PURPOSE: This study tries to explore mothers' stress patterns and the related factors influencing mothers' stress over time after giving birth to premature babies. METHOD: Eighty four mothers who had given birth to premature babies were selected from Hospitals in B city. Data was collected using a self-reporting questionnaire that the mothers' stress level. RESULT: The mothers' stress after giving birth to premature babies gradually diminished and the stress pattern of mothers changed over time. Mother's age, occupation, income level, gestational period of the measures baby, weight at birth, nutrition type, lactation mode, number of complications, and existence or non-existence of an operation were analyzed as the factors that affected the mother's stress. CONCLUSION: The stress pattern of mothers giving birth to premature babies changed overtime. Based on the study results, it is considered that the nursing intervention programs should be developed in order to reduce the stress of premature baby's mothers with time elapse.
Adult ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Mothers/*psychology ; Pregnancy ; Premature Birth/*psychology ; Stress, Psychological/*etiology ; Time Factors

PURPOSE: This study was done to identify the parenting experience of mothers of premature infants in order to provide basic data for educational solutions and desirable directions. METHODS: Q-methodology was used as it provides a method of analyzing the subjectivity of each item. The participants were 33 mothers of premature infants who sorted 34 selected Q-statements which were then classified into the shape of a normal distribution using a 9-point scale. Subjectivity on parenting experience among the mothers was analyzed using the pc-QUANAL program. RESULTS: Four types of parenting experience were identified. Type I was named 'struggling', type II, 'self blame', type III, 'information collecting', and type IV, 'self-introspection'. CONCLUSION: The results of this study indicate that different approaches to educational programs are needed for mothers of premature infants based on the four types of parenting experience.
Adult ; Demography ; Female ; Humans ; Infant, Newborn ; *Infant, Premature ; Interviews as Topic ; Mothers/*psychology ; *Parenting ; Q-Sort ; Questionnaires

MRI (magnetic resonance imaging ) had been the most up-to-dated modality in evaluating white matter disease in recent years, whereas US (ultrasonogram) has been used extensively in diagnosis of neonatal PVL(periventricular leukomalacia) conventionally. We evaluated the diagnostic value of MRI by reviewing the MR findings and correlation of MR and US of PVL in II preterm infants. Evaluation criteria were MR signal intensity and discrimination of PVL on each pulse sequences land comparision between MR and US findings performed simultaneously, on the extent of PVL, size of the largest cyst and detectability of hemorrhagic lesion. MR findings of 11 cases of PVL were of low signal patterns on T1WI (T1weighted image) in 7, low signal patterns of PDWI (proton density weighted image) in 9, iso signal patterns on T2WI(T2weighted image) in 8 and low signal patterns on STIR(short time inversion recovery) in 7 cases. The lesions of 11 PVL were well discriminated in all 11 cases of T1WI, 7 cases of STR, 5 case of PDWE and 2 cases of T2WI. The lateral ventricle was diffuse dilated (n=1) and focally dilated (n=3) in atrial area. In the comparative study, MR presented more extensive lesions in 7 cases, larger cysts in 6 cases out of 7 PVL and more definitive hemorrhage in 3 cases out of 4 cases than sonography. In conclusion MR was more valuable than sonography in evaluating the extent of lesions, size of the largest cystic lesion and detetion of hemorrhage. TIWI and STIR images were more useful in detection of PVL than T2WI and PDWI.
Diagnosis ; Discrimination (Psychology) ; Hemorrhage ; Humans ; Infant, Newborn ; Infant, Premature ; Lateral Ventricles ; Leukoencephalopathies ; Magnetic Resonance Imaging

PURPOSE: This study was to investigate the effects of non-nutritive sucking on physiological and behavioral state of pre-term infants during tube feeding. METHOD: This nonequivalent, non-synchronized experimental study included 50 pre-term infants. An attempt was made to match gestational age and birth weight of infants in each group. Infants in the experimental group were given a pacifier 2 minutes before, during, and for 2 minutes after tube feeding. Infants in the control group did not get a pacifier. Both groups were tested at three stages for changes in the physiologic state and behavioral state-2 minutes before, during, and 2 minutes after feeding. Date was analyzed with SPSS WIN 10.0 using an chi-square-test, t-test, and repeated measures ANOVA. RESULT: Heart rates and oxygen saturation levels of the two groups were significantly different(P=.001, P=.000). The behavioral states of the two groups were significantly different during and post feeding(P=.000, P=.000). CONCLUSION: This result suggests non-nutritive sucking by using a pacifier is an effective intervention for pre-term infants during tube feeding.
*Enteral Nutrition ; Female ; Heart Rate ; Humans ; Infant ; Infant Behavior/*physiology/psychology ; Infant Care ; Infant, Newborn ; Infant, Premature/*physiology/psychology ; Male ; Oxygen Consumption ; *Pacifiers

PURPOSE: The purpose of this study was to examine the effects of Kangaroo Care(KC) on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants. METHODS: The research design was a nonequivalent control group pretest-posttest. Data was collected from September 1. 2006 to June 20. 2007. The participants were 22 mothers in the experimental group and 21 in the control group. KC was applied three times per day, for a total of ten times in 4 days to the experimental group. RESULTS: The degree of anxiety was statistically significantly different between the two groups but maternal role confidence and maternal infant attachment was statistically insignificant. CONCLUSION: This data suggests that KC was effective for mothers anxiety relief but it was not effective for maternal role confidence and maternal infant attachment of mothers. The implications for nursing practice and directions for future research need to be discussed.
Adult ; *Anxiety ; Female ; Humans ; Infant Care/*methods ; Infant, Newborn ; Infant, Premature/*psychology ; Maternal Behavior/psychology ; Mother-Child Relations ; Mothers/*psychology ; Neonatal Nursing

PURPOSE: This study was designed to explore the relationship of situational meaning with maternal self-esteem in mothers with high risk newborn. METHOD: The subjects of this study were 82 mothers with high risk newborn. Data were collected using a translated Family Meaning Attribution Scale and Maternal Self-Report Inventory. Data were analyzed using descriptive statistics, t-test, Pearson Correlation Coefficients and Stepwise Multiple Regression. RESULT: The average score of the situational meaning in high risk newborn mothers was 64.01(possible score is between 0-96) and the average score of each item was 1.98. The average score of the maternal self-esteem in high risk newborn mothers was 81.96(possible score is between 26-104) and the average score of each item was 3.15. No significant differences were found in situational meaning according to general characteristics except whether it was a planned pregnancy or not. No significant differences were found in maternal self-esteem according to general characteristics except disease or admission experience during pregnancy. There was significant positive correlation between situational meaning and maternal self-esteem. CONCLUSION: It is necessary for nurses to provide high risk newborn mothers with care for improving situational meaning that is attributed to the mothers. It can be helpful to improve maternal self-esteem and in the end it will facilitate the maternal transition in mothers with high risk newborn.
Adult ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/*psychology ; *Infant, Premature ; *Maternal-Child Nursing ; Mothers/*psychology ; Pregnancy ; *Self Concept ; Socioeconomic Factors

PURPOSE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
*Weight Gain ; Stress/physiopathology/prevention & control ; *Massage/psychology ; Male ; Infant, Premature/*physiology/*psychology ; Infant, Newborn ; *Infant Behavior ; Humans ; Female ; Autonomic Nervous System/physiology ; Analysis of Variance

PURPOSE: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. METHODS: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. RESULTS: The mean gestational age and birth weight (BW) of all infants were 27(+)6+/-1(+6) weeks and 951+/-245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033+/-285 g vs. 821+/-126 g, P=0.048) and weight on operation day (1,195+/-404 g vs. 893+/-151 g, P=0.042), longer hospital days (105+/-29 vs. 141+/-39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative FiO2 (0.29+/-0.06 vs. 0.38+/-0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. CONCLUSION: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high FiO2 might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.
Birth Weight ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Ductus Arteriosus, Patent ; Gestational Age ; Hemodynamics ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Ligation ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sepsis

PURPOSE: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. METHODS: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. RESULTS: The mean gestational age and birth weight (BW) of all infants were 27(+)6+/-1(+6) weeks and 951+/-245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033+/-285 g vs. 821+/-126 g, P=0.048) and weight on operation day (1,195+/-404 g vs. 893+/-151 g, P=0.042), longer hospital days (105+/-29 vs. 141+/-39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative FiO2 (0.29+/-0.06 vs. 0.38+/-0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. CONCLUSION: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high FiO2 might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.
Birth Weight ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Ductus Arteriosus, Patent ; Gestational Age ; Hemodynamics ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Ligation ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sepsis

PURPOSE: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. METHODS: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. RESULTS: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. CONCLUSION: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.
Birth Weight ; Cause of Death ; Critical Period (Psychology) ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Parents ; Premature Birth ; Retrospective Studies ; Sepsis