• Child Health Nursing Research
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• v.6 no.2
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• pp.224-239
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• 2000

This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 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(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from (1) to (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 α 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 was slightly high(3.6±.7). The highest scored dimension was 'appearance and behavior of the baby'(3.9±1.5), and next were 'relationship with their baby and parental role change'(3.5±1.4), 'communication with health team'(3.4±.9), 'sight and sounds of NICU'(3.2±.8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

• Women's Health Nursing
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• v.7 no.1
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• pp.56-66
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• 2001

This study examines the factors that are associated with the choice of the Sanhujoriwon utilization among the Korean postpartal women. Data were collected from 140 postpartal women in 9 hospitals around Seoul. Data were analyzed based on descriptive statistics and chi-square test. The results were as follows: 1. Forty percent of the respondents chose to go to a Sanhujoriwon while they were in a hospital after having given birth to a child. 2. The number of persons who could help a respondent beside her husband showed a statistically significant association with the choice of the Sanhujoriwon utilization. In addition, burden from multiple roles expected after the birth was positively associated with the choice of the Sanhujoriwon utilization. Recommendations by husbands or friends to use the Sanhujoriwon also increased the proportion of the choice of the Sanhujoriwon utilization. 3. Knowledge about the Sanhujoriwon appeared to be an important factor. Having heard about the Sanhujoriwon, an appropriateness of the price, and a positive image of the Sanhujoriwon were positively associated with the choice of the Sanhujoriwon utilization. It was expected that the degree of depressive symptoms and confidence of raising a newborn baby would affect the Sanhujoriwon utilization. This was not the case in this study. Intimacy developed between the postpartal women, their husbands and their relatives as well as parents in-law did not show a statistically significant relationship to the choice of the utilization. Implication of these findings and major findings of this study were discussed.

• Korean Parent-Child Health Journal
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• v.4 no.1
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• pp.1-18
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• 2001

Fatigue after delivery affect women's birth experience and interrupt the process of labor. Finally woman cannot have a positive birth result and will experience a postpartum fatigue. But researches about fatigue during the labor are lacked. Nurse help adapting a mother's role, bonding with new baby, recovering after birth, and improving woman's quality of life through decreasing fatigue during the labor and intercepting a continued postpartum fatigue. So it is very important that measuring a fatigue and confirming relationships between fatigue and factors affecting fatigue. The purpose of this study was measuring the level of fatigue within 4hours after delivery and identifing factors affecting fatigue. The ultimate goal was to contribute to improving a birth experience and adapting after birth through decreasing the level of fatigue and interventions. The data was collected for this study at the hospital of two universities and the third hospital in Seoul from Aug. 15. to Nov. 10. 2000. The subjects were 106 of mothers who deliveried a normal newborn and were tested within four hours after birth. The instruments were The Visual Analogue Scale for fatigue, The State Anxiety Inventory, and The Labor Support Inventory. The data were analyzed by using percentage, mean, SD, t-test, ANOVA, Pearson correlation. The results of this study were as follows; (1) The level of fatigue during the labor was 61.48point. (2) The deferences according to general and obstetric character affecting fatigue founded that there were Significant differences according to job(t=2.659, p=0.009), and the type of delivery(t=-2.035, p=0.044). (3) The deferences according to factors affecting fatigue revealed that there was significant difference according to quality of sleep(F=2.935, p=0.037). The significant fatigue and the fatigue after delivery was anxiety(r=0.343, p=0.000). The above findings indicate that the level of fatigue during the labor is higher than during pregnancy and postpartum. Woman having a job, delivering by vacuum was more fatigued. The level of fatigue according to a quality of sleep was significant difference. The poor quality of sleep, higher level of fatigue. And the more anxiety after delivery, the more fatigue. So, the variable nursing interventions for lessening the level of fatigue through appling the situation for rest, relaxation during the labor to reserve energy, and decreasing anxiety should be provided for mothers.

• Child Health Nursing Research
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• v.19 no.1
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• pp.1-11
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• 2013

Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.

• Korean Parent-Child Health Journal
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• v.2
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• pp.83-110
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• 1999

The purpose of this study was to identify the sleep/activity patterns of neonates and to provide a baseline data for the development effective mother-infant relationship. Subjects of this study were 36 newborns aged 1-21 days and stayed in Postpartum Care Center in Taejon during the period of October 28th, 1999 to February 10th, 2000. The data were collected using NCASA developed by Barnard et al. and were analyzed with SPSS 7.5 for window program. The results of this study were as follows: 1. An average day sleep of neonates was 8.0 hours, night sleep was 3.6 hours, and total sleep was 11.6 hours. A longest period of day sleep was 3.8 hours and a longest period of night sleep was 3.4 hours. The regularity of day sleep was 22.1%, night sleep was 23.3%, and total was 22.1%. 2. The frequency of daytime feeding was 6.9, nighttime fee ding was 3.4, resulting in total of 10.3. The regularity of feeding was 37.4%, and the frequency of night awakening was 2.4. 3. Associations among variables related to neonate's sleep/activity records were as follows : - The regularity of total sleep was positively correlated with the frequencies of day sleep(r=.57, P=.00), night sleep (r=.40, P=.01), and total sleep(r=.65, P=.00). - The frequency of total feeding was negatively correlated with the frequencies of day sleep(r=-.29, P=.04), night sleep(r=-.39, P=.02), and total sleep(r=-.42, P=.00), as well as longest day sleep(r=-.50, P=.00). - The regularity of feeding was negatively correlated with the frequency of night sleep(r=-.35, P=.02), longest period of day sleep(r=-.32, P=.04), and longest period of night sleep(r=-.30. P=.04), whereas positively correlated with frequencies of daytime feeding (r=.29, P=.02) and nighttime feeding (r=.32, P=.05). - The frequency of night awakening was negatively correlated with amount of night sleep(r=-.39, P=.02) and frequency of daytime feeding(r=-.42, P=.01) while positively correlated with frequencies of nighttime feeding(r=.68, P=.00) and total feeding(r=.50, P=.00). 4. Although there was no statistical significant difference between sleep pattern and infant's age, following tendency was noted: - As baby gets older, total amount of sleep and longest period of day sleep decreased while longest period of night sleep increased. - As baby gets older, the regularity of day sleep decreased while the regularity of night sleep and total sleep slightly increased. - The frequencies of daytime and total feedings increased while the frequency of nighttime feeding decreased. In conclusion, the author found that the neonates of this study showed less amount of sleep, more night awakening, and more night time feedings than NCAST sample. There was a certain sleep/activity pattern existed: If babies were fed more frequently, daytime or nighttime sleeping hours became shorter, and if babies had longer daytime sleep, frequent nighttime awakenings were noted. This pattern illustrated the significant influence of feeding and sleep periods on each other. Awakening in the night is natural and normal patterns in the newborn period. The result of this study will provide information to parents about what to expect their infants.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.855-861
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• 2007

Purpose : The most common causes of acute viral gastroenteritis in newborn period are rotavirus, astrovirus, norovirus and enteric adenovirus. This study was designed to investigate the clinical characteristics, clinical symptoms, isolation rate and distribution of these viruses in full-term neonates during neonatal period. We also studied the influence on the viral isolation rate by postnatal care place and feeding type. Methods : We evaluated 112 healthy full-term neonates who were admitted to Eulji hospital, presenting with symptoms of acute viral gastroenteritis from September 2004 to August 2005. Epidemiologic, clinical and laboratory data were reviewed. Enzyme-linked immunosorbent assay (ELISA) for rotavirus, astrovirus and norovirus and RT-PCR for enteric adenovirus were performed in study subjects.Results : The mean age at the admission was $11.4{\pm}5.4days$, mean weight loss was $5.9{\pm}5.1%$, mean hospitalization duration was $6.3{\pm}3.4days$. Moderate and severe weight loss were expressed in 51.7% and metabolic acidosis was in 13.4%. The percent of living in postnatal care facility (PCF) was 74.1 % and the percent of mixed feeding was 64.3%. Isolation rate of virus was 33%. The most prevalent virus was rotavirus (59.5%), followed by astrovirus (29.7%) and norovirus (10.8%). There was no differences in virus isolation rate by postnatal care place and by feeding type. The rotavirus was main virus in both home group and PCF group. But astrovirus was more detected in PCF and norovirus was more detected in home (P<0.05). According to monthly distribution of virus, acute viral gastroenteritis in newborn period was concentrated in September to December. Conclusion : The isolation rate of 4 type viruses was 33% and rotavirus was the leading cause of acute gastroenteritis during neonatal period. There was no differences in clinical characteristics on each viral groups.

• Neonatal Medicine
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• v.17 no.1
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• pp.13-20
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• 2010

Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.139-171
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• 2018

The 「Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes」(hereinafter referred to as 'the Act on Mediation of Medical Disputes') provides that the state should compensate the victims of medical accidents occurred irresistibly in childbirth despite that health and medical service personnel fulfilled their duty of care for their damage within the range of its budget(Article 46 of the Act on Mediation of Medical Disputes). Given that victims of medical accidents could expect demage recovery only through lawsuits thus far, this act can be said to be a groundbreaking act. However, However, as 30% of the costs for such medical accident compensation projects are borne by those who have records of childbirth among the founders of health and medical institutions (Article 21 of the Act on Mediation of Medical Disputes), there has been a question about whether doctors are held responsible despite that the accidents such as the deaths of mothers and newborn babies occurred irresistibly without doctors' fault. However, recently, the Constitutional Court ruled that 'the range of founders of health and medical institutions' and 'share ratios of finances for compensation' in Article 46 (3) of the Act on Mediation of Medical Disputes' related to the imposition of the share of costs are institutional (Constitutional Court ruling dated April 26, 2018, 2015Heonga13, hereinafter referred to as 'the ruling in the case'). Although the ruling in the case was made based on only the principle of statutory reservation and the principle of ban on comprehensive authorization, this paper added a practical judgment. This paper proved that the share of costs in this case has the nature of burden charges in pursuit of study and does not infringe on the property rights of the founders of health medical institutions even in light of the principle of proportionality because there is a legitimate reason for imposing the burden charge. The imposition of the share of costs in the system for compensation for medical accidents occurred irresistibly is against the principle of liability with fault in part. However, the medical accident compensation projects are rational a national policy for the victims of medical accidents and the medical world clearly gains some benefits from the effect to terminate medical disputes. The expansion of finances for compensation through the payments of the share of costs will reduce the suffering and misunderstanding of victims of medical accidents occurred in the process of childbirth and will be very helpful to the construction of stable treatment environments of medical workers by quickly establishing the medical accident compensation projects as such.

• Journal of Nutrition and Health
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• v.34 no.1
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• pp.14-22
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• 2001

In this study, we examined the effects of dietary fatty acids and vitamin E supplementation on antioxidant systems in the rat brain regions. The Sprague Dawley rats were fed the experimental diets 3-4 wks prior to the conception. Experimental diet consisted of 10% fat(wt/wt) which were safflower oil(SO, poor in $\omega$3 fatty acids), mixed oil(MO, P/M/S ratio=1.03:1.45:1,$\omega$6/$\omega$3 ratio=6.3) and mixed oil supplemented with vitamin E(ME:MO+500mg vitamin E/kg diet). At 3 and 9 weeks of age of the newborn rats, frontal cortex(FC), corpus striatum(CS), hippocampus(H) cerebellum(CB) were dissected out from the whole brain. Activities of glutathione peroxidase(GSH-P(sub)x, superoxide dismutase(SOD) concentrations of malondialdehyde(MDA) were mesaured. Dietary fatty acids were not effective in antioxidative system for rat brain. However, when vitamin E was supplemented to the diet(ME), the activities of GSH-P(suh)x tended to increase in comparison to MO group. Therefore, the activites of GSH-P(suh)x of FC and H at the age of 3 weeks showed significant differences(p<0.05). The activities of Total-SOD tended to decrease in ME group compared to MO group. There were significant differences(p<0.05) in FC and CS at the age of 3 weeks. The activities of Mn-SOD tended to increase and Cu, Zn-SOD tended to decrease when vitamin E was supplemented. The activity levels of antioxidative enzymes at the age of 3 weeks and 9 weeks were similar. This suggested that the activity level of antioxidative enzymes reached to the adult level at the age of 3 weeks which is the end point of lactation period. The concentrations of MDA were not altered by experimental diets. When the activities of antioxidant enzymes were compared, the activities of antioxidant enzymes were the lowest in H and FC. In conclusion, the antioxidative system were not altered by dietary fatty acid at the age of 3 weeks and 9 weeks, but the supplementation of vitamin E altered the antioxidative systems. Therefore, these findings should be considered comprehensively in scope of the balance of various antioxidative systems and their interactions(Korean J Nutrition 34(1):14-22, 2001)

• Journal of Nutrition and Health
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• v.30 no.3
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• pp.336-348
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• 1997

The objectives of this study were to examine the growth pattern of infants by anthropometric measurement according to the 5 feeding practices of infants with the subject of two hundred healthy newborn babies from their birth till sixty month of age at intervals of two months. Breast group(BF, n=38), formula group(FF, n=102) and mixed group(ME, n=14) were fed breast milk, formula milk, breast and formula milk, from birth till 6 mo. of age, respectively. Convert 1 group (C1F, n=14) and covert 2 group(CF, n=32) were fed breast milk and mixed milk at 2 mo. of age afterthat switched to formula milk, respectively. From these, the following results were made. All the infants of this study showed superiority to Korean standard growth rate in regards to each growth item for each month age. In the case of males, at their birth, the subscapular skinfold thickness and the total skin fold thickness in the BF group was significantly larger than in MF group and FF group(p<0.05). At 6th month age, the chese circumference of MF group was 45.9cm, and significantly larger than those of BF, FF and C2F groups(p<0.05). In the case of females, at theri birth and 2nd month age, there was no difference among all the feeding groups in regards to each growth rate. At 4th month age, the Kauf index of C1F group was 16.21 and significantly lower than those of four groups(p<0.05). And total skinfold thickness in BF group was larger than in C1F group. The increase rate per month age of all growth items were larger at 2nd month age than at the later months both in males and in females. And until 2nd month age males showed more increase than females in regards to each growth item but after 2nd month age, this sapect did not show up. Multiple linear regression was used to determine predictive factors for infant growth. It was expected that at 6th month age, in the measurement of head circumference and chest circumference and cross-sectional fat area, BF-males were bigger by 22-39% of the explanation index than the infants of other groups. As a result, in spite of the significant lower intakes of energy and nutrients in breast-fed infants than in formula-fed infants, breast-fed infants showed more growth than the average of Korean infant standard growth rate at every month age, and showed no significant growth difference among feeding groups.