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Maternal Health in the COVID-19 Era: Unraveling Complexities and Long-term Implications for the Journal of Korean Maternal and Child Health COVID-19 时代的产妇保健:韩国妇幼保健杂志》的复杂性和长期影响
Pub Date : 2024-01-31 DOI: 10.21896/jksmch.2024.28.1.1
Jeung-Im Kim
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引用次数: 0
Motherhood as Experienced by Women in a Prenatal and Early-Childhood Home Visitation Program, and Associated Factors 参加产前和幼儿家访计划的妇女的母性体验及相关因素
Pub Date : 2024-01-31 DOI: 10.21896/jksmch.2024.28.1.22
Ji Yun Lee, Y. Khang, Yu-Mi Kim, Kyung Ja June, Sung-Hyun Cho, Hong-Jun Cho
Purpose: This study is intended to examine the difficulties facing mothers of young children (early childhood) and to understand the associated factors.Method: We analyzed 1,003 data items of women with children under age 2 who participated in a prenatal and early-childhood home visitation program in Seoul from 2016 to 2019. For our research, we used self-administered registration and service monitoring data. The difficulties the women faced as mothers were measured using the “Being a Mother Scale” (BaM-13). This analysis considered covariates including maternal and infant ages, their number of children, economic conditions, presence of disabilities, single motherhood, multicultural migration background, employment status, unintended pregnancy, instrumental and emotional support, and depression scores.Results: The average score for being a mother was 14.45 (standard deviation=6.61), and higher scores were recorded for women with spouses, Korean women (as opposed to multicultural immigrant women), women whose pregnancies were unplanned, women without instrumental support, and severely depressed women.Conclusion: Motherhood poses great difficulties to women with children under age two. To help women transition from motherhood, it is important to understand their situations in relation to their social and psychological characteristics, as well as the cultural, social, and contextual perspectives they bring to motherhood.
目的:本研究旨在探讨幼儿(幼儿期)母亲面临的困难,并了解相关因素:我们分析了 2016 年至 2019 年期间在首尔参加产前和幼儿家访项目的有 2 岁以下子女的妇女的 1003 项数据。在研究中,我们使用了自填式登记和服务监测数据。我们使用 "做母亲量表"(BaM-13)测量了妇女作为母亲所面临的困难。该分析考虑的协变量包括母婴年龄、子女数量、经济条件、是否残疾、单身母亲、多元文化移民背景、就业状况、意外怀孕、工具和情感支持以及抑郁得分:作为母亲的平均得分是 14.45(标准差=6.61),有配偶的妇女、韩国妇女(相对于多元文化移民妇女)、意外怀孕的妇女、没有工具支持的妇女和严重抑郁的妇女得分更高:结论:对于有两岁以下子女的妇女来说,做母亲是一件非常困难的事情。要帮助妇女从母亲身份过渡,就必须了解她们的社会和心理特征,以及她们为母亲身份所带来的文化、社会和背景视角。
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引用次数: 0
The Development of the Journal of Korean Maternal and Child Health 韩国妇幼保健杂志》的发展历程
Pub Date : 2024-01-31 DOI: 10.21896/jksmch.2024.28.1.3
Jong Yun Hwang
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引用次数: 0
Effects of Posttraumatic Stress Disorder and Depression on Paternal Attachment to High-Risk Infants 创伤后应激障碍和抑郁对高风险婴儿的父性依恋的影响
Pub Date : 2024-01-31 DOI: 10.21896/jksmch.2024.28.1.12
Yu Jin Lee, Hyeon Ok Ju
Purpose: This study has sought to determine the levels of posttraumatic stress disorder (PTSD), depression, and attachment among fathers raising high-risk infants and to identify the factors influencing paternal attachment.Methods: The participants were 85 fathers who were raising high-risk infants aged 6 months or younger and visiting a general hospital in Busan Metropolitan City. A structured questionnaire was administered to collect information on the general characteristics of fathers and children, PTSD, depression, and attachment. Hierarchical regression analysis was conducted to identify the factors associated with paternal attachment.Results: The average scores reported by fathers were as follows: 4.68±0.27 out of 5 for attachment, 19.51±15.40 out of 88 for PTSD, and 13.21±10.07 out of 60 for depression. Among fathers, 29.4% and 20% experienced PTSD and depression, respectively. The first model revealed that the use of a ventilator, the age of the infant, and desired sex of the infant were associated with paternal attachment, predicting 30% of the variance. In the second model, in which PTSD and depression were added, PTSD influenced paternal attachment. This model predicts a 52% variance.Conclusion: The formation of paternal attachment, which begins immediately after a child’s birth, plays a crucial role in a child’s cognitive, emotional, and social development. To enhance the attachment of fathers raising high-risk newborns, neonatal nurses should screen fathers for PTSD early and plan appropriate interventions.
目的:本研究旨在确定抚养高危婴儿的父亲的创伤后应激障碍(PTSD)、抑郁和依恋水平,并找出影响父亲依恋的因素:研究对象为在釜山广域市一家综合医院就诊的 85 名抚养 6 个月或 6 个月以下高危婴儿的父亲。我们发放了一份结构化问卷,以收集有关父亲和孩子的一般特征、创伤后应激障碍、抑郁和依恋的信息。研究人员进行了层次回归分析,以确定与父亲依恋相关的因素:父亲的平均得分如下结果:父亲的平均得分如下:依恋为 4.68±0.27(满分 5 分),创伤后应激障碍为 19.51±15.40(满分 88 分),抑郁为 13.21±10.07(满分 60 分)。在父亲中,分别有 29.4% 和 20% 的人患有创伤后应激障碍和抑郁症。第一个模型显示,使用呼吸机、婴儿年龄和婴儿期望性别与父亲依恋相关,预测了30%的变异。在加入创伤后应激障碍和抑郁的第二个模型中,创伤后应激障碍影响了父亲依恋。该模型预测了 52% 的变异:父亲依恋的形成始于孩子出生后,对孩子的认知、情感和社会发展起着至关重要的作用。为了增强抚养高风险新生儿的父亲的依恋,新生儿护士应及早筛查父亲是否患有创伤后应激障碍,并制定适当的干预计划。
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引用次数: 0
Family-Centered Care for High-Risk Infants and the Roles of Healthcare Professionals 以家庭为中心的高风险婴儿护理和医疗保健专业人员的作用
Pub Date : 2024-01-31 DOI: 10.21896/jksmch.2024.28.1.5
Y. Im, Young-Ah Park
With an increasing trend toward low birth rates and premature births, the importance of managing the health of high-risk infants has received constant emphasis. It is necessary to establish a family-centered care culture in neonatal intensive care units where high-risk infants are hospitalized. This study is intended to examine the current status of family-centered care and the direction of the role played by healthcare professionals, focusing on the characteristics of high-risk infants and their families. Healthcare professionals should listen to the needs of the family and facilitate their involvement to improve the performance of family-centered care and systematic support. Specific guidelines are required to strengthen the competence and leadership of healthcare professionals. The paradigm shift toward family-centered care for high-risk infants is a challenge for healthcare professionals and parents, but it will serve as a vision and strategy to improve the health of high-risk infants and their families by including the family in the healthcare process.
随着低出生率和早产趋势的加剧,管理高危婴儿健康的重要性不断受到重视。在高危婴儿住院的新生儿重症监护病房建立以家庭为中心的护理文化十分必要。本研究旨在针对高危儿及其家庭的特点,探讨以家庭为中心的护理现状和医护人员的角色定位。医护人员应倾听家庭的需求,促进他们的参与,以提高以家庭为中心的护理和系统支持的绩效。要加强医护人员的能力和领导力,就必须制定具体的指导方针。以家庭为中心的高危婴儿护理模式的转变对医护人员和家长来说都是一个挑战,但它将成为一种愿景和策略,通过将家庭纳入医疗保健过程来改善高危婴儿及其家庭的健康状况。
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引用次数: 0
Erratum: Narrative Review on the Trend of Childbirth in South Korea and Feasible Intervention to Reduce Cesarean Section Rate 勘误:关于韩国分娩趋势和降低剖腹产率的可行干预措施的叙述性综述
Pub Date : 2023-10-31 DOI: 10.21896/jksmch.2023.27.4.267
Saerom Kim, Jeong-Won Oh, Jung-Won Yun
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引用次数: 0
Screening and Management of Thyroid Dysfunction During Pregnancy 妊娠期甲状腺功能障碍的筛查和处理
Pub Date : 2023-07-31 DOI: 10.21896/jksmch.2023.27.3.148
Sul Lee, S. Kim
Thyroid hormone is known to play a crucial role in implantation and embryonic development, as well as in the development of the nervous and musculoskeletal systems of fetus. In particular, thyroid dysfunction is associated with various pregnancy-related complications such as miscarriage, preterm birth, fetal growth restriction, and preeclampsia. Previous studies have primarily focus on the adverse effects of hypothyroidism on fetal neurodevelopment. However, the physiological and metabolic alterations occurring during pregnancy in thyroid physiology make it difficult to diagnose thyroid dysfunction. Therefore, obstetricians should have a comprehensive understanding of physiological changes of the thyroid and be familiar with the latest guidelines regarding the complications and management of thyroid dysfunction during pregnancy.
众所周知,甲状腺激素在胚胎植入和胚胎发育以及胎儿神经和肌肉骨骼系统的发育中起着至关重要的作用。特别是,甲状腺功能障碍与各种妊娠相关并发症有关,如流产、早产、胎儿生长受限和先兆子痫。以往的研究主要集中在甲状腺功能减退症对胎儿神经发育的不良影响。然而,妊娠期间甲状腺生理发生的生理和代谢变化使甲状腺功能障碍的诊断变得困难。因此,产科医生应全面了解甲状腺的生理变化,熟悉妊娠期间甲状腺功能障碍并发症和处理的最新指南。
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引用次数: 0
Perinatal Outcomes in Women With Endocervical and Decidual Polyps During Pregnancy 妊娠期间宫颈内息肉和蜕膜息肉妇女的围产期结局
Pub Date : 2023-07-31 DOI: 10.21896/jksmch.2023.27.3.135
Hee-Sun Kim, J. Bae
Although cervical polyps are benign, they may cause atypical symptoms such as vaginal bleeding, increased vaginal discharge, and localized infection. A recent study found that the detection of polyps in early pregnancy is a risk factor for preterm delivery before 28 weeks and at 34 and 37 weeks of gestation. Furthermore, cervical polyps are also are highly associated with cervical insufficiency (Hirayama et al., 2022). Another study found that the risk of preterm delivery before 37 weeks of gestation and spontaneous abortion are higher in pregnant women with decidual polyps than in those with endocervical ones (Tokunaka et al., 2015). A 2021 retrospective cohort study of 4,172 pregnant women included 92 patients diagnosed with cervical polyps before 12 weeks of gestation who had not undergone polypectomy. This study reported that the incidence of spontaneous preterm birth before 34 weeks of gestation was higher in pregnant women with cervical polyps than in those without them (5.4% vs. 0.7%, p<0.01). Furthermore, regression analysis revealed that cervical polyps are an independent risk factor for spontaneous preterm birth before 34 weeks of gestation, with an odds ratio of 4.09 (Wakimoto et al., 2022). Despite these findings, continued research on cervical polyps is required because studies on the effects of cervical polyps during pregnancy are limited, and their management remains controversial. Polyps observed in the cervix during pregnancy are benign gynecological neoplasms found in 2%-5% of women of child bearing age (Farrar & Nedoss, 1961; Younis et al., 2010). Cervical polyps can be asymptomatic during pregnancy but often cause repetitive vaginal bleeding. Moreover, they can cause preterm labor, infection, chorioamnionitis, and increased bleeding during labor (Golan et al., 1994; Wakimoto et al., 2022).
虽然宫颈息肉是良性的,但它们可能引起非典型症状,如阴道出血、阴道分泌物增多和局部感染。最近的一项研究发现,在妊娠早期发现息肉是妊娠28周前、34周和37周早产的危险因素。此外,宫颈息肉也与宫颈功能不全高度相关(Hirayama et al., 2022)。另一项研究发现,患有蜕膜息肉的孕妇37周前早产和自然流产的风险高于宫颈内息肉孕妇(Tokunaka et al., 2015)。2021年的一项回顾性队列研究对4172名孕妇进行了研究,其中包括92名在妊娠12周前被诊断为宫颈息肉且未接受息肉切除术的患者。本研究报道宫颈息肉孕妇在妊娠34周前自发性早产的发生率高于无宫颈息肉孕妇(5.4%比0.7%,p<0.01)。此外,回归分析显示宫颈息肉是妊娠34周前自发性早产的独立危险因素,比值比为4.09 (Wakimoto et al., 2022)。尽管有这些发现,由于对妊娠期间宫颈息肉影响的研究有限,其治疗仍存在争议,因此需要继续对宫颈息肉进行研究。妊娠期子宫颈息肉是一种良性妇科肿瘤,发生率为2%-5%的育龄妇女(Farrar & Nedoss, 1961;Younis et al., 2010)。宫颈息肉在怀孕期间可能没有症状,但经常引起反复的阴道出血。此外,它们可导致早产、感染、绒毛膜羊膜炎和分娩时出血增加(Golan等,1994;Wakimoto et al., 2022)。
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引用次数: 0
Comparison of Perinatal Outcomes According to the Majority of Physicians: Obstetrics Versus Endocrinology 大多数医生认为围产期结局的比较:产科与内分泌科
Pub Date : 2023-07-31 DOI: 10.21896/jksmch.2023.27.3.167
Haemin Kim, H. Cha, W. Seong
Purpose: To compare the perinatal outcomes among the majority of physicians who manage pregnancies complicated by gestational diabetes mellitus (GDM), particularly those who require insulin treatment.Methods: We conducted a retrospective study involving 206 singleton pregnant women diagnosed with GDM between January 2017 and September 2022. The study participants were divided into 2 groups according to the majority of physicians (obstetrics vs. endocrinology). We compared the maternal characteristics and perinatal outcomes between the 2 groups and performed a subgroup analysis of preterm birth cases.Results: During the study period, 206 pregnant women were diagnosed with GDM and 36.9% (76 of 206) required insulin treatment. Among the GDM A2 pregnancies, 26 patients visited or consulted endocrinologists, and 50 patients were managed by obstetricians. There were no significant differences in maternal characteristics and perinatal outcomes between the two groups. Eighteen infants were delivered before 37 weeks of gestation (12 in the obstetrician group and 6 in the endocrinologist group). In preterm-delivered patients, the birth weight was heavier in the endocrinology group (median [range], 2.66 [1.98–3.77] vs. 3.71 [2.48–4.17], p=0.025) despite similar gestational age at delivery (median [range], 35.5 [33.1–36.5] vs. 36.0 [34.2–36.6], p=0.511). However, there were no significant differences in perinatal outcomes, including the rate of neonatal hypoglycemia, oxygen treatment and the duration of neonatal intensive care unit admission.Conclusion: Our data show that GDM can be managed by obstetricians even in cases requiring insulin treatment.
目的:比较大多数处理妊娠合并妊娠糖尿病(GDM)的医生的围产期结局,特别是那些需要胰岛素治疗的医生。方法:我们对2017年1月至2022年9月期间诊断为GDM的206名单胎孕妇进行了回顾性研究。根据大多数医生将研究参与者分为两组(产科与内分泌科)。我们比较了两组的产妇特征和围产期结局,并对早产病例进行了亚组分析。结果:在研究期间,206名孕妇被诊断为GDM,其中36.9%(76人)需要胰岛素治疗。在GDM A2妊娠中,26例患者拜访或咨询内分泌科医生,50例患者由产科医生管理。两组产妇特征及围产儿结局无显著差异。妊娠37周前分娩18例(产科组12例,内分泌组6例)。在早产患者中,尽管分娩时胎龄相近(中位数[范围],35.5[33.1-36.5]比36.0 [34.2-36.6],p=0.511),但内分泌组的出生体重更重(中位数[范围],2.66[1.98-3.77]比3.71 [2.48-4.17],p=0.025)。然而,围产儿结局,包括新生儿低血糖率,氧气治疗和新生儿重症监护病房入院时间没有显著差异。结论:我们的数据表明,即使在需要胰岛素治疗的病例中,产科医生也可以控制GDM。
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引用次数: 0
Parenting Experience of Shift Nurses With Elementary School-Aged Children During the COVID-19 Pandemic: A Phenomenological Study 新冠肺炎大流行期间值班护士带学龄儿童的育儿经验:现象学研究
Pub Date : 2023-07-31 DOI: 10.21896/jksmch.2023.27.3.154
J. Kim, Mi-Youn Jang, Aeri Song, J. Yu, Myung-Sook Baik
Purpose: This phenomenological study aimed to comprehend the altered parenting experience of nurses during the coronavirus disease 2019 (COVID-19) pandemic.Method: Using a qualitative approach, the research design employed a phenomenological methodology. The participants were 6 nurses with elementary school-aged children. The nurses were employed in tertiary general hospitals, working on rotating shifts during the COVID-19 pandemic. In-depth interviews were conducted to collect individual data, which were then analyzed using Colaizzi phenomenological method.Results: Analyzing the collected data led to 178 significant results, from which 13 themes were derived. These 13 themes were further integrated into 5 distinct theme clusters: (1) struggling as a nurse-mom, (2) providing a supportive presence, (3) facing challenges in facilitating children's learning activities, (4) navigating parental roles in a chaotic situation, and (5) pursuing physical safety. These clusters were subsequently categorized into four overarching categories: “suffering,” which encompassed the themes of pressure of infection and providing a supportive presence, as well as “controlling,” “parenting,” and “seeking,” representing the remaining clusters, respectively.Conclusion: The parenting experiences of shift nurses during the COVID-19 pandemic encompassed various aspects, including the challenges posed by the pressure of infection, the importance of providing a supportive presence, difficulties in managing children’s learning activities, navigating parental roles amid chaotic circumstances, and the pursuit of physical safety. These experiences significantly impact the stability of shift nurses’ caregiving abilities for both their patients and their children. Therefore, it is crucial to establish a comprehensive nationallevel care support system in times of disaster situations like the COVID-19 pandemic.
目的:本现象学研究旨在了解2019冠状病毒病(COVID-19)大流行期间护士育儿经历的变化。方法:采用定性方法,采用现象学方法进行研究设计。研究对象为6名带小学生的护士。这些护士受雇于三级综合医院,在新冠肺炎大流行期间轮班工作。通过深度访谈收集个体数据,并采用Colaizzi现象学方法进行分析。结果:对收集到的数据进行分析,得到178个显著结果,从中衍生出13个主题。这13个主题被进一步整合到5个不同的主题集群中:(1)作为护士妈妈的挣扎,(2)提供支持性存在,(3)面对促进儿童学习活动的挑战,(4)在混乱的情况下定位父母角色,(5)追求人身安全。这些集群随后被分为四个主要类别:“痛苦”,其中包括感染压力和提供支持的主题,以及“控制”,“养育”和“寻求”,分别代表其余的集群。结论:新冠肺炎大流行期间值班护士的育儿经历涉及多个方面,包括感染压力带来的挑战、提供支持性存在的重要性、管理儿童学习活动的困难、混乱环境中父母角色的定位以及对人身安全的追求。这些经历显著影响轮班护士对病人和孩子的护理能力的稳定性。因此,在COVID-19大流行等灾害情况下,建立全面的国家一级护理支持体系至关重要。
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引用次数: 0
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Journal of The Korean Society of Maternal and Child Health
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