PURPOSE: This qualitative study aimed to identify the common, lived experiences of grandmothers who cared for their grandchildren as the primary caregivers. METHODS: This study was based on the phenomenological method described by Colaizzi (1978). RESULTS: Seven theme clusters emerged from the data as follows: "grandmother caregivers accept the parenting role of the incessant responsibilities and the distrust of non-kin caregivers.", "grandmother caregivers have a double maternal roles; an instrument-oriented maternal role to their own child and relationship-oriented maternal role to their grandchild.", "grandmother caregivers are partially authorized to make decisions in the matters of their grandchild.", "grandmother caregivers suffer a deterioration in their health by an acceleration of the aging process.", "caregiving causes grandmother caregivers to feel a sense of social isolation, and persue various coping strategies to control this feeling.", "grandmother caregivers have a greater feeling of self-esteem, but they often conflict with their adult children if they don't feel appreciated by them.", "grandmother caregivers have limited social support and their health issues are often overlooked in the family context." CONCLUSION: The results of this study can guide nurses and health care workers to understand the experiences of grandmother caregivers and to implement individualized nursing interventions suited for them.
Aged ; Caregivers/*psychology ; Child ; Child Care/*psychology ; Child, Preschool ; Family/*psychology ; Female ; Humans ; Infant ; Intergenerational Relations ; Middle Aged ; Nursing Methodology Research ; Parenting/*psychology ; Questionnaires ; Social Support

PURPOSE: Nowadays, concern about the care of one's offspring has been increasing due to increased active participation of wornen in society and having fewer children than in the past. Therefore, we performed a study to evaluate the rnajor fields of child care counselling and establish effective child care counselling. METHODS: We retrospectively analyzed 2,754 cases of child care counselling about sex ratio, distribution of age, major fields of concern and major questions of each field using personal computer communication from April 1994 to March 1999. RESULTS: Sex distribution was usually unknown. The most frequent questions concerned the infantile period, especially less than 6 months of age. Nutrition, digestive system, development and psychology were the major fields of child care counsellng. CONCLUSION: We conclude that the major period of child care counselling was during the infantile period, and there was a major concern about nutrition, development and psychology. But, more efforts and studies are needed to establish effective child care counselling.
Child ; Child Care* ; Child* ; Digestive System ; Humans ; Microcomputers* ; Psychology ; Retrospective Studies ; Sex Distribution ; Sex Ratio

PURPOSE: To investigate the attitude, knowledge, and practice of safety and related factors of teachers in child care centers. METHODS: The total sample consisted of 116 teachers from child care centers in Kyunggi Province. A questionnaire and checklist were used to collect data, which was analyzed with SPSS 11.5 Win program. RESULTS: Most of the teachers were anxious about child accidents, and thought of safety as a primary concern. The mean score for knowledge on safety was 10.23, and the rate of correct answers ranged from 34.8% to 98.3%. The mean score on practice of safety was 42.01. Teachers with higher education showed significantly higher scores in safety efficacy. Teacher's knowledge on safety was significantly different depending on the experience of safety education, but this did not apply to safety practice. Safety practice was significantly related to confidence in safety performance, health beliefs on safety, stress, and social support, but not related to knowledge of safety. CONCLUSION: Psychosocial factors were found to be important in safety practice. Related factors found in this study should be considered when providing safety programs for child care centers.
Checklist ; Child ; Child Care* ; Child* ; Education ; Gyeonggi-do ; Humans ; Infant ; Infant Welfare ; Psychology ; Child Health ; Surveys and Questionnaires

COVID-19/psychology* ; Child ; Child Health ; Health Care Rationing ; Health Policy ; Health Services Accessibility ; Humans ; Pandemics ; Parents/psychology* ; Patient Acceptance of Health Care ; Singapore/epidemiology*

BACKGROUND: Children and parents experience significant anxiety and distress during the preoperative period. This is important because preoperative anxiety in children is associated with adverse postoperative outcome. So we suggest behaviorally oriented preoperative anxiety intervention program based on the anesthesia and psychology with smartphone application, world-widely used. METHODS: A total 120 patients (aged 1-10 years old) who were scheduled for elective surgery under general anesthesia was included in this randomized controlled trial. We randomized the patients into three groups, with using intravenous (IV) midazolam sedation (M group), with using smartphone application program (S group), and with using low dose IV midazolam plus smartphone application program (SM group). And the child anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at holding area, 5 min after intervention, entrance to operating room. RESULTS: In all three groups, mYPAS after intervention were lower than the preoperative holding area (M group 52.8 +/- 11.8 vs 41.0 +/- 7.0, S group 59.2 +/- 17.6 vs 36.4 +/- 7.3, SM group 58.3 +/- 17.5 vs 26.0 +/- 3.4). A comparison of mYPAS scores between each group showed that the S group reduced anxiety lower than M group (P < 0.01), and the SM group exhibited significantly lower anxiety than the two other groups (P < 0.01). CONCLUSIONS: The preoperative preparation program using smartphone application is simple and customized by individual development that effective in the reduction of preoperative anxiety.
Anesthesia ; Anesthesia, General ; Anxiety* ; Child ; Humans ; Midazolam ; Operating Rooms ; Parents ; Preoperative Care ; Preoperative Period ; Psychology

PURPOSE: This paper is a report of a concept analysis of 'quality of pediatric nursing care'. METHODS: Rodgers's evolutionary method of concept analysis was used. Data were collected from published literature related to quality of pediatric nursing care. RESULTS: Quality of pediatric nursing care was identified with three dimensions and seven attributes: 1) nurse's character: technical competence, interpersonal competence, 2) nurse's activities: developmentally appropriate care, attentiveness, entertainment, 3) nurse-parent interaction: nurse-parent partnership, emotional support. Antecedents of quality of pediatric nursing care were 'child and parent's expectation about pediatric nursing care', 'previous caring experience of pediatric nurses'. Consequences of quality of pediatric nursing care were 'meet child and parent's needs' and 'better health outcomes.' CONCLUSION: 'Quality of pediatric nursing care' is a core concept in pediatric nursing practice. Appropriate instruments to operationalize the concept need to be developed.
Child ; Humans ; Nurse-Patient Relations ; Nurses/psychology ; Pediatric Nursing/*standards ; Professional Competence ; *Quality of Health Care

Practicing medicine is a social activity. Because doctor-patient interaction requires respect, leadership, and interpersonal skills that extend beyond medical diagnosis and treatment, medical education must incorporate non-clinical competencies. While qualities such as lifelong learning skills, resource management, teamwork skills, and active involvement in leadership and bettering the healthcare system have received little attention in medical academia, these competencies have proven vital for a physician in contemporary society. These non-clinical competencies are, in fact, the traits or components of social competency. Social competency has been an area of interest, particularly with regard to the development of children and adolescents, in the fields of education, psychology, and less commonly, economics. However, traditional Korean residency programs have not paid much attention to social competency due to their closed culture originating from the colonial period. Resident education is still heavily dependent on a patriarchal system based on "family" values. Resident education is concentrated in medical knowledge and skills within specialty departments functioning as a family-like unit. Specialty training has a very narrow, constrained vision without incorporating much education on the social dimension of medical practice. Nevertheless, developing a social competency scheme for resident education was initiated in 2008, when the Korean Medical Association celebrated the centennial of producing licensed physicians. However, the scheme is still under development and not widely used. Korean medical educators must, therefore, recognize the value of social competencies and include them as graduation outcomes of residency training to prepare doctors to meet the challenges of the future.
Adolescent ; Child ; Delivery of Health Care ; Diagnosis ; Education ; Education, Medical ; Humans ; Internship and Residency ; Leadership ; Learning ; Psychology

Renal transplantation is the treatment of choice for children with end-stage renal disease. The outcome of pediatric kidney transplantation has improved dramatically in recent years, with lower acute rejection rates, superior graft survival, and low mortality. These improvements have allowed increased attention to other aspects of care for long-term survivors. Taking this into consideration, this review article will focus on the key issues related to pediatric kidney transplantation such as growth, neurocognitive function, nonadherence, and posttransplantation infectious complications, including lymphoproliferative disease, to broaden the understanding of pediatricians who provide pre-and postoperative care to children with end-stage renal disease.
Child ; Graft Survival ; Humans ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Postoperative Care ; Rejection (Psychology) ; Survivors

PURPOSE: The purpose of this study was to examine the effects of Kangaroo Care(KC) on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants. METHODS: The research design was a nonequivalent control group pretest-posttest. Data was collected from September 1. 2006 to June 20. 2007. The participants were 22 mothers in the experimental group and 21 in the control group. KC was applied three times per day, for a total of ten times in 4 days to the experimental group. RESULTS: The degree of anxiety was statistically significantly different between the two groups but maternal role confidence and maternal infant attachment was statistically insignificant. CONCLUSION: This data suggests that KC was effective for mothers anxiety relief but it was not effective for maternal role confidence and maternal infant attachment of mothers. The implications for nursing practice and directions for future research need to be discussed.
Adult ; *Anxiety ; Female ; Humans ; Infant Care/*methods ; Infant, Newborn ; Infant, Premature/*psychology ; Maternal Behavior/psychology ; Mother-Child Relations ; Mothers/*psychology ; Neonatal Nursing

To compare mortality rate, the adjustment of case-mix variables is needed. The Pediatric Index of Mortality (PIM) 3 score is a widely used case-mix adjustment system of a pediatric intensive care unit (ICU), but there has been no validation study of it in Korea. We aim to validate the PIM3 in a Korean pediatric ICU, and extend the validation of the score from those aged 0–16 to 0–18 years, as patients aged 16–18 years are admitted to pediatric ICU in Korea. A retrospective cohort study of 1,710 patients was conducted in a tertiary pediatric ICU. To validate the score, the discriminatory power was assessed by calculating the area under the receiver-operating characteristic (ROC) curve, and calibration was evaluated by the Hosmer-Lemeshow goodness-of-fit (GOF) test. The observed mortality rate was 8.47%, and the predicted mortality rate was 6.57%. For patients aged < 18 years, the discrimination was acceptable (c-index = 0.76) and the calibration was good, with a χ² of 9.4 in the GOF test (P = 0.313). The observed mortality rate in the hemato-oncological subgroup was high (18.73%), as compared to the predicted mortality rate (7.13%), and the discrimination was unacceptable (c-index = 0.66). In conclusion, the PIM3 performed well in a Korean pediatric ICU. However, the application of the PIM3 to a hemato-oncological subgroup needs to be cautioned. Further studies on the performance of PIM3 in pediatric patients in adult ICUs and pediatric ICUs of primary and secondary hospitals are needed.
Adult ; Benchmarking ; Calibration ; Child ; Cohort Studies ; Critical Care* ; Discrimination (Psychology) ; Humans ; Intensive Care Units* ; Korea* ; Mortality* ; Retrospective Studies ; Risk Adjustment