Knowledge Of Newborn Care Research Articles

아기모형을 활용한 신생아 돌봄 교육 프로그램 적용 효과

The aims of this study were to examine the effects of a newborn care program (NCP) using an infant model. The subjects of this study were 48 mothers in the G city postpartum center. The NCP educational program was provided orally and via demonstration three times in two weeks. Pre and post questionnaires were given and the data was collected in July 2013 to September 2013. The findings suggest that knowledge of the newborn levels were increased significantly after the NCP (Mean=2.27 vs. 2.81, t=-7.049, p<.001). Parenting efficacy levels were increased significantly after the NCP (Mean=2.69 vs 2.89, t=-5.545, p<.001). The satisfaction with the education levels was 4.12. These findings suggest that providing a structured NCP educational program will be useful for adapting and obtaining a new mother role by improving the level of parenting efficacy and newborn care knowledge.

Use of job aids to improve facility-based postnatal counseling and care in rural Benin.

This study examined the effect of a job aids-focused intervention on quality of facility-based postnatal counseling, and whether increased communication improved in-hospital newborn care and maternal knowledge of home practices and danger signs requiring urgent care. Ensuring mothers and newborns receive essential postnatal services, including health counseling, is integral to their survival. Yet, quality of clinic-based postnatal services is often low, and evidence on effective improvement strategies is scarce. Using a pre-post randomized design, data were drawn from direct observations and interviews with 411 mother-newborn pairs. Multi-level regression models with difference-in-differences analyses estimated the intervention's relative effect, adjusting for changes in the comparison arm. The mean percent of recommended messages provided to recently-delivered women significantly improved in the intervention arm as compared to the control (difference-in-differences [∆i - ∆c] +30.9, 95 % confidence interval (CI) 19.3, 42.5), and the proportion of newborns thermally protected within the first hour (∆i - ∆c +33.7, 95 % CI 19.0, 48.4) and delayed for bathing (∆i - ∆c +23.9, 95 % CI 9.4, 38.4) significantly increased. No significant changes were observed in early breastfeeding (∆i - ∆c +6.8, 95 % CI -2.8, 16.4) which was nearly universal. Omitting traditional umbilical cord substances rose slightly, but was insignificant (∆i - ∆c +8.5, 95 % CI -2.8, 19.9). The proportion of mothers with correct knowledge of maternal (∆i - ∆c +27.8, 95 % CI 11.0, 44.6) and newborn (∆i - ∆c +40.3, 95 % CI 22.2, 58.4) danger signs grew substantially, as did awareness of several home-care practices (∆i - ∆c +26.0, 95 % CI 7.7, 44.3). Counseling job aids can improve the quality of postnatal services. However, achieving reduction goals in maternal and neonatal mortality will likely require more comprehensive approaches to link enhanced facility services with community-based initiatives.

Newborn care knowledge and practices among mothers attending pediatric outpatient clinic of a hospital in Karachi, Pakistan.

To assess newborn care knowledge and practices among mothers. A cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. A total of 170 mothers accompanying their infants attending the Paediatric Out Patient Department were interviewed through a structured questionnaire. Areas of inquiry included Antenatal care seeking, delivery care, cord care, eye care, bathing and breastfeeding practices. Ninety-two percent mothers reported at least one antenatal care visit. Tetanus Toxoid coverage was 88%. Home deliveries were 18%. Seventy-four percent reported applying various substances like coconut oil, mustard oil, purified butter and turmeric to the cord stump. Kohl application to newborn's eyes was 68%, while 86% reported first bath within 24 hrs of birth. 48% mothers initiated breastfeeding within 2 hours of delivery. Colostrum was discarded by 43% and prelacteal feeds given by 73%. Exclusive Breast Feeding rate was 26%. Family income of Rs. 10, 000 (USD120) or less/month and maternal education level of primary or less were significantly associated with home delivery, unhygienic cord care and kohl application to the newborn's eyes. Home delivery was a risk factor for poor cord care (OR=4.07) and discarding colostrum (OR= 3.18). Antenatal care coverage was good, but knowledge regarding newborn care was poor. Harmful practices regarding newborn care were prevalent among mothers. Institutional deliveries did not guarantee optimal practices. Tradition and culture played a significant role. Health education can improve the mothers' knowledge regarding newborn care practices.

G313(P) Establishing a Neonatal Unit in Arba Minch Hospital, Ethiopia

BackgroundNeonatal mortality remains high in Ethiopia at 35/1000, despite improvements in reducing the overall child mortality. Through the RCPCH VSO Fellowship a Paediatric trainee was placed in Arba Minch Hospital,...

Primary healthcare worker knowledge related to prenatal and immediate newborn care: a cross sectional study in Masindi, Uganda

BackgroundGlobal neonatal mortality remains unacceptably high. Health workers who attend to prenatal and postnatal mothers need to be knowledgeable in preventive and curative care for pregnant women and their newborn babies. This study aimed to determine the level of knowledge related to prenatal and immediate newborn care among primary healthcare workers in Masindi, Uganda.MethodsA cross-sectional study was conducted. Interviews comprised of 25 multiple-choice questions were administered to health workers who were deployed to offer prenatal and postnatal care in Masindi in November 2011. Questions were related to four domains of knowledge: prenatal care, immediate newborn care, management of neonatal infections and identifying and stabilizing Low-Birth Weight (LBW) babies. Corresponding composite variables were derived; level of knowledge among health workers dichotomized as ‘adequate’ or ‘inadequate’. The chi-square statistic test was used to examine associations with independent variables including level of training (nursing assistant, general nurse or midwife), level of care (hospital/health centre level IV or health centre level III/II) and years of service (five years or less, six years or more).Results183 health workers were interviewed: general nurses (39.3%), midwives (21.9%) and nursing assistants (38.8%). Respectively, 53.6%, 46.5%, 7.1% and 56.3% were considered to have adequate knowledge in prenatal care, newborn care, management of neonatal infections and identifying/stabilizing LBW babies. Being a general nurse was significantly associated with having adequate knowledge in identifying and stabilizing LBW babies (p < 0.001) compared to being a nursing assistant. Level of care being hospital/health centre level IV was not significantly associated with having adequate knowledge in prenatal or newborn care with reference to health centres of level III/II.ConclusionKnowledge regarding prenatal and newborn care among primary healthcare workers in Masindi was very low. The highest deficit of knowledge was in management of neonatal infections. Efforts are needed to orientate health workers regarding prenatal and newborn care especially the offer of infection management among newborns. Similar levels of knowledge between health workers deployed to hospital/health centre level IV and health centres of level III/II raise important implementation questions for the referral system which is crucial for maternal and newborn survival.

Corrigendum: Effects of Newborn Care Education for First-time Fathers on Their Knowledge and Confidence in Newborn Care at Postpartum One Month

Corrigendum: Effects of Newborn Care Education for First-time Fathers on Their Knowledge and Confidence in Newborn Care at Postpartum One Month

Knowledge and perceptions of quality of obstetric and newborn care of local health providers: a cross-sectional study in three districts in Malawi.

Quality of service delivery for maternal and newborn health in Malawi is influenced by human resource shortages and knowledge and care practices of the existing service providers. We assessed Malawian healthcare providers' knowledge of management of routine labour, emergency obstetric care and emergency newborn care; correlated knowledge with reported confidence and previous study or training; and measured perception of the care they provided. This study formed part of a large-scale quality of care assessment in three districts (Kasungu, Lilongwe and Salima) of Malawi. Subjects were selected purposively by their role as providers of obstetric and newborn care during routine visits to health facilities by a research assistant. Research assistants introduced and supervised the self-completed questionnaire by the service providers. Respondents included 42 nurse midwives, 1 clinical officer, 4 medical assistants and 5 other staff. Of these, 37 were staff working in facilities providing Basic Emergency Obstetric Care (BEMoC) and 15 were from staff working in facilities providing Comprehensive Emergency Obstetric Care (CEMoC). Knowledge regarding management of routine labour was good (80% correct responses), but knowledge of correct monitoring during routine labour (35% correct) was not in keeping with internationally recognized good practice. Questions regarding emergency obstetric care were answered correctly by 70% of respondents with significant variation depending on clinicians' place of work. Knowledge of emergency newborn care was poor across all groups surveyed with 58% correct responses and high rates of potentially life-threatening responses from BEmOC facilities. Reported confidence and training had little impact on levels of knowledge. Staff in general reported perception of poor quality of care. Serious deficiencies in providers' knowledge regarding monitoring during routine labour and management of emergency newborn care were documented. These may contribute to maternal and neonatal deaths in Malawi. The knowledge gap cannot be overcome by simply providing more training.

Contribution of community-based newborn health promotion to reducing inequities in healthy newborn care practices and knowledge: evidence of improvement from a three-district pilot program in Malawi

BackgroundInequities in both health status and coverage of health services are considered important barriers to achieving Millennium Development Goal 4. Community-based health promotion is a strategy that is believed to reduce inequities in rural low-income settings. This paper examines the contributions of community-based programming to improving the equity of newborn health in three districts in Malawi.MethodsThis study is a before-and-after evaluation of Malawi’s Community-Based Maternal and Newborn Care (CBMNC) program, a package of facility and community-based interventions to improve newborn health. Health Surveillance Assistants (HSAs) within the catchment area of 14 health facilities were trained to make pregnancy and postnatal home visits to promote healthy behaviors and assess women and newborns for danger signs requiring referral to a facility. “Core groups” of community volunteers were also trained to raise awareness about recommended newborn care practices. Baseline and endline household surveys measured the coverage of the intervention and targeted health behaviors for this before-and-after evaluation. Wealth indices were constructed using household asset data and concentration indices were compared between baseline and endline for each indicator.ResultsThe HSAs trained in the intervention reached 36.7% of women with a pregnancy home visit and 10.9% of women with a postnatal home visit within three days of delivery. Coverage of the intervention was slightly inequitable, with richer households more likely to receive one or two pregnancy home visits (concentration indices (CI) of 0.0786 and 0.0960), but not significantly more likely to receive a postnatal visit or know of a core group. Despite modest coverage levels for the intervention, health equity improved significantly over the study period for several indicators. Greater improvements in inequities were observed for knowledge indicators than for coverage of routine health services. At endline, a greater proportion of women from the poorest quintile knew three or more danger signs for pregnancy, delivery, and postpartum mothers than did women from the least poor quintile (change in CI: -0.1704, -0.2464, and -0.4166, respectively; p < 0.05). Equity also significantly improved for coverage of some health behaviors, including delivery at a health facility (change in CI: -0.0591), breastfeeding within the first hour (-0.0379), and delayed bathing (-0.0405).ConclusionsAlthough these results indicate promising improvements for newborn health in Malawi, the extent to which the CBMNC program contributed to these improvements in coverage and equity are not known. The strategies through which community-based programs are implemented likely play an important role in their ability to improve equity, and further research and program monitoring are needed to ensure that the poorest households are reached by community-based health programs.

Online Neonatal Training and Orientation Programme in India (ONTOP-IN)--The Way Forward for Distance Education in Developing Countries

Internet-based distance learning combined with local hands-on skill enhancement can provide high-quality standardized education to in-service healthcare professionals in a wide geographical area. Primary objective of this study was to evaluate the efficacy of internet-based distance learning in conjunction with local hands-on skill enhancement in improving knowledge and skills of essential newborn care among in-service nursing health professionals. A total of 98 participants from seven health facilities in India and Maldives were enrolled in the study. Delivery of course material staggered over 5 weeks in the form of two lessons every week was moderated by two to three online tutors at each site. Participants managed actual case scenarios, participated in discussion forums and synchronous chat sessions within a closed group. Skill learning was administered by local tutor at the partnering health facilities. Knowledge and skill enhancement were evaluated by administering online multiple-choice questions (MCQs) test and on-site objective structured clinical evaluation (OSCE) stations before and after completion of the course. Participants' satisfaction was evaluated on a five-point Likert scale. Among 98 participants enrolled in the study, 78 (79%) completed the post-test assessment. There was significant increase in knowledge and skills scores (MCQ test: mean difference: 6.4 (95% CI: 5.6-7.17), OSCE: mean difference: 15.4 (95% CI: 12.7-18.1). All the participants expressed satisfaction with content and delivery of the learning module. To conclude, online training and teaching in essential newborn care is feasible and acceptable for in-service nursing professionals and serves as a useful tool for professional development of their practical skills and knowledge.

Antenatal counseling in maternal and newborn care: use of job aids to improve health worker performance and maternal understanding in Benin

BackgroundAntenatal care provides an important opportunity to improve maternal understanding of care during and after pregnancy. Yet, studies suggest that communication is often insufficient. This research examined the effect of a job aids-focused intervention on quality of counseling and maternal understanding of care for mothers and newborns.MethodsCounseling job aids were developed to support provider communication to pregnant women. Fourteen health facilities were randomized to control or intervention, where providers were trained to use job aids and provided implementation support. Direct observation of antenatal counseling sessions and patient exit interviews were undertaken to assess quality of counseling and maternal knowledge. Providers were also interviewed regarding their perceptions of the tools. Data were collected before and after the job aids intervention and analyzed using a difference-in-differences analysis to quantify relative changes over time.ResultsMean percent of recommended messages provided to pregnant women significantly improved in the intervention arm as compared to the control arm in birth preparedness (difference-in-differences [ΔI-C] = +17.9, 95%CI: 6.7,29.1), danger sign recognition (ΔI-C = +26.0, 95%CI: 14.6,37.4), clean delivery (ΔI-C = +21.7, 95%CI: 10.9,32.6), and newborn care (ΔI-C = +26.2, 95%CI: 13.5,38.9). Significant gains were also observed in the mean percent of communication techniques applied (ΔI-C = +28.8, 95%CI: 22.5,35.2) and duration (minutes) of antenatal consultations (ΔI-C = +5.9, 95%CI: 3.0,8.8). No relative increase was found for messages relating to general prenatal care (ΔI-C = +8.2, 95%CI: -2.6,19.1). The proportion of pregnant women with correct knowledge also significantly improved for birth preparedness (ΔI-C = +23.6, 95%CI: 9.8,37.4), danger sign recognition (ΔI-C = +28.7, 95%CI: 14.2,43.2), and clean delivery (ΔI-C = +31.1, 95%CI: 19.4,42.9). There were no significant changes in maternal knowledge of general prenatal (ΔI-C = -6.4, 95%CI: -21.3,8.5) or newborn care (ΔI-C = +12.7, 95%CI: -6.1,31.5). Job aids were positively perceived by providers and pregnant women, although time constraints remained for health workers with other clinical responsibilities.ConclusionsThis study demonstrates that a job aids-focused intervention can be integrated into routine antenatal care with positive outcomes on provider communication and maternal knowledge. Efforts are needed to address time constraints and other communication barriers, including introduction of on-going quality assessment for long-term sustainability.

O hospital infantil como marco no atendimento ao recém-nascido de risco em Santa Catarina (1987-2009)

O objetivo deste estudo é descrever como se deu o processo de implantação da Unidade de Terapia Intensiva neonatal, em Florianópolis, na década de 1980, e apresentar a sua relevância para o cuidado ao recém-nascido de risco. Pesquisa qualitativa, com abordagem sócio-histórica. O contexto do estudo foi o Hospital Infantil Joana de Gusmão. Os sujeitos foram 13 profissionais de saúde que participaram da implantação da unidade. A análise dos dados utilizou o método genealógico. Os resultados indicam que esta unidade representou um marco no cuidado intensivo neonatal catarinense e que os profissionais que contribuíram na implantação e implementação do cuidado foram fundamentais na instituição do saber, das práticas de cuidado ao recém-nascido e na instituição de novos sujeitos profissionais. Conclui-se que a necessidade de atendimento especializado foi a grande propulsora da criação da terapia intensiva neonatal e da constituição do saber profissional para o cuidado ao recém-nascido.

Antenatal education for expectant mothers results in sustained improvement in knowledge of newborn care

Basic perinatal education to increase parental knowledge of neonatal illnesses (such as respiratory distress, sepsis, complications of prematurity) could be a feasible way to reduce high neonatal mortality rates in limited-resource nurseries. To assess the efficacy of antenatal education in increasing mothers' knowledge of basic newborn care in a limited-resource nursery, and to determine whether the knowledge is retained postpartum. In March to April 2008, we implemented a 10-min educational program on basic neonatal care for women receiving prenatal care in a maternal child hospital in Vientiane, Laos. The educational intervention was a structured, face-to-face interactive module taught by Lao providers using pictographic and written materials about temperature control, umbilical cord care and signs of neonatal illness. We assessed knowledge before and immediately after the module using a standardized interview tool. When possible, we reassessed knowledge postpartum to determine whether they retained information after the training. We recruited 101 women (average age=26.3 years), and the majority (53%) were primigravidas. Participants were well educated by local standards; 57% of women had >8 years and 28% had >12 years of education. Women's knowledge of neonatal care increased by 10% on immediate posttest (P<0.0001), especially regarding knowledge of umbilical cord care and temperature control (normal temperature ranges, thermometer use). Maternal education (P=0.025) and previous births (P=0.037) correlated positively with higher pretest scores. Higher maternal education correlated with higher posttest scores (P=0.01); however, less-educated women increased their scores as much as did women with more education. Nulliparous women also increased their posttest scores to comparable levels in women with previous deliveries. Women retested after delivery retained the educational message, achieving similar posttest and postdelivery scores (P=0.08). Brief antenatal education increases mothers' understanding of basic newborn care. Mothers retain this knowledge into the early postpartum period and during early infancy when it might help reduce morbidity and mortality. The education was efficacious for women with little education. Brief antenatal educational modules seem a feasible, sustainable means of improving mothers' knowledge of newborn care. We speculate that similar programs could improve neonatal morbidity and mortality in developing countries.

Factors Associated with Maternal Knowledge of Newborn Care among Postnatal Mothers Attending a Rural and an Urban Hospital in Egypt

Factors Associated with Maternal Knowledge of Newborn Care among Postnatal Mothers Attending a Rural and an Urban Hospital in Egypt

Effects of an Educational Program of Pregnancy and Delivery on Pregnancy related Knowledge, Newborn Care Knowledge, and Postpartum Care Self-efficacy of Marriage Immigrant Women

This study was designed to evaluate the effects of an educational program on pregnancy and delivery including pregnancy related knowledge, newborn care knowledge, and postpartum care self-efficacy for married immigrant women. A nonequivalent control group quasi-experimental design was used. The educational program was developed by though an educational need assessment of married immigrant women and an expert opinion. The program was provided for 3 weeks, once a week for two hours. The data were analyzed with SPSS program using Kolmogorov-Smirnov, X(2)-test, Fisher's exact test, and t-test. The program significantly improved pregnancy related knowledge, newborn care knowledge, and postpartum care self-efficacy for the married immigrant women who participated in the program compared to the women who did not. The results indicate that the educational program has an affirmative effect on pregnancy related knowledge, knowledge of newborn care, and postpartum care self-efficacy in these women. It is suggested, therefore, that the educational program be used to every married immigrant woman at the public health centers or delivery clinics help them to adjust to the childbearing and childrearing experience and this will ultimately enhance the quality of family life of married immigrant women in Korea.

Evaluating the effects of an Internet education programme on newborn care in Taiwan

The objectives of this study were to evaluate an Internet education programme provided to primigravida in the third trimester of pregnancy with the aim of enhancing mothers' knowledge about newborn care and increasing their maternal confidence. Shorter hospital stays have had an impact on the traditional role of mother-baby nurses in providing education about parenting to their parturient women. Internet education is an efficient way to provide nursing instruction. A randomised controlled trial was used. A total of 118 women receiving prenatal care in a hospital clinic who met study criteria and who consented were assigned randomly to intervention and control groups. The study was conducted at a hospital in Taiwan. The target population was women at 32-34 weeks gestation, using the Internet on a regular basis. The primigravida were randomly assigned to either the control group (n = 57) or the experimental group (n = 61). Two primary outcome measures were newborn-care knowledge and maternal confidence. The changes in newborn-care knowledge were 7.21 for the experimental group, compared with 1.95 for the control group; the difference between the least-squares means computed by ancova was 5.73 and statistically significant (p < 0.001). The changes in maternal confidence were 8.46 for the experimental group and 3.05 for the control group; the difference between the least-squares means computed by ancova was 5.94 and statistically significant (p < 0.001). Results suggest that Internet education about newborn care may contribute to greater care knowledge and maternal confidence. Relevance to clinical practice. Internet newborn-care education programmes can achieve success in promoting newborn care and provide health professionals with evidence-based intervention.

Evaluation of the educational impact of the WHO Essential Newborn Care course in Zambia

To evaluate the effectiveness of the World Health Organization (WHO) Essential Newborn Care (ENC) course in improving knowledge and skills of nurse midwives in low-risk delivery clinics in a developing country. The investigators identified the content specifications of the training material, developed both written and performance evaluations and administered the evaluations both before and after training clinical nurse midwives in Zambia. Based on these evaluations, both the knowledge and skills of the nurse midwives improved significantly following the course (from a mean of 65% correct pretraining to 84% correct post-training and from 65% to 77% correct on the performance and written evaluations, respectively). The ENC course written evaluation was validated and both tools allowed evaluation of the ENC course training. We found significant improvements in trainees' knowledge and skills in essential newborn care following the WHO ENC course; however, lack of basic resources may have limited the application of the ENC guidelines. Implementation of the ENC course should be undertaken in consideration with the local conditions available for newborn care.

Factors associated with maternal knowledge of newborn care among hospital-delivered mothers in Sri Lanka

The aim of this study was to assess mothers' knowledge on newborn care as well as factors associated with poor knowledge. A cross-sectional study sampled 446 mother-newborn pairs from five hospitals in the Puttalam district of Sri Lanka by stratified random sampling. Maternal knowledge on newborn care was assessed using a questionnaire with 50 statements via exit interview. A knowledge score was created by allocating 1 point for each correct response, which was dichotomised as 'satisfactory' or 'poor' by the median score. Only 21.7% correctly answered that 'surgical spirit' (70% isopropyl alcohol) should not be applied on the umbilical stump. More than 90% of mothers knew about breastfeeding on demand, the advantages of colostrum and the duration of exclusive breastfeeding. Except for a few conditions, mothers demonstrated a satisfactory knowledge in recognising danger signs of the newborn. According to multivariate analysis, primiparae (odds ratio (OR)=2.31; 95% CI 1.53-3.50), unemployed women (OR=3.31; 95% CI 1.89-5.80) and those with delayed antenatal booking visits (OR=2.02; 95% CI 1.26-2.23) were more likely to have poor knowledge. In conclusion, mothers had a satisfactory level of knowledge about breastfeeding and recognition of danger signs, but knowledge about care of the umbilical cord was poor. Maternal education programmes should place more emphasis on first-time mothers, unemployed women and those with delayed booking visits.

A Study on the Effects of Father Class upon Father's Level of Knowledge and Confidence about Postpartal Woman and Newborn Care

【The purpose of this study is to find out how Father Class, which is being practiced at a hospital located in Seoul, influences on fathers' level of knowledge and confidence of postpartal mother and newborn care. Research design was quasi-experimental study using non equivalent experiment and control group. The data, questionaires, were collected from Sep. 13, 2001 to Oct. 31, 2001 through e-mail, telephone and mail, after discharge from S hospital located in Seoul, where experimental group was educated at Father Class and control group take part in class. The objects were fathers who have first baby through normal delivery or C-sec delivery including experimental group 48 persons and control group 52 persons. Four instruments were revised ones of Lee Mi Kyoung's(1990) and Kwak Yon Hee's tool based on resources of direct interviews of fathers and one expert, professor. The reliability of four instruments were Cronbach's $\alpha$ scores .85 -93. Data were analyzed by SPSS 10.0 program using $x^2$ -test, and t-test and, One- way ANOVA, and Pearson correlation, etc. The results of this study are as follows; 1.The two groups were confirmed as a homogeneous group by showing no significant difference statistically at level of 5%. 2.The results of proving hypothesis are followings: 1)The first hypothesis, the fathers who participated in Father Class will have higher level of knowledge about postpartal mother care than fathers who didn't was accepted by significant difference statistically (p=0.000). 2)The second hypothesis, the fathers who took part in class will have higher confidence in postpartal mother care than fathers who didn't, was supported by significant difference statistically (p=0.000). 3) The third hypothesis, the fathers who attended class will have better knowledge about taking care of newborn than was accepted by significant difference statistically (p=0.000). 4)The fourth hypothesis, the fathers who participated in class will have higher confidence in newborn care than others, was supported by significant difference statistically (p=0.000). 3.The further analysis showed whether they participated in Prenatal Birth Preparing Class influenced on father's level of knowledge and confidence in postpartal mother and newborn care. In conclusion, Father Class is effective nursing intervention strategy that can help new fathers attain father and husband roles by enhancing level of confidence in and knowledge of postpartal mother and newborn care.】

The Effects of Education on Knowledge and Confidence in Postpartal Self-care and Newborn baby care

A maternity ward in a hospital in Seoul has an educational program for postpartal mothers since its opening, but evaluation on the program has not been done. This study was to find whether the educational program contributed to increase of knowledge and confidence of the post-partal mothers in the area of postpartal self-care and the newborn baby care or not. This study aimed at improvement of the educational program for posrpartal mothers and the newborn babies. Subjects were 40 primiparae who were admitted to the obstetric ward in a general hospitals in Seoul from August 20th to September 10th, 1995. Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery, gave a birth to a healthy baby, and agreed to participate in this study. All subjects were well educated and were in well-to-do group. Most of them received antenatal care adequately. They were tested on knowledge and self-confidence in the area of postpartal self-care and infant care two times, one at the admission time and the other prior to discharge. After the first test, nurses in a maternity ward and nursery taught them on postpartal self-care and infant care. Education consisted of a 1 hour planned program and incident teachings done at bed side. Four tools were developed by authors based literature review.The test tool for knowledge of postpartal self-care consisted of 15 items which included the definition of postpartum, dangerous symptoms in postpartum, lochia, time to begin coitus, postpartum exercise, sitz-bath, and perineal care.The test tool for self-confidence in postpartal self-care included such items as emergency care on dangerous symptoms in postpartum, sexual life and contraception after postpartum, self-confidence in postpartum exercise and perineal care.The test tool for knowledge of newborn baby care consisted of 18 items which included bathing, umbilical cord care, vaccination, breast feeding, abnormal symptoms of neonate. The test tool for self confidence in the newborn baby care included umbilical cord care, vaccination, breast feeding, emergency care for baby. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. SAS / PC (Release 6.04 for DOS) program are as follows.1. Mothers' knowledge of postpartal self-care increased significantly after education (t=10.04, df=38, p=0.0001).2. Mothers' self-confidence in postpartal self-care increased significantly after education (t=6.53, df=38, p=0.0001).3. Mother's knowledge of the newborn abay care increased significantly after education (t=9.74, df=38, p=0.0001).4. Mothers' self-confidence in the newborn baby care increased significantly after education(t=8.22, df=38, p=0.0001) Suggestions for further studies and nursing practice were as follows.1. We suggest studies by randomized control-group pretest-posttest design or nonequivalent control group pretest-posttest design will be done.2. We suggest follow-up studies to find if mothers's confidence will last or not after discharge.3. We suggest general hospitals to establish a phone-counseling system.

Advances and issues in bronchopulmonary dysplasia

Introduction Bronchopulmonary dysplasia (BPD) can truly be considered a disease of medical progress. It was first fully described in the literature and named by Northway et el.’ in 1967. Dr. Northway, a radiologist at Stanford University, recognized a distinctive radiographic pattern of chronic lung disease in infants surviving in the neonatal intensive care unit there directed by Dr. Philip Sunshine. More specifically, these patients were premature infants with respiratory distress syndrome (hyaline membrane disease) who were being managed with intermittent positivepressure ventilation using mechanical ventilators that delivered relatively high pressure and oxygen tension to the respiratory tract. Concurrently, one of the other pioneer neonatal intensive care units at Vanderbilt University observed the same phenomenon as Dr. Mildred Stallman’s team managed to increase the survival of premature infants with respiratory failure by using miniaturized mechanical ventilation instruments. Earlier in the decade, the death of Patrick Kennedy (son of President and Mrs. John Kennedy) focused the nation’s attention on the respiratory complications of premature birth. This tragic death and the combination of new knowledge and technology in newborn care led to the establishment of neonatal intensive care units and the emergence of new diseases such as BPD. It is ironic that a quarter of a century later, BPD remains an enigma to neonatologists and pediatric pulmonologists and intensivists. It is for this reason that several specialized centers of research supported by the National Institutes of Health have concentrated their efforts on enhancing and understanding the basic science and clinical aspects of lung injury, cellular repair processes, and treatment of BPD. Fortunately, during the past few years, there have been significant advances in our understanding of BPD. Although a number of issues remain, more progress is expected in the future as lung injury processes become explained. This review will summarize research developments of the past few years on the bases of published articles in refereed journals. More detailed information can be obtained in the scientific reports per se.