Nursing Students' Knowledge, Attitudes, Perceived Behavior Control and Intention to Report Cases of Child Abuse

PURPOSE: This study was designed to explore nursing students' knowledge, attitudes and intention to report cases of child abuse. METHODS: A descriptive research design was used with a convenience sample of 202 nursing students. After explaining the purpose of the study, participants who signed the consent form were asked to complete a self-descriptive questionnaire, which included the Child Abuse Intension Scale (CARIS). RESULTS: The number of correct answers for knowledge of child abuse and the law was 7.0/13. The mean scores were, for attitude toward childrearing belief and discipline, 17.1±5.2, for punishment and culpability of offender or victim, 24.6±4.1, for professional responsibility, 30.5±5.1, and for perceived behavioral control, 25.3±5.0. The intended reporting behavior differed significantly by severity of abuse. Factors influencing the intention to report child abuse were attitude towards punishment of parents, professional responsibility, and perceived behavioral control (R2=.133). CONCLUSION: On the basis of our finding, developing education programs to help nursing students detect child abuse and improve reporting rates is important. Thus, we suggests that nursing students be provided with educational protocol for detection and reporting of child abuse.

A Study on Obesity and Behavior Problems in Elementary Children Living in Poverty

PURPOSE: The aim of this study was to explore the relationship of being from low-income families on children's behavior problems and obesity. METHODS: The research design was a descriptive survey study, and the participants were 197 children from low-income families who took part in activities at a local children's center. They were selected through convenience sampling. The participants completed a questionnaire, BASC-2 (Behavior Assessment System for Children). RESULTS: The results are as follows: 22.3% had obesity, a rate higher than that of children in general. Further, 37.3% had attention deficit problems, 33.8% had problems adapting to school and 49% had other adaption problem. There was a gender-specific difference with respect to all of the behavior problems. CONCLUSION: The results of this study indicate a lack of an identified child policy for behavior problems and health, and suggest a need for various programs and policies which could lead to development of behavior screening programs for children from low-income families.

Hospital Nurses' Experience of Do-Not-Resuscitate in Korea / 간호학회지

PURPOSE: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. METHODS: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. RESULTS: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. CONCLUSION: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

Lectins Isolated from Mushroom Fomitella fraxinea Enhance MHC-restricted Exogenous Antigen Presentation

BACKGROUND: Immunomodulators enhancing MHC-restricted antigen presentation would affect many cellular immune reactions mediated by T cells or T cell products. However, modulation of MHC-restricted antigen presentation has received little attention as a target for therapeutic immunoregulation. Here, we report that lectins isolated from mushroom Fomitella fraxinea enhance MHC-restricted exogenous antigen presentation in professional antigen presenting cells (APCs). METHODS: Lectins, termed FFrL, were isolated from the carpophores of Fomitella fraxinea, and its effects on the class I and class II MHC-restricted presentation of exogenous ovalbumin (OVA) were examined in mouse dendritic cells (DCs) and mouse peritoneal macrophages. The effects of FFrL on the expression of total MHC molecules and the phagocytic activity were also examined in mouse DCs. RESULTS: DCs cultured in the presence of FFrL overnight exhibited enhanced capacity in presenting exogenous OVA in association with class I and class II MHC molecules. FFrL increased slightly the total expression levels of both class I (H-2K(b)) and class II (I-A(b)) MHC molecules and the phagocytic activity of DCs. Antigen presentation-enhancing activity of FFrL was also observed in macrophages isolated from mouse peritoneum. CONCLUSION: Lectins isolated from the carpophores of Fomitella fraxinea increase MHC-restricted exogenous antigen presentation by enhancing intracellular processing events of phagocytosed antigens.

An Analysis of the Concepts in Child Health Nursing Studies in Korea (2): The Practice, The Client-Nurse, The Environmental Domain / 아동간호학회지

The main purpose of this study is to examine the concepts appeared on research and provide future research directions in field of child health nursing. 205 studies of the total 318 studies had been analyzed first for the concepts of the client domain and this time 113 studies were analyzed for the practice, the client-nurse and the environmental domain in nursing. The practice domain includes mentalistitic, enactment, knowledge utilization, role related phenomenon, the client-nurse domain includes touch, communication, interaction phenomenon, and the environmental domain includes physical, social, symbolic environment. 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). 1. 103 studies belonged to the practice domain. Among them, 56(54%) studies used concepts related to enactment phenomenon like education(21.4%), giving information(7.1%), breast feeding(5.4%), caring(5.4%), airway suction(5.4%), nonnutritive sucking(5.4%). 44(43%) studies used concepts related to knowledge utilization like program development and evaluation of smoking, mother-infant interaction, home health nursing, obesity management. And only 3(3%) studies used role related concepts like quality of nursing, direction of health education, contents of child health nursing education. 2. Only 2(0.006%) studies belonged to the client-nurse domain. One concept is empathy in communication phenomenon and the other concept is role conflict in interaction phenomenon. 3. 8(0.02%) studies belonged to the environmental domain. Among them, 3 studies related to physical environment like space, noise and 5 studies related to social environment like social support, home environment. But the concept of symbolic environment was not used. The findings of this study provide the evidence that research related to the client-nurse domain and the environmental domain should be conducted actively to improve the practice of child health nursing. So that the research in field of child health nursing should be dealt with the concepts of four domains to develop knowledge systematically.

The Metaanalysis of Trends and Contents of Child Nursing Intervention Research / 아동간호학회지

The purpose of this study was to identify the trends and contents of intervention towards children using meta analysis, to support the basis for using in the field and research method about nursing intervention. We used 27 materials which was reported from 1970 to August, 1999 : dissertation study and Korean Nurses' Academic society Journals, the Journal of Korean Academic society of Adult Nursing, The Korea Journal of Maternal and Child Health Nursing. The types of intervention we used came from 3 different researchers. Snyder showed cognitive, movement, social sensory intervention. McCloskey & Bulechek categorized as the following : self-care assistance, acute care management, life-style alteration, health promotion, life support intervention, Craft & Denehy classified psychosocial intervention and biophysiological intervention. Some findings are summarized as follow : Out of the 27 researches sensory intervention had the most in there thesis, recently cognitive intervention research has a tendency to increase. 18 researches has acute care management in there theses, and health promotion was found the least. Out of the 27 thesis 15 thesis was classified as biophysiological intervention and 12 had psychosocial. 27 thesis had 11 types of interventions which originally was categorized by Snyder, therefore sensory intervention thesis had the most. 11 types of intervention which originally was classified by McClosky & Bulechek, teaching and information had the most out of acute care management. Out of 27 thesis, 14 had dealt with newborns, especially newborns with sensory intervention. Therefore school age and above had cognitive intervention which was used for teaching and information. Infants, preschool, schoolage children received acute care management the most, health promotion intervention was used towards adolescences. Depending on the characteristics of dependent variables, it was analysed using meta however 17 thesis are possible except primary experimental research. Mean effect size comparison by Snyder classification, cognitive intervention was the largest mean(1.51), sensory intervention was larger(0.71) also, movement intervention was in the middle(0.56) as shown. Comparison done by McClosky & Bulechek, the intervention leading to life style alteration was the largest mean(1.97), teaching was used the most. Comparison by Craft & Denehy classification, psychosocial intervention was larger(1.15) than biophysiological intervention (0.67). The result of nursing intervention through age classification, the largest weighted mean effect size in the research was towards infants and neonates. The research which was focused on nursing intervention, has important meaning in nursing practice and knowledge development. When we know that children`s nursing intervention is necessary and overcome our biased view, efficiency of children's nursing intervention are increased and professionalized. Therefore results will be important basic data to guide a development of child nursing intervention & classification.

The Study for Apical Pulse Measurement Technique Through Hospitalized Children / 아동간호학회지

The purpose of this study was to determine the most accurate technique measuring the apical pulse rate, using three counting duration 15, 30 and 60 seconds, and two methods start '0' and start '1'. The instrument used in the study was the EKG moniter, stethoscope and stopwatch. Data was analyzed by utilizing SPSSWIN program. General characteristics of the subjects were analyzed by frequency, percentile, mean, SD. The subject of this research is made up of 46 children and 20 nurses. The children were infants, & under the age of 5. They were hospitalised in PICU & NICU in 2 tertiary hospitals in seoul from Jan. 1. 1998 to Sep. 10. 1998. The measurement of starting 1 & measurement of starting '0' used the T-test to find out the measurement error. Apical pulse duration of 15, 30, 60 seconds were used to find out measurement error, the measurement error depend on experience of Nurse were analyzed by using ANOVA. The result of this study are as follows : 1. When comparing the starting poin of apical pulse 0 & 1, starting with 1 the measurement error is less, but not statically significant. 2. When counting the apical pulse by 15, 30, 60 sec. 60 seconds counting duration was more accurate, but not statistically significant. 3. The mean of measure error : Group under 100/ min, is 10.33 : from 100 or 119/min, is 8.30 : from 120 to 139/min, is 4.76 ; from 140 to 159/min, is 6.09 : above 160, is 17.83. The differences of these groups are statistically significant. When 60sec were counted, under 140/min the mean of measurement error is 3.4. Also when 30 seconds were counted from 140/min to 159/min the measurement error is 7.14, above 160/min the measurement error is 16.4. That measurement mean is the smallest than the other durations. During the 15 sec. count the measurement error was the largest of them all. 4. By the experience of the nurses, the apical pulse count measurement error was discovered. Under a year experience this measurement error was the largest(11.09), 1 year to under 3 years, the error is the smallest(4.86). 3 year to under 6 years the error is 8.33, 5 years above the error is 6.11 but this is not statistical significant. Under a year experience when counting 15, 30, 60 seconds the error is the largest. The group of the nurses from a year to under 3 years, the measurement error is the smallest of all the groups. The result of the study is to determine the technique measuring the apical pulse rate, Hargest (1974), starting point '0' is not proved. When the pulse rate increases the 30 sec measurement rate is accurate. Under 140/min the 60 sec measurement rate is the most accurate. Depending on the nurses experiences, there is a variable difference to the apical pulse rate measurement. Especially new nurses training courses should enforce the children's pulse rate count and the basic vital signs.