• Child Health Nursing Research
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• v.12 no.2
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• pp.215-222
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• 2006

Purpose: This study was done to identify the effects of the distraction generated by character stamp and stickers on reduction of intravenous injection pain. Method: This study was conducted using a quasi experimental non-equivalent control group non-synchronized design. 60 preschool children who admitted to a Pediatric Department in a C University Hospital were selected as subjects. Convenience assignment was used. The two groups were homogeneous on characteristics. Results: In the experimental group, objective pain(t=3.666, p=.001), subjective pain (t=3.415, p=.001) and perceived pain by the mother(t=2.528, p=0.014) decreased after intravenous injections than the control group. There were no statistical significant differences in pulse rate or fear between the experimental and the control group.　Conclusion: These findings indicate that using character stamp and stickers could be considered as an independent nursing intervention for intravenous injection pain reduction in preschooler.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.510-516
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• 2020

This study investigated the characteristics and factors affecting inpatient infants, children, and adolescents who experienced falling, using NHDIS data from 2008 through 2017, The study analyzed data of 116 patients who were under 18 and who experienced injuries (KSCD, S00-S99) by falling (KSCD, W00-W19). Frequency analysis, cross-tabulations, and multiple regression analysis were conducted, using SPSS 23. There were more boys than girls, and most of the falls occurred at the ages of over one to under six years old. Most of the children had respiratory diseases, and most had open wounds or bruises due to falling. Also, most of the falls were related to the bed. In the factor analysis, age (β=.318), the main diagnosis (β=.231), and injury (β=.169) except gender affected falling. This suggests that it is necessary to conduct fall prevention education for children, considering the developmental stage characteristics and age group. It is necessary to screen the risk group such as children with a disease with relatively less restriction of activities or with a hyperactive disorder, and to develop a related manual. Hopefully, the results will be used as the basic data for fall prevention education and creating a fall prevention manual according to the characteristics of children's developmental stage for patients who need hospitalization, their caregivers, and the relevant medical team.

• Journal of Korean Academy of Nursing
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• v.24 no.3
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• pp.389-412
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• 1994

This study was done to investigate stress and coping methods of mothers with brain disease children. The subjects for this study were obtained by taking a sample of mothers with brain disease children hospitalized in neurosurgery ward of K medical center in Seoul from Nov. 20, 1992 to Mar. 10, 1993. The collected date were analized by S.P.S.S. program(frequency, percentage, mean, t-test, ANOVA, Pearson Correlation). The results of the study were as follow. 1. The mean of the degree of mothers' stress was 3.681. Of the stress categories, illness treatment (4.216) was highest, and the next were in order of ill-ness status and prognosis(4.154) , family relation-ships and personal roles(3.202), interpersonal relationships(2.916). 2. The mean of the degree of mothers' coping method was 2.930. Of the coping method categories, communication with medical team or parents in similar situations(3.332) was highest, and the next were in or-der of family cooperation and optimistic thought about the situation(3.241), reforcement of self esteem and maintenance of psychological stability(2.538). 3. There was not seen a stastically significant correlation between stress factors and coping methods of mothers. But with categories, the higher the stress to illness status and prognosis was, the hight coping methods' degree of communication with medical team or parents in similar situations was shown a positive correlation, if not high (r=.2776, P=.046) . And the higher the stress to illness treatment was, the higher coping methods' degree of communication with medical team or parents in simial situations was shown a positive correlation, if not high (r=.2727, P=.049). 4. With the difference of stress according to mothers' general characteristics, religion and monthly income shew a statically significant difference. The mothers' group who have a religion shew the higher degree of stress(t=-3.17, P=.003), The group who get the most income shew highest degree of stress (F=.4693, P=.0156). With the difference of coping according to mothers' general characteristics, the most support-ing person, satisfaction with husbands and mothers' own health status shew a statistically significant difference. The group who get the most support from parents-in-law(F=3.7508, P=.013), the group who are much satisfied with husband(F=3.589, P=.016), and the group whose health status are good(F=3.3675, P=.046), shew the highest coping degree. 5. There were no significant difference in degree of stress and coping by children's characteristics The significance of the study will be concluded as follows. 1. Investigating the stress factors, which mothers are perceiving, it will be utilized as the basic materials of nursing plan so as to reduce the stress of mothers. 2. In searching for the ways of mothers' more helpful coping methods, it shows the necessity of the active nursing intervention for the mothers in the process of coping with their stress. That is, the nurse should serve the earnest nursing as counselor, supporter, educator, and information - provider. 3. Recogning mothers as well as children with brain disease as a client, the nurse will be able to help the mother, who is taking care of the children, cope with the stress situation well, and to make a contribution to the recovery, rehabilitation, and health of the children and to the enhancement of the family' health.

• Clinical and Experimental Pediatrics
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• v.58 no.7
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• pp.245-250
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• 2015

Purpose: Wheezing following viral lower respiratory tract infections (LRTIs) in children <2 years of age is an important risk factor for the development of asthma later in life; however, not all children with viral LRTIs develop wheezing. This study investigated risk factors for the development of wheezing during viral LRTIs requiring hospitalization. Methods: The study included 142 children <2 years of age hospitalized for LRTIs with at least one virus identified as the cause and classified them into children diagnosed with LRTIs with wheezing (n=70) and those diagnosed with LRTIs without wheezing (n=72). Results: There were no significant differences in the viruses detected between the two groups. Multivariate logistic regression analysis showed that, after adjusting for potentially confounding variables including sex and age, the development of wheezing was strongly associated with parental history of allergic diseases (adjusted odds ratio [aOR], 20.19; 95% confidence interval [CI], 3.22-126.48), past history of allergic diseases (aOR, 13.95; 95% CI, 1.34-145.06), past history of hospitalization for respiratory illnesses (aOR, 21.36; 95% CI, 3.77-120.88), exposure to secondhand smoke at home (aOR, 14.45; 95% CI, 4.74-44.07), and total eosinophil count (aOR, 1.01; 95% CI, 1.01-1.02). Conclusion: Past and parental history of allergic diseases, past history of hospitalization for respiratory illnesses, exposure to secondhand smoke at home, and total eosinophil count were closely associated with the development of wheezing in children <2 years of age who required hospitalization for viral LRTIs. Clinicians should take these factors into consideration when treating, counseling, and monitoring young children admitted for viral LRTIs.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.223-247
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• 1996

This study was done to provide information which would lead to nursing care of the elderly being more holistically through an understanding of the phenomena of powerlessness based on the lived experience of powerlessness by the elderly, the meaning the elderly give to such phenomena, and what essence of powerlessness is. The methodology used in this study was Max Van Manen's phenomenological method based on the philosophy of Merleu-Ponty and a concerted approach was realized through the 11 steps suggested in the Van Manen's method. Data collection was done from March 2, 1995 to December 30, 1995. The subjects for this study were four elderly persons who lived with their families and who were over 60 years of age. Data were collected about the lived experience of the elderly, this researcher's experience of powerlessness, the linguistic meaning of powerlessness, idioms of the word or a feeling of powerlessness, and descriptions of powerlessness in the elderly as they appeared in the literature, are works, and phenomenological literature. All data were used to provide insights into the phenomena of powerlessness. Data about the experience of powerlessness by the elderly were collected through open interviews, participation, and observation. In the analysis of the theme of this study, the aspects of the theme, powerlessness in the elderly were clarified, thereby abstracting and finding meaningful statements by the elderly about their feeling of powerlessness, and then those significant statements were expressed as linguistic transformations. The summarized findings from the study are as follows : 1. Five meanings of powerlessness in the elderly were defined. 〈weakness〉, 〈dependence〉, 〈frustration〉, 〈worthlessness〉 and 〈giving up〉. 2. 〈Weakness〉 means that the elderly experience, not only their aging but also, their becoming weak and the loss of physical function frequently caused by diseases. 〈Dependence〉 means that the elderly experience dependence without any influence from the surroundings and that elderly patients who are hospitalized lose their autonomy, follow entirely their doctor's prescriptions, use aid equipment and directions, and depend only on those things. 〈Frustration〉 means that the elderly experience the loss of their roles from the past, there by feeling that there is no work for them to do anymore and therefore feel unable to do anything. 〈Worthlessness〉 means that the elderly experience the feeling of losing their social roles from the past, having no financial ability, thereby being a burden to their children or the people around them, and therefore regarding themselves useless. 〈Giving up〉 means that the elderly experience the feeling of closeness to death in the final stage of their lifetime, lose hope to be healed from their disease, and recognize the incontrollability of their own body. 3. From a general view of the meaning of the theme the powerlessness in the elderly-the most essential meaning of the theme is the 〈sense of loss〉. For the elderly are experiencing a sense of loss in the situation of being elderly and therefore being often hospitalized. Brief definitions of the five phenomena could be 〈weakness〉 meaning the loss of physical strength, 〈dependence〉 the loss of mentality caused by disease and hospitalization, 〈frustration〉 and 〈worthlessness〉 the loss of social performance caused by the loss of social functions from the past, and lastly 〈giving up〉 the loss of the controllability of such situations of aging and suffering disease. In light of the discussion above, it is understandable that the hospitalized elderly experience powerlessness not only as it related to their diseases but also to their normal aging, and this related to other characteristics of being elderly means that the 〈sense of loss〉 is the very essence of their powerlessness. 4. While most cases are of the normal elderly experiencing powerlessness in relation to their social network, cases of elderly who are hospitalized are of those experiencing powerlessness in relation to the loss of their physical desire. 5. The findings discussed above can serve as guidelines for nurses who take care of the ill elderly who are hospitalized and that can provide cues to appropriate nursing service, recognizing that the subjective experience of the objective age of the elderly is so important. Nurses can provide highly qualitative nursing service, based on their deep understanding of the suffering of the elderly due to feelings of powerlessness.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4549-4553
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• 2014

Background: Infection is a serious cause of mortality in febrile neutropenia of pediatric cancer patients. Recently, monotherapy has replaced the combination therapy in empirical treatment of febrile neutropenia. Since there has been no reported trial comparing the efficacy of meropenem and piperacillin-tazobactam (PIP/TAZ) monotherapies, the present retrospective study was conducted to compare safety and efficacy in febrile neutropenic children with cancer. Materials and Methods: Charts of febrile, neutropenic children hospitalized at our center between March 2008 and April 2011 for hemato-oncological malignancies were reviewed. Patients received PIP/TAZ 360 mg/kg/day or meropenem 60 mg/kg/day intravenously in three divided doses. Duration of fever and neutropenia, absolute neutrophil count, modification, and success rate were compared between the two groups. Resolution of fever without antibiotic change was defined as success and resolution of fever with antibiotic change or death of a patient was defined as failure. Modification was defined as changing the empirical antimicrobial agent during a febrile episode. Results: Two hundred eighty four febrile neutropenic episodes were documented in 136 patients with a median age of 5 years. In 198 episodes meropenem and in 86 episodes PIP/TAZ were used. Duration of fever and neutropenia, neutrophil count, sex, and primary disease were not different between two groups. Success rates and modification rate between two groups showed no significant differences (p>0.05). Overall success rate in the meropenem and PIP/TAZ groups were 92.4% and 91.9% respectively. No serious adverse effects occurred in either of the groups. Conclusions: Meropenem and PIP/TAZ monotherapy are equally safe and effective in the initial treatment of febrile neutropenia in children with cancer.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.131-140
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• 2005

The purpose of this study is to review the operative management and outcome of operation for Crohn's disease. The medical records of 17 patients who underwent operations for Crohn's disease at Seoul National University Children's Hospital from January of 1988 to June of 2005 were reviewed. The male-to -female ratio was 1.8: 1. The median age at the onset of symptoms and the time of diagnosis was 9 years 6 months and 11 years 6 months respectively. The median time interval from diagnosis to operation was 2 years and 1 month (0 month~8 years). The ileocolic or ileocecal region was the most common site of involvement. The indications for operation were intractable symptoms (8 cases) and obstruction or stricture (7 cases). The median postoperative hospitalized days were 14.4 days (8~35 days). Five patients (29 %) experienced postoperative complications. Symptom free state or symptom relief was observed in 11 cases after surgery and 6 cases had intermittent episodes of remissions and recurrences. In pediatric Crohn's disease patients who present with intractable symptoms despite medical treatment or develop surgical complications, symptom free state or symptom relief can be achieved by minimal resection of the diseased segment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.369-376
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• 2019

Purpose: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. Methods: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. Results: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and $22.8{\mu}g/mL$, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. Conclusion: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.431-440
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• 2019

Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.1
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• pp.41-51
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• 2022

Purpose: Community-acquired bacterial enteritis (CABE) is a common problem in developed countries. It is important to understand the epidemiologic changes in bacterial pathogens for prevention and treatment. Therefore, we studied the epidemiologic changes in CABE in Korean children. Methods: A total of 197 hospitalized pediatric patients aged <19 years that presented with dysentery symptoms and showed positive polymerase chain reaction results for bacterial species in stool samples, were enrolled in this study for 10 years (June 2010 to June 2020). We classified patients in phase I (06, 2010-06, 2015) and phase II (07, 2015-06, 2020) and analyzed their epidemiologic and clinical characteristics. Results: The most common pathogens were Campylobacter species (42.6%) and Salmonella species were the second most common pathogens (23.9%). The abundance of pathogens decreased in the following order: Clostridium difficile (9.6%), Shigella (5.6%), and Clostridium perfringens (5.6%). Escherichia coli O157:H7 was found to be the rarest pathogen (2.0%). Campylobacter species showed an increase in the infection rate from 32.1% in phase I to 49.6% in phase II (p=0.0011). Shigella species showed a decline in the infection rate in phase I from 14.1% to 0.0% in phase II (p<0.001). C. difficile and C. perfringens showed an increase in infection rate in phase II compared to phase I, but the difference was not statistically significant. Conclusion: The infection rate of Campylobacter species in CABE has been rising more recently, reaching almost 50%. This study may help establish policies for prevention and treatment of CABE in Korean children.