This study was conducted to evaluate the effect of breast milk olfactory stimulation on physiological responses, oral feeding progression, and body weight in preterm infants.

A repeated measures design with nonequivalent control group was used. The participants were healthy, preterm infants born at a gestational age of 28~32 weeks; 12 in the experimental group and 16 in the control group. Data were collected prospectively in the experimental group, and retrospectively in the control group, by the same methods. Breast milk olfactory stimulation was provided 12 times over 15 days. The data were analyzed using the chi-square test, Mann-Whitney U test, Wilcoxon signed rank test and linear mixed models using SPSS 19.

The gastric residual volume (GRV) of the experimental group was significantly less than that of the control group. The heart rate, oxygen saturation, respiration rate, transition time to oral feeding, and body weight were not significantly different between the two groups.

These findings indicate that breast milk olfactory stimulation reduces GRV and improves digestive function in preterm infants without inducing distress.

The purpose of this study was to identify parental coping strategies in the face of early infant and toddler injury, and to provide basic data for a parental education program and the most desirable directions it should take.

A Q-methodology to analyze the subjectivity of each item was used. Thirty-four Q-statements were derived from a literature review and interviews. Forty-seven parents were classified into a shape of normal distribution using a 9-point scale. Collected data were analyzed by the pc-QUANL program.

Five types of parental coping in early infant and toddler injury were identified. Type I was “hospital treatment focused”, type II was “Improving the safety of the child's environment”, type III was “expression of negative emotion”, type IV was “taking the lead in problem solving”, and type V was “Interrogating the person in charge of the situation in which the injury occurred”.

The results of this study indicate that different approaches to educational programs can be used for parents in early childhood injury.

This study was performed to identify the experience of becoming a father of a high risk premature infant.

Grounded theory was used for this research. The participants were 12 fathers who had premature infants lighter than 2,500g of birth weight, less than 37 weeks of gestational age and having stayed 2 weeks or longer in a NICU right after birth. Theoretical sampling was done to identify participants and indepth interviews were done for the data collection. For data analysis, the process suggested by Corbin and Strauss was used.

For these participants the core phenomenon of the experience of becoming a father of a high risk premature infant was ‘striving through with belief and patience’. The phenomenon was ‘being frustrated in an unrealistic shock’. Contextual conditions were ‘uncertainty in the health status of the premature baby’ and ‘no one to ask for help’ and intervening conditions were ‘possibility in the health recovery of the premature baby’ and ‘assistance from significant others’. Action/interaction strategies were ‘withstanding with belief in the baby’ and ‘enduring with willpower as head of the family’ and the consequence was ‘becoming a guardian of the family’.

For the participants, the process of becoming the father of a high risk premature infant was striving through the situation with belief in their babies' ability to overcome the crisis and waiting for the babies' recovery with patience.

The study was conducted to investigate the skin hydration level in various body sites and identify the influencing factors in neonates.

An exploratory comparison study was designed to measure the stratum corneum hydration, using a National DM-R2 on the forehead, abdomen, buttocks, and the back of the hands and feet of 198 neonates including 92 premature infants.

The results showed 32.7%-36.5% of stratum corneum hydration for all sites. Premature infants revealed a higher hydration level on the peripheral sites (dorsal hand and feet) than those of the full-term infants, possibly resulting from therapeutic regimens including an incubator or radiant warmer. Infants in an incubator showed a higher hydration level than those in radiant warmers, suggesting more attention to fluid management for infants in the open environment. In addition, all stratum corneum hydration measurements except one, from the forehead, showed a positive correlation with postnatal age in full-term infants while showing no relation to any measurements in premature infants.

The study demonstrated the very low skin hydration levels in hospitalized neonates, particularly in premature neonates with more susceptible skin hydration instability despite therapeutic interventions for fluid balance. More vigilant fluid management is imperative in neonates, particularly those in the open environment.

The purpose of this study was to test the effects of infant massage (auditory (mother's voice), tactile/kinesthetic (massage) and visual (eye to eye contact) stimulation) on weight and height of infant and mother-infant interaction with normal infants over a period of 4 weeks.

This study was designed as a nonequivalent control group pretest-posttest design. The experimental group infants (aged 2-6 months) participated in one of the infant massage programs at the health district center for 4 weeks. The control group (N=26) was paired with the experimental group (N=26) by matching the infant's age and sex. Infant weight, height, and mother-infant interaction were measured two times and recordings of the mother-infant interaction were done using the video equipment in a room at the health center for 10 minutes.

After 4 weeks of massage, there were no significant differences weight gain and height increase between the two groups. Comparison of the total scores for the mother-infant interaction between the two groups showed a significant difference (t=5.21, p=.000). There were also significant differences on maternal response (t=3.78, p=000), infant response (t=5.71, p=000) and dyadic response (t=4.05, p=000) in the mother-infant interaction between the two groups.

Overall, the results of this study reassure that infant massage facilitates the mother-infant interaction for infants and mothers who give massage to their baby.

The purpose of this study was to identify the effects of Yakson therapy as a pain management tool on the physiologic and behavioral reponses of infants with a painful heelstick procedure.

Infants were randomly assigned to a group that underwent a series of Yakson therapy and a control that received nothingbefore a heelstick. Heart rate, oxygen saturation, and NIPS were compared between the experimental (n=16) and control (n=16) infants during an undisturbed baseline and after a standard heelstick procedure. Yakson therapy consisted of laying a hand on the back, and caressing the abdomen by hand for 5 minutes.

The pain scores of the Yakson group were lower than the control group. Foroxygen saturation, there were statistically significant differences between groups. For heart rate, there were no statistically significant differences between groups.

This data suggests that Yakson therapy had a pain relief effect in behavior responses and SaO₂. Accordingly, Yakson therapy should be used as a nursing intervention for simple pain management for a heel prick.

This study is aimed to confirm the effects of Yakson therapy on the growth and physical response of preterm infants, and maternal attachment to them compared with GHT therapy.

The design of this study is nonequivalent control group with repeated measuring by quasi experimental study. The subjects are preterm infants in 26 - 34 gestational age hospitalized in the NICU of 4 university hospitals with an experimental group of 15 and a control group of 14. Yakson therapy consists of three phases: laying a hand, caressing by hand, and laying a hand again taking 5 minutes for each phase.

As a result of administering Yakson therapy to preterm infants; the average weight gain of the Yakson group was higher than that of the GHT group, but there is no significant difference between groups. The oxygen saturation and maternal attachment difference between the Yakson and the GHT group were not significant. Significant differences in the average daily increase of oral intake and apical pulse rate were observed between the Yakson group and GHT group.

These data suggested that Yakson therapy may be an effective nursing intervention which can facilitate growth and physical response of preterm infants.

The purpose of this study was to evaluate the premature infants' responses to infant massage (tactile and kinesthetic stimulation). These responses measured by weight, physiological (vagal tone, heart rate, oxygen saturation) and behavioral responses (behavioral states, motor activities, and behavioral distress).

This study was conducted using an equivalent control pretest-posttest design. The sample was divided into two groups of 13 infants with gestational age less than 36 weeks at birth, birth weight less than 2000g, and no congenital anomalies. The experimental group received the massage intervention twice daily for 10 days. The data were collected for 10 minutes prior to and 10 minutes after the massage.

The vagal tone was significantly higher after massage than before massage in the experimental group, while no change in the control group. The experimental group had significantly higher scores for awake state and motor activity than the control group. Significantly greater awake state, more fidgeting or crying, and increased motor activity were reported after massage than before massage.

The results of this study showed that massage therapy might enhance optimal physiological responses and behavioral organization of premature infants. Nursing staff in the NICU can use massage to promote the infant's capability to respond positively to his environment and to provide developmental support for healthy premature infants.

Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP.

In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP.

A significant difference was identified among the mean scores in CRIES(F_{(2, 91)}=47.847, p=.000), FLACC(F_{(2, 91)}=41.249, p=.000) and PIPP(F_{(2, 91)}=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC.

The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

The main purpose of this study was to establish a nursing intervention data base to improve maternal attachment.

The first group of mothers(control group), experienced their first physical contact with their infants after being discharged from the hospital. The second group (experimental group) practiced early initial mother-infant postpartum contact known as the most sensitive period for founding maternal-infancy attachment. The subjects of this study gave birth to normal infants at M hospital from Aug.25 to Sept.30, 2004. During the same time, data was collected through direct observation, with instruments designed by Cropley et al., to assess the behaviors of normal attachment. The statistical methods for data analysis were percentage, mean, standard deviation and t-test with an SPSS program.

The group practicing initial mother-infant contact, showed a higher degree of physical and functional bonding than the group experiencing the first contact after discharge from the hospital (control group)(p<.01). The group practicing initial mother-infant contact, showed higher degrees of bonding attachment assessments than the group experiencing their first initial contact after their discharge from the hospital(p<.01).

The group practicing early mother-infant contact, showed more maternal-infant interaction than the group experiencing their initial contact after their discharge from the hospital. These results show that maternal attachment behavior increases according with an early initial mother-infant contact.

This study was performed to investigate the quantities of three neo-maternal exposures; visiting frequency, auditory contact and physical contact, and to examine the relationship between the quantities of each exposure and maternal attachment, maternal self-esteem and postpartum depression in 40 mothers of NICU babies during the first week in the NICU.

Each neo-maternal exposure was counted at every mother's visit to the newborn and maternal attachment, maternal self-esteem and postpartum depression were measured using the maternal attachment inventory, the maternal self-report inventory and Edinburgh Postpartum Depression Scale (EPDS) on the first and seventh day in the NICU.

The Mean of each neo-maternal exposure was 8.77(2.81) for the visiting frequency, 5.82(3.66) for the auditory contact and 5.60(2.89) for the physical contact during 7 days in the NICU. No significant changes were found in the scores of maternal attachment, maternal self-esteem and postpartum depression between the first and the seventh day in the NICU. The quantities of neo-maternal exposures were positively related to the scores of maternal attachment and maternal self-esteem but not related to postpartum depression.

The results of the study suggest the lack of early neo-maternal exposure in cases of NICU hospitalization negate its beneficial effects on maternal psychological well-being in increasing maternal attachment and self-esteem. More efforts are neededfor the neo-maternal interaction and the reevaluation of NICU visitation hours in order to promote maternal-infant interaction.

The purpose of this study was to develop a health education program for child care workers of infants, toddlers and preschoolers to improve their care ability. The program provided child care teachers and children with information on how to take care of their health.

This program development was based on a systematic design of instruction by Dick & Carey(1996). The process included a review of literature, setting an instructional goal, getting advice from various experts, designing instruction and instructional medias, designing formative evaluation, revising the program and making a summative evaluations.

The products of this program were the ‘ Teachers Guide Book & CD-ROM.” The guide book included health education programs for infants, toddlers and preschoolers. The infant program included a basic baby care program for teachers. The toddlers and preschoolers program included basic health promotion, dental health, nutrition management, communicable disease prevention, substance abuse prevention and a safety program.

These programs provided a systematic content of health education for children andtheir teachers, and useful data which can be applied to child care centers.

This study was aimed at finding the effects of cycled lighting on body weight, physiological variables and the behavioral state of LBWI (low birth weight infants) in the NICU.

The subjects were 20 LBWI at 2 NICUs. They were assigned to an experimental or control group which consisted of 10 subjects in each. Cycled light was applied to the experimental group for 10 days.

It was certified that the application of cycled lighting resulted in increased body weight and O₂ saturation, and decreased heart rate of the LBWI. However, there was no effect in decrease of respiration and stabilization of the behavioral state.

The application of cycled lighting might be a nursing intervention which would in turn have positive effects on the growth of LBWI.

A quasi-experimental study was performed to investigate the effects of a home visiting discharge education program on the maternal self-esteem, attachment, postpartum depression and family function in 35 mothers of neonatal intensive care unit (NICU) infants.

Twenty-three mothers in the intervention group received the home visiting discharge education while 12 mothers in the control group received the routine, hospital discharge education. Baseline data was collected in both groups one day after delivery. The intervention group received the home visiting discharge education while the control group did the routine hospital-based discharge education. The questionnaire including the data on maternal self-esteem, attachment, postpartum depression and family function were collected within 1week after the discharge by mail.

The scores of maternal self-esteem, and attachment were significantly increased, and the postpartum depression and the family function score were decreased after the home visiting discharge education in intervention group. There were no changes in these variables before and after the routine hospital-based discharge education in control group.

These results support the beneficial effects of home visiting discharge education on the maternal role adaptation and family function of the mothers of NICU infants.

This research was conducted to evaluate the effects of asystemic follow-up care program on health promotion and risk reduction in 64 high-risk infants(HRI) including premature infants and their mothers.

The intervention consisted of systemic NICU education, tele-counseling and 3 home visits in 6 months. The subjects were divided into either the intervention group or the control group receiving the conventional education without the tele-counseling and home visiting. Infant health promotion was measured using physical assessment, types of health problems, reflexes, OPD visiting history, DDST, immunization, feeding assessment, Infant death rate, etc. Maternal self-esteem, postpartum depression and family function were measured using the maternal self-report inventory(MRI), EPDS, and family apgar score(Fapgar), retrospectively.

All premature infants in the intervention group were in the normal range of growth and development, and the regular vaccination schedule. The health problems in the intervention group were addressed early so not to develop into adverse effects. The follow-up program for 6 months showed beneficial effects on MRI, EPDS, and Fapgar.

A systemic follow-up health care program is beneficial on health promotion and risk reduction in 64 HRI including premature infants and their mothers.

The purpose of this study was to identify the effectiveness of sensory stimulation program administered by primipara on the physical growth and mother-infant feeding interaction for the first 6 months of infancy.

Data were collected from December 1, 2001 to June 30, 2003. A total of 35 mothers and their infants were assigned to a control(n=17) and an experimental(n=18) group. Mothers in the experimental group received education related to sensory stimulation program and administered to their infants twice a day for 6 months. Both groups were measured the weight, length, head circumference and chest circumference of infants at 6 weeks, 10 weeks, 14 weeks, 18 weeks, and 22 weeks and the mother-infant feeding interaction at 6 weeks, 10 weeks through the home visiting.

Compared to the control group, the experimental group had significantly larger increases in head circumference for intervention period. In addition to, the experimental group showed significantly higher score in mother-infant interaction than control group.

These data suggested that sensory stimulation program administered by primipara may improve the physical growth of full term infant and mother-infant feeding interaction.

The purpose of this study is to identify the influencing factors of mother-infant attachment and construct a descriptive model that explains mother-infant attachment during the early postpartum period.

The hypothetical model of this study consisted of 8 variables with 23 constructed paths. The subjects of this study were 152 postpartum women. Data was analyzed to test the hypothetical model using covariance structure analysis.

The final model which is modified from the hypothetical model improved to Chi-Square 41.92, GFI .95, AGFI .89, RMSR .02, RMSEA .06, NFI .94, and NNFI .95. Mother-infant attachment during the early postpartum period was proven to be influenced directly by neonatal perception, maternal sensitivity, and maternal-fetal attachment and also indirectly by social support, maternal-fetal attachment and maternal identity. These variables accounted for 32% of the variance of the mother-infant attachment during the early postpartum period.

It is necessary that the nurses provide postpartum women with an intervention using social support for improving maternal identity and alleviating maternal role strain. It can be helpful to improve maternal sensitivity and in the end it will facilitate the mother-infant attachment during postpartum period.

The main purpose of this study was to identify the correlation between the child rearing attitudes and the maternal role strain of mother with infants.

This study is designed as a descriptive research study and the data was collected from 82 mothers and infants by means of an interview and questionnaire in a period from July 2002 to December 2002, when they came to screen their infant's growth and developmental state at a public health center.

The results of this study were as follows : There was a significant positive correlation between the child rearing attitudes and maternal role strain(r.= .53, p= .000). There was a significant difference between the father's employment state and child rearing attitude of mothers(t.=5.22, p<.000). There was a significant difference between male infant and female infants in maternal role strain(t.=3.8, p=0.04).

When the child rearing attitude was positive, the subject's maternal role strain was high. Also further research is needed on social support or other factors in the subjects in child-rearing attitudes and maternal role strain.

The study investigates the degree of maternal self-esteem, postpartal depression, and family function in mothers of normal and of low birth-weight infants.

A retrospective cohort design was applied to compare the variables of interest between a group of 73 mothers with normal birth weight infants and a group of 45 mothers with low birth-weight infants, using the maternal self-report inventory(MSRV), Edinburgh Postnatal Depression Scale(EPDS) and Family APGAR(FAPGAR).

The total mean score was 82.57 for MSRV, 8.45 for EPDS, and 6.83 for FAPGAR with no differences between two groups. A positive correlation was found between MSRV and FAPGAR, while a negative correlations between MSRV and EPDS, and FAPGAR and EPDS. Regardless of the direction of the relationship, the degrees of the correlations were stronger in low birth-weight mothers group than in normal group.

No differences in MSRV, EPDS and FAPGAR between the normal and the low birth-weight group considered as beneficial effects of the follow-up management which low birth-weight group was engaged in. This suggested the early intervention(follow-up) for the family with risk factor(low birth-weight) could reduce negative outcomes such as the impaired maternal self-esteem and family function, and the occurrence of postpartal depression, retrospectively.

To examine the effects of body position and time after feeding on gastric residuals in low birth weight infants(LBW).

A repeated measures design was conducted. Twenty LBW infants being fed via indwelling nasogastric tubes were randomly assigned to one of 5 different position orderings. In each position, gastric residuals were measured at 30, 60, 90, 120, 150, and 180 minutes after feeding.

In comparisons of gastric residuals with position and time, the main effects of position and time were statistically significant (F = 5.038, p = 0.001; F = 429.763, p < 0.001, respectively), but the interaction between position and time was found not to be significant. In pairwise comparisons, the gastric residuals were more reduced in the right anterior oblique and prone positions compared with the left lateral position (P < 0.05) and the differences across time periods were significant (p < 0.001).

The body position after feeding has a significant affect on gastric residuals over time in LBW infants. The right anterior oblique or prone position is recommended rather than left lateral position after feeding. Knowledge of the proper position and the pattern of gastric emptying over time after feeding may lead to the development of evidence-based nursing care.