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Original Articles
The Effects of Kangaroo Care on Body Weight, Physiologic Responses and Behavioral States in Premature Infants
Hyun Young Koo
Journal of Korean Academy of Nursing 2000;30(1):171-182.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.1.171
AbstractAbstract PDF

This study was performed to investigate the effect of kangaroo care on body weight, physiological responses and behavioral states in premature infants. The subjects were 32 premature infants, fifteen for the kangaroo care group and seventeen for the control group, who hospitalized in a neonatal intensive care unit at a university-affiliated hospital. The kangaroo care was applied 8 times during the twenty five days with 40 minutes for each session. The kangaroo care provides the skin-to-skin contact during which a premature infant wearing a diaper and a hat is placed on its mother's chest. As for the measures, body weight was measured everyday. The levels of epinephrine, norepinephrine and 17-OHCS were measured twice, before beginning the first intervention and after finishing the last intervention. While each session of the care is undergoing, such physiological responses were measured periodically as heart rate, respiration rate, oxygen saturation, core temperature and skin temperature. The results were as follows : 1. The weight gain was significantly greater in the kangaroo care group than that in the control group during the period of performing the kangaroo care. 2. No significant difference was revealed between the two groups in heart rate, respiration rate, oxygen saturation and core temperature. The kangaroo care group also showed significant increases in the skin temperature. 3. The differences in the levels of epinephrine, norepinephrine and 17-OHCS were not significant between the kangaroo care and the control groups. The level of norepinephrine in the two groups was significantly increased over time. 4. Sleep pattern changed significantly in the kangaroo group from a very restless sleep to a very quiet sleep. These results suggest that kangaroo care is an effective nursing intervention for premature infants in gaining weight, achieving stable physiological responses and facilitating a quiet sleep.

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Effects of a Sensory Stimulation on Weight, Stress Hormone and Behavioral State in Premature Infants
Kun Ja Lee
Journal of Korean Academy of Nursing 1999;29(2):445-455.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.2.445
AbstractAbstract PDF

This study has been conducted on the nonequivalent control group pretest-posttest design in quasi experimental basis and newly born premature infants from intensive care unit of G Medical University Hospital in Inchon Metropolitan were selected in two groups of 21 infants each. The first group for experimental and the other for control. Data has been collected form October 30, 1997 to August 29, 1998. For the experimental group tactile and kinesthetic stimulation was applied 2 times a day for 10 days(10:00~11:00 hours in the morning and 17:00~18:00 in the afternoon). As a weight weighing instrument, electronic indicator scale(Cas Co, Korea) was used. To determine urine cortisol concentration level in stress hormone, radio immuno assay method was used. And high performance liquid chlomatogarphy was used to determine urine norepinephrine, concentration level. To determine behavior status, tools developed by anderson et al(1990) and remodeled by Kim Hee-Sook(1996) were used. Collected data were analyzed with the SAS program using x2-test, student t-test, repeated measures ANOVA and paired t-test. The result were as follow. 1. As for the daily weight gain, the experimental group showed first change in weight and this group also showed higher weight in the average weight than the control group. Statistically, however, there was no significant factor between the two groups. 2. The cortisol concentration in urine showed decrease in the experimental group norepinephrine concentration in urine showed increase in both experimental and control groups. No statistical significance was shown between the two groups. 3. In the aspect of behavior status, the experimental group showed statistical significance by showing inactive in the state of alert and conversion to a positive state than the control group. In conclusion, the sensory stimulation in this study showed a positive aspect through there was no statistical significance n the weight gain and urine stress hormone concentration. In the behavior status, there was statistical significance in the frequency of staying inactive in the state of alert and conversion to a positive state.

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Yakson vs. GHT Therapy Effects on Growth and Physical Response of Preterm Infants and on Maternal Attachment
Hye Sang Im
Journal of Korean Academy of Nursing 2006;36(2):255-264.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.2.255
AbstractAbstract PDF
Purpose

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.

Method

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.

Result

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.

Conclusion

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

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The Effects of a Home-Visiting Discharge Education on Maternal Self-esteem, Maternal Attachment, Postpartum Depression and Family Function in the Mothers of NICU Infants
Young Mee Ahn, Mi Ran Kim
Journal of Korean Academy of Nursing 2004;34(8):1468-1476.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1468
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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The Effects of the Systemic Follow up Health Care Program on the Health Promotion and the Risk Reduction in Premature Infants and Their Mothers
Young Mee Ahn
Journal of Korean Academy of Nursing 2004;34(6):1129-1142.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.6.1129
AbstractAbstract PDF
Purpose

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.

Method

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.

Result

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.

Conclusion

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

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Comparison of Maternal Self-esteem, Postpartal Depression, and Family Function in Mothers of Normal and of Low Birth-weight Infants
Young Mee Ahn, Jung Hyun Kim
Journal of Korean Academy of Nursing 2003;33(5):580-590.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.5.580
AbstractAbstract PDF
Purpose

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

Method

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).

Result

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.

Conclusion

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.

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Review Article
An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group
Dasom Kim, Insook Lee
J Korean Acad Nurs 2017;47(5):577-588.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.5.577
AbstractAbstract PDF
Abstract Purpose

This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review.

Methods

We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers.

Results

Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach.

Conclusion

As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

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Original Articles
Effects of a Hospital Based Follow-Up Program for Mothers with Very Low Birth Weight Infants
Min Hee Kim, Eun Sun Ji
J Korean Acad Nurs 2016;46(1):79-89.   Published online February 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.1.79
AbstractAbstract PDF
Purpose

This paper reports the results of a hospital centered follow-up program on parenting stress, parenting efficacy and coping for mothers with very low birth weight (VLBW) infants.

Methods

The follow-up program consisted of home visiting by an expert group and self-help program for 1 year. A non-equivalent control group pre-post quasi-experimental design was used. Participants were 70 mothers with low birth weight infants and were assigned to one of two groups, an experimental groups (n=28), which received the family support program; and a control group (n=27), which received the usual discharge education. Data were analyzed using χ2-test, t-test, and ANCOVA with IBM SPSS statistics 20.0.

Results

Mothers' parenting stress (F=5.66, p=.004) was significantly decreased in the experimental group. There were also significant increases in parenting efficacy (F=13.05, p<.001) and coping (F=8.91, p=.002) in the experimental group.

Conclusion

The study findings suggest that a follow-up program for mothers with VLBW infants is an effective intervention to decrease mothers' parenting stress and to enhance parenting efficacy and coping.

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Growth Patterns of Premature Infants Up to 40th Term Week of Corrected Age
Youngmee Ahn, Min Sohn, Sangmi Lee
J Korean Acad Nurs 2011;41(5):613-622.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.613
AbstractAbstract PDF
Purpose

Study purpose were to describe growth patterns of premature infants in weight, length and head circumference from birth to 40th week of corrected ages (CA) and to explore factors affecting patterns.

Methods

A longitudinal descriptive study was conducted with 267 premature infants. They were categorized into 2 groups; GA group with measurements at birth and the CA group with measurements at CA, which was categorized into 3 groups (group 1-3) by WHO guideline for gestational age (GA) at birth.

Results

GA group presented greater measures in all than CA group at same week of life. Among CA groups, group 3 showed the highest measurements, up to 37 weeks of life, though this disappeared at 38-40 weeks. Reversely, group 1 revealed the highest growth rates in all measures, followed by group 2 and group 3. Significant interaction was observed in all measures between week of life and any type of groups.

Conclusion

Higher measures in GA group, as well group 3 among CA groups, supported the superiority of intra-uterine environment overriding quality of regimen from NICU. Regardless of growth acceleration, smaller infants remain smaller, indicating that intra-uterine thrifty phenotype may continue at least up to the 40th week of CA.

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