• The Journal of Korean Academic Society of Nursing Education
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• v.28 no.1
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• pp.5-14
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• 2022

Purpose: Neonatal nurses are expected to have clinical competency to provide qualified and safe care for high-risk infants. An educational intervention to enhance nurses' clinical competence is often a priority in the nursing field. This study was conducted to explore nurses' perceived importance and performance confidence of nursing care activities in neonatal intensive care units. Methods: One hundred forty-one neonatal nurses from seven hospitals across South Korea participated in the online survey study. The scale of neonatal nursing care activity consisted of 8 subdomains including professional practice (assessment, diagnosis, planning, intervention, evaluation, education, research, and leadership). The Importance-Performance Matrix was used to analyze the importance of and confident performance in each of the nursing subdomains. Results: Both importance and performance confidence increased as nurses' age (p=.042 and p<.001) and clinical experience (p=.004 and p<.001). Participants scored relatively higher in importance and performance confidence in the professional practice subdomains (assessment, intervention, evaluation), but scored lower in the education and research subdomains. Conclusion: To provide evidence-based nursing care for high-risk infants in neonatal intensive care units, educational interventions should be developed to support nurses based on the findings of the research.

• Pediatric Infection and Vaccine
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• v.19 no.3
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• pp.121-130
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• 2012

Purpose : The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). Methods : A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. Results : Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count ($14,473{\pm}6,824/mm^3$ vs. $11,254{\pm}5,775/mm^3$, P=0.002) and the C-reactive protein ($6.32{\pm}8.51mg/L$ vs. $1.28{\pm}2.35mg/L$, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). Conclusion : This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.513-518
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• 2009

In childhood tuberculosis, it is possible to clearly distinguish among three basic stages: exposure, infection, and disease. The incidence of tuberculosis in children is low compared with that in adults, but latent infection is a major concern because children, who are exposed to Mycobacterium tuberculosis especially early in childhood, are at increased risk of developing the disease. Younger children particularly infants have a high relative risk of miliary or meningeal disease. The clinical manifestations of childhood tuberculosis differ noticeably from those of the disease seen in adults. Adolescents with tuberculosis have different demographic and clinical features from those of adults or children. Tuberculosis in adolescents has become relatively more important as the incidence of infection in childhood has decreased.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.289-297
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• 2023

Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients' life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.

• Neonatal Medicine
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• v.17 no.2
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• pp.201-206
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• 2010

Purpose: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. Methods: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. Results: The mean gestational age and birth weight (BW) of all infants were $27^{+6}{\pm}1^{+6}$ weeks and 951${\pm}$245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033${\pm}$285 g vs. 821${\pm}$126 g, P=0.048) and weight on operation day (1,195${\pm}$404 g vs. 893${\pm}$151 g, P=0.042), longer hospital days (105${\pm}$29 vs. 141${\pm}$39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative $FiO_2$ (0.29${\pm}$0.06 vs. 0.38${\pm}$0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. Conclusion: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high $FiO_2$ might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.

• Child Health Nursing Research
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• v.3 no.2
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• pp.228-240
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• 1997

It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study, Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the muthers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommanded that home health care will be one of the approach to support the mothers caretaking activities.

• Clinical and Experimental Pediatrics
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• v.55 no.8
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• pp.280-285
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• 2012

Purpose: The authors analyzed the trend from the birth-related statistics of high birth weight infants (HBWIs) over 50 years in Korea from 1960 to 2010. Methods: We used 2 data sources, namely, the hospital units (1960's to 1990's) and Statistics Korea (1993 to 2010). The analyses include the incidence of HBWIs, birth weight distribution, sex ratio, and the relationship of HBWI to maternal age. Results: The hospital unit data indicated the incidence of HBWI as 3 to 7% in the 1960's and 1970's and 4 to 7% in the 1980's and 1990's. Data from Statistics Korea indicated the percentages of HBWIs among total live births decreased over the years: 6.7% (1993), 6.3% (1995), 5.1% (2000), 4.5% (2000), and 3.5% (2010). In HBWIs, the birth weight rages and percentage of incidence in infants' were 4.0 to 4.4 kg (90.3%), 4.5 to 4.9 kg (8.8%), 5.0 to 5.4 kg (0.8%), 5.5 to 5.9 kg (0.1%), and >6.0 kg (0.0%) in 2000 but were 92.2%, 7.2%, 0.6%, 0.0%, and 0.0% in 2009. The male to female ratio of HBWIs was 1.89 in 1993 and 1.84 in 2010. In 2010, the mother's age distribution correlated with low (4.9%), normal (91.0%), and high birth weights (3.6%): an increase in mother's age resulted in an increase in the frequency of low birth weight infants (LBWIs) and HBWIs. Conclusion: The incidence of HBWIs for the past 50 years has been dropping in Korea. The older the mother, the higher was the risk of a HBWI and LBWI. We hope that these findings would be utilized as basic data that will aid those managing HBWIs.

• Child Health Nursing Research
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• v.18 no.3
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• pp.95-100
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• 2012

Purpose: The purpose of this study was to facilitate home visits to assess the current rate of child abuse in order to provide an agenda for the early detection and prevention of child abuse and neglect in Korea. Methods: For this retrospective descriptive research, 20 public health centers were selected, 1,991 families were visited and 2,680 children were assessed. Results: We found 415 cases (15.5%) of potential abuse and 7 cases (0.3%) of actual abuse. The greatest risk group was to children age 4 to 6 years. According to the HOME Inventory, there were 17 infants (5.8%) presenting a potential risk for child abuse and neglect. Conclusion: Visitation screening is highly recommended for prevention in the high-risk preschool age group.

• Neonatal Medicine
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• v.16 no.2
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• pp.205-212
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• 2009

Purpose: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. Methods: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. Results: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score ($\leq3$) was lower in the immediate group than the delayed group. Conclusion: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.

• Journal of Families and Better Life
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• v.31 no.1
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• pp.11-27
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• 2013

The purpose of this study was to investigate the overall developmental characteristics of Korean children ages 0 to 8, and then explore specifically how children's social and emotional developmental levels are related to mothers' psychological states. This study was part of newly launched Boryung Baby Panel Study using web-based survey in 2011. The subjects were all mothers of 940 infants(0-2 years), 654 toddlers(3-5 years), and 484 school-age children(6-8 years) The mothers were asked to administer the web-based standardized developmental checklist for their child and fill out the questionnaires of psychological variables(life satisfaction, depression, parenting attitude, parenting efficacy, and parenting stress). The data was analyzed using descriptive analysis, t-test, and logistic regression for SPSS 20.0 windows. Major findings were as follows: 1. Infants(0 to 2) showed higher developmental level in cognition and fine motor skill domain compared to other domains. 2. Most toddlers(3 to 5) showed normal development in the most domain such as gross motor skill, fine motor skill, language, letter, number, self-help behavior. 3. In socio-emotional development domain, the ratio of risk or delay group were highest at both infant and toddler. 4. The 6-8 years old children that belong to risk group by the result of SDQ(emotion and behavior assessment) were also relatively high. 5. The relation of the children's socio-emotional developmental level and the mother's psychological variables were reciprocal. Based on these findings, the implications and the limitations of current study were discussed.