The pregnancy experience of Korean mothers with a prenatal fetal diagnosis of congenital heart disease.

BACKGROUND: Prenatal diagnosis of fetal congenital heart disease (CHD) is becoming widely available but there is a lack of understanding on such expectant mothers' experiences during pregnancy. This was the first study to investigate the pregnancy experience of Korean mothers with a prenatal fetal diagnosis of CHD. METHODS: In-depth interviews were conducted with 12 mothers regarding their child's prenatal diagnosis of CHD and the adaptive processes during pregnancy. The data were transcribed and analyzed according to the grounded theory framework. RESULTS: When the diagnosis of fetal CHD was suspected, mothers desperately sought accurate information regarding CHD while hoping in vain for a misdiagnosis. When the definitive diagnosis was made, most pregnant women experienced psychological trauma and pain, framed in the stigma and burden of having an imperfect child. Provision of accurate health advice and emotional support by a multidisciplinary counseling team was crucial at this phase, forming recognition that CHD could be treated. When fetal movements were felt, mothers came to acknowledge the fetus as an independent being, and made their best efforts to protect the fetus from harmful external influences using traditional TaeKyo mindset and practices, which in turn, were helpful in restructuring the meaning of the pregnancy. CONCLUSIONS: Mothers went through a dynamic process of adapting to the unexpected diagnosis of CHD, which was closely linked to being able to believe that their child could be treated. Early counseling with precise information on CHD, continuous provision of clear explanations on prognosis, sufficient emotional support, and well-designed prenatal education programs are the keys to an optimal outcome.

Parenting stress in mothers of children with congenital heart disease.

PURPOSE: The main purposes of this study were to examine the relationships among uncertainty, social support and parenting stress in mothers of children with congenital heart disease (CHD) and to identify the factors related to parenting stress. METHODS: This was a survey study using a questionnaire. Fifty-one mothers of children with CHD were recruited at the pediatric cardiac outpatient clinic at one university-affiliated hospital in Seoul between July 14th and September 25th, 2006. Abidin's Parenting Stress Index-Short Form, Mishel's Parents' Perception Uncertainty in Illness Scale, and Brandt and Weinert's Personal Resource Questionnaire were used to collect data. RESULTS: The results of bivariate analysis showed that parenting stress was significantly related to social support, ambiguity, lack of clarity, and lack of information, but was not related to unpredictability, one of the subconcepts of uncertainty. Multiple regression analysis showed that parenting stress was significantly related to social support and Internet information. CONCLUSION: Mothers who reported they had more social support and less uncertainty showed lower parenting stress. Also, the Internet could be an effective method to obtain information and to share child-rearing experiences with other mothers of children with CHD.

[Factors influencing functional status in patients with heart failure].

PURPOSE: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. METHOD: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. RESULT: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. CONCLUSION: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.

[Relationship between depression and resilience among children with nephrotic syndrome].

PURPOSE: The purposes of this study were to describe the relationship between depression and resilience and to identify variables associated with depression among children with nephrotic syndrome. METHOD: Data was collected from 45 children who were registered at one hospital in Seoul. The criteria for sample selection were 10 to 15 year-old children who were diagnosed at least 6 month prior. The instruments included a self-reported questionnaire on resilience by Kim, CDI by Beck, and MBRI by Kwak. Descriptive, Pearson correlation and multiple regression analyses were done. RESULT: The mean score of depression was 11.44 (range:0-54) and resilience was 97.47 (range:32-128). There were significant positive relationships between depression and age (r=0.302, p<.005) and academic achievement (r=-0.318, p<.005). In addition, negative relationships between depression and maternal attitude (r=-0.412, p<.001) and resilience (r=-0.649, p<.001) occurred. The results of multiple regression analysis showed that maternal behavior (beta=-0.421, p<.005) and resilience (beta=-0.639, p<.001) were related to depression. CONCLUSION: Children with higher resilience and with an affectionate mother were less depressed. Thus, it is important to identify strengths of children and help them to increase resilience and implement parenting and counseling programs for parents' of these children. Similar studies with children with other chronic illnesses are needed.

[The effect of exercise program on health and depression in the elderly].

PURPOSE: The main purpose of this study was to compare the effects of OSCE method and the traditional evaluation method on nursing skills performance of students enrolled in fundamentals of nursing courses. METHOD: The study was designed as a quasi-experimental, nonequivalent control group post test design with two classes of sophomore students attending fundamentals of nursing courses at one baccaleureate nursing school located in a metropolitan Seoul area. The control group was evaluated using a traditional method and the experimental group was evaluated using the OSCE method. Data were collected from June, 2001 to June, 2002. There were 35 students in the OSCE method group and 39 students in the control group. Data analysis was done using SPSS WIN 9.0. RESULT: The results showed that the students in the OSCE method group did significantly better in clinical nursing skills performance than the students in the traditional method group. And the OSCE method group showed significantly higher satisfaction score in the evaluation method than the control group. CONCLUSION: The OSCE method is an effective tool for evaluating clinical nursing skills performance in student nurses. It is necessary to explore more efficient ways to develop OSCE cases in wider areas of nursing education. It is also recommended to replicate similar studies in nursing education.

Relationship between the intention to repeat a papanicolaou smear test and affective response to a previous test among Korean women.

The purposes of this descriptive cross-sectional study were to describe (1). women's affective (emotional) responses before, during, and after a Papanicolaou smear test and after receiving the test result and (2.) the difference in affective response between women who did or did not intend to repeat the Papanicolaou smear test in the future. The theory of reasoned action was used as the theoretical basis for this study. Participants were selected by convenience sampling and included 515 women aged 24 to 69 years who had a previous Papanicolaou smear test, did not have cervical cancer, and who agreed to participate. Affective response was measured with an instrument developed by Park. Intention to repeat the Papanicolaou smear test was measured with a single question on intention of repeating the Papanicolaou smear test. Women with intention to repeat the Papanicolaou smear test showed higher apprehension after the test ( = 2.695, =.04) and higher positive affective responses such as feeling relieved, great, and comfortable after receiving the test result ( = 3.014, =.003). This result suggests that women with the intention to repeat the test are more concerned with the test result and that emotional relief after confirming normal findings is an important motivator for repeating the Papanicolaou smear test.