• Title/Summary/Keyword: base of support

Search Result 1,084, Processing Time 0.025 seconds

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
    • /
    • v.20 no.2
    • /
    • 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.

  • PDF

Recognition and Attitude to Implement at ion of Service Area Assigned System of Public Health Programs among the Health Officer (공공보건사업의 지역담당제 실시에 관한 보건기관 근무 공무원의 인식과 태도)

  • Kim, Mi-Soon;Lee, Moo-Sik;Kim, Nam-Song
    • Journal of agricultural medicine and community health
    • /
    • v.26 no.2
    • /
    • pp.15-41
    • /
    • 2001
  • Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

  • PDF

The Establishment of Seongjusa Temple and the Production of Iron Buddhas (성주사 창건과 철불 조성 연구)

  • Kang Kunwoo
    • MISULJARYO - National Museum of Korea Art Journal
    • /
    • v.104
    • /
    • pp.10-39
    • /
    • 2023
  • Seongjusa Temple was founded in Boryeong in Chungcheongnam-do Province by Monk Muyeom (800-888), better known as Nanghye Hwasang. After returning from studying in China, Muyeom stayed in the Silla capital city of Gyeongju for a period. He later settled in a temple that was managed by the descendants of Kim In-mun (629-694). He then restored a burned-out temple and opened it in 847 as a Seon (Zen) temple named Seongjusa. It prospered and grew to become a large-scale temple with several halls within its domains. The influence of Seongjusa in the region can be seen in the Historical Record of Seongjusa Temple on Sungamsan Mountain, which relates that there were seventy-three rooms within the domains of the temple. What is most notable in the record is that the temple is referred to as "栴檀林九間," which means either "a structure with nine rooms built with Chinese juniper wood" or "a place that houses Chinese juniper wood and has nine rooms." Regardless of the interpretation, Seongjusa Temple had a large amount of juniper wood. Around this time, the term "juniper" referred to the olibanum tree (Boswellia sacra) native to the islands of Java and Sumatra in Southeast Asia. It is presumed that at some point after the death of Jang Bogo, the maritime forces that controlled the southwestern coast of Korea may have acquired a large amount of Southeast Asian olibanum wood and offered it to Seongjusa Temple. During the reign of King Munseong, Kim Yang (808-857) patronized Seongjusa Temple and its head monk Muyeom, who enjoyed a lofty reputation in the region. He sought to strengthen his own position as a member of the royal lineage of King Muyeol and create a bridge between the royal family and Seongjusan Buddhist sect. The court of King Wonseong designated Seongjusa Temple as a regional base for the support of royal authority in an area where anti-royal sentiment remained strong. Monk Muyeom is believed to have created an iron Buddha to protect the temple, enlighten the people, and promote regional stability. Given that the Seongjusa community had expanded to include more than 2,000 followers, the iron Buddha at Seongjusa Temple would have been perceived as an image that rallied the local residents. It is assumed that there were two iron Buddhas at Seongjusa Temple. The surviving parts of these Buddhas and the size of their pedestals suggest that they were respectively enshrined in the Geumdang Main Hall and the Samcheonbuljeon Hall of Three Thousand Buddhas. It is presumed that the first iron Buddha in Geumdang was a large statue over two meters in height and the second one was medium-sized with the height over one meter. The Historical Record of Seongjusa Temple on Sungamsan Mountain contains the phrase "改創選法堂五層重閣" which indicates that a multistoried Geumdang was newly built to enshrine a large Buddha sculpture like the first iron Buddha when Seongjusa Temple was founded. Also, according to the Stele of Seongjusa Temple and the surviving finger fragments, the first Buddha was making the fear-not and wish-granting (abhayavarada) mudras. The main Buddha of Seongjusa Temple is possibly Nosana Buddha, just like the main Buddhas at the contemporaneous temples Silsangsa, Borimsa, and Samhwasa. Given that Monk Muyeom studied Hwaeom teachings in his early years and received royal patronage upon his return, it is believed that the retro tendencies of the Hwaeom school, centered on the royal family of the Silla Dynasty, were reflected in Seongjusa temple.

Recognition Level of Organization, Motivation and Job Satisfaction Factors of the Staff of Health Centers (보건소직원의 조직에 대한 인식과 동기부여요인 및 직무만족요인)

  • 남철현;위광복
    • Health Policy and Management
    • /
    • v.10 no.3
    • /
    • pp.19-49
    • /
    • 2000
  • This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

  • PDF