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.

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.

This study was designed to determine the predictors of postpartum depression.

One hundred- sixty one women within one year after delivery from one public health center located in the northern area of Seoul were used in this study. The instruments were a survey of general characteristics, the Edinburgh Postnatal Depression Scale, recent life events index, perceived social support from family, Quality of marriage index, parenting stress index, and Rosenberg's self-esteem inventory. Data was analysed using descriptive statistics, Pearson correlation coefficients, and logistic regression.

The average item score of the EPDS was 6.67. 12.4% of respondents, who scored above a threshold 12, were likely to be suffering from a depression of varying severity. The fitness of the model for explaining postpartum depression from six variables, plan for pregnancy, family support, quality of marital relation, perceived social support, life events, childcare stress, and self-esteem, was statistically significant and the predictive power of these variables was 90.9%. The significant predictors of postpartum depression were family support and child care stress.

Further research is needed to identify the prevalence rate of postpartum depression using more reliable sampling methods from a large general population. Nursing interventions need to be developed for promoting family support and reducing childcare stress.

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.

This study was conducted to develop a customized birth control program and identify its effects on attitude, subjective norm, behavioral control, intention, and behavior of contraception among immigrant postpartum mothers.

In this experimental study, Vietnamese, Filipino or Cambodian married immigrant postpartum mothers were recruited. They were assigned to the experiment group (n=21) or control group (n=21). The customized birth control program was provided to the experimental group for 4 weeks.

The experimental group showed a significant increase in the score of attitude, subjective norm, behavioral control, intention, and behavior of contraception.

Findings in this study indicate that the customized postpartum birth control program, a systematic and integrative intervention program composed of customized health education, counseling and telephone monitoring, is able to provide effective planning for postpartum health promotion and birth control behavior practice in married immigrant women.

To identify the effects of foot reflexology massage on fatigue, stress and depression of postpartum women.

A nonequivalent control group pre-post design was used. A total of 70 women in a postpartum care center were recruited and were assigned to the experimental group (35) or control group (35). Foot reflexology massage was provided to the experimental group once a day for three days. Data were collected before and after the intervention program which was carried out from December, 2013 to February, 2014. Data were analyzed using Chi-square test, Fisher's exact test, and t-test.

The level of fatigue in the experimental group was significantly lower than the control group (t= - 2.74, p =.008). The level of cortisol in the urine of women in the experimental group was significantly lower than the control group (t= - 2.19, p =.032). The level of depression in the experimental group was significantly lower than the control group (t= - 3.00, p =.004).

The results show that the foot reflexology massage is an effective nursing intervention to relieve fatigue, stress, and depression for postpartum women.

This study was done to develop a prediction model for postpartum depression by verifying the mediation effect of antepartum depression. A hypothesized model was developed based on literature reviews and predictors of postpartum depression by Beck.

Data were collected from 186 pregnant women who had a gestation period of more than 32 weeks and were patients at a maternity hospital, two obstetrics and gynecology specialized hospitals, or the outpatient clinic of K medical center. Data were analysed with descriptive statistics, correlation and exploratory factor analysis using the SPSS/WIN 18.0 and AMOS 18.0 programs.

The final modified model had good fit indices. Parenting stress, antepartum depression and postpartum family support had statistically significant effects on postpartum depression, and defined 74.7% of total explained variance of postpartum depression. Antepartum depression had significant mediation effects on postpartum depression from stress in pregnancy and self-esteem.

The results of this study suggest that it is important to develop nursing interventions including strategies to reduce parenting stress and improve postpartum family support in order to prevent postpartum depression. Especially, it is necessary to detect and treat antepartum depression early to prevent postpartum depression as antepartum depression can affect postpartum depression by mediating antepartum factors.

This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression.

Participants were 215 women who answered a self-administered questionnaire which included demographics, Postpartum Depression Predictors Inventory-Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression.

Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (κ=.55-.95). Postpartum depression rates were 36.3% and 36.7% at two follow-up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR=4.32, 95% CI: 1.41-13.19; OR=5.19, 95% CI: 1.41-19.08), social support (OR=1.40, 95% CI: 1.18-1.66; OR=1.27, 95% CI: 1.06-1.53) and maternity blues (OR=4.75, 95% CI: 1.89-11.98; OR=4.22, 95% CI: 1.60-11.12) were commonly associated with postpartum depression at two follow-up points. Child care stress (OR=1.85, 95% CI: 1.01-3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR=1.57, 95% CI: 1.09-2.27) was only associated with postpartum depression at 6 weeks postpartum.

The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.

The purpose of this study was to identify influence of childbirth experience and postpartum depression on quality of life in women after birth.

Two hundred and eleven postpartum women were asked to complete the questionnaires on their childbirth experience during their admission and on their postpartum depression and quality of life between one to three weeks after birth. Initial data were collected from February 1 to May 30, 2011 at two obstetric hospitals in Busan, Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression.

The women's childbirth experience and postpartum depression were identified as factors influencing quality of life after birth. The model explained 50% of the variables.

Results suggest that childbirth educators should include strategies to increase a positive childbirth experience and to decrease postpartum depression in their education programs in order to improve women's quality of life.

Mothers' postpartum depression is a worldwide health concern that produces compromising effects on their infants. This study was conducted to compare the infants' temperament and health problems according to the presence of maternal postpartum depression.

Data were collected from May to October in 2009. The sample was 137 mothers at one month postpartum. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess depressive symptoms.

At one month postpartum, 22.6% of mothers were classified as having postpartum depression. Infants of depressed mothers were more frequently classified as difficult temperament infants. They showed lower scores on the amenability, rhythmicity and persistency and higher scores on activity in temperament. Also, infants of depressed mothers reported more infant health problems at one months. Maternal depression showed significant negative correlations with family functioning, social support and marital satisfaction.

Study findings show that postpartum maternal depression is associated with infants' temperament and health, and thus screening and early interventions for postpartum depression would promote the health of both the mother and infant.

The purpose of this study was to examine the effects of laughter therapy on postpartum fatigue and stress respon-ses of postpartum women.

The research design was a nonequivalent control group non-synchronized design. The participants were 67 postpartum women who agreed to participate in this study, selected by convenience sampling: (experiment group-33 and control group-34). The data were collected from August 5 to September 30, 2010. The experimental group received laughter therapy from a laughter therapy expert for 60 min, twice a week for 2 weeks, a total of 4 sessions. To evaluate the effects of laughter therapy, postpartum fatigue by self-report questionnaire and cortisol concentration in breast milk were measured. The data were analyzed using the SPSS WIN 13.0 Program.

The first hypothesis that "the degree of postpartum fatigue in the experimental group participating in laughter therapy would be lower than that of the control group" was accepted. These findings indicate that laughter therapy has a positive effect on decreasing postpartum fatigue.

The finding provides evidence for use of complementary and alternative nursing in Sanhujori facilities and obstetric units to reduce postpartum women's fatigue.

The purpose of this study was to determine the effects of music therapy on postpartum blues and maternal attachment of puerperal women.

The research design was a nonequivalent control group non-synchronized design. The participants were puerperal women who agreed to participate in this study and through a convenience sampling, 60 puerperal women were recruited (30 in the experimental group, 30 in the control group). After measuring postpartum blues and maternal attachment, music therapy was provided to the experimental group over 40 min, once a day, and for 8 days. Then, postpartum blues and maternal attachment for the experimental and control group were measured again on the 8th day. The data were analyzed using the SPSS WIN 12.0 Program.

The first hypothesis that "the degree of postpartum blues for the experimental group who participated in music therapy would be lower than that of the control group" was accepted (t=4.350, p<.001). The second hypothesis that "the degree of maternal attachment of the experimental group who participated in music therapy would be higher than that of the control group" was accepted (t=4.828, p<.001).

These findings indicate that music therapy has positive influences on decreasing postpartum blues and increasing maternal attachment of puerperal women.