Along with the low birth rate in Korea, the aging of mothers is progressing very rapidly. Recent studies have reported that the obstetric infrastructure is crumbling due to the accelerating closures of obstetric medical institutions resulting from the low birth rate and low reimbursement rates for obstetric procedures. The number of birth centers has also decreased, but women's interest in natural birth has actually increased, such that deliveries at birth centers now account for 11.8% of deliveries in obstetric clinics. In the Netherlands, Japan, and the United Kingdom, initiatives to promote natural birth through care provided by midwives increased the rate of natural births, decreased the number of cesarean sections, and lowered the rate of postpartum complications. In light of these examples, South Korea should also encourage natural delivery by midwives. A national support system for midwife applicants is necessary, and the requirements for institutions that train midwives should be revised. Independent birth centers should have emergency prescription privileges, and women should be given the choice to have a natural delivery by creating birth centers within hospitals.
본 연구는 산후조리원 내 신생아를 위한 원격 관리 시스템을 제안한다. 기존 시스템들은 공기질 문제만을 해결하거나, 모니터링 문제만을 해결하는 등 단순한 동작과 감시에 초점이 맞추어졌으나, 제안하는 시스템은 실내와 신생아 주변에 설치된 각각의 센서를 통하여 공기질을 포함한 실내 환경과 신생아를 모니터링하여 간호사와 산모가 쉽게 신생아의 건강을 웹과 엡으로 모니터링하고 원격으로 관리한다. 또한, OpenCV 라이브러리를 이용하여 신생아의 얼굴을 인식하고 표정별 이미지를 저장할 수 있도록 설계 및 구현하고 있다.
This study sought to figure out women's functional status after childbirth under the Sanhujori. Functioal status was defined as the women's readiness to assume infant care responsibilities and resume her usual activities including household, social and community, self-care and occupational activity. A convenience sample of 211 women who are in the postpartal period of the range from 1 week to 3 months above and residing in Seoul. Korea was studied from January, 1997 to December, 1998 for two years. Mean age of respondents was 29.9 years and mean of the present postpartal period was 7.5 weeks. The present postpartal period was of 5-8 weeks 26.5%, 3-4weeks 26.1%, 9-12 week 23.7% and below 2 weeks 7.1%, 32.7% of women had a job and the mean period of return to job was 2.76 weeks. During Sanhujori the non professional care giver was family members from women's maiden home 73.5% and only 2% of husband. The period women needed for the recovery from now was 5.39 weeks and it means that women need 12.9weeks for recovery after childbirth. For the present subjective health status after childbirth, bad was 20.2%, good 18.3 and average 61.5% and for the recovery status, completely recovered 29.5%, slightly 61.8% and rarely 8.7%. The mean of functional status at the 7.5weeks was baby care activity 3.65, household 2.57, self-care 2.46, occupational 2.44 and social 1.53 in rank. Except baby care the functional status was generally low or very low. The related factors to the functional status were the period and subjective evaluation of Sanhujori women experienced, the present period of postpartum, and subjective feeling of recovery. This result strongly reflects the effects of Sanhujori culture and Sanhujori per se on women's postpartal life including functional status and reconfirmed the relationship between health status and the experience of Sanhujori after delivery as the previous findings from various study showed. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the cross-sectional and longitudinal research for the refinement of the reality of Sanhujori not only as cultural phenomenon but as an inseparable factor influencing in women's postpartal healthy adaptation and for the appropriateness of intervention and quality of care for desirable health outcome.
Breastfeeding is an excellent way of feeding infants and continues to be an important source of nutrition and antibodies for infants. Although breast-feeding is believed to be important, the rate of breastfeeding among Korean women is very low. One reason for the low breastfeeding rate is that the health professionals in the past have given little practical help couples to overcome difficulties encountered during breastfeeding. The promotion of breastfeeding has recently become a high priority among health professionals because of the undisputed physiological, psychological, social, economic, and nutritional benefits. Fathers have been found to influence the course of breastfeeding, but no one has conducted a systematic investigation into in and included fathers perspectives of breastfeeding in Korea. It is important to find strategies to solve the problems by assessing the knowledge, attitude and practice of breastfeeding with fathers as well as mothers. The purpose of this research is to find ways to promote primiparous(first child) couples's breastfeeding by assessing their general knowledge, attitude and practice of it. More specifically its purposes is to identify the relationship between knowledge, attitude, practice and the background factors of breastfeeding of primiparous couples in order to promote and support breastfeeding. The data will help health professionals to guide first-pregnancy couples to prepare and overcome any difficulties encountered during breastfeeding. Data were collected through a questionnaire which included both structured and open-ended questions. The questionnaire was composed referencing earlier literature, studies and surveys. This survey was made postpartum 2-3days after childbirth on 96 couples. The numbers of subjects for data analysis were selected 51 couples through pilot screening test. Data were coded and analyzed using the Statistical Package for Social Sciences : Cronbach's alpha coefficient, T-test, ANOVA, Stepwise pearson's correlation coefficient. The relations between the variables of breastfeeding were examined using a Pearson's correlation coefficient. This study showed that, the internal validity of the instrument was tested by Cronbach's alpha. The result was : mother knowledge 0.72, mother attitude 0.88, and father knowledge 0.70, father attitude 0.92, practice 0.76 and planning of breast feeding 0.95. The average age of mothers in the sample was 28.9 years old, and the average age of fathers in the sample was 31.3 years old. The other descriptive informations available included. the study also found that fathers were more important than doctors or nurses. However results of the study indicate that there were no differences between father and mother knowledge of breastfeeding(t=-0.39, p=0.698), and father attitude was statistically significant higher than mother attitude of breastfeeding (t=2.24, p=0.030). In analysis, the variable 'practice' with breastfeeding was the relationship with mother knowledge (p=0.031) and mother attitude(p=0.015). In this study, the correlation between one couple' knowledge and attitude was not significant. Primiparous couples surveyed in the postpartum period regarding knowledge, attitude and practice about breastfeeding might be affected by recall bias, the effects of the euphoria of the first 24-48 hours postpartum, but these variables were not examined. This study results add to the body of knowledge about nursing care for breastfeeding mothers and fathers. This indicates that a need for education about breastfeeding and, that fathers be included in it as well as mothers.
The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach $\alpha$ .8176), 8 items of need of education(Chronbach $\alpha$ .8836), 3 items of pain (Chronbach $\alpha$ .9252), and 3 items of discomfort (Chronbach $\alpha$ .8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was $4.25{\sim}4.64$. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain ($r=.752^{**}$) and weak positive correlation between discomforts and the level of educational need($r=.308^*$). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.
Objectives: The aim of this study was to observe the changes of women's postpartum symptoms, the quality of life and depression scale over the first six weeks after childbirth. Methods: Twenty seven mothers who received Korean medical treatment in the outpatient department treatment (from September 27th, 2017 to January 5th, 2018) were evaluated for Verbal numerical rating scale (VNRS), edema index, EuroQol Visual Analogue Scale (EQ-VAS), and Edinburgh Postnatal Depression Scale (EPDS). Results: There were 17 high risk participants (63.0%) and 10 normal participants (37.0%). The VNRS of edema is the highest in the first week, and the VNRS of joint pain is the highest from the second week to the sixth week in all patients. The Extra Cellular Water/Total Body Water (ECW/TBW) of high risk group significantly decreased from $0.403{\pm}0.011$ to $0.387{\pm}0.006$(p<0.05) in the first 2 weeks. The ECW/TBW of normal group significantly decreased from $0.393{\pm}0.070$ to $0.383{\pm}0.011$ (p<0.05) in the first 2 weeks. The EQ-VAS of high risk group increased from $64.12{\pm}13.941$ to $69.35{\pm}18.155$ (p<0.05) in the first 2 weeks. But this difference was not significant statistically (p=0.234). The EQ-VAS of normal group significantly increased from $62.50{\pm}21.763$ to $74.00{\pm}9.661$ (p<0.05) in the first 2 weeks. The difference of EPDS was not statistically significant between the first week and the sixth week in every participants. Conclusions: VNRS was the highest in edema in the first week, joint pain was the highest from the second week to six week. The edema index of high risk groups was higher than that of the normal group in the first week (p<0.05). The EQ-VAS of normal group significantly increased (p<0.05) in the first 2 weeks but high risk group didn't. In the EPDS, the ratio of nine or more points of high risk group was more than twice than normal group in the first 2 weeks.
This study was conducted to identify the educational need of pregnant women, and to evaluate the effect of the 2-hour childbirth class provided by researchers. The subjects were composed of 183 pregnant women who participated voluntarily in the 2-hour childbirth class, and the data were collected by self reporting structured questionnaire designed by researchers. The data were analyzed with descriptive statistics, paired t test, and McNemar test by SPSS pc program. The results were as follows ; 1. Mean age of th subjects was 27 and most subjects graduated from the high school and the college. 80.3% of the subjects had nuclear family. 82.5% of the subjects were full time housewives. 2. 85.8% of the subjects were ipara. Though 71.6% of the subjects might have antepartal care in the clinic, 67.2% of the subjects had no chance to participate in the childbirth class before this study. 3. Subject's health and lifestyle, especially related to eating habits, were changed in the antepartum period. We found that the pregnancy affected positively on health and lifestyle of the women. Over 75% of the subjects became to understand the progress of labor, breath methods during the labor, and perineal exercise. Most subjects changed to think that they could control their body more actively and positively during the labor after participating in the childbirth class. 93.4% answered that 'childbirth class was necessary and important'. Most subjects wanted to be taught the contents, such as postpartum care, breast feeding, and infant care in the childbirth class. In conclusion, pregnant women to attend the childbirth educational program with their husband, and the 2-hour childbirth class provided by the researchers very effective in many aspects. Therefore we anticipated that the childbirth class on basis of pregnant women's needs will contribute to improvement of pregnant women's health and well-being during the labor.
Background: This study aimed to identify factors associated with women's decisions to attend cervical cancer screening and to explore those linked with intention to attend in the coming year and to continue regular screening. Materials and Methods: A community based case-control study was conducted among woman 30-60 years of age in catchment area of Chatapadung Contracting Medical Unit (CCMU), networking of Khon Kaen Center Hospital, Thailand. Self-administered questionnaires were used to collect data, and in-depth interviews were then performed to explore in greater detail. Results: There were 195 participants. Only one third (32.3 %) had been screened for cervical cancer within the past 5 years. Some 67.7% reported that they had not been screened because they had no abnormal symptoms, single marital status, and no children. Only 10.6% of those never had screening intent to be screened within the next 12 months. High family income (adjusted OR=2.16, 95%CI=1.13-4.14), good attitude towards a Pap test (OR=1.87, 95%CI=1.09-4.23), and having received a recommendation from health care providers were important factors associated with decisions to attend cervical cancer screening (OR=1.73, 95%CI=1.01-4.63). From in-depth interviews, there were five reasons of their decisions to attend cervical cancer screening including yearly check-up, postpartum check-up, having abnormal symptom, encouragement by health care providers, and request from workplace. Conclusions: High family income, good attitude towards a Pap test, and receiving proper recommendation by health care providers, were important factors associated with decision to have cervical cancer screening among women 30-60 years old. Trying to enhance these factors and reduce barriers regarding screening, may increase the coverage rate for cervical cancer screening in Thailand.
Purpose: To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. Materials and Methods: This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certified cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Results: Mean age of participants was $28.9{\pm}6.2$ years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Conclusions: Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.
Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.
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