• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.4
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• pp.213-219
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• 2017

Objectives: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. Methods: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. Results: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. Conclusion: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.

• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.211-217
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• 2017

Purpose: The purpose of this study was to trace the development of premature babies who had undergone neurodevelopmental treatment in the neonatal intensive care unit and to identify the effects of early neurodevelopmental treatment on the development of premature babies. Methods: Fifty-one premature babies, who had been hospitalized in the neonatal intensive care unit and received an infant motor performance test and Bayley scales-III evaluation of their developments during the six months of corrected age were included. They were divided into three groups: the intervention group (n=16), control group (n=23), and comparison group (n=12), depending on the risk of developmental delays and the existence of an intervention. The results of this study were analyzed using SPSS 22.0 for windows. The statistical significance level was set at ${\alpha}=0.05$. Results: Regarding the infant motor performance test scores for each group before the intervention, at two weeks after the start of intervention, and at post-conception of 40 weeks, the intervention group showed a significantly higher improvement than the control or comparison group (p<0.01). With respect to the Bayley scales-III at the corrected age of six months, the intervention group exhibited statistically significant differences from the control group in the domains of language and fine movements (p<0.01). Conclusion: The findings of this study could confirm that the early neurodevelopmental treatment of premature babies in the neonatal intensive care unit has continuous effects on the development of premature babies even after being discharged from the hospital.

• The Journal of Korean Physical Therapy
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• v.30 no.3
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• pp.90-95
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• 2018

Purpose: To investigate the relationship between gross motor capacity and neuromuscular function in children with cerebral palsy (CP) through a short-term intensive intervention. Methods: Twenty-four children younger than 6 years of age (17 boys, 7 girls, mean $age{\pm}standard$ deviation, $42.71{\pm}14.43months$) who were diagnosed with CP underwent short-term intensive treatment for 8 weeks. An evaluation of gross motor function capacity using the gross motor function measure (GMFM-66 and GMFM-88) was performed to measure muscle strength, selective motor control (SMC), and spasticity, factors related to neuromusculoskeletal function. Changes in spasticity, strength, range of motion, selective motor function, and exercise intensity scores were evaluated in terms of the gross motor function classification system (GMFCS) and ages. Results: The GMFM-88 and GMFM-66 scores significantly increased, by $4.32{\pm}4.04$ and $2.41{\pm}1.51%$, respectively, following the 8-week intervention. The change in the GMFM-66 score did not reflect a statistically significant difference in the GMFCS level. However, there was a statistically significant difference in the GMFM-88 score change in individuals at GMFCS Level III, the strength and spasticity of subjects at GMFCS Levels I-II did not significantly differ (p<0.05). The changes in the GMFM-66 scores for strength, SMC, range of motion (ROM), and spasticity significantly differed according to age (p<0.05) in children aged 36 months and older. Overall, there was a statistically significant difference in strength, SMC, and spasticity (p<0.05) before and after intensive short-term treatment. Conclusion: The 8-week short-term intensive care intervention improved the motor function score of study participants, emphasizing the need for early intervention and additional research in this area.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.2
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• pp.109-119
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• 2018

Purpose: The purpose of this study was to investigate the effects of a delirium prevention intervention for patients in neurology and neurosurgery intensive care units (ICUs). Methods: This study was a quasi-experimental study. Participants were 87 patients. The experimental group was provided with nonpharmacologic and multicomponent delirium prevention interventions, consisting of regular delirium assessment, improvement in orientation, early therapeutic intervention, and environmental interventions. The control group was provided with routine intensive care. Data were analyzed using $x^2$ test, Fisher's exact test, and t-test. Results: Both groups were homogeneous. The incidence of delirium and length of hospitalization were significantly lower in the experimental group compared to the control group. ICU stay, mortality and unplanned extubation were lower in the experimental group compared to the control group, but there was no significant difference. Conclusion: Findings indicate that the delirium prevention intervention is effective in reducing incidence of delirium and length of hospitalization. Therefore, this intervention should be helpful in preventing delirium in neurology and neurosurgery ICUs and can be used as a guide in the prevention of delirium in neurological diseases's patients.

• Journal of Korean Critical Care Nursing
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• v.4 no.1
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• pp.25-35
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• 2011

Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

• Clinical and Experimental Pediatrics
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• v.64 no.9
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• pp.436-442
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• 2021

This article aimed to summarize the impact and burden of pediatric postintensive care syndrome (PICS-p) in the physical, mental, cognitive, and social health domains after a review of the current pediatric literature in MEDLINE and PubMed. We also aimed to elucidate the limitations of the current evaluation tools used in limited-resource settings. PICS-p can impact a child's life for decades. Most validated tools are time-consuming, require qualifications, and expertise, are often limited to older children, and can evaluate only one domain. A novel, simple, and comprehensive surveillance tool can aid healthcare providers in the early detection and intervention of PICS-p. Further studies should validate and refine the parameters that will enhance the outcomes of pediatric intensive care unit survivors.

• Journal of Korean Academy of Nursing
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• v.49 no.6
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• pp.724-735
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• 2019

Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

• The Journal of Korean Academic Society of Nursing Education
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• v.22 no.3
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• pp.316-325
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• 2016

Purpose: This study was conducted to identify the effects of early exercise education using videos on exercise knowledge and compliance of elderly patients who undergo total knee replacement surgery. Methods: This is a quasi-experimental study with a nonequivalent control group non-synchronized design. The participants were 70 elderly patients who had total knee arthroplasty in the C university hospital located in G city, Korea. Thirty-five patients were assigned to an experimental group and the other patients were assigned to a control group. After the total knee arthroplasty, the early exercise education accompanied by watching video instruction was conducted on the experimental group at post-operation second and third day for 15 minutes. General exercise education was administered to the control group. The exercise knowledge and compliance of the elderly patients were measured through structured questionnaires. Conclusion: The results of this study indicate that early exercise education using videos has positive effects to improve the exercise knowledge and compliance of elderly patients after total knee arthroplasty. This early exercise education can be used going forward as nursing intervention for elderly patients who undergo total knee replacement surgery.

• Journal of the Korean Home Economics Association
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• v.43 no.12 s.214
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• pp.97-111
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• 2005

Early Head Start (EHS) can provide services to a child and family from pre-birth until the child is three years old. Services are comprehensive, intensive, individualized and flexible according to child and family needs, and integrated with community service delivery systems. The local program designs and operations were developed and carried out within the framework of the Head Start Revised Performance Standards, which included specific provisions for services to pregnant women, infants and toddlers and emphasized prevention, early intervention, safety, and health education. As with preschool Head Start, EHS programs are required to make available 10 percent of their enrollment for infants and toddlers with disabilities as defined by Part C regulations of the state in which the program operated. Quality child care has become a priority for EHS. A majority of EHS children need child care, and the quality is important to their development. An evaluation of EHS in 17 programs selected from the first program cohorts showed that the program had significant and positive impacts on a wide range of parent and child dimensions, some with implications for children's later school success. Among the issues for policy attention identified by American EHS for the Korean system are: - The need to create a comprehensive infant/toddler care system - The need to address access of teachers for young children - The need to improve quality.

• Biomolecules & Therapeutics
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• v.25 no.6
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• pp.569-577
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• 2017

Sepsis is a syndrome characterized by systemic inflammatory responses to a severe infection. Acute hyper-inflammatory reactions in the acute phase of sepsis have been considered as a primary reason for organ dysfunction and mortality, and advances in emergency intervention and improved intensive care management have reduced mortalities in the early phase. However it has been recognized that increased deaths in the late phase still maintain sepsis mortality high worldwide. Patients recovered from early severe illness are unable to control immune system with sepsis-induced immunosuppression such as immunological tolerance, exhaustion and apoptosis, which make them vulnerable to nosocomial and opportunistic infections ultimately leading to threat to life. Based on strategies to reverse immunosuppression, recent developments in sepsis therapy are focused on molecules having immune enhancing activities. These efforts are focused on defining and revising the immunocompromised status associated with long-term mortality.