Tertiary Hospitals' and Women's Special Hospitals' Postpartum Nursing Intervention Survey / 임상간호연구

PURPOSE: This study was done to assess development and postnatal care interventions in postnatal care intervention records for maternity ward nurses in tertiary hospitals and women's hospitals in South Korea. METHODS: This mixed-method research was a Time-Motion (TM) study. Data were collected through external observation of 12 nurses in 4 wards over 24 hours. Mann-Whitney U test and independent t-test were employed for the analysis of frequency and provision time of direct/indirect care activity. χ² (Fisher's exact test) was utilized to determine the difference in frequency between two groups. IBM SPSS 22.0 statistical program was employed for calculation. All statistical significance levels were at α= .05. RESULTS: According to the KPCS-1 (Korean Patient Classification System-1), women's hospitals are group 3 and tertiary hospitals, group 4. With respect to time difference in direct care, tertiary hospitals showed 791 minutes and women's hospitals, 399 a difference of 392 minutes. For time difference in indirect care, women's hospitals had 2,415 minutes while tertiary hospitals, 2,080, a difference of 335 minutes for women's hospitals. No difference was found in the average total care workload between the two institutions. Individual time also showed no difference (p>.05). CONCLUSION: High-risk maternal care strength in tertiary hospitals and breast-feeding strength in women's hospitals need to be benchmarked with each other.

Effect of Birth Experience on Cognitive Function

PURPOSE: This study aimed to investigate whether birth experience affects short-term memory (1,2-back task) by examining parturient and non-parturient women. METHODS: A total of 31 women were enrolled in this study, of which 16 were parturient women who had given birth within the past 2 years (mean age: 33.9±2.2 years) and 15 were non-parturient (mean age: 31.4±2.1 years). The mean age did not significantly differ between the two groups, so the effects of age were eliminated. To match the level of education between the two groups, college graduation was an inclusion criterion. A 1,2-back task consisting of six alphabets from A–F was created using the SuperLab software. For each task, there were 100 stimuli (alphabets) and 30 answers. The participants practiced the task prior to the main experiment to ensure that they adequately understood the procedure. RESULTS: The correct answer rates in the 1-back and 2-back tasks were 93.56±22.23% and 76.89±21.98%, respectively, in the non-parturient group and 95±10.04% and 80.83±13.67%, respectively, in the parturient group. The reaction time in the 1-back and 2-back tasks were 650.57±173.77 ms and 736.77±138.35 ms, respectively, in the non-parturient group and 621.91±81.90 ms and 737.5±195.99 ms, respectively, in the parturient group. There were no significant differences in the answer rates between the two groups, suggesting that parturition did not have a significant impact on the 1,2-back task performance. CONCLUSION: Birth experience does not significantly impair cognitive function. However, the findings of this pilot study are not highly reliable because of the limitations of the small sample size, degree of load, various types of working memory, and impact of hormones.

Development of Korean Menstrual Symptom Scale for University Students

PURPOSE: To develop Korean Menstrual Symptom Scale (KMSS) for university students and test its reliability and validity. METHODS: The scale was developed by intensive literature review, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity, and extraction of final items. Thirty-nine items were constructed. Data for validity and reliability testing were collected with a questionnaire survey from 391 university students. Data were analyzed with descriptive statistics, factor analysis, and reliability coefficients (Cronbach's α) with the SPSS program. RESULTS: There were 37 final items which were sorted into six factors: ‘negative affection (8 items)’, ‘change of activity level (7 items)’, ‘physical symptom (9 items)’, ‘mood change (9 items)’, ‘change in concentration level (4 items)’, and ‘body water retention (5 items)’. The cumulative percent of variance was 63.3%. Regarding the reliability of the scale, its Cronbach's α was 0.96. Cronbach's α values for these factors ranged from 0.75 to 0.91. CONCLUSION: The KMSS demonstrated acceptable validity and reliability. Repeated research is needed to measure menstrual symptom experienced by women of variable ages.

Breastfeeding Initiation and Continuation by Employment Status among Korean Women

PURPOSE: The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. METHODS: Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. RESULTS: Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. CONCLUSION: These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

Associations of Breastfeeding Knowledge, Attitude and Interest with Breastfeeding Duration: A Cross-sectional Web-based Study

PURPOSE: Maternal knowledge, positive attitudes and interest toward breastfeeding may improve the sustainability of breastfeeding. This study examined the associations of knowledge, attitudes, and interest toward breastfeeding with the duration of breastfeeding in Korean mothers who used the internet. METHODS: We conducted a cross-sectional study of 604 Korean mothers who breastfed their babies. Mothers were recruited through the internet and their knowledge, attitudes and interest toward breastfeeding were assessed using a web-based self-administered questionnaire. Geometric means and odds ratio (OR) with 95% confidence intervals were calculated. RESULTS: Higher knowledge, attitudes, and interest toward breastfeeding were associated with longer duration of breastfeeding in Korean mothers. In particular, mothers who had optimal breastfeeding duration were more likely to be aware of the easiness of breast milk stimulation and breastfeeding, the development of attachment between mother and child, and pleasure from breastfeeding compared to those mothers with shorter duration. The association with optimal breastfeeding duration was more pronounced among mothers who graduated from high school for total attitude scores and total interest scores, compared to mothers who graduated from college or above. CONCLUSION: The results of this study suggest that it is important to improve maternal knowledge, attitudes, and interest toward breastfeeding in Korean mothers who use the internet as a source of knowledge. Also, the study results imply that the development of strategies to target mothers with relatively low education levels may improve breastfeeding rates.

Menopause Knowledge, Attitude, Symptom and Management among Midlife Employed Women

OBJECTIVES: Midlife women's knowledge, positive attitudes and management toward menopause may improve the quality of peri and post-menopause life. This study was to identify correlations of the knowledge, attitude, symptoms and management toward menopause in middle-aged women. METHODS: We used a cross-sectional questionnaire study applying to 231 perimenopausal and menopausal women aged from 40 to 59 years old. The completed data of 189 perimenopausal and menopausal women were analyzed through t-test, ANOVA and pearson's correlation coefficient using the SPSS statistical programme. RESULTS: The menopausal women showed significantly higher physical symptoms than perimenopausal women. The menopausal women showed significantly higher psychosomatic symptom than perimenopausal women. There was a significant correlation between the menopausal attitude and management. CONCLUSION: This study suggests that the fundamental data of developing midlife women's symptom index (MSI) and providing menopause management could be a strategy to encourage successful menopausal transition in middle-aged women.

Student Experience and Satisfaction with Clinical Nursing Practice in Women's Health Nursing / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. METHODS: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. RESULTS: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. CONCLUSION: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.

A Survey of Female College Students' Knowledge and Attitudes Toward Breastfeeding / 대한지역사회영양학회지

Breastfeeding is an ideal approach for physical and emotional development of babies, as well as recovery of mothers. A breastfeeding education for female students seems to be an effective intervention to increase the Korean women breastfeeding rate. The purpose of this study was to evaluate their knowledge, attitudes, and other related breastfeeding variables for developing a design for a pre-parental breastfeeding educational information for Korean female students of childbearing age. The sample consisted of 205 Korean female college students, ranging in age from 20 to 25 years old. In this study, a self-administered questionnaire included 6 pages with close-ended multiple-choice questions, and included a cover page with 15 questions on demographic characteristics and personal experiences related to breastfeeding. Data analysis was done utilizing inferential statistics using SPSS 12.0 computer program. The findings indicated that breastfeeding education programs should focus on the practical aspect of attitudes toward breastfeeding, and that educational information design should focus on the practical aspects of breastfeeding for all levels of students' education by nurses. Therefore, education for female college students seems to be an effective intervention to increase breastfeeding rate. This study is useful for descriptions of educational activities to help female students develop positive attitudes to breastfeed, to help these students have confidence toward breast-feeding in future by providing correct information and practical techniques on breastfeeding.

Development of an Evaluation Checklist for Internet Health/Disease Information / 대한의료정보학회지

OBJECTIVE: This study was conducted to develop Internet health information evaluation checklist for medical professionals, web coordinators or managers, and general health information consumers. METHODS: Based on the literature review, evaluation model and prototype of evaluation checklist for Internet health information were developed. Expert group of Internet quality evaluation reviewed and refined original evaluation checklist through intensive focus group meetings. Revised web-based evaluation checklist for Internet health information was verified by medical professionals, web health information managers, and online members of National Health Insurance Corporation. RESULTS: The checklist for medical professionals consisted of 28 items to check 3 categories such as disease information, operation/procedure/examination information, and health/life pattern information. The checklist for health information managers focused on primary filtering of health information and consisted of 14 items. This can be utilized for automatic selection of health information in portal systems. The checklist for consumers consisted of 10 items and focused on convenience and utility of the evaluation tool for enhancing the acceptability. CONCLUSION: Continuous development and revision of health information evaluation checklist like this study can be useful way for improving Internet health information quality.

A Grounded-theory Approach to the Process of Life Adaptation in Women with Cervical Cancer* / 여성건강간호학회지

PURPOSE: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. METHOD: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. RESULT: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient, " "selective food eating, " "steady exercising, " "getting rid of stress, " and "preparing for death". The intervening conditions, "supportive system, " "forms of life, " and "burden on family, " influenced overcoming cancer. CONCLUSION: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.

Infant Feeding Practices and the Factors that Influence Feeding Practices among Women in Seoul and the Chungbuk Area / 대한지역사회영양학회지

In order to obtain baseline data for the development of an educational program on breastfeeding, a survey was carried out to investigate infant feeding practices, the characteristics the subjects have in common, and the factors that influence the feeding methods among women in Seoul and the Chungbuk area. Subjects included 671 lactating mothers who visited public health centers or pediatric clinics between December 1999 and February 2000, and were interviewed using a questionnaire. The results were as follows : With respect to feeding methods, the incidence of breastfeeding, formula feeding, mixed feeding and formula feeding switched from breastfeeding was 20.6%, 29.8%, 11.6%, and 38.0%, respectively. With respect to the characteristics the subjects had in common, the incidence of women who planned their infants' feeding methods before pregnancy, during pregancy, and after delivery was 48.7%, 31.0%, and 20.3%, respectively. The incidence of women who started breastfeeding in the hospital after delivery was 38.8%. About seventy seven percet of the subjects had not previously attended an educational program on breastfeeding, and most of these wanted to participate in the future in an educational program to learn about breastfeeding. Some of the topics they were interested in were 'Nutritional Management for Sufficient Breast Milk' (60.3%), "Breast Care" (25.0%), and "Correct Nursing Positions" (9.8%). Most (88.2%) of the women who breastfeed suffered from physical discomforts including discomfort of the waist, and legs and discomfort due to cracked or sore nipples. "Insufficient breast milk" was the main reason for breastfeeding cessation or for switching to formula feeding. With respect to formula feeding practices, the main reasons for selecting a specific brand of formula were "the same brand the hospital used after delivery" (34.3%) and "an advertised brand" (23.3%). The strongest factor for promoting breastfeeding was "the support of husband or parents", next were "breastfeeding in the hospital after delivery" and "planning to breastfeed before pregnancy" in that order. The characteristics the subjects had in common relating to formula feeding were "mother's job", "high economic level", "Caesarian section" and "planning to breastfeed after delivery". In conclusion, it is recommended that breastfeeding be pro-moted, and educational programs be developed and offered as soon as possible to each group which had unfavorable attitudes toward breastfeeding. In addition, the monitoring and supervision of formula advertisements is required to protect consumers from the adverse effects of exaggerated advertising.

Dysmenorrhea and Menstrual Attitudes in Adult Women / 여성건강간호학회지

The survey was conducted to look out the characteristics of menstruation and it's management, menstrual attitudes and degree of dysmenorrhea in the adult women. The subjects were 601 women, aged 20 year old and over, selected by convenient sampling. The results were as follows; 1. The mean age of the subjects was 29.1 years, the subjects were consisted of 346 unmarried and 304 delivery experienced person. 2.The characteristics of menstruation were as follows; irregular 167 person(27.8%), painful 451 person(75%), mean score of pain was 5.9 point and first day was most severe(45.1%). On the while, they have used the method to manage the pain such as "endure 50.8%", "to have a medicine 31.5%". 3.Menstrual attitudes were as follows; attitudes was negative such as it was meaningful as a woman (78.9%), only for birth a baby (51.6%), and menstruation was acceptable (42.9%), hope to get away(28.8%). 4.The degree of dysmenorrhea was a significant difference by age(F=4.0, P<0.01). Especially, in the subcategory, it was significant except for water retension. That is, lower concentration(F=2.60, p<0.05), negative affect(F=3.09, p<0.05), behavior change (F=6.41, p<0.050), pain(F=3.89, p<0.01), autonomic nerve response(F=2.80, p<0.05). We can conclude there were many women to have negative attitudes to menstruation and first day was most severe dysmenorrhea and it was different by age. From this results, we may suggest as follows; 1. We suggest the program for women to have a positive attitudes will be developed. 2. We can suggest that we need to develop the active and effective method to control dysmenorrhea in the first day during menstruation.

A Survey on the Feeding Practices of Women for the Development of a Breastfeeding Education Program: Breastfeeding Knowledge and Breastfeeding Rates / 대한지역사회영양학회지

A survey was carried out to investigate the breastfeeding knowledge, breastfeeding rates and related factors among women in Seoul and the Chungbuk area, in order to obtain baseline data for the development of an education program on breastfeeding. Subjects included 671 lactating mothers who visited public health or pediatric centers, between December, 1999 and February, 2000 and were interviewed using a questionnaire. The results are as follows: In the breastfeeding knowledge, most of the subjects (93.4%) knew correctly that 'breastfeeding is better for a baby's emotional development than formula feeding,' whereas only half of the subjects (51.7%) answered correctly the question on whether 'formula is more nutritious than breastmilk.' The breastfeeding rates were about 57%, 40%, 33% and 12%, respectively for baby's aged 1, 3, 6, and 12 months. These results showed that the breastfeeding rate rapidly decreased with the baby's age. Lower breastfeeding rates were associated with high educational level (college graduate and above), high income, mothers' employment, no experience of attending breastfeeding education programs, and no planning on breastfeeding prior to pregnancy. There was a significant relationship between the level of knowledge and breastfeeding practice; the higher the knowledge score, the higher the breastfeeding rate. In conclusion, an education program should be developed and offered for each low breastfeeding rate group, in order to promote breastfeeding.

Design and Evaluation of the Program on the Internet for Sexuality Education of Adolescences / 여성건강간호학회지

Sexuality education in the period of adolescents need much care and attention. The programs of sexual education through the Internet are excellent resources for adolescents to gain the information related to their sexual health. And systematic program which is necessary for adolescents to manage their sexual health has been rarely found in Korea. The purpose of this study was to offer valuable database for program design and evaluation on sexual education of middle school students through the Internet. Needs assessment for the information of sexual education on the internet among middle school students were carried out. A questionnaire survey was conducted with respondents of 602 middle school students from January to March in 2002. In the sexual counseling center for middle school students, counseling cases through internet were analyzed and evaluated from October, 2001 to September, 2002, We have selected 16 Sexual educational websites in Seoul confirmed Korean Educational Human Resource. Contents which was illustrated in 16 sexual educational websites were analyzed and evaluated by 12 sexual counselors. Design and evaluation of the program on the internet for sexuality education of adolescences was conducted on the basis of this study results by middle school expert teachers, sexual counselors, sexuality education professionals. Data was statistically analyzed using dBSTAT 4.0 for Windows.The extent and phase of the teaching-learning program of the sexuality education on the internet was seen as follows :1. We evaluated to need for sexuality education on the internet by middle school student.2. We assessed the properness of sexuality education curriculum on the internet frequently used by middle school students.3. We designed teaching strategy and learning program for sexuality education of the middle school students. 4. We developed the assessment method for the teaching-learning program of the sexuality education in adolescences on the internet.Middle school students responded that sexual education through Internet is needed in the order of programs related to acquaintances with opposite sex, Sexual culture and ethics, Sexual health, Reproductive health structure and development, Marriage and family, Psychology of Sexuality, Pregnancy and birth. In the internet counseling, cases on the 'reproductive health structure and development' was ranked as the top. In short we have found the most needs as follows; Meaning of the marriage life and having family, Sexes and Love, Human relation, Sexual Culture.We recommend as follows on the basis of this study results: 1. It is necessary for sexuality education program on the internet to specify acccording to age and target the specific individual needs. 2. Sexual educators have to employ various educational materials such as flash, cartoon, multimedia in order to provide effective sexuality education. 3. Internet based sex education need to be evaluated regularly through reassessment of the effectiveness of sexuality education for content quality and richness.