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.

A quasi-experimental study was conducted to examine the effect of ice pack application to post cardiac surgery toddlers before C-tube removal. Twenty toddlers aged 13 months to 24 months, who were admitted to the hospital for open heart surgery during the period from July, 1993 to October, 1993 were randomly assigned to the experimental or control group. An ice pack was applied to the C-tube insertion site for 8 minutes before C-tube removal for the experimental group. The children were videotaped during the procedure to assess pain behavior and crying time. The score on the Modified Behavioral Pain Scale(MBPS), crying time, and vital signs were measured to determine the effect of ice pack application. The data were analyzed using Mann-Whitney U test, Paired t-test, and Pearson corelation coefficient. The result of the study are as follows: 1. There was a significant difference between the experimental group and the control group in pain behavior (U=17.0, p=.01). 2. There was no significant difference between the two groups in crying time. 3. There was a significant difference between the two groups in heart rate(U=24.5, p=.05). 4. There was a significant difference between the two groups in systolic blood pressure(U=24.0, P=.05). 5. There was a significant difference between the two groups in diastolic blood pressure (U=23.0, p=.04). 6. There was no significant difference between the two groups in respiration rate. 7. Pain behavior was significantly correlated with heart rate, systolic blood pressure, and crying time(r=.50, .54 and .59, p<.05). The result showed that the ice pack application was effective to reduce pain related to C-tube removal for the toddlers. From the study, it is recommended that the effectiveness of the cold application to children undergoing different painful procedures be examined to determine the most effective length of cold application to reduce pain in children.

PURPOSE: The purpose of this study was to examine the effects of sensory stimulation on premature infants.
METHOD
Thirty three premature infants admitted to NICU of D University Hospital in C city were randomly assigned in two groups (Experimental group: 16, Control group:17). For the experimental group, tactile and kinesthetic stimulation developed by Dr. Field was applied 2 times a day for 10 days. Behavioral state was measured using the Anderson Behavioral State Scale (ABSS). Heart rate, respiration, and oxygen saturation were obtained for each infant before and after sensory stimulation. Hypothesis testing was done using the X2- test, student t-test, and repeated measures of ANOVA.
Result
Hypothesis 1: There was a significant difference in the daily body weight gain between experimental and control group (F= 40.77, p= .0001). Hypothesis 2: There was a significant difference in the frequency of 'inactive awake state' between two groups (X2= 39.778, p= .001). Hypothesis 3: There were significant differences in the mean of heart rate and O2 saturation between two groups (t= -2.174, p= .037; t= 3.080, p= .005). However, there was no significant difference in the mean of respiration rate between two groups (t= -1.966, p= .581).
CONCLUSION
The effectiveness of a sensory stimulation on weight gain and behavioral state in premature infants was supported. Further study is recommended to develop a sensory stimulation method as an independent nursing intervention for premature infant.

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.

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.