While the survival rate of preterm infants and employment rates of mothers with infants have been dramatically increasing, little is known about the impact of maternal employment and having premature infants on maternal health recovery after delivery. The purpose of this longitudinal study was to examine differences in postpartum health by mother's employment and infant's prematurity over time during the first 3 months postpartum. The study used a longitudinal design and was secondary data analysis from a large study. A convenience sample of 132 mothers was recruited with mothers who had fullterm or preterm infants through the postpartum unit. They were followed up for 3 times (at 1-2 days, 6 weeks, and 3 months) during the first 3 months postpartum period. Level of fatigue and hysical symptoms were indicators for postpartum physical health; Positive affect and negative affect were assessed for postpartum mental health, and role functional status after childbirth was for role performance. Finding indicated that health indicators changed significantly over time but there was no main or interaction effect for maternal employment status. There were main effects of infant's prematurity on positive affect, negative affect, and role functional status (self-care and social and community activities). This study enhanced the understanding of postpartum health of mothers with preterm infants as well as those with fullterm infants during the postpartum period.
Employment* ; Fatigue ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Longitudinal Studies ; Maternal Health ; Mental Health ; Mothers ; Parturition ; Postpartum Period* ; Statistics as Topic ; Survival Rate

This study was to compare mother's postpartum physical health, mental health, and role performance between mothers with fullterm infants and preterm infants over 3 months postpartum period. The study used a correlational and longitudinal design and was secondary data analysis from a large study. A convenience sample of 132 mothers who had fullterm and preterm infants was followed up for 3 times (postpartum 1-2 days, 6 weeks, and 3 months) during the first 3 months postpartum period. Postpartum physical health was assessed by level of fatigue in the morning and in the afternoon, and number of physical symptoms. Postpartum mental health was assessed by positive affect, anxiety, and depression; and postpartum role performance was measured by role functional status. Mothers with preterm infants experienced higher levels of fatigue in the morning, lower positive affect, higher anxiety and higher depression over 3 data collection time points, compared to mothers with fullterm infants. Mothers with preterm infants also resumed lesser self-care activity and social and community activity than the counterparts. It implies that some aspects of preterm birth and caring for preterm infants continue to negatively affect the mother's health outcomes during the postpartum period.
Anxiety ; Depression ; Fatigue ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature* ; Mental Health ; Mothers* ; Postpartum Period* ; Premature Birth ; Self Care ; Statistics as Topic

PURPOSE: This study was to develop a breastfeeding promotion program and to test effects of the program on levels of breast discomfort, breast size, sodium in breast milk, and type of feeding in mothers with breast engorgement following cesarean birth. METHODS: A non-synchronized non-equivalent control group pretest-posttest design was used in this study. The participants were 70 postpartum mothers who were admitted to a postpartum care center and experienced breast engorgement following cesarean birth. The planned nursing intervention was the breastfeeding promotion program consisting of breast massage and 1:1 breastfeeding education, counseling, and support focusing on individualized problem solving provided for 10 days. Fifty-three women completed the program (experimental group 26, control group, 27). Measurements were level of breast discomfort, breast size, sodium in breast milk and type of feeding at pre and posttest. RESULTS: Women who participated in the program experienced lower scores for breast discomfort, greater decrease in breast size, lower levels of sodium in breast milk, and practiced breastfeeding more than those in the control group. CONCLUSION: Results indicate that this breastfeeding promotion program is effective in reducing breast engorgement and improving breastfeeding practices, and is therefore recommended to enhance breastfeeding promotion practice in postpartum care centers.
Adult ; Breast/physiology ; *Breast Feeding ; Cesarean Section ; Female ; Humans ; Infant, Newborn ; Male ; Massage ; Milk, Human/chemistry ; Mothers/*psychology ; Postpartum Period ; *Program Development ; *Program Evaluation ; Sodium/analysis ; Young Adult

PURPOSE: The purpose of this review was to describe a psychoneuroimmunology (PNI) framework for postpartum depression (PPD) and discuss its implications for nursing research and practice for postpartum women. METHODS: This study explored the role of hypothalamic-pituitary-adrenal (HPA) axis and inflammation as possible mediators of risk factors for PPD through literature review. RESULTS: From this PNI view, human bodies are designed to respond with the reciprocal interactions among the neuro-endocrine and immune system when they are faced with physical or psychological stressors. Chronic stress induces alterations in the function of HPA axis, and a chronic low-grade inflammatory response is associated with depression. The dysfunctions of cytokines and HPA axis have been observed during the postpartum period. Stress promotes glucocorticoid receptor resistance, which can promote inflammatory responses. This, in turn, can contribute to the pathophysiology of depression. This can especially affect populations at vulnerable time-points, such as women in the postpartum. CONCLUSION: From a PNI perspective, well-designed prospective research evaluating the role of stress and inflammation as an etiology of PPD and the effect of stress reduction is warranted to prevent PPD.
Axis, Cervical Vertebra ; Cytokines ; Depression ; Depression, Postpartum* ; Female ; Human Body ; Humans ; Immune System ; Inflammation ; Nursing Research ; Postpartum Period ; Psychoneuroimmunology ; Receptors, Glucocorticoid ; Risk Factors

PURPOSE: The purposes of this study were to identify the level of total symptom distress, uncertainty, depression and ways of coping in women with endometriosis based on Mishel's model of Uncertainty in Chronic illness, and to exam the relationships among symptom distress, depression and ways of coping and the mediating effect of ways of coping between uncertainty and depression. METHOD: The research was used for correlational research design and data were collected with 123 women with endometriosis who live in a local area by convenience sampling. RESULTS: The finding showed that the levels of symptom distress and uncertainty were moderate and the depression was above the middle level. There were positive relationships among symptom distress, uncertainty and depression but a negative relationship between problem focused coping and depression. The significant predictors for depression were symptom distress, uncertainty, and problem focused coping with 40% of explained variance. Problem focused coping showed mediating effect between uncertainty and depression. CONCLUSION: Therefore, nursing intervention for the strategy of increasing problem focused coping as well as lowering uncertainty and depression is recommended. Further study is needed to conduct a repetitive study with randomized nationwide population and to evaluate the theory with different outcomes for adaptation versus maladaptation.
Adaptation, Psychological ; Chronic Disease ; Depression* ; Endometriosis* ; Female ; Humans ; Negotiating ; Nursing ; Research Design ; Uncertainty*

PURPOSE: The purpose of this study was to examine the effect of a moderate-intensity, walking exercise program on the body composition, blood lipids and psychosocial outcomes in postmenopausal obese women. METHODS: With a quasi-experimental pre- and post-test design, a total of 36 postmenopausal obese women was recruited in 2 metropolitan areas by convenience sampling. Sixteen women participated in 1 hour of moderate-intensity walking exercise 5 days per week for 3 months and 20 women did not. Cardiovascular risk factors include body composition and blood lipids. Body composition was measured as body mass index, % body fat, and waist/hip ratio; Blood lipids were measured with total cholesterol, triglyceride, HDL and LDL; psychosocial outcomes were evaluated by self-esteem and depression. RESULTS: Over 3 months, the score of self-esteem increased and depression decreased in the exercise group relative to the control group. However, there were no significant differences in body composition and blood lipids. CONCLUSIONS: This study suggests that 3 months of moderate-intensity exercise training can improve psychosocial outcomes but further studies are needed to replicate walking exercise on physiologic variables among postmenopausal obese women. These findings are of public health relevance and add a new facet to the growing literature on the health benefits of moderate exercise.
Adaptation, Psychological ; Adipose Tissue ; Body Mass Index ; Female ; Humans ; Middle Aged ; Obesity/*psychology/*therapy ; *Postmenopause ; Risk Factors ; Treatment Outcome ; Waist-Hip Ratio ; *Walking

Purpose: This study aimed to examine the effects of an eye health education program on the level of knowledge and eye health practice of middle school students. Methods: This quasi-experimental study was conducted using a pretest-posttest nonequivalent control group non-synchronized design. The study participants were from one middle school first graders in a province of Korea. The experimental group was composed of three classes (76 students), and the control group was composed of three other classes (77 students). Pretests were conducted in June for the experimental group and in August for the control group. The experimental group received an eye health education program developed for this study consisting of four sessions in total, given once a week for 45 minutes per session. The control group was instructed by the school's health teacher in the eye health education included in the existing health education curriculum. Posttests were conducted three weeks after the training in the control group and immediately after the fourth eye health education session in the experimental group. Results: After being instructed in the eye health education program, the eye health-related knowledge (t=9.45, p<.001) and eye health practice (t=2.18, p=.031) of the experimental group participating in the education program were higher than those of the control group. Conclusion The eye health education program was effective in improving middle school student’s level of eye health-related knowledge and eye health practice. School health teachers could implement this program as a part of the standard eye health education for middle school students. The long-term effects of practicing eye health behavior needs to be confirmed in a future study.