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Volume 8(4); October 2002

Original Articles
Development and Evaluation of Injury Prevention Education Proposal for Elementary School Children.
Jung Eun Lee, Ji Hyun Kim, Shin Jeong Kim
Korean J Child Health Nurs 2002;8(4):365-380.
This study was to develop and evaluate injury prevention education proposal which will helpful and can be utilized directly on the first line spot for elementary school children. Education proposal development and evaluation process was 1) Construction of 10- times education proposal contents proper to schooler 2) Testify validity through 3 pediatric nursing professor and 4 elementary school nurse 3) Pretest was done from March, 2002 to July on 3-6th grade 313 elementary school students 4) Through correction and revision after pretest evaluation meeting, final injury prevention education proposal was developed 5) After 10- times injury education, evaluation was carried out about the degree of help in education contents and general constitution of injury education to total subjects of educated children. Injury prevention education proposal consists of 10 times and each subjects are followings. 1st is "introduction of injury prevention education and the importance of injury prevention" 2nd is "safety in and around home", 3rd is "injury prevention in school", 4th is "prevention of violence", 5th is "motor vehicle safety", 6th is "water safety", 7th is "prevention of fire and burns", 8th is "toy and product safety", 9th is "sports and recretional activities safety"and the final 10th is "injury prevention caused by animals". In the evaluation, the degree of help in education contents showed it helped to children averaged 1.66 and general constitution showed averaged 2.17 that children satisfied about developed injury prevention proposal. This study expected to provide systematic and concrete guidance in injury prevention education for elementary school children.
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Factors that Affect Accidents from Riding on Inline Skates and/or Kick Boards among Students in the Elementary Schools.
Joo Hyung Kim, Eun Hee Koh, Shin Hae Kwun, Sun Hong Kim, Young Hee Nam, Eun Song Suh, Joo Hyun Lim, Min Joo Han, Jung Hun Chung, Hae Jin Chung, Won Jung Cho
Korean J Child Health Nurs 2002;8(4):381-390.
This study examines the factors that are associated with accidents from riding on inline skates and/or kick boards among students in the elementary schools. Data were collected from 902 students in 3 elementary schools in Seoul. Data were analyzed based on descriptive statistics and chi-square test. The results were as follows: 1.Thirty-eight percent of the students investigated were found to have kick boards while sixty-one percent of the students had inline skates. 2.The age of mothers who answered the questionnaires showed a statistically significant association with injuries of their children on inline skates and/or kick boards. Children whose mothers are younger had a lower percentage of injuries on inline skates and/or kick boards. 3. Children with a lower score on K-CBCL had a higher chance of having an accident from riding on inline skates and/or kick boards. That is, children with lack of attention were more likely to be involved in an accident. First-born children were less likely to have an accident. 4. While mothers' attitudes toward the safety of inline skates and kick boards appeared not to be associated with accidents of their children, their preventive actions for the safety related to riding on inline skates and kick boards reduced the chance to be involved in an accident of their children. In conclusion, this study shows that mothers with children going to the elementary schools should be more action-oriented to prevent their children's accidents from riding on inline skates and/or kick boards than merely recognizing the safety of inline skates and/or kick boards on their own. Implication of these findings and major findings of this study were discussed.
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Assessment of Gestational Age using New Ballard Examination in Premature Infants.
Kun Ja Lee, Myung Hee Lee
Korean J Child Health Nurs 2002;8(4):391-399.
PURPOSE
Knowing the accurate gestational age(GA) is critical in nursing care of premature infants. A descriptive study was performed to examine the reliability and clinical applicability of the New Ballard examination(NBE) in premature infants.
METHOD
A NBE was performed to measure GA by assessing the neuromuscular and physical maturity in the course of physical examination of a convenient sample of 74 premature infants.
RESULT
1. The highest item of NBE score was posture (mean=2.82) and the lowest item was breast (mean=1.84). 2. There was a highly correlation between both the GA by LMP(GA-LMP) and GA by NBE (GA-NBE)(r=.844, p=.000). 3. There was a greater positive relationship in neuromuscular maturity than physical maturity in the GA-NBE of the premature infants(r=.786 vs r=.933). 4.There was a positive correlation between neuromuscular, physical, total maturity, GA-LMP and GA-NBE in the birth weight, length, 1 , 5 minute apgar score. 5.There was no significant difference neuromuscular, physical, total maturity in NBE by delivery history.
CONCLUSION
The study supports the reliability a clinical relevance of NBE in assessment of the accurate GA in premature infants.
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The Effects of Informational Intervention on Postoperative Pain following Tonsillectomy in Children.
Young Hae Kim, Hwa Za Lee
Korean J Child Health Nurs 2002;8(4):400-413.
The purpose of this study was to evaluate the effect of informational intervention on postoperative pain following tonsillectomy in children. This study was performed on 30 children, aged 5-15 years, undergoing tonsillectomy and their parents by providing informational intervention with colored figure; operation procedure and information. Pain assessment was done by Pain Questionnaire. The results from this study were as follows : 1. Children in experimental group with mean 16.07 had lower pain scores than control group with mean 14.87 at 4th hours after operation(p < 0.05). It showed "significant difference" and first hypothesis was adopted. 2. Children in experimental group with mean 20.60 had lower pain scores than control group with mean 17.27 at 8th hours after operation(p < 0.05). It showed "significant difference" and second hypothesis was adopted. 3. Children in experimental group with mean 28.80 had lower pain scores than control group with mean 25.70 at 24th hours after operation(p < 0.05). It showed "significant difference" and third hypothesis was adopted. 4. When we analyzed the time difference and difference between two groups simultaneously by repeated measure ANOVA, the significant difference was not found. And so "the experiential group with operation-related information will show the lower pain sense than the control group just as the time flows after operation", fourth hypothesis was rejected. Generally, it was found that providing information about operation to children and their parents reduced effectively postoperative pain in children, but in clinical settings there are minimum preoperative information-providing because of insufficient time and inconvenience although nursing staffs and patients know its needs. Conclusionally providing preoperative information should help children and their parents cope with Pre, Peri and Post operative events effectively.
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A Concept Analysis of the Caretaking Behavior for Children.
Soon Goo Kim
Korean J Child Health Nurs 2002;8(4):414-421.
The purpose of this study is to analyze the concept of caretaking behavior for children. This study adopts the methode of Walker and Avant in analysis. Based on the results of the study, the attributes, precedents, and consequences of caretaking behavior for children are follows ; 1.The affirmative attributes of caretaking behavior are affection binding, nutritional guidance, education, caring, protection moral training and acquisition of parents' role. The negative attributes of caretaking behavior are inconsistent moral training, incapability of affection binding and overprotection. 2. The precedent of caretaking behavior are postpartum contact with their babies, cognizance capacity of child-caretaking, economic support, level of preparation for child-caretaking and self-consciousness as parents. 3. The affirmative consequences of caretaking behavior are promotion of child growth and development, formation of maternal-infantile attachment, development of children sociality, satisfaction of parental role and reinforcement of relationship between the members of family. The negative consequences of caretaking behavior are burden and conflict to parental role, children's illness, role conflict and role stress among the members of the family and family breaking up.
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Study on Bullying among Primary School Students.
Eun Soon Jung, Yi Soon Kim, Hwa Za Lee, Young Hae Kim, Mi Gyoung Song
Korean J Child Health Nurs 2002;8(4):422-434.
This study was conducted with 512 students in 4 primary schools located at the inner and the outskirt of K city, Northern Kyungsang Province from November 6, 2001 to November 27, 2001(during 3 weeks). This study was a research about the difference of a bullying degree and tendency of both teasing and teased students. The purpose of the study was to help nursing teachers in charge of student consultation and treatment. The findings are as follows. First, for to whom students confess their worries, students in lower grade talked to their parents while students in higher grade talked to their close friends. The higher grader, the higher rate in solving their problems by themselves. For how many students are teased by their peers in groups, 52.0% students answered 1 or 2 students in a class. For the reasons of bully, 37.0% higher graders answered, very selfish and putting on airs after 29.6% lower graders answered, ugly and bad at speaking. Second, for perception of peer relation, 81.3% students participating in the study answered, very important. For a question whether students satisfy present relation with their friends by gender, 53.7% boys were satisfied while 34.6% girls were satisfied. Third, for difference in bullying by gender, boys mainly teased others by using words and physical power(p < 0.000) while girls estranged others. When it goes to teased students, it was the case: boys were bullied physically(p < 0.000) and linguistically while girls were hurt by estrangement. Having nothing direct to do with school achievement, nursing teacher should make good use of such an advantage that students tend to easily confess their worries to them and take care of psychological aspects of students in treatment. Furthermore, it needs to include contents of bully in the regular heath care education.
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A Study on the Occurrences and Preventive Strategies of Accident in Children.
Jeong Yi Bae
Korean J Child Health Nurs 2002;8(4):435-448.
Accidents are important causes of death and disability in children. They also have enormous financial implications. Young children become an victim of accidents easily because of their physical fragileness and their coping behavior being vulnerable to any actions taken by accidents. Once they have a accident, the children whose not fully developed, suffer from devastating long-term after-effects. Lee, Lee, Kang and Han(1995) reported that ninety percent of accidents can be prevented. But there is no national system to manage, evaluate and analyse the information about child accidents, even though it is necessary for accident prevention policies and health promotion of the general public. The purpose of the study was to determine how often children have accidents and define the accident prevention strategies in children. The investigator conducted a descriptive study by performing the surveys, interviews, and workshops for the 2,458 young children, 10 teachers, and 1,494 parents. The data collection for the study began on September 2000 and completed on April 20, 2001. The analysis of the data was done with Window SPSS 10.0 for descriptive statistics. Among those children, 1,298 children(52.8%) injured from accidents. The children who had accident answered that they injured from traffic accident(27.3%), inside the home(26.3%), on the playground(17.0%), during playtime(13.6%), in the school(5.9%) and food poisoning(7.1%). To define accident prevention strategies for the school children, the parents and the teachers who had a special interest in this topic formed a special task force under the guidance of the investigator. The team was charged to prepare the basis of content materials by identifying the problems, setting standards for the program, prioritizing the process, and selecting the methods of implementation and evaluation. Eight issues and concerns identified by the team were: 1)allowing young children to learn undesirable habits and behaviors that would bother others without knowing; 2) not guarding young children from car accident; 3)unattended accident at playground; 4) considering home places safe; 5)unattended accident at school. These issues were found to be coinciding with the actual child accident cases occurred recent years in Korea. Greater efforts are required to reduce unnecessary deaths and disability from childhood accidents. This study gave a very useful and important data to prepare accident prevention educational program and to prepare accident prevention strategies.
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An Analysis of the Concepts in Child Health Nursing Studies in Korea(1): from 1990 to 2000.
Kyung Ja Han, Hyun Ah Kim, Sook Young Kim, Jeong Soo Kim
Korean J Child Health Nurs 2002;8(4):449-457.
The main purpose of this study is to examine the concepts appeared on researches and provide the future research directions in field of child health nursing. A descriptive study was conducted. 205 studies were included in an analysis the concepts in terms of the domain of client for a total 321 researches. All were originally published between 1990 and 2000 in Korea. An analysis of concepts for this study was used the metaparadigm framework for nursing proposed by H.S. Kim(2000). The concepts for this study were categorized by essentialistic concepts, problematic concepts, health-care experiential concepts with the following results. 1.Based on the four domains suggested Kim (2000), 205 studies(63.9%) belong to the domain of client ; 109 studies(34%) belong to the practice domain of nursing; 3 studies(0.9%) belong to the client-nurse domain; and 4 studies belong to the domain of environment, respectively. 2.In the domain of client, 117(57.1%) studies used concept of parent. Among them, mother was the prevailing research population(103 studies). 64 studies(31.2%) used child population and the developmental stage of children varied from preterm to puberty but school aged children was the most target population(28 studies). Family as a concept of client was used in 20 studies(9.8%) but most primary care provider was the mother. 3. In terms of research design, non-experimental design(83.5%) is the most and among them survey was 159 studies(77.6%). Qualitative research(23 studies) and experimental research(10 studies) methods were used relatively few. 4.In terms of the categories of concepts, 196 (61.4%) studies included the essentialistic concepts like stress and coping(20.4%), mothering role and child care(7.8%), health (5.6%), breast feeding(4.7%). 31 studies included problematic concepts like power- lessness, safety, obesity, pain, anxiety. And 65 studies included health-care experiential concepts like compliance, growth, hope, environment but relatively few. The findings of this study provide the evidence that research related problematic concept and health-care experiential concept should be conducted actively to improve the practice of child health nursing. Also to deeply understand the phenomena of client in field of child health nursing, interpretive research methods should be conducted actively, too.
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Qualitative Analysis of Nurses' Metacommunicative Behaviors in a Pediatric Unit.
Hyun Sook Shin
Korean J Child Health Nurs 2002;8(4):458-468.
The purpose of this study was to identify metacommunicative behaviors between nurses and patients in a pediatric unit. The research method included observation using videotaping. Data were collected from December, 2001 to February, 2002. Total six nurses, and eight patients and their mothers in a pediatric unit participated in this study. The interactions were videotaped under the participants' consent. The participants were observed for total 8 hours over 2-day period. Special episodes which were identified as metacommunicative behaviors in the taped interactions were transcribed. Transcription included verbal and nonverbal interactions. Selected episodes were classified using Mitchell's definition. Each classified definitions were named, and categorized by its purpose. The results were as follows: Nineteen metacommunicative behaviors which used frequently by nurses-approaching, mediating eye level, eye contact, touching, encouraging, turnabout, mimic voice, giving choices, friendly demand, expansion, tagging, repeating and confirming, identification, reflection, baby talk, symbolization, description of acts, relaxed posture, turning away- were identified and organized into four categories. They were call for attention, facilitating response, empathy, and tension release. In conclusion, nurses in this study used metacommunicative behaviors frequently and these behaviors were effective in interacting with children. It is suggested that any educational programs to teach communication skills to nurses need to include techniques on metacommunicative behaviors. This will help nurses to be more sensitive to different characteristics of their patients.
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The Parent-Child Relationship in Traditional Korean Society Described in Korean Classic Novels.
Eun Sook Park, Eun Kyung Kim, Jung Wan Won, Won Oak Oh, Min Hyun Suk, Yeo Jin Im
Korean J Child Health Nurs 2002;8(4):469-481.
The purpose of this study was to explore the parents and child relationship in traditional Korean society through the Korean classic novels. The Data were analyzed through latent content analysis in focusing on the parents and child relationship. Forty-six Korean classic novels written in Chosun Dynasty (from 1392 to 1910 AD) were chosen to analyze and they were represented the characteristic Confucian ideas. The sentences containing the expression of child-care and parent-child relationship were selected during intensive reading line by line and analyzed. Sixty-nine meaningful concepts were drawn out from 258 significant sentences by the similar meaning and common theme and classified as 3 categories and 11 sub-categories. The important parent-child relationship expressed in Korean traditional society were as follows: From the category of the Meaning of Child, 4 sub-categories were drawn; gift of heaven, successor of the family line, driving power of life, and rewards from the offspring. From the category of attitude to the child, 3 sub- categories were drawn; a notion of preferring a son to a daughter, close maternal-child relation, and expectation to the future of child. From the category of nurturing behavior, 4 subjects were drawn; Tae-Gyo(fetal education), affective behavior, socialization, and health management behavior. Above result helps to improve the basic understanding the relationship of parent and child in modern society. And by the understanding of child in the family, unhealthy relationship of parent and child can be prevented and furthermore family centered child health promotion can be achieved.
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