Medication self-management and the quality of discharge education among parents of children with epilepsy.

INTRODUCTION: Medication self-management is critical among children with epilepsy. In the present study, we aimed to investigate the perceptions regarding the quality of discharge education among parents of children with epilepsy. In addition, we assessed the impact of their perceptions on medication self-management. The quality of discharge education was assessed in two parts: content and delivery. The quality of delivery was defined as the manner in which nurses teach the content regarding hospital discharge. METHODS: Forty-seven parents of children with epilepsy completed the questionnaires regarding demographics, the quality of discharge education, and medication self-management (the Quality of Discharge Teaching Scale and the Pediatric Epilepsy Medication Self-Management Questionnaire). RESULTS: Parent-reported quality of discharge education was positively correlated with medication self-management (r = 0.305; p = .037). Parent-reported quality of delivery, but not the amount of content, was positively correlated with medication self-management (r = 0.347; p = .017). CONCLUSIONS: These data suggest that efforts to improve medication self-management among children with epilepsy should include strategies to develop teaching skills among nurses delivering the discharge education.

Healthcare Transition Readiness, Family Support, and Self-management Competency in Korean Emerging Adults with Type 1 Diabetes Mellitus.

PURPOSE: The current study investigated factors related to healthcare transition readiness, including family support and self-management competency, in emerging adults with Type 1 diabetes mellitus (T1DM). DESIGN AND METHODS: A cross-sectional survey was conducted with 87 individuals, aged 16-24 years. Participants were recruited both from the outpatient clinic of Severance Children's Hospital, and an online self-help group for emerging adults with T1DM in South Korea. Participants reported perceived levels of family support, self-management competency, and healthcare transition readiness through a structured questionnaire. RESULTS: Healthcare transition readiness was positively correlated with family support (r = 0.257, p = .016) and self-management competency (r = 0.606, p < .001). Multivariate linear regression analyses revealed that only self-management competency was a significant factor associated with healthcare transition readiness (ß = 0.699, p < .001). CONCLUSIONS: For emerging adults with T1DM, ongoing family involvement in diabetes care and enhanced self-management competency can strengthen their healthcare transition readiness. Furthermore, primary factors associated with healthcare transition readiness in the present study were identified as self-management competency and participants' age. PRACTICE IMPLICATIONS: Healthcare providers should assess and enhance healthcare transition readiness in emerging adults with T1DM. A primary method of addressing transition readiness is helping people strengthen their self-management competency.

The Effect of a Parental Visitation Program on Emergence Delirium Among Postoperative Children in the PACU.

PURPOSE: The purpose of this study was to examine the effects of parental presence on the incidence of emergence delirium (ED) of children in the postanesthesia care unit (PACU). DESIGN: A quasi-experimental pretest and post-test study with nonequivalent and nonsynchronized control groups. METHODS: About 93 children aged 3 to 6 years undergoing general anesthesia for tonsillectomy were divided into two groups: parental presence and absence. ED was recorded using the Pediatric Anesthesia Emergence Delirium Scale at 0, 10, 20, and 30 minutes after PACU admission. FINDINGS: ED score at each time point in the experimental group was lower than the control group, but not statistically significant. ED score in the experimental group significantly decreased over time (F = 6.98; P = .010). CONCLUSIONS: Parental visitation programs could be effective on the degree of ED in children in the PACU setting. This result may contribute to the establishment of PACU visitation program policy in South Korea.

Family management of childhood atopic dermatitis.

AIMS: To identify the variables that affect family management of childhood atopic dermatitis and establish a prediction model based on Bandura's self-efficacy theory. BACKGROUND: Atopic dermatitis is a chronic recurrent skin disease and common health problem in childhood. It is necessary to use an approach that includes parental factors when considering the effective management of childhood atopic dermatitis. DESIGN: A cross-sectional study design. METHODS: A convenience sample, comprising 168 Korean mothers caring for a child with atopic dermatitis under the age of 13, was recruited from the paediatric outpatient departments of two general hospitals in Seoul, South Korea. Data were collected using structured self-reported questionnaires including severity, antecedents, effort, self-efficacy and family management of childhood atopic dermatitis from 1 November 2015-28 February 2016. Descriptive statistics about the participants and variables were examined and data were analysed using structural equation modelling. RESULTS: The hypothetical model had an adequate fit to the data, indicating that severity, antecedents, effort and self-efficacy influenced family management of childhood atopic dermatitis. CONCLUSION: These results suggest that strategies to support children with atopic dermatitis and their family should consider the influence of such variables.

Effects of a prevention program for internet addiction among middle school students in South Korea.

OBJECTIVES: This study explored the effects of a self-regulatory efficacy improvement program on self-control, self-efficacy, internet addiction, and time spent on the internet among middle school students in South Korea. The program was led by school nurses, and it is integrated self-efficacy and self-regulation promotion strategies based on Bandura's social cognitive theory. DESIGN AND SAMPLE: A quasi-experimental, nonequivalent, control group, pre-posttest design was used. The participants were 79 middle school students. MEASURES: Measurements included the Self-Control Scale, Self-Efficacy Scale, Internet Addiction Proneness Scale, and an assessment of internet addiction. RESULTS: Self-control and self-efficacy significantly increased and internet addiction and time spent on the internet significantly decreased in the intervention group compared with the control group. CONCLUSION: A program led by school nurses that integrated and applied self-efficacy and self-regulation intervention strategies proved effective for prevention of students' internet addiction.

The effect of predominant breast-feeding on the risk of obesity in Korean preschool children.

The purpose of this study was to investigate the prevalence of predominant breast-feeding practices based on the criteria given by the World Health Organization and to identify the association between predominant breast-feeding during infancy and the development of obesity during preschool in South Korean children. This study employed a nonexperimental, retrospective study design. Five hundred and twenty-eight preschool children aged three to six years and their mothers were recruited. Twenty-seven percent of the participants engaged in predominant breast-feeding; on average they fed predominantly breast milk for the first 6.7 months. After adjusting for child and maternal characteristics, children who had mixed feeding were 1.68 times more likely to become obese than those who were predominantly breast-fed. In this study, it was identified that predominant breast-feeding has a positive effect on maintaining healthy body weight in Korean preschoolers. While encouraging predominant breast-feeding is only a part of the solution, it is an effective and important first step toward preventing preschool obesity.

Economic differences in risk factors for obesity among overweight and obese children.

The purpose of the study was to identify the economic differences in familial, physiological, psychological, and lifestyle characteristics associated with overweight and obese children in South Korea. A total of 407 overweight and obese children participated in the study. The obesity rate was 69.0% and the prevalence of metabolic syndrome (MS) was 33.3% in the low-income bracket, and the prevalence of MS was 27.2% for the population. The children in the low-income group were more prone to have poor eating behavior and more likely to spend more than 2 hr viewing television. They also were more likely to have lower self-esteem and more depressive symptoms. School nurses should understand that risk factors for childhood obesity are more prevalent in low-income groups, which will eventually aggravate health disparities between socioeconomic status groups. Therefore, prevention programs for childhood obesity, which target high-risk groups of such children need to be developed and prioritized.

Fibroblast growth factor-7 facilitates osteogenic differentiation of embryonic stem cells through the activation of ERK/Runx2 signaling.

Fibroblast growth factor-7 (FGF7) is known to regulate proliferation and differentiation of cells; however, little information is available on how FGF7 affects the differentiation of embryonic stem cells (ESCs). We examined the effects of FGF7 on proliferation and osteogenic differentiation of mouse ESCs. Exogenous FGF7 addition did not change the proliferation rate of mouse ESCs. In contrast, the addition of FGF7 facilitated the dexamethasone, ascorbic acid, and ß-glycerophosphate (DAG)-induced increases in bone-like nodule formation and calcium accumulation. FGF7 also augmented mRNA expression of runt-related transcription factor-2 (Runx2), osterix, bone sialoprotein (BSP), and osteocalcin (OC) in the presence of DAG. FGF7-mediated increases in the mineralization and bone-specific gene expression were almost completely attenuated by pretreating with anti-FGF7 antibody. FGF7 treatment accelerated the DAG-induced activation of extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK) in the cells. A pharmacological inhibitor specific to ERK, but not to JNK or p38 kinase, dramatically suppressed FGF7-mediated mineralization and accumulation of collagen and OC in the presence of DAG. This suppression was accompanied by the reduction in Runx2, osterix, BSP, and OC mRNA levels, which were increased by FGF7 in the presence of DAG. Collectively, our results suggest that FGF7 stimulates osteogenic differentiation, but not proliferation, in ESCs, by activating ERK/Runx2 signaling.

The effects of audiovisual distraction on children's pain during laceration repair.

This study aimed to determine the effects of audiovisual distraction on pain in children during laceration repair in emergency room settings. This study was designed as a randomized controlled trial. Eighty-four children aged 3-10 years were randomized to either the experimental group or the control group. Pain response was assessed by the Faces Pain Rating Scale, a visual analogue scale and the Procedure Behaviour Checklist. We measured salivary cortisol levels as a physiological pain response. The results showed that the sensory and affective pain responses were significantly lower in magnitude in the experimental group than in the control group. There was no statistically significant difference in physiological pain responses between the two groups. Audiovisual distraction might be a helpful method to reduce children's pain during laceration repair in emergency room settings.

Factors influencing health-related quality of life of overweight and obese children in South Korea.

The purpose of this study was to identify factors influencing health-related quality of life (HRQoL) of overweight and obese children in Korea. This study employed a cross-sectional descriptive study design. A total of 132 overweight and obese children participated in the study. Anthropometric measurements included body mass index, percent body fat, and waist-hip ratio. The instruments included lifestyle patterns, psychosocial characteristics (stress, self-esteem, and depression), and HRQoL. The study found that significant predictors of HRQoL included self-esteem, depression, and physical stress; these variables accounted for 58.7% of the variance (p < .05), while children with low monthly household income had significantly lower HRQoL, compared with that of their counterparts (p < .05). HRQoL has multiple dimensions, thus, in addition to lifestyle change, health programs for overweight and obese children should focus on psychological health, and consider social and environmental factors as well.

Association between sleep duration and psychological health in overweight and obese children in Korea.

This study examined the moderating effects of different body mass index groups on the relationship between sleep duration and psychological variables (i.e. self-esteem, depression, and perceived obesity stress) among overweight and obese children in Korea. A non-experimental, cross-sectional study design was used. Study participants included 424 children residing in one metropolitan city of Korea and participating in weight-control programs. Self-reported data collection and physical examinations were performed. An age- and sex-specific reference growth chart was used to produce body mass index for age percentiles, and to classify overweight and obese groups. The results indicated that the main effects of sleep duration and the body mass index group × sleep duration interaction terms were statistically significant for all investigated psychological variables (P < 0.05), indicating that the body mass index group variable moderated the relationship between sleep duration and these psychological variables. This study found that sleep duration < 7 h was particularly detrimental to the investigated psychological variables in overweight, rather than obese, children.

The effects of an animation distraction intervention on pain response of preschool children during venipuncture.

OBJECTIVE: The purpose of this study was to identify the effects of an animation distraction intervention on pain response of preschoolers during venipuncture. METHOD: The research employed a nonequivalent control group pretest-posttest quasi-experimental design. The experimental group (n = 20) was provided with an animation distraction intervention using a laptop computer during their first venipuncture, and the control group (n = 20) received standard treatment. RESULTS: There were statistically significant differences in self-reported pain response, behavioral pain response, blood cortisol, and blood glucose between the experimental group and the control group. CONCLUSION: This intervention requires minimum effort and time and may be a cost-effective and convenient nursing intervention that could be used easily in clinical settings.

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p < 0.05), and the barriers to research utilization scores decreased significantly after the EBP clinical practicum. The results highlight the effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum.

Identification of an extensively drug-resistant Escherichia coli clinical strain harboring mcr-1 and blaNDM-1 in Korea.

The development of colistin resistance in carbapenem-resistant strains poses a serious public health problem. In this study, we collected 249 carbapenem-resistant Escherichia coli isolates from patients in Seoul in 2018, and screened all isolates for colistin resistance and for the presence of mobile colistin resistance (mcr) genes. Colistin-resistant strains were further analyzed using multilocus sequence typing, antimicrobial susceptibility testing, detection of antibiotic resistance determinants, plasmid transconjugation, and whole-genome sequencing. Three of the 249 carbapenem-resistant isolates were resistant to colistin, and mcr-1 was detected in one isolate (SECR18-0888), which belonged to sequence type 156 and was resistant to all antibiotics tested except tigecycline. The mcr-1.1 gene was located on an ~62 kb self-transferable IncI2 plasmid along with the blaCTX-M-55 gene, and the blaNDM-1, blaTEM, qepA1, and rmtB genes were additionally detected in SECR18-0888. As an extensively drug-resistant E. coli strain producing MCR-1 and NDM-1 was identified in Korea for the first time, continued monitoring of colistin resistance in carbapenem-resistant Enterobacteriaceae should be reinforced.

Health problems and health behaviors of Korean preschoolers living with parents and under guardianship.

PURPOSE: A comparative analysis was conducted to identify and compare the health status and behaviors of preschoolers attending daycare centers in South Korea between children living with parents and those under guardianship. DESIGN: The study design was descriptive and correlational. SAMPLE: Data were collected from 152 parents and 85 guardians of preschool children using a structured questionnaire. RESULTS: Of 237 children, 23.9-32.5% were overweight or obese, while 13.8-30.0% were underweight. Boys under guardianship were more likely to be obese. Hand-foot-mouth disease and atopic dermatitis were more prevalent among children living with parents, while those under guardianship were less likely to have dentistry visits, more likely to be absent from childcare due to pneumonia, and had significantly fewer health-related conversations with their guardians. In relation to health behaviors, the frequency of tooth-brushing and high-calcium food consumption was significantly lower among children under guardianship than among those living with parents. CONCLUSION: Compared with children living with parents, those under guardianship were exposed to unfavorable circumstances in terms of health management practices and health behaviors, which implies that the guardians were less interested in health care and dealt inappropriately with the health problems of their foster children.

Impact of the mother-nurse partnership programme on mother and infant outcomes in paediatric cardiac intensive care unit.

OBJECTIVES: To identify the effects of a mother-nurse partnership programme based on the core components of information sharing, negotiation and participation in care. Specifically, we examined the programme's effects on parental satisfaction, parental self-efficacy, perceived partnership and anxiety, as well as infants' time to reach full oral feeding and length of postoperative hospital stay, following cardiac surgery on infants at a paediatric intensive care unit with a restrictive visiting policy. RESEARCH METHODOLOGY/DESIGN: Quasi-experimental study. An analysis of covariance was used to investigate between-group differences while ensuring homogeneity. SETTING: A paediatric cardiac ICU. MAIN OUTCOME MEASURES: Parental satisfaction, parental self-efficacy, perceived partnership and anxiety. RESULTS: Data from 37 and 36 mothers in the control and experimental groups respectively, were analysed. Compared with controls, experimental group mothers reported significantly higher parental satisfaction (F = 39.29, p < .001), parental self-efficacy (F = 7.45, p = .008), perceived partnership (F = 62.30, p < .001) and lower anxiety (F = 12.93, p < .001), upon transfer to the ward. Infant outcomes did not differ between the groups. CONCLUSION: This programme appears to facilitate collaboration between nurses and mothers and positively influences mothers' emotional and cognitive outcomes following infants' cardiac surgery.

What Are the Barriers at Home and School to Healthy Eating?: Overweight/Obese Child and Parent Perspectives.

BACKGROUND: Most studies that have investigated factors influencing eating habits among obese children have focused mainly on individual or interpersonal factors and applied quantitative research methods. PURPOSE: This study was undertaken to identify the barriers in home and school settings that hamper healthy eating in overweight and obese children in South Korea. METHODS: Focus group interviews were conducted with 15 overweight/obese children and 15 parents. A standard manual with open-ended questions was developed. Content analysis was used to identify key findings. RESULTS: Participants were aware of the importance of home and school environments in shaping children's eating habits. Five major barriers, respectively, at home and at school emerged from the data. At home, the food preferences of parents affected the eating habits of their children. Moreover, parents worried about providing differentiated diets for siblings and about the permissiveness of grandparents toward grandsons. Furthermore, working parents preferred easy-to-prepare instant foods and said that their children ate overly quickly. At school, children cited time pressures, poor cafeteria environments, and ineffective nutrition education as barriers, whereas parents worried about inconsistent management by teachers and the unsafe food environment around the school. CONCLUSIONS: These environment-related barriers may be resolved through changes in the behavior of children, parents, and teachers as well as through the continued efforts of schools, community stakeholders, and policymakers, all of whose cooperation is essential to fostering a healthy food environment for children.

[Factors Affecting the Self-Management of Adolescents with Type 1 Diabetes Mellitus based on the Information-Motivation-Behavioral Skills Model]. / ì œ1형 당뇨병 ì²­ì†Œë „ì˜ 자기관리 영향요인: ì •ë³´-동기-í–‰ë™ê¸°ìˆ ëª¨ë¸ì„ 기반으로.

PURPOSE: The purpose of this study was to investigate associations between self-management and diabetes knowledge, diabetesrelated attitudes, family support, and self-efficacy in adolescents with type 1 diabetes mellitus based on the information-motivation- behavior skills model. METHODS: Data collection was conducted between March 18 and September 30, 2018. Patients (N=87) aged 12 to 19 years were recruited from the outpatient clinic of S children's hospital and an online community for patient with type 1 diabetes mellitus. Data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearsons correlation, and hierarchical multiple linear regression with SPSS IBM 23.0, with the two-tailed level of significance set at 0.05. RESULTS: The mean score of self-management in adolescents with type 1 diabetes mellitus was 61.23±10.00 out of 80. The regression analysis showed that self-efficacy and family support significantly explained 56.9% of the variance in self-management (F=21.38, p<.001). Self-efficacy (ß=.504, p<.001) and family support (ß=.188, p<.001) were significant predictors of self-management. CONCLUSION: It is necessary to develop individual interventions to improve self-efficacy and family support for adolescents with type 1 diabetes mellitus to help them enhance their self-management.

[Correlations between a Flexible Parental Visiting Environment and Parental Stress in Neonatal Intensive Care Units]. / ì‹ ìƒì•„ì§‘ì¤‘ì¹˜ë£Œì‹¤ 미숙아 부모의 자율면회 방문 현황과 부모 ìŠ¤íŠ¸ë ˆìŠ¤ì™€ì˜ 상관관계.

PURPOSE: The purpose of this study was to examine the correlation between a flexible parental visiting environment and parental stress in neonatal intensive care units (NICUs). METHODS: The study participants included 60 parents of premature infants in NICUs. Structured questionnaires and interviews, as well as observations by researchers using a caregiving behavior checklist, were used to measure the flexibility of the parental visiting environment and parents' stress levels. Quantitative and qualitative data were collected concurrently and were initially analyzed as separate data sets. Data collection extended from March 11, 2018 to June 30. 2018 and the data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, and Pearson correlation coefficients. RESULTS: There was a negative correlation (r=-.30, p=.021) between parental stress and the total number of visits in 7 days. We also found that the average duration of each visit and the number of caregiving behaviors performed by parents were positively correlated (r=.73, p<.001). CONCLUSION: When designing a flexible visiting environment for parents, parents should be encouraged to visit their babies. By doing so, stress can be reduced both for babies and for parents. Therefore, it is suggested that the related polices and regulations in South Korea should be changed to provide more a flexible visiting environment to promote better parent-child attachment and family adjustment.

Emergence of a multidrug-resistant clinical isolate of Escherichia coli ST8499 strain producing NDM-13 carbapenemase in the Republic of Korea.

We described a carbapenem-resistant Escherichia coli ST8499 strain producing New Delhi metallo-ß-lactamase-13 (NDM-13) from patient in Korea. The isolate exhibited multidrug resistance, but remained susceptible to colistin and tigecycline. The blaNDM-13 gene was located on a 130-kb self-transmissible plasmid. This is the first report of NDM-13 carbapenemase in Korea.