• 대한간호학회지
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• 제12권2호
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• pp.80-90
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• 1982

This study was undertaken to determine the influence of a chronic disease on body image, and to show that body image is directly related to one's self concept. Body image is the concept of one's own body based on present and past perception, and is elated to one's self concept. Body image is a dynamic concept constantly changing throughout the life cycle but it changes greatly in illness, surgery, and accident. The child with a chronic disease experiences pain and immobilization due to illness and he/she experiences a strange environment in the hospital. illness often brings feeling of frustration and loss of self-esteem. Therefore this study was done to compare the body image of a child with a chronic disease（Asthma), with that of a normal healthy child, and to determine the relationship between the body image and self concept. The subjects in this study were 36 children being treated for asthma at the allergy clinic of Y University Hospital in Seoul (patient group) and 44 children attending elementary school in Kwanak Ku Seoul (normal healthy group). For the measurement of the body image, the researcher used Secord & Jourard's Body Cathexis Scale, and another scale which was constructed after reading about Osgood's Semantic Differential Method. For the measurement of the self concept, the researcher used Jacox & Stewart's Health Self Concept. The period for data collection was from October 7th to October 27th, 1982. The analysis of data was done by use of Percentage, t-test, Chi-square test, Pearson Correlation Coefficient and ANOVA, The results of the study were as follows: 1. The first hypothesis,“That the chronically ill (Asthma) child will have a more negative body image than the normal healthy child.”was supported. 2. The second hypothesis,“The more negative the body image, the lower the self concept.”was also supported. 3. The researcher failed to obtain statistically significant results in the analysis of the general characteristics which affect the body image except in the case of the older child as compare to the younger Child having a mole positive body image (r=.2751, r=.2481, p<.05). However it was found that, 1) Boy's have a more positive body image than girls (Mean=〔37.81, 141.09〕,〔37.00, 126.54〕), 2) The child who has been hospitalized has a more negative body image than the child who has never been hospitalized (Mean=〔33.25, 122.45〕,〔35.68, 129.93〕). 3) The younger the child when the disease is discovered and diagnosed, the more negative the body image (Onset of illness: Mean=〔31.44, 117.33〕,〔34.00, 103.50〕, 〔35.75, 140.38〕,〔36.33, 130.00〕, Time of Diagnosis: Mean=〔29.00, 117.33〕,〔33.89, 115.00〕,〔33.36, 124.93〕,〔37.10, 139. 20〕). In conclusion the chronically ill(.Asthma) child has a more negative body image than the normal healthy child, and the more negative the body image the lower the self concept. Therefore the concept of body image is useful in understanding the influences of chronic disease on body' image and self concept.

• Pediatric Infection and Vaccine
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• 제24권1호
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• pp.23-30
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• 2017

목적: 소아 입원환자에서 A/H1N1, A/H3N2형 및 B형 인플루엔자 감염을 비교하고 항바이러스제의 효용성을 분석하고자 하였다. 방법: 2014년 1월부터 4월까지 창원파티마병원에 인플루엔자 감염으로 입원한 소아 환자들을 후향적으로 분석하였다. 결과: 총 302명 중 인플루엔자 A/H1N1형 15명(5.0%), A/H3N2형 100명(33.1%), B형 187명(61.9%)이었다. A는 24개월 미만, B는 24개월-6세 사이 감염자에서 높은 분포를 보였고(P=0.005). B형 인플루엔자 감염군에서 발열 기간이 유의하게 길었다(P=0.001). 총 161명(53.3%)가 백신 접종자였으며, 감염 환자군 모두에서 oseltamivir를 복용한 환자들의 발열 기간이 유의하게 더 짧은 것으로 나타났다. 결론: A형과 B형 인플루엔자 환자는 연령 분포 및 임상 경과에 유의한 차이를 보였으며, oseltamivir는 효과의 차이는 있었으나 두 군 모두에서 효용성이 있다.

• Child Health Nursing Research
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• 제7권2호
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• pp.179-190
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• 2001

The purposes of the study were to develop an instrument for family value and to identify the relationships of family value, family hardiness, and family adaptation by appling the family value scale to family with cancer children. The study was conducted in three phases. 1) A survey was conducted from July 20 to August 20, 1999 and 18 items of general family value scale was modified from the data of 153 fathers and 164 mothers. 2) In-depth interviews were made with 29 parents of cancer children from April 20, 1998 to May 20, 1999 to develop family value scale with cancer children, and 12 statements were developed. 3) The final survey was conducted from July 18, 2000 to August 30, 2000 and the data from 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics were analyzed to identify the relationships of the concepts. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, and Regression for path analysis. The study findings are as follows. The psychometric testing of general family value scale was Cronbach's alpha = 0.78. The reliability of the family value scale with cancer children showed the reliability as Cronbach's alpha = 0.73. Demographic characteristics showing significant correlations were cancer children's age, period of illness, period after completing treatment, mother's age, mother's education level, monthly income, payment type, confidence with health professional, and severity of children's illness. The correlation coefficients among major variables showed that family stressor was positively related with family strains(r=0.33, p<.001), and negatively related with family hardiness(r=-0.21, p<.001). Family strains was negatively related with family hardiness(r= -0.41, p<.001) and family adaptation(r=-0.46, p<.001). Correlations of family hardiness was positive with family value with cancer children(r=-0.31, p<.001), and negative with general family value(r=-0.16, p<.01). Family hardiness was positively related with family adaptation(r=0.35, p<.001). The causal relationship between study variables showed that family strains predicts general family value(γ=0.12, t=2.02), family value with cancer children predicts family hardiness(γ=0.31, t=6.30), family strains predicts family hardiness(γ=-0.40, t=-7.70), family value with cancer children predicts family adaptation(γ=-0.23, t=-4.11), and family hardiness predicts family adaptation(γ=0.43, t=7.78).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권4호
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• pp.223-231
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• 2014

Purpose: With previous methods based on only age and location, there are many difficulties in identifying the etiology of acute abdominal pain in children. We sought to develop a new systematic classification of acute abdominal pain and to give some helps to physicians encountering difficulties in diagnoses. Methods: From March 2005 to May 2010, clinical data were collected retrospectively from 442 children hospitalized due to acute abdominal pain with no apparent underlying disease. According to the final diagnoses, diseases that caused acute abdominal pain were classified into nine groups. Results: The nine groups were group I "catastrophic surgical abdomen" (7 patients, 1.6%), group II "acute appendicitis and mesenteric lymphadenitis" (56 patients, 12.7%), group III "intestinal obstruction" (57 patients, 12.9%), group IV "viral and bacterial acute gastroenteritis" (90 patients, 20.4%), group V "peptic ulcer and gastroduodenitis" (66 patients, 14.9%), group VI "hepatobiliary and pancreatic disease" (14 patients, 3.2%), group VII "febrile viral illness and extraintestinal infection" (69 patients, 15.6%), group VIII "functional gastrointestinal disorder (acute manifestation)" (20 patients, 4.5%), and group IX "unclassified acute abdominal pain" (63 patients, 14.3%). Four patients were enrolled in two disease groups each. Conclusion: Patients were distributed unevenly across the nine groups of acute abdominal pain. In particular, the "unclassified abdominal pain" only group was not uncommon. Considering a systemic classification for acute abdominal pain may be helpful in the diagnostic approach in children.

• Child Health Nursing Research
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• 제3권1호
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• pp.30-41
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• 1997

This is descripitive study conducted to identify educational needs of mothers of nephrotic syndrome patients. The study subjects were composed of 74 mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from June to september in 1996. A questionaire for this study was item Kikert type 5 point scale, developed on the basis of previous literature and researcher's clinical experience and the reliability of the used instruments was α=.97. t-test, and ANOVA were used to determine the effect of general characteristics of subjects on their educational needs. Pearson correlation was done to measure relations between general characterictics of subjects and their educational needs and Stepwise Multiple Regression was done to test a variable affecting educational needs. The results were as follows. 1. Mean score of the educational needs of the subjects was 137.06(Maximum 176) . The educational needs of home care was the highest score, but the question numbers are smaller than other categories. So, the educational need of the diagnosis and treatment was regarded as the highest in contents. 2. The number of subject's children, except for patient revealed significant negative correlation to educational need. 3. The number of subject's children, except for patient(R²=.215289 P=.0006)and the age of patient (R²=.23770 P=.0001) were emerged as important variables affecting the degree of mothers' educational need. Suggestion are as follows on the basis of these results. 1. It is proposed that nurses use these results of the study activly for the educational program for Nephrotic Syndrome patients and their mothers. 2. It is identified that the educational needs of the mothers of nephrotic syndrom is high. So, it is suggested to identify and analysis the degree of the nurse's educational performance perceived by mother. 3. It is suggested to make a comparative study of the degree of nurse's understanding of the importance on educational items with the instruments of this study.

• 한국실내디자인학회논문집
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• 제24권4호
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• pp.152-160
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• 2015

This paper proposes high quality of healthcare environments for a user-oriented children's hospital by identifying the user needs according to residential characteristics of the child, especially the hospitalization period. Caregivers, mostly parents of children in a children's hospital, participated in a questionnaire survey. The user's demands, satisfaction and hospital environment assessment were measured. A total of 103 copies of the questionnaire were finally collected and analyzed. The data was processed statistically using SPSS WIN 18.0 Version software. The results and conclusions are as follows. 1)The participants were categorized into three groups according to the hospitalization period of the child (less than 7 days, 7-20 days, and more than 21 days). 2)When the patients stayed longer in the hospital, their satisfaction was lower and their demands were higher. The long-term group required a more spacious bathroom for the child inpatients and their caregivers as well as sufficient individual storage spaces that are appropriate for the length of stay. 3)The longer they were hospitalized, the more negative they evaluated the hospital environment. These results suggest that the period of hospitalization is one of the crucial factors that impact the user's satisfaction and demands. Therefore, it is necessary to identify the design factors such as territoriality, privacy, accessability, and aesthetics to improve the satisfaction of the long-term child inpatients and their caregivers.

• Clinical and Experimental Pediatrics
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• 제60권3호
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• pp.77-85
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• 2017

Purpose: Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. Methods: Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ${\geq}38.0^{\circ}C$ for longer than ${\geq}14days$ and failure to reach a diagnosis after one week of investigations were included. Results: Total 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%). Conclusion: Almost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.89-95
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• 2012

Background: As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. Methods: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological, and radiographic differences and scoring system. Results: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). Conclusion: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

• Clinical and Experimental Pediatrics
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• 제60권7호
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• pp.221-226
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• 2017

Purpose: Escherichia coli sequence type (ST) 131, a multidrug-resistant clone causing extraintestinal infections, has rapidly become prevalent worldwide. However, the epidemiological and clinical features of pediatric infections are poorly understood. We aimed to explore the characteristics of ST131 Escherichia coli isolated from Korean children with urinary tract infections. Methods: We examined 114 uropathogenic E. coli (UPEC) isolates from children hospitalized at Chung-Ang University Hospital between 2011 and 2014. Bacterial strains were classified into STs by partial sequencing of seven housekeeping genes (adk, fumC, gyrB, icd, mdh, purA, and recA). Clinical characteristics and antimicrobial susceptibility were compared between ST131 and non-ST131 UPEC isolates. Results: Sixteen UPEC isolates (14.0%) were extended-spectrum ${\beta}-lactamase$ (ESBL)-producers; 50.0% of ESBL-producers were ST131 isolates. Of all the isolates tested, 13.2% (15 of 114) were classified as ST131. There were no statistically significant associations between ST131 and age, sex, or clinical characteristics, including fever, white blood cell counts in urine and serum, C-reactive protein, radiologic abnormalities, and clinical outcome. However, ST131 isolates showed significantly lower rates of susceptibility to cefazolin (26.7%), cefotaxime (40.0%), cefepime (40.0%), and ciprofloxacin (53.3%) than non-ST131 isolates (65.7%, 91.9%, 92.9%, and 87.9%, respectively; P<0.001 for all). ESBL was more frequently produced in ST131 (53.3%) than in non-ST131 (8.1%) isolates (P<0.01). Conclusion: ST131 E. coli isolates were prevalent uropathogens in children at a single medical center in Korea between 2011 and 2014. Although ST131 isolates showed higher rates of antimicrobial resistance, clinical presentation and outcomes of patients were similar to those of patients infected with non-ST131 isolates.

• Journal of Korean Medical Science
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• 제33권43호
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• pp.268.1-268.11
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• 2018

Background: We aimed to compare the therapeutic efficacy of prolonged macrolide (PMC), corticosteroids (CST), doxycycline (DXC), and levofloxacin (LFX) against macrolide-unresponsive Mycoplasma pneumoniae (MP) pneumonia in children and to evaluate the safety of the secondary treatment agents. Methods: We retrospectively analyzed the data of patients with MP pneumonia hospitalized between January 2015 and April 2017. Macrolide-unresponsiveness was clinically defined with a persistent fever of ${\geq}38.0^{\circ}C$ at ${\geq}72$ hours after macrolide treatment. The cases were divided into four groups: PMC, CST, DXC, and LFX. We compared the time to defervescence (TTD) after secondary treatment and the TTD after initial macrolide treatment in each group with adjustment using propensity score-matching analysis. Results: Among 1,165 cases of MP pneumonia, 190 (16.3%) were unresponsive to macrolides. The proportion of patients who achieved defervescence within 48 hours in CST, DXC, and LFX groups were 96.9% (31/33), 85.7% (12/14), and 83.3% (5/6), respectively. The TTD after initial macrolide treatment did not differ between PMC and CST groups (5.1 vs. 4.2 days, P = 0.085), PMC and DXC groups (4.9 vs. 5.7 days, P = 0.453), and PMC and LFX groups (4.4 vs. 5.0 days, P = 0.283). No side effects were observed in the CST, DXC, and LFX groups. Conclusion: The change to secondary treatment did not show better efficacy compared to PMC in children with macrolide-unresponsive MP pneumonia. Further studies are needed to guide appropriate treatment in children with MP pneumonia.