• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.9 no.1
• /
• pp.13-25
• /
• 1998

Aim：We think that the most important etiology in parent abuse is the psychodynamic and psychopathology in the family. So, we investigated the adolescents being admitted in SNMH, whose chief complaints were parent abuse. We were trying to explore families psychodynamic and psychopathology, especially mother-child interaction and to differentiate them in according to developmental psychopathology. Method：Our objects were the adolescent patients admitted in SNMH from 1987 to 1997 because they attacked parents verbally and physically. We examined 21 adolescents except those with psychosis, organic mental disorder, autism and mental retardation by means of interview or chart review. Result and Conclusion：The number of male patients was 14 and the number of female patients was 7. The most common diagnosis was conduct disorder and borderline personality disorder. The mean age was in the mid-teens. We observed 4 subgroups that were divided developmentally in object relation. 1) Symbiotic group with mother：(1) They did not separate and remain in symbiotic relationships with their mothers based on insecure attachment. Fathers were abscent emotionally and physically, and their mothers were prominent in close relationships with the patients in their family , where as the patients were the only man in the family. Adolescents entered the second separation-individuation. They expressed anger and internal tension involved with the close attachment with their mothers and also attempted separation from their mothers through physically attacking them. (2) These patients had suffered from physical illness and developmental delay since birth. Therefore the parents overprotected their children. The children had persistent infantile omnipotence and fantasies of power, so they could not deal with unrealistic states, adapt to reality, and depended on their parents overtly. They easily acted out unless their demands were fulfilled. 2) Borderline personality disorder：We observed deficiencies in care taking. Their parents had personality problems and immaturity. They coulden’t help their children to be separated in the rapproachment phase. Their conflict about dependence-independence was revived in the second separation-individuation adolescent period. We understand parent abuse as an attempt to overcome the conflict. 3) Conduct disorder：They did not build up basic attachment with their parents. They think of their parents as only a means of fulfilling their needs. When patients’ need were not fulfilled and remained in a conflicted state, they attacked their parents, unable to control their aggressions and impulses.

• Korean Parent-Child Health Journal
• /
• v.10 no.2
• /
• pp.147-157
• /
• 2007

Purpose: Assessment of stress and coping effort of hospitalized children's mother are very important factor to support and recover the children. The purpose of this study was to identify the stress and coping effort in mothers whose children are hospitalized. And analyzes the correlation between mother's stress and coping effort on the hospitalized children. Method: This study surveyed 70 mothers whose children are hospitalized. The data was collected for this study at one university hospital in Daejeon from June 1,2007 to July 10, 2007. The instruments used in this study were the mother's stress scale which was developed by Ok-Nam, You(1998), modified by Ho-Jin, Mun(2001), and the mother's coping effort were measured with the Coping Health Inventory for Parents(CHIP) developed by McCubbin and Patterson(1981). The data was analyzed by using SPSS program and include ANOVA, and Pearson's Correlation. Result: The mother's stress was average 2.42 out of a possible 4 points. Type of coping effort was in order of type III(cope with it by understanding medical circumstances)(M=2.73), type I(Cope with it through positive definition)(M=2.43), type II (cope with it by maintaining psychological stability)(M=2.28). Total coping effort according to general character of mothers whose children are hospitalized showed a significant difference in occupation(P<.05). Correlations between mother's stress and total coping effort was r=-.361(P<.05). Conclusion: This study based on nursing of stress and coping effort of hospitalized children's mothers. Pediatric nurses need to establish a stronger communication board and a relationship between medical staff and children's parents so that have supportive information. And to establish a support program that strengthens the coping effort of hospitalized children's mothers.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.8 no.2
• /
• pp.287-297
• /
• 1997

Conduct disorder has been subclassified by the symptom characteristics of socialization, aggression, or age of onset. In ICD-10, ‘Conduct disorder confined to family context’ has been developed as a distinct subtype. Which delineates the conduct problems which take place only in the family and related situation. These authors experienced a case which presents a child who shows aggressive and violent behavior to his parent and brother, severe tamper tantrum and destructiveness only in family. By through history taking, observation and treatment after admission, we could find that insecure and ambivalent attachment between parent and child due to chronic neglect and abuse, and inconsistent parental behavior contribute to many behavioral and emotional problems of this child. We reviewed the relationship between conduct disorder and family pathology and treatment strategy for conduct disorder with family problems.

• Korean Parent-Child Health Journal
• /
• v.9 no.1
• /
• pp.3-16
• /
• 2006

Purpose: The purpose of this study was to provide basic data for hospitalized children under the condition of painful procedure. Method: The data were collected from July 15th to Oct 30, 2003 from 68 hospitalized children suffer from acute disease, 68 mothers take care of children, 14 pediatric ward nurses. To evaluate the degree of pain perception of children, mothers & nurses, face pain rating scale and behavior characteristic were used. Result: The result were as follows. 1) The pain perception score of children, mothers & nurses. child perceived highest as the score of 3.60 2) The most frequent behavioral characteristic children were 'crying(47.1%)' mothers were 'soothing the child(54.4%)' and nurses were 'support not to move(52.9%)' 3) The degree of pain perception of children, mothers and nurses according to subjects' general characteristics and painful procedure, there were stastical difference according to children's age, mothers age and duration of painful procedure 4) There were significant correlation between the degree of pain perception and behavioral characteristics of children, mothers & nurses. Conclusion: Nurses should not underestimate children's pain and need to provide knowledge and information to the child and their parents regarding painful procedure.

• Korean Parent-Child Health Journal
• /
• v.8 no.2
• /
• pp.97-111
• /
• 2005

Purpose: The purpose of the study was to analyze the families values of the family with hospitalized children in order to offer descriptive data, which will facilitate family adjustment in those families. Method: It's intended in this study, as of descriptive approach, to verify the theoretical framework based on McCubbin's Resiliency Model and to examine the influence of family values on family adaptation. The survey was conducted from June 20, 2003 to November 30, 2003 and the analysis included 202 parents of the hospitalized children. The data analysis utilized SPSS 11.0 program. Result: The correlation coefficients among major variables showed that family stressor was positively related with family strains(r=.249, P<.01), and negatively related with family hardiness(r=-.183, P<.05). Family strains was negative related with general family value(r=-.243, p<.01), and family adaptation(r=-.505, P<.05). Correlations of general family value was positive with family hardness (r=.153, p<.05), and family adaptation (r=.200, p<.01). Conclusions: There was correlating relationship between family strains and family adaptation, and general family value showed correlation with family strains, family hardiness, and family adaptation. Theresfore the continuing future research on the relationship between family value and family adaption is necessary.

• Child Health Nursing Research
• /
• v.11 no.3
• /
• pp.273-281
• /
• 2005

Purposes: The purposes of this study were to evaluate parent satisfaction with inpatient hospital services in children's hospitals and to identify variables related to parent satisfaction. Method: A descriptive correlation study was conducted. Parents of 165 children who were inpatients in two children's hospitals participated in the study. Data were collected using structured questionnaire at the time of discharge. For statistical analysis, t-test, ANOVA, and Pearson correlation analysis were used. Results: The highest parent satisfaction domain was nursing service, and the lowest parent satisfaction domain was hospital service and accommodations. Parents were less likely to be satisfied with hospital facilities, equipment, noise and cleaning and less likely to be satisfied with the lack of information they received and with the lack of communication with health care professionals. Parents with longer length of stay and with older children reported higher satisfaction than their counterparts. Moreover, parent satisfaction was related to their intention to revisit and related to intention to recommend this surveyed hospital over others. Conclusions: Efforts to improve parent satisfaction in children's hospital service and accommodation are needed to improve the quality of health care. Communication by health care professionals with parents and a partnership between parents and health care professionals are necessary to improve quality of care.

• Korean Parent-Child Health Journal
• /
• v.9 no.2
• /
• pp.150-160
• /
• 2006

Purpose: This study was to examine how an invasive procedures education program affected the anxiety and supportive behavior of mothers with hospitalized children, and to help provide an efficient to improve their maternal role performance by boosting their supportive behavior. Method: To evaluate their anxiety, Spilberger(1972)'s Anxiety Inventory that was translated by Kim Jeong-taek, et al.(1978) was employed, and Weon Dae-yeoung(1999)'s modified version of Melnyx(1994)'s Index of Parent Support During Instructive Procedure was utilized to assess their supportive behavior. The collected data were analyzed with SPSS program. Statistical data on real number and percentage were acquired, and $x^2$-test and t-test were conducted. Result: There was a more favorable change in the anxiety(trait anxiety and state anxiety) of the experimental group that participated in an invasive procedures education program(a mean of -0.14) than in that of the control group that didn't(a mean of 0.16). The experimental group(an average of 4..65) outstripped the control group(a mean of 3.42) in that regard. Conclusions: The invasive procedures education program that catered to the mothers with hospitalized children turned out to be effective in easing their anxiety and enhancing their supportive behavior.

• Childhood Kidney Diseases
• /
• v.15 no.2
• /
• pp.179-183
• /
• 2011

Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.

• Journal of Hospice and Palliative Care
• /
• v.7 no.2
• /
• pp.221-231
• /
• 2004

Purpose: The purpose of this study was to analyze the need for child hospice care programs in families of children with cancer. Methods: The survey of 104 families who were taking care of children with cancer was conducted. This survey was conducted from February 2004 to July 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .94 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of 3.40 (${\pm}3.8$). The need for 'emotional care of children' showed the highest mean (M=3.55), 'management of terminal physical symptoms'(M=3.49), 'control of secondary physical problems' (M=3.41), 'acceptance of the family's difficulty' (M=3.20), 'spiritual care for preparing for death'(M=3.17), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the child's mother's age (F==4.980, P=.009), whether or not there were cancer patients among their siblings or relatives (t=2.423, P=.017). Conclusion: The family of children with cancer have a heavy burden of ambivalence, especially in relieving the anxiety and fear of their children, communicating about death, and managing physical symptoms. Child hospice care must be provided considering the needs of families of children with cancer. Thus popular needs as well as hospice nurses' higher concern and support for hospice care of children require further education and program development to meet the current demands.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.18 no.3
• /
• pp.87-94
• /
• 2018

We present the case of long-term observation of a patient with chronic kidney disease (CKD) caused by advanced focal segmental glomerulosclerosis (FSGS) resulting from underlying congenital chloride diarrhea (CLD). A 20-year-old woman was admitted for prolonged proteinuria despite conservative treatment for CLD. She was diagnosed with CLD and started taking KCl salt supplementation from the time of birth. Mild proteinuria was first found at 12 years of age, which progressed to moderate proteinuria at 16 years of age. At 16 years of age, CKD stage 2 with FSGS was diagnosed based on the initial assessment of the glomerular filtration rate (GFR) and kidney histology. On admission, we re-assessed her renal function, histology and genetic analysis. GFR had deteriorated to CKD stage 4 and renal histology revealed an advanced FSGS combined with tubulointerstitial fibrosis. A homozygous mutation in the SLC26A3 gene (c.2063-1G>T) was found by diagnostic exome sequencing and may have been inherited from both parents. CLD patients can be more vulnerable to renal injury, which may also cause progression of renal failure. Therefore, even if there is an early diagnosis and adequate salt supplementation, close monitoring of renal function and tailored treatment should be emphasized for renal protection and favorable CLD prognosis.