Maternal Experiences of Anger While Raising a Child

Purpose@#This study aims to explore mothers’ experiences of anger while raising a child in South Korea based on a qualitative descriptive approach. @*Methods@#A total of ten mothers of children aged 1-3 years participated in the study. In-depth individual interviews were conducted from August to September 2019 to collect data, which were then subjected to thematic analysis. @*Results@#A total of 4 main themes and 10 subthemes were identified. The 4 themes were “individual and environmental factors that influence anger,” “a vicious cycle of anger expression and guilt,” “being a little bit more mature as a mother,” and “need for anger management.” This study described various causes, ways of expressing, and effects of anger, as well as the mother’s coping strategies. These experiences were viewed as milestones along the journey to becoming a real parent and helped mothers develop empathy for other children and mothers. The participants expressed support for expanding the social support system for child-rearing and providing psychological programs for mothers. @*Conclusion@#Mothers of children aged 1-3 years experienced anger owing to various factors, but adapted by developing coping skills. This study recommends family-based support interventions to help mothers manage their emotions and parenting roles.

Factors associated with healthcare utilization for infant falls in South Korea: a cross-sectional online survey

Purpose@#Falls are a common cause of unintentional injuries in infants. This study was conducted to examine the patterns of healthcare utilization following infant falls in South Korea. @*Methods@#This cross-sectional descriptive study utilized an online survey designed to gather information regarding the general characteristics of parents and infants, fall-related variables, and healthcare use. @*Results@#The most serious falls identified by parents occurred at an average infant age of 6.97 months. Most fall incidents took place indoors (95.7%), and many occurred under the supervision of caregivers (68.0%). Following the fall, 36.4% of the participants used healthcare services. Logistic regression analysis revealed that healthcare use following an infant fall was significantly associated with being a firstborn child (odds ratio [OR]=5.32, 95% confidence interval [CI], 2.19-15.28) and falling from a caregiver's arms (OR=4.22; 95% CI, 1.45-13.68). @*Conclusion@#To prevent and decrease the frequency of infant falls, improvements are needed in both the domestic environment and parenting approaches.

Assessment of Sleep Quality of Infants and Their Mothers Using Actigraphy

Objectives@#The purpose of this study was to explore and evaluate the characteristics and quality of infant and maternal sleep (total sleep time, sleep efficiency, and wakefulness after sleep onset) using an actigraph. @*Methods@#The characteristics and quality of sleep were assessed in 22 dyads of mothers and infants aged 3–12 months. The quality of infant and mother sleep was collected using an actigraph for 12 consecutive days; this was repeated three times at 4-week intervals, and characteristics of infant sleep were measured using the Brief Infant Sleep Questionnaire-Revised. @*Results@#Bedsharing with infants at 7–12 months of age was higher (12.5%) than with those at 3–6 months of age (50.0%). Regarding the sleeping position, half of the infants aged 3–6 months adopted the lateral (25.0%) and prone (25.0%) positions, and the remaining half (50.0%) aged 7–12 months adopted the lateral position. It was found that 45.5% of mothers of infants used breastfeeding and pacifiers to induce sleep in infants and to help their babies go back to sleep when they woke up. The total sleep time and sleep efficiency of infants and mothers were 434.68 minutes per day and 73.1% and 379.53 minutes per day and 82.8%, respectively, indicating that both infants and mothers had low sleep quality. @*Conclusions@#To safeguard infants’ sleep, it is necessary to provide appropriate information and education to parents and necessary interventions for resolving sleep problems and improving the quality of sleep for both infants and mothers.

Factors Associated with the Method of Feeding Preterm Infants after Hospital Discharge

PURPOSE: To investigate factors that may affect the method of feeding among preterm infants at 4 weeks after discharge. METHODS: This study included 222 mother-infant dyads born before a gestational age of 37 weeks. The feeding method and general medical characteristics of the participants were assessed at 4 weeks after discharge using a structured questionnaire. Multinomial logistic regression analysis was used to examine which factors were associated with breastfeeding at home. RESULTS: Of the 222 infants who qualified for the study, 71 (32.9%) continued to receive breastmilk at 4 weeks post-discharge. Multinomial logistic regression analysis showed that breastfeeding at 4 weeks post-discharge was associated with higher breastfeeding self-efficacy, vaginal delivery (experience), direct breastfeeding in the neonatal intensive care unit (NICU), gestational age between 30 and 34 weeks, and breastmilk consumption in the NICU. The following factors were associated with mixed feeding at 4 weeks post-discharge: being employed, having higher breastfeeding self-efficacy, and direct breastfeeding in the NICU. CONCLUSION: NICU nurses should provide opportunities for direct breastfeeding during hospitalization and support breastfeeding to enhance breastfeeding self-efficacy. These factors may help to ensure the continuation of breastfeeding after discharge. Moreover, factors that affect breastfeeding should be considered when providing interventions.

A Systematic Review of Interventions with Siblings of Pediatric Cancer Patients

PURPOSE: The purpose of this study was to review interventions available to nurses caring for siblings of children with cancer. METHODS: Searches of CINAHL, MEDLINE, PubMed, EMBASE, and RISS identified ten intervention studies published from January, 2000 to November, 2016. RESULTS: Ten studies on interventions for siblings of pediatric cancer patients were identified as follows: 4 included camps, 4 included support groups, and 2 provided individual interventions. Theoretical frameworks were mainly cognitive behavioral theory and most studies were led by psychologists and multidisciplinary teams. The purpose of the interventions was primarily enhancing psychosocial adjustment. Siblings' fear of disease, self-esteem, and social support were improved significantly after the interventions. Findings were inconsistent with regard to depression, anxiety, behavioral problems, post-traumatic stress, health-related quality of life, and siblings' perceptions of the illness. CONCLUSION: Study findings showed the potential for enhancing emotional and behavioral outcomes in siblings of children with cancer. However, the number of studies was very small, and several methodological limitations were identified. In the future, more randomized controlled trials with larger samples are needed to extend the evidence base. Moreover, future research should identify sibling's characteristics and circumstances most likely to bring benefits to the siblings.

Perceived Parental Stress and Nursing Support of Fathers with High Risk Infants

PURPOSE: The purpose of this study was to examine the paternal stress and nursing support as perceived by fathers of high risk infants admitted to Neonatal Intensive Care Units (NICU). METHODS: The study participants included 88 fathers of high risk infants in NICUs. Their parental stress and nursing support were measured using a self-report questionnaire. RESULTS: The parental stress level of the fathers was 3.57 of a possible 5. Among the parental stress items, 'Relationship with infant and parental role' had the highest scores. The perceived nursing support level was a relatively high, 3.90 on a 5-point scale. The lowest score was for the item 'showed concern about my well-being.' The parental stress was lower in fathers with low income, higher in fathers in nuclear families and when the infants' condition was serious. CONCLUSION: The findings indicate that fathers of high risk infants experience intense parental stress. Thus when designing care to provide support for these fathers and their infants, it is necessary to encourage the fathers' engagement, provide information on how to respond to the baby, and include supportive care to the fathers.

Facial soft tissue measuring analysis of normal occlusion using three-dimensional CT imaging / 대한치과교정학회지

Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program; soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (sigma=root(x2 + y2 + z2)) values were obtained using V surgery program. In the linear measurement between landmarks, there was a significant difference between males and females except Na'-Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.

A Case of Hemangioendothelioma Diagnosed by Antenatal Ultrasonography / 대한산부인과학회잡지

Hemangioendothelioma is the most common tumor of liver in infancy characterized by heart failure due to arteriovenous shunt and thrombocytopenia. Recently with the advance of technology, this tumor can be diagnosed with antenatal ultrasonography. We report a case of hemangioendothelioma that demonstrates huge abdominal mass with increased blood flow in liver detected by ultrasonography.

A Case of Amniotic Fluid Embolism during the Labor / 대한산부인과학회잡지

Amniotic fluid embolism continues to be a life-threatening. It is an unexpected and rare complication of pregnancy often presenting with sudden maternal cardiovascular collapse, disseminated intravascular coagulation (DIC), and maternal death. In the past, the diagnosis of amniotic fluid embolism was made when a woman presented with one of those clinical hallmarks and at autopsy fetal squamous and amniotic fluid cells were found within the maternal pulmonary arteries. However, several studies have demonstrated that squamous cells, trophoblasts, and other debris of fetal origin may commonly be found in the central circulation of women with conditions other than amniotic fluid embolism. Thus, this finding is neither sensitive nor specific. We present a case that was diagnosed clinically as amniotic fluid embolism by characteristic signs and symptoms during the labor, resulting in maternal death.

Latex anaphylaxis during labor: case report / 대한산부인과학회잡지

Allergy to latex gloves has been described as an unusual complication during labor. However, IgE mediated hypersensitivity reaction to natural rubber have recently been identified as an international health problem. In this first case report in Korea, latex anaphylaxis during labor is described in an operating room nurse who has been continuously exposed to latex gloves. Because of the increasing frequency of latex allergy, obstetrician should take care and give more attention to the clinical history, as well as be aware of this possibility especially in high risk groups.

Ultrasound Measurement of Korean Fetal Growth Parameters by Gestational Age in Midtrimester Pregnancy / 대한산부인과학회잡지

OBJECTIVE: This study was done to formulate Korean fetal biometry charts of midtrimester presenting percentile values as a function of gestational age. METHODS: The relationships between the ultrasound measurement of 5 fetal parameters (biparietal diameter, head circumference, abdominal circumference, femur length, transverse cerebellar diameter) and nuchal skinfold thickness and menstrual age were determined by a cross-sectional study. The study group consisted of 215 normal healthy pregnant Korean women with known last menstrual period and regular menstrual period who had been performed genetic amniocentesis at our hospital and for whom complete pregnancy outcome information was available. All ultrasound examination was performed by one expert examiner. For each of the 5 parameters, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles were determined. RESULTS: Ready-to-use fetal measurement charts in midtrimester are presented in a format giving the percentile values as a function of gestational age. CONCLUSION: These fetal biometry charts, obtained from midtrimester, Korean women can be used as a reference value.

A case of acardiac twin with conservative management / 대한산부인과학회잡지

Acardiac twin is a rare complication of multifetal pregnancy. The literatures report an incidence of 1% among monochorionic twin pregnancies, i. e. 1 of 35,000 pregnancies. The absence of identifiable fetal heart structures in one twin and reduction anomalies in many organ systems suggest the diagnosis. It has been hypothesized that in the presence of artery-to-artery and vein-to-vein anastomoses in a monozygotic placenta, blood is perfused by hemodynamically advantaged pump-twin to the recipient twin by retrograde flow. The principal perinatal problems associated with acardiac twinning are congestive heart failure of pump-twin, maternal polyhydramnios, preterm delivery and intrauterine death. The outcome is invariably fatal for the acardiac twin and 50-75% of the normal twin. Management options include observation, medical therapy, and selective termination of acardiac twin. The most appropriate intervention for the various clinical presentations of this disorder is undetermined, and conservative nonintervention is often appropriate. Long-term follow-up data on surviving pump twins are lacking. We experienced a case of acardiac twin gestation which showed satisfactory outcome with conservative management, so we present the case with a brief review of the literature.

3 Cases of Primary Hepatocellular Carcinoma First Detected During Pregnancy / 대한산부인과학회잡지

No abstract available.

A Case of Complete Response in Locally Advanced Vulvar Cancer after Concomitant Chemoradiation Therapy / 대한산부인과학회잡지

Cancer of the vulva accounts for approximately 0.5% of all gynecologic malignancies. At diagnosis, one-third of these cases is detected in an advanced stage (FIGO stages III, IV), and local extension of primary vulvar cancer may involve adjacent midline structures such as the clitoris, urethra, vagina, and anus. Initial surgical therapy of such locally advanced primary cancers may compromise the functional integrity of midline structures, necessitating ultraradical surgery including pelvic exenteration. In view of the relatively elderly age of the patients and the morbidity of this ultraradical dissection, concomitant chemoradiation therapy - that the efficacy had been proven in head and neck cancer, anal cancer has approached for patients with locally advanced vulvar cancer. We experienced a case of stage III vulvar cancer patient, who underwent concomitant chemoradiation therapy with 5-fluorouracil(FU) and cisplatin and who showed complete response. So, we report this case with brief review of the literatures.

3 Cases of Pregnancies in Patients with Liver Cirrhosis / 대한산부인과학회잡지

Far Eastern countries including Korea show the high prevalence of hepatitis B virus carriers, so that the incidence of liver cirrhosis is higher than in western countries. But pregnancies with liver cirrhosis are rarely encountered in clinical settings, since liver cirrhosis usually develops after childbearing ages and often causes the disturbance of estrogen metabolism, resulting in severe menstrual irregularity and infertility. Therefore, little is known about the interactions between liver cirrhosis and pregnancy. Liver cirrhosis and portal hypertension are not contraindications to pregnancy but necessitate intensive monitoring throughout pregnancy because the complications of liver cirrhosis, which pose additional risks during pregnancy, are numerous and unpredictable. We report 3 cases of pregnancies in patients with liver cirrhosis with brief review of the literature.