Purpose This study aimed to evaluate the effects of a rational emotive behavior therapy (REBT)-based emotional regulation program for mothers of premature infants in the neonatal intensive care unit (NICU).
Methods The study utilized a nonequivalent control group pretest-posttest design. Seventeen mothers were recruited for the experimental group and 21 mothers for the control group. Data were collected from July 9, 2018, to Oct 12, 2018 from mothers of premature infants in the NICU regarding parental stress, state anxiety, depression, and maladaptive cognitive emotion regulation. The experimental group received eight sessions of the REBT-based emotional regulation program for 3-4 weeks, and the control group only received standard nursing care.
Results Significant differences were found between the two groups in maladaptive cognitive emotion regulation (Z=-3.88, p<.001), stress (Z=-2.76, p=.006), state anxiety (Z=-3.72, p<.001), and postpartum depression(Z=-2.62, p=.009) after the intervention in the experimental group.
Conclusion The REBT-based emotional regulation program for mothers of premature infants was effective for reducing maladaptive cognitive emotion regulation, stress, anxiety, and postpartum depression. Therefore, it may be necessary to provide an REBT-based emotional regulation program for mothers of premature infants in the NICU in clinical practice.
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Purpose The purpose of this study was to identify the noise level and frequency experienced by premature infants receiving incubator care in the neonatal intensive care unit (NICU).
Methods The participants were 20 premature infants receiving incubator care in the NICU of a university hospital in Daejeon Metropolitan city. The noise level was measured using a professional sound-level meter (ET-958, FLUS, Shenzhen, China) based on a noise classification table developed by the author. The data were analyzed with descriptive statistics, the t-test, analysis of variance, and Pearson correlation coefficients using SPSS for Windows version 22.0.
Results The average noise level experienced by premature infants receiving incubator care in the NICU was 51.25 dB (range: 45.0~81.7 dB). The frequency of noises was highest for factors related to nursing activities (40.3%), followed by human factors (29.1%), machine alarm sounds (20.1%), incubator operation (6.6%), and internal environmental factors (3.9%).
Conclusion According to the above results, the noise level experienced by premature infants receiving incubator care in the NICU exceeded the recommendations of the American Academy of Pediatrics. Therefore, it is necessary to develop an interventional program to reduce noise in the NICU, and to conduct follow-up studies to verify its effectiveness.
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Purpose Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop.
Methods A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019.
Results Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life.
Conclusion The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.
Purpose The purpose of this study was to investigate partnerships with nurses, social support and readiness for discharge among mothers of premature infants in the neonatal intensive care unit (NICU) and to examine the factors associated with readiness for discharge.
Methods A survey was conducted among 85 mothers of premature infants hospitalized in a NICU in Seoul, Korea. The collected data were analyzed with descriptive statistics, the t-test, one-way analysis of variance, Pearson’ correlation coefficients, and multiple linear regression using SPSS version 25.0.
Results The results of the regression analysis showed that partnerships with nurses (β=.32, p=.011) and parenting experience (β=.32, p=.001) were significantly associated with readiness for discharge.
Conclusion To improve the readiness for discharge among mothers of premature infants, developing strategies to strengthen their partnership with nurses and to provide family-centered care will be needed.
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Purpose This study aimed to characterize the relationship between parental stress and nurses’ communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU).
Methods The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents’ perceptions of nurses’ communication ability and styles were measured using a questionnaire.
Results The average scores for parental stress and nurses’ communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses’ perceived verbal communication ability. Higher scores for nurses’ verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby’s appearance and behaviors, and treatments in the NICU.
Conclusion The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.
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Purpose The purpose of this study was to explore and describe the meaning and essence of a mother’s experience of hospitalization of her newborn in the neonatal intensive care unit (NICU).
Methods This study employed a qualitative research design. An interview was conducted with a mother whose newborn was hospitalized in the NICU, and the data were analyzed using Giorgi’s phenomenological method.
Results Five main themes and 19 formulated meanings were indentified. The 5 themes were ‘drowning in pain’, ‘just look outside the glass door’, ‘being a pillar’, ‘a deepening attachment’, and ‘prepare for nurturing with hope’.
Conclusion The results of this study provided an in-depth understanding of the experience of a mother with a newborn in the NICU. These results can be used in the development of a nursing intervention program that provides psychological and emotional support to the mother and family.
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Purpose The study was conducted to measure stratum corneum hydration (SCH) and pH (SCP) in high-risk newborns in the early postnatal period and to explore the features related to patterns of change in those parameters.
Methods SCH and SCP were measured on the dorsal hand in 99 hospitalized newborns during the first 14 days of life and the results were analyzed using a general linear model.
Results The mean hydration was 42.9% on day 1, which decreased to 34.6% by 2 weeks (F=15.61, p=<.001). An association was observed between SCH and prematurity (F=21.12, p<.001), as well as for their interaction (F=8.11, p<.001). The mean SCP was 6.2±0.3 on day 1, and decreased to 5.7±0.2 (F=95.75, p<.001), with no association with prematurity. After adjusting for birth weight, SCH was higher in newborns with vaginal delivery (F=9.07, p=.023) and who received phototherapy (F=11.81, p=.011). For SCP, only delivery type had a significant influence (F=6.40, p=.044).
Conclusion This study suggests that SCH is typically in the 30% range during the early postnatal period, and that an acid mantle on the SC surface is very unlikely to form; these findings could be applied to the nursing process for promoting skin integrity in high-risk neonates.
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Purpose This study was conducted to assess the knowledge and performance of developmentally supportive positioning for premature infants (DSPP) among neonatal intensive care unit (NICU) nurses.
Methods The participants in this study were 131 nurses working in the NICU at five university hospitals in Daejeon and the city of Cheong-ju. The collected data were analyzed with descriptive statistics, the t-test, analysis of variance, and Pearson correlation coefficients using SPSS for Windows version 22.0.
Results NICU nurses’ average DSPP knowledge score was 24.7 out of 33.0, and their average DSPP performance score was 3.2 out of 4.0. A statistically significant positive correlation was observed between knowledge and performance of DSPP (r=.32, p<.001).
Conclusion To improve the level of NICU nurses’ knowledge and performance of DSPP, educational programs should be developed and their effectiveness should be verified.
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Purpose Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of high-risk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia.
Methods A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth.
Results A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia.
Conclusion Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants.
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Purpose This study was conducted to examine the effect of education on infection control for multidrug resistant organism (MDRO).
Methods One group pre-post time series design was used. Infection control education for MDRO infection was provided to nurses working in the Neonatal Intensive Care Unit (NICU). Knowledge and recognition were evaluated before and after education. Hand hygiene compliance, MDRO isolation rate and central line-associated bloodstream infection (CLABSI) rate were used as outcome variables. Data from 45 nurses was used for analysis.
Results General knowledge about MDRO increased (p=.011). Responses to questions about image of MDRO and MDRO management tended to change in a positive direction (p = .046). Hand hygiene compliance was 100% at pre-test, 79.5% during education period and 98.4% at post-education period. MDRO isolation rate was 6.83 per 1,000 patient days at pre-test, 10.24 during education period and 6.68 at post-education period. CLABSI rate was 3.76 per 1,000 central line days at pre-test, 6.84 during education period and 4.71 at post-education period.
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Purpose This study was performed to explore the weight variations in high-risk term newborns hospitalized during the early postnatal period.
Methods A retrospective explorative study was performed with 64 term newborns who were hospitalized in the NICU after birth. Data on daily weight, birth information, and clinical features such as phototherapy, placements, nutritional status were reviewed through medical records for 14 days of life. General Linear Model, GLM was applied to analyze the weight variation by clinical features of these high–risk term newborns for 14 days of life.
Results Newborns at 40 weeks of gestation showed little weight loss during the few days after birth then steadily gained weight to 7.6% at the 14th day. Infants born at 37-39 gestation showed little weight gain for 14 days though the weight loss itself was not apparent. As well, return to birthweight was not observed in newborns with phototherapy, infants placed on a warmer or infants having gastrointestinal dysfunction for 14 days of life.
Conclusion Even for term newborns, physiologic weight loss may not be warranted even if newborn is born at less than 40 week of gestation, or with high-risk conditions that warrant admission to NICU.
Purpose This study was done to identify the meaning and substantial nature of NICU practice among nursing students by applying a research method based on hermeneutic phenomenology in an attempt to lay a foundation for enhancing theoretical and practical child nursing education.
Methods The participants were eight nursing student who had experience in clinical practicing in NICU. In-depth interviews were performed from April to December, 2014 until data were fully saturated. Collected data were analyzed using Colaizzi’s method.
Results Seven theme clusters were extracted from fourteen themes. The seven theme clusters of the nursing students’ clinical practice experience in NICU were: 1) Excitement about the clinical practice setting 2) Afraid of practice environment 3) Babies have priority over clinical practice 4) Comparing with adult nursing clinical practice 5) Feeling pity for babies and their parents 6) New awareness about the role of nurses 7) Demands of enhancing clinical practice.
Conclusion The results of the study provide useful information in understanding nursing students’ practice experience in NICU and establishing effective strategies to support these nursing students.
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PURPOSE The purpose of this study was to describe breastfeeding knowledge, attitude and nursing practice of neonatal intensive care unit (NICU) nurses. METHODS Survey methodology using a self administered questionnaire was employed as the research design. A total of 153 questionnaires from 7 university hospital NICUs in Seoul, Daejeon, and Daegu were used for data analysis. RESULTS The percentage of correct answers on the breastfeeding knowledge questions for the NICU nurses was 59.3%. The nurses in NICU reported a somewhat positive attitude to breastfeeding, mean per item 3.70+/-0.41 on a scale of 5 points. Their breastfeeding nursing practice was at a moderate level, mean per item, 3.26+/-0.74.
Breastfeeding knowledge had significant correlations with breastfeeding attitude (r=.554, p<.001) and nursing practice (r=.203, p=.002). Also, There was a significant correlation between breastfeeding attitude and nursing practice (r=.243, p=.002). CONCLUSION These results suggest that breastfeeding educational programs and strategies for NICU nurses should be developed to increase their breastfeeding knowledge, attitude, and nursing practice.
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