In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U. S. PURPOSE: The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. METHODS: A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preterm infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation) of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas: the demographic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. RESULTS: 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Man birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of discharge from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurse for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specificaids to self regulation on the 3rd and 10th day after birth, and on the day discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge form the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical environment. and the stress responses of the infants in NICU. 8. The were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feeding was 31+5 weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. CONCLUSION: It, thus, appears that to minimize the senso-rymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preterm infant as the infants grow older in NICU.
Birth Weight ; Bottle Feeding ; Female ; Foot ; Gestational Age ; Humans ; Incubators ; Infant* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal* ; Korea ; Male ; Nursing Stations ; Oxygen ; Parturition ; Plastics ; Posture ; Pregnancy ; Self-Control ; Telephone ; United States* ; Ventilators, Mechanical ; Weight Gain ; Child Health

It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study. Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the mothers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommended that home health care will be one of the approach to support the mothers caretaking activities.
Breast ; Child ; Delivery of Health Care ; Early Intervention (Education) ; Education ; Hand ; Home Care Services ; Humans ; Infant ; Mothers* ; Nutritional Support ; Parenting ; Parents ; Risk Factors ; Child Health

A case of multiple myeloma associated with adenocarcinoma of the stomach was review. A 59-year, old Korean man had been abmitted to St. Mary's Hospital in January 1984, with chief complaint of posterior neck pain, and intermittent headache for one year prior to amission. Osteo lytic punched-out lesions were noted on skull and other skeletal x-ray films. Bone marrow aspirates revealed diffuse infiltration of mature and immature plasma cells. Laboratory findings revealed anemia and Bence-Jones proteinuria. Immunoelectrophoresis revealed findings consistent with IgA-lamda type multiple myloma. Alkylating agents and steroids were tried with some clinical improvements. In August 1985, the patient revisited outpatient clinic with chief complaints of epigastric pain and neck mass. Endoscopic biopsy and excision biopsy of the cervical lymph node were performed. By microscopic examination, adenocarcinoma of the stomach and metastasis of multiple myeoma to the supraclavicular lymph nodes were confirmed. Subtotal gastrectomy was performed. By gross and microscopic revealed metastasis to the regional lymph nodes.
Male ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

No abstract available.
Biopsy, Fine-Needle* ; Breast*

PURPOSE: To develop an Infant Developmental Assesment Scale appropriate for Korean infants that includes cultural context. METHOD: The total sample included 990 infants aged birth to 24months. The developmental tests were conducted at hospital well baby clinic, daycare centers, public health centers and homes located in city, urban and rural areas. Item analysis was done to examine content validity of the scale. Test responses were analyzed by SPSS to examine the inter-rater reliability, and construct validity. RESULTS: Based on the naturalistic observation and analysis of other developmental instruments, 260 Korean infant developmental items were created. The mean score of the developmental quotient of 966 infants was 101.63+/-10.89. Correlation coefficient of inter-rater reliability was .99. In addition, 84.6% of total items showed Kappa .70 and above. The development quotient was significantly different depending upon the residential area and father's occupation, therefore, construct validity using known group technique was supported. CONCLUSION: The developed instrument can be used to assess the development of handicapped infants, as well as normal infant's general abilities and to study individual differences within the normal range for Korean.
Child ; Child Development* ; Disabled Persons ; Equidae ; Health Promotion ; Humans ; Individuality ; Infant* ; Occupations ; Parturition ; Public Health ; Reference Values ; Child Health

PURPOSE: This study was conducted to identify behavioral items for Korean infants under 24months by naturalistic observation. These items will be the basis for developmental scale for Korean infants. METHOD: Data were collected by observing and interviewing fifty one infants and their mothers during the period from November 15 to December 14, 2003. Raw data in descriptive form were obtained by unstructured naturalistic observation, and were reformed to behavioral items through discussion with professors in pediatric nursing and experienced nurses in child care department. Also, behavioral items were classified into five developmental areas. RESULT: Total number of behavioral items was two hundreds and thirty eight. 52 items for motor development, 66 items for personal-social, 40 items for hearing and speech, 41 items for eye-hand coordination, and 39 items for performance. CONCLUSION: This is meaningful that fundamental items for Korean developmental scale for infants were identified by observing behaviors of Korean infants. On the basis of these items, average age will be calculated for passing each item by testing Korean infants. We hope to develop Korean infant developmental scale as a final outcome in the future research.
Child ; Child Care ; Child Development ; Hearing ; Hope ; Humans ; Infant Behavior ; Infant* ; Infant, Newborn ; Mothers ; Pediatric Nursing ; Child Health

The purpose of this correlational study was to find the correlation between the infant temperament, mother-infant interaction, and child-rearing environment. The subjects of this study were 37 dyads of healthy mothers and healthy infants. Data were collected from 15th of March to 3rd of September, 1999. Convenient sampling was done at Obstetric wards of one University hospital, and demographic data were collected before discharge. At one month and three month postpartum, we visited subject's home, and collected the data on the infant temperament, and also video taped the mother-infant interaction during feeding. In addition, child-rearing environment was checked by researcher according to HOME(Home Observation for Measurement of the Environment) at three months postpartum. Mother-infant interactions were rated according to the NCAST Feeding Scale later. Data were analyzed by window SPSS program, and correlations between the infant temperament, mother-infant interaction, and child-rearing environment were analyzed by Pearson's correlational coefficient. The results were as follows: 1. Infant temperament. 1) Among the subscales of infant temperament, mothers perceived cuddliness and amenability most positively at one month, and responsivity and amenability most positively at three months. 2) In subscale analysis of stability, amenability, responsivity, and persistence were stable with the time. 3) Significant relationships were found between the malleability and amenability, between the malleability and responsivity at one month, and also between the malleability and amenability, and between the malleability and cuddliness at three months. 2. Correlations of infant temperament and mother-infant interaction. 1) There was no significant relationship between the infant temperament and mother-infant interaction at one month. 2) There was a significant relationship between the infant temperament and mother-infant interaction at three months(r=.335, p < .05). In subscale analysis, there were significnt relationships between the total score of infant temperament and maternal sensitivity to infant's cues(r=.372, p < .05), and between the total score of infant temperament and maternal response to infant's distress (r=.331, p < .05). 3. Correlations of infant temperament and child-rearing environment. 1) There was no significant relationship between the total score of infant temperament at one month and total score of HOME at three months. In subscal analysis, the total score of infant temperament at one showed significant relationships with the organization of environment(r=.413, p < .05), and the emotional, verbal response at three months(r=.337, p < .05). 2) There was a significant relationship between the total score of infant temperament at three months and the total score of HOME at three months (r=.599, p < .01). In subscal analysis, the total score of infant temperament at three months showed significant relationships with the organization of environment(r=.410, p < .05), maternal involvement(r=.482, p,.01), and the emotional, verbal response(r=.695, p < .01) at three months. 4. Correlations of mother-infant interaction and child-rearing environment. There was a significant relationship between the maternal score of mother-infant interaction at one month and three months and the total score of HOME at three months (r=.474, p < .01; r=.452, p < .01). In conclusion, it was proved that infant temperament had significant relationships with mother-infant interaction and child-rearing environment, especially when the infants were getting older. This showed the possibility for changeability of infant teperament by the maternal factors.
Humans ; Infant* ; Mother-Child Relations* ; Mothers ; Postpartum Period ; Temperament* ; Child Health

PURPOSE: Instead of a chaotic non circadian environmental approach, continuing regular day-night rhythm in neonatal nurseries may benefit the development of preterm infants. The purpose of this study was to define the effects of cycled lighting on circadian rhythms of premature infants. METHODS: The experimental group included 15 preterm infants, and the control group, 15 premature infants in the NICU of a general hospital in Seoul. All infants were between 32 and 37 weeks' postconceptional age. The experimental group infants were provided with cycled lighting before discharge. The incubator or bassinet cover of the experimental group was off between 7 AM and 7 PM, and was covered between 7 PM and 7 AM. RESULTS: There were significant differences in the NNNS score (p=.039), and some significant differences in the sleep-activity pattern between the experimental group and the control group, but distinct differences in sleep-activity patterns between the two groups could not be defined. CONCLUSION: The results of this study suggest that cycled lighting can be helpful in the neurobehavioral development of preterm infants. By modifying the NICU environment to provide a more developmentally supportive milieu, nursing professionals can better meet the infants' physiologic and neurobehavioral needs.
Circadian Rhythm ; Hospitals, General ; Humans ; Incubators ; Infant ; Infant, Newborn ; Infant, Premature ; Light ; Lighting ; Nurseries ; Child Health

No abstract available.
Leukemia, Monocytic, Acute* ; P-Glycoprotein*

PURPOSE: This study was conducted to evaluate the effectiveness of the maternal role education program for primiparas in mother-infant interaction, childrearing environ- ment, and infant development. METHOD: A Non-equivalent control group time-series design was used. For the intervention group, programmed parenting education focusing on mother-infant interaction, home environment for infant development, and parent counseling and support was provided via home visits or telephone for twelve months. RESULT: Significant differences were found in the mother-infant interaction feeding scale at one and three months, but no differences were found in the teaching scale at six and twelve months between the intervention and control groups. Also, the difference in childrearing environment (HOME) between the two groups was significant at three, six, twelve months. In addition, the intervention group showed higher GQ in the Griffiths mental development scale at three and six months. In multiple regression analysis, 22.6% to 43.6% of infant development was explained by HOME, mother-infant interaction, and previous development. CONCLUSION: The maternal role education program proved to be effective in promoting mother-infant interaction, organizing the childrearing environment, and fostering infant development.
Child ; Child Development ; Counseling ; Education* ; Education, Nonprofessional ; Foster Home Care ; House Calls ; Humans ; Mother-Child Relations ; Parents* ; Telephone