• 대한간호학회지
• /
• 제20권2호
• /
• pp.153-173
• /
• 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.

• Advances in pediatric surgery
• /
• 제12권2호
• /
• pp.137-146
• /
• 2006

Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods: from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7:1 to 2.1:1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.

• Asian-Australasian Journal of Animal Sciences
• /
• 제33권11호
• /
• pp.1848-1857
• /
• 2020

Objective: An experiment was designed to determine if behaviour traits expressed by twin- and triplet-bearing lambs and their dams at 3 to 18 hours of age (after the immediate ewe-lamb bonding had occurred) were associated with lamb survival to weaning. Methods: The behaviour of twin and triplet lambs and their dams was assessed in the paddock at 3 to 18 hours after birth. Observations were made of the number of high- and low-pitched bleats, time to stand, make contact with dam, suck from dam and follow dam were recorded for each lamb. The maternal behaviour score of each dam was assessed. A random sub-sample of lambs were assessed during a maternal-recognition test at 12 or 24 hours of age. Traits included time spent standing, sitting, walking, time taken to reach the ewes and time spent with the ewes as well as the number of high- and low-pitched bleats emitted by the lamb. Results: In the paddock, for each additional second required for twin-born lambs to follow their dam, lambs were 1.004 (95% confidence interval [CI] 1.000 to 1.008) times more likely to survive to weaning (p<0.05). The opposite relationship, however, was seen in triplet lambs. For each additional second required for triplet-born lambs to follow their dam, lambs were 0.996 (95% CI 0.993 to 0.999) times as likely to survive to weaning (p<0.05). During the maternal recognition test, twin-born lambs were 0.989 (95% CI 0.979 to 1.000) times as likely to survive to weaning for every additional second they took to reach the contact zone (p<0.05). Similarly, triplet-born lambs were 0.994 (95% CI 0.989 to 0.999) as likely to survive for every additional second they took to reach their dam (p<0.05). Conclusion: All ewe behaviours and the majority of lamb paddock and test behaviours were not associated with the survival of twin- or triplet-born lambs and, therefore, are of little use as indicators of lamb survival to weaning.

• Child Health Nursing Research
• /
• 제25권4호
• /
• pp.468-476
• /
• 2019

Purpose: This study was conducted to evaluate cognitive ability in preschoolers born prematurely and to investigate related factors. Methods: A prospective, longitudinal study was conducted with 64 children at 5-6 years of corrected age (CA) (second follow-up) among 76 children who had been assessed at 2.0~3.5 years of CA (first follow-up) from a sample of 343 preterm infants born from 2008 to 2010. To evaluate each child's cognitive ability, during a home visit, we used the Kaufman Assessment Battery for Children-II (KABC-II) at the second follow-up. To explore factors related to cognitive ability, we measured children's hemoglobin level at the second follow-up and used the data collected in our previous study, including the Bayley Scale of Infant Development-II (BSID-II) at the first follow-up. Results: The mean total KABC-II quotient was $117.0{\pm}14.4$. The 5-minute Apgar score (${\beta}=.29$, p=.006), hemoglobin level (${\beta}=.22$, p=.032), and the mental development index quotient of the BSID-II (${\beta}=.51$, p<.001) were statistically significant predictors of the KABC-II quotient in multiple linear regression analysis. Conclusion: The cognitive function of young children born prematurely was influenced by early neurodevelopment and factors reflecting their health status, such as anemia and a low 5-minute Apgar score.

• Human Ecology Research
• /
• 제60권1호
• /
• pp.147-162
• /
• 2022

Although the globally known one-child policy in China was abolished in 2016, the overall fertility rate in the country declined to 1.3 in 2020. In this study, we examined whether the achievement of major developmental tasks during the childrearing stage was associated with intentions to have a second child among Chinese married women. Based on family development theory, we included parenting adaptation, division of childcare responsibilities with the partner, and marital adjustment as key developmental tasks during the childrearing stage. The participants of this study were 315 married Chinese women who lived with a spouse and a child who had not yet entered elementary school. Data were collected through an online survey in February and March 2021. A multiple regression analysis of the data revealed that a lower level of economic parenting stress, a higher level of fairness in dividing childcare responsibilities with the partner, and a more positive change in their marital relationship after having the first child were associated with greater intentions to have a second child.

• Asian-Australasian Journal of Animal Sciences
• /
• 제17권8호
• /
• pp.1158-1161
• /
• 2004

This study chiefly aims to ascertain the effect of birth weight and litter size on productive performance in rabbits. After delivery kits were removed from their mothers for individual weighing and randomly assigned to one of the following three experimental treatments: Group (KT 6) with six tiny kits (about 45 g) per litter (21 litters); Group (KT 8) with eight tiny kits (about 45 g) per litter (17 litters); Group (KN8) with eight normal kits (about 70 g) per litter (20 litters). The litters, separated from their mothers by putting them in a closed cage, suckled one time a day for 15 minutes. Daily milk production was measured by weighing the does immediately before and after suckling; body weight of kits was measured on a weekly basis. At weaning 60 rabbits per group were raised for six weeks to ascertain post-weaning performance and health. Compared with the two other groups, the kits of group KT8 ingested smaller quantities of milk both during the first 3 weeks (497.7 vs. 520.0 vs. 544.3 g, respectively for groups KT8, KN8, KT6) and the following period (261.3 vs. 285.0 vs. 302.7 g, respectively for KT8, KN8, KT6). The differences between groups KT8 and KT6 were statistically significant (p<0.01) in the first period while in the second period also KN8 group showed milk intake different in respect of KT8 (p<0.01) and KT6 (p<0.05) groups. Solid feed intake was significantly (p<0.05) lower in group KT6 (23.1 vs. 26.2 vs. 26.8 g/d, respectively for groups KT6, KN8, KT8). At weaning the kits of group KN8 always weighed more (966 vs. 894 vs. 888 g; p<0.01, respectively for groups KN8, KT6, KT8). After weaning, no parameter considered (daily weight gain, feed intake, feed conversion ratio, mortality and risk sanitary index) was affected by birth weight and litter size.

• Asian-Australasian Journal of Animal Sciences
• /
• 제15권10호
• /
• pp.1469-1474
• /
• 2002

This study was designed to evaluate the influence of a single or double dose of Fe dextran with organic trace mineral supplementation on the performance of piglets from dams fed diets with either inorganic (ITM) or organic trace minerals (OTM). It also determined the effect of the source of the trace minerals on the reproductive performance of sows. The trace mineral premixes were prepared using metal proteinates and the corresponding inorganic salts for the OTM and the ITM, respectively. Each mineral premix provided 100 ppm Fe/175 ppm Fe, 35 ppm Cu/170 ppm Cu, 90 ppm Zn/120 ppm Zn, and 40 ppm Mn/35 ppm Mn when added at 0.20% in sows /weaned pigs' diets, respectively. The first dose of Fe dextran was administered to piglets at 3 d and the second dose at 10 d after birth. One dose of Fe dextran supplied 100 mg of Fe. A total of 16 gestating sows (Landrace${\times}$Yorkshire) in parities 2 to 4 were randomly allocated to four treatments: 1) diet with ITM/one dose of Fe dextran to piglets, 2) diet with ITM/two doses of Fe dextran to piglets, 3) diet with OTM/one dose of Fe dextran to piglets, and 4) diet with OTM/two doses of Fe dextran to piglets. The total born alive, weaned, body weight at birth and at weaning were not affected by the sow's dietary treatment. Although organic trace mineral supplementation tended to increase the milk Fe content (p<0.10) at 7 d postpartum, piglets in all treatments performed equally from birth to weaning. The double doses of Fe dextran neither improved the average daily gain (ADG) nor influenced the survival of piglets from birth to weaning (21 d). Results suggest that a single dose of Fe dextran given to suckling pigs is adequate to sustain their needs for growth throughout the lactation period (21 d). Furthermore, there was a 21% improvement in both the ADG and the average daily feed intake (ADFI) (p<0.05) in weaned pigs fed diets with OTM. Cu and Fe in the liver (p<0.01), and Zn in both the bone (p<0.01) and the serum (p<0.01) were higher in piglets fed OTM than in those fed ITM. It would be concluded that single dose of Fe dextran administration with organic trace mineral supplementation show similar growth performance compared to 2 dose Fe dextran administration with inorganic mineral supplementation in young pigs.

• 한국보육지원학회지
• /
• 제8권1호
• /
• pp.125-143
• /
• 2012

본 연구는 저출산 원인을 파악하기 위해 기혼남성의 인구통계학적 변수, 양육 부담감, 역할 만족도, 출산장려정책 인지도가 어떠한지 살펴보았고, 추가 출산계획에 영향을 미치는 요인들을 알아보았다. 본 연구의 목적을 수행하기 위한 연구방법은 서울 경기 인천지역에 거주하는 만 5세 이하의 자녀를 둔 기혼남성들을 대상으로 설문지를 실시하여, 최종 188부를 분석자료로 사용하였다. 수집된 자료는 SPSS 12.0 프로그램을 사용하여 기술통계, 로지스틱 회귀분석 등을 실시하였다. 연구결과, 첫째, 현재자녀수가 적을수록, 배우자의 연령이 낮을수록, 역할만족도가 높을수록, 출산장려정책인지도가 높을수록, 배우자가 취업하지 않았을때 "남편과 아내 모두 자녀출산을 원함"범주에 드는 경향이 높은 것으로 나타났다. 둘째, "아내만 원함"의 경우는 현재자녀수가 적을수록, 기혼남성의 역할만족도가 낮을수록, 배우자가 취업하지 않았을때 높은 것으로 나타났다. 셋째, "남편만 원함"의 경우는 현재자녀수가 적을수록, 배우자가 취업 하였을때 높은 것으로 나타났다. 마지막으로 "남편과 아내 모두 자녀출산을 원치 않음"의 경우는 현재자녀수가 많을수록 높은 것으로 나타났다.

• 디지털융복합연구
• /
• 제15권9호
• /
• pp.65-78
• /
• 2017

본 연구는 기혼여성의 자녀가치관과 추가출산의향의 관계에서 출산장려정책(보육료지원, 육아휴직제도)의 조절효과를 분석하는 것을 목적으로 하였다. 이를 위하여 "2015년 전국 출산력 및 가족 보건복지 실태조사"자료 중 총 2,143명의 자료를 선택하여 위계적 다중회귀분석과 조절회귀 분석방법을 적용하였다. 배경변수(교육수준, 소득, 연령, 기존 자녀 수)를 통제한 후, 위계적 다중회귀분석을 실시한 결과, 이상적 자녀수, 도구적 가치관과 정서적 가치관의 순으로 추가출산의향에 양(+)의 영향을 미치는 것으로 나타났다. 그리고 '육아휴직'은 추가출산의향에 유의한 영향이 없는 반면에, '보육료 지원'은 음(-)의 영향이 있는 것으로 나타났다. 또한 '보육료 지원'만이 '도구적, 정서적 가치관'과 추가출산의향의향의 관계에서 조절효과가 있는 것으로 나타났다. 이러한 결과는 효율적인 출산율 제고를 위해서는 무엇보다 자녀가치관을 높이기 위한 출산장려 문화정책이 필요하며, 아울러 추가출산 가능성이 높은 여성들을 대상으로 자녀수 등을 고려한 맞춤형 지원이 필요함을 시사한다.

• Neonatal Medicine
• /
• 제17권2호
• /
• pp.193-200
• /
• 2010

목적: 초극소 저체중 출생아는 경구수유를 진행하는데 여러가지 어려움을 겪어, 경구수유로의 이행이 늦어진다. 본 연구에 서는 초극소 저체중 출생아 중, 수유 시 산소포화도 저하가 발생하는 군과 산소포화도 저하가 없는 군 사이의 특징을 비교하고, 초극소 저체중 출생아의 경구수유 이행 및 입원기간에 미치는 영향에 대해 알아보았다. 또한 초극소 저체중 출생아에서 구강자극요법을 시행하는 경우, 수유 시 산소포화도 저하와 경구수유 능력의 발달, 입원기간에 미치는 효과를 알아보았다. 방법: 제 1상 연구에서는 2003년 10월부터 2009년 1월까지 서울아산병원 신생아 중환자실에 입원한 125명의 초극소 저체중 출생아를 대상으로 차트 분석을 통한 후향적 연구를 실시하여, 수유 시 산소포화도 저하 여부에 따른 특성, 산소포화도 저하가 경구수유 능력 발달 및 입원기간에 미치는 영향에 대해 알아보았다. 제 2상 연구에서는 2009년 3월부터 2010년 5월까지 29명의 초극소 저체중 출생아에게 구강자극요법을 시행하며 전향적으로 자료를 수집하였고, 81명의 초극소 저체중 출생아에서 후향적 코호트 연구를 통해 두 그룹을 비교 분석하였다. 결과: 초극소 저체중 출생아의 72.8%에서 수유 시 산소포화도 저하를 보였고. 그 중 37.4%에서 서맥을 동반하였다. 수유 시산소포화도 저하가 발생하는 시점은 평균 58.2일이었고, 당시 평균 175.4 mL의 수유를 하고 있었으며, 대부분 위관영양과 경구수유를 병행하고 있었지만, 36.3%에서는 위관영양만 시행하고 있었다. 수유 시 산소포화도 저하가 발생한 군은 정상군 보다 출생 시 재태연령이 낮고, 5분 아프가 점수가 낮았으며, 위식도 역류 및 상인두 부조화가 유의하게 많았다. 또한 기관지폐이형성이 있는 초극소 저체중 출생아에서 수유 시 산소포화도의 저하가 발생할 확률은 19배 증가하였다. 수유 시 산소포화도 저하가 있는 군은 경구수유로 완전히 이행하는 시기가 늦었으며, 입원기간도 길었다. 위 결과를 토대로, 초극소 저체중 출생아에서 구강자극요법을 시행하였을 때 대조군에 비해 경구수유 시작시기 및 경구수유로 완전히 이행한 시기가 빨랐으며, 입원기간이 단축되었다. 결론: 초극소 저체중 출생아에서 구강자극요법은 경구수유능력 발달에 긍정적인 효과가 있으며 입원기간을 단축하는데 도움이 된다.