Journal of Korean Academy of Nursing

Effect of Direct Breastfeeding Program for Premature Infants in Neonatal Intensive Care Unit: Kang, Ji Hyun , Son, Hyunmi , Byun, Shin Yun , Han, Gyumin; J Korean Acad Nurs 2021;51(1):119-132. Published online February 28, 2021; DOI: https://doi.org/10.4040/jkan.20240

Abstract PDF: Purpose
This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs).
Methods
This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ² -test and repeated measures ANOVA using an SPSS program.
Results
The experimental group showed a higher direct breastfeeding practice rate (χ² = 19.29, p < .001), breastfeeding continuation rate (χ² = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment.
Conclusion
The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.

Pain Assessment using CRIES, FLACC and PIPP in High-Risk Infants: Youngmee Ahn, Heeok Kang, Eunjin Shin; Journal of Korean Academy of Nursing 2005;35(7):1401-1409. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.7.1401

Abstract PDF: Purpose
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.
Method
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.
Results
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.
Conclusions
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.

Evaluation of Mental Status in High-Risk Neonates using Infants Coma Scale: Young-Mee Ahn, Min Sohn, Sang-Mi Lee; J Korean Acad Nurs 2010;40(4):561-570. Published online August 31, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.4.561

Abstract PDF: Purpose
This was a cross sectional descriptive study to introduce the Infants Coma Scale (ICS), describe mental status of high risk infants using ICS and explore the relationships between ICS and clinical variables in infants hospitalized in a neonatal intensive care unit of a university hospital in Korea.
Methods
After ICS was developed and tested by the authors, a research nurse evaluated the mental status of the infants using the English version of ICS and obtained clinical information on the infants from their medical records.
Results
Data from 88 infants were analyzed. About 60% were male, 90% were preterm births, and 40% had pathologic abnormalities. Their mean gestational age was 32.4 (±3.50) weeks and the mean birth weight was 1,842 (±728.6) grams. The Cronbach's alpha for the ICS was .78. There was a statistically significant positive correlation between ICS total score and five clinical variables including gestational age, birth weight, 1 and 5 min Apgar scores and respiration status.
Conclusion
Mental status is an important parameter in nursing assessment. ICS is a valid and reliable instrument, which clinicians can easily use to evaluate the mental status of high risk infants.

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