Effect of Honey-Based Oral Care on Oral Health of Patients with Stroke Undergoing Rehabilitation: A Randomized Controlled Trial.

PURPOSE: To investigate the effects of honey-based oral care on the oral health of patients with stroke undergoing rehabilitation. METHODS: In this randomized controlled trial, 44 stroke patients from a tertiary hospital's rehabilitation ward were assigned to receive either honey-based oral care or normal saline, with treatments administered twice daily for 2 weeks. The study, conducted from November 2021 to July 2022, employed a double-blind method, blinding both participants and evaluators to treatment allocations. Key outcomes measured included oral status, dental plaque index (DPI), and xerostomia. The final analysis included 13 patients in the experimental group and 16 in the control group. RESULTS: The intervention significantly changed the oral status, DPI, and xerostomia between the groups. The experimental group showed significantly improved oral status (Z = -4.63, p=.001), DPI (Z = -4.58, p<.001), and xerostomia (t = -6.33, p<.001) compared to the control group. The experimental group showed significant improvements in oral status (Z=-3.27, p<.001), DPI (Z=-3.19, p=.001), and xerostomia (t=7.37, p<.001) after the intervention, confirming the efficacy of honey-based oral care. CONCLUSIONS: Honey-based oral care effectively improves oral status and xerostomia, and reduces DPI in patients with stroke. CLINICAL TRIAL REGISTRATION NUMBER: Trial registration. Clinical Research Information Service (CRIS), KCT0008201. Registered on 04 February 2023. The first patient was enrolled on November 16, 2021, at https://cris.nih.go.kr/cris/search/listDetail.do?searchWord=KCT0008201&search_yn=Y.

Stigma and quality of life in lung cancer patients: The mediating effect of distress and the moderated mediating effect of social support.

Objective: This study aimed to investigate the mediating effect of distress on the relationship between stigma and quality of life (QOL) in lung cancer patients, and to explore the moderated mediating effect of social support. Methods: A total of 184 individuals diagnosed with primary lung cancer participated in the study. Data on general and disease-related characteristics, stigma, distress, QOL, and social support were collected using a comprehensive structured questionnaire. Medical records were also utilized for an in-depth analysis of disease-related attributes. The data were meticulously analyzed using the SPSS PROCESS macro ver. 3.4 for detailed insights. Results: The findings elucidated a clear pathway whereby stigma negatively impacted patients' QOL through the mediating effect of distress. Interestingly, the extent of this impact was significantly influenced by the presence of friendship support, underscoring its unique moderated mediating role. Conversely, support from family and health care professionals did not demonstrate a significant influence in this context. Conclusions: These findings underscore the importance of addressing stigma and distress to improve the QOL of lung cancer patients. The study highlights the pivotal role of friendship support in moderating this relationship, suggesting the need for tailored interventions to strengthen social networks. These insights provide valuable guidance for developing more nuanced and effective patient support strategies in oncology care.

Online Gambling Patterns and Predictors of Problem Gambling Among Korean Adolescents During the COVID-19 Pandemic: A Cross-sectional Study.

PURPOSE: This study examined online gambling patterns among Korean adolescents during the COVID-19 pandemic and identified predictors of problem gambling based on a socio-ecological model. METHODS: It used nationally representative data from the 2020 National Survey on Youth Gambling Problems conducted by the Korea Center on Gambling Problems. This study selected a sample of 780 adolescents aged 13-18 years who reported having gambled online at least once in the last three months from the raw data of respondents. They were classified as the non-problem group and problem group according to the Gambling Problems Severity Scale (GPSS) of the Canadian Adolescent Gambling Inventory (CAGI). The predictive factors of problem gambling were analyzed by logistic regression analysis. RESULTS: The prevalence of problem gambling was 24.6 %. Its predictors included intrapersonal [male (odds ratios, OR = 1.67); gambling prior to COVID-19 (OR = 2.08)] and interpersonal factors [frequent gamblers in peers (OR = 4.34); peer pressure (OR = 2.34)]. Social factors, such as gambling in online community (OR = 5.60), sports betting (OR = 53.24), and lotteries (OR = 17.03) were associated with problem gambling. CONCLUSIONS: The major predictors of problem gambling among adolescent online gamblers included peer gambling and specific types of gambling. To prevent problem gambling, strategies targeting peer groups are essential. In addition, nurses need to share with families, schools, communities, and policymakers that online gambling, such as lotteries and sports betting, are high-risk of adolescent problem gambling, and recommend them to collaborate for stricter regulatory measures.

Development and evaluation of a tailored mHealth parenting program for multicultural families: a three-arm cluster randomized controlled trial.

Objective: Health management of children during early childhood requires substantial information. Multicultural families find it difficult to obtain and use parenting-relevant information for their young children. This study aimed to develop, implement, and evaluate a tailored Health parenting program and lay-health workers' support to improve children's health in multicultural families in Korea. Methods: In this study, we employed the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model as the conceptual framework, guiding the creation of a tailored mHealth application supplemented by a lay-health worker support module. The efficacy of the program was assessed through an experimental three-arm cluster randomized controlled trial. A total of 101 participants were stratified into three distinct groups as follows: (1) Experimental Group A, which received the mHealth program alongside the lay-health worker support component; (2) Experimental Group B, exposed solely to the mHealth program; and (3) Control Group, devoid of any intervention. Within these groups, 101 marriage migrant women hailing from Vietnam, the Philippines, and China were incorporated, with each group comprising 33, 30, and 38 participants, respectively. The study's primary endpoint encompassed a comprehensive assessment of health-promoting behaviors, proficiency in eHealth literacy, and the family strength. Results: The analysis revealed noteworthy interactions among the three distinct groups over the course of time, with implications for health-promotion behaviors (p = 0.041), eHealth literacy (p = 0.037), and family strength (p = 0.044). Specifically, the experimental groups exhibited substantially elevated levels of the specified outcome variables when contrasted with the control group. Notably, the positive effects persisted even up to 12 weeks subsequent to the conclusion of the intervention, underscoring the program's capacity to foster enduring improvements in the observed metrics. Conclusion: This study highlights the benefits of offering contextually appropriate information to target groups constrained by challenges in information access, evaluation, and utilization. Notably, drawing from their positive experiences in this process, we underscore the importance of employing lay health workers. These workers play a crucial role in fostering and ensuring sustained behavioral changes.

Protective and risk factors of problematic smartphone use in preteens using panel study on Korean children.

Background: Increased smartphone use by children and adolescents places them at higher risk of overdependence. The problematic smartphone use of preteens is rapidly increasing. The preteen period is one of considerable developmental change and the influence of problematic smartphone use should be identified by reflecting on this change and considering its social psychological factors. Methods: This study employed a secondary analysis using data from the 10th (2017) to 11th (2018) wave of the Panel Study on Korean Children. STATA/BE 17 was used to analyze the panel logit model. Among the 1,286 participants aged 9-10 from the Panel Study on Korean Children, 342 with complete responses were selected as the participants of this study. Results: The risk group for problematic smartphone use showed an increase from 126 in 2017 to 149 in 2018. Factors influencing risk of preteens' problematic smartphone use were the child's externalizing problems (p = 0.015) and permissive parenting behavior (p = 0.003). Protective factors influencing preteens' problematic smartphone use were peer communication (p = 0.023), parental supervision (p = 0.020), and authoritative parenting behavior (p = 0.001). Conclusions: Preteens with externalizing problems are at a higher risk for problematic smartphone use and are therefore a group to be observed with caution. It is also required to guide them to form good relationships with friends. Finally, in the problematic smartphone use of preteens, parents are both a protective factor and a risk factor. Therefore, guidance is required so that children can behave properly.

A systematic review of socio-ecological factors influencing current e-cigarette use among adolescents and young adults.

INTRODUCTION: The use of e-cigarettes has increased considerably among young people. To successfully develop interventions to prevent e-cigarette use, influencing factors must be identified. This review determines individual, interpersonal, organizational/community, and society/policy factors affecting e-cigarette use among adolescents and young adults. METHODS: A literature search was performed using five electronic databases (PubMed, CINAHL, EMBASE, Cochrane, and PsycInfo) for articles published in the English language to March 2022. A total of 85 studies were selected out of 17,259 for a systematic review based on the PRISMA flow. The full protocol is available from PROSPERO (CRD42021254558). RESULTS: Factors related to e-cigarette use were identified and classified into four domains based on the socio-ecological model. The individual factors were classified into five factors: demographics, health-related behaviors, mental health, perception of e-cigarettes, and characteristics of e-cigarettes. The interpersonal factors were classified into two factors: friend characteristics, including friend's e-cigarette use or smoking, and family factors such as parental smoking and parental advice. The organizational and community factors were home, school, online community, and retail shop accessibility. The society and police factors were regulation, media, and residence area. CONCLUSION: The findings indicate that multi-dimensional factors influence e-cigarette use among adolescents and young adults. Therefore, an approach that considers these factors is required to develop effective interventions for the prevention of e-cigarette use.

Environmental factors affecting mothers' decision-making about the HPV vaccination for their daughters.

OBJECTIVE: This study aimed to investigate environmental factors influencing mothers' decision-making regarding vaccination of the human papillomavirus (HPV) for their daughters. METHODS: This was a cross-sectional study, with data collected using online surveys from July to September 2018. Participants were 230 mothers of second-year female middle-school students in South Korea. The proportional stratification sampling method was used to reflect the difference in medical level between regions. Independent variables consisted of individual (demographic characteristics, HPV-related characteristics, knowledge, attitude, and subjective norms) and environmental factors (the influence of healthcare providers, school, and community environments) were examined. The potential factors influencing vaccination uptake were determined using hierarchical logistic regression. RESULTS: The factors influencing mothers' decision-making about the HPV vaccine for their daughters were their attitude toward HPV vaccination (OR = 0.78 p < .001), whether a healthcare provider provided HPV-vaccine-related information (OR = 2.42, p = .030), and presenting positive-framed information (OR = 4.21, p = .020). CONCLUSIONS: To increase HPV vaccination among the target population, it is necessary to consider environmental factors identified in this study. Healthcare providers should provide accurate information regarding the vaccination. Information emphasizing the vaccination's benefits is particularly important.

[Effect of Direct Breastfeeding Program for Premature Infants in Neonatal Intensive Care Unit].

PURPOSE: This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs). METHODS: This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ²-test and repeated measures ANOVA using an SPSS program. RESULTS: The experimental group showed a higher direct breastfeeding practice rate (χ² = 19.29, p < .001), breastfeeding continuation rate (χ² = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment. CONCLUSION: The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.

Gender Differences in Parental Impact on Problematic Smartphone Use among Korean Adolescents.

This study aimed to examine the effective parental impact in preventing problematic smartphone use in adolescents by identifying the parent-related factors. A secondary analysis of cross-sectional data from a Korean national survey was conducted. Data from 2758 male and 2419 female adolescents, aged 10 to 19 years, were analyzed; the respondents were divided into normal and risk groups based on their standardized smartphone addiction diagnostic scale scores. Parent-related factors of smartphone addiction were analyzed using a logistic regression model. Among both male and female adolescents, mobile messenger usage, and family environment emerged as significant predictors of problematic smartphone use. In addition, for male adolescents, smartphone use frequency and parent's awareness of content use were significant predictors. The findings indicated the importance of parental roles in preventing problematic smartphone use in adolescents. Parents should create a healthy family environment by avoiding smartphone overuse and modeling the appropriate usage of smartphones.

What influences adolescents to continuously use e-cigarettes?

OBJECTIVE: The use of e-cigarettes is rapidly increasing in adolescents. Health care providers pay attention to e-cigarette users because of the risk of developing addiction and problematic behavior. Based on ecological perspective, this study investigated factors influencing continued e-cigarette use. METHODS: We classified 1556 current e-cigarette users into experimental and continued users using the Korean national representative data. Data were analyzed using the chi-square test and logistic regression based on a complex sample analysis. RESULTS: Among current e-cigarette users, 55.1% were continued users. Adolescents who use e-cigarettes because of the belief that they are less harmful than cigarettes, concealment, easy purchase, and adding various flavors had a high risk of continued use. Continued users were more likely to have a higher weekly allowance, lower rate of living with family, and higher chance of smoking parents and exposure to passive smoking at home. CONCLUSIONS: Continued e-cigarette use was influenced by interpersonal and environmental factors, such as ease of purchase and addition of flavoring substances. Improving the environment of adolescents can prevent continued use of e-cigarettes.

[Factors Influencing Developmental Care Performance among Neonatal Intensive Care Units Nurses]. / ì‹ ìƒì•„ì§‘ì¤‘ì¹˜ë£Œì‹¤ 간호사의 발달지지간호 수행 영향요인.

PURPOSE: This study was conducted to identify factors related to developmental care performance among neonatal intensive care units (NICU) nurses. METHODS: The participants were 139 nurses who had provided care to premature infants for more than 6 months and were recruited from the NICU of 8 hospitals. Data were collected from September 1 to December 1, 2017 through questionnaires that encompassed developmental care performance, developmental care perceptions, and the nursing work environment. RESULTS: More than half (51.8%) of the participants responded that they had never received developmental care education, and for 89.6% of those who had received developmental care education, it was a one-time event. The average developmental care performance of NICU nurses was 0.81, with a range of 0.5~1 point. Multiple regression analysis, demonstrated that the nursing work environment (ß=.27, p=.001) and developmental care perceptions (ß=.23, p=.004) influenced developmental care performance, with a total explanatory power of 14%. CONCLUSION: Based on these results, developmental care education for the NICU nurses must be provided systematically. In addition, strategies to improve nurses' perceptions of developmental care and to provide appropriate support for the nursing work environment can promote developmental care performance.

[Characteristics Influencing the Occurrence of Respiratory Medical Device-related Pressure Ulcers in the Pediatric Intensive Care Unit]. / 소아중환자실 환아의 호흡기계 의료장치 ê´€ë ¨ 욕창 발생 ê´€ë ¨ 특성.

PURPOSE: This prospective study was conducted to determine the incidence and related characteristics of respiratory medical device-related pressure ulcers (MDRPU) in children admitted to a pediatric intensive care unit (PICU). METHODS: The participants were 184 children who were admitted to the PICU of P University Hospital from April 2016 to January 2017. Data were collected on the occurrence of respiratory MDRPU and characteristics regarding the application of respiratory medical devices. RESULTS: Respiratory MDRPU occurred in 11.9% of participants (58.3%: stage I ulcers, 37.5%: mucosal ulcers). The devices associated with respiratory MDRPU were endotracheal tubes (54.2%), high-flow nasal cannulas (37.5%), and oximetry probes (8.3%). Respiratory MDRPU associated with an endotracheal tube were significant differences according to the site and strength of fixation, the use of a bite block and adhesive tape, skin dryness, and edema. In high-flow nasal cannulas, significant differences were found according to the site of fixation, immobility after fixation, and skin dryness. CONCLUSION: The occurrence of respiratory MDRPU is significantly affected by the method and strength of fixation, as well as skin dryness and edema. Therefore, appropriate consideration of these factors in nursing care can help prevent respiratory MDRPU.

Negligible Egg Positive Rate of Enterobius vermicularis and No Detection of Head Lice among Orphanage Children in Busan and Ulsan, Korea (2014).

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.

Impact of health education on the prevalence of enterobiasis in Korean preschool students.

Health education has been shown to be effective in slowing the spread of the disease, infectious disease in particular. To evaluate the impact of health education on the prevalence and pattern of new infection of enterobiasis, children from 6 kindergartens in Ulsan city, South Korea, were recruited after undergoing a screening for enterobiasis, and then divided into three groups, including group medication (GM), education (Edu), and control group. All children in GM group received medical treatment with 500 mg albendazole twice, with 15 days interval. In the Edu group, only children diagnosed positive for Enterobius vermicularis eggs received medical treatment with 500 mg albendazole twice, with 15 days interval and all parents in the group received brochures providing information about enterobiasis. In the control group, only children diagnosed positive for E. vermicularis eggs received medical treatment with 500 mg albendazole twice, with 15 days interval, and no information about enterobiasis was provided to parents. Two post-treatment examinations were performed at three and six months after treatment. The infection rate in the GM group was dramatically decreased at 3 months, and this rate was almost the same as at 6 months after treatment. Infection rate of children in the Edu group was shown to drop from 9.9% to 3.0% at 3 months, and to 2.7% at 6 months after treatment; however, the infection rate in the control group continued to be higher than in the other two groups at both 3 and 6 months, with smaller change at 3 months compared to the other two groups. In addition, both new infection and re-infection cases in the Edu group were fewer, compared to those in the control group. In conclusion, although GM is the best method for eradication of enterobiasis, providing health information about enterobiasis to parents could reduce the prevalence, as well as the rate of new infection or re-infection with E. vermicularis in their children.

Parents' knowledge about enterobiasis might be one of the most important risk factors for enterobiasis in children.

To know the prevalence of Enterobius vermicularis infection and what are the most important risk factors, we evaluated the incidence and risk factors of enterobiasis among children attended in kindergartens in Busan metropolitan city, Republic of Korea. A total of 1,674 children from 21 kindergartens in 11 of 16 autonomous districts of Busan were evaluated for E. vermicularis infection by the cellotape anal swab technique. The overall egg-positive rate for E. vermicularis was 10.7% (179/1,674), and the prevalence of enterobiasis in each kindergarten ranged between 0% and 32.4%. There was an increasing tendency of the egg positive rate according to the population density; the higher the population density communities had, the higher egg-positive rate for E. vermicularis was detected (P = 0.001). Among personal hygiene factors involving children, thumb-sucking (P = 0.036) and fingernail-trimming (P = 0.024) were highly associated with enterobiasis. In addition, taking anthelmintic medications against E. vermicularis infection was strongly associated with enterobiasis (P = 0.014). Moreover, parents' knowledge of enterobiasis was correlated significantly with the incidence of enterobiasis of their children (P = 0.006). In conclusion, we need to consider not only personal hygiene but also parents' knowledge about enterobiasis as a factor in order to develop new strategies for elimination or to complete reduction of enterobiasis in Korea.