PURPOSE: This study aimed to evaluate the effects of an empowerment program on maternal stress, anxiety, depression and parenting confidence. METHODS: A total of 44 mothers of preterm infants were assigned into an experimental or a control group (n=22 each). The experimental group received the usual nursing care and 7 sessions of an empowerment program. The control group only received the usual care. The program was implemented from June to December, 2016 in the neonatal intensive care unit of K university-affiliated hospital in Daegu, Korea. The outcome variables measured were parental stress (PSS: NICU), anxiety (STAI), depression (CES-D) and parenting confidence. Data were analyzed using t-test or repeated measures ANOVA. RESULTS: Scores for both parental stress (t=3.07 p=.004) and depression (F=3.76, p=.26) were significantly lower in the experimental group than in the control group. However, there were no significant differences in anxiety between the groups (F=0.79, p=.505). Parenting confidence scores (F=9.05, p=.001) were significantly higher in the experimental group than in the control group. CONCLUSION: A maternal empowerment program can be an effective means of reducing parental stress and depression as well as enhancing parenting confidence, for mothers of preterm infants.
Anxiety* ; Daegu ; Depression* ; Humans ; Infant, Newborn ; Infant, Premature* ; Intensive Care Units ; Intensive Care, Neonatal* ; Korea ; Mothers* ; Nursing Care ; Parenting* ; Parents* ; Power (Psychology)* ; Stress, Psychological

PURPOSE: The present survey was conducted to investigate the perceptions among nurses of neonatal pain and the associated use of pharmacologic measures (PMs) and nonpharmacologic comfort measures (CMs) in neonatal intensive care units (NICUs). Pain perception, the necessity and actual use of PMs and CMs, and their relationships were investigated and compared according to nurses' positions, educational levels, the existence of guidelines, and prior education on neonatal pain management. METHODS: Participants were 141 nurses from five NICUs at university hospitals. A questionnaire was developed by researchers based on previous studies of neonatal pain management and current practices in surveyed NICUs. Five-point Likert scales were used to assess nurses' perceptions of pain, the necessity of PMs and CMs, and their actual use in 29 painful procedures. RESULTS: The mean scores of perceived pain and the necessity of PMs and CMs were 3.68, 2.96, and 3.79 points, respectively. The actual use of PMs and CMs was 1.67 and 2.63 points, respectively. The perceived necessity of PMs correlated with the actual use of PMs (r = .316, p < .001), and CMs were performed (r = .390, p < .001). Keeping or reading guidelines, or receiving education on pain management resulted in a higher perception of the necessity of PMs. CONCLUSION: Korean nurses in NICUs often underestimate the necessity of pain relief measures and use few PMs or CMs. Therefore, systematic approaches to implement guidelines, such as adaptation of guidelines for each NICU, dissemination of guideline content to all NICU staff, and regular measurements of compliance with the guidelines, are recommended.
Adult ; *Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Humans ; Infant, Newborn ; *Intensive Care Units, Neonatal ; Intensive Care, Neonatal/*methods ; Nursing Staff, Hospital/*psychology ; Pain/nursing ; Pain Management/*methods/psychology/*utilization ; Questionnaires ; Republic of Korea ; Young Adult

PURPOSE: The purpose of this study was to identify the relationship among family stress, family meaning and family adaptation of families with high risk neonates. METHOD: The date was collected on the basis of self- report questionnaires (August 2004 to March 2005); Tow-hundred twelve parents, who had high risk neonates in C hospital's neonatal intensive care unit, participated on request. RESULTS: Family sense of coherence, family meaning, social support, family stress, marital communication and patient condition had a significant, direct effect on family adaptation. Family cohesion, religion, confidence in the health professional, and length of stay had a significant, direct effect on family meaning. CONCLUSION: The results of this study suggest the consequences associated with high risk neonates may be alleviated by a family support intervention designed to improve parental communication skills as well as to maintain family cohesiveness. Medical care could also encourage more emotional support of parents towards their neonate.
*Adaptation, Psychological ; Adult ; Family/*psychology ; Family Relations ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal/*psychology ; Male ; Parents/*psychology ; Predictive Value of Tests ; Questionnaires ; Social Support ; *Stress, Psychological

PURPOSE: 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. METHOD: 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. RESULT: 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. CONCLUSION: 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.
*Self Concept ; *Object Attachment ; Mothers/psychology ; *Mother-Child Relations ; Maternal Behavior ; *Intensive Care Units, Neonatal ; Infant, Newborn ; Humans ; Female ; Depression, Postpartum/*psychology ; Adult

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

PURPOSE: Ureaplasma colonization is related with perinatal complications in preterm infants. Little is known about the difference in virulence among various Ureaplasma urealyticum serovars. The aim of this study was to determine U. urealyticum serovars of preterm infants in order to assess whether any of the serovars were associated with bronchopulmonary dysplasia (BPD). METHODS: Three hundred forty-four preterm infants with a gestational age less than 34 weeks admitted to Gangnam Severance Hospital neonatal intensive care unit from July 2011 to December 2012 were included in this study. Tracheal and gastric aspirations were conducted on infants to confirm Ureaplasma colonization. Ureaplasma colonization was confirmed in 9% of infants, of these, serovars were determined by real-time polymerase chain reaction. RESULTS: A total of 31 infants (gestational age, 29.3+/-3.1 weeks; birth weight, 1,170+/-790 g) were U. urealyticum positive. The Ureaplasma positive group treated for more days with oxygen and ventilation than the negative group (P<0.05). Histologic chorioamnionitis and moderate to severe BPD were more frequent in the Ureaplasma positive group than in the negative group (P<0.05). U. urealyticum isolates were either found to be a mixture of multiple serovars (32%), serovar 9 alone or combined with other serovars (39%), serovar 11 (26%), 2 (13%), 8 (10%), 10 (13%), and 13 (25%). No individual serovars were significantly associated with moderate to severe BPD and chorioamnionitis. CONCLUSION: This is the first study to describe the distribution of U. urealyticum serovars from Korean preterm infants. Ureaplasma-colonized infants showed higher incidence of BPD and chorioamnionitis.
Aspirations (Psychology) ; Birth Weight ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Colon ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Oxygen ; Pregnancy ; Ureaplasma urealyticum* ; Ureaplasma* ; Ventilation ; Virulence

PURPOSE: The purpose of this study was to identify the effects of a workbook program on percieved stress levels, maternal role confidence and breastfeeding practices of mothers of premature infants. METHOD: This study employed a quasi-experimental non-equivalent pre-and-post test to compare the two groups. Data was collected from 32 subjects from March 10. to September 5, 2003 at an NICU located in S. city. In the sample, fifteen mothers were in the experimental group and seventeen were in the control group. A workbook program was provided twice during a period from two-three days after the baby's admission to one week after the first intervention. The instruments used were the PSS and self confidence scale. Data was analyzed by means of frequency, SD, x2-test, Fisher's exact test, Mann-Whitney test, and the Wilcoxon signed rank test. RESULT: There was a significant difference in perceived stress levels between the experimental and control group (U=2.366, p=.018). There was not a significant difference in maternal role confidence between the two groups (U=1.002, p=.316). There was a significant difference in breastfeeding practice between the two groups (X2= 4.910, p=.035). CONCLUSION: It is concluded that a program using a workbook has a positive effect on decreasing the perceived stress level and increasing breastfeeding practice.
Stress, Psychological/*prevention & control ; Mothers/*education ; *Maternal Behavior ; *Manuals ; Intensive Care Units, Neonatal ; *Infant, Premature ; Infant, Newborn ; Humans ; Female ; Breast Feeding/*psychology ; Adult

PURPOSE: We aimed to assess the influence of perinatal factors on intra-arterial mean blood pressures of very low birth weight infants during the first seven days of life and the association of intra-arterial mean blood pressures on the common morbidities and neonatal death of very low birth weight infants. METHODS: The retrospective study on intra-arterial mean blood pressures over the first seven days of life in 103 very low birth weight infants who admitted to the neonatal intensive care unit at the Dankook University Hospital from Jan. 1996 to Dec. 2000 was done. Trend data for each infants were assessed in 9 time periods until seven days of age. Perinatal factors that might influence intra-arterial mean blood pressures and the association of intra-arterial mean blood pressures on neonatal death and common morbidities were assessed. RESULTS: Intra-arterial mean blood pressures of very low birth weight infants increased with birth weight and gestational age (P<0.05), and significantly increased with postnatal age over the seven day periods from 35.0+/-4.9 mmHg (period 1) to 44.2+/-6.5 mmHg (period 9). Intra-arterial mean blood pressures of infants weighing less than 1,000 g were significantly lower than infants weighing 1,000 to 1,499 g at all each time periods (P< 0.05). Intra-arterial mean blood pressures were found to correlate significantly with antenatal steroid (P<0.005), and correlate inversely with PDA (P<0.001), pulmonary hemorrhage (P<0.005) and ROP (P<0.05). CONCLUSION: Intra-arterial mean blood pressures in very low birth weight infants during the first seven days were found to correlate significantly with postnatal age, gestational age, birth weight and antenatal steroid and probably correlate with some common morbidities of very low birth weight infants. It is therefore important to maintain adequate blood pressure ranges during the first seven days of life that are the most critical periods of illness for the majority of very low birth weight infants.
Birth Weight ; Blood Pressure* ; Critical Period (Psychology) ; Gestational Age ; Hemorrhage ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Retrospective Studies

PURPOSE: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo SET(R) was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor N-595(R) and Masimo SET(R)) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. METHODS: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2< or =85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. RESULTS: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo SET(R) pulse oximetry (48 in Nellcor N-595(R), 27 in Masimo SET(R)) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor N-595(R), 19 in Masimo SET(R)). CONCLUSION: The Masimo SET(R) pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor N-595(R) pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.
Anoxia ; Artifacts ; Body Weight ; Clinical Alarms ; Electrocardiography ; Enzyme Multiplied Immunoassay Technique ; Foot ; Handling (Psychology) ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Oximetry ; Oxygen

PURPOSE: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo SET(R) was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor N-595(R) and Masimo SET(R)) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. METHODS: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2< or =85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. RESULTS: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo SET(R) pulse oximetry (48 in Nellcor N-595(R), 27 in Masimo SET(R)) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor N-595(R), 19 in Masimo SET(R)). CONCLUSION: The Masimo SET(R) pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor N-595(R) pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.
Anoxia ; Artifacts ; Body Weight ; Clinical Alarms ; Electrocardiography ; Enzyme Multiplied Immunoassay Technique ; Foot ; Handling (Psychology) ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Oximetry ; Oxygen