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.

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.

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.

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.

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.

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.

Accidents are the leading cause of death in children worldwide. The purpose of this study is to use basic data of safety education, counseling, and information available regarding accident prevention to examine the degree of mother's accident prevention practices for their children. Data were collected from June to October, 1998 from 587 mothers including 2 University hospitals located in Seoul and KyoungKi-Do. By using the 30 item questionnaire, which was created by researchers through literature review, the degree of mothers' accident prevention practices for their children was measured. The degree of accident prevention practices of mothers shown ranged 70-118 and averaged 3.19. Compared to the composit area average score, drug keeping had the highest score of 3.57. The next highest scores and traffic safety(3.41), and super vision of child(3.30). Prevention against burning was the lowest point at 2.58. With the respect to the demographic characteristics, there were statistically significant differences in the mothers' education(F=4.291, p=.014), type of residence(F=3.979, p=.008), and child developmental age(F=5.275, p=.001). The degree of accident prevention practices of mothers were relatively high. But the area which showed the low degree of accident prevention practices, required nurses' active education, counseling, social interest and support, and mass media participation.

The main purpose of this study was to identify the effects of group social support and individual social support on the reduction of burden and improvement in family functioning of families with asthmatic children. The design of this study was a randomized pre-posttest quasi-experimental design to compare the two experimental groups. The theoretical framework for this study was derived from the study of burden in family caregivers by Suh and Oh(1993) based on the main effect model of social support theories. The data were collected from February 12, 1998 to May 29, 1998 at the pediatric out patient department of a university hospital located in Suwon city. The sample consisted of 39 family members who were identified as families with asthmatic children, Eighteen subjects were randomly assigned to the group social support group and 21 were assigned to the individual social support group. Group and individual social support members were seen for 60 to 90 minutes, four times over one to three weeks. The instruments used in this study were the Burden Scale developed by Suh and Oh(1993), the Visual Analogue Scale, and the Family Adaptability Cohesion Evaluation Scale(FACES-III) developed by Olson, Portner, and Lavee(1985). The collected data were analyzed using Mann-Whitney test, x2-test, Wilcoxon sign rank test, t-test, ANOVA(Scheff), pearson correlation coefficient, multiple regression, and social support process and content analysis. The results are as follow ; 1. There was no significant difference before the experimental treatment among the subjects in the group social support group and individual social support group for general characteristics, burden, or family functioning. 2. Hypothesis 1 ; "There will be a greater reduction on the burden score of the group social support group compared to the individual social support group" was not statistically significant(U=174.5, p=.683). The burden scores showed a significant decrease after participation in social support as compared to before participation for both groups. However there was a tendency for more reduction in the burden scores for the group social support than for individual social support. 3. Hypothesis 2 ; "There will be a greater improvement in the family functioning scores for the group social support group compared to the individual social support group" was not statistically significant(U=153.0, p=.309). There was a tendency toward improvement in the family functioning scores of the group social support as compared to that of the individual social support. 4. According to the length of the treatment period, families with asthmatic children displayed affirmative responses, and the families set up a self-help group of mothers with asthmatic children n order to share their experiences, to get information and to solve their problems. In conclusion, it was found that group social support was the more effective nursing intervention for reducing burden and for improving family functioning of families with asthmatic children.

The purpose of this study was to describe the relationship between family stress and adaptation in families with a disabled child through literature review using McCubbin's Double ABCX family crisis framework. The literature review focused on (1) family stress and factors affecting family stress, (2) the critical individual, familial and social resources which families acquire and employ over time in managing crisis situation, (3) the changes in definition and meaning families develop in an effort to make sense out of their predicament, (4) the coping strategies families employ, and (5) the range of outcomes of these family efforts The results showed that families reported financial difficulties and the burden of care-giving demands as major family stressors. Siblings of disabled children manifested depressive symptoms and social isolation, but was not consistent study results. The parents' views of the cause of the disabling condition fundamentally affected their behavior toward their disabled child. Especially, the fathers' views of the child's characteristics made the greatest contribution to positive changes in the mothers' perceptions. The term perceived social support refers to the cognitive appraisal by individuals that they are cared for and valued, that significant others are available to them if needed, and that they are satisfied with their interpersonal relationships. The perceived social support was more protective than social support source, network size and network density. Parental adaptation was found to be related to the child's communication competence rather than family coping strategies proposed by Lazarus and Folkman. One study results showed that there was no difference in depressive symptoms and physical health between mothers with a disabled child and those without all though mothers with a disabled child had negative attitudes and perceived themselves as having significantly less social support and lower family functioning. But a longitudinal study revealed decreases in the negative impact of the child and increases in sibling and overall family adaptation.

Accidents involving children are an important cause of death and disability. They also have enomorous financial implication. In order to prevent childhood accidents, research and education for safety should be strengthened. The purpose of this study was to determine how often young children have accidents and what factors affect the accident rate. The sample consisted of 771 children who were in the second, third and forth grades of two elementary schools located in Kyung-gi Province. One school had students from middle class families living in apartment complexes and the other, students from lower income families mainly living in single house. The questionnaires included items on the occurrence of accidents and the parents' attitudes regarding accidents during the academic year from March 1997 to February 1998. The questionnaires were distributed to conveniently selected students to be completed by their parents and collected during the period of May 28, to June 6, 1998. The data were analyzed using SAS PC statistical package. The results of the study are as follows : 1. Of 771 student subjects, 393 had 887 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were May, Sunday, and between 1 and 4 p.m. each. 3. In the analysis of the location where the injury took place, the most frequent place was on around their homes followed by school and, then, inside the home. 4. Most of the accidents were caused by carelessness on the part of the children and the most frequent type of injury was an abrasion. 5. Children most injured their legs. 6. They were treated at home most often and usually emergency treatment was performed by family members with, disinfection being the main type of first aid. Cost of the treatment ranged from 8,000 to 20,000 won in most cases. 7. House type and parents' education level were statistically significant in chi-square analysis. 8. Parents educate their children about traffic safety most frequently followed by fire safety and, then, prevention of violence. 9. Parents think that prevention of violence should be the most important part of injury prevention education both at school and home. 10. To identify factors related to accident occurrence, multiple logistic regression was performed and the main factors were birth order and house type.

The purpose of the study was to investigate the level of health behavior of school-age children and to identify the predicting variables of the school-age children's health behavior. The subject were 467 children in grades four to six, enrolled in two elementary schools located in two cities. The mean age of the subject was 10.03(SD=1.33). The data were analyzed using t-test, ANOVA, correlation analysis, and stepwise multiple regression. The result are as follows: 1. The mean of the score of health behavior of the school-age children was 154.6, showing thar they are practicing health behavior relatively well. 2. There were significant differences in the mean scores of health behavior according to grade(F=6.53, p=.001), sex(t=-3.70, p=.000), educational level of the parents(F=4.92, p=.002; F=4.47, p=.004), occupation of the patients(F=3.31, p=.003;F=4.76, p=.000), and socioeconomic status(F=11.87, p=.000). 3. There were significant correlations between health behavior and health motivation(r=.53, p=.000). self-concept(r=.32, p=.000), perceived health status(r=.16, p=.000), and health locus of control(r=.15, p=.001). 4. Health motivation, self-concept, grade, socioeconomic status, and health locus of control were identified as predictor variables of health behavior of the school-age children from the stepwise multiple regression analysis. The total percent of variance accounted for by these five variables was 35.0%. From the result, it is suggested that in the development of a school health education program, the effect of health motivation and self-concept to promote student's health behavior in school-age children should be considered.

This study was designed to investigate the effects of information by using cartoon on preoperative anxiety of children following tonsillectomy. The subjects were 30 children aged between 7 and 12 who were hospitalized at C university hospital for undergoing tonsillectomy from December 20, 1996 to August 14, 1997. Sixteen of them were assigned to the experimental group, while fourteen subjects to the control group. The data were collected through preoperative state anxiety, pulse rate, pain before and after giving information by using cartoon. The results were as follows : 1. Preoperative state anxiety increased in both groups(P=0.0348). No significant difference found between experimental and control group. But preoperative anxiety in experimental group was apt to increase less than that in the control group. 2. Pulse rate didn't make significant difference within and between groups. 3. Pain increased in both groups(P=0.0001). No significant difference found between experimental and control group. 4. Experimental group between the aged 7 and 9 decreased preoperative state anxiety, but experimental group between the aged 10 and 12 increased preoperative state anxiety after treatment(P=0.0298). These findings may indicate that the information by using cartoon is effective in children between the aged 7 and 12.

This study is to define the caring experience of mothers with insulin-dependent diabetes mellitus children, by finding core category, contextual factors, intervening factors, and the patterns of caring, and to develop a practice theory on it. Research method followed grounded theory methodology by Strauss and Corbin. Subjects were six mothers, whose children have had insulin-dependent diabetes mellitus for 4 months to 14 years by the interview time. They were selected by theoretical sampling. Data were collected from September, 1995 to January, 1996. Interview were done by long interview took 50 minutes to 2 hours. Content of interview was recorded and transcribed later. Based on the results of previous interview, content of next interview was planned until data reached to the saturation point. Results were as follows : One hundred and forty concepts were found. These concepts were grouped into thirty-three categories, and then to ten categories. Mothers with diabetic child were revealed to face "being overwhelmed by burden". Overwhelming by burden is found to be progressed through the cycle production-coping-decrease or in crease process. Mothers showed four patterns of adaptation in caring the diabetic children. 1) If mothers felt large amount of overwhelming by burden because of difficulty of caring and unsympathizing but they had sufficient support, no condition of the child, and their coping mechanism was positive, most of them overcome with strong will, but some fell into burnout. 2) If mothers felt large amount of overwhelming by burden because of difficulty of caring, unsympathizing, insufficient support, serious condition of the child, and their coping mechanism was negative, they fell into burnout by coping with feeling. 3) In mothers felt small amount of overwhelming by burden because of little difficulty of caring and sympathizing, sufficient support, no serious condition of the child, but their coping was negative, most of them fell into burnout by coping with feeling, but some overcome. 4) If mothers felt small amount of overwhelming by burden because of little difficulty of caring and unsympathizing, sufficient support, no serious condition of the child, and their coping was positive, they overcome with strong will. On the basis of the above result, in order to help mothers take good care of their children, nursing assesment and intervention on life readjustment, and getting support should be required. Especially, through understanding mothers' personalities, individual support consistent with each of them should be required. Therefore education, counseling, mutual support and exchange of information will have to be accomplished.

PURPOSE: The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. METHODS: Thirty-two participants (BMI≥85 percentile or relative obesity≥10) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM-intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gymbased exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits (diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. RESULTS: The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. CONCLUSION: This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.