Development of Pediatric Patient Classification System / 임상간호연구

Purpose@#This study was performed to develop a valid and reliable Pediatric Patient Classification System (PPCS). @*Methods@#The study was conducted in a children’s hospital which included various ward settings.Content validity was analyzed by Delphi method and to verify intraclass correlation reliability, 7 nurse managers and 29 staff nurses classified 216 patients. To verify construct validity, the staff nurses classified 216 patients according to PPCS comparing differences by age, days of stay, type of stay and medical department. @*Results@#The developed PPCS has 12 categories, 55 nursing activities and 80 criterions. High agreement among nurses (r=.90) suggested substantial reliability. Construct validity was verified by comparing differences in age, days of stay, type of stay and medical department (p<.05). The entire patient group were classified to four groups using PPCS. @*Conclusion@#The findings suggest that PPCS would be a useful tool for estimating nursing demands related to medications and the complexity of pediatric patients.

Effects of Self-directed Fundamental Nursing Practice using Smartphone Videos on Self-efficacy, Practice Satisfaction, and Skill Competency / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify whether self-directed fundamental nursing practice using a smart phone affected self-efficacy, practice satisfaction, and skill competency of nursing students. METHODS: This was a nonequivalent control group pretest-posttest quasi-experimental design. The participants were 40 children in the experimental group and 40 in the control group. In experimental group, self-directed fundamental nursing practice using a smart phone was given to nursing students. Data for this study was collected from 25 March 2015 to 10 April 2015. The data were analyzed using SAS 21.0. RESULTS: In self-efficacy and skill competency, there were no statistically significant differences between the experimental group and control group. In practice satisfaction, there were statistically significant differences between the experimental group and the control group. CONCLUSION: The results indicate that self-directed fundamental nursing practice using smartphone video is effective in practice satisfaction. Therefore, this intervention can be utilized in nursing practice education as an effective educational device.

Prospective Study on the Factors Related to Premature Infant's Development at Six-Months

PURPOSE: This study was conducted to monitor the development of Korean premature infant at six-month age and to explore factors related to developmental status of the premature infants. METHODS: Participants were 58 premature infants whose corrected age was six-months old and their mothers. The developmental states of infants were followed-up with the Korean Prescreening Developmental Questionnaire (KPDQ-II). Clinical characteristics of the infants were identified from the medical records. Other characteristics including Edinburgh Postnatal Depression Scale, husband's support, social support, and mother-infant attachment were assessed using self-report questionnaires from the mothers. RESULTS: Forty three percent of the infants were in the group of questionable status of development on the KPDQ-II. There were significant differences between the premature infants with normal developmental status and those with questionable developmental status depending on gender (χ2=5.03, p=.034), gestational age (t=2.59, p=.012), hospital stay (t=-2.08, p=.042), revised Neurobiologic Risk Score (t=-3.05, p=.004) and mother-infant attachment score (t=2.12, p=.040). CONCLUSION: Mother-infant attachment, as well as physiological state of premature infants, is an important variable in early development. Therefore, early monitoring for the development has to be done for physiologically vulnerable premature groups. Also, providing proper nursing support to improve maternal attachment needs to be considered.

Effects of a Smart Phone Individualized Distraction Intervention on Anxiety in Pre-Op Pediatric Patients

PURPOSE: The purpose of this study was to identify whether individualized distraction intervention using a smart phone affected pre-op anxiety of children. METHODS: This was a nonequivalent control group pre-post test quasi-experimental design. The participants were 30 children in the experimental group and 30 in the control group. In experimental group, a smart phone individualized distraction intervention was given to children from the reception area to the operation room. RESULTS: For heart rate, there were no statistically significant differences between the experimental group and control group. In the behavioral anxiety response, there were statistically significant differences between the experimental group and control group (t=-3.11, p=.003). CONCLUSION: The finding suggest that, for pre-op children, the individualized distraction intervention using a smart phone had some significance as a nursing intervention having a positive impact. Such interventions can help pediatric nurses to relieve pre-op anxiety and improve health of children in their care.

Relations of Postpartum Depression with Socio-Demographic and Clinical Characteristics of Preterm Infants and Mothers

PURPOSE: This study was conducted to explore relationships of postpartum depression with socio-demographic and clinical characteristics of preterm infants and mothers. METHODS: Participants were the mothers of 80 premature infants admitted to neonatal intensive care units. Postpartum depression was measured using the Edinburg Postnatal Depression Scale (EPDS). Clinical characteristics were examined through the medical records. The physiological state for the infants was evaluated using the revised Neurobiologic Risk Score (NBRS). Data were analyzed using the t-test, ANOVA, and Pearson correlation coefficients. RESULTS: Average for EPDS was 9.75+/-5.06, and 30% of the participants were at high risk for postpartum depression. There were significant differences in postpartum depression according to mother's education level (F=3.493, p=.035), economic state (F=5.828, p=.004), multiple pregnancy (t=2.141, p=.037), chorioamnionitis (t=2.349, p=.021), oligohydramnios (t=-2.226, p=.029), broncho-pulmonary dysplasia (t=2.085, p=.040), germinal matrix hemorrhage (t=2.259, p=.027), and revised NBRS (t=-2.772, p=.007). There was a significant positive correlation between postpartum depression and number of health problem of infants (r=.252, p=.024) and revised NBRS (r=.316, p=.004). CONCLUSION: As 30% of the mothers with preterm infants were at high risk for postpartum depression, they require attention. When providing interventions, socioeconomic status as well as the physiological state of premature infants should be considered.

The Effect of a Postpartum Nursing Intervention Program for Immigrant Mothers

PURPOSE: The purposes of this study were to develop a postpartum nursing intervention program for immigrant women and evaluate the effects on postpartum depression, child rearing confidence, home environment, and infant temperament. METHODS: This research was a non-equivalent control group pre-test and post-test design. Participants were pregnant immigrant women from China, Vietnam, and the Philippines residing in Kyunggi province and Seoul. Twenty women were assigned to the intervention group, and 19 women to the control group. For the intervention group, the women were visited at home and provided emotional support and parenting education for three months. To analyze the intervention effects, repeated measure ANOVA and t-test were used. RESULTS: Child rearing confidence was higher in the experimental group than the control group at interaction effect of time and group, six weeks and three months postpartum. However, there were no significant effects for maternal depression, infant temperament, and husband support. Home Observation for Measurement of the Environment (HOME) score in the experimental group was higher than that of the control group at three month postpartum. CONCLUSION: Results indicate that the nursing intervention program had positive effects and can be used to further the health status of immigrant mothers and children.

The Value of Neutrophil-Lymphocyte Count Ratio for Disease Severity in Nursing Home Acquired Pneumonia Patients

BACKGROUND: We evaluated the value of neutrophil-lymphocyte count ratio (NLCR) in patients admitted to the Emergency Department (ED) with suspected nursing home acquired pneumonia (NHAP). METHODS: From May 2011 to January 2013, 116 patients admitted to the ED with suspected NHAP were retrospectively studied. The clinical characteristics, C-reactive protein (CRP), white blood cell count, neutrophil count, lymphocyte count, and NLCR were assessed. CURB-65 score was used to calculate disease severity. General ward or intensive care unit (ICU) admissions, and 72-hour and 30-day mortality for each infection marker was assessed. RESULTS: The 116 patients had a median age of 77 years. As the CURB-65 score increased from 0-1 (low risk), to 2-3 (moderate risk), and to 4-5 (high risk), the NLCR consistently increased (mean, 6.9, 8.89, and 16.22, respectively). The difference between the moderate and high risk groups was significant (p=0.008). The NLCR (mean+/-standard deviation) was high in patients with NHAP (10.28+/-8.81) and increased even more for patients admitted to the ICU (15.69+/-14.81) or who died within 72-hour (15.63+/-9.57). NLCR showed the trend of higher value in ICU admission (p=0.072), and CRP was significantly different between ICU and general ward admission (p=0.007). CONCLUSION: NLCR at ED admission correlated with NHAP severity and was comparable to the traditional infection marker. NLCR can be assessed simply and added to the assessment tools to determine the severity of pneumonia during ED admission.

Perception of the Importance of Health Promotion Behavior for Infants and Toddlers according to Mothers of Children in this Age Group and Graduate Students in Nursing

PURPOSE: This study was done to examine the importance of health promotion behavior for infants and toddlers as perceived by mothers of children in early childhood, and graduate students in nursing and to provide information for health promotion in early childhood. METHODS: This study was a cross-sectional survey research study. The participants were 91 mothers of children in early childhood, and 115 graduate students in nursing. RESULTS: The comparisons showed that graduate students in nursing reported higher perception of the importance health promotion behavior for infants and toddlers than did the mothers. In health promotion behavior, the highest score was in the category of safety. CONCLUSION: Providing information by nurses is necessary to promote health promotion behavior for mothers of children in early childhood. Therefore, it is important for healthcare professionals to develop effective programs for these mothers who want to promote good health promotion behavior in their children.

Surface characteristics of a novel hydroxyapatite-coated dental implant

PURPOSE: This study evaluated the surface characteristics and bond strength produced using a novel technique for coating hydroxyapatite (HA) onto titanium implants. METHODS: HA was coated on the titanium implant surface using a super-high-speed (SHS) blasting method with highly purified HA. The coating was performed at a low temperature, unlike conventional HA coating methods. Coating thickness was measured. The novel HA-coated disc was fabricated. X-ray diffraction analysis was performed directly on the disc to evaluate crystallinity. Four novel HA-coated discs and four resorbable blast medium (RBM) discs were prepared. Their surface roughnesses and areas were measured. Five puretitanium, RBM-treated, and novel HA-coated discs were prepared. Contact angle was measured. Two-way analysis of variance and the post-hoc Scheffe's test were used to analyze differences between the groups, with those with a probability of P<0.05 considered to be statistically significant. To evaluate exfoliation of the coating layer, 7 sites on the mandibles from 7 mongrel dogs were used. Other sites were used for another research project. In total, seven novel HA-coated implants were placed 2 months after extraction of premolars according to the manufacturer's instructions. The dogs were sacrificed 8 weeks after implant surgery. Implants were removed using a ratchet driver. The surface of the retrieved implants was evaluated microscopically. RESULTS: A uniform HA coating layer was formed on the titanium implants with no deformation of the RBM titanium surface microtexture when an SHS blasting method was used. CONCLUSIONS: These HA-coated implants exhibited increased roughness, crystallinity, and wettability when compared with RBM implants.

Surface characteristics of a novel hydroxyapatite-coated dental implant

PURPOSE: This study evaluated the surface characteristics and bond strength produced using a novel technique for coating hydroxyapatite (HA) onto titanium implants. METHODS: HA was coated on the titanium implant surface using a super-high-speed (SHS) blasting method with highly purified HA. The coating was performed at a low temperature, unlike conventional HA coating methods. Coating thickness was measured. The novel HA-coated disc was fabricated. X-ray diffraction analysis was performed directly on the disc to evaluate crystallinity. Four novel HA-coated discs and four resorbable blast medium (RBM) discs were prepared. Their surface roughnesses and areas were measured. Five puretitanium, RBM-treated, and novel HA-coated discs were prepared. Contact angle was measured. Two-way analysis of variance and the post-hoc Scheffe's test were used to analyze differences between the groups, with those with a probability of P<0.05 considered to be statistically significant. To evaluate exfoliation of the coating layer, 7 sites on the mandibles from 7 mongrel dogs were used. Other sites were used for another research project. In total, seven novel HA-coated implants were placed 2 months after extraction of premolars according to the manufacturer's instructions. The dogs were sacrificed 8 weeks after implant surgery. Implants were removed using a ratchet driver. The surface of the retrieved implants was evaluated microscopically. RESULTS: A uniform HA coating layer was formed on the titanium implants with no deformation of the RBM titanium surface microtexture when an SHS blasting method was used. CONCLUSIONS: These HA-coated implants exhibited increased roughness, crystallinity, and wettability when compared with RBM implants.

Relationship of Prenatal Stress and Depression to Maternal-Fetal Attachment and Fetal Growth

PURPOSE: Prenatal depression is associated with potential negative consequences for the mother and infant. The purpose of this study was to examine pregnant women's stress, and depression and their impact on maternal-fetal attachment and fetal growth. METHODS: Data were collected by means of a questionnaire and fetal sonogram from a convenience sample of 166 pregnant women. RESULTS: Women who have a low educational level, poor health and are dissatisfied with their marriage showed low maternal-fetal attachment. Prenatal depression had significant correlations with length of pregnancy and level of stress. Even though correlation between maternal stress and fetal weight (r=-.15, p=.099) and correlation between maternal depression and maternal-fetal attachment (r=-.13, p=.095) were not statistically significant, the impact of the prenatal psychological state of mothers can not be ignored as it relates to fetal health. CONCLUSION: Maternal-fetal attachment and fetal growth can be affected by maternal emotional state, including stress or depression. These findings suggest that primary care nurses in hospitals and public health centers should provide prenatal depression screening and nursing intervention programs for management and prevention of prenatal stress and depression.

Ways of Coping and Health-Related Hardiness in University Students / 기본간호학회지

PURPOSE: The purpose of this descriptive study was to explain the relationship between ways of coping and health-related hardiness in university students at G city. METHOD: The participants were a convenience sample of 250 students. The data were collected by a questionnaire given to the students between June 1 to June 10, 2006. Descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression were used to analyze the data. RESULTS: The most frequently used method of coping was pursuit of social support. The mean score for level of health-related hardiness was 3.34+/-0.55. There were significant differences in ways of coping according to satisfaction with college life (F=4.036, p=.008). There were significant differences in health-related hardiness according to smoking or not (F=6.237, p=.002). There were positive correlation between problem focused coping and hardiness (r=.357, p=.000), between social support and hardiness (r=.345, p=.000), between hope seeking thought and hardiness (r=.247, p=.000). In regression analysis, ways of coping was significantly influenced by hardiness(16.6%). CONCLUSION: The results suggest that programs for strengthening hardiness can be considered as significant nursing interventions for helping university students cope with stress.

Health Behaviors of Nurses at a University Hospital according to Type of Work / 영남의대학술지

BACKGROUND: The goal of this study was to examine the health behaviors of nurses and provide basic information on health promotion for nurses. MATERIALS AND METHODS: A self-administered questionnaire survey was completed by 340 nurses working at a university hospital in Daegu, Korea from March 6 to March 30, 2006. The questionnaire included demographic characteristics, working environment, health behaviors, self-assessed health status, and the practice of health promotion activities according to the work group(shift group vs. non-shift group). RESULTS: There were significant differences in 'regular diet', 'drinking', 'ordinary health management', 'regular exercise', 'leisure activities', 'rest', and 'feeling of fatigue' between the two groups. The score for the practice of health promotion activities of the non-shift group was 121.9, which was higher than the 115.4 for the shift group. By field of practice of health promotion activities, there were significant differences in 'self-realization' and 'nutrition' between the two groups. CONCLUSION: The shift group did not appear to have enough time to take care of their health. It is therefore important to provide a working environment in which nurses are encouraged to increase their interest and efforts to maintain healthy behaviors. In addition, programs for education and training should be developed to help nurses adopt healthy life styles and enhance their self-esteem.

Perception of Parental Role by University Students / 아동간호학회지

PURPOSE: This study was conducted to describe the perception of parental role held by university students and to examine difference in perception of parental role according to student characteristics. METHOD: The participant were 338 university student in Gangreung city. The instrument was developed by researcher and consisted of 4 subcategories ; child rearing environment, parental sensitivity, growth and development of infant, and physical care. Data were collected from May 10 to June 1 in 2004 and were analyzed using SPSS Win 10.0 program. RESULT: The university students' perception of total parental role had a mean item score of 4.02, with 4.12 for parental sensitivity, 4.00 for child rearing environment, 4.00 for physical care and 3.95 for growth and development. There were significant differences in perception of parental role according to sex(t=-5.55, p=.00), grade(F=13.12, p=.00), type of college(F=28.34, p=.00), father's age(F=5.01, p=.00), father's education(F=5.01, p=.00), mother's education(F=3.33, p=.03) student's marriage plan(t=2.37, p=.01) main caretaker(F=9.53, p=.00) person who lived with student in childhood(F=3.62, p=.01) and student's perception of the need for education for parental role(t=3.74, p=.00). CONCLUSION: The impact of childhood experience has lifelong significance on subsequent health and development. Especially, the experience of childhood is highly affected by the quality of parental role. It is important to identify university student's perception of parental role as pre-parent preparation for parenting. Therefore, pre-parent education program are necessary.

The Study on the Development and Effectiveness of Parent Role Education Program / 간호학회지

PURPOSE: This study was conducted to evaluate the effectiveness of the maternal role education program for primiparas in mother-infant interaction, childrearing environ- ment, and infant development. METHOD: A Non-equivalent control group time-series design was used. For the intervention group, programmed parenting education focusing on mother-infant interaction, home environment for infant development, and parent counseling and support was provided via home visits or telephone for twelve months. RESULT: Significant differences were found in the mother-infant interaction feeding scale at one and three months, but no differences were found in the teaching scale at six and twelve months between the intervention and control groups. Also, the difference in childrearing environment (HOME) between the two groups was significant at three, six, twelve months. In addition, the intervention group showed higher GQ in the Griffiths mental development scale at three and six months. In multiple regression analysis, 22.6% to 43.6% of infant development was explained by HOME, mother-infant interaction, and previous development. CONCLUSION: The maternal role education program proved to be effective in promoting mother-infant interaction, organizing the childrearing environment, and fostering infant development.

The Study on the Development and Effectiveness of Parent Role Education Program I: Focusing on the six-months results / 아동간호학회지

Recent research indicates that the new mothers want to learn about childrearing, and have burden in care of infants. Also it indicates that the new mothers say the lack of confidence and knowledge about infant care. This study was a prospective longitudinal reseach developing parent role education program and evaluating the effectiveness of this program for mother- infant interaction, childrearing environment and infant development. Longitudinal quasi-experimental design was used. The subjects were the healthy infants weighing over 2,500gm at birth, whose gestational age was more than 37weeks, and their mothers. The sample consisted of 19 mother-infant dyads for intervention group and 18 dyads for control group. Data were collected from March 15th to December 14th in 1999. For the intervention group received programmed education that was consisted of discharge education, telephone counselling, and home visiting for maternal education. The data were analyzed using chi-square test and t-test to test the equivalence of two groups, and the effectiveness of intervention program. This study was focused on the results of six months time point. The results were as follows: 1. There was significant difference in the mean score of mother-infant interaction(NCAST) between two groups. Intervention group showed higher scores in the subscales of sensitivity to cues, cognitive growth fostering, and caregiver total. 2. There was no significant difference in the mean score of child rearing environment (HOME) between two groups of six-month- infants. But when each subscale of HOME was examined, intervention group showed higher scores in the dimensions of opportunities for variety in daily stimulation, maternal involvement with child, and emotional, verbal response. 3. Six-month-infants of the intervention group showed significantly higher GQ in the Griffiths mental development scale. In conclusion, the maternal education program was effective in promoting the mother-infant interaction, organizing the childrearing environment, and fostering the infant development. These results were very meaningful that we found parent role education necessary for normal infants' mothers, and nurses can make a great contribution in promoting health of infants and mothers.

The Descriptive Study on the Mother's Responsiveness to Infant Cue / 아동간호학회지

This research was to examine the mother's responsiveness to infant cue in order to improve interaction between mother and infant. The subjects were 144 mothers who gave birth to at general hospital for a public health center in Kangnung. The gestational age of infants was more than 38weeks and birth weight was more than 2500g. A questionnaire was developed by applying the content about infant cue in Barnard's NCAST program. This questionnaire was revised through the examination of expert is in this field. The questions were classified into 3 categories : 10 questions about engagement cue, 11 questions about disengagement cue, and 9 questions about general cue and reflex behavior. Each item measured the mother's responsiveness to infant cue using 5 scales : 2 positive responsiveness. 1 negative responsiveness, and 1 meaningless, 1 for in case which mother can't recognize the meaning of reaction. The result presented that mothers showed positive reaction to engagement cue. However, most mothers still didn't recognize that their infants can lead a mother-infant interaction and show active response in interaction. Mothers tended to treat them as just passive objects. In disengagement cue, mothers tended not to give proper responsiveness to their infants when the infants desired feeding or not and they did not desire mother-infant interaction. In general cue and reflex behavior, the mother's reaction was positive and they took it granted as a infant's behavior. When each item was analyzed by the general characteristics of the subject, there was significant differences according to the mother's age, birth weight, average house income, birth order, feeding type, nature of infant, and infant's age.