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Kim and Park: Health-care Needs of High-risk Pregnant Women Hospitalized in Maternal-Fetal Intensive Care Units: A Mixed-methods Design
Orginal Article

Korean J Women Health Nurs 2018;24(2):196-208.

Published online: 20 June 2018

DOI: https://doi.org/10.4069/kjwhn.2018.24.2.196

Health-care Needs of High-risk Pregnant Women Hospitalized in Maternal-Fetal Intensive Care Units: A Mixed-methods Design

Hyunjin Kim1, Horan Park2,

1Samsung Medical Center, Seoul, Korea

2College of Nursing, The Catholic University of Korea, Seoul, Korea

Corresponding author: Park, Horan College of Nursing, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Tel: +82-2-2258-7406, Fax: +82-2-2258-7772, E-mail: hrpark@catholic.ac.kr

Received 23 April 201827 May 2018       Accepted 3 June 2018

Copyright © 2018 Korean Society of Women Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To identify the characteristics and health-care needs of high-risk pregnant women in maternal-fetal intensive care units (MFICU).

Methods

A mixed-methods design was adopted. Data were collected from 78 high-risk pregnant women admitted to the MFICU. Qualitative data included ten participants' experiences with hospitalization and childbirth, which were analyzed using mixed content analysis. Quantitative data were analyzed using at-test and one-way ANOVA testing.

Results

The average score for pregnancy and childbirth health-care needs was 3.54 points. Average score by area was before-admission health care (3.70), health care of baby (3.67), health of childbirth (3.61), postpartum health (3.51), and pregnancy health care during hospitalization (3.48). Qualitative results showed diverse feelings and experiences of high-risk pregnant women and their need for health care, which was expressed in three themes and 11 sub-themes.

Conclusion

Nurses should recognize high-risk mothers' feelings and needs for pregnancy and childbirth-focused health care to help patients accept their vulnerability and cope positively.

Keywords: Needs assessment, Healthcare, Pregnancy, High risk, Prenatal care

References

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Table 1.
Differences in Pregnancy and Childbirth Health Care Needs according to General and Obstetric Characteristics of High-risk Pregnant Women in Maternal-Fetal Intensive Care Unit (N=78)
Variables Characteristics Categories n (%) Pregnancy and childbirth health care needs
M±SD t or F(p)
General Age (year) 20∼29 10 (12.8) 3.70±0.28 1.63(.203)
characteristics   30∼34 31 (39.7) 3.54±0.32  
    ≥35 37 (47.4) 3.49±0.34  
  Religion Buddhism 6 (7.7) 3.56±0.38 1.10(.115)
    Christianity 20 (25.6) 3.44±0.39  
    Catholic 10 (12.8) 3.68±0.24  
    No religion 42 (53.8) 3.55±0.32  
  Marriage Married 78 (100) 　 　
  Level of education Junior school 1 (1.3) 3.91±0.00 2.09(.131)
    ≤High school 59 (75.6) 3.5±0.33  
    ≥College 18 (23.1) 3.65±0.34  
  Occupation Yes 45 (57.7) 3.49±0.32 –1.22(.227)
    No 33 (42.3) 3.59±0.35  
  Average income of family ＜200 8 (10.3) 3.59±0.27 0.16(.924)
  month (10,000 won) 200∼400 17 (21.8) 3.53±0.37  
    400∼500 15 (19.2) 3.57±0.42  
    ＞500 38 (48.7) 3.51±0.31  
  Need for financial aid Yes 29 (37.2) 3.52±0.35 –0.37(.714)
    No 49 (62.8) 3.55±0.33  
Obstetric Gestational period (week) 14∼28 29 (37.2) 3.50±0.34 –0.85(.398)
characteristics   ≥29 49 (62.8) 3.56±0.34  
  Hospital day 3∼5 41 (52.6) 3.52±0.34 1.77(.177)
    6∼9 19 (24.4) 3.47±0.37  
    ≥10 18 (23.1) 3.6±0.29  
  Birth experience Yes 25 (32.1) 3.54±0.34 0.80(.936)
    No 53 (67.9) 3.54±0.34  
  Experience of Yes 11 (14.1) 3.54±0.28 0.53(.958)
  premature birth No 67 (85.9) 3.54±0.35  
  Experience of treatment for Yes 25 (32.1) 3.56±0.27 0.37(.713)
  prevent premature birth No 53 (67.9) 3.53±0.36  
  Experience of Yes 15 (19.2) 3.44±0.36 –1.20(.233)
  artificial insemination No 63 (80.8) 3.56±0.33  
  Diagnosis PTL 20 (25.6) 3.60±0.30 1.05(.400)
    PPROM 18 (23.1) 3.52±0.37  
    Short cervical length 10 (12.8) 3.62±0.35  
    PPT 6 (7.7) 3.35±0.32  
    Placenta abruption 1 (1.1) 3.43±0.00  
    Gestational hypertension 11 (14.1) 3.39±0.22  
    IIOC 1 (1.3) 3.95±0.00  
    Other 11 (13.5) 3.61±0.41  
  Drug administration for Yes 38 (48.7) 3.52±0.26 –0.50(.618)
  maintenance of pregnancy No 40 (51.3) 3.56±0.40  
  Prenatal education Yes 27 (34.6) 3.61±0.28 1.32(.192)
    No 51 (65.4) 3.5±0.36  
    Incongruent time and place 22 (53.7) 3.52±0.36 1.85(.151)
    Do not know the place 5 (12.2) 3.72±0.31  
    Do not need it 6 (14.6) 3.24±0.44  
    Enough information available 18 (19.5) 3.51±0.30  
    in books and on internet      

PTL=preterm labor; PPROM=preterm premature rupture of membranes; PPT=placenta previa totalis; IIOC=incompetent internal os of cervix.

Table 2.
Pregnancy and Childbirth Health Care Needs of Hospitalized High-Risk Pregnant Women in Maternal-Fetal Intensive Care Unit (N=78
Category Content description of item M±SD Rank
Pre-admission Avoiding risk-factors related to disease (medicine, food etc.) 3.69±0.54 3
health care Information related to disease 3.65±0.50 4
　 Information admission period and cost 3.54±0.50 5
  Dangerous symptoms 3.86±0.45 1
  Information about the course of treatment 3.76±0.46 2
  Sub total 3.70±0.39  
Pregnancy Psychological change during hospitalization 3.41±0.54 18
health care Anemia control and taking vitamins during 3.32±0.54 22
during Disease information during hospitalization 3.59±0.52 9
hospitalization Signs of risk during hospitalization (Preterm birth symptom, infection, bleeding, headache, hypoglycemia etc.) 3.79±0.46 1
　 Explanation of examination and treatment during hospitalization 3.72±0.53 6
　 Information about purpose, precautions, and side effects of therapeutic agents 3.73±0.50 3
　 Materials that should be avoided during hospitalization (caffeine, medicine etc) 3.50±0.59 14
　 Nutrition during hospitalization 3.35±0.53 21
　 Constipation control during hospitalization 3.29±0.58 25
　 Control of frequent voiding during hospitalization 3.24±0.60 27
　 Exercise and activities during hospitalization 3.29±0.56 25
　 Sleeping and rest during hospitalization 3.31±0.63 24
　 Cleansing during pregnancy (shampoo for hair, shower) 3.38±0.58 19
　 Relieving back pain during hospitalization 3.44±0.55 15
　 Contraction relief during hospitalization 3.56±0.59 11
　 Control of gut trouble during hospitalization 3.32±0.57 22
　 Care for swelling during hospitalization 3.38±0.56 19
　 Fetal development process 3.73±0.47 3
　 Screening for congenital abnormal 3.59±0.63 9
　 Counting fetal movement 3.44±0.59 15
　 Confirming uterine contraction 3.64±0.51 7
　 Prevention of and care for abortion 3.64±0.55 7
　 Prevention of and care for premature birth 3.73±0.50 3
  Complication of pregnancy (diabetesmellitus, hypertension etc.) 3.51±0.57 13
　 Breast care during pregnancy 3.55±3.41 12
  Skin care during pregnancy 3.00±0.66 29
  Body weight change during pregnancy 3.22±0.59 28
  Support by husband and family during hospitalization 3.42±0.59 17
  High-risk pregnant women and support policy for premature 3.76±0.46 2
  Sub total 3.48±0.38  
Time of Information on onset symptoms of labor 3.77±0.42 1
delivering Labor process 3.68±0.49 2
health care Means of controlling labor pain 3.67±0.50 4
　 Explanation on the test and treatment 3.68±0.52 2
  Preparation for spontaneous delivery 3.54±0.55 6
  Information on cesarean delivery 3.58±0.52 5
  Husband's participation during delivery 3.36±0.72 7
  Sub total 3.61±0.41  
Postpartum Postpartum vaginal bleeding 3.74±0.47 2
health care Postpartum nutrition 3.53±0.52 8
　 Avoidable medicine during breast feeding 3.76±0.43 1
  Postpartum constipation control 3.47±0.52 10
  Postpartum comfortable position 3.42±0.59 14
  Postpartum vaginal discharge (lochia) 3.58±0.52 7
  Postpartum cleansing (bath, shower) 3.47±0.55 10
  Sexual life after labor 3.22±0.63 18
  Promoting safety after delivery 3.69±0.51 3
  Postpartum depression control 3.65±0.50 5
  Postpartum breastfeeding method 3.68±0.52 4
  Postpartum breast management and breastpump method 3.65±0.50 5
  Postpartum formula feeding method 3.47±0.59 10
  Questions after discharge 3.46±0.57 13
  Information watchful after discharge 3.53±0.52 8
  Information on next pregnancy and childbirth education 3.29±0.70 16
  Support for recovering routine work 3.23±0.66 17
  Preparation for parental role 3.41±0.61 15
  Sub total 3.51±0.39  
Baby health care Baby care 3.67±0.52 5
　 Normal growth and development of child 3.74±0.47 3
  Dealing with baby's emergency 3.87±0.33 1
  Information for premature 3.81±0.43 2
  Detailed explanation on the questions and counseling regarding the baby 3.73±0.44 4
  Prepare for baby layette 3.22±0.76 6
  Sub total 3.67±0.35  
Total 　 3.54±0.33 　
Table 3.
General Characteristics of Interviewees (N=10)
Data number Age (year) Level of education Total hospital day Experience of previous birth Diagnosis Prenatal education Postpartum complication
N1 27 ≤High school 10 No PTL No No
N2 32 ≥College 11 No PPROM No No
N3 31 ≤High school 8 No Gestational hypertension No No
N4 33 ≥College 13 Yes PTL Yes No
N5 35 ≥College 15 No Gestational hypertension Yes No
N6 34 ≥College 10 No PTL Yes No
N7 30 ≥College 8 No PPT No No
N8 29 ≤High school 12 Yes IIOC No No
N9 36 ≥College 16 No PPROM No No
N10 37 ≥College 14 Yes Gestational hypertension No No

PTL=preterm labor; PPROM=preterm premature rupture of membranes; PPT=placenta previa totalis; IIOC=incompetent internal os of cervix.

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