Participation in and perceptions of antibiotic stewardship behaviors among nurses at a children's hospital in South Korea: a descriptive study.

PURPOSE: This study investigated participation in and perceptions of antibiotic stewardship among nurses at a children's hospital. METHODS: This descriptive study included 125 nurses working in the inpatient ward, intensive care unit and emergency room of a single tertiary children's hospital. The study measured 14 factors influencing antibiotic stewardship behaviors using the theoretical domains framework. Each factor was analyzed by categorizing it into components (capability, opportunity, and motivation) that have been proposed as influencing factors in the COM-B model of behavior. One-way analysis of variance and Pearson correlation coefficients were used to explore differences in antibiotic stewardship behaviors and influencing factors according to general characteristics and the correlation between antibiotic stewardship behaviors and COM-B components. RESULTS: No statistically significant difference in antibiotic stewardship behaviors was found based on the experience of antibiotic stewardship education or the nursing department. However, significant differences were observed in the perception levels of factors related to antibiotic stewardship behaviors according to the experience of antibiotic stewardship education in skill (physical) (p=.042), knowledge (p=.027), intentions (p=.028), and social influences (p=.010). Additionally, significant differences were observed in perception levels according to the sub-components of the COM-B model, specifically physical capability (p=.042), psychological capability (p=.027), and social opportunity (p=.010). CONCLUSION: To expand nurses' involvement and roles in antibiotic stewardship, nurses should acknowledge the significance of appropriate antibiotic use, aiming to enhance the quality of medical care and ensure patient safety. In pursuit of this objective, tailored education aligning with the specific needs and practices of nurses is essential.

Weight status in survivors of childhood acute lymphocytic leukemia in South Korea: a retrospective descriptive study.

PURPOSE: This study investigated weight status in survivors of childhood acute lymphocytic leukemia (ALL) and identified related factors. METHODS: A retrospective review of the electronic medical records of survivors of childhood ALL (n=230) was conducted. We analyzed the survivors' characteristics, including sex, age, weight status at diagnosis, central nervous system involvement, risk classification, length of treatment, radiation therapy, and hematopoietic stem cell transplantation. Analysis of variance and the chi-squared test were applied to investigate influencing factors. RESULTS: The weight status distribution was as follows: 23 individuals (10.0%) were classified as underweight, 151 individuals (65.7%) were healthy weight, and 56 individuals (24.3%) were overweight/obese. Age at diagnosis (F=10.03, p<.001), weight status at diagnosis (x2=43.41, p<.001), and risk classification (F=10.98, p=0.027) showed significant differences among the weight status groups. Survivors who were older at diagnosis and those in the very high-risk category had a higher likelihood of experiencing underweight status during their survivorship, while survivors who were overweight/obese at diagnosis were more likely to remain overweight/obese at the time of survival. CONCLUSION: Considering the potential health implications related to an unhealthy weight status in survivors of ALL, it is imperative to undertake early identification and implement interventions for at-risk individuals.

Factors Affecting Dyslipidemia among Korean Adolescents: An Analysis Using the 8th Korea National Health and Nutrition Examination Survey (2021).

A high prevalence of dyslipidemia has recently been shown not only in adults, but also in adolescents. When occurring in adolescence, dyslipidemia is a risk factor for cardiovascular disease in adulthood. This study aimed to identify significant factors affecting dyslipidemia in South Korean adolescents. We used data from the third year of the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII-3) on 381 Korean adolescents aged 12-18 years. The data were analyzed using frequency analysis, descriptive statistics, the Rao-Scott χ test, the t-test, and univariate and multivariate logistic regression using complex sample analysis. On a weighted population basis, 28.1% of the adolescents among the participants were identified as the group with dyslipidemia. Obesity, waist circumference, serum uric acid, and alanine aminotransferase (ALT) were significantly related to the prevalence of dyslipidemia. Physical activity 4-7 days a week was related to a decrease in the prevalence of dyslipidemia only in male adolescents. The results of this study can be used as evidence for the risk assessment of adolescent dyslipidemia and the establishment of systematic health management guidelines according to risk factors for the prevention of adolescent dyslipidemia.

The perceptions and performance of family-centered care among pediatric nurses at a children's hospital in South Korea: a descriptive study.

PURPOSE: This study aimed to examine pediatric hospital nurses' perceptions and performance of family-centered care. METHODS: A descriptive study design was used. This study surveyed 162 nurses who worked at a single tertiary children's hospital in South Korea. The modified Family-Centered Care Scale was used to assess nurses' perceptions and performance of family-centered care. Barriers to the implementation of family-centered care were described in an open-ended format. RESULTS: Pediatric hospital nurses had a higher score for perceptions (mean score=4.07) than for performance (mean score=3.77). The collaboration subscale had the lowest scores for both perceptions and performance. The perceptions of family-centered care differed significantly according to the nurses' clinical career in the pediatric unit and familiarity with family-centered care, while performance differed according to clinical career only. Perceptions and performance were positively correlated (r=.594, p<.001). Barriers to implementation included a shortage of nursing personnel, a lack of time, and the absence of a family-centered care system. CONCLUSION: To improve the performance of family-centered care, nurses' perceptions of family-centered care should be improved by offering education programs and active support, including sufficient staffing, and establishing systems within hospitals.

Clinical characteristics and nursing diagnoses of pediatric patients hospitalized with inflammatory bowel disease: a single-center retrospective study in South Korea.

PURPOSE: This study aimed to identify clinical characteristics of South Korean pediatric inflammatory bowel disease (IBD) in a children's hospital over the past 5 years, with a specific focus on comparing the features observed between Crohn's disease (CD) and ulcerative colitis (UC). Additionally, it aimed to examine the nursing diagnoses given to patients. METHODS: This retrospective study analyzed the medical records of Korean pediatric patients under 18 years of age who were diagnosed with IBD and hospitalized at a children's hospital in Seoul, South Korea, from January 2017 to December 2021. RESULTS: The number of pediatric patients diagnosed with IBD steadily increased. This finding was particularly prominent for CD patients, the majority of whom were male. Pediatric patients with CD had significantly higher rates of abdominal pain and perianal lesions, while pediatric patients with UC had a higher rate of bloody stool. Laboratory findings indicated that CD patients had higher levels of inflammatory markers and lower albumin levels than UC patients. The nursing diagnoses given during hospitalization mostly related to safety and protection, physical comfort, and gastrointestinal function. CONCLUSION: This study provides insights into Korean pediatric IBD patients, enabling early detection and the development of nursing intervention strategies. From a comprehensive perspective, nursing care should not only address patients' physical needs but also their psychosocial needs.

Effectiveness of a natural wellness group program using interactive real-time video for unmarried mothers: A quasi-experimental study.

BACKGROUND: Unmarried mothers who raise their children alone in South Korea experience various difficulties in maintaining their health. Improving the health of unmarried mothers, who are socioeconomically vulnerable, is important not only for them but also for the healthy growth and development of their children. We aimed to implement a natural wellness group program using an interactive real-time video platform for unmarried mothers and to verify its effects. METHODS: This quasi-experimental study utilized a sequential explanatory mixed-methods design. The participants were unmarried mothers raising children aged 0-6 years. The quantitative data collection occurred from August to November 2021. For the qualitative data collection, semi-structured interviews were conducted with seven participants from the experimental group. The experimental group received eight 90-minute weekly online sessions, whereas the control group received no intervention. The outcome variables were physical and mental health, depression, anxiety, self-esteem, and parenting stress. RESULTS: A total of 42 unmarried mothers (21 experimental, 21 control) participated. The Wilcoxon signed-rank test revealed significant post-intervention differences in mental health, depression, and self-esteem in the experimental group. Moreover, a generalized estimating equation analysis revealed significant differences in self-esteem levels between the experimental and control groups. Four themes identified through qualitative analysis revealed that the natural wellness group program using interactive real-time video not only increased mothers' vitality and relaxation but also improved depression and anxiety, and had a positive effect on parenting stress. CONCLUSIONS: Natural wellness group programs using interactive real-time videos can help improve the psychological health of unmarried mothers with young children, a group that tends to be socially and psychologically marginalized.

Health Behavior and Social-Emotional Health Status of School-Aged Children According to their Experience with Atopic Dermatitis Diagnosis: Based on the 12th (2019) Panel Study on Korean Children.

Atopic dermatitis (AD) is a chronic inflammatory skin disease that is common in children and is increasing worldwide. This study aimed to identify differences in children's health behavior and social-emotional health status based on AD diagnosis at late school age. For this purpose, we conducted a descriptive survey using the 12th Panel Study on Korean Children data obtained in 2019. The data were analyzed using descriptive statistics, the Rao-Scott χ2 test, and a t-test using a complex sample analysis. A total of 1412 11-year-old Korean children participated in the study, of whom an estimated 8.2% were diagnosed with AD. In the children diagnosed with AD, the transition from exclusive breastfeeding to mixed feeding was later than that in children without AD (F = 5.71, p = 0.024), and the prevalence of AD in their parents was higher (F = 6.97, p = 0.014). Regarding health behaviors, the children diagnosed with AD had a higher intake frequency of protein (F = 5.41, p = 0.028) and vegetables (F = 6.09, p = 0.020). Regarding social-emotional health, subjective health status (F = 3.94, p = 0.026) and friend relationships (F = 2.95, p = 0.007) were lower in the children diagnosed with AD. These results, as preliminary data for interventions for school-aged children with AD, suggest that the difficulties of children's peer relationships should be considered and dealt with in further interventions.

Health-related quality of life in children with epilepsy: a concept analysis.

PURPOSE: This study aimed to conduct a concept analysis of health-related quality of life in children with epilepsy to promote conceptual clarification and facilitate mutual understanding of the concept. METHODS: Walker and Avant's concept analysis method was adopted. RESULTS: Health-related quality of life in children with epilepsy consists of six attributes: health status, inner strength, close relationships, resource-rich community, social acceptance, and changeability. According to the ecological system paradigm, these attributes are structured into five dimensions: organism, microsystem, macrosystem, exosystem, and chronosystem. These dimensions provide a comprehensive approach to the relationship between children with epilepsy and their environment. Epilepsy and interactions with multilevel ecological systems that are directly and indirectly related to children with epilepsy precede the concept, followed by positive and negative affective responses. CONCLUSION: The findings of this study may support effective communication in various practice settings, thereby contributing to the health and well-being of children with epilepsy, as well as the development and expansion of interventions to improve their health-related quality of life.

Factors Affecting High-Risk for Diabetes among Korean Adolescents: An Analysis Using the Eighth Korea National Health and Nutrition Examination Survey (2020).

The purpose of this study was to identify significant factors affecting diabetes and pre-diabetes in South Korean adolescents, including adolescents' and parental factors. We used data on 416 Korean adolescents aged 12-18 years and their parents (302 fathers and 375 mothers) from the eighth National Health and Nutrition Examination Survey gained in 2020. The data were analyzed by descriptive statistics, t-test, Rao-Scott χ2 test, and univariate logistic regression using complex sample analysis. Among the participants, 101 adolescents (22.7%) were classified as the high-risk group for diabetes. Significant factors affecting the risk for adolescent diabetes in both sexes were higher BMI, fasting plasma glucose, hemoglobin A1c, and insulin. The father's high degree of stress perception was only related to male adolescents, and the father's poor subjective health status was related to females at risk for diabetes. In mothers, physician-diagnosed diabetes, fasting plasma glucose, and hemoglobin A1c were factors affecting both sexes. Results from this study can be used as preliminary data for the early detection of high-risk groups for diabetes in adolescents, and for the development of systematic health care guidelines to prevent diabetes in adolescents.

The experience of unmarried mothers raising their children in residential facilities: a phenomenological qualitative study.

BACKGROUND: Birth outside of marriage has been gradually increasing in Korea. However, social perception of unmarried mothers is still negative, and a number of them are not accepted by their family. Therefore, the Korean government has implemented a policy to provide financial aid and communal residence to unmarried mothers who cannot raise children with their family, or afford residence. Unmarried young mothers who rely on this government policy have low economic independence and social adaptation skills. Additionally, they have a high chance of encountering numerous challenges in raising children due to their living conditions in residential facilities and social prejudice. This study was conducted to gain an in-depth understanding of the lived experience of unmarried mothers raising children in residential facilities. METHODS: Data were collected through in-depth interviews with nine unmarried mothers living in residential facilities with their children. An interpretative phenomenological analysis was conducted to analyze the data. RESULTS: The findings revealed that unmarried mothers struggled with various difficulties given the limitations of living in the facility, but attempted to navigate their uncertain future with the determination to be good mothers. Three main themes and eight sub-themes emerged: (1) adaptation to the identity of "unmarried mother", (2) willingly undertaking the heavy burden of childrearing, (3) indispensable but insufficient supports from facilities. Participants had childrearing responsibilities, and tried to be good mothers for their children while struggling to adapt to their new identities. However, their self-doubt as a "good mother" and the absence of the child's father made them feel sorry for their child. Their daily experiences raising children and simultaneously preparing for their own independence were exhausting. The supports from the facilities were helpful but unsatisfactory and led to various psychosocial difficulties such as anxiety, depression, fear, guilty, and anger in unmarried mothers. CONCLUSIONS: Besides information and resources for parenting and independence, active approaches are needed to improve the psychological stability of unmarried mothers raising their children in facilities, and sustain a long-term socioeconomic support system. Thoughtful services tailored to mothers and children are also needed, instead of standardized services.

The physical and emotional health of South Korean mothers of preterm infants in the early postpartum period: a descriptive correlational study.

PURPOSE: This study investigated the physical and emotional health of South Korean mothers of preterm infants in the early postpartum period. METHODS: In this descriptive correlational study, the participants included 91 mothers of preterm infants who were admitted to the neonatal intensive care unit of a tertiary hospital in South Korea. Physical health status was measured using a self-reported questionnaire, postpartum depression using the Edinburgh Postnatal Depression Scale, anxiety using the State-Trait Anxiety Inventory, and guilt using a 4-item scale. RESULTS: Fatigue had the highest score among mothers' physical health problems, followed by shoulder pain, nipple pain, neck pain. The average postpartum depression score was 11.02 points, and 44% of women had postpartum depression with a score of 12 or above. Postpartum depression significantly was correlated with physical health (r=.35, p=.001), anxiety (r=.84, p<.001), and guilt (r=.75, p<.001) and was significantly higher for women with multiple births, and preterm infants who required ventilator and antibiotic treatment. Anxiety also showed a significant difference according to preterm infants' condition. CONCLUSION: The significant correlations between postpartum depression and physical health, anxiety, and guilt indicate a need for nursing interventions that provide integrated management of mothers' physical and emotional health.

Effects of a hybrid online and offline program for facilitating father-infant interactions in South Korea: a quasi-experimental study.

PURPOSE: This study examined the effects of an educational program for fathers on improving father-infant interactions, child-rearing knowledge, and attachment. METHODS: In this quasi-experimental study, the participants were recruited by convenience sampling among fathers with infants (2-6 months of age) residing in three districts of Seoul. Fifteen participants in the experimental group and 17 participants in the control group completed the follow-up investigation. A 5-week online and offline intervention program with five sessions was provided to the experimental group. The data were analyzed using generalized estimating equations (GEEs). RESULTS: There was a significant difference in the change in father-infant interaction scores of the experimental group, especially in the caregiver aspect with a significance level of .100 in time and group-to-group interactions (B=6.46, p=.051, 95% confidence interval [CI]=-0.02-12.94). The changes between the groups and times were not statistically significant when it came to infant development knowledge and father-infant attachment. CONCLUSION: We conclude that hybrid online and offline education should be implemented as an effective method to improve fathers' interactions with their children based on accurate knowledge about infant development.

Influence of parenting role sharing, parenting stress, and happiness on warm parenting behavior in mothers of children aged 6 years: an analysis using data from the seventh panel study on Korean children.

PURPOSE: The aim of this study was to examine the relationships among parenting role sharing, parenting stress, happiness, and parenting behavior of mothers with 6-year-old children. METHODS: This study used data from the seventh Panel Study of Korean Children, which began collecting longitudinal data on a sample of newborn households nationwide in 2008 and will continue yearly until 2027. The participants were 1,560 mothers of children aged 6 years. We conducted statistical analyses using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The mean age of the mothers was 36.8±3.7 years. The mothers' perceived parenting role sharing (r=.07, p=.007), parenting stress (r=-.54, p<.001), and happiness (r=.38, p<.001) were significantly correlated with warm parenting behavior. Stepwise multiple regression analysis revealed that parenting stress (ß=-.47, p<.001), happiness (ß=.15, p<.001), and parenting role sharing (ß=.11, p<.001) were significant predictors for warm parenting behavior by mothers. CONCLUSION: It is essential to reduce mothers' stress and increase their positive emotions (happiness). Fathers should actively share parenting roles in raising children to enhance mothers' warm parenting behavior.

The effect of peer relationship enhancement programs on the prevention of smartphone addiction among late school-age children in South Korea.

PURPOSE: This study investigated the effectiveness of a peer relationship enhancement program in preventing smartphone addiction among late school-age children. DESIGN AND METHODS: This study employed a non-equivalent control pretest-posttest design. The participants (the experimental and control groups comprised 27 and 25 participants, respectively) included late school-age children who were registered at eight community children's centers in a region in South Korea. The program comprised group-based play and art activities, spanning 12 sessions, each of which was 90 min long. The outcome variables were peer relationships, depression, self-control, and smartphone addiction. Data were collected through baseline, post-intervention, and follow-up assessments and analyzed through repeated measures analysis of variance (RM-ANOVA). RESULTS: This program had a significant effect on peer relationships, depression, and smartphone addiction; however, no effect was found on self-control. CONCLUSION: The peer relationship enhancement program of this study was effective in preventing smartphone addiction by improving peer relationships and reducing depression in late school-age children. PRACTICAL IMPLICATIONS: The peer relationship enhancement program can be utilized in various pediatric nursing settings to prevent smartphone addiction. Therefore, it contributes to the expansion of the field of pediatric nursing practices.

Intervention Studies on the Enhancement of Self-Concept Among Adolescent Mothers: A Systematic Review.

Self-concept affects the overall process of pregnancy, childbirth, and parenting among adolescent mothers. The current systematic review explores intervention studies on the enhancement of self-concept among adolescent mothers, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English and Korean literature published within the past 10 years was searched and five articles met the inclusion criteria. To improve self-concept among adolescent mothers, especially self-esteem, it was deemed necessary to strengthen a balanced capacity of physiological, psychological, sociocultural, and developmental aspects, based on a comprehensive assessment. To provide effective intervention, it was essential to reflect the cultural characteristics of adolescent mothers' native countries. Lectures were confirmed as a representative method of enhancing self-concept and participatory learning methods, such as group discussions, group activities, practical skills training, and supervision, were considered effective for enhancing self-esteem by strengthening not only knowledge but also the motivation of adolescent mothers. [Journal of Psychosocial Nursing and Mental Health Services, 60(3), 31-39.].

eHealth Literacy, Awareness of Pandemic Infectious Diseases, and Healthy Lifestyle in Middle School Students.

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented public health crisis worldwide. This pandemic has led to the spread of online misinformation, closure of schools, postponement of re-opening of schools, and restrictions on healthy outdoor activities. These, in turn, have caused a disruption in the daily life of middle school students. This study aimed to identify the relationships between eHealth literacy, awareness of pandemic infectious diseases, and healthy lifestyle in middle school students. For this purpose, we conducted a descriptive, correlational study in two cities in the capital of South Korea. A total of 138 middle school students completed self-reported questionnaires about eHealth literacy, awareness of pandemic infectious diseases, and healthy lifestyle. Middle school students displayed moderate levels of eHealth literacy (3.72 ± 0.97), awareness of pandemic infectious diseases (3.33 ± 0.92), and healthy lifestyle (2.98 ± 0.72). Positive correlations were found between eHealth literacy and awareness of pandemic infectious diseases (r = 0.44, p < 0.001), between eHealth literacy and healthy lifestyle (r = 0.52, p < 0.001), and between awareness of pandemic infectious diseases and healthy lifestyle (r = 0.38, p < 0.001). These findings suggest that eHealth literacy may be an important aspect of increasing the awareness about pandemic infectious diseases and forming healthy lifestyle habits in Korean middle school students during the COVID-19 pandemic.

The Development of a Health Promotion Program for Unmarried Mothers Living in Residential Facilities Using Urban Forests: An Intervention Mapping Approach Based on the Transtheoretical Model.

Unmarried mothers living in residential facilities (UMLFs) in Korea face complex and challenging physical, psychological, and socioeconomic issues. This study developed a physical and mental health promotion program using urban forests for UMLFs based on the transtheoretical model and evidence. We utilized an intervention mapping approach (IMA) and assessed the needs of UMLFs by analyzing previous quantitative studies. Moreover, we conducted a qualitative hermeneutic phenomenological study involving nine participants. Based on the needs assessment, important and changeable determinants were identified; further, the program performance and change objectives were classified to achieve the program goals and establish the intervention strategy. We found that physical activity using forests, self-reflection using metaphors, five-sense activities, achievement activities using natural objects, building interpersonal relationships in the forest, and designing future plans, are desirable methods for improving the health of UMLFs. The IMA was deemed appropriate for the systematic development of health promotion programs for UMLFs through clear links among change objectives, theoretical methods, and practice strategies. These results should be applied to future intervention studies.

[Effects of Program to Promote Obesity Prevention Behaviors on Pre-Schoolers: Focused on Kindergartener in Korea].

PURPOSE: This study aimed to develop a program to promote obesity prevention behaviors for pre-schoolers and to confirm the effectiveness of the program in Korea. METHODS: The program comprised 8 sessions for 4 weeks including combined classroom lectures and physical activities. A non-equivalent control group pre-post test study design was used, and seventy two children, aged 5 to 6 years (experimental group: 33, control group: 39) and their parents participated in the study. To examine the effectiveness of the program, children's knowledge, intake of sugar-added beverages and fruits & vegetables, time of outdoor play and screen time, and parental self-efficacy were measured. Data were analyzed with SPSS/WIN ver. 22.0 and R 4.0.2, using descriptive analysis, chi-square test, Fisher's exact test, the independent t-test, and Analysis of covariance (ANCOVA). RESULTS: The results showed that the experimental group reported significantly increased knowledge (p < .001) and longer time of outdoor play on weekends (p = .033). However, there were no significant differences in the intake of sugar-added beverages and fruits & vegetables, screen time, and parental self-efficacy in the two groups. CONCLUSION: This study confirms the applicability of an obesity prevention intervention at kindergartens in Korea. The results can be used as basic data for the study of childhood obesity prevention in Korea.

Development of a Stress Scale for Siblings of Childhood Cancer Patients.

Most siblings of childhood cancer patients (SCCP) report not only post-traumatic stress but also daily stresses due to changes in their daily lives. The purpose of this study was to develop a stress scale for SCCP and to examine the validity and reliability of the scale. Based on conceptual analysis, 40 preliminary items were selected. After its content validity was determined by six experts, 37 items were chosen. For the psychometric testing, 125 SCCPs, aged 11-16, were surveyed. Through item analysis and exploratory factor analysis for construct validity, 27 items explained 61.2% of the variance, and they were categorized into six factors. Criterion validity was confirmed by examining the overall correlation with standard instruments according to the age group. Reliability was evaluated using Cronbach's alpha (0.91) and test-retest correlation (r = 0.597). This self-administered questionnaire with a 4-point Likert-type scale may be useful in clarifying and measuring stress levels in SCCPs.