• Title/Summary/Keyword: Pediatric intervention

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Development of a Standardized Clinical Practice Education Program in Occupational Therapy Student (작업치료 대학생의 임상실습 교육 프로그램 개발)

  • Lee, Min-Jae;Lee, Sun-Min
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.27-38
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    • 2022
  • Purpose : This study is aimed to develop and validate the clinical practice education program and clinical competence scale of occupational therapy student. Methods : The development of the clinical practice education program used the delphi technique method, which had a total of five steps. Based on the occupational therapist's job analysis, the first stage assessed the importance of 21 experts, and the second stage examined the importance of 19 new specialists to derive constitutive factors. In the third stage, in-depth interviews were conducted with three experts based on the derived factors, and in the fourth stage, the final clinical practice education program was derived. In the final stage, the details of the clinical training program were drawn up based on the themes and were reviewed by two experts. Structured and unstructured interviews were conducted with 43 job experts. Results : The expert survey through the delphi technique was conducted three times, and content analysis and descriptive statistics were conducted to examine the distribution of responses. The final 11 educational program topics and contents were derived. Topics are confirmation of client information, evaluation and intervention, cognitive therapy, spinal cord injury, brain injury, musculoskeletal disorders, pediatric occupational therapy, interventions in activities of daily living, driving rehabilitation, vocational rehabilitation, occupational therapy assessment tool, safety training and management. Conclusion : The clinical practice education program reduce the difference between school education and clinical education of occupational therapy student. Occupational therapy helps college student understand occupational therapy practices and improve the quality of clinical education. Through more research and supplementation of clinical practice education programs in the future, it is suggested that clinical practice education be successfully operated in various practice institutions and used as basic data for designing and evaluating useful educational models.

The Analysis of Registration Status of Interventional Clinical Trials for Children and Adolescents with Tension-Type Headache - Focused on WHO ICTRP - (소아 청소년 긴장성 두통 대상 중재 임상시험의 등록 현황 분석 - WHO ICTRP를 중심으로 -)

  • Choi Seo Yeon;Jeong Yoon Kyoung;Han Ju Hui;Bang Miran;Lee Sun Haeng;Chang Gyu Tae;Lee Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.3
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    • pp.13-28
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    • 2024
  • Objectives This study aimed to analyze registrations in the World Health Organization International Clinical Trials Registry Platform for children and adolescents with tension-type headaches. Methods We collected and analyzed information on the basic and clinical characteristics of patients who participated in related clinical trials. All relevant clinical trials registered on or before July 2, 2024 were included in this study. Results Twenty clinical trials were selected for the analysis. Behavioral therapy was the most common intervention (60%), followed by drug, device, and manual therapies. The type of headache was the most frequently mentioned inclusion criteria, noted in 70% of the patients. Outcome indicators included headache frequency and intensity, quality of life, daily functioning, and mood. Conclusions Further clinical trials should require informed consent, an appropriate research design, suitable controls, and clear presentation of diagnostic criteria for more accurate and ethical studies.

A clinical study of deep neck abscess in children (소아 심경부 농양의 임상적 고찰)

  • Lee, Soo Jung;Shin, Mee Yong;Kim, Chang Hwi;Koh, Yoon Woo
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.363-368
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    • 2007
  • Purpose : It has been reported that deep neck abscesses are recently increasing again. We analyzed pediatric cases with deep neck abscesses during the last several years to contribute to the treatment of the disease. Methods : The clinical data of 30 children under 16 years of age with deep neck abscess from February 2001 to July 2006 were analysed retrospectively. Results : The mean age was 9 years (2-16 years), and the male/female ratio was 19/11. Abscesses in the peritonsillar space were most common (57%), followed by the retropharyngeal (30%) and parapharyngeal (13%) spaces. Upper respiratory infection in 10 cases (33%), dental infection in four case (14%), cervical lymphadenitis in three case (10%) and sinusitis in two case (6%) contributed to the development of deep neck infections. The frequent symptoms were fever in 16 case (53%), sore throat in 15 case (50%), poor oral intake in 10 (33%), odynophagia in eight (27%), and neck pain in eight (27%). Unilateral tonsillar hypertrophy and displacement in 15 case (50%) were most common. Neck mass in 13 patients (43%), neck stiffness in three (10%) and trismus in three (10%) were also found. Bacteria were isolated in 8 among 10 pus cultures; Streptococcus species 7 and Micrococcus luteus 1. All of those bacteria except Micrococcus luteus were sensitive to penicillin G. Surgical intervention was applied to 12 cases (40%), and the remaining 18 patients (60%) were treated with antibiotics only. There were no differences between the two groups in the duration of admission and antibiotic treatment. No complicated cases were observed. Conclusion : Peritonsillar abscesses were most frequent. Upper respiratory infection was the most common predisposing factor, followed by dental infection and sinusitis. Symptoms of respiratory tract obstruction were not found. The most common pathogens were Streptococcus species. Deep neck abscesses in children, if diagnosed at the early stage, possibly can be treated by antibiotics only, without surgical intervention.

A Case of Multiple Giant Coronary Aneurysms with Large Mural Thrombus due to Kawasaki Disease in a Young Infant (가와사끼병 영아에서 발생한 혈전을 동반한 거대관상동맥류 1례)

  • Choi, Eun Na;Kim, Jeoung Tae;Kim, Yuria;Yoo, Byung Won;Choi, Deok Young;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kye;Kim, Dong Soo;Park, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.321-326
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    • 2005
  • Kawasaki disease is an acute systemic vasculitis of unknown origin. Giant coronary aneurysm is one of the most serious complications, although peripheral artery vasculitis can produce life-threatening events. Myocardial ischemia and infarction can be caused by coronary artery stenosis, aneurysm, and stagnation of blood flow in coronary arteries which triggers thromboembolism. Atypical presentation in young infants often interferes with prompt diagnosis and timely treatment, resulting in poor outcomes. We describe a 3-month-old infant with multiple giant coronary aneurysms with flow stagnation, stenosis and large mural thrombus due to Kawasaki disease. He presented with a prolonged course of severe coronary involvement in spite of all measures to reduce coronary complications. Finally, surgical intervention was tried because of the worsening coronary artery abnormalities. The patient died of acute cardiorespiratory failure shortly after weaning from cardiopulmonary bypass.

The Effects of Artificial Dead Space on the Pulmonary Ventilation of Intubated Children with Mechanical Ventilation (기관 삽관후 인공호흡기를 적용한 개심술 환아의 인공기도 체외 용적이 폐환기 상태에 미치는 영향)

  • 유정숙;윤선희;송계희;민열하
    • Journal of Korean Academy of Nursing
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    • v.31 no.1
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    • pp.31-42
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    • 2001
  • This study was done to evaluate the effect reducing artificial dead space on intubated children. Data were collected from July 1st, 1998 to August 31st, 1999. The subjects were selected from a pediatric intensive care unit of 'S' hospital and intubated with 3.5 mm or 4.5 mm endotracheal tube after open heart surgery. They were composed of 34 patients : 17 patients were assigned to the experimental group and the rest of them were placed in the control group. The artificial airway volume was minimized in the experimental group, and the control group maintained the artificial airway volume. ETCO2, PaCO2, SPO2 were measured as indicators of pulmonary ventilation. The tools of this study were GEM-Premier and Space-Lab patient monitors. The data were analyzed using the SPSS/PC+ program. The $\chi$2 -test was used to find general characteristics. The t-test was used to test the homogenety of the pulmonary ventilation status and mechanical ventilation setting before intervention between the two groups. Also, the paired t-test was used to examine the hypothesis. The results can be summerized as : 1. CO2 can be expelled effectively from the body in case artificial dead space was decreased. 2. As the artificial dead space was reduced, the difference between ETCO2 and PaCO2 was decreased, in other words pulmonary ventilation was improved. 3. If the artificial dead space occupied above 15 percent of tidal volume, the effect of CO2 was retention revealed in the body. 4. If the artificial dead space occupied below effect. Based on the results, the following is suggested to be applied practically : 1. A kind of the ventilator circuit acting artificial dead space should be removed from the intubated children with mechanical ventilaion. 2. The endotracheal tube should not be cut because extra-body space of the endotracheal tube did not have an effect on the dead space of the intubated children. Since the researcher could not cover this aspect in the study, they recommend the following. 1. The study should be extended to the other pulmonary disease patients for the effect of improving pulmonary ventilation. 2. Also, further studying with a more narrow interval in the extra-body space of the artificial airway will be able to explain the point of artificial dead space with proper ventilation.

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Comparision of Group and Individual Social Support on Burden and Family Functioning in Families with Asthmatic Children (집단 사회적지지와 개별 사회적지지가 천식아동 가족의 부담감과 가족기능에 미치는 영향)

  • 전화연
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.418-428
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    • 1999
  • The main purpose of this study was to identify the effects of group social support and individual social support on the reduction of burden and improvement in family functioning of families with asthmatic children. The design of this study was a randomized pre-posttest quasi-experimental design to compare the two experimental groups. The theoretical framework for this study was derived from the study of burden in family caregivers by Suh and Oh (1993) based on the main effect model of social support theories. The data were collected from February 12, 1998 to May 29, 1998 at the pediatric out patient department of a university hospital located in Suwon city. The sample consisted of 39 family members who were identified as families with asthmatic children, Eighteen subjects were randomly assigned to the group social support group and 21 were assigned to the individual social support group. Group and individual social support members were seen for 60 to 90 minutes, four times over one to three weeks. The instruments used in this study were the Burden Scale developed by Suh & Oh(1993), the Visual Analogue Scale, and the Family Adaptability Cohesion Evaluation Scale(FACES-III) developed by Olson, Portner, and Lavee(1985). The collected data were analyzed using Mann-Whitney test, x$^2$-test, Wilcoxon sign rank test, t-test, ANOVA (Scheff), Pearson correlation coefficient. multiple regression, and social support process and content analysis. The results are as follow : 1. There was no significant difference before the experimental treatment among the subjects in the group social support group and individual social support group for general characteristics, burden, or family functioning. 2. Hypothesis 1 : “There will be a greater reduction on the burden score of the group social support group compared to the individual social support group” was not statistically significant(U=174.5, p=.683). The burden scores showed a significant decrease after participation in social support as compared to before participation for both groups. However there was a tendency for more reduction in the burden scores for the group social support than for individual social support. 3. Hypothesis 2 : “There will be a greater improvement in the family functioning scores for the group social support group compared to the individual social support group” was not statistically significant(U=153.0. p=.309). There was a tendency toward improvement in the family functioning scores of the group social support as compared to that of the individual social support. 4. According to the length of the treatment period, families with asthmatic children displayed affirmative responses, and the families set up a self-help group of mothers with asthmatic children in order to share their experiences, to get information and to solve their problems. In conclusion, it was found that group social support was the more effective nursing intervention for reducing burden and for improving family functioning of families with asthmatic children.

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The Effect of Patent's Burden and Quality of Life on the Daily Performance Ability of Children With Developmental Disabilities (발달장애아동의 일상생활 수행능력이 부모의 부담감과 삶의 질에 미치는 영향)

  • Lee, In-Young;Lee, Jae-Shin;Cha, Tae-Hyun;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.18 no.1
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    • pp.1-12
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    • 2020
  • Objective : In this study, we are going to check the impact of the daily performance of a child with developmental disabilities on the parent's burden and quality of life. Methods : 120 parents of children with developmental disabilities were targeted in Chungcheong and Jeolla provinces. To measure the daily performance ability of children with developmental disabilities, we used evaluative Pediatric Evaluation of Disability Inventory and The burden of parents was measured by Family Burden Questionnaire and the quality of life by Beach Center Family Quality of Life Scale. Based on the data collected, independent t-test, one-way anova, Pearson correlation analysis and regression analysis were conducted to check the impact of a child's daily performance ability of developmental disability on the parent's burden and quality of life. Results : The daily performance ability of a children with developmental disabilities showed a negative correlation with the burden of the parents and a positive correlation with the quality of life. The hygiene and bowel & bladder control of children with developmental disabilities had an important influence on parent's burden, while hygiene, toileting, and bowel & bladder control of children with developmental disabilities had a significant effect on their parent's quality of life. Conclusion : It has been shown that the daily performance ability of a children with developmental disabilities has a major influence on parent's burden and quality of life. In order to reduce the burden and improve quality of life, therapeutic intervention, education and interview programs for daily life of children with developmental disabilities need to be carried out systematically by occupational therapists.

Auditory brainstem response (ABR) results in NICU graduates (신생아 집중치료실 퇴원아의 청성뇌간반응(ABR) 결과에 미치는 위험인자 및 경과)

  • Choi, Hee-Joung;Lee, Tae-ho;Oh, Ki-Won;Kim, Heng-Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1301-1307
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    • 2006
  • Purpose : Hearing loss is one of the most common birth defects, and early detection and intervention positively impact language/speech and cognitive development. It has been reported that NICU graduates have a high incidence of hearing loss. So we investigated the incidence, risk factors and clinical outcome of hearing loss in NICU graduates. Methods : This study involved neonatal auditory brainstem response (ABR) testing of newborn infants who graduated from the NICU of Kyungpook National University Hospital during a 3-year period (between July 2002 and June 2005) and subsequent follow-up of these infants. Results : ABR evaluations were performed on 474 infants. Of these infants, 64 showed abnormal ABR (13.5 percent). Of 128 ears from these 64 infants, two ears (1.6 percent) and 10 ears (7.8 percent) were classified as severe and profound hearing loss, respectively. The infants with abnormal ABR had higher incidence of prematurity, low birth weight, very low birth weight, neonatal asphyxia, cranio-facial malformation and amikacin treatment over 15 days (P<0.05). In infants with hyperbilirubinemia, the peak level of serum bilirubin, duration of phototherapy and exchange transfusion were not associated with the higher incidence of hearing loss. Follow-up ABR evaluation was performed on 15 infants with abnormal ABR at $8.8{\pm}4.4months$. In follow-up ABR, 80.0% showed improvement or normalization of threshold sensitivity. Conclusion : NICU graduates exhibit high risk for hearing loss. Systemic and effective hearing assessment program is needed for these high risk infants.

Rotavirus-associated neonatal necrotizing enterocolitis (로타바이러스 감염이 관련된 신생아 괴사성 장염)

  • Seo, Hyun Joo;Jung, Yu Jin;Park, Soo Kyung;Choi, Seo Hui;Lee, Ji Hyuk;Kim, Myo Jing;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.56-60
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    • 2009
  • Purpose : This study aimed to test whether rotavirus-associated necrotizing enterocolitis (RV+NEC) produced different clinical findings or outcomes from those of non-rotavirus necrotizing enterocolitis (RV-NEC). Methods : Eight patients from the RV+NEC group and 22 patients from the RV-NEC group diagnosed with modified Bell stage II or higher NEC were selected for this study. Fecal specimens from all infants were tested for rotavirus infection using a monoclonal antibody-based enzyme immunoassay (EIA). Clinical, radiographic, and clinical outcome data were analyzed retrospectively. Results : RV+NEC infants had a significantly higher birth weight and were born at a significantly higher gestational age ($33.5{\pm}3.3$ weeks vs. $29.3{\pm}4.4$ weeks; P=0.01). There were no differences in the occurrence of thrombocytopenia, mural gas, and pneumoperitoneum between the 2 groups. However, portal vein gas was more common in the RV+NEC group (88% vs. 9%; P<0.01). Neither the incidence of Bell stage III (or higher) NEC nor surgical intervention differed between the two groups. The number of complications and mortality rates were also similar. Conclusion : Rotavirus-associated NEC occurs in infants with a higher birth weight and those born at a greater gestational age. However, the severity of the condition and the resulting outcomes did not differ from those for infants affected by non-rotavirus NEC.

CD Program Development Applied Logotherapy to Improve Quality of Life of Older School-age Children with Terminal Cancer (학령후기 말기 암 환아의 삶의 질 증진을 위한 의미요법 CD 프로그램 개발)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Song, Mi-Kyung
    • Journal of Hospice and Palliative Care
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    • v.11 no.2
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    • pp.82-90
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    • 2008
  • Purpose: The purpose of this study was to develop a CD program of applied logotherapy to improve the quality of life of older school-age children with terminal cancer. Methods: Keller's ARCS (Attention, Relevance, Confidence, Satisfaction) theory and a model for developing learning materials (Dick and Cray) were applied to develop this program which comprised four distinct phases: planning, developing, applying, and evaluation stages. Results: This program was entitled 'Finding treasures in my mind' and consisted of 5 sessions, and its educational contents were made up as follows: "Treasure One" is 'learning three natures of the human mind', "Treasure Two" is 'learning creative value as first method to find meaning of life', "Treasure Three" is 'learning experiential value as second method to find meaning of life', "Treasure Four" is 'learning attitudinal value as third method to find meaning of life', and "Treasure Five" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'What is it?', 'Travelling'. 'Laughing Song', and 'End'. Conclusion: This CD program is an applied logotherapy with flash animation technique as an emotional and spiritual intervention program for easier and more scientific application in pediatric oncology and hospice area.

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