• Title/Summary/Keyword: Postpartum Care

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A Case-Control Study on the Predictors of Neonatal Near-Miss: Implications for Public Health Policy and Practice

  • Johnson, Avita Rose;Sunny, Sobin;Nikitha, Ramola;Thimmaiah, Sulekha;Rao, Suman P.N.
    • Neonatal Medicine
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    • v.28 no.3
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    • pp.124-132
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    • 2021
  • 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.

A Survey on the Educational Needs and Competence of Nurses in Maternal Fetal Intensive Care Unit (고위험 산모 신생아 통합치료센터(MFICU) 간호사의 교육 요구와 직무역량 인식조사)

  • Kim, Yunmi;Kim, Jeung-Im;Jeong, Geum Hee;Kang, Hee Sun;Kim, Mijong;Moon, So-Hyun;Kim, Miok
    • Women's Health Nursing
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    • v.25 no.2
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    • pp.194-206
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    • 2019
  • Purpose: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. Methods: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. Results: The education needs of nurses in MFICU had an average of 4.21 points (${\pm}0.50$) and their nursing competence was average 3.38 points (${\pm}0.60$). The items reported as high education needs but low competency by nurses in MFICU were as following: 'postpartum hemorrhage and shock,' 'cardiopulmonary resuscitation (CPR) for neonate,' 'CPR during pregnancy,' 'disseminated intravascular coagulation,' 'sepsis,' and 'mechanical ventilation during pregnancy.' Conclusion: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review

  • Jung, Seulgi;Kim, Yoojin;Park, Jeongok;Choi, Miyoung;Kim, Sue
    • Women's Health Nursing
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    • v.27 no.2
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    • pp.75-92
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    • 2021
  • Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

Effects of Traditional Recipes and Saenghwatang on Postpartume Care (전통 산후 회복식과 한방 생화탕이 산모의 회복 정도에 미치는 효과)

  • Park, Sung-Hye
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.5
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    • pp.652-658
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    • 2005
  • This experimental was carried out to evaluate the clinical effects of Ophicephalus argus and Crubita moschate which have been traditionally applied to postpartum care in Korea, and compare them with the effect of Saenghwtang. Fifty Sprague-Dawley female rats weighing $250\~280$ g were divided into five groups: a normal saline-treated group (NSG), a Saenghuatang-treated group (STG), an Ophicephlus argus-treated group (OTG), and a Crubita moschate-treated group (CTG), also non-pregnant group (NPG). Except for the NPG, each extract was administered for one week to each group after delivery. We measured the WBC, RBC, serum levels of hemoglobin and hematocrit, the platelet count, serum levels of fibrinogen, albumin, thyroxine and urine levels of sodium and potassium. STG showed a significant (p<0.05) decrease of WBC count, fibrinogen content and urine levels of sodium and potassium and a significant (p<0.05) increase of RBC, hemoglobin, albumin and thyroxine in comparison with those of the NSG. OTG showed a significant (p<0.05) decrease of WBC count, fibrinogen and the significant (p<0.05) increase of albumin and thyroxine in comparison with those of the NSG. CTG showed a significant (p<0.05) increase of albumin and thyroxine in comparison with that of NSG. These results suggest that Saenghwatang is more effective than Ophicephalus argus and Crubita moschate for postpartum recuperation although they also have some effects on recuperation of deteriorative blood components after delivery. Therefore, these findings indicate that futher investigation for the other effects of Ophicephalus argus and Crubita moschate is necessary.

The Effects of Phone Counseling on Maternal Role in Primiperous Mothers (전화 상담이 초산모의 모성 역할에 미치는 영향)

  • Kang So-Jeong
    • Child Health Nursing Research
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    • v.7 no.4
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    • pp.405-420
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    • 2001
  • The main purpose of this study was to identify the effect of phone counseling carried out to promote the role of the primiperous mothers. The data were collected from march 20 to may 30, 1998. The subjects for the study were the mothers of 60 first bon neonates admitted to and discharged from Sam-sung Medical Center's neonatal ward. Thirty subjects were assigned to the experimental group and thirty to the control group. A measure of maternal identity as well as level of self confidence in taking care of an infant after giving birth was taken. Informational supportive nursing was then provided to the mothers through phone counseling for a total of four times at 2~3 days, 7~8days, 12∼13days and 18∼1days after discharged. The level of self confidence in taking care of an infant was then remeasured. The control group was not provided with supportive nursing through phone counseling instead the level of confidence in taking care of an infant was measured at 3 weeks. Taking previous study documentary evidence into consideration the researcher developed a supportive nursing telephone counseling program that provided both informational and emotional support suitable to primiperous mothers. A semantic differential scale developed according to Osgood and translated and adapted by Koh Hyo-Jung was used as the maternal self identity measurement tool. The tool used to measure self confidence in taking care of infant was the developed by Bak Mi Suk which includes 13 items from Pharis's self confidence scale The data were analyzed using χ²-test, t-test and paired t-test. The result of the study are as follows 1. First hypothesis The level of self confidence in taking care of an infant for the group of primiparas who received phone counseling in the postpartum period would be higher than that of the primiparas who did not receive phone counselling : As the experimental group's level of self confidence in taking care infants was significantly higher than that of the control group this hypothesis is accepted 2. Second hypothesis The level of maternal identity will be higher for the group of primiparas who received phone counseling than that of primiparas who did not received phone counseling As the experimental group's level of maternal identity was significantly higher than that of the control group this hypothesis is accepted In looking at the results of the study as a whole, it can be concluded that emotional and informational nursing support provided through phone counselling is an effective strategy in promoting the role of new mothers.

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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 the Evaluation of Maternal Child Health Services in Public Health Centers (일개 시 보건소의 모자보건 선도보건사업 평가에 대한 연구)

  • Kim, Yong-Soon;Park, Jee-Won;Bang, Kyung-Sook;Jung, Soon-Re;Woo, Hea-Suk;Lee, Hea-Jung;Jang, Hyeon-Soon
    • Research in Community and Public Health Nursing
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    • v.13 no.2
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    • pp.280-291
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    • 2002
  • Objectives: This study was conducted to evaluate the maternal child health services provided by public health centers in Pyungtaek city. Methods: Data were collected based on multiple sources of official records. A questionnaire survey was obtained from 50 mothers with premature babies, and 89 mothers with full- term babies, in order to compare their demographic factors, and physical, obstetrical, and emotional status. In addition, the investigators collected data on pre and post follow-up care for the remature group to evaluate the effects of home visiting services on them. Moreover, additional data were collected from 135 pregnant women and 315 mothers with infants, to assess their degree of satisfaction for prenatal education course and breast feeding practices. Results: 1) The pregnant women's satisfaction for the prenatal education course, knowledge, and practices on self care were considered to be high. 2) Of the mothers with infants, 62.9% experienced breast feeding, but only 35.9% of them did it for six months. 3) Premature birth rate in the region was 5.6%, and 75.6% of all premature babies received follow-up care. 4) The mothers with premature babies experienced premature rupture of membrane. placenta previa, preeclampsia, and cesarean section more frequently than the mothers with full-term babies. 5) At the pre-intervention data collection point. mothers with premature babies experienced significantly less social support than mothers with full-term babies. In addition, mothers with premature babies reported higher levels of stress and care-giving burdens, and lower level of self esteem, than mothers with full-term babies, although the differences were not statistically significant. 6) In the premature group, stress, care giving burdens, and postpartum depression decreased after the intervention, whereas maternal self esteem, and the husband's support were increased after the intervention. Social support from significant others were somewhat decreased. 7) Satisfaction for the home visiting service in the mothers with premature babies was very high. Conclusion: These results showed a possibility that the recently started maternal child health services provided by the public health centers may be efficient. Although statistically significant differences were not found, the investigators found a potential for changes in a positive direction. Long-term effects of the health services on maternal child health needs should be addressed in future studies.

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A Study on the Sleep pattern of normal neonates in Seoul and Kyungki area (서울.경기지역 신샌아의 수면/활동 양상에 관한 연구)

  • Kim, Il-Ok;Yang, Eun-Young;Lee, Ja-Hyung
    • Korean Parent-Child Health Journal
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    • v.3 no.2
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    • pp.41-48
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    • 2000
  • The sleep is the most important problem for new parents. However, there were very rare the study about sleep of normal neonates and early infants in Korea. So we attempted pilot survey study of neonates' sleep pattern. The purpose of this study was to investigate the sleep pattern of normal neonates in Seoul and Kyungki area and to provide for basis for nursing intervention for parents of them. The subjects of this study were 37 normal full-term neonates of 2~3weeks of age who were visited by researcher or assistant at postpartum care unit, health care clinic, outpatient clinic located in Seoul and Kyungki area from April 20, 1999 to March 15, 2000. This study was descriptive survey study under the convenient sampling method. The instrument of this study was the NCASA translated by Korean Parent Child Health Academic Association. The collected data were coded as 1/4hour unit, and analyzed by MS Office Excel program. The result of this study were as followed: 1. The mean amount of total sleep was 15.1hours. The mean amount of daytime sleep was 9.5hours. The mean amount of nighttime sleep was 5.7 hours. The mean amount of longest sleep was 2.9hours. The mean amount of shortest sleep was 0.6hour. 2. The mean amount of total activity was 8.9hours. The mean amount of daytime activity was 6.5 hours. The mean amount of nighttime activity was 2.3hours. The frequency of feeding was 10.4 times a day. The frequency of daytime feeding was 7.3 times. The frequency of nighttime feeding was 3.1 times. It is suggested that various subjects and more data according to age, and comparative study among different cultures are needed for further study in the future.

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The study of recognition on cold and heat application of the adult (일반인의 냉온요법에 대한 인식 조사)

  • Kim Min-Jeong
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.452-463
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    • 1999
  • This study was performed to inquire into recognition of cold and heat application. The subjects in the study were 429 adults who were collected by disproportional quota sampling according to age, sex. The instrument was 36 questions that constitured closed questions and semiopened questions that encluded general characteristics, recognition of cold and heat applications. and what will you do when requested cold and heat applications on abdomial and perineal areas. Data were collected from september 25 to October 25, 1998. Data was analysed by SPSS/win, into frequency, Pearson correlation, t-test, ANOVA. The results were following. 1) The subjects consisted of male and female who was from teenage to fifty year old above. According to general characteristics, who endureed moderate cold-heat application, had constitutional fever, good sweat, and taked a cold bath accationally. And the woman think that their body were more cold than man. and the number of cold bath was less than man. Woman felt more harder than man that endured exposing cold. According to the recognitions of cold-heat applications, the 61.9% of the subjects think that cold application is more positive, and the 61.7% of the subjects think that heat application is more positive. 2) The subjects think that oral cavity, abdomen, back, extremes must be warm. 3) The percents of cold or heat application at abdomen were 77.4%, 86.5% respectely and the percents of cold or heat application at perineum were 56.9%. 93.6% respectely. With the above results. we know that the subjects have the fixed perceptions that each body part has to maintain its temperature. especially, they think that postpartum care is correlated with cold-heat application. So when we intervent nursing care, we also must regard their recognitions of cold and heat applications. and we need to educate and explain correctly about cold-heat application.

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The study on related factors of feeding type and comparison of development between breast-fed and formula-fed infants (수유방법별 관련요인 및 영아의 성장비교)

  • Hyun, Hye-Jin;Kwon, Mi-Kyung;Han, Kyung-Ja;Yeoun, Soon-Nyung
    • Journal of Home Health Care Nursing
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    • v.5
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    • pp.5-19
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    • 1998
  • This study presents results of surveys conducted Seoul and Kangreung public health center using structured questionnaire developed by researchers to identify factors that were relevant to the method of feeding. To compare the infant's development between the breast-fed infants and formula-fed infants, infant's height, weight, triceps skinfold during 1month and 4months were cheked. The results were as follows : 1. At postpartum, 59.1% infants had formula feeding, while 22.6% had breast feeding. At 1 month old, 49.6% infants had formula feeding, 27.8% had breast feeding. At 4 months old, 60.9% infants had formula feeding, while 26.1% had breast feeding. 2. 'Lack of breast milk' was the predominant reason for formula feeding. 3. The sujects didn't enough eat not only rice and seaweed soup but also any other specific foods during breast feeding period. 4. Factors that affected the method of feeding were the patterns of delivery, mother's height & weight, first baby feeding type(at post partum), infant sex, mother's age, preparation of breast feeding, first baby feeding type, regular clinic visit (at 4months old). 5. The birth weight and height were correlated with mother's weight and height. 6. There were no significant different on infant's weight, height, triceps skinfold between breast-fed infants and formula-fed infants.

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