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: This study was to explore the perception about menstruation and discomforts of using disposable menstrual pads in menstruating women. METHOD: A survey was conducted of 132 menstrual women recruited by convenience sampling. Data were collected by a face-to-face interview and a study questionnaire, and analyzed by frequency and chi-square-test. RESULT: More than half of the subjects expressed a negative perception about menstruation, while 25% expressed a mixed perception and 24.2% expressed a positive perception. Women who perceived their menstruation negatively had more menstrual pain than the others (p<.001). The most frequently experienced discomforts of using disposable pads were an unpleasant smell (18.9%), leakage (18.9%), and discomfort (16.6%). Adverse effects of using disposable pads were reported as an itching sense (23.1%), skin rash (20.2%), and skin irritation (10.6%). Alternate materials were reported with tampons, alternate washable pads, and maternity pads. CONCLUSION: The results indicate that disposable menstrual pads cause several discomforts and common adverse effects such as skin problems. To decrease these discomforts and relieve adverse effects, planned nursing education including women's personal hygiene methods and information about an alternate pad may be helpful.
Dysmenorrhea ; Education, Nursing ; Exanthema ; Female ; Humans ; Hygiene ; Menstrual Hygiene Products ; Menstruation ; Pruritus ; Surveys and Questionnaires ; Skin ; Smell

PURPOSE: This study explored influencing factors on quality of life (QoL) above middle-aged women in relation to demographic factors, health-related factors, menopausal status, metabolic syndrome (MS) and its risk factors. METHODS: This study was secondary data analysis from the Sixth Korea National Health and Nutrition Examination Survey 2013~2015 that utilized a complex, multi-stage probability sample design. Study sample of 2,310 was inclusive of (28.8%) of women who were over 40. To evaluate the factors that would influence an impaired quality of life, χ² test, GLM, and logistic regression analysis were done. RESULTS: Level of quality of life was lower in women with late post-menopause(over 10 years since menopause) than women with pre-menopause. Factors influencing impaired QoL were as follows: graduated middle school and elementary school or less (OR=2.43, 4.42, respectively, p<.05), no job (OR=1.92, p<.001), stress (OR=1.92, p=.001), depression (OR=1.93, p=.001), insufficient sleep (OR=1.64, p=.003), late post-menopause (OR=2.61, p=.044) and over 85cm of waist circumference (OR=1.76, p=.01). CONCLUSION: These results suggest that late post-menopause may be an independent factor influencing an impaired QoL. To promote post-menopausal womens' health, a nursing strategy is required to teach women how to manage levels of stress, depression, insufficient sleep, and abdominal obesity through health education, nutritional counselling, and physical activity program.
Demography ; Depression ; Female ; Health Education ; Humans ; Korea ; Logistic Models ; Menopause ; Metabolic Syndrome X ; Motor Activity ; Nursing ; Nutrition Surveys ; Obesity, Abdominal ; Postmenopause ; Premenopause ; Quality of Life* ; Risk Factors* ; Sampling Studies ; Statistics as Topic ; Waist Circumference

PURPOSE: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. METHODS: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX(R) to calculate 10-year probability of major osteoporotic and hip fracture. RESULTS: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. CONCLUSION: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.
Chronic Disease ; Female ; Hip ; Humans ; Incidence ; Menopause ; Nursing Assessment ; Osteoporosis ; Prevalence ; Surveys and Questionnaires ; Risk Factors

PURPOSE: This study was done to examine current status of women's health nursing practicum and identify necessary core nursing skills in this practicum area. Moreover, one syllabus and evaluation sheets for women's health nursing clinical practicum at one university were reviewed. METHODS: A survey design was used with 81 educators who were teaching maternity or women's health nursing and its practicum. RESULTS: Most clinical sites for practicum were university hospitals (43.0%), women's hospitals (32.7%), or general hospitals (17.3%); but the majority (77.8%) of educators expressed difficulty in finding appropriate practicum places. Common teaching and learning methods were clinical guides for practicum (44.6%), e-learning content (30.2%), and simulation (23.6%). Core nursing skills for this practicum included assessment of stages of labor, preparation of uterine-fetal monitoring devices and interpretation of results, monitoring uterus and fetal activity, and performing Leopold's maneuver. For postpartum care, the following were included; postpartum fundal massage, assessment of breast engorgement, fundus height, and episiotomy sites, inserting urinary catheter, and teaching the use of patient-controlled analgesia. CONCLUSION: To improve the quality of clinical practicum, development of a clear course syllabus, standardized clinical guidebook, and core nursing skills is required and should be shared with all relevant nurse educators.
Analgesia, Patient-Controlled ; Breast ; Clinical Competence ; Education ; Episiotomy ; Female ; Fetal Movement ; Hospitals, General ; Hospitals, University ; Infant, Newborn ; Learning ; Massage ; Maternal-Child Nursing ; Nursing* ; Postnatal Care ; Postpartum Period ; Pregnancy ; Urinary Catheters ; Uterus ; Women's Health*

PURPOSE: In this study the effects of breast massage on breast pain, breast-milk sodium, and newborn suckling in early postpartum mothers were investigated. METHODS: The design was a non-synchronized nonequivalent control group pretest-posttest design. Sixty postpartum mothers who were admitted to a postpartum care center and had problems with breastfeeding were recruited. Of these mothers, 44 were assigned to the intervention group and received two 30-minute breast massages within 10 days of postpartum period. The others were assigned control group and received only routine care. Breast pain was measured using a numeric pain scale and number of times newborns suckled was observed throughout breastfeeding. Breast milk was self-collected to evaluate breast-milk sodium. RESULTS: Mean age of postpartum mothers was 30 years old. Compared to the control group, women in the intervention group reported significant decreases in breast pain (p<.001), increases in number of times newborns suckled after the first and second massage (p<.001), and a decrease in breast-milk sodium after the first massage (p=.034). CONCLUSION: Breast massage may have effects on relieving breast pain, decreasing breast-milk sodium, and improving newborn suckling. Breast massage can be used to solve breast problems. Further research is needed to validate our findings.
Adult ; *Breast Feeding ; Female ; Humans ; Infant, Newborn ; Lactation ; Male ; *Massage ; Mastodynia/*therapy ; Milk, Human/*chemistry ; Postpartum Period ; Sodium/*analysis

PURPOSE: This study was to explore association of maternal role adjustments, parenting stresses, and demographic factors to breastfeeding adaptation. METHODS: A correlational survey design was used to recruit 183 mothers who breastfeed or breastfed their babies. Participants' visited outpatient departments and were admitted to pediatric ward at 2 hospitals in metropolitan city of Korea. Inclusion criteria for subjects were mothers whose babies were from 1 month to 24 months old. Data were collected using a self-report questionnaire for mothers' and babies' demographic variables, maternal role adjustments, parenting stresses, and maternal breastfeeding adaptations. RESULTS: Higher levels of maternal adaptations and low levels of parenting stresses were associated with greater maternal breastfeeding adaptations. Types of feeding during hospital stays and baby's health status at birth were also associated with maternal breastfeeding adaptation. CONCLUSION: Results showed that a higher level of mothers' adjustment to breastfeeding; indicated lesser parenting stresses with higher levels of maternal adaptation. Nursing interventions for breastfeeding should be applied for appropriate breastfeeding adaptation during mothers' hospital stay. As baby's poor health status at birth medical team should provide a proper breastfeeding education.
Breast Feeding* ; Demography ; Education ; Humans ; Korea ; Length of Stay* ; Mothers ; Nursing ; Outpatients ; Parenting* ; Parents* ; Parturition*

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.
Absorptiometry, Photon ; American Heart Association ; Blood Pressure ; Body Mass Index ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Exercise ; Female ; Femur ; Health Promotion ; Humans ; Lipoproteins ; Lumbar Vertebrae ; Menopause ; Obesity ; Osteoporosis ; Reference Values ; Risk Factors

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.
Absorptiometry, Photon ; American Heart Association ; Blood Pressure ; Body Mass Index ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Exercise ; Female ; Femur ; Health Promotion ; Humans ; Lipoproteins ; Lumbar Vertebrae ; Menopause ; Obesity ; Osteoporosis ; Reference Values ; Risk Factors

Purpose: This study aimed to explore the lived experience and meaning of pregnant women’s adaptation. Methods: Ten pregnant women living in Daejeon and Sejong agreed to participate in this study. The data were collected through telephone in-depth interviews regarding ‘pregnant women’s adaptation. The qualitative data were analyzed using Giorgi’s method of descriptive phenomenology. Results: Five core situation components were extracted from the raw data, along with 12 themes and 33 focal meanings. The five core situations were 1) the situation when the woman first recognized the pregnancy, 2) the situation of change related with pregnancy, 3) the situation related to the upcoming birth, 4) postpartum-related situations, and 5) the situation related to parenting. The 12 themes were as follows: “anxiety, pressure, and embarrassment due to pregnancy,” “efforts to adapt to physical changes,” “efforts to adapt to the psychological difficulties of pregnancy,” “efforts to adapt to the financial burden and role changes caused by pregnancy,” “connecting with the fetus,” “adapting to a new marital relationship centering on the baby,” “the frustration of childbirth,” “fear of childbirth,” “postpartum care, need help with lactation planning,” “parenting beyond one’s imagination,” “dad’s willingness to participate in parenting,” and “career disconnect and consideration of workplace needs.” Conclusion We conclude that pregnant women experience adaptation in physical, psychological, relational, and social aspects. The thematic clusters identified in the results might be used to develop a nursing intervention to promote adaptation to pregnancy among pregnant women.