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Research Papers
Factors Influencing the COVID-19 Vaccination Intentions in Parents for Their Children Aged 5~11: Korea, April 2022
Choi, In Suk , Kim, Eun A
J Korean Acad Nurs 2023;53(2):208-221.   Published online April 30, 2023
DOI: https://doi.org/10.4040/jkan.22096
AbstractAbstract PDF
Purpose
This study aimed to investigate COVID-19 vaccination intentions in Korean parents for their children aged 5 to 11 years and the factors influencing them.
Methods
A cross-sectional online survey of 363 parents of children aged 5 to 11 years was conducted in Korea in April 2022. Data were analyzed using independent t-test, χ2-test, Fisher’s exact test, and hierarchical logistic regression analysis using SPSS/WIN 26.0 and MedCalc software version 20.113.
Results
Of 363 Korean parents with children aged 5 to 11, 42.4% intended to vaccinate their children. Significant factors influencing vaccination intention were the second or third birth order of children (OR = 3.45, 95% CI = 1.45~8.21), vaccine hesitancy-confidence (OR = 2.00, 95% CI = 1.51~2.65), vaccine hesitancy-collective responsibility (OR = 1.57, 95% CI: 1.10~2.25), and COVID-19 anxiety-avoidance (OR = 1.55, 95% CI = 1.13~2.11).
Conclusion
Findings suggest that COVID-19 vaccine campaigns based on reliable information and evidence from health authorities are needed to increase COVID-19 vaccination. Well-designed health communications for the target population may help to increase parental vaccine acceptance.
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The Influence of Parental Self-Esteem on Late School-Aged Children’s Media Device Addiction: The Mediating Effect of Marital Conflict and Children’s Self-Esteem
Heo, Dayeon , Kim, Suk-Sun
J Korean Acad Nurs 2022;52(4):421-434.   Published online August 31, 2022
DOI: https://doi.org/10.4040/jkan.22036
AbstractAbstract PDF
Purpose
This study aimed to examine the effect of parental self-esteem on late school-aged children’s media device addiction by mediating marital conflict and children’s self-esteem.
Methods
This study used data from the 11th (2018) Panel Study on Korean Children. The participants consisted of 1,082 family triads (fathers, mothers, and children). Data were collected using the Rosenberg Self-Esteem Scale, Marital Conflict Scale, and K-Internet Addiction Scale. The data were analyzed using structural equation modeling with SPSS/WIN 27.0 and Mplus 8.7.
Results
The final model showed a good fit for the data. Children’s media device addiction was directly related to mothers’ self-esteem, mothers’ marital conflict, and children’s self-esteem. Fathers’ self-esteem had a significant indirect effect on children’s media device addiction by mediating both fathers’ and mothers’ marital conflict. In addition, mothers’ self-esteem had a significant indirect effect on children’s media device addiction by mediating mothers’ marital conflict.
Conclusion
The findings indicates that self-esteem and marital conflict for both fathers and mothers have a significant effect on children’s media device addiction. It suggests that more attention might be given to fathers and mothers in developing interventions to prevent children’s media device addiction.
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Invited Paper
Healthcare Considerations for Special Populations during the COVID-19 Pandemic: A Review
Kim, Jeung-Im , Im, YeoJin , Song, Ju-Eun , Jang, Sun Joo
J Korean Acad Nurs 2021;51(5):511-524.   Published online October 31, 2021
DOI: https://doi.org/10.4040/jkan.21156
AbstractAbstract PDF
The coronavirus disease 2019 (COVID-19) has emerged as a threat to human health and public safety. People of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 infection. However, the clinical manifestations of this infection differ by age. This study purposes to describe healthcare considerations for special populations, such as children, pregnant and lactating women, and older adults, who may have unique healthcare needs, in the pandemic situation. To realize the research purpose, we conducted a review of the practice guidelines of public documents and qualified studies that were published online/offline during a specific period. The review identified current knowledge on care for newborns, children in schools, pregnant women (from antenatal to postpartum care), and older adults suffering from high-risk conditions. Subsequently, we summarize vaccination guidance for special populations and, finally, discuss the issues currently affecting special populations. Therefore, this current knowledge on care for special populations helps nurses to provide accurate information on vaccinations aimed at preventing COVID-19 and protecting the masses from infection. Currently, the scarcity of information on COVID-19 variants necessitates further research on measures to reduce pandemic spread.
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Research Papers
Structural Equation Modeling of the Interaction between Mothers and Preschool-Age Children
Chai, Hyun-Yi , Choi, Mi-Young
J Korean Acad Nurs 2021;51(5):630-642.   Published online October 31, 2021
DOI: https://doi.org/10.4040/jkan.21096
AbstractAbstract PDF
Purpose
This study aimed to identify the factors influencing the interaction between mothers and preschool-age children and construct a structural equation model based on the factors identified.
Methods
The data were collected from the mothers of children aged three to six years enrolled in kindergartens in Seoul, Gyeonggi, Chungbuk, and Jeonbuk. A total of 328 questionnaires were used for the analysis. Analysis was performed using SPSS 26.0 and AMOS 26.0 programs.
Results
The child’s self-regulation (β = .42, p < .001) had the most significant influence on the interaction between mothers and preschool children, followed by the mother’s parenting stress (β = - .23, p = .008), social support (β = .17, p < .001), and the child’s active temperament (β = .15, p < .001). The child’s gender, emotional temperament, social temperament, and mother’s education level had indirect influences.
Conclusion
These results suggest that interventions considering the child’s temperament, mother’s parenting stress, and social support are required to promote the interaction between preschool-age children and mothers.
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Effects of Program to Promote Obesity Prevention Behaviors on Pre-Schoolers: Focused on Kindergartener in Korea
Hwang, Inju , Bang, Kyung-Sook
J Korean Acad Nurs 2021;51(2):188-202.   Published online April 30, 2021
DOI: https://doi.org/10.4040/jkan.20217
AbstractAbstract PDF
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.
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Identifying Trajectories of Behavioral Problems in Children with Allergic Diseases: Secondary Data Analysis of the 5th to 7th Panel Study of Korean Children
Son, Miseon , Ji, Eunsun
J Korean Acad Nurs 2020;50(6):822-836.   Published online December 31, 2020
DOI: https://doi.org/10.4040/jkan.20177
AbstractAbstract PDF
Purpose
This study aimed to identify latent classes of behavioral problem trajectories in children with allergic diseases and investigate their predictors.
Methods
This study used data from the 5th to 7th Panel Study of Korean Children. The participants included 840 children aged 4~6 years with allergic diseases. Statistical analyses were conducted using latent class growth analysis and multinomial logistic regression.
Results
The trajectories of both internalizing and externalizing behavioral problems in children with allergic diseases were classified into five groups, that is deteriorative, recovering, changing 1 (decreasing-increasing), changing 2 (increasing-decreasing), and low state persistent group. For the internalizing behavioral problems, predictors were temperament, father’s education, family interaction, and disconnection in peer interaction. For the externalizing behavioral problems, predictors child’s gender, temperament, marital conflict, parenting stress, family interaction, and parenting environment.
Conclusion
Deteriorative group has high-risk behavioral problems in children with allergic diseases. We suggest to provide interventions considering latent problem trajectories based on ecological environments for allergic children.
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Review Article
Parental Factors Associated with Smartphone Overuse in Preschoolers: A Systematic Review and Meta-Analysis
Lee, Gumhee , Kim, Sungjae , Yu, Heajin
J Korean Acad Nurs 2020;50(3):349-368.   Published online June 30, 2020
DOI: https://doi.org/10.4040/jkan.19186
AbstractAbstract PDF
Purpose
This study aimed to identify parental factors associated with smartphone overuse in preschoolers.
Methods
A systematic reviewwas conducted according to PRISMA guidelines. Relevant studies published in peer-reviewed journals from 2009 to June 2019 were identifiedthrough systematic search in 10 electronic databases (PubMed, CINAHL, Cochrane Central, EMBASE, Web of Science, NDSL, KISS, KMbase,KoreaMed, and RISS). Standardized effect sizes were calculated to quantify the associations of parental factors with smartphoneoveruse in preschoolers using meta-analysis.
Results
A total of 30 cross-sectional studies involving 7,943 participants met the inclusioncriteria. The following were negatively correlated with smartphone overuse in preschoolers: mother’s parenting self-efficacy (r =-.35),mother-child attachment (r =-.28), mother’s positive parenting behavior (r =-.28), mother’s positive parenting attitude (r =-.25), and father’sparenting involvement (r =-.15). Further, maternal factors such as smartphone addiction tendency (r =.41), parenting stress (r =.40), negativeparenting behavior (r =.35), negative parenting attitude (r =.14), smartphone usage time (r =.26), employment status (r =.18), and age(r =.12) were positively correlated with smartphone overuse in preschoolers.
Conclusion
Several parental factors influence smartphoneoveruse in preschoolers. These findings emphasize the need to assess and enhance the parental factors identified in this study to preventsmartphone overuse in preschoolers. Accordingly, we recommend the development of preventive interventions to strengthen parent-relatedprotective factors and mitigate risk factors.
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Original Articles
Mothers’ Experiences of Caring for Children with Precocious Puberty: A Q-Methodological Approach
Lee, Hye Jin , You, Mi-Ae
J Korean Acad Nurs 2020;50(2):255-270.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.255
AbstractAbstract PDF
Purpose
This study explored experiences of mothers caring for children with precocious puberty.
Methods
Q-methodology was used for analyzing individual subjectivity. Seventy Q-statements were selected and scored by 50 participants on an 11-point scale. The collected data were analyzed using the PC QUANL program.
Results
The following eight types of care experiences of mothers of children with precocious puberty were identified: Type I-1: hypersensitive and best-result oriented, Type I-2: treatment burden, Type II-1: treatment-oriented, Type II-2: self-blame, Type III-1: accepting and compliant, Type III-2: treatment confused, Type IV-1: serious and engaged, and Type IV-2: naturalism- oriented.
Conclusion
These results can help develop specific education
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Development of a Scale for Alcohol Drinking Prevention Behavior in Early Elementary School Based on Ajzen’s Theory of Planned Behavior
Kim, Younkyoung , Lee, Chong Mi , Kang, Seo Young
J Korean Acad Nurs 2020;50(2):210-227.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.210
AbstractAbstract PDF
Purpose
This study aimed to develop a scale to measure variables related to alcohol drinking prevention behavior in early elementary school, based on the theory of planned behavior.
Methods
A scale was developed to measure variables related to alcohol drinking prevention behavior. Initial items for direct evaluation were constructed through a literature review, and those for belief-based indirect measure were generated through interviews with 30 second- and third-grade elementary school students. The collected data from 286 third-grade elementary school students were then subjected to item analysis, exploratory and confirmative factor analysis, criterion-related validity testing, and internal consistency assessment.
Results
The final scale consisted of 35 items. Intention, attitudes, subjective norms, and perceived behavioral control explained 82.7% of the variance; behavioral beliefs, normative beliefs, and control beliefs explained 65.6% of the variance; and evaluation of outcome, motivation to comply, and power of control beliefs explained 72.8% of the variance. The confirmatory factor analysis indicated that the theoretical models had a satisfactory goodness of fit. Criterion-related validity was confirmed between the direct evaluation variables and the indirect measure variables (attitudes r=.64, p <.001; subjective norms r=.39, p <.001; perceived behavioral control r=.62, p <.001). Cronbach’s a was .89 for the direct evaluation variables and .93 for the indirect measure variables.
Conclusion
The scale developed in this study is valid and reliable. It could be used to measure and explain variables related to alcohol drinking prevention behavior in early elementary school.
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The Effect of a Social Skills Program on Violent Behaviors in Children Aged 60~72 Months
Tülay Kuzlu Ayyildiz, Güler Cimete
J Korean Acad Nurs 2019;49(6):771-782.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.771
AbstractAbstract PDF
Purpose

To determine the effects of a child and parent program on developing social skills for preventing violent behaviors in children aged 60~72 months through a specially developed pre and posttest, control group, quasi-experimental study.

Methods

A social skills development program based on Gardner's Multiple Intelligence Theory was used. The data were collected using the Social Skills Assessment Scale (SSAS), a Chart to Monitor Verbal and Behavioral Violence in Children, the Parental Attitude Scale and the Parent Interview Form. This quasi-experimental study that included a pretest, posttest, and control group had a sample comprising 67 children and parents, with 36 in the experimental group, and 31 in the control group.

Results

Over a six-month period, while the social skill scores of the children in the experimental and control groups increased, their violent behaviors decreased (p<.050). Increase in social skill scores and decrease in violent behaviors were higher in the experimental than in the control group children (p<.050). The parents in the experimental group stated that they had started to empathize with their children, using “I” language, and applied rules more consistently after the program.

Conclusion

This program was successful in preventing violent behaviors in children through the development of social skills. Hence, it can be effectively implemented through a teacher/nurse collaboration.

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Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby
Meera Park, Kyung Min Park
J Korean Acad Nurs 2019;49(2):137-148.   Published online April 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.2.137
AbstractAbstract PDF
Purpose

This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby.

Methods

The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used.

Results

For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004).

Conclusion

This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.

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The Effect on Pain of Buzzy® and ShotBlocker® during the Administration of Intramuscular Injections to Children: A Randomized Controlled Trial
Birsen Sivri Bilgen, Serap Balcı
J Korean Acad Nurs 2019;49(4):486-494.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.486
AbstractAbstract PDF
Abstract Purpose

To investigate the effect of Buzzy® and ShotBlocker® on reducing pain induced by intramuscular penicillin injections in children.

Methods

This was a randomized controlled study. A total of 150 Turkish children aged 7~12 years who presented to our pediatric emergency clinic and met the inclusion criteria were recruited. The children were randomly assigned to each group (control=50, Buzzy®=50, ShotBlocker®=50). Data were collected using an information form, the State-Trait Anxiety Inventory for Children, Visual Analog Scale, and Faces Pain Scale-Revised.

Results

The children in the control group had significantly higher pain scores during the penicillin injection than the children in the ShotBlocker® and Buzzy® groups. The children in the Buzzy® group had significantly less pain than the children in both the ShotBlocker® and control groups (p<.001).

Conclusion

Buzzy® was more effective compared with ShotBlocker® in this study.

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Environment Factors Affecting Childhood Obesity: Voices from Students, Parents, and Teachers with Photograph
Eunok Park, Hyo Young Lee
J Korean Acad Nurs 2019;49(3):254-262.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.3.254
AbstractAbstract PDF
Abstract Purpose

This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community.

Methods

Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion.

Results

School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity.

Conclusion

To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.

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Validity and Reliability of a Korean Version of Yale Food Addiction Scale for Children (YFAS-C)
Jung Ho Kim, Ji Hyun Song, Ran Kim, Mi Young Jang, Hyon Joo Hong, Hyun Ji Kim, Sung Hee Shin
J Korean Acad Nurs 2019;49(1):59-68.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.59
AbstractAbstract PDF
Abstract Purpose

This study evaluated the psychometric properties of the Korean version of Yale Food Addiction Scale for Children (YFAS-C).

Methods

Participants were 419 young adolescent students (11~15 years old). The content validity of the expert group was calculated as the content validity index (CVI) after the translation and reverse translation process of the 25 items of the YFAS-C. The multitrait-multimethod matrix (MTMM) method was used to verify the construct validity; the generalized linear model (GLM) was used to evaluate the concurrent and incremental validity. Reliability was calculated as Kuder-Richardson-20 (KR-20) and Spearman-Brown coefficients.

Results

The CVI of the 25 items was greater than the item-level CVI .80 and the scale-level CVI .90. The Korean version of YFAS-C had verified convergent validity in emotional eating and external eating and discriminant validity in restrained eating. In addition, it had verified concurrent validity in emotional eating and external eating. Finally the incremental validity of the Korean version of YFAS-C was statistically significant on BMI. Reliability was KR-20 a=.69 and the Spearman-Brown coefficient was .64.

Conclusion

The Korean version of YFAS-C is a valid and reliable scale for measuring the severity of food addiction; it can be a useful scale for preventing obesity by predicting food addiction early.

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Development and Effects of Social Learning Theory Based Eye-Health Program for Preschoolers
Sunghwa Lee, Haejung Lee, Hyungsik Seo, Jaeho Jung
J Korean Acad Nurs 2018;48(4):407-418.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.407
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop an eye-health program based on social learning theory (EPST) of preschoolers and evaluate its effectiveness.

Methods

A nonequivalent control group pre-post test design was utilized and 141 six-year-old preschoolers and their parents participated (experimental group=69, control group=72) in the study. The EPST in this study included eye-health education and eye exercises. Attention, memory, replay, motivation, reinforcement, and self-efficacy were used as interventional strategies. To examine the effectiveness of EPST, proficiency in eye-health activities, refractive power, and visual acuity were measured before and after the intervention. Data were analyzed with SPSS WIN 21.0 using the Shapiro-Wilk test, χ 2-test, Mann-Whitney U test and Wilcoxon signed rank test.

Results

Following the intervention, eye-health activities, refractive power, and visual acuity significantly improved in the experimental group compared to the control group.

Conclusion

The results of this study suggest that EPST is effective in improving eye-health activities, refractive power, and visual acuity in preschoolers, and its wider implementation in educational institutions will promise improved eye-health among preschoolers.

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Perception on Parental Coping on Unintentional Injury of Their Early Infants and Toddlers: Q Methodological Approach
Da In Lee, Ho Ran Park, Sun Nam Park, Sungsil Hong
J Korean Acad Nurs 2018;48(3):335-348.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.3.335
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify parental coping strategies in the face of early infant and toddler injury, and to provide basic data for a parental education program and the most desirable directions it should take.

Methods

A Q-methodology to analyze the subjectivity of each item was used. Thirty-four Q-statements were derived from a literature review and interviews. Forty-seven parents were classified into a shape of normal distribution using a 9-point scale. Collected data were analyzed by the pc-QUANL program.

Results

Five types of parental coping in early infant and toddler injury were identified. Type I was “hospital treatment focused”, type II was “Improving the safety of the child's environment”, type III was “expression of negative emotion”, type IV was “taking the lead in problem solving”, and type V was “Interrogating the person in charge of the situation in which the injury occurred”.

Conclusion

The results of this study indicate that different approaches to educational programs can be used for parents in early childhood injury.

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Structural Equation Model of Health-Related Quality of Life in School Age Children with Asthma
Yunsoo Kim, Ho Ran Park
J Korean Acad Nurs 2018;48(1):96-108.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.96
AbstractAbstract PDF
Abstract Purpose

This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary.

Methods

Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support. The endogenous variables were asthma self-efficacy, asthma symptom control, perceived health status, parental quality of life, and children's quality of life. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed.

Results

Eighteen of the twenty-four hypotheses selected for the hypothetical model were attentive and supported statistically. Quality of life was explained by asthma self-efficacy, asthma symptom control, perceived health, parental quality of life, and asthma knowledge with 83.5%.

Conclusion

Strategies for promoting self-efficacy and enforcing asthma knowledge will be helpful for the improvement of health-related quality of life with school-aged asthmatic children.

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Effects of Parenting Stress and Controlling Parenting Attitudes on Problem Behaviors of Preschool Children: Latent Growth Model Analysis
Jeong Won Han, Hanna Lee
J Korean Acad Nurs 2018;48(1):109-121.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.109
AbstractAbstract PDF
Abstract Purpose

This study was conducted to examine the longitudinal effects of parenting stress and parental control attitudes on problem behaviors in preschool children, using a latent growth model.

Methods

Participants were 1,724 pairs of parents and 1,724 preschool children who had completed the panel survey on Korean children (5th~7th survey panels).

Results

An analysis of the multivariate latent growth model of parenting stress, parental control attitudes, and children's problem behaviors suggested that the parents’ intercepts for parenting stress influenced their intercepts for parental control attitudes (father: b=.21, p<.001; mother: b=.55, p<.001). In addition, the slopes for fathers’ parenting stress was the only aspect that affected the slopes for mothers’ parental control attitudes (b=.77, p<.001). Moreover, both the intercepts and slopes of parenting stress and parental control attitudes significantly affected the children's problem behaviors.

Conclusion

This study is significant as it provides longitudinal evidence of the impact of parenting stress and parental control attitudes on children's problem behaviors. The findings suggest that accurately assessing changes in parenting stress and parental control attitudes and developing intervention programs to reduce them will be effective in reducing problem behaviors in children.

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A Study on Self-esteem, Coping Type and the Quality of Life in Mothers of Handicapped Children
Mi Kyung Sim
Journal of Nurses Academic Society 1997;27(3):673-682.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.673
AbstractAbstract PDF

The purpose of this study was to examine the relationship between self-esteem and quality of life(QOL) and between coping type and quality of life (QOL) in mothers of handicapped children and further to identify the level of self-esteem and quality of life of the subjects. The subjects of this study were the 51 mothers of handicapped children who were registered in two special schools in Taejon. The data were collected using a questionnaire and the period of the data collection was from April 18th to May 26th, 1997. The instruments for this study were Resenberg's self-esteem scale, Folkman and Lazarus's Ways of Coping Checklist(WCC) and the quality of life scale designed by Ro, You Ja. The results were analyzed using SPSS/PC+. Data analysis included the descriptive correlational statistics of ANOVA, Pearson Correlational Coefficient, and t-test. The results are as follows : 1. The level of self-esteem showed a mean score 34.51 and the level of QOL, a mean score 137.55. An Active type of coping was used more often than a passive one. 2. The level of self-esteem differed according to monthly income and was significantly higher in mothers of children with acquired handicaps than those of children with congenital handicaps. The level of QOL differed according to monthly income. 3. There was positive correlation between health status and self-esteem(r=.355, p<.05), and between health status and QOL(r=.367, p<.01). 4. Test for hypothesis ; Hypothesis 1, "The higher the level of self-esteem in mothers of handicapped children, the higher their level of quality of life will be." was supported(r=.755, p<.001). Hypothesis 2, "The QOL level for the active coping group as compared to the passive coping group will be higher." was not supported.

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A Study of the Relationship between the Intention of Pregnancy and the Child-Rearing Attitudes of Mothers with Infants
Jung Ha Sim
Journal of Nurses Academic Society 1997;27(2):454-464.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.454
AbstractAbstract PDF

The purpose of this study was to identify the correlation between the intention of pregnancy and the child rearing attitudes of mothers with infants. The data was collected from 138 mothers by means of an interview and questionnaire in a period from April 1 to April 30, 1997, when they came to have their infants vaccinated at one hospital and one health care center. The collected data was analyzed by means of the SPSS Program using percentage, means and standard deviation in each area and the ANOVA and Pearson correlation Coefficient. The results of this study were as follows : 1. It showed that the mother's degree of intention of pregnancy was 3.90(+/-1.19) among the possible score of 0~5 and the score of child rearing attitudes was 70.1 among the possible score of 20~100. The mean score of the items was 3.50(+/-.36) among the possible score of 0~5. 2. There was a significant relation between the intention of pregnancy and child rearing attitudes. It was mildly positive but was significant(r=.21, p<0.05). 3. There was a significant relation between the period from marriage to the time of pregnancy and the intention of pregnancy(F=.57, p<0.05). Also, it was found out that the group of mothers who became pregnant later than 12 months after marriage wanted after pregnancy more than the group of women who were pregnant within 12 months after marriage(F=11.30, p<0.01). 4. There was a significant relation between the period from marriage to the time of pregnancy and child rearing attitudes(F=4.14, p<0.05). It showed that the child rearing attitudes of the group of women who became pregnant later than 12 months after marriage was positive(F=11.42, p<0.01). Also, in case tat the both the husband and wife decided on the pregnancy, the child rearing attitudes were more positive(F=7.15, p<0.05). In conclusion, when the intention of pregnancy was stronger, the subjects' child rearing attitudes were more positive. Also when both the husband and wife decided on the pregnancy, the attitudes were more positive. So it seems that both husband and wife should discuss and agree upon pregnancy, having a sufficient period during which both the spouses prepare for the intention of pregnancy. Additionally, it is suggested that when the husband and wife are doing family planning, it would be beneficial to use a program of 'Woman's Intention on Pregnancy' during this process.

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An Ethnographic Study about Taegyo Practice in Korea
Hyeon Ok Kim
Journal of Nurses Academic Society 1997;27(2):411-422.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.411
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The purpose of this study is twofold :(i) to investigate how much effort the married couples are making for the good health of both the pregnant woman and her unborn child from the time of their marriage to and during the period of conception ; and(ii) to comprehensive investigate socio-cultural backgrounds which affect prenatal effort. Result of this study provide a basis for the prenatal care program which will be appropriate to our culture. This study has been done by the ethnographic research method. The subjects of this study are 53 people in all consisting of 33 pregnant women and 20 husbands. In order to investigate socio-cultural factors which influence Taegyo, producers of Taegyo music were interviewed. In addition, the researcher surveyed the markets of Taegyo music, participated in special courses of prenatal education, analyzed the content of the books and periodicals dealing and collected the concept of Taegyo distributed by the mass media. The full-fledged study continued for eight months from February to August, 1996. The data were analyzed as soon as they were collected. Spradly's(1979, 1980) developmental, sequential method of domain analysis, taxonomic analysis, componential analysis, and theme analysis in this order was adopted as the procedure of analyzing the data. To obtain the exactness of study, Sandelowski's(1986) four criteria, that is, Credibility, Fittingness, Auditability, and Confirmability were applied to all stages of data collection, data analysis, the interpretation of the result, and the description of the result. The following are the result : 1. The couples' Taegyo at the stage of preconception was related to their physical, psychological, spiritual conditions under which a healthy baby will be born. Specific methods they prefer are : "the choice of one's spouse," "physical check-up," "physical good health," "praying," and so on. 2. When the married couple have sex in order to conceive, their Taegyo was related to the imposition of their physical, psychological, and environmental conditions. Specific methods they prefer are: "having sex at specific time," "having sex in nice place," "to purify their minds while having sex," and so on. 3. The married couples' Taegyo while they are in pregnancy was related to the imposition of their physical, psychological, emotionmental, environmental, social and spiritual conditions. Specific methods they prefer are : "listening to music," "reading," "looking at beautiful things only," "to avoid looking at or listening to bad things," "to eat food in good shape," "to avoid drugs," "eating Korean herbal medicine," "sexual abstinence," "to avoid dangerous places," " to keep emotional tranquility," "moderate exercises and rest," "leading a pure life," "praying," "being aware of their words and behavior," "for the couple to keep a good relationship," "interaction with their unborn child," "to support Taegyo for pregnant women," and so on. 4. The married couple put Taegyo into practice on the basis of the following principles : the principle of respecting an unborn child, the principle of forming a good disposition, the principle of top-down parental love, the principle of synergy between a pregnant woman and her unborn child, the principle of expecting a good child, the principle of forming a good habit, and the principle of acquiring a parental role. 5. The practice of Taegyo is influenced by such factors as the married couple, the supporting system, and the married couple, the supporting system, and the mass media. As the husband-and-wife factor, their information of Taegyo, the degree of importance is assigned to their characters, their time to spare, their healthiness, the age of pregnant woman, their conception plan, their religion, their belief of the Taegyo effects, and the birth of a baby in this order. The factor of the supporting system consists of her husband's support, he family support, and her neighbor's support. The mass media specialized in Taegyo, periodicals for pregnant women, booklets for advertizing powdered milk, Taegyo music of record manufacturing companies, and the teaching materials for gifted children. Among these the mass media is especially taking advantage of Taegyo as its main source of economic profits and leading the public behavior pattern to a prodigal one. Taegyo is a self-control behavior which requires practice for the following : the physical and psychological good health of the pregnant woman and her unborn child, the development of the unborn child's good character, the envelopment of the unborn child's intelligence and talents, the expectation of the unborn child's good features, shape a good habit, the expectation of the unborn child's bright future, and the learning of a parental role, the expectation of male birth. Above all it is a type of our good cultural tradition which pursues a value higher than the one that the prenatal care does. The principles of pregnancy care inherent in the habit of Taegyo will provide us a guideline for the development of the prenatal care.

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Effects of a Social Support Group on Burden and Well-being of Mothers of Developmentally Delayed Children
Ka Sil Oh
Journal of Nurses Academic Society 1997;27(2):389-400.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.389
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This study examined the effects of group social support on the reduction of burden and increase in well-being of mothers of developmentally delayed children. The research used a one group pre-post experimental design. The independent variable in the experiment was group social support. Two series of 4-weekly meetings for group social support were conducted by the researcher with the intention of developing a self-help group. The dependent variables were burden and well-being. Well-being was operationalized as physical symptoms and quality of life. Thirty mothers of developmentally delayed infants from the rehabilitation center of a medical center participated in the study. Data were collected by interview and a self-administered questionnaire. The mean age of the subjects was 29.9 years. Changes of the dependent variables between pre and post tests were compared using the t-test. Even though there was a slight improvement in the scores for the dependent variables, they were not statistically significant. The items, "I resent my baby", "I feel angry about my interactions with my baby", "I feel guilty in my relationship with my baby" showed a significant decrease in burden score and were statistically significant. Symptoms of loneliness, constipation, anxiety, restlessness were less and feeling of happiness was greater after participation in the group social support, than on the pretest. The mothers showed emotional instability and frustrations during the group sessions but their reactions in general were positive. Emotional support, stress management and information provided were identified as the most valuable content of the sessions. However, participation was not active due to the mother's denial, delayed acceptance and/or avoidance of their infants' problems. It can be seen that group social support for the mothers with developmentally delayed children should be provided after infancy when the mothers have time to accept their children's conditions and are ready to receive support. The use of comprehensive instruments which measure burden in both families and mothers needs to be developed for future research.

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A Study of Stress and Coping Strategies in School-Age Children
Hee Sun Shin
Journal of Nurses Academic Society 1996;26(4):808-819.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.4.808
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The purpose of this study was to examine the stressors and coping strategies of school-age children and to explore the relatioship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjcets consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35(SD=.86). The Feel Bad Scale (FBS), Schoolager's Coping Strategy Inventory (SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire(HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from. 81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov. 25 to Dec. 19,1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows: 1. The mean score for the FBS was 204.79(range: 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range: 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range: 0-8l) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms(r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56. 78%. The study revealed that stressful life events correlated with health symptoms in School-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

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A Companison Study of Stress, Coping and Adaptation between Fathers and Mothers of Mentally Retarded Children
Young Im Moon, Hyung Young Koo
Journal of Nurses Academic Society 1996;26(1):165-176.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.1.165
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The purpose of this study was to contribute to family nursing in the areas of reducing stress and improving coping for parents of mentally retarded children. Data were collected through self-report questionnaires during a period of 2 months between November 1994 and January 1995 in the Kyoung-in area. The subjects consist of 176 parents (88 mothers and 88 fathers) of mentally retarded children attending schools for the handicapped. The levels of general stress and of parental role stress were measured with the General stress scale and the Parental role stress scale, respectively. The coping scale developed by Folkman and Lazarus was adopted to measure the level of coping, and the patterns of adaptation scale developed by Damrosch and Perry was adopted to measure the patterns of adaptation. The data were analyzed by a SAS program using Fisher's exact test, paired t-test, and oneway ANOVA. The results are as follows: 1. The level of general stress was significantly higher in mothers than in fathers. Mothers experienced a significantly greater level of parental role stress than fathers did. No significant difference in the level of coping was observed between mothers and fathers. There were differences in maternal and paternal patterns of adaptation. 2. The adaptation pattern of fathers was different according to their level of general stress, parental role stress and coping. The adaptation pattern of mothers was not different according to their level of general stress and parental role stress, but was according to their level of coping. 3. General stress experienced by fathers was different according to education, health status and support from their spouses. Satisfaction with family life, satisfaction with spouse and the support from spouse influenced coping used by fathers. Their level of parental role stress was not associated with any of their general characteristics. 4. In mothers, the level of general stress was different according to their health status, the level of parental role stress was related to satisfaction with family life and satisfaction with spouse. Their level of coping was associated with the support from spouse. The above findings indicate that mothers did not have more coping strategies than fathers did, despite the results which showed that mothers experienced greater stress than fathers did. Especially, the adaptation pattern of mothers was different according to their level of coping. Hence, nursing interventions directed at managing stress and improving coping should be used with mothers who use adaptation pattern 1. In particular, fathers should actively participate in parenting, and support their spouses.

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A Study on the Relationship of Perceived Self-efficacy and Sick-role behavioral Compliance in Diabetic children
Yeon Hee Choi
Journal of Nurses Academic Society 1996;26(1):127-137.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.1.127
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This study was designed to identify the relationship of perceived self-efficacy and sick-role behavioral compliance in diabetic children. The forty-two diabetic children participating in this study were selected from outpatients. The period of data collection was August 8 to December 9, 1994. Collected data were analyzed by means of chi-square test, t-test, Pearson correlation using SPSS/PC+. The result are summarized as follows: 1. The mean score of perceived self-efficacy was 3. 21 that of sick-role behavioral compliance 3.17. 2. Perceived self-efficacy and sick-role behavioral compliance had a positive correlation which was statistically significant (r=0.77, P<0.001). 3. There were statistically significant difference in perceived self-efficacy according to age(p<0. 01) and acknowledgment of prescribed calories in the diabetic diet (p<0.001). 4. There were statistically significant difference in sick-role behavioral compliance according to age(p<0.01) and acknowledgment of prescribed calories in the diabetic diet (p<0.001). These results suggest that perceived self-efficacy is an important variable in the compliance of diabetic children. Nursing intervention needs to be directed at promoting perceived self-efficacy to maintain sick ?role behavioral compliance for diabetic children. Therefore programs of nursing intervention should be revised in order to promote perceived self ?efficacy in diabetic children.

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Chlid Abuse in High-risk Group
Hye Young Ahn, Shin Jeong Kim, Ju Ae Ko
Journal of Korean Academy of Nursing 2002;32(6):775-783.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.775
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PURPOSE: The purpose of this study was to provide basic data on preventive child abuse program development. METHOD: Data were collected on 105 high-risk families of child abuse intervention was obtained from their main child rearer who raised the child under 18 years, olds during 10 months period from May, 2000 to March 2001. RESULT: The results were as follows : 1. Child abuse occurred in the subject's home, in the case of mild child abuse, 'throwing an object at the child' had the highest percentage 39.1%, in severe child abuse, 'rod, stick, belt, broom beating or using a variety of objects such as' had the highest percentage 49.5%, and in very severe child abuse, 'hospitalized by belting' had the highest percentage 3.8%. 2. The degree of child abuse potential showed high risk child abuse score with a mean of 213.3. The degree of beliefs in corporal punishment showed that subjects perceived corporal punishment of children positively with a mean of 32.2. 3. With respect to the child abuse potential, there were significant correlations with the subjects' age (r=.294, p=.002), education level (r=-.442, p=.000), and family income (r=-.355, p=.000). CONCLUSION: From this study not only child abuse occurrence but also child abuse potential were severely increased in poor livelihood families. Therefore to the high risk group, individual preventive approach must be applied.

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The Study on the Development and Effectiveness of Parent Role Education Program
Kyung Ja Han, Kyung Sook Bang, Mi Kyung Kwon, Jung Soo Kim
Journal of Korean Academy of Nursing 2001;31(3):417-431.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.3.417
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PURPOSE: This study was conducted to evaluate the effectiveness of the maternal role education program for primiparas in mother-infant interaction, childrearing environ- ment, and infant development. METHOD: A Non-equivalent control group time-series design was used. For the intervention group, programmed parenting education focusing on mother-infant interaction, home environment for infant development, and parent counseling and support was provided via home visits or telephone for twelve months.
RESULT
Significant differences were found in the mother-infant interaction feeding scale at one and three months, but no differences were found in the teaching scale at six and twelve months between the intervention and control groups. Also, the difference in childrearing environment (HOME) between the two groups was significant at three, six, twelve months. In addition, the intervention group showed higher GQ in the Griffiths mental development scale at three and six months. In multiple regression analysis, 22.6% to 43.6% of infant development was explained by HOME, mother-infant interaction, and previous development. CONCLUSION: The maternal role education program proved to be effective in promoting mother-infant interaction, organizing the childrearing environment, and fostering infant development.

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An Effect of the Mother-Child Attachment Promotion Program for the Child with Pervasive Developmental Disorder
Sook Bin Im
Journal of Korean Academy of Nursing 2000;30(5):1133-1144.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1133
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This study was conducted to evaluate the effects of the program for the autistic children which was designed to promote mother-child attachment. The subjects of this study were consisted of 11 pairs of mother and child( 7 for participant group:PG, 4 for non-participant group: NPG), who were diagnosed as Pervasive Developmental Disorder. The intervention was consisted with play activity centered mother-child interaction, educational activity for mothers, lecture, video-feedback, and supports. The main data were collected by video-taping and analyzed by Wilcoxon Rank Sign Test, and Content Analysis. The results obtained were as follows, 1. Before the program, there were no significant group differences on the children's and the mother's characteristics. After the program, total score on the attachment of PG was higher than that of NPG, but not significant. Only proximity-seeking behaviors and contact-maintaining behaviors were higher significantly(p<.05). Then the characteristics on contact- maintaining behaviors of PG were lasting longer and reciprocal than those of NPG. 2. After the program, the score on mother's nurturing behavior of PG was significantly more increased. The mother's behaviors to her child of PG became more child- centered, positively responsive, expressive supportively. But there were pretty big individual difference. It can be concluded that Mother-child Attachment Promotion Program is effective. Thus it can be recommended to be a early intervention model for autistic children.

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The Educational Needs of a Mother when Nurturing Children
Kyung Hee Yoo
Journal of Korean Academy of Nursing 2000;30(4):905-916.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.4.905
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The purpose of this study was to investigate the educational needs of a mother when nurturing children from neonates to the schoolage. A total of 657 subjects responded to the survey about the level of educational needs when nurturing children. The subjects of the study constituted of 401 mothers who visited the health center for immunization and 256 mothers who visited the pediatric outpatient department or whose children were hospitalized in pediatrics. This instrument had 64 items about nurturing children from neonates to the schoolage and one item had a score range of one to four. In data analysis, SPSSWIN 9.0 program was utilized for descriptive statistics. The results were as follows. 1) Mothers who had the neonates represented the highest educational needs about parental-neonates attachments with 3.47 of mean score compared to neonatal convulsion(3.44), management of common colds(3.44), nutrition(3.44), fever control (3.42). 2) Mothers who had infancy represented the highest educational needs about management of common colds with 3.34 of mean score compared to psychosocial developments (3.23), management of foreign bodies (3.22), feeding the food(3.19), playing with the infant(3.16). 3) Mothers who had toddlers represented the highest educational needs about psychosocial developments with 3.35 of mean score compared to discipline for children(3.34), management of teeth (3.29), management of common colds (3.21), management of accidents(3.20). 4) Mothers who had the a child in preschool represented the highest educational needs about psychosocial developments with 3.53 of mean score compared to management of accidents(3.23), discipline for children (3.00). 5) Mothers who had the child in secondary school represented the highest educational needs about psychosocial developments with 3.42 of mean score compared to management of teeth(3.13), management of accidents (3.05).

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A Study on the Preliminary Validation of a Postoperative Pain Measure for Parents for Children's Pain Assessment after Surgery
Hee Sun Shin, Yeon Yi Jung
Journal of Korean Academy of Nursing 2000;30(4):847-856.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.4.847
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Parents are primary care taker for the children and have an important role for the assessment and managent of children's pain following surgery. The purpose of the present study was to examine the validity and clinical utilization of the Postoperative Pain Measure for Parents (PPMP) developed by Chambers et al. Subjects were 52 children aged 4-12 years admitted for tonsillectomy and other minor surgery and their mothers. Faces Pain Scale, State Anxiety, and Postoperative Pain Measure for Parents were used. The data were collected by two research assistant on the operation day and 1st day after surgery at hospital during the period of July 20 to August 28, 1998. The results are as follows: 1. Eta correlation coefficient between 15 items of PPMP and child rated pain were calculated. Correlation coefficients were more than .2 for both day. 2. Internal consistency for PPMP were .82 and .83. 3. The scores of the PPMP were 10.73 (SD=3.71) and 9.27(SD=4.07) on the operation day and 1st day after surgery and there was no significant difference between two days(p=.056) On the other hand, there was a significant difference on the child rated pain by Faces Pain Scale between operation day and 1st day after surgery(p=.001). 4. The correlation(Spearman Rho) between PPMP and child rated pain were .40(p=.003) and .56(p=.000). The score of the PPMP and the children's state anxiety were highly correlated on the operation day and 1st day after surgery (.60, .52, p=.000). 5. Partial correlation between PPMP and child rated pain except state anxiety were .18(p=.23) and .48(p=.001) on the opration day and 1st day after surgery. 6. Using a cut-off score 10 out of 15, the measure showed excellent sensitivity (>80%) and moderate specificity (46.15%, 60% ). This study provides preliminary evidence for the use of the PPMP as a valid pain assessment tool with children between the ages of 4-12 years following surgery. It is suggested to explore the validity with a different subjects with other surgery and to examine the validity for infant and younger children.

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