• Title/Summary/Keyword: Chronic Illness child

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THE CLINICAL FEATURES OF THREE SUB-DIAGNOSED GROUPS OF TIC DISORDERS AND FACTORS RELATED WITH ILLNESS SEVERITY (틱 장애의 진단분류에 따른 임상특징과 질환 심각도와 연관된 변인들)

  • Jung, Hee-Yeon;Hwang, Jeong-Min;Chung, Sun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.115-124
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    • 2001
  • Objective:The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method:Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results:Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion:These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.

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An Ethnographic Study of Sanhubyung experienced by Women in Korean Postpartal Culture (한국의 산후 문화와 여성이 경험한 산후병에 관한 일상생활기술적 연구)

  • 유은광
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.825-836
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    • 1995
  • This ethnogrphic exploratory study sought to de-fine the meaning of Sanhubyung, as consequence from the perspective of the women who experienced it. A convenience sample of 9 elderly women in San Francisco. and 20 postpartal women and their 20 non-professional helpers during postpartum in Seoul, Korea were observed and interviewed for 23 months from January 1991 to December 1992 at the Human Development Center in San Francisco and at the hospital and their homes in Seoul, Korea. Sanhubyung was regarded as the consequence of "Doing a Sanhujori Wrongly," as a group of symptoms or sequelae which have two types of characteristics of symptoms . chronic and acute. It can be called a culture bound syndrome in the cultural context re-lated to childbearing phenomenon in Korea. If women violate the principles of Sanhujori, such symptoms can appear at various times : during the period of postpartum itself, at any time, periodically, especially at the anniversary of the child's birth, late forties, and in old age. Acute symptoms that can be classified into immediate and late types include painful and edematous gingiva, sensitive teeth, strange sensation and pain in the knees or backache. Besides, there is a localized sense of soreness and pain ; sense of being in a draft and cold, stomach upset, GI irritation, chilling, shivering, and tiredness, pain and dazzling in the eyes. Chronic symptoms occur in the head, neck, teeth, back, hands, knees, hands and feet, arms and legs, eyes, sinews and joints, bones, and in the body or as a whole. Generally these symptoms are pain, often accompanying a feeling of being cold and in a draft, regardless of actual weather conditions. In conclusion, this findings reflect the Oriental way of thought of causal relationship of women's health and illness based on the wholistic paradigm of harmony and balance of two forces, Yin(cold) -Yang(hot). It provides a challenge to the professional sector to rethink the effect of culture on health and illness. Finally, it suggests care providers use cultural assessment for the appropriateness of the intervention and quality of care for desirable health outcomes.

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Asthma in childhood: a complex, heterogeneous disease

  • Chung, Hai-Lee
    • Clinical and Experimental Pediatrics
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    • v.54 no.1
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    • pp.1-5
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    • 2011
  • Asthma in childhood is a heterogeneous disease with different phenotypes and variable clinical manifestations, which depend on the age, gender, genetic background, and environmental influences of the patients. Several longitudinal studies have been conducted to classify the phenotypes of childhood asthma, on the basis of the symptoms, triggers of wheezing illness, or pathophysiological features of the disease. These studies have provided us with important information about the different wheezing phenotypes in young children and about potential mechanisms and risk factors for the development of chronic asthma. The goal of these studies was to provide a better insight into the causes and natural course of childhood asthma. It is well-known that complicated interactions between genes and environmental factors contribute to the development of asthma. Because childhood is a period of rapid growth in both the lungs and the immune system, developmental factors should be considered in the pathogenesis of childhood asthma. The pulmonary system continues to grow and develop until linear growth is completed. Longitudinal studies have reported significant age-related immune development during postnatal early life. These observations suggest that the phenotypes of childhood asthma vary among children and also in an individual child over time. Improved classification of heterogeneous conditions of the disease will help determine novel strategies for primary and secondary prevention and for the development of individualized treatment for childhood asthma.

Renal scar formation after urinary tract infection in children

  • Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.55 no.10
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    • pp.367-370
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    • 2012
  • Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephropathy is not always acquired; rather, it reflects reflux-associated congenital dysplastic kidneys. The viewpoint that chronic kidney disease results from renal maldevelopment-associated VUR has led to questioning the utility of any regimen directed at identifying or treating VUR. Despite the recognition that underlying renal anomalies may be the cause of renal scarring that was previously attributed to infection, the prevention of renal scarring remains the goal of all therapies for childhood UTI. Therefore, children at high risk of renal scar formation after UTI should be treated and investigated until a large clinical study and basic research give us more information.

A Study of Labor Force Participation and Living Arrangement on Health Status and Subjective Life Satisfaction in Later Life (노인들의 노동시장 참여형태와 동거유형이 건강수준 및 주관적 삶의 만족도에 미치는 영향 연구)

  • Kang, Lee-Ju;Lee, Young-Ae
    • Korean Journal of Human Ecology
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    • v.19 no.6
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    • pp.1031-1044
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    • 2010
  • Corresponding to the rapid growth of the aging population without an adequate social safety net for the elderly, older people face great disadvantages due to sudden illness or poor health and a lack of support from the younger generation. Furthermore, older women are suffering from a drastic deterioration of their economic status because of insufficient retirement savings. Examining the impact of labor force participation and living arrangement on health status and life satisfaction in later life, it is important to consider gender differences in context of social policies for the elderly. Using data based on a stratified national sample of the elderly by the Korean Longitudinal Study of Aging (KLoSA), multiple regression model were used to estimate the relationships between labor force participation and health status and subjective life satisfaction concerning the quality of their later life. The result indicates that good health status and high level of life satisfaction are associated with the type of paid work status for the elderly men, but those are associated with the type of non paid work, such as family businesses employees for the elderly women. Significant differences in chronic health condition and subjective life satisfaction by employment characteristics are found among the elderly. In addition, older women's high level of life satisfaction was associated with the participation of the social activity. The major conclusion from these results should help us understand gender differences in the elderly and acknowledge further exploration of gender variations in these people's later life.

The Clinical Study for Empyema: 176 Cases (농흉의 임상적 고찰[176예])

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.475-485
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    • 1980
  • For the past 5 year 6 months from January 1975 to June 1980, 176 patients with empyema have been treated in Chonnam University Hospital. They were 134 males and 42 females ranging from ] 8 days to 69 years of age. [mean age: 26.1 years] The duration of illness prior to treatment was relatively shorter in pediatric group than in adult group, that is, the duration of less than 1 month was 89.5% in pediatric group and 38.0% in adult group. In bacteria study there were Staphylococcus 26.1%, Streptococcus 17.6%, E. coil 10.8%, Pseudomonas 10.8%, Diplococcus pneumoniae 5.7% and Candidia. And 4 children and 3 adults had infections of two species of bacteria. The underlying pathologic lesions were pyogenic pneumonia 34.7%, tuberculosis 29.5%, paragonimiasis 15.3%, trauma 9.7% and postoperative state. The over-all mortality rate was 1.7% [3 patients]. The causes of death were sepsis In 1 child and sepsis secondary to esophageal fistula in 2 adults. Adequate drainage and obliteration of the pleural space seems to be the most important aspect of treatment and can frequently be achieved by initial tube drainage in acute empyema, especially in the pediatric group. The chronic thick walled or loculated cavities required open window therapy, decortication, resection therapy and sterilization. Modified Eloesser`s operation and 0.3-0.5% potadine irrigation brought good result in the patients who had general weakness, marked pulmonary parenchymal destruction due to pyothorax, and pyothorax with severe bronchopleural fistula.

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Exploring Positive Psychology of Children with Type 1 Diabetes Focusing on Subjective Happiness and Satisfaction with Life (제1형 당뇨병 아동의 긍정적 심리요인에 대한 탐색적 연구: 주관적 행복감과 삶의 만족감을 중심으로)

  • Sohn, Min;Kim, Euiyeon;Lee, Ji Eun;Kim, Kwanghee
    • Child Health Nursing Research
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    • v.21 no.2
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    • pp.83-90
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    • 2015
  • Purpose: The purpose of this study was to describe the subjective happiness and satisfaction with life of children with type 1 diabetes and explore related factors. Methods: A descriptive cross-sectional study design was used and the study was conducted with children at a diabetes camp. Data were collected using a self-report questionnaire to explore positive and negative psychological factors. The questionnaire included Subjective Happiness Scale, Satisfaction with Life Scale, Perceived Stress Scale and the Center for Epidemiological Studies Depression Scale for Children (CES-DC), Multidimensional Scale of Perceived Social Support, and General Self-Efficacy Scale. Results: Data from 15 children were used for data analysis. The correlational analysis results showed that subjective happiness was positively correlated satisfaction with life, social support, and self-efficacy, and was negatively correlated with perceived stress. Satisfaction with life was positively correlated social support, and was negatively correlated with perceived stress. Conclusion: Results indicate that the positive psychology factors were closely related with social support and self-efficacy and may alleviate perceived stress and depressive feelings. Therefore, researchers and clinicians should include positive psychological factors in their health management model for children with chronic illness.

A Study on the Development of the Korean Family Resilience Scale (한국가족의 기능 회복력 측정도구 개발 연구 - 만성질환아 가족을 대상으로 -)

  • ;;;;Hesook Suzie, Kim
    • Journal of Korean Academy of Nursing
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    • v.32 no.4
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    • pp.560-569
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    • 2002
  • The purpose of this study was to develop an instrument to measure family resilience for Korean families with a chronically ill child, and to test the validity and reliability of the instrument. Method: The items of instruments used based on the researchers' previous study of concept analysis of Korean family resilience. Nineteen item scales were developed with five domains. In order to test reliability and validity of the scale, data were collected from 231 families, who had a child with a chronic illness. Data was collected between August and September of 2001 in a 3rd level University Hospital in Seoul, Korea. Result: The results were as follows: As a result of the item analysis, 19 items were selected from the total of 37 items, excluding items with low correlation with the total scale. Five factors were evolved by factor analysis, which explained 56.4% of the total variance. The first factor 'Family strength' explained 28.5%, 2nd factor 'Family maturity' 8.7%, 3rd factor 'The ability to use of external resources' 7.0%, 4th factor 'Control' 6.6%, 5th factor 'The driving force for finance' 5.7%. The attributes in these factors were different with those identified by concept analysis of the family resilience in Korean families from the previous study. Cronbach's $\alpha$ coefficient of this scale was .8039 and Guttman spilt- half coefficient was .8184. Conclusion: The study support the reliability and validity of the scale. Because the main concept of family resilience was family strength, there were distinct differences in dimensions of family functioning scales.

Breast Feeding Attitudes and Correlates of Intention of Breast Feeding of Mothers (모유수유 결정 관련요인에 관한 연구)

  • Shin Hee Sun;Jeon Mi Yang
    • Child Health Nursing Research
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    • v.2 no.2
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    • pp.35-44
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    • 1996
  • The purpose of this study was to examine the knowledge and attitude of breast feeding and to explore the predictive variables for the intention of breast feeding of mothers. One hundred and thirty-five mothers who delivered at the D University hospital during the period of May to June in 1996 comprised the sample. Data were collected by questionnaire methods before discharge at the hospital. Data were analyzed using percent, 1-test, and logistic regression. The results were as follows : 1. During their pregnancy, majority of mothers (74.8%) got the breast feeding information. Information sources were book (34.5%), family and relatives(32.4%), mass media(24.3%), and professionals such as nurses and doctors (8.8% ). The frequently reported sources of most encouragement for breast feeding were mother in law(20.7%) and baby's father (11.1% ). 2. The mean score of the items of Knowledge and Attitude toward Breast Feeding Scale were 42.56 (SD=5.47) and 39.07(SD=5.15) , representing positive attitude toward breast feeding. The correlation between knowledge and attitude score was significant(r 〓.54, p<.001). Knowledge of breast feeding were significantly different between breast feeding intention group (including partial breast feeding) and artificial feeding intention group(t=2.79, p<.01) 3. Logistic regression analysis revealed that feeding method in the hospital, delivery type, knowledge toward breast feeding, disease related to pregnancy, complication related to delivery, and educational level of mother were predictives of the intention of breast feeding. 4. The most frequently rated reasons for the plan for mixed feeding were concern about insufficient milk (37.9%) and work(27.6%), The major reasons for plan for artificial milk feeding were having premature baby(25.9%) and maternal health problems including infection(14.8% ) and drug use due to chronic illness (14.8%). From the result of the study, it is recommended to develop supportive nursing intervention strategy to promote breast-feeding intention and practice. The intervention could be more effective to begin early in pregnancy and include teaching for breast feeding skills as well as information provision for positive attitude formation.

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A Survey on Home Health Care Needs in Youn-Cheon County in Korea (일개 군지역의 가정간호 요구조사)

  • 한경자;박성애;하양숙;윤순녕;송미순
    • Journal of Korean Academy of Nursing
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    • v.24 no.3
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    • pp.484-498
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    • 1994
  • The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1, 352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below, 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and / or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the control and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1% of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal-neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior(8.89%), with health-re-lated educational needs(8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources(3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by com-munity based home care nurses.

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