Purpose The aim of the study was to assess the prevalence of preschooler obesity/overweight and to identify associated factors.
Methods This study was a cross-sectional study. Data for 591 preschoolers, 432 fathers and 538 mothers from the Korea National Health and Nutrition Examination Survey 2013-2014 were included. Obesity/overweight was defined by 2007 Korean National Growth Charts. T-test, Rao-Scott χ2, multivariate logistic regression was used for the analysis.
Results Prevalence rates for preschooler obesity/overweight were 14.9% (obesity, 5.4%; overweight, 9.5%). The preschoolers with atopic dermatitis or allergic rhinitis or asthma (OR=2.78, 95% CI [1.27-6.09], p=.011) and eating more thiamine per day (OR=1.01, 95% CI [1.00-1.02], p=.001) showed higher obesity/overweight development. The only parental factor affecting preschooler obesity/overweight was parental body mass index (father, OR=1.18, 95% CI [1.09-1.28], p<.001; mother, OR=1.09, 95% CI [1.04-1.15], p<.001).
Conclusion Interventions on preventing preschooler obesity should be introduced much earlier for children with risk factors. Results from this study can be used as preliminary data to develop effective strategies to prevent obesity in Korean preschoolers.
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Purpose The purpose of the study was to identify and describe the caregiving difficulties that mothers of children with spina bifida experience from their own perspectives.
Methods A qualitative descriptive study was designed. Data were collected from five mini-focus group interviews and four individual interviews using open-ended questions. Nineteen mothers of children with mild spina bifida participated in the study during 2014-2015. Data were analyzed using qualitative content analysis to identify major difficulties perceived by the mothers.
Results Five domains were identified with 12 subdomains. “Daily routine continence management” describes difficulties arising in bladder and bowel management for the child with spina bifida. “Management of school life of child” deals with difficulties in relation to the school facilities, such as the toilets, as well as teachers and friends. “Relationship with family and neighbors” illustrates problems in relations with their spouse, normal children, relatives and neighbors. “Maintaining physical and psychological health” includes physical and psychological problems of the mothers. “Finance” describes economic burden that the mothers face in the management of child’s illness.
Conclusion The findings from this study provide insight into the practical issues related to the management of chronic conditions of children with spina bifida from the mothers’ perspectives.
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Purpose The purpose of this study was to investigate the relationship among knowledge and attitude toward palliative care and perception of death for Neonatal Intensive Care Unit (NICU) nurses.
Methods A cross-sectional descriptive study was conducted with 110 nurses who work in NICUs in South Korea. The participants filled out a questionnaire regarding their knowledge, attitude towards palliative care and perception of death. The attitude scale was divided into 3 subscales: comfort level, nurses’ role and nurses’ involvement with family.
Results Comfort level regarding attitude towards palliative care was positively correlated with knowledge (r=.220, p=.016) and the perception of death (r=.194, p=.042). Nurses’ role showed a positive correlation with perception of death (r=.395, p=.001).
Conclusion NICU nurses’ knowledge of palliative care was below standard across the board, implying that there is a definite need for palliative care education for nurses. The education program for palliative care should include a section that focuses on fostering a positive perception of death as well as defining and delineating the role of nurses.
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Purpose The aim of this study was to conduct a systematic review and to describe the characteristics of child abuse screening instruments.
Methods Articles regarding the development of a child abuse screening instrument were investigated using the systematic review method. A literature search using the keywords “child and abuse or maltreatment and instrument or screening tool” in English, and “child,” “abuse,” and “instrument” in Korean, was conducted of material published in PubMed, PsycINFO, CINAHL, SCOPUS, ERIC, and RISS. Database and bibliographic searches, and quality appraisal using the Quality Assessment of Diagnostic Accuracy Studies tool that included systemic reviews, yielded 17 records.
Results Key elementary child abuse screening instruments were developed for physical, psychiatric, affective and sexual and child neglect assessment. The instruments’ target populations were children at home and in institutions. The reviewed instruments had the advantage of diagnosing past, concurrent, and indirectly, potential child abuse.
Conclusion The results of this study demonstrate that child abuse screening instruments are available for screening and for assessment of abused children in various circumstances. This review of child abuse screening instruments offers evidence for the acceptable use of optimal psychometric tools for child abuse assessment and provides guidelines for child health nursing practice.
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Purpose The purposes of this study were to explore knowledge, barriers, and self-efficacy in relation to pain management practice, and to identify factors influencing pain management practice in pediatric nurses.
Methods A descriptive correlational study was conducted. The participants were 237 pediatric nurses from a metropolitan city. Data were analyzed using t-test or analysis of variance and Pearson correlation and multiple regression analyses.
Results The mean percentage of correct answers on the children’s pain management knowledge scale was 58.8%. Child and parent related factors were the main barriers for pain management. Self-efficacy to assess children’s pain across developmental stages was particularly low. Pain management practices for assessing pain and non-pharmacological interventions were relatively low. Factors significantly affecting children’s pain management practice were current conditions of work department and self-efficacy in pain management, and these factors accounted for 37.5% of the variance in pain management practice.
Conclusion The results suggest that an integrative education program needs to be developed to improve self-efficacy in children’s pain management practice. Moreover, good communication, building cooperative relationships with children and parents, and a more active role by pediatric nurses are required to carry out more effective pain management.
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Purpose The purposes of this study were to investigate daycare teachers’ knowledge, anxiety and management of childhood fever and to identify factors affecting their management of childhood fever.
Methods A descriptive correlation study was conducted. Participants were 109 daycare center teachers from G metropolitan city. A self-administered questionnaire was used for data collection.
Results The mean percent of correct answers for knowledge about childhood fever was 42.9%. Levels of anxiety related to children’s fever were high among day care teachers in this study. Many daycare center teachers used management practices which were not recommended for childhood fever management. There was a statistically significant difference in participants’ knowledge about childhood fever by marital status and having a child. Moreover, there were statistically significant positive correlation between daycare center teachers’ knowledge and management and negative correlation between daycare center teachers’ anxiety and management of childhood fever. Knowledge and anxiety related to childhood fever accounted for 15.2% of variance for fever management.
Conclusion Results show that day care teachers’ knowledge and anxiety related to fever are important factors in predicting their fever management. Development and evaluation of educational interventions to improve daycare teachers’ childhood fever management are recommended.
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Purpose To investigate the perception and barriers of Kangaroo-Mother Care (KMC) among nurses in Neonatal Intensive Care Units (NICU).
Methods Participants were 131 nurses working in NICU who completed self-report questionnaires which included information regarding perception, barriers, and practice of KMC. Collected data were analyzed using SPSS 18.0 program for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients.
Results Of the participants, 33.6% reported the practice of KMC in their NICU, with 75.6% wanting to receive training in KMC and 31.3% having received KMC education. Most of the participants agreed that KMC enhances attachment, parental confidence, and effective breast feeding but they reported a negative perception in providing KMC for premature infants weighing less than 1,000 grams or intubated premature infants. Major barriers to practicing KMC were safety of infants, possible work overload for nurses, as well as absence of consistent guidelines. Barriers to KMC among nurses who received the KMC training were lower than nurses who did not receive the KMC training (t=-2.11, p=.037).
Conclusion Education program and standardized clinical practice protocol should be developed to foster the positive perception and to reduce nurse barriers to KMC.
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Purpose This study of secondary analysis aims to compare family management style according to severity in children with atopic dermatitis.
Methods A convenience sample of 109 Korean mothers caring for a child with atopic dermatitis, were recruited from the pediatric departments of two general hospitals in Seoul. Data were collected from November 1, 2015 to February 28, 2016. A structured self-report questionnaire was used. Data were analyzed using descriptive statistics, correlation analysis, and one-way ANOVA with IBM SPSS Version 22.0.
Results For family management style, condition management effort, family life difficulty, and view of condition impact were significantly different according to the severity of the atopic dermatitis in these children.
Conclusion The findings indicate that family management strategies to enhance care of children with atopic dermatitis as well as members of the family should include these significant variables in a family-centered approach.
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Purpose Smoking during pregnancy contributes to the risk of negative health outcomes in mothers and babies. The purposes of this study were to review the harmful effects of maternal smoking during pregnancy on fetal and child development, to discuss if maternal smoking should be criminalized as a form of child abuse, and to explore advocating for fetal rights.
Methods A variety of published literature and legal documents including the Korean constitution, criminal laws, and children’s welfare laws were reviewed and critically analyzed.
Results Women who smoke during pregnancy are more likely to experience abortion related to placental dysfunction. Their unborn risk premature birth, fetal growth restriction, low birth weight, neurobehavioral disturbances, and/or other complications and newborn babies are also at risk for complications. The advocates for fetal rights can assert that maternal smoking should be regarded as a crime.
Conclusion Findings show that maternal smoking during pregnancy is a major risk factor for many adverse pregnancy outcomes. Effective strategies and health policies for smoking cessation during pregnancy are required to protect pregnant women and their babies.
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Purpose It is crucial to provide adequate enteral nutrition for postoperative recovery, wound healing and normal growth in infants in pediatric cardiac ICUs. This study was done to develop a feeding protocol using the vaso-active inotropic (VAI) score and to evaluate the impact of nutritional outcomes following the new feeding protocol for infants who underwent cardiac surgery.
Methods This study consisted of three phases. First, a feeding protocol was developed based on a literature review. Second, ten experts rated the content validity. Third, a comparison study was conducted to evaluate the impact of the new feeding protocol. Data were analyzed using SPSS Version 20.
Results Twenty-nine infants were enrolled in the pre-protocol group, and 22 infants in the post-protocol group. Patients in the 2 groups were similar. Time to reach feeding goal was significantly decreased from 56.0 (27-210) hours to 28.5 (10-496) hours in the post-protocol group (Z=-4.22, p<.001). Level of enteral feeding knowledge among nurses increased significantly after implementation of the protocol.
Conclusion The feeding protocol using VAI score facilitates the achievement feeding goal to decrease feeding interruptions and help nurses in their practice. Larger studies are necessary to examine clinical outcomes following the implementation of this feeding protocol.
Purpose This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory.
Methods A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together.
Results For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (≥21 days; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (≥38; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (≥35 years; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all.
Conclusion Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.
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Purpose The purpose of this study was to investigate the use of smartphones to address parents’ educational needs.
Methods The participants were parents of children under 18 years old, Participants were 347 parents (222 mothers, 125 fathers). Data were collected from August, 15 to September, 2, 2016 using self-report questionnaire. Data were analyzed using descriptive statistics, t-test and ANOVA with the SPSS WIN 21.0 program.
Results Parents had an average score of 3.30 (±.41) for the need to have smartphone health education. Among the educational subcategories, ‘child and family’ showed the highest average for educational needs (3.40, ±.57). According to the demographic characteristics of the participants, there were significant difference in parents’ age (t=4.354, p=.014), and parents’ who have received health education versus parents who have not (t=2.483, p=.014).
Conclusion Findings indicate that the smartphone may be an effective educational method for parents.
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Purpose The purpose of this study was to identify effects of Massage therapy on feeding intolerance and physical growth in premature infants.
Methods This study was conducted in the NICU of U university hospital, from June to December 2014. A quasi experimental design was used. A total of 60 premature infants were randomly assigned into two groups of 30 infants each. Infants of control group were given conventional treatment, while infants of experimental group given conventional treatment plus massage therapy. Massage therapy was performed for 15 minutes, 60 minutes before feeding, 3 times per day for 21 times over 7 days. The number of feedings withheld for feeding intolerance, number of gastric residuals, number of fecal excretions and physical growth variables (weight, height) were measured.
Results After the intervention, number of fecal excretions and weight gain in the experimental group were significantly higher than that of the control group. Also, number of gastric residuals in the experimental group was lower than that of the control group.
Conclusion Massage therapy laid the basis for nursing intervention to promote feeding tolerance and physical growth in premature infants.
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Purpose Fatigue in mothers of hospitalized children is an important component for her child’s health. This study was done to identify factors influencing fatigue in mothers of hospitalized children.
Methods A descriptive correlation study design was used. Participants were 157 mothers of hospitalized children in a university hospital located in one city. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression.
Results Mean score for fatigue in mothers of hospitalized children was 2.11±0.53. There were significant differences in scores for fatigue in these mothers according to education, sleep satisfaction, and family support. Multiple regression analysis showed that the important factors related to fatigue in mothers of hospitalized children were parenting stress (β =.44), hours of sleep (β =-.25), and age (β =-.21). These factors explained 38% of the total variance.
Conclusion Research results suggest that nursing interventions for mothers of hospitalized children are needed in order to improve the comfort and health of the mothers and facilitate the recovery of their child.
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Purpose The purpose of this study was to examine current status of somatic symptoms of late school-aged children using the school health clinic and to investigate the influence of perceived attachment security and social support on their somatic symptoms.
Methods For this descriptive study, self-report questionnaires were completed by fifth and sixth graders attending ‘A’ elementary school in Gyeonggi-do. Data from 216 students were included. Data analysis included descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression analysis.
Results Most frequent somatic symptoms were headache, fainting, backache, numbness in a body part, and muscle ache in that order. More frequent somatic symptoms were reported by girls, students who recognized their family SES as low, students who used school health clinic often and students who were dissatisfied with school life. Somatic symptom showed negative correlations with attachment stability and perceived social support from family and teachers. In the regression analysis, the variables; low attachment stability, female gender, and low satisfaction with school affected more frequent somatic symptoms.
Conclusion Careful monitoring of late school-aged children expressing frequent somatic symptoms is required. Intervention programs to improve attachment security and satisfaction with school should be developed for school children, especially girls, presenting with somatic symptoms.
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Purpose A longitudinal study was conducted to explore flora colonization and oral glucose high-risk newborns during the first 7 days after birth.
Methods Oral secretions of hospitalized newborns were obtained for microbial cultures and glucose test at days 1-7 after birth.
Results Among the total 112 newborns, 40% were girls and 73% were premature. Mean gestational age was 34.4±3.2 weeks and weight was 2,266±697.5 grams. The most common flora included Streptococcus (28.2%), Methicillin-resistant Staphylococcus aureus (MRSA, 10.9%), Staphylococcus (6.0%), and Coagulase- Negative Staphylococcus (CNS, 4.0%). The average oral glucose level was 29.2±23.0 mg/dL~58.2±39.5 mg/dL. Newborns with higher oral glucose than serum (crude odds ratio [ORc] =1.75; 95% confidence interval [CI] =1.03-2.97), phototherapy (ORc=3.30; 95% CI=2.29-4.76) and prone position (ORc= 2.04; 95% CI=1.13-3.69) were more likely to be colonized. Having oral tubes (ORc=0.42; 95% CI=0.29-0.59), parental nutrition (ORc=0.21; 95% CI=0.13-0.32) and antibiotics (ORc=0.51; 95% CI=0.36-0.73) had protective effects. For oral glucose statistical significances existed on time effect among newborns with Streptococcus (F=9.78, p=.024), MRSA (F=7.60, p=.037) or CNS (F=11.15, p=.019) and interaction between time and colonization among newborns with all of four flora (F=2.73, p=.029) or colonization with only Staphylococcus (F=2.91, p=.034).
Conclusion High-risk newborns develop flora colonization at an early period of life. Their clinical features were associated with types and time of oral flora colonization. They need close monitoring and multifaceted intervention to improve oral environment and infection control.
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