metropolitan area value was estimated 248.4 billion won. Contribute to the effects caused by the cost factor of the analysis was 23.1% of the total 57.3 billion won. Independence elements 57.6 billion (23.2%), the analysis of the therapeutic elements 133.4 billion (53.7%) of the net was. The result of the study anticipates the role of basic research material for the necessity of intervention, support, and aid by the Welfare facilities for the elderly field at this point in time where the welfare budget policy in terms of universal social service is reinforced, rather than the trend, until recently, of realizing the Elderly welfare budget and service as Consumption expenditure and consumable benefits and the function of performing the effect and evaluation in tentative action of social conflict.

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

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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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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A Study on Suitable Site for Day Nursery in Tae-gu (대구의 보육시설 현황과 입지선정)

  • Bae, Sook-Hee
    • Journal of the Korean association of regional geographers
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    • v.2 no.1
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    • pp.25-38
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    • 1996
  • As the proportion of women's participation in economic activities is rising, the increase of husband and wife both working and nuclear families makes children up-bringing a social problem. But many families have difficulties by the shortage of day nurseries which can solve it. As we can see in the research, the most urgent problem is the extension of nurseries in quantity. In Taegu, since it became a wide-area city, there are 473 nurseries. But in the respect of distribution, only less than 10% of Dongs have more than 7 nurseries and more than 90% of Dongs have less than 7 nurseries. Consequently nurseries are extremely insufficient. Moreover 29 Dongs don't have any nurseries at all and they take 18.6% of Dongs. The second problem is the unbalanced distribution of nurseries. West and north ward which are industrial complex and swarmed with low-income families, and Tal-sung county which is recently included in the wide-area city keenly need the establishment of nurseries. Besides, Bi-san 1 Dong and Non-gong which have only $1{\sim}2$ nurseries though they have high proportion of children and women who can be pregnant are also the areas which take precedence of nursery establishment. The third problem is that government support must be increased in the areas which have many small, petty and profit-making private nurseries so that good quality teachers can make breeding activities in nice facilities and environment. In materials which are obtained by the interviews with publich servants in charge of family welfare in some ward offices. Young and unexperienced persons who aquired certificate of qualification take day-nursery permits and run nurseries only a few months. and if the profits are insufficient, they sell the nurseries for premiums to third persons who are not qualified. Then the third managers only think of profits without thought of good quality childcare. As the result, the nurseries become asylums not nurseries. That is why the conditions of nursery establishment must be restricted to suitable scale and experienced persons. The fourth problem is that the nurseries in work places are extremely insufficient. The women who have jobs have many things to do before they go to work such as preparing meals and leaving children in the care of someone. Hence the childcare problem of working women must be solved. In nuclear families, childcare is the most serious problem for working women. The fifth one is the reduction of childcare expenses. Women must sacrifice themselves a lot to make social activities. To say nothing of physical and mental burden, they have to spend much of their salaries on childcare. And yet they don't take the benefit of good quality childcare. For the participation of women in public affairs, society must support the childcare problem to have then be devoted to their jobs without worries about their children. Therefore Taegu wide-area city must select west, north ward which are industrial complex and the low-income swarmed area before everything and establish many national, public and corporate nurseries which cost less expenses.

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Is Fertility Rate Proportional to the Quality of Life? An Exploratory Analysis of the Relationship between Better Life Index (BLI) and Fertility Rate in OECD Countries (출산율은 삶의 질과 비례하는가? OECD 국가의 삶의 질 요인과 출산율의 관계에 관한 추이분석)

  • Kim, KyungHee;Ryu, SeoungHo;Chung, HeeTae;Gim, HyeYeong;Park, HeongJoon
    • International Area Studies Review
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    • v.22 no.1
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    • pp.215-235
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    • 2018
  • Policy concerns related to raising fertility rates are not only common interests among the OECD countries, but they are also issues of great concern to South Korea whose fertility rate is the lowest in the world. The fertility rate in South Korea continues to decline, even though most of the national budget has been spent on measures to address this and many studies have been conducted on the increase in the fertility rates. In this regard, this study aims to verify the effectiveness of the detailed factors affecting the fertility rate that have been discussed in the previous studies on fertility rates, and to investigate the overall trend toward enhancing the quality of life and increasing the fertility rate through macroscopic and structural studies under the recognition of problems related to the policy approaches through the case studies of the European countries. Toward this end, this study investigated if a high quality of life in advanced countries contributes to the increase in the fertility rate, which country serves as a state model that has a high quality of life and a high fertility rate, and what kind of social and policy environment does the country have with regard to childbirth. The analysis of the OECD Better Life Index (BLI) and CIA fertility rate data showed that the countries whose people enjoy a high quality of life do not necessarily have high fertility rates. In addition, under the recognition that a country with a high quality of life and a high birth rate serves as a state model that South Korea should aim for, the social characteristics of Iceland, Ireland, and New Zealand, which turned out to have both a high quality of life and a high fertility rate, were compared with those of Germany, which showed a high quality of life but a low fertility rate. According to the comparison results, the three countries that were mentioned showed higher awareness of gender equality; therefore, the gender wage gap was small. It was also confirmed that the governments of these countries support various policies that promote both parents sharing the care of their children. In Germany, on the other hand, the gender wage gap was large and the fertility rate was low. In a related move, however, the German government has made active efforts to a paradigm shift toward gender equality. The fertility rate increases when the synergy lies in the relationship between parents and children; therefore, awareness about gender equality should be firmly established both at home and in the labor market. For this reason, the government is required to provide support for the childbirth and rearing environment through appropriate family policies, and exert greater efforts to enhance the effectiveness of the relevant systems rather than simply promoting a system construction. Furthermore, it is necessary to help people in making their own childbearing decisions during the process of creating a better society by changing the national goal from 'raising the fertility rate' to 'creating a healthy society made of happy families'

Contract Farming Through a Cooperative to Boost Agricultural Sector Restructuring: Evidence from a Rural Commune in Central Vietnam (베트남 농업구조개혁과 협동조합의 계약영농: 중부베트남의 농촌을 사례로)

  • Duong, Thi Thu Ha;Kim, Doo-Chul
    • Journal of the Economic Geographical Society of Korea
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    • v.25 no.1
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    • pp.109-130
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    • 2022
  • The Vietnamese government has proposed contract farming through a new type of cooperative as an institutional innovation which aims to restructure the agricultural sector. However, policy changes often impact farmers, who bear the primary effects of the transition process. Understanding households' strategies for land use and livelihood is crucial for policymaking in the agricultural development field. This study was conducted in the rural Binh Dao commune in Central Vietnam. We analyzed household members' labor force changes and their livelihood behaviors after their participation in a contract farming scheme using qualitative analysis methods combined with geographic information system (GIS) support, based on secondary data and in-depth interviews of 190 farmers. Simultaneously, we created a digital map of the cooperative's production area to investigate changes in land use and production activities. The findings show that contract farming shaped the vertical coordination of the value chain from the farmers to the cooperative and agricultural product trading companies. Subsequently, it encouraged land use and labor efficiency due to mechanical support. In addition, it also increased productivity and protected farmers from market risks. However, despite its positive effects on agricultural productivity in this case, the contract farming scheme could not achieve the restructuring of the rural labor force toward non-agricultural sectors. Ironically, farmers in the Binh Dao commune tended to increase cultivable land during the agricultural restructuring program, rather than switching their labor forces to non-agricultural sectors. The lack of stable non-farming job opportunities in rural Vietnam results in challenges to the efficiency of agricultural restructuring programs. Consequently, farmers in the Binh Dao commune are still smallholder farmers, depending on the family labor force.

Cultivation Support System of Ginseng as a Red Ginseng Raw MaterialduringtheKoreanEmpire andJapaneseColonialPeriod (대한제국과 일제강점기의 홍삼 원료삼 경작지원 시스템)

  • Dae-Hui Cho
    • Journal of Ginseng Culture
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    • v.5
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    • pp.32-51
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    • 2023
  • Because red ginseng was exported in large quantities to the Qing Dynasty in the 19th century, a large-scale ginseng cultivation complex was established in Kaesong. Sibyunje (時邊制), a privately led loan system unique to merchants in Kaesong, made it possible for them to raise the enormous capital required for ginseng cultivation. The imperial family of the Korean Empire promulgated the Posamgyuchik (包蔘規則) in 1895, and this signaled the start of the red ginseng monopoly system. In 1899, when the invasion of ginseng farms by the Japanese became severe, the imperial soldiers were sent to guard the ginseng farms to prevent the theft of ginseng by the Japanese. Furthermore, the stateled compensation mission, Baesanggeum Seongyojedo (賠償金 先交制度), provided 50%-90% of the payment for raw ginseng, which was paid in advance of harvest. In 1895, rising seed prices prompted some merchants to import and sell poor quality seeds from China and Japan. The red ginseng trade order was therefore promulgated in 1920 to prohibit the import of foreign seeds without the government's permission. In 1906-1910, namely, the early period of Japanese colonial rule, ginseng cultivation was halted, and the volume of fresh ginseng stocked as a raw material for red ginseng in 1910 was only 2,771 geun (斤). However, it increased significantly to 10,000 geun between 1915 and 1919 and to 150,000 geun between 1920 and 1934. These increases in the production of fresh ginseng as a raw material for red ginseng were the result of various policies implemented in 1908 with the aim of fostering the ginseng industry, such as prior disclosure of the compensation price for fresh ginseng, loans for cultivation expenditure in new areas, and the payment of incentives to excellent cultivators. Nevertheless, the ultimate goal of Japanese imperialism at the time was not to foster the growth of Korean ginseng farming, but to finance the maintenance of its colonial management using profits from the red ginseng business.

The status of care satisfactions of the disabled persons with community-based rehabilitation plan (장애인의 치료만족도에 따른 지역사회중심재활에 관한 연구)

  • Lee In-Hak;Park Rae-Joon;Kim Mi-Ran
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.13-32
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    • 1998
  • A questionaire was conducted to obtain ran satisfactions in information of the 325 disabled persons among the total 9,314 handicapped people in Taejon area, and was surveyed during the period of June 1 to August 31, 1997. The results are as follows: 1. Among the studied disabled persons, $54.5\%$ of male, and $45.5\%$ of female. 2. Before disabled in occupation, $32.0\%$ of out of work group were high, $6.5\%$ of farm, student group were low. Before disabled in occupation by gender, male group is $29.9\%$ of out of work group were high, $0.6\%$ of housework group were low. female group is$34.5\%$ of out of work group were high, $4.7\%$ of student group were low(P<0.001). 3. After disabled in occupation, $75.1\%$ of out of work group wert high, $10.8\%$ of in working group were low. After disabled in occupation by gender, male group is $87.6\%$ of out of work group were high, $1.7\%$ of housework group were low. female group is $60.1\%$ of out of work group were hgh, $10.8\%$ of in working group were low(P<0.001). 4. Medical security status, $64.9\%$ of medical aid group wore high, $35.1\%$ of medical insurance group were low. Medical security status by gender, male group is $71.2\%$ of medical aid group were high, $28.8\%$ of medical insurance group were Iew. female group is $57.4\%$ of medical aid group wan high, $42.6\%$ of medical insurance were low(P<0.01). 5. Disabled record status, $68.6\%$ of record group were high, $31.4\%$ of non group were low. Disabled record status by gender, male group is $78.5\%$ of record group were high, $21.5\%$ of non record group were low. female group is $56.6\%$ of record group were high, $43.4%$ of non record group were low(P<0.001). 6. Disabled duration status, $42.2\%$ of loss than 9 year group were high, $10.2\%\;of\;20-29,\;30-39$ year group were low. Disabled duration status by gender,'male group is $44.6\%$ of less than 9 year group were high, $6.2\%$ of 20-29 year group wert low. female group is $39.2\%$ of less than 9 year were high, $39.2\%$ of 30-39 year group were low (P<0.05). 7. Cause of disabled status, $26.5\%$ of other group, $23.7\%$ of congenital group were high. $9.2\%$ of unknown group, $6.8\%$ of industry accident, $2.5\%$ of drug poisoning group were low. Cause of disabled status by gender, male group is $27.7\%$ of other group, $23.7\%$ of congenital group were high, $2.3\%$ drug poisoning group were low. female group is $25.0\%$ of other group, $20.9\%$ of congenital group were high, $2.5\%$ of drug poisoning group were low (P<0.001). 8. Disabled type status, $19.4\%$ of double disabled group were high, $2.2\%$ of muscle paralysis group were low. Disabled type status by gender, male group is $22.0\%$ of double disabled group were high, $2.3\%$ of muscle paralysis group were low. female group is $23.3\%$ of rheumatism group were high, $0.7\%$ of amputation group were low(P<0.001). 9. Smoking status, $73.2\%$ of non smoking group were high, $26.8\%$ of smoking group were low. Smoking status by gender, male group is $59.9\%$ of double non smoking group were high, $40.1\%$ of Smoking group were low, female group is $89.2\%$ of non smoking group were high, $10.8\%$ of smoking group were low(P<0.001). 10. Drinking status, $80.0\%$ of non drinking group were high, $20.0\%$ of drinking group were low. Drinking status by gender, male group is $72.3\%$ of non drinking group were high, $27.7\%$ of drinking group were low. female group is $89.2\%$ of non drinking group were high, $10.8\%$ of drinking group were low(P<0.001). 11. Stress level status, $52.9\%$ of high stress group were high, $1.8\%$ of very severe stress group were low. Stress level status by gender, male group is $50.8\%$ of high stress group were high, $2.3\%$ of very severe stress group were low. female group is $55.4\%$of high stress group were high, $1.4\%$ of very severe stress group were low. 12. Heed status, $28.0\%$ of economic support were high, $4.6\%$ of speech therapy, brace group were low. Need status by Sender, male group is $2i2\%$ of economic support group were high, $4.5\%$ of bracegroup were low. female group is$27.7\%$ of economic support group were high, $3.4\%$ of speech therapy group were low. 13. Care satisfaction comparision, 3.09, 0.55 point of IBR, 4.01, 0.45 point of CHR(P<0.001). 14. The variables which had positive correlation with IBR were gender(r=0.1406, P<0.01), age(r=0.1872, p<0.001), economic level(r=0.1246, P<0.05), disabled record(r=0.1137, P<0.05), education level(r=-0.1122. p<0.05). 15. The variables which had positive : correlation with CBR were gender(r=0.1613, P<0.01), age(r=0.2255, P<0.001). list of family(r=0.12i3, P<0.01), disabled record(r=0.1273, P<0.05). education level(r=-0.1294, P<0.01).

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Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

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Primiparas만 Perceptions of Their Delivery Experience and Their Maternal-Infant Interaction : Compared According to Delivery Method (초산모의 분만유형별 분만경험에 대한 지각과 모아상호작용 과정에 관한 연구)

  • 조미영
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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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.

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