• Title/Summary/Keyword: 만성 질환 아동

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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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THE STUDY ON RELATIONSHIP BETWEEN PSYCHOPATHOLOGY AND NEUROLOGICAL FACTORS IN CHRONIC EPILEPTIC CHILDREN (경련 질환 환아의 정신병리와 신경학적 요인과의 관계에 대한 연구)

  • Kim, Bung-Nyun;Cho, Soo-Churl;Hwang, Yong-Seung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.92-109
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    • 1996
  • The objectives of the present study were to provide comprehensive assessment of the impact of epilepsy on the psychological well-being of children with epilepsy and to identify the neurological factors associated with the psychopathology. The participant patients were recruited from the population of children and adolescent aged 7 to 16 attending the OPD of department of pediatric neurology in Seoul National University Hospital in Korea. We exclude mental retardation, pervasive developmental disorder and brain organic pathology. As control group, formal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The first author interviewed the children and their family members and obtained the developmental history and family information. We used the following 10 scales for assessing psychological and behavioral problems in patients and their family member. The scales were standardized and their validity and reliability were confirmed before. Parent rating scales : Yale children's inventory, Disruptive behavior disorder scale, Parent's attitude to epilepsy questionnaire, Family environment scale, Symptom check-list-90 revision, Children behavior check-list. Children's self rating scales : Children's depression inventory, Spielberger's state-trait anxiety anxiety, Piers-Harris self-concept inventory and Self-administered Dependency questionnaire for Mother. The result showed the risk factors associated depression were early onset, complex partial seizure, lateralized temporal focal abnormality on EEG, Drug polypharmacy, high seizure frequency and sick factors associated anxiety were old age of patient, lateralized temporal focal abnormality EEG, Drug polypharmacy, high seizure frequency. Also the result of this present study indicated that risk factors associated oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder were young age, male, early onset, lateral temporal EEG abnormality and high seizure frequency. According to these results, common risk factors associated psychological and behavioral problems were lateralized EEG temporal abnormality, high seizure frequency in neurological factors.

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The effects of a chronic disease/disability and stress from health on depressive symptoms among one-person households: A focus on the moderating effect of social support (1인 가구의 만성질환 및 장애여부, 건강 스트레스와 우울감과의 관계: 사회적 지지 조절효과를 중심으로)

  • Chung, Hyeeun
    • Human Ecology Research
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    • v.57 no.2
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    • pp.201-211
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    • 2019
  • This study examines the effects of chronic disease/disability and stress from health on depressive symptoms among one-person households living in Seoul and Gyeonggi Province in Korea. This study also investigates the moderating effect of social support on the relationship between 1)having a chronic disease/disability and depressive symptoms as well as 2)stress from health and depressive symptoms. This study used data from an online survey targeting one-person households living in Seoul and Gyeonggi Province. The final sample included 499 one-person households. Using a multiple regression analysis with SPSS 20.0, results showed that having a chronic disease/disability was associated with a higher level of depressive symptoms. In addition, stress from health was associated with a higher level of depressive symptoms. In regard to the roles of social support, economic support and emotional support had a direct negative effect on depressive symptoms. Emotional support had a moderating effect on the relationship between having a chronic disease/disability and depressive symptoms. In addition, emotional support also had a moderating effect on the relationship between stress from health and depressive symptoms. Based on these findings, this study suggests that policy makers should reduce the economic burden from a chronic disease/disability and help one-person households to strengthen their social support network.

Exercise Strategies for the Prevention and Treatment of Obesity in Children (아동 비만의 예방 및 치료를 위한 운동 전략)

  • Cho, Jin-Kyung;Han, Jin-Hee;Kang, Hyun-Sik;Yoon, Jin-Hwan
    • Journal of Obesity & Metabolic Syndrome
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    • v.23 no.3
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    • pp.156-161
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    • 2014
  • Childhood obesity has more than doubled in children and adolescents in the last decade. Obese youth are more likely to have risk factors for cardiovascular disease and type 2 diabetes such as high cholesterol, high blood pressure, insulin resistance, and metabolic syndrome. There is no single or simple solution to the childhood obesity epidemic, but to learn that obesity is closely related to lifestyle factors including poor fitness and physical inactivity as well as prolonged sitting time in conjunction with westernized dietary habits. In addition to a healthy and balanced diet, promotion of physical activity combined with carefully supervised resistance exercise training, and reduced screen time is a primary recommendation for the prevention and treatment of obesity in children and adolescents. This review provides evidence based data to support this multiple-step physical activity strategy as the most effective and preventive means against childhood obesity.

Impervious Surface as a Thematic Parameter of Analysis for Childhood Asthma Hospitalizations : Spatio-temporal Approaches (소아천식 유병율 분포의 분석변수로서 불투수면 : 시공간적 접근)

  • Um, Jung-Sup
    • Journal of the Korean association of regional geographers
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    • v.16 no.6
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    • pp.706-723
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    • 2010
  • The impervious surface was frequently employed as a proxy of the total environmental burden in the urban area. The impervious surface was extracted from a satellite image and the GIS (Geographical Information System) database for childhood asthma hospitalizations was generated for a total of 62,136 children using the National Health Insurance database of South Korea. Children living in an impervious environment do result in almost twice as many hospitalizations (26.58%) for asthma, as compared to the sub-urban pervious living (15.82%). Furthermore, the risk zones with persistently high hospitalizations for three years were specifically identified over the impervious sub-district alone. The impervious zone showed a small inter-year variation of hospitalizations (r: 0.937) while the sub-urban pervious fringe was found to display a yearly variation(r: 0.371). The strong temporal autocorrelation means that the impervious areas have frequent long-lived hospitalizations for asthma, thus children living in impervious areas were likely to have had more chronic asthma attacks than those living in pervious areas. These experimental results indicate that an impervious surface as thematic parameter of analysis is a crucial explanatory variable for asthma hospitalizations and its longer persistence among children.

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The Impact of Chronic Illness on Children and their Families (아동의 만성질환이 환아 및 환아 가족의 일상생활에 미치는 영향)

  • Han, Kyung-Ja;Park, Yeun-Hwan
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.8 no.2
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    • pp.135-147
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    • 2001
  • The aim of this descriptive study was to identify the impact of chronic illness on children and their families. Mothers of 177 children with chronic disease were recruited from aged one to 17 years hospitalizing the pediatric nursing unit at one university hospital. 28 questions. a self-complete maternal questionnaire developed by researchers based on literatures and 'The Impact of Childhood Illness Scale' (Hoare & Russell, 1995) assess four aspects of the child's and family's lifestyle with two dimensions for each question. the frequency of the problem and its importance of concern that it cause. In the data analysis. Pearson correlation coefficients and analysis of variance were used to test any association and a statistical comparisons. between individual variables and the impact on child's and family's lifestyle. The results were as follows: 1) There were the higher mean scores on the importance dimension than on the frequency dimension on total impact on child's and family's lifestyle. On the importance dimension. mothers had much higher levels of concern about impact on child's development and adjustment among subscales. On the frequency dimension, mothers had much higher levels of concern about impact on the family daily living on subscales. 2) The impact on child's and family's lifestyle related on individual variables were: (1) On the importance dimension. there was statistically significant low in the impact on child's development and adjustment among subscales in older parent group compared with it of younger parent group. (2) On the frequency dimension. there were statistically significant high in the impact on child's development and adjustment among subscales in the children with leukemia or cancer compared with it of the other children who had another chronic illnesses. And there were statistically significant high in the impact on child's development and adjustment among subscales in less than high school educated mothers compared with it of mothers who was educated college level. (3) On the frequency dimension. There were statistically significant high in the impact on family's daily living among subscales and total impact on child's and family's lifestyle in female children. (4) There was positive correlation between impact on parents daily living and frequency of child's hospitalization on the frequency dimension. but there was negative correlation between the two variables on the importance dimension. (5) There was positive correlation between impact of chronic illness and its treatment and duration of child's hospitalization on the frequency dimension. In conclusion. these results were reflected by the high level of concerns about impact on child's development and adjustment although mothers had frequently responded about the impact on the family daily living. We suggest consistent intervening program that help the family empowering to make children live with and adjust to their chronic illnesses from the point of diagnosis and after discharge from the hospital. We also suggest these results can be utilized as a useful data in the practice of home health nursing for children who have chronic illnesses and their families.

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The Study on the Quality of Life for the Mothers of Hospitalized Chronic Pediatric Patients (만성질환아 어머니의 삶의 질에 관한 연구)

  • Choi Myung Ae;Lee Hyun Sook;Kim Dae Hee;Park Myung Hee;Yoon So Young;Cho Yeon Hee;Bang Kyung Sook;Park Yeon Hwan
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.249-261
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    • 2000
  • The purpose of this study were to identify the quality of life for the mothers of hospitalized chronic pediatric patients, and to explore the factors affecting the QOL of those mothers. The subjects were 201 mothers whose children had hospitalized at one University hospital with chronic diseases. Data were collected from the December, 1997 to December, 1998. We used a revised QOL instrument consisting of 34 items, 5 point likert scale based on the Noh's QOL instrument. The revised QOL consists of six subscales, those are physical status and function, self esteem, emotional status, economic status, relationship with family members, and relationship with neighborhood. Data were analyzed by t-test, ANOVA, Pearson's correlation using SPSS-PC. The results were as follows: 1. The mean score of quality of life for the mothers of chronic pediatric patients was 100.31, and item mean was 2.95. In subscale analysis, item mean of economic status was the lowest, and that of relationship with family members was the highest. 2. Correlations between characteristics of chronic pediatric patients, their mothers and QOL of mothers were as follows; 1) Total QOL of mothers had a significant positive relationship with progressing time relapse after diagnosing and age of mothers. There was a significant negative relationship between the total QOL of mothers and number of hospitalization of their children. 2) QOL on self esteem and economic status had a significant relationship with age of pediatric patients, the time relapse after diagnosis, and age of mothers. Total number of family members and QOL on economic status showed a significant positive relationship. QOL on emotional status, economic status, and relationship with family members of mothers showed negative correlations with the number of hospitalization of their children. 3. Followings were the result of difference in QOL among different demographic cha- racteristics of the subjects. 1) QOL on economic status of mothers was significantly higher when fathers of pediatric patients had jobs. 2) Total QOL score, QOL on emotional status, and QOL on relationship with neighborhood were significantly higher when mothers of pediatric patients had spouses. 3) QOL on self esteem of mothers was significantly higher when mothers had religion. 4. Followings were the result of difference in QOL among different diagnosis of the children. 1) Total QOL score of mothers whose children had congenital heart disease was higher than that of mothers whose children had leukemia and cancer. 2) QOL on emotional status, economic status, and relationship with family members of mothers whose children had congenital heart disease were higher than those of mothers whose children had leukemia, cancer, and epilepsy.

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A study on the utilization of complementary and alternative medicine for elementary children (학동기 소아에서 보완대체요법의 이용실태)

  • Ahn, Young Joon;Kim, Eun Young;Moon, Kyung Rae
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1103-1108
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    • 2009
  • Purpose: Recently, complementary and alternative medicine (CAM) has been increasingly used in children. Studies have shown that 34% of adults and 11% of children use CAM in the USA and Canada. The purpose of this study was to investigate the prevalence and patterns of CAM use in elementary children in Korea. Methods:From July to August 2007, parents of elementary children completed a questionnaire survey at Gwang-ju. In all, 794 questionnaires were analyzed. Results:Of the 794 respondents, 278 answered that their pupils (35%) had experienced CAM. The following types of CAM therapy were used: herbal medicine, 62.5% dietary supplements, 31.2% vitamins, 30.2% and acupuncture, 11.1%. CAM therapies were used for the following diseases: nutritional deficiency, 33.3% atopic dermatitis, 31.3% arthralgia, 31.3% allergic rhinitis, 28.8% obesity, 26.3% and asthma. The following were the motives to use CAM: prevention of diseases (33.5%), dissatisfaction with modern medicine (21.2%), and complementary therapy to modern medicine (20.5%). People gained information about CAM through neighbors (65%) and mass media (21%). Moreover, 83 parents (30%) were satisfied with CAM because of its effectiveness. Conclusion:Many parents have advocated the use of CAM in their children. However, most of them used CAM without any prescription or adequate knowledge. Further studies are required to determine the efficacy of CAM.

Association between dietary protein intake and overweight and obesity among Korean children and adolescents: data from the 2014-2019 Korea National Health and Nutrition Examination Survey (한국 아동 및 청소년의 단백질 섭취와 과체중 및 비만과의 연관성: 2014-2019년 국민건강영양조사 자료를 활용하여)

  • Sumin Kim;Kyungho Ha
    • Journal of Nutrition and Health
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    • v.56 no.1
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    • pp.54-69
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    • 2023
  • Purpose: Proteins are major components of the body and essential nutrients for proper growth and development. However, studies on protein intake in children and adolescents are insufficient. A few previous studies have reported the relationship with growth indicators, but results vary depending on the source of protein. Therefore, the current study investigates the relationship between protein intake and overweight and obesity among children and adolescents in Korea. Methods: Based on the 2014-2019 Korea National Health and Nutrition Examination Survey, 5,567 children and adolescents aged 6-18 years, who participated in a 24-hour dietary recall with information on height and weight, were included in this study. Protein intake was estimated as percentage of total energy (% of energy) and was classified into animal and plant protein according to the food source. Overweight and obesity were defined using the 2017 pediatric and adolescent growth chart. Results: Total protein intake of the subjects was estimated as 14.5% of total energy (animal protein 8.3% and plant protein 6.3%). The group with the highest total protein intake had a higher odds ratio (OR) of overweight/obesity than those with the least protein intake (OR, 1.36, 95% confidence interval (CI), 1.10-1.67, p for trend = 0.003). When classified by food source, the group with the highest animal protein intake had a significantly higher OR of overweight/obesity than subjects with the lowest intake (OR, 1.30, 95% CI, 1.05-1.61, p for trend = 0.016). However, plant protein was not significantly associated with overweight/obesity. Conclusions: These findings suggest that a high intake of animal protein in children and adolescents increases the risk of being overweight and obese. In order to develop normal growth and prevent obesity in the future, it is necessary to determine an appropriate protein intake level through nutrition education programs and prospective studies on balanced protein intake.

Predictors of Latent Class of Longitudinal Medical Expenses of Older People and the Effects on Subjective Health (노인 의료비 변화궤적의 잠재계층 유형: 예측요인과 주관적 건강에 대한 영향)

  • Song, Si Young;Jun, Hey Jung;Choi, Bo Mi
    • 한국노년학
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    • v.39 no.3
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    • pp.467-484
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    • 2019
  • The purpose of this study is to explore latent classes of longitudinal medical expenses of older people and to analyze its predictors and its effects on subjective health. Among participants of the Korean Health Panel, the sample of this study includes 1,119 people who is 65-year-old or older and reported their medical expenses for nine consecutive years. The analyses were conducted in three steps. First, Growth Mixture Model (GMM) was applied to find distinct subgroups showing similar patterns in medical expenses. The results showed four groups which were classified as high medical expenditure maintenance group, medical expenditure increase group, low medical expenditure maintenance group, and medical expenditure reduction group. Second, the multinominal logistic regression found that the presence of spouse, economic participation, the number of chronic diseases, and the type of health insurance were significant predictors of latent classes in medical expenses. In particular, the greater the number of chronic diseases, the higher the likelihood of belonging to the high medical expenditure maintenance group. In addition, medical benefit recipients are more likely to belong to the low medical cost maintenance and medical cost reduction groups. Third, multiple regression analysis revealed that the older people in the groups with low or reducing expenses reported better subjective health than people with higher expenses. This study has its meanings in exploring the heterogeneity in longitudinal medical expenses among older people and its predictors and its associations with health outcome. The results of this research provide background information in establishing public health policy for older people.