Comparative Study on Predictors of Maternal Confidence between Primipara and Multipara

PURPOSE: This study was done to investigate the predictors of maternal confidence between primipara and multipara mothers. METHODS: The participants enrolled in this study were 145 mothers between 2 and 5 days postpartum. Data were collected using a questionnaire and analyzed using descriptive analysis, t-test, chi2 test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The predictors of maternal confidence among primipara mothers were social support, self-esteem, mode of delivery (R2=.287, p<.001). Whereas, gender of baby, antenatal fetal attachment, and educational status explained maternal confidence among multipara mothers (R2=.270, p<.001). CONCLUSION: The results indicate that when nurses develop programs to encourage maternal confidence for new mothers, they should take into account the differences between predictors of maternal confidence according to the mothers' experience of birth.

Stress Responses of Neonates Related to Maternal Characteristics

PURPOSE: To investigate the pre- and post-heelstick stress response patterns of infants and to identify related maternal factors. MATERIALS AND METHODS: Fifty-two mothers and their 57 infants were studied. Stress response patterns in neonates were collected by measurements of pulse rate, oxygen saturation, and salivary cortisol. Maternal demographic factors and awakening saliva were collected. RESULTS: Median level of pulse rate of infant increased from 132.1 to 140.4 beats per minute and salivary cortisol was elevated from 0.41 microg/dL to 0.70 microg/dL during the periods of discomfort, while oxygen saturation decreased from 97% to 95%. Infant's pulse rate change was negatively correlated with gestational age (GA) (r = - 0.37, p < 0.05), whereas the change of infants' salivary cortisol was correlated positively with maternal age (r = 0.29, p < 0.05). GA was the only independently significant predictor of pulse rate responses (R2 = 0.15, p < 0.05). Influence of maternal age on infants' salivary cortisol changes (R2 = 0.09, p < 0.05) was observed in a stepwise multiple regression. CONCLUSION: These findings suggest that maternal age and gestational period can be influential factors for stress responses in infants. Therefore, it would be important to consider the demographic characteristics of mother-infant pairs to evaluate these influential factors.

Predictors of Health-related Quality of Life (HRQoL) in the Home-dwelling Disabled Persons by using EQ-5D: Results from the 3rd Korea National Health and Nutritional Examination Survey 2005 / 성인간호학회지

PURPOSE: This study was a secondary data analysis aimed at identifying the predictors of health-related quality of life (HRQoL) of the home-dwelling disabled person by using EQ-5D which is a standardized instrument used as a measure of health outcome. METHODS: Data were drawn from the 3rd Korea National Health and Nutritional Examination Survey conducted by the Ministry of Health and Welfare (MOHW). Subjects were 1,021 home-dwelling disabled persons over 19 years of age. Data were analyzed by using descriptive statistics, t-test, Pearson's correlation, one-way ANOVA, Scheffe test, and Stepwise multiple regression. RESULTS: HRQoL (Health Related Quality of Life) is differentiated within age, genders, educational level, employment status, economic status, types and grades of disability, health problems associated with limited mobility, and the limited duration of time. HRQoL is correlated with age, number of cohabiters, educational level, grades of disability, activities of daily living (ADL), and instrumental ADL (IADL). HRQoL is significantly associated with ADL, health problems in connection with limited mobility, employment status, types of disability, marital status, grades of disability, and the limited duration of time. These factors explained 63.7% of variance in HRQoL. CONCLUSION: HRQoL among the disabled is related to their characteristics, ADL, and IADL. For this reason, it is necessary to develop health programs to promote those variables required to improve HRQoL.

The effect of sucrose on infants during a painful procedure / 소아과

PURPOSE: The purpose of this study was to test the efficacy of treating the pain among newborn infants associated with a medical procedure with sucrose with regard to overall physiological and behavioral stability. METHODS: 103 newborn infants were enrolled in this study. The control group (n=63) did not receive any treatment. The experimental group (n=40) received 2 mL of 24% sucrose solution two minutes before a routine heel stick. The pain was assessed by measurements of physiological changes [e.g. pulse rate, oxygen saturation, salivary cortisol (hydrocortisone)] and behavioral changes [e.g. crying time, and the neonatal infant pain scale (NIPS) for neonates]. RESULTS: There were no differences among the groups with respect to physiological changes associated with the pain from the procedure. However, there were significant group differences in behavioral changes to the pain. In the control group, the median crying time was 13 seconds, while in the experimental group, the median crying time was 3.5 seconds (P=.000). In the control group the median NIPS score was 4, while in the experimental group the median NIPS score was 2 (P=.000). CONCLUSIONS: These findings suggest that sucrose can be an effective method for the management of stress responses in infants with regard to behavior. However, this treatment had no significant physiological effects.

A Study on Activities of Daily Living and Perceived Health Status of Disabled Persons at Home in Rural Areas

PURPOSE: This study was attempted to provide basic data required to develop community-base rehabilitation program for disabled persons at home by investigating their characteristics, ADL, and perceived health status. METHOD: The subjects were 146 disabled persons at home in rural areas. Data were collected from January 22 to January 31, 2004. Data were analyzed using frequencies, percentages, means, standard deviations, minimums, maximums, chi2-test, Fisher's exact test, t-test, one-way ANOVA, Scheffe test, Contingency coefficient, Pearson's correlation, Stepwise multiple regression. RESULTS: The average score of ADL was 5.51+/-1.92: sphincter control (5.85+/-2.10), communication (5.66+/-2.02), transfers (5.67+/-2.21), self care (5.44+/-2.05), social cognition (5.33+/-2.08), and locomotion (4.85+/-2.32). This means that the respondents were in the state of dependence. The main items requiring others' help were 'bathing' (57.7%) and 'going up and down stairs' (51.1%). ADL was significantly different according to age, gender, occupation, medical fee payer, type, severity and duration of disability, BMI, and alcohol drinking. Among the respondents, 82.8% perceived that their health status was bad. Main factors influencing the perceived health status of disability were age and ADL(R2=.343). CONCLUSION: Perception of health status among the disabled is related to their characteristics and ADL, so it is necessary to develop community-base rehabilitation programs in order to improve ADL and the perception of health status.

A Study on the Needs of Health & Community Services Among the Disabled at Home in Rural Areas

PURPOSE: This study was to investigate the needs of health & community services among the disabled at home in rural areas. METHODS: The subjects were 146 persons with disabilities living in J-gun. The questionnaire was based on the needs of 8 categorical services. Data were analyzed using frequency, percentage, mean, standard deviation, minimum, maximum, t-test, one-way ANOVA and Scheffe test. RESULTS: Among the respondents, 27.4% visited the public health center in community for rehabilitation therapy. The average score of need was 2.62+/-.79: education services (2.92+/-1.05); medical services (2.81+/-.82); nursing care services (2.75+/-1.08); connection services (2.62+/-1.20); housing services (2.60+/-1.09); emotional services (2.41+/-1.03); other services (2.24+/-1.06); and support of self-sustenance service (1.92+/-1.15). The items in highest need were medical checkup (70.7%), medication (62.1%), traditional oriental therapy (60.4%) and physical therapy (58.9%), and those of lowest need were device repair (8.7%) and guidance of facility admission (7.1%). Needs were significantly different according to age (F=4.751, p=.001), employment status (t=2.108, p=.037) and medical fee payer (F=5.061, p=.002). CONCLUSION: The needs of education & medical services were relatively high. Demographic factors were statistically significant in determining needs. For the disabled at home in rural areas, more various services or programs should be executed based upon the needs and characteristics of based upon the needs and characteristics of the subjects.

Effects of Non-nutritive Sucking on the Physiological and Behavioral States of Pre-term Infants during Tube Feeding / 간호학회지

PURPOSE: This study was to investigate the effects of non-nutritive sucking on physiological and behavioral state of pre-term infants during tube feeding. METHOD: This nonequivalent, non-synchronized experimental study included 50 pre-term infants. An attempt was made to match gestational age and birth weight of infants in each group. Infants in the experimental group were given a pacifier 2 minutes before, during, and for 2 minutes after tube feeding. Infants in the control group did not get a pacifier. Both groups were tested at three stages for changes in the physiologic state and behavioral state-2 minutes before, during, and 2 minutes after feeding. Date was analyzed with SPSS WIN 10.0 using an chi-square-test, t-test, and repeated measures ANOVA. RESULT: Heart rates and oxygen saturation levels of the two groups were significantly different(P=.001, P=.000). The behavioral states of the two groups were significantly different during and post feeding(P=.000, P=.000). CONCLUSION: This result suggests non-nutritive sucking by using a pacifier is an effective intervention for pre-term infants during tube feeding.

Effect of Non-Nutritive Sucking on the Oxygen Saturation Level and Behavioral State of Preterm Infants during Tube Feeding

PURPOSE: The main purpose of this study was to evaluate effects of non-nutritive sucking (NNS) on the oxygen saturation level and behavioral state of preterm infants during tube feeding. METHODS: This study was performed prospectively in the NICU, Chonbuk National University Hopspital from November, 2004 through April, 2005. Preterm infants of gestational age 28 to 37 weeks, who had neither major congenital defects interfering feeding nor respiratory difficulty needing ventilatory support, were included. A total of 64 subjects were divided randomly into the control group (n=32), and the non-nutritive sucking (NNS) group (n=32). The patients in each group were tested for changes in oxygen saturation and behavioral state at 3 different times; 2 minutes before, during, and 2 minutes after feeding. RESULTS: The oxygen saturation of the NNS group increased during feeding and gradually decreased after feeding while the control group decreased during feeding and increased slightly after feeding (P<0.001). During feeding, the "quiet awake" state was observed more frequently in the NNS group and the "crying" state was observed more frequently in the control group. During the post-feeding assessment, the "sleep" state was more frequent in the NNS group and the "crying" state was more frequent in the control group. CONCLUSION: The infants in the NNS group showed significantly higher oxygen saturation level and they were less fussy during tube feeding and slept better after feeding.

Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants / 아동간호학회지

The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit(NICU), and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program, in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi-experimental non-equivalent pre and post test to compare ; non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures(Hobbs, 1968 ; Steffensmeier, 1982), and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the NICU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations Mann-Whitney test ; chi-square test : Repeated Measures Analysis of Variance ; ANCOVA, Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants, just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the planned nursing intervention program be came lower as time passed compared to the others' (F=16.61, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, P=.01). (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depend ing on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others' (U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.