• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.20-27
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• 2007

Purpose : Child sexual abuse is a significant and serious problem that affects public health and society. Pediatricians are responsible for preventing and detecting sexual abuse of children. The aim of this study was to examine clinical findings of child sexual abuse. Methods : The authors retrospectively studied 292 patients between the ages of 0 and 18 who were referred for evaluation of sexual abuse to the Emergency Department of the National Police Hospital from Oct 1, 2001 to May 5, 2005. Results : Sixty three (21.6 percent) of sexual abuse victims were younger than 6 years of age; 89 (30.5 percent) were 6-12 years of age; and 104 (47.9 percent) were 12-18 years of age. Attack time was the most common between noon and 6 pm. Victims were attacked in their home or nearby (51.4 percent). One hundred fifty six (53.6 percent) offenders were accquaitances, thirty nine (13.4 percent) of whom were family members. The disclosure of attack by parents with abnormal physical symptoms was more common in younger children than in adolescence. Eighty nine (30.5 percent) victims had no specific physical findings, 51 percent had injury to the hymen, 37.3% had injury to external genitalia, and 4 percent had anal injury. One case of gonorrhea and thirteen cases of chlamydia were found. Sperm was found in 19 cases and acid phosphatase was positive in 28 cases. The absence of physical findings and laboratory findings was more common in younger children than in those in adolescence. The time interval from attacks to hospital visits had a significant negative correlation with age. Conclusion : For younger victims, the time interval from attack to hospital visitis was more prolonged. Victims may have no physical evidence of sexual abuse. Therefore, a careful history should be obtained and a through physical examination should be performed. Pediatricians must play a leading role in evaluation and treatment of sexually abused children, considering children,s growth and development. Coordination with other professionals is necessary to provide consultation, medical treatment, and legal assistance for the sexually abused children and families.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.154-163
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• 2010

Purpose: Colonic polyposis is less common in children than in adults. The clinical data pertaining to colonic polyposis in children are limited. Children with colonic polyposis have complications associated with numerous polyps, malignant transformation of the polyps, and extraintestinal neoplasms. We studied the clinical spectrum, endoscopic characteristics, and histologic findings of colonic polyposis in Korean children. Methods: We reviewed the clinical data of 37 children with multiple colonic polyps between 1987 and 2009. The mean age at the time of diagnosis of colonic polyposis was 8.0${\pm}$3.2 years. Results: Peutz-Jeghers syndrome, juvenile polyposis syndrome, familial adenomatous polyposis (FAP), and lymphoid polyposis was diagnosed in 22, 7, 6, and 2 children, respectively. The most common clinical presentation in children with colonic polyposis was hematochezia. A family history of colonic polyposis was noted in 7 children. The colonoscopic findings of colonic polyposis varied with the size and number of polyps. The majority of polyps were multi-lobulatd and pedunculated in children with Peutz-Jeghers syndrome. The polyps in children with juvenile polyposis syndrome were primarily round and pedunculated. For the children with FAP, the colon was carpeted with small, sessile polyps. There were multiple sessile polyps in the patients with lymphoid polyposis. Surgical polypectomy was performed in 14 children (38%). Intestinal segmental resection was performed in 13 children (35%). Four patients with FAP underwent total colectomy. Four children with Peutz-Jeghers syndrome had extraintestinal neoplasms. No malignant transformation of polyp was identified. Conclusion: Children with colonic polyposis should undergo a careful initial evaluation and require periodic re-evaluation.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.13-23
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• 1979

A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.

• Journal of Yeungnam Medical Science
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• v.9 no.2
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• pp.275-287
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• 1992

In order to survey the reality of anxiety and depression among the Koreans residing in China, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionairs, named Combined self-rating anxiety depression scale(CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows : There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were $29.70{\pm}7.03$, while those of Chinese were $29.45{\pm}9.01$. The score of the CADS above 50(clinially significant level) was seen in 12(2.54%) Koreans and 21(4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the comparison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libido. The Chinese marked significantly higher in facial flushing, anxiousness, dissatisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship(p<0.01 respectively), with past history of psychiatric hospitalization(Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image(p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness(p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education(p<0.01 respectively). In place of growth, the Koreans showed not much difference in the areas while more Chinese grew up un large cities(p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking(p<0.01 respectively). In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars(p<0.01 respectively). There were no significant difference between two groups about religion.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.82-90
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• 1998

This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools；distractibility and inattention, conduct problems, and lack of academic skills in middle schools；and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.

• Journal of Home Health Care Nursing
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• v.3
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• pp.53-66
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• 1996

Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

• Journal of Hospice and Palliative Care
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• v.13 no.4
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• pp.216-224
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• 2010

Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

• Journal of Korean Home Economics Education Association
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• v.25 no.4
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• pp.63-77
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• 2013

The purpose of this study is to develop the home economics-relevant program on Korean traditional culture for adolescents from multicultural families for them for experience it directly, set up ego-identity and improve social adaptability. Further, we checked the effectiveness and efficiency of the developed program. First we developed the program composed of a total of 12 sessions based on experiencing Korean culture. It consists of largely 5 madang(parts) centered on themes such as Eowool madang, Hangeul madang, Play madang, Cooking madang and hostory madang. We ran the developed program for 3 months targeting a total of 18 persons composed of the adolescents from multicultural families and their mothers residing in S city of eastern area of Jeonnam province. We measured the participants' ego-identity, social adaptibility and participation satisfaction to examine the effectiveness of the program. The results of pre-test, post-test and satisfaction which are evaluation instruments used in this program are as follows. First, it appeared that the self-identity of the adolescent of multicultural families inceased by 0.30 from average score of 3.03 before the participation in the program to 3.33 after the participation. Social adaptability increased by 0.30 from average 3.11 before the participation to 3.41 after the participation. Second, in the program participation satisfaction, it appeared that first the middle satisfaction marked average 3.30 which exceeded median value at 3.00, meaning a little high satisfaction, whereas the final satisfaction had an averagescore of 4.03, which means a big satisfaction concerning the program participation. The results indicated that the home economics-relevant program was effective in improving the ego-identity and social adaptability of adolescents from multicultural families and supporting a role of as a member of Korean family.

• Korean Journal of School Psychology
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• v.17 no.2
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• pp.165-180
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• 2020

As a tiered system of supports, School-Wide Positive Behavior Support (SWPBS) is an evidence-based practice in the educational system of Korea. An important aspect of SWPBS is the ongoing progress monitoring and evaluation of implementation fidelity. This study aimed to develop and validate the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC). The preliminary KT3-FC consisted of a 37-item, 6-factor checklist. In the first phase of the study, 10 experts reported that the range of content validity of the KT3-FC was adequate. In the second phase of the study, 185 teachers (52 men and 133 women) who implemented SWPBS completed the KT3-FC, Individualized Supports Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and PBS Effectiveness Scale. An exploratory factor analysis resulted in a 5-factor structure, with 20 items, instead of 37 items, consisting of: (a) progress monitoring and evaluation of the individualized supports, (b) provision of supports by aligning and integrating mental health and SWPBS, (c) crisis management planning, (d) problem behavior assessment, and (e) establishment of individualized support team. The internal consistency of the KT3-FC was good (full scale α = .950, sub-factor α = .888 ~ .954). In addition, the KT3-FC showed good convergent validity, having statistically significant correlations with the Individualized Support Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and the PBS Effectiveness Scale. Finally, the confirmatory factor analysis showed that the 5-factor model of the KT3-FC had some good model fits, indicating that the newly developed fidelity measure could be a reliable and valid tool to assess the implementation of Tier 3 supports in Korean schools. Accordingly, the KT3-FC could contribute to implement SWPBS as an evidence-based behavioral intervention for Korean students.

• Korean Journal of School Psychology
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• v.17 no.3
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• pp.401-419
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• 2020

The purpose of this study was to validate the Korean Implementation Fidelity Checklist of Tier 1 School-Wide Positive Behavior Support (KIFC-T1) for use in the Korean educational system. Tier 1 support, which is universal supports, within a multi-tiered, school-wide positive behavior support (SWPBS) model, aims to provide support to and prevent problem behaviors among all students in a school. The initial KIFC-T1 consisted of 48 items and 11 factors and was developed based on a literature review. Its content was validated by experts. The validated KIFC-T1 was introduced to 185 special school teachers who had experience implementing SWPBS and who used the instrument to assess the degree to which their schools had implemented Tier 1 support. Based on their responses, the construct validity of the KIFC-T1 was examined using factor, item, and internal consistency reliability analyses. The concurrent validity of the tool was examined using the PBS Evaluation Tool, School Climate Questionnaire, School Discipline Practice Scale, and PBS Effectiveness Scale. The analyses revealed that KIFC-T1 had a stable five-factor structure with 35 items, had good reliability (Cronbach's α=.956, each factor's Cronbach's α=.834-.951), and its results were statistically significantly correlated with those of the PBS Evaluation Tool, School Discipline Practice Scale, and the PBS Effectiveness Scale. However the KIFC-T1's results were not statistically significantly correlated with the results of the School Climate Questionnaire. These results suggest that KIFC-T1 is a reliable and valid tool for assessing the fidelity of universal support implementations.