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The Review and Future Perspectives of the Postpartum Care Service System for the Improvement of the Private-Postpartum Care Center’s Publicity 民营产后护理中心宣传完善的产后护理服务体系回顾与展望
Pub Date : 2021-07-31 DOI: 10.21896/jksmch.2021.25.3.153
Hee-Sun Kim, Jae Hee Lee, Jeong rim Lee, Ji-Won Eom, J. Koo, Byoung Lok Park, Hyunsoo Park, Insook Sohn
The study aimed to review the current postpartum care service system and suggest measures of improvement for the public reinforcement of the private-postpartum care center (PCC). We conducted a review of literature, including an internet search, and we analyzed the in-depth interviews using questionnaires answered by workers from the 6 private-PCCs operated in Goyang city. Using these data, we derived possible measures which could improve the publicity of private-PCCs. It was found that the 11 nationwide public-PCCs had serious operating deficits, and its utilization by the vulnerable was insufficient. In areas where private-PCCs are concentrated, we can propose the following policies to strengthen publicity, rather than establishing another public-PCC. First, it is important to provide support for private-PCCs to apply cost reductions for vulnerable groups, similar to the maternal and newborn medical care of public-PCCs. Second, publicity would be strengthened by reorganizing the pregnancy and childbirth education program, while also offering additional services for mothers with stillbirths and abortions. For the integrated management of postpartum care services, this should be shifted towards reinforcing the publicity of private-PCCs, rather than operating a public-PCC in relatively concentrated private-PCC areas. Through these policies, it is expected that financial and administrative waste will be reduced, and an integrated management system for postpartum care services will be established.
本研究旨在检讨目前的产后护理服务体系,并提出改善民办产后护理中心(PCC)的措施。我们进行了文献回顾,包括互联网搜索,并使用来自高阳市6家私营pccs的员工回答的问卷分析了深度访谈。利用这些数据,我们得出了可能的措施,以提高私营pccs的宣传。调查发现,全国11家公立医院经营赤字严重,弱势群体利用不足。在民营政协集中的地区,我们可以提出以下政策来加强宣传,而不是再建立一个公立政协。首先,重要的是为私营医疗保健公司提供支持,使其能够像公立医疗保健公司的孕产妇和新生儿医疗服务一样,为弱势群体提供成本削减。第二,通过重新组织怀孕和分娩教育项目来加强宣传,同时也为死产和堕胎的母亲提供额外的服务。对于产后护理服务的综合管理,应转向加强民营分娩中心的宣传,而不是在民营分娩中心相对集中的地区开设公立分娩中心。通过这些政策,预计将减少财政和行政浪费,并建立产后护理服务的综合管理体系。
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引用次数: 0
Congenital Syphilis in Neonate: A Single Center Study for 10 Years 新生儿先天性梅毒:10年单中心研究
Pub Date : 2021-07-31 DOI: 10.21896/jksmch.2021.25.3.204
N. Lee, M. Jeong, S. Jeong, M. Bae, Y. Han, K. Park, S. Byun
Purpose: Syphilis infections are becoming more prevalent in the Republic of Korea, and inadequately treated syphilis can lead to congenital syphilis (CS) in newborns. This study aimed to analyze the clinical manifestations of syphilis in mothers and newborns and to make suggestions to improve disease prognosis. Methods: This single-center study was performed between August 2009 and August 2019 and included 29 newborns with CS. We retrospectively evaluated the clinical features, rapid plasma reagin (RPR) card test, fluorescent treponemal antibody absorption test (FTA-ABS), morbidity, and treatment regimen of all the syphilis-affected mothers and their newborns. Results: At the time of delivery, mean maternal age was 29.0±6.1 years old, and newborn gestational age was 38.0 weeks. In cases when syphilis was confirmed during the second and third trimesters of pregnancy, the newborn with CS had morbidity (p=0.004). The mean RPR titer was related to morbidity (p= 0.036). Positive results of FTA-ABS IgM (p<0.001) and pleocytosis in the cerebrospinal fluid (CSF) (p= 0.020) also increase morbidity. The most common symptoms were desquamation and skin rash, followed by hepatomegaly, neurodevelopmental disability, and bone abnormalities. The highest number of CS cases per 1,000 live births in this hospital was in 2014. Conclusion: CS is a preventable and treatable disease if physicians detect symptoms and provide appropriate treatment through RPR examinations during every trimester. General practitioners should be widely trained on various aspects including early detection, formal treatment, and regular follow-up. Additionally, medical services should be provided for the entire childbearing population regardless of the socioeconomic status.
目的:梅毒感染在韩国变得越来越普遍,治疗不当的梅毒可导致新生儿先天性梅毒(CS)。本研究旨在分析母婴梅毒的临床表现,提出改善疾病预后的建议。方法:本研究于2009年8月至2019年8月进行,纳入29例CS新生儿。回顾性评价所有梅毒母亲及其新生儿的临床特征、快速血浆反应素(RPR)卡试验、荧光螺旋体抗体吸收试验(FTA-ABS)、发病率及治疗方案。结果:分娩时,产妇平均年龄29.0±6.1岁,新生儿胎龄38.0周。在妊娠中期和晚期确诊梅毒的病例中,新生儿CS的发病率(p=0.004)。平均RPR滴度与发病率相关(p= 0.036)。FTA-ABS IgM阳性(p<0.001)和脑脊液(CSF)多细胞增多(p= 0.020)也增加了发病率。最常见的症状是脱屑和皮疹,其次是肝肿大、神经发育障碍和骨骼异常。该医院每1000名活产婴儿中CS病例数最高的年份是2014年。结论:如果医生在每个妊娠期通过RPR检查发现症状并给予适当治疗,CS是一种可预防和治疗的疾病。全科医生应在早期发现、正式治疗和定期随访等各方面进行广泛培训。此外,应向所有育龄人口提供医疗服务,无论其社会经济地位如何。
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引用次数: 0
Response Guidelines for Coronavirus Disease 2019 in Newborn Infants: A 2021 Update 2019年新生儿冠状病毒病应对指南:2021年更新
Pub Date : 2021-07-30 DOI: 10.21896/jksmch.2021.25.3.162
Do-Hyun Kim
Since the first report of neonatal case on March 29, 2020, a small number of coronavirus disease 2019 (COVID-19) cases in newborn infants have been reported in Korea. The COVID-19 pandemic in Korea has urged the development of response guidelines for newborn infants born to mothers with suspected or confirmed COVID-19. These guidelines have been revised following further updates on COVID-19. The Korean Society of Pediatric Infectious Diseases and the Korean Society of Neonatology issued updated guidelines for COVID-19 in newborn infants on December 31, 2020. The present review introduces the management of newborn infants born to mothers with suspected or confirmed COVID-19, based on current updated guidelines for COVID-19. The management includes infection precautions for healthcare workers, neonatal resuscitation, neonatal isolation and medical care, breastfeeding, testing for COVID-19, and mother/baby contact.
自2020年3月29日首次报告新生儿病例以来,国内出现了少量新生儿新冠肺炎(COVID-19)病例。在韩国,新冠肺炎大流行敦促制定针对疑似或确诊COVID-19母亲所生新生儿的应对指南。根据COVID-19的进一步更新,本指南已进行了修订。韩国儿科传染病学会和韩国新生儿学会于2020年12月31日发布了最新的新生儿COVID-19指南。本综述根据最新的COVID-19指南,介绍了对疑似或确诊COVID-19母亲所生新生儿的管理。管理包括卫生保健工作者的感染预防措施、新生儿复苏、新生儿隔离和医疗保健、母乳喂养、COVID-19检测以及母婴接触。
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引用次数: 1
A Study on the Relationship between Fatigue, Psychosocial Stress, and Behavior that Reduces Endocrine Disrupting Chemicals Exposure in Infertile Males 不育男性疲劳、心理社会压力和减少内分泌干扰物暴露行为之间关系的研究
Pub Date : 2021-07-30 DOI: 10.21896/jksmch.2021.25.3.211
S. Kim, S. Choi
Purpose: This study aimed to identify the relationships between fatigue, psychosocial stress, and behavior of infertile males that reduces endocrine-disrupting chemical (EDC) exposure and to provide baseline data needed for nursing intervention. Methods: A total of 110 infertile males were recruited from a special fertility hospital in Gwangju city in Korea. The participants were administered a self-reported questionnaire. Results: The mean scores were as follows: for fatigue, 59.1 out of 133; for psychosocial stress, 20.3 out of 54; and for behavior that reduced EDC exposure, 52.6 out of 85. Fatigue and psychosocial stress had a positive correlation(r=0.68, p<0.001), behavior that reduces EDC exposure was negatively correlated with fatigue and psychosocial stress(r=-0.54, p<0.001; r=-0.61, p<0.001) Conclusion: Fatigue and stress were higher in infertile males. Our findings suggest that a nursing intervention program should focus on reducing fatigue and stress in infertile males and induce behaviors that decrease EDC exposure.
目的:本研究旨在确定疲劳、心理社会压力和不育男性行为之间的关系,以减少内分泌干扰化学物质(EDC)的暴露,并为护理干预提供所需的基线数据。方法:从韩国光州某生育专科医院招募110例不育男性。参与者被要求填写一份自我报告的问卷。结果:疲劳平均得分为59.1分(133分);在心理社会压力方面,54分中有20.3分;对于减少EDC暴露的行为,85人中有52.6人。疲劳与心理社会压力呈正相关(r=0.68, p<0.001),减少EDC暴露的行为与疲劳和心理社会压力呈负相关(r=-0.54, p<0.001);r=-0.61, p<0.001)结论:不育男性的疲劳和应激水平较高。我们的研究结果表明,护理干预计划应侧重于减少不育男性的疲劳和压力,并诱导减少EDC暴露的行为。
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引用次数: 0
First-Time Mothers’ Grit, Spousal Support, and Age, and Their Relationships with Nurturing Passion, Postpartum Depression, and Happiness 初为人母的勇气、配偶支持、年龄及其与养育激情、产后抑郁和幸福感的关系
Pub Date : 2021-07-30 DOI: 10.21896/jksmch.2021.25.3.177
Yerim Jeong, Yae-Joung Kim, Sujin Yang
Purpose: This study aimed to examine whether first-time mothers’ grit, spousal support, and age can make significant differences in latent means of child-rearing passion, postpartum depression, and happiness. Methods: Data were collected from April 2 to July 16, 2019. Two hundred sixteen first-time mothers of infants and toddlers aged 0–2 years participated in a self-reported questionnaire study in which scales of nurturing passion, postpartum depression, happiness, grit, and spousal support were included. The collected data were analyzed with IBM SPSS ver. 18.0 (IBM Co., Armonk, NY, USA) for descriptive statistics and Pearson correlation analyses. In addition, Mplus (ver. 7.0) was used for the Multiple Indicators Multiple Causes (MIMIC) model approach. Results: The MIMIC model yielded an appropriate fit to the data (χ2=103.74, degrees of freedom=53, comparative fit index=0.96, root mean square error of approximation=0.07, standardized root mean square residual=0.05). The paths from grit and spousal support all had significantly positive beta coefficients (p<0.05) to child-rearing passion (β=0.3 and β=0.26, respectively) and happiness (β=0.22 and β=0.39, respectively), while the corresponding paths to postpartum depression were all negatively significant (β= -0.24 for both). These results suggest that unlike chronological maturity (i.e., age), grittier individuals with stronger spousal support display greater passion for child-rearing, as well as greater happiness. In a similar vein, they suffered less from postpartum depression. Conclusion: These results imply that grit can be employed to enhance first-time mothers’ child-rearing passion and happiness as it can also concurrently offset the effects of a negative labor and child-birth experience on first-time mothers’ mental health, e.g., in terms of reducing postpartum depression.
目的:本研究旨在探讨初为母亲的勇气、配偶支持和年龄是否对育儿热情的潜在手段、产后抑郁和幸福感有显著影响。方法:2019年4月2日至7月16日收集数据。216名0-2岁婴儿和幼儿的母亲参加了一项自我报告的问卷研究,其中包括养育激情,产后抑郁,幸福感,毅力和配偶支持的量表。收集的数据用IBM SPSS ver进行分析。18.0 (IBM Co., Armonk, NY, USA)进行描述性统计和Pearson相关分析。此外,Mplus (ver。7.0)用于多指标多原因(MIMIC)模型方法。结果:MIMIC模型与数据拟合较好(χ2=103.74,自由度=53,比较拟合指数=0.96,近似均方根误差=0.07,标准化均方根残差=0.05)。坚毅和配偶支持对育儿热情(分别为β=0.3和β=0.26)和幸福感(分别为β=0.22和β=0.39)的影响路径均为显著正(p<0.05),对产后抑郁的影响路径均为显著负(β= -0.24)。这些结果表明,与时间成熟度(即年龄)不同,拥有更强配偶支持的坚强个体对养育孩子表现出更大的热情,也表现出更大的幸福感。同样,她们患产后抑郁症的几率也更小。结论:这些结果表明,毅力可以增强初产妇的育儿热情和幸福感,同时也可以抵消负面分娩和分娩经历对初产妇心理健康的影响,如减少产后抑郁。
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引用次数: 0
Factors Predicting afterward Childbirth for Infertile Women: The Intensity of Physical Activity 不孕妇女分娩后的预测因素:运动强度
Pub Date : 2021-07-30 DOI: 10.21896/jksmch.2021.25.3.197
Kyueun Han, Miner Km
Purpose: The aim of this study was to investigate the intensity of physical activity predicting afterward childbirth for infertile women in order to improve the development of an infertility support.Methods: The complete enumeration data of the National Health Insurance Service of Korea for women who had been diagnosed with infertility in 2016 were analyzed to investigate the predictors of childbirth in 2016–2017. The data were analyzed using descriptive statistics and linear regression with SPSS.Results: When age and body mass index were controlled for, intermediate intense physical activity increased the rate of childbirth, but low or heavy intensity did not.Conclusion: Women who have been diagnosed with infertility should be given advice to engage in intermediate levels of physical activity in order to increase their chances of having a child.
目的:本研究的目的是探讨体力活动强度对不孕妇女分娩后的预测,以改善不孕支持的发展。方法:分析韩国国民健康保险公团2016年诊断为不孕症的妇女的完整统计数据,探讨2016 - 2017年分娩的预测因素。数据采用描述性统计和SPSS线性回归分析。结果:在控制年龄和体重指数的情况下,中等强度的体力活动增加了分娩率,而低强度或高强度的体力活动没有增加分娩率。结论:被诊断为不孕症的妇女应该被建议从事中等水平的体育活动,以增加她们生育孩子的机会。
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引用次数: 1
A Structural Model for Breastfeeding Behavior of First-Time Mothers 第一次母亲母乳喂养行为的结构模型
Pub Date : 2021-07-30 DOI: 10.21896/jksmch.2021.25.3.184
Seol Hui Park, Seang Ryu
Purpose: This study aimed to develop a structural model to explain breastfeeding behavior of primipara based on information-motivation-behavioral skills. Variables were breastfeeding knowledge, breastfeeding motivation, breastfeeding self-efficacy, and parenting stress. Methods: Participants were first-time mothers who were breastfeeding infants from birth to 6 months. Data were collected from 5 pediatric hospitals and 1 public health center in Jeollanam-do from December 24, 2018 to February 28, 2019. A total of 285 questionnaires were included in the analysis. Data were analyzed using IBM SPSS Statistics ver. 20.0 and AMOS 20.0 programs. Results: Fitness statistics for the hypothetical model were appropriate (χ2=48.30 [degrees of freedom= 14, p<0.001], goodness of fit index=0.96, normed fit index=0.89, comparative fit index=0.92, standardized root mean square residual=0.06). Breastfeeding self-efficacy had the most direct and total impact on breastfeeding behaviors (β=0.38, p=0.01). Breastfeeding self-efficacy was directly and totally influenced by breastfeeding knowledge (β=-0.18, p=0.01), breastfeeding motivation (β=0.26, p=0.01). Parenting stress showed a direct effect on breastfeeding self-efficacy (β=-0.14, p=0.02) and breastfeeding behavior (β=0.20, p=0.01), confirming its modulating effect on both variables. Conclusion: Since breastfeeding self-efficacy was the most important variable for the breastfeeding behavior in first-time mothers, nursing interventions should be developed to promote breastfeeding selfefficacy including accurate breastfeeding information and enhanced breastfeeding motivation. Strategies that could relieve or adjust parenting stress should be considered since parenting stress had a causal relationship with breastfeeding self-efficacy and breastfeeding behavior.
目的:建立基于信息-动机-行为技能的初产妇母乳喂养行为的结构模型。变量为母乳喂养知识、母乳喂养动机、母乳喂养自我效能感和育儿压力。方法:参与者是第一次母乳喂养婴儿从出生到6个月的母亲。数据收集自2018年12月24日至2019年2月28日全罗南道5家儿科医院和1家公共保健中心。分析共纳入285份问卷。数据采用IBM SPSS Statistics ver进行分析。20.0和AMOS 20.0程序。结果:假设模型的拟合统计量适宜(χ2=48.30[自由度= 14,p<0.001],拟合优度指数=0.96,归一化拟合指数=0.89,比较拟合指数=0.92,标准化均方根残差=0.06)。母乳喂养自我效能感对母乳喂养行为的影响最直接、最全面(β=0.38, p=0.01)。母乳喂养自我效能感受母乳喂养知识(β=-0.18, p=0.01)和母乳喂养动机(β=0.26, p=0.01)的直接和完全影响。父母压力对母乳喂养自我效能感(β=-0.14, p=0.02)和母乳喂养行为(β=0.20, p=0.01)有直接影响,证实了父母压力对两个变量的调节作用。结论:母乳喂养自我效能感是影响初产母亲母乳喂养行为的最重要变量,应通过制定准确的母乳喂养信息和增强母乳喂养动机等护理干预措施来提高母乳喂养自我效能感。由于父母压力与母乳喂养自我效能感和母乳喂养行为存在因果关系,因此应考虑缓解或调节父母压力的策略。
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引用次数: 1
The Study of Relationship among Infertility Stress, Gratitude, and Couple Relationship Changes of Women Undergoing Reproductive Treatments 生殖治疗女性不孕压力、感恩与夫妻关系变化的关系研究
Pub Date : 2021-07-30 DOI: 10.21896/jksmch.2021.25.3.169
Miok Kim, Jummi Park, J. Hong, Minkyung Ban
Purpose: We aim to assess infertility stress, gratitude, and changes in couple relationship of the women under reproductive treatments and to identify the relationships between variables. Methods: The subjects were 212 infertile women receiving reproductive treatments. The data were collected by self-administered questionnaires from June to August in 2019. The questionnaire consisted of the questions about infertility stress, gratitude and changes in their couple relationships. Descriptive statistics, t-tests, 1-way analysis of variance, and correlation coefficient were analyzed using the SPSS 26.0 Windows program. Results: The level of Infertility stress, gratitude, and changes in couple relationship averaged 3.23±0.59 (range of 1 to 6), 4.85±1.06 (range of 1 to 6), 3.03±0.55 (range of 1 to 5), respectively. Infertility stress had a negative correlation with gratitude (r=-0.322, p<0.001) and changes in couple relationship (r= -0.371, p<0.001). Gratitude also had a negative correlation with changes in couple relationship (r=-0.370, p<0.001). Conclusion: The results revealed that infertility stress has a negative correlation with gratitude and changes in couple relationship. Thus, psychological interventions that can alleviate negative emotions should be provided.
目的:我们旨在评估不孕不育的压力、感恩和夫妻关系的变化,并确定变量之间的关系。方法:以212名接受生殖治疗的不孕妇女为研究对象。这些数据是在2019年6月至8月通过自填问卷收集的。调查问卷包括不孕压力、感恩和夫妻关系变化等问题。采用SPSS 26.0 Windows软件进行描述性统计、t检验、单因素方差分析和相关系数分析。结果:不孕压力、感恩和夫妻关系变化的平均水平分别为3.23±0.59(1 ~ 6范围)、4.85±1.06(1 ~ 6范围)和3.03±0.55(1 ~ 5范围)。不孕压力与感恩(r=-0.322, p<0.001)和夫妻关系变化(r= -0.371, p<0.001)呈负相关。感恩与夫妻关系变化呈负相关(r=-0.370, p<0.001)。结论:不孕压力与感恩及夫妻关系变化呈负相关。因此,应该提供能够缓解负面情绪的心理干预。
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引用次数: 0
Congenital Cytomegalovirus Infection in Pregnancy: A Case Report with Sequential Fetal Brain Changes and the Latest Information on Diagnosis, Treatment and Prevention 妊娠期先天性巨细胞病毒感染:胎儿脑序贯改变1例及最新诊断、治疗和预防信息
Pub Date : 2021-04-30 DOI: 10.21896/JKSMCH.2021.25.2.142
E. J. Choi, J. Han
Congenital cytomegalovirus (CMV) infection is the most common nongenetic cause of sensorineural hearing loss and a major cause of visual, intellectual, and neurodevelopmental impairment worldwide. The seroprevalence of CMV among women of childbearing age in developing countries reaches almost 100%, and the incidence of CMV infection in neonates is 1%–2%. Approximately 87% of the infected neonates are asymptomatic at birth and 13% of them have permanent sequelae. The burden of congenital malformations due to congenital CMV infection is higher than that due to Down syndrome, fetal alcohol syndrome, and spina bifida. Nevertheless, there is little knowledge regarding congenital CMV pathogenesis, diagnosis, treatment, and prevention. In this study, we report a case that showed sequential changes of fetal brain following CMV infection in pregnancy. Additionally, we reviewed the latest information on the diagnosis, treatment, and prevention of congenital CMV infection.
先天性巨细胞病毒(CMV)感染是感音神经性听力损失最常见的非遗传性原因,也是世界范围内视觉、智力和神经发育障碍的主要原因。发展中国家育龄妇女巨细胞病毒的血清阳性率几乎达到100%,新生儿巨细胞病毒感染率为1%-2%。大约87%的受感染新生儿在出生时无症状,其中13%有永久性后遗症。先天性巨细胞病毒感染导致先天性畸形的负担高于唐氏综合征、胎儿酒精综合征和脊柱裂。然而,关于先天性巨细胞病毒的发病机制、诊断、治疗和预防方面的知识很少。在这项研究中,我们报告了一例妊娠期巨细胞病毒感染后胎儿大脑的序列变化。此外,我们回顾了先天性巨细胞病毒感染的诊断、治疗和预防的最新信息。
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引用次数: 0
Coronavirus Disease 2019 and Pregnancy 2019冠状病毒病与妊娠
Pub Date : 2021-01-31 DOI: 10.21896/JKSMCH.2021.25.1.10
H. Cha, W. Seong
With the continued fight against coronavirus disease 2019 (COVID-19), new guidelines on its management are emerging; however, information on COVID-19 and pregnancy remains limited. Therefore, this study aimed to review the guidelines of the American College of Obstetricians and Gynecologists, Society for Maternal Fetal Medicine, and Royal College Obstetrics and Gynecology and International Society of Ultrasound in Obstetrics and Gynecology.
随着与2019冠状病毒病(COVID-19)的持续斗争,正在制定新的管理指南;然而,关于COVID-19和怀孕的信息仍然有限。因此,本研究旨在回顾美国妇产科学会、母胎医学学会、皇家妇产科学院和国际妇产科超声学会的指导方针。
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引用次数: 15
期刊
Journal of The Korean Society of Maternal and Child Health
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