Maternal Experiences of Anger While Raising a Child

Purpose@#This study aims to explore mothers’ experiences of anger while raising a child in South Korea based on a qualitative descriptive approach. @*Methods@#A total of ten mothers of children aged 1-3 years participated in the study. In-depth individual interviews were conducted from August to September 2019 to collect data, which were then subjected to thematic analysis. @*Results@#A total of 4 main themes and 10 subthemes were identified. The 4 themes were “individual and environmental factors that influence anger,” “a vicious cycle of anger expression and guilt,” “being a little bit more mature as a mother,” and “need for anger management.” This study described various causes, ways of expressing, and effects of anger, as well as the mother’s coping strategies. These experiences were viewed as milestones along the journey to becoming a real parent and helped mothers develop empathy for other children and mothers. The participants expressed support for expanding the social support system for child-rearing and providing psychological programs for mothers. @*Conclusion@#Mothers of children aged 1-3 years experienced anger owing to various factors, but adapted by developing coping skills. This study recommends family-based support interventions to help mothers manage their emotions and parenting roles.

Assessment of Sleep Quality of Infants and Their Mothers Using Actigraphy

Objectives@#The purpose of this study was to explore and evaluate the characteristics and quality of infant and maternal sleep (total sleep time, sleep efficiency, and wakefulness after sleep onset) using an actigraph. @*Methods@#The characteristics and quality of sleep were assessed in 22 dyads of mothers and infants aged 3–12 months. The quality of infant and mother sleep was collected using an actigraph for 12 consecutive days; this was repeated three times at 4-week intervals, and characteristics of infant sleep were measured using the Brief Infant Sleep Questionnaire-Revised. @*Results@#Bedsharing with infants at 7–12 months of age was higher (12.5%) than with those at 3–6 months of age (50.0%). Regarding the sleeping position, half of the infants aged 3–6 months adopted the lateral (25.0%) and prone (25.0%) positions, and the remaining half (50.0%) aged 7–12 months adopted the lateral position. It was found that 45.5% of mothers of infants used breastfeeding and pacifiers to induce sleep in infants and to help their babies go back to sleep when they woke up. The total sleep time and sleep efficiency of infants and mothers were 434.68 minutes per day and 73.1% and 379.53 minutes per day and 82.8%, respectively, indicating that both infants and mothers had low sleep quality. @*Conclusions@#To safeguard infants’ sleep, it is necessary to provide appropriate information and education to parents and necessary interventions for resolving sleep problems and improving the quality of sleep for both infants and mothers.

The Relationship Between Participating in Online Parenting Communities and Health-Promoting Behaviors for Children Among First-Time Mothers: The Mediating Effect of Parental Efficacy

Purpose@#To examine the mediating effects of parental efficacy on the relationship between participating in online parenting communities and health-promoting behaviors for children among first-time mothers with infants and toddlers. @*Methods@#The participants were 174 first-time mothers who used online parenting communities. Data were collected through self-report online questionnaires. Descriptive statistics, independent t-test, 1-way analysis of variance, Pearson correlation coefficient and multiple linear regression analysis were performed. The significance of the mediating effect was verified using the Sobel test and PROCESS macro. @*Results@#Significant predictors for health-promoting behaviors for children among first-time mothers were maternal age, maternity leave, monthly income, weekly use of online communities, daily use of online communities, satisfaction with online communities, and parental efficacy, which explained 51.0% of maternal health-promoting behaviors for children. Parental efficacy partially mediated the relationship between mothers’ satisfaction with using online communities and their health-promoting behaviors for children. @*Conclusion@#Interventions to enhance satisfaction with online parenting communities and parental efficacy should be developed to promote the health of infants and toddlers. Therefore, it is necessary to consider the needs of mothers for child rearing and health care, and develop online parenting communities that can provide qualitative health information and enable safe online interactions between mothers.

Experiences of Parenting Children With Spinal Muscular Atrophy

Purpose@#This study aims to describe the experiences of parenting children with spinal muscular atrophy. @*Methods@#Participants consisted of 11 parents of children diagnosed with spinal muscular atrophy, more than 6 months prior to the study. Data were collected through one-on-one interviews and between 1 and 3 interviews were conducted per participant, between August and November 2021. Braun and Clarke's thematic analysis was used to analyze collected data. @*Results@#This study described that the experience of parenting children with spinal muscular atrophy was based on four major themes: “a difficult journey from diagnosis to acceptance,” “changed life while parenting children,” “comfort even in the difficult parenting,” and “preparing for child's future happiness.” @*Conclusion@#There is a need to provide comprehensive information about child rearing problems experienced by parents of children with spinal muscular atrophy. It is also necessary to develop supportive healthcare and social-welfare interventions to support the needs of children and families with spinal muscular atrophy.

Factors Influencing Changes in Parenting Behavior during Coronavirus Disease 2019 Pandemic

Purpose@#This study aimed to examine the effects of maternal coronavirus disease 2019 (COVID-19) impact, parental stress, parenting behavior, and spousal support on changes in parenting behavior during the COVID-19 pandemic. @*Methods@#A total of 162 mothers who raised infants and toddlers under 24 months of age participated in this descriptive study via a web survey. The researchers collected data, which included demographic variables about mothers and babies, COVID-19 impact, parenting stress, spousal support, parenting behavior, and changes in parenting behavior after the pandemic. Data were analyzed using IBM SPSS Statistics ver. 24.0 using descriptive statistics, paired t-tests, analysis of variance, Pearson correlation, and multiple regression tests. @*Results@#With the spread of COVID-19, mothers with infants and toddlers appeared to be affected in the order of psychological burden, resources, and financial burden, and their parenting stress increased compared to that before the pandemic. The change in mothers’ parenting behaviors during the COVID-19 pandemic increased significantly as the mothers were significantly influenced by COVID-19. In addition, it was confirmed that the change in parenting behavior significantly decreased as mothers’ parenting stress increased. @*Conclusion@#Change in infants’ and toddlers’ mothers’ parenting behavior was associated with both COVID-19 impact and parenting stress in South Korea during the pandemic.

Missed nursing care and its influencing factors among neonatal intensive care unit nurses in South Korea: a descriptive study

Purpose@#Preventing missed care is important in neonatal intensive care units (NICUs) due to neonates’ vulnerabilities. This study examined missed care and its influencing factors among NICU nurses. @*Methods@#Missed care among 120 Korean NICU nurses was measured using a cross-culturally adapted online questionnaire. The frequency of missed care for 32 nursing activities and the significance of 23 reasons for missed care were collected. @*Results@#All participants had missed at least 1 activity, missing on average 19.35 activities during a typical work-day. The most common missed item was “provide developmental care for the baby”. The most common reason for missed care was “emergency within the unit or deterioration of one of the assigned patients”. The final regression model explained 9.6% of variance in missed care. The average daily number of assigned patients receiving inotropes or sedation over the last month influenced the total number of missed care items. @*Conclusion@#Missed care was affected by nurses’ workload related to the number of patients taking medication. Frequently missed activities, especially those related to developmental care, require patience and time, conflicting with safety prioritization and inadequate working conditions. NICU nurses’ working conditions should be improved to ensure adequate time for nursing activities.

Nursing students’ confidence in clinical competency and job readiness during the COVID-19 pandemic era / 한국간호교육학회지

Purpose@#This study explored nursing students’ experiences of attending clinical practicum courses in 2020 during the COVID-19 pandemic era, focusing on their confidence in clinical competency and job readiness. @*Methods@#The data for this study were collected using online questionnaires that were uploaded to a free online survey website and distributed via a link to the survey to 334 nursing students attending four-year nursing colleges at four national universities. Data analysis was done with descriptive statistics, independent t-tests, and ANOVA. @*Results@#The participants were mostly female (83.2%) college seniors (78.1%). About 60% of the participants practiced between 40% to 100% of their clinical practicum hours in alternative ways. Almost a third of the participants reported that they were not ready for a job (30.2%). However, participants’ confidence in clinical competency and job readiness was not related to the rate of alternative practice, but rather to both achievement of educational outcomes and satisfaction in the nursing practicum. @*Conclusion@#Due to COVID-19, it is evident that effective and efficient materials and ways of delivering clinical courses are constantly to be sought and developed. In particular, recently graduated nurses who experienced abrupt and considerable alterations in their clinical practicum courses due to COVID-19 are in need of attention while they strive to make clinical adaptations.

Effects of a Positive Psychology-based Mental Health Promotion Program for High School Students

Purpose@#The purpose of this study was to investigate the effects of a positive psychology-based mental health promotion program for high school students. @*Methods@#This study used a randomized control group pretest-posttest design. A total of 47 high school students participated from two high schools in Gyeonggi Province. They were randomly assigned to an experimental group (n=24), which participated in the 8-session program, or to a control group (n=23). Psychological well-being, depression, and self-esteem were measured. @*Results@#A significant difference in psychological well-being was observed between the two groups after the program. However, there were no significant between-group differences in depression or self-esteem. @*Conclusion@#The positive psychology-based mental program was effective at increasing psychological well-being in adolescents, especially high school students. This study suggests that a school curriculum could incorporate positive psychology-based mental programs for high school students to promote their mental health.

An Estimation of Supply and Demand for Primary Healthcare Nursing Workforce in the North Korean Region after Korean Reunification / 간호행정학회지

PURPOSE: This study was done to estimate supply and demand for nursing workforce to provide community-based primary healthcare in the North Korean region to cost-efficiently narrow the health gap between the two Koreas in case of a Korean reunification. METHODS: To understand the nursing education system and current state of nursing workforce in North Korea, the authors interviewed six North Korean defectors who had worked as nurses in North Korea. Based on the interview results and literature review, the supply and demand for the primary healthcare nursing workforce that would be needed after Korean reunification were estimated RESULTS: Currently, a total of 2,100 to 2,700 North Korean nurses were estimated to have graduated from nursing schools with a 2 year curriculum or completed 6-month military nurse training courses every year. The projected number of nurses in demand to provide primary health care ranged from 84,160 to 105,200 and the shortage would be between 31,586 and 52,626. CONCLUSION: An active utilization of the North Korean nursing workforce to improve the health of North Koreans after reunification will be the best way to reduce the reunification cost which will be inflicted mainly on South Korea.

Effects of a Community Outreach Program for Maternal Health and Family Planning in Tigray, Ethiopia

PURPOSE: We examined the effects of a community outreach program for maternal health in Tigray, Ethiopia, on women's knowledge about pregnancy, childbirth, postpartum care, and family planning, and assessed their participation in antenatal care, postpartum checkups, institutional childbirth, and contraceptive use. METHODS: We recruited Ethiopian women of reproductive age (15 to 49 years) in Tigray, Ethiopia. Two villages in Tigray, Kihen and Mesanu, which have similar population sizes and living environments, were chosen as the intervention and comparison groups, respectively. A two-group pretest-posttest design with cluster sampling was employed. We conducted self-report questionnaire surveys using face-to-face interviews. The 2.5-year community outreach program was developed based on Rogers' diffusion of innovation theory. It consisted of mass media use and health education for lay women in the community, along with training of health care providers, including nurses, midwives, and health extension workers, in maternal health care. RESULTS: The intervention group showed significant increases in knowledge and behaviors regarding maternal health and family planning compared to the comparison group (p < .001). In particular, there was a dramatic increase from 10.8% to 93.5% in the institutional birth rate in the intervention group. CONCLUSION: The community outreach program and health care professional training effectively improved knowledge and behaviors regarding maternal health in Ethiopian women. Mass media and interpersonal communication channels for health education may be useful health interventions in developing countries.

Factors Associated with the Method of Feeding Preterm Infants after Hospital Discharge

PURPOSE: To investigate factors that may affect the method of feeding among preterm infants at 4 weeks after discharge. METHODS: This study included 222 mother-infant dyads born before a gestational age of 37 weeks. The feeding method and general medical characteristics of the participants were assessed at 4 weeks after discharge using a structured questionnaire. Multinomial logistic regression analysis was used to examine which factors were associated with breastfeeding at home. RESULTS: Of the 222 infants who qualified for the study, 71 (32.9%) continued to receive breastmilk at 4 weeks post-discharge. Multinomial logistic regression analysis showed that breastfeeding at 4 weeks post-discharge was associated with higher breastfeeding self-efficacy, vaginal delivery (experience), direct breastfeeding in the neonatal intensive care unit (NICU), gestational age between 30 and 34 weeks, and breastmilk consumption in the NICU. The following factors were associated with mixed feeding at 4 weeks post-discharge: being employed, having higher breastfeeding self-efficacy, and direct breastfeeding in the NICU. CONCLUSION: NICU nurses should provide opportunities for direct breastfeeding during hospitalization and support breastfeeding to enhance breastfeeding self-efficacy. These factors may help to ensure the continuation of breastfeeding after discharge. Moreover, factors that affect breastfeeding should be considered when providing interventions.

Effects of Simulation-Based Learning in the Nursing Care of Children with Asthma / 한국간호교육학회지

PURPOSE: The purpose of this study was to examine the effects of simulation-based learning on the knowledge about and performance confidence in the nursing care of children with asthma. METHODS: A one-group pre- and post- study design was used. A total of 70 nursing students participated in the study. In groups of five, the participants experienced simulation-based learning during their child health nursing practicum. The given scenario was about nursing care for children with asthma. The simulation learning was provided for 3 hours, and included a group discussion before the simulation and a debriefing. RESULTS: After the simulation, knowledge about and performance confidence in the nursing care of children with asthma significantly increased. The nursing students reported a high level of satisfaction with the simulation-based learning. There was a significant positive correlation between knowledge and performance confidence. CONCLUSION: Simulation-based learning was effective for nursing students in the nursing care of children with asthma. Our results suggest utilizing this new way of learning to strengthen the clinical experience of child health nursing in nursing students.

Relationships Among Preschoolers' Smartphone Addiction Tendency, Their Problem Behaviors, and Parenting Efficacy of Their Mothers

PURPOSE: The purpose of this study was to explore the relationships among preschoolers' smartphone addiction tendency, problem behaviors, and parenting efficacy of the mothers of these children. METHODS: A cross-sectional, descriptive study design was used with self-administered questionnaires. A total of 83 mothers of preschoolers aged 4-6 years and their preschool teachers from a kindergarten participated in the study. RESULTS: Mean daily time spent by the preschoolers on smartphones was about 45 minutes/day. About 40% spent more than 60 minutes/day on smartphones. The majority (69.8%) used smartphones without adult supervision. The level of smartphone addiction tendency among the preschoolers was 1.52+/-0.45 on a 4-point scale. Preschoolers whose mothers use smartphones for more than 60 minutes/day showed a higher level of smartphone addiction tendency than preschoolers whose mothers use smartphones for less than 60 minutes/day. Also smartphone addiction tendency among preschoolers had a positive correlation with hyperactive-distractible behavior (r=.228, p=.038) and a negative correlation with parenting efficacy of their mothers (r=-.299, p=.006). CONCLUSION: Our findings demonstrated that preschooler's smartphone addiction tendency is significantly associated with hyperactive-distractible behaviors of the children and low parenting efficacy among their mothers. Therefore well-designed care plans for these populations should be provided to decrease smartphone addiction tendency.

Relationships Among Preschoolers' Smartphone Addiction Tendency, Their Problem Behaviors, and Parenting Efficacy of Their Mothers

PURPOSE: The purpose of this study was to explore the relationships among preschoolers' smartphone addiction tendency, problem behaviors, and parenting efficacy of the mothers of these children. METHODS: A cross-sectional, descriptive study design was used with self-administered questionnaires. A total of 83 mothers of preschoolers aged 4-6 years and their preschool teachers from a kindergarten participated in the study. RESULTS: Mean daily time spent by the preschoolers on smartphones was about 45 minutes/day. About 40% spent more than 60 minutes/day on smartphones. The majority (69.8%) used smartphones without adult supervision. The level of smartphone addiction tendency among the preschoolers was 1.52+/-0.45 on a 4-point scale. Preschoolers whose mothers use smartphones for more than 60 minutes/day showed a higher level of smartphone addiction tendency than preschoolers whose mothers use smartphones for less than 60 minutes/day. Also smartphone addiction tendency among preschoolers had a positive correlation with hyperactive-distractible behavior (r=.228, p=.038) and a negative correlation with parenting efficacy of their mothers (r=-.299, p=.006). CONCLUSION: Our findings demonstrated that preschooler's smartphone addiction tendency is significantly associated with hyperactive-distractible behaviors of the children and low parenting efficacy among their mothers. Therefore well-designed care plans for these populations should be provided to decrease smartphone addiction tendency.

Trend Analysis of Research Articles Published in Child Health Nursing Research 2014

PURPOSE: This descriptive study was performed to explore trends in child health nursing research by analyzing the themes, contents and structure of articles published in 2014 in Child Health Nursing Research, the official journal of the Korean Academy of Child Health Nursing. METHODS: Thirty-eight articles were reviewed using keywords, author (s), subjects, ethical considerations, designs, statistics involved, funding resources, and others. RESULTS: Ten domains from 160 keywords were identified as follows, child related, psycho-social variable related, parents and family related, nursing and health related, and others. A mean of 2.9 authors per article was identified and 71% of the authors were academic- affiliated. Twenty-eight articles were human-participant related while 21 articles addressed both Institutional Review Board and written consent. Non-experimental design was the most commonly used method followed by experimental design, and qualitative design. The duration for acceptance was a mean of 89.1 days from submission with most articles requiring a second round of article review. Half of the articles were supported by grant organizations such as Korean National Research Foundation. CONCLUSION: The findings of the analysis show an improvement in the scientific quality with a diversity of articles in Child Health Nursing Research.

Factors Influencing Maternal Support for Physical Activity of Preschool Children

PURPOSE: The purpose of this study was to explore maternal physical activity support for preschool children. METHODS: Survey methodology using a self-administered questionnaire was employed. Mothers with preschool children from a daycare center in Daejeon participated in the study. One hundred and fifty-six questionnaires were analyzed. RESULTS: Mothers with preschool children showed a moderate level of physical activity support for their children. Significant factors affecting physical activity support of mothers were monthly household income (beta=.417, p=.002), maternal self-efficacy for physical activity support (beta=.231, p=.003), information for physical activity support (beta=.173, p=.022), and experience of education about physical activity support (beta=.237, p=.002). These variables explained 26.4% of the variance in physical activity support (F=7.628, p<.001). CONCLUSION: To improve maternal support for increasing physical activity of preschool children, maternal education and appropriate information should be provided to improve self-efficacy for physical activity support.

Effects of Maternal-Child Health Education Program for Nurses in Tigray, Ethiopia on Their Knowledge and Confidence

PURPOSE: The purpose of this study was to identify effects of a maternal-child health education program for nurses in Tigray, Ethiopia. METHODS: One-group pre-posttest design was used. The maternal-child health (MCH) education program was given to nurses from 5 health centers in Tigray, Ethiopia. Knowledge and confidence levels were measured before and after each education session. Data were analyzed using paired t-test. RESULTS: The topics of the 5 educational sessions were family planning, antenatal care, care during labor, immunization, and integrated management of neonate, and child illness. Knowledge scores (1st: Z=3.931, p=.001; 2nd: Z=6.189, p<.001; 3rd: Z=5.658, .001, 4th: Z=8.734, .001, 5th: Z=14.167, .001) and confidence levels (1st: Z=8.467, .001; 2nd: Z=4.183, .001; 3rd: Z=4.992, .001) improved significantly. CONCLUSION: The findings of this study imply that the MCH education program for nurses was effective in developing the maternal-child health capacity of the nurses in Tigray, Ethiopia.

Breastfeeding Knowledge, Attitude, and Nursing Practice of Nurses in Neonatal Intensive Care Units

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.

Impact of Critical Thinking Disposition, General Self-Efficacy, and Leadership on Clinical Competence in Nursing Students / 한국의학교육

PURPOSE: The purpose of this study was to evaluate the relationships among critical thinking disposition, general self-efficacy, leadership and clinical competence, and identify the factors influencing clinical competence in nursing students. METHODS: In this descriptive study, 153 nursing students (from 2nd to 4th school year) of a university in South Korea were enrolled in December 2010. The instruments for this study were the Korean versions of the Critical Thinking Disposition Scale, General Self-Efficacy Scale, Leadership Inventory, and Clinical Competence Scale. Data were analyzed by descriptive statistics, t-test, MANOVA, Pearson correlation, and multiple linear regression with PASW 18.0 software. RESULTS: The mean scores (ranging from 1 to 5) in nursing students for critical thinking disposition, general self-efficacy, leadership, and clinical competence were 3.44, 3.51, 3.55, and 3.42, respectively. Positive correlations were found for clinical competence with critical thinking disposition, general self-efficacy, and leadership. The strongest predictor of clinical competence was leadership. In addition, leadership, nursing school year, and subjective academic achievement accounted for 34.5% of variance in clinical competence. CONCLUSION: This study revealed that developing leadership, critical thinking disposition, and self-efficacy in undergraduate nursing education is important to improve clinical competence of nursing students.

Psychometric Evaluation of the Korean Version of the Adapted Illness Intrusiveness Rating Scale

PURPOSE: To examine the psychometric properties of the Korean version of the adapted Illness Intrusiveness Rating Scale (a-IIRS). The a-IIRS is a modified version of the original IIRS that measures illness-disruptions to daily life in patients with diverse diagnoses. While the psychometric properties of the original IIRS have been validated, no study has been conducted to validate the Korean version of a-IIRS. METHODS: After translation and back-translation processes, the Korean version of a-IIRS was developed. A pilot test was conducted with 10 patients with chronic diseases. A convenience sample of 380 patients with diabetes, hypertension, and/or arthritis was used. Exploratory and confirmatory factor analyses, known-group technique, hypothesized relationships, internal consistency, and item analysis were tested. RESULTS: Three factors were extracted from principal components analysis with varimax rotation: Relationships and Personal Development, Instrumental Life, and Intimacy. Confirmatory factor analysis corroborated the good fit of the three-factor model. Illness intrusiveness was significantly different among the study subjects categorized into three groups according to different health status: poor, fair and good. The instrument was positively correlated with the scales of fatigue and depression. The tool demonstrated high internal consistency with adequate item-total correlations. CONCLUSIONS: The findings are consistent with previous study results on IIRS and support the reliability and validity of the Korean version of a-IIRS. The instrument is culturally relevant for Korean patients with chronic diseases. Health care professionals need to consider illness intrusiveness when caring for patients with chronic diseases and promote their quality of life.