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임신 2삼분기 여성의 조기진통 증상과 조산에 영향을 미치는 다인성 요인
김증임(Kim, Jeung-Im),조미옥(Cho, Mi-Ock),최규연(Choi, Gyu-Yeon) 한국간호과학회 2017 Journal of Korean Academy of Nursing Vol.47 No.3
Purpose: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). Methods: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. Results: Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 (kg/m²) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). Conclusion: The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.
일본의 재가간호 및 방문간호 -새로운 개호보험제도의 실시를 앞두고-
김증임,Kim, Jeung-Im 한국지역사회간호학회 1999 지역사회간호학회지 Vol.10 No.1
Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.
김증임 ( Jeung Im Kim ),강희선 ( Hee Sun Kng ),박소미 ( Somi Ahn Park ),안숙희 ( Suk Khee Ahn ) 여성건강간호학회 2014 여성건강간호학회지 Vol.20 No.2
Purpose: This study was done to examine current status of women’s health nursing practicum and identify necessary core nursing skills in this practicum area. Moreover, one syllabus and evaluation sheets for women’s health nursing clinical practicum at one university were reviewed. Methods: A survey design was used with 81 educators who were teaching maternity or women’s health nursing and its practicum. Results: Most clinical sites for practicum were university hospitals (43.0%), women’s hospitals (32.7%), or general hospitals (17.3%); but the majority (77.8%) of educators expressed difficulty in finding appropriate practicum places. Common teaching and learning methods were clinical guides for practicum (44.6%), e-learning content (30.2%), and simulation (23.6%). Core nursing skills for this practicum included assessment of stages of labor, preparation of uterine-fetal monitoring devices and interpretation of results, monitoring uterus and fetal activity, and performing Leopold’s maneuver. For postpartum care, the following were included; postpartum fundal massage, assessment of breast engorgement, fundus height, and episiotomy sites, inserting urinary catheter, and teaching the use of patient-controlled analgesia. Conclusion: To improve the quality of clinical practicum, development of a clear course syllabus, standardized clinical guidebook, and core nursing skills is required and should be shared with all relevant nurse educators.
텍스트 네트워크 분석을 이용한 조산 경험 이야기의 시각화
김증임,Kim, Jeung-Im 한국여성건강간호학회 2020 여성건강간호학회지 Vol.26 No.3
Purpose: This study aimed to identify the components of preterm birth (PTB) through women's personal narratives and to visualize clinical symptom expressions (CSEs). Methods: The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). Results: The participants' mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical condition, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. "Stress" was ranked first in terms of frequency and "uterine contraction" had individual attributes. Conclusion: The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included for developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women's health nursing practicum.