아동의 만성질환이 환아 및 환아 가족의 일상생활에 미치는 영향

한경자,박연환,Han, Kyung-Ja,Park, Yeun-Hwan 한국가정간호학회 2001 가정간호학회지 Vol.8 No.2

The aim of this descriptive study was to identify the impact of chronic illness on children and their families. Mothers of 177 children with chronic disease were recruited from aged one to 17 years hospitalizing the pediatric nursing unit at one university hospital. 28 questions. a self-complete maternal questionnaire developed by researchers based on literatures and 'The Impact of Childhood Illness Scale' (Hoare & Russell, 1995) assess four aspects of the child's and family's lifestyle with two dimensions for each question. the frequency of the problem and its importance of concern that it cause. In the data analysis. Pearson correlation coefficients and analysis of variance were used to test any association and a statistical comparisons. between individual variables and the impact on child's and family's lifestyle. The results were as follows: 1) There were the higher mean scores on the importance dimension than on the frequency dimension on total impact on child's and family's lifestyle. On the importance dimension. mothers had much higher levels of concern about impact on child's development and adjustment among subscales. On the frequency dimension, mothers had much higher levels of concern about impact on the family daily living on subscales. 2) The impact on child's and family's lifestyle related on individual variables were: (1) On the importance dimension. there was statistically significant low in the impact on child's development and adjustment among subscales in older parent group compared with it of younger parent group. (2) On the frequency dimension. there were statistically significant high in the impact on child's development and adjustment among subscales in the children with leukemia or cancer compared with it of the other children who had another chronic illnesses. And there were statistically significant high in the impact on child's development and adjustment among subscales in less than high school educated mothers compared with it of mothers who was educated college level. (3) On the frequency dimension. There were statistically significant high in the impact on family's daily living among subscales and total impact on child's and family's lifestyle in female children. (4) There was positive correlation between impact on parents daily living and frequency of child's hospitalization on the frequency dimension. but there was negative correlation between the two variables on the importance dimension. (5) There was positive correlation between impact of chronic illness and its treatment and duration of child's hospitalization on the frequency dimension. In conclusion. these results were reflected by the high level of concerns about impact on child's development and adjustment although mothers had frequently responded about the impact on the family daily living. We suggest consistent intervening program that help the family empowering to make children live with and adjust to their chronic illnesses from the point of diagnosis and after discharge from the hospital. We also suggest these results can be utilized as a useful data in the practice of home health nursing for children who have chronic illnesses and their families.

가정간호기록지 개발에 관한 연구

한경자,박성애,하양숙,윤순녕,송미순,Han, Kyung-Ja,Park, Sung-Ae,Hah, Yang-Sook,Yun, Soon-Nyoung,Song, Mi-Soon 한국가정간호학회 1996 가정간호학회지 Vol.3 No.-

The objective of this study is to develope the record forms for the home care nursing. Through the literature review and 4 times of workshop participated with the health practitioner and nursing professors from July 1993 to March 1995, the standands of home nursing care, initial assessment tools, progress notes by diseases and the referral sheet were developed. The Community health practitioner were trained for home nursing care and participated with 5 nursing professors in the workshop to validate the content of the record forms. It is suggested that the more refinement of these record forms fased a defined conceptual framework in the various home nursing area is needed in the future.

신생아집중간호단위 환경과 저체중출생아의 반응에 대한 연구

한경자,Han Kyung Ja 한국아동간호학회 1998 Child Health Nursing Research Vol.4 No.2

In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it

저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구

한경자,Han, Kyung-Ja 한국가정간호학회 2001 가정간호학회지 Vol.8 No.1

The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers o

영아 기질과 모아상호작용, 양육환경과의 관계

한경자,방경숙,Han Kyung Ja,Bang Kyung Sook 한국아동간호학회 2000 Child Health Nursing Research Vol.6 No.2

The purpose of this correlational study was to find the correlation between the infant temperament, mother-infant interaction, and child-rearing environment. The subjects of this study were 37 dyads of healthy mothers and healthy infants. Data were collected from 15th of March to 3rd of September, 1999. Convenient sampling was done at Obstetric wards of one University hospital, and demographic data were collected before discharge. At one month and three month postpartum, we visited subject's home, and collected the data on the infant temperament, and also video taped the mother-infant interaction during feeding. In addition, child-rearing environment was checked by researcher according to HOME(Home Observation for Measurement of the Environment) at three months postpartum. Mother-infant interactions were rated according to the NCAST Feeding Scale later. Data were analyzed by window SPSS program, and correlations between the infant temperament, mother-infant interaction, and child-rearing environment were analyzed by Pearson's correlational coefficient. The results were as follows: 1. Infant temperament. 1) Among the subscales of infant temperament, mothers perceived cuddliness and amenability most positively at one month, and responsivity and amenability most positively at three months. 2) In subscale analysis of stability, amenability, responsivity, and persistence were stable with the time. 3) Significant relationships were found between the malleability and amenability, between the malleability and responsivity at one month, and also between the malleability and amenability, and between the malleability and cuddliness at three months. 2. Correlations of infant temperament and mother-infant interaction. 1) There was no significant relationship between the infant temperament and mother-infant interaction at one month. 2) There was a significant relationship between the infant temperament and mother-infant interaction at three months(r=.335, p<.05). In subscale analysis, there were significnt relationships between the total score of infant temperament and maternal sensitivity to infant's cues(r=.372, p<.05), and between the total score of infant temperament and maternal response to infant's distress (r=.331, p<.05). 3. Correlations of infant temperament and child-rearing environment. 1) There was no significant relationship between the total score of infant temperament at one month and total score of HOME at three months. In subscal analysis, the total score of infant temperament at one showed significant relationships with the organization of environment(r=.413, p<.05), and the emotional, verbal response at three months(r=.337, p<.05). 2) There was a significant relationship between the total score of infant temperament at three months and the total score of HOME at three months (r=.599, p<.01). In subscal analysis, the total score of infant temperament at three months showed significant relationships with the organization of environment(r=.410, p<.05), maternal involvement(r=.482, p,.01), and the emotional, verbal response(r=.695, p<.01) at three months. 4. Correlations of mother-infant interaction and child-rearing environment. There was a significant relationship between the maternal score of mother-infant interaction at one month and three months and the total score of HOME at three months (r=.474, p<.01; r=.452, p<.01). In conclusion, it was proved that infant temperament had significant relationships with mother-infant interaction and child-rearing environment, especially when the infants were getting older. This showed the possibility for changeability of infant teperament by the maternal factors.

영아어머니의 자녀돌봄의 부담감과 지지, 교육 및 상담요구에 관한 조사연구

한경자,Han Kyung Ja 한국아동간호학회 1997 Child Health Nursing Research Vol.3 No.2

It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study, Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the muthers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommanded that home health care will be one of the approach to support the mothers caretaking activities.

딥러닝 및 열화상 카메라를 활용한 마스크 착용 여부 판별 시스템 개발

박문빈,이종태 대한산업공학회 2021 대한산업공학회 춘계학술대회논문집 Vol.2021 No.6

영아건강증진을 위한 부모역할교육 프로그램의 개발 및 그 효과에 관한 연구

한경자(Han Kyung-Ja),방경숙(Bang Kyung-Sook),권미경(Kwon Mi-Kyung),김정수(Kim Jung-Soo) 한국간호과학회 2001 Journal of Korean Academy of Nursing Vol.31 No.3

영아의 건강증진을 위한 부모역할교육 프로그램의 효과에 관한 연구 -생후 12개월의 결과를 중심으로-

한경자 ( Kyung Ja Han ),권미경 ( Mi Kyung Kwon ),방경숙 ( Kyung Sook Bang ),김정수 ( Jung Soo Kim ) 부모자녀건강학회 2002 부모자녀건강학회지 Vol.5 No.2

This longitudinal quasi-experimental research was conducted to develop parent role education program and to evaluate the effect of this program for mother-infant interaction, child-rearing environment and infant development. The subjects were the healthy infants weighing over 2,500gm at birth, whose gestational age was more than 37weeks, and their healthy mothers. The sample consisted of eighteen mother-infant dyads for intervention group and sixteen dyads for control group. Data were collected from March 15th in 1999 to Jun 20th in 2000. The intervention group received programmed education consisted of discharge education, telephone counselling, and home visiting care. But control group were collected data without programmed education. In this study, the Nursing Child Assessment Teaching Scale(NCATS) devised by Barnard was used to determine the mother-infant interaction, HOME was used to determine the childrearing environment, and Griffiths mental development scale was used to determine the infant development. The data were analyzed using SPSS Win using chi-square test, t-test, and repeated measure ANOVA. This study was focused on the results of twelve months time point. Summaries of the results were as follows: 1. There was no significant difference in mother-infant interaction(NCATS) between intervention group and control group. But both of two groups showed significantly higher in interaction score at twelve months than at six months in the subscales of social-emotional growth fostering, and responsiveness to caregiver. 2. There was no significant difference in child rearing environment(HOME) between two groups at twelve months. But when each subscale of HOME was examined, intervention group showed higher scores in the dimensions of maternal involvement with child(p=.001), and maternal emotional-verbal responsivity(p=.048). 3. There was no significant difference in GQ of the Griffiths mental development scale between two groups, although significant difference was found in performance subscale. 4. Infant development at twelve months showed significant correlation with mother-infant interaction and childrearing environment at six months, although mother-infant interaction and childrearing environment at twelve months did not show significant correlations with infant development at twelve months. 5. Developmental scores at six months showed significant correlations with variety in daily stimulation, and mother`s emotional, verbal responsivity, whereas developmental scores at twelve months showed significant correlations with acceptance of child behavior at six months, and appropriate play material at twelve months. In conclusion, the maternal education program for primipara showed long term effect in some categories in organizing the childrearing environment, and fostering the infant development. We suggest further study and implications of parent role education program for high risk parents such as parents in low economic status or with premature babies.

Disciplinary Session 12 / Dance / Culture , Environment and Dance : 남북한 무용극의 변천과정과 형태에 관한 비교연구

한경자 ( Kyung Ja Han ) 한국체육학회 1998 국제스포츠과학 학술대회 Vol.1998 No.2