Purpose: The purpose of this study was to suggest the importance of natural childbirth by investigating the results of midwife-led perinatal periods and whether they were positive experiences for both individual women and their families. Methods: This retrospective study aimed to confirm the perinatal outcomes of midwife-attended vaginal births. Among 1,127 women who gave midwife-led birth in Gyeonggi-do, Seoul between January 1, 2019 and December 31, 2021, data were collected for 829 women. Records were excluded that were missing necessary data. Data on childbirth were analyzed using frequency, percentage, mean, standard deviation, and the chi-square test. Results: Among the mothers who underwent natural childbirth, 549 (66.2%) were multiparous. In addition, all 829 patients (100%) breast-fed their infants. First-degree perineal lacerations occurred in 29.2% of patients, and second-degree lacerations occurred in 48%. Non–high-risk subjects made up 56.0% of the study sample. The average bleeding amount was 281.44±4.50, and the average 1-minute Apgar score for infants was 8.25±0.02. Conclusion Compared to childbirth in a hospital, natural childbirth was associated with a lower risk of birth canal laceration, postpartum bleeding, and Cesarean section. In addition, the health statuses of the newborns were confirmed to be good . Based on the results of this study, there is a need for a strategy in which midwife-led natural childbirth is integrated into the local medical system, as well as a need to raise women's awareness of natural childbirth and positively influence the experience.

Purpose: Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA2DS2-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-terminal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m2 ), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA2DS2-VASc score 0–1. Materials and Methods: This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0–1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated. Results: Overall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA2DS2-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassification improvement=0.576, p=0.040; integrated differential improvement=0.033, p=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P–Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, p=0.003). Conclusion The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0–1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA2DS2-VASc score 0–1.

PURPOSE: This qualitative study aimed to describe the common themes of the expectations of childbirth on primigravida whose fetus are diagnosed with congenital heart disease. METHODS: A phenomenological method was used in this study. The data were collected by individual in-depth interviews with six participants during 2016~2017. Colaizzi's phenomenology was adopted for this qualitative study as a research method. RESULTS: Four categories were derived from the data as following: ‘Acknowledge of life and waiting for the baby’, ‘Overcoming guilt and becoming stable’, ‘Strengthening for my baby‘, ‘Trust toward medical staffs’. CONCLUSION: The results of this study can guide nurses and health care workers to understand the expectation of childbirth on primigravida whose fetus are diagnosed with congenital heart disease and to implement individualized nursing interventions suited for them.
Delivery of Health Care ; Fetus ; Guilt ; Heart Defects, Congenital ; Methods ; Nursing ; Parturition ; Qualitative Research

PURPOSE: The purpose of this study was to explore essences and meaning in experiences of women who have had spontaneous abortion. METHODS: A phenomenological methodology was used for the study. A total of five women with the spontaneous abortion participated in the study. In-depth interviews were done for data collection, and the data were analyzed using Colaizzi's method. RESULTS: Five theme clusters, along with 32 sub-themes and 13 themes. The five theme clusters were: ‘Waiting and expecting pregnancy’, ‘Desire to overcome the spontaneous abortion’, ‘My baby makes me cry and laugh’, ‘My precious baby’, and ‘Want to hear with sympathy and talk with you’. CONCLUSION: The women who have had the spontaneous abortion experiences can prevent potential physical and psychological complications after miscarriage by getting education and intervention in nursing. Moreover, they may experience that negative factors of the spontaneous abortion can be turned into positive things through emotional support of family and medical teams.
Abortion, Spontaneous* ; Data Collection ; Education ; Female ; Humans ; Methods ; Nursing ; Pregnancy ; Qualitative Research

PURPOSE: This study was done to explore deeply the essence and meaning of abortion related experience of nurses. METHODS: Data were collected through in-depth informal interviews, observation, and field records with two nurses from July 1 to July 30, 2015. Data were analyzed using narrative inquiry methodology. RESULTS: Three fundamental themes were derived from data analysis: 'Considering women with abortion-experience as women to be nursed', 'to be absolutely understood', and 'to make us to think how to help'. CONCLUSION: It is significant that this study was carried out holistically on the experience and change in physical, emotional, social, and spiritual aspects of nurses with abortion-experience, simultaneously interpreting from the prospective of nurses. Therefore the basis of nursing interventions are suggested; holistic aspects as education, counseling, group meetings, and program assistance for the women, the families, and those concerned with abortion- experience.
Counseling ; Education ; Female ; Group Processes ; Humans ; Nursing ; Prospective Studies ; Qualitative Research ; Statistics as Topic

PURPOSE: The purpose of this study was to evaluate the effect of abdominal massage on alleviating pain caused by the injection of recombinant gonadotropin for In Vitro Fertilization (IVF) among infertile women. METHODS: This study employed a nonequivalent control group non-synchronized design. A total sample of 149 infertile women who never experienced in vitro fertilization was recruited at C fertility center. Seventy women were assigned into experimental group and 79 into controls. The experimental group had been informed to do abdominal massage prior to the injection and to record their subjective pain using visual analogue scale. The control group had been informed to record their subjective pain in the same way just after the injection. RESULTS: Compared to the pre-tested pain scores, the pain scores in experimental group were significantly reduced by 0.7 points, whereas the control group increased by 0.9 points (t=-4.55, p=.001). CONCLUSION: This study confirms that the use of abdominal massage prior to the injection is an effective way to alleviate pain on injection site. This massage may be a useful intervention for infertile women about pain alleviation.
Female ; Fertility ; Fertilization in Vitro* ; Gonadotropins ; Humans ; In Vitro Techniques* ; Massage*

PURPOSE: This study was a comparative study to understand the levels of anxiety, pain and maternal-fetal attachment between women who became pregnant after infertility treatment and became pregnant naturally. METHODS: This study used a comparative survey design. Data were collected by 50 couples of natural pregnancy and of who became pregnant after infertility treatment who visited delivery room in C Medical hospital, Seoul. These couples were to have first baby, and cervix dilatation of women was less than 3 cm regardless of diagnosis. RESULTS: The score of anxiety of infertile women was significantly higher than that of naturally pregnant women; however, that of spouses showed no difference. The pain score for infertile women was significantly higher in both the active and transition phases. Pain scores that reported by their spouses did not show differences in either phase. The score of maternal-fetal attachment showed no difference between two groups of women. CONCLUSION: The result showed the importance of nursing intervention to reduce women's anxiety and pain, through both antenatal-childbirth education programs and assertive nursing interventions. It is necessary to develop and evaluate new intervention which would be more effective for reducing pain and anxiety for couples who became pregnant after infertility treatment.
Anxiety* ; Cervix Uteri ; Delivery Rooms ; Diagnosis ; Dilatation ; Education ; Family Characteristics ; Female ; Humans ; Infertility* ; Nursing ; Pregnancy ; Pregnant Women ; Seoul ; Spouses

OBJECTIVES: Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. METHODS: The evaluation areas of the CRM system includes three areas: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. RESULTS: Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. CONCLUSIONS: This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems.
Delivery of Health Care ; Health Care Sector ; Health Information Management ; Health Promotion ; Information Systems ; Medical Informatics

PURPOSE: The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. METHOD: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 10 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, x2-test, and t-test. RESULT: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. CONCLUSION: It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it's simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.
Edema ; Extremities ; Humans ; Lymphedema* ; Nursing* ; Self Care ; Stroke

PURPOSE: The purpose of this descriptive study was to gain basic data to develop a self-care protocol for the lymphedema patients. METHOD: The subjects of this study consisted of 115 patients with lymphedema from 8 hospitals and two community health and welfare centers in Busan and Seoul. The data was collected with questionnaire by self reporting of patients between March 2001 and December 2001. Data was analyzed by mean and percentage. RESULT: For self-care activities in daily life, compliance of 'use skin care preparations', 'use heat and cold', 'protect from local compression on affected limbs', 'protect from insect biting', 'use aids to protect affected limbs', 'take diuretics and take protein diet' did not reach to 50%. For self-care activities related to complex physical therapy, 28.7% of subjects complied with compression garment, 14.8% with manual lymph drainage, and 13.0% with exercise. 20.0% of subjects tried to treat with acupuncture and 13.9% with heat therapy. CONCLUSION: From this study, it is suggested that patients need to get a self-care education with correct information about self care activities and health care professionals need to develop more convenience self-care techniques of massage and exercise.
Acupuncture ; Busan ; Compliance ; Delivery of Health Care ; Diuretics ; Drainage ; Education ; Hot Temperature ; Humans ; Insects ; Lymphedema* ; Massage ; Self Care* ; Self Report ; Seoul ; Skin Care ; Surveys and Questionnaires