PURPOSE: The study was done to investigate behavioral problems in toddlers who were born prematurely and to analyze related factors. METHODS: A cross-sectional explorative study was conducted with 72 preterm birth (PTB) children at 24 to 41 months of corrected age who were born at 28 to 37 weeks' gestation. During home visits, behavior problems were assessed using the Behavior Rating Index for Children (BRIC). Using a BRIC score of > or =30, children with suspected behavior problems were grouped in the non-regular behavior group. RESULTS: Of the children, 38.9% belong to the non-regular behavior group. The mental development index score for the Korean-Bayley Scale of Infant Development-II was higher for the non-regular behavior group compared to the regular behavior group (t=2.26, p=.027). Logistic regression analysis showed that lower maternal attachment (<96, OR=3.4, 95% CI[1.1, 10.4]) and higher parenting stress (> or =97, OR=4.8, 95% CI[1.3, 17.3]) were independently related to non-regular behavior. CONCLUSION: PTB Toddlers are at risk for behavior problems which are associated with low cognitive performance. Maternal-child attachment and maternal parenting stress were strongly related to behavior problems in these children. More attention is needed to understand possible behavior problems in young children with PTB, particularly focusing on maternal-child interaction and maternal mental well-being.
Child ; House Calls ; Humans ; Infant ; Logistic Models ; Parenting ; Parents ; Pregnancy ; Premature Birth

PURPOSE: This study was conducted to describe parenting stress in mothers of preschoolers who were born prematurely and to determine factors affecting parenting stress in child's problem behavior, mother-child interaction and parenting alliance. METHODS: An exploratory survey study was conducted with 66 mothers of preschool children (5~6 years) with preterm births (PTB). Data were collected using Parenting Stress Index (PSI), Child Behavior Checklist (CBCL), Mother-Preschool Child Interaction Scale (MPIS), and Parenting Alliance Inventory (PAI). RESULTS: Of the 66 mothers, 8(12.1%) showed high scores that were more than borderline for the PSI total score. In the multiple linear regression analysis, lower scores on the PAI (β=−.41, p<.001), higher scores on the externalizing problem behavior of the CBCL (β=.40, p=.001), and lower scores on the MPIS (β=−.21, p=.043) were statistically significant contributors to maternal parenting stress. CONCLUSION: Findings indicate that mothers of PTB preschool children are at risk for parenting stress. Child's externalizing problem behavior, poor maternal-child interaction and parenting alliance were independent factors raising maternal parenting stress. More attention is needed on paternal parenting support, child's behavioral development, interaction with children for effective prevention and management of maternal parenting stress of PTB young children.
Checklist ; Child ; Child Behavior ; Child, Preschool ; Humans ; Linear Models ; Mother-Child Relations ; Mothers* ; Parenting* ; Parents* ; Premature Birth ; Problem Behavior

Purpose: This study was conducted to investigate factors affecting health behaviors in late school-aged children from multicultural families. Methods: This study included 401 children (112 from multicultural families and 289 from non-multicultural backgrounds) in grades 4~6 in 11 elementary schools. Data on health behaviors and related factors (school adjustment, the mother-child relationship, self-efficacy, etc.) were collected from the children using self-reported questionnaires between May and June in 2019. The collected data were analyzed through a univariate analysis and multiple regression analysis. Results: The health behavior score of multicultural children was lower than that of non-multicultural children (t=3.32, p=.001). In multicultural children, school adjustment (β=.55, p<.001), mother-child relationship (β=.25, p=.001), and perceived health status (very healthy=1; β=.19, p=.011) were significant factors affecting their health behavior and explained 47.0% (F=30.93, p<.001) of the variance. Conclusion Multicultural late school-aged children are at risk to engage in a lower level of health behaviors than their non-multicultural counterparts. More attention should be paid to ways of improving multicultural children’s perceptions of their health status, maternal relationships, and school adjustment in order to promote health behaviors.

Purpose: This study investigated the parenting experiences of mothers of young children born moderate-to-late preterm (MLPT) in South Korea. Methods: In this qualitative study, semi-structured focus group interviews were conducted with 10 mothers of MLPT children from infancy to preschool age. The interviews were video-recorded, transcribed verbatim, and analyzed using qualitative content analysis. Results: Four categories resulted from the analysis of parenting experiences of mothers with young MLPT children, as follows: "becoming a mother of an early-born child", "difficulties as the primary caregiver for a high-risk child", "helpful social support, but still a lack of professional support for parenting a high-risk child", and "mothers and children growing together". Conclusion Mothers of young MLPT children experienced difficulties due to concerns about their child's health, growth and development, and insufficient child-rearing support. Therefore, social support systems should be strengthened and more aggressive nursing strategies should be adopted for mothers of young MLPT children.

PURPOSE: Study purpose were to describe growth patterns of premature infants in weight, length and head circumference from birth to 40th week of corrected ages (CA) and to explore factors affecting patterns. METHODS: A longitudinal descriptive study was conducted with 267 premature infants. They were categorized into 2 groups; GA group with measurements at birth and the CA group with measurements at CA, which was categorized into 3 groups (group 1-3) by WHO guideline for gestational age (GA) at birth. RESULTS: GA group presented greater measures in all than CA group at same week of life. Among CA groups, group 3 showed the highest measurements, up to 37 weeks of life, though this disappeared at 38-40 weeks. Reversely, group 1 revealed the highest growth rates in all measures, followed by group 2 and group 3. Significant interaction was observed in all measures between week of life and any type of groups. CONCLUSION: Higher measures in GA group, as well group 3 among CA groups, supported the superiority of intra-uterine environment overriding quality of regimen from NICU. Regardless of growth acceleration, smaller infants remain smaller, indicating that intra-uterine thrifty phenotype may continue at least up to the 40th week of CA.
Adult ; Anthropometry ; Birth Weight ; Body Height ; Body Weight ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature/*growth & development ; Infant, Small for Gestational Age/growth & development ; Longitudinal Studies ; Male

PURPOSE: This study was conducted to measure adiposity and to investigate related factors in preschoolers born prematurely. METHODS: A longitudinal follow-up study was conducted with 52 preschoolers at 5 years of corrected age among 343 preterm infants. Their adiposity status was evaluated based on measurements of body mass index, subscapular and triceps skin fold thickness (SFT), waist circumference, waist-to-height ratio, and mid-arm circumference at a home visit. RESULTS: The findings showed that SFT measurements, particularly at the triceps, reflected the degree of adiposity more accurately than other conventional measures. A shorter gestation, older maternal age, and the mother having more years of formal education were associated with higher levels of adiposity in the preschoolers. CONCLUSION: The adiposity of children born prematurely needs to be thoroughly monitored with additional SFT measurements, considering the risk of accelerated growth patterns overriding regular catch-up growth in children born prematurely.
Adiposity* ; Body Mass Index ; Child* ; Child, Preschool ; Education ; Follow-Up Studies ; House Calls ; Humans ; Infant, Newborn ; Infant, Premature ; Maternal Age ; Mothers ; Pregnancy ; Premature Birth ; Skin ; Skinfold Thickness ; Waist Circumference

Purpose: This study was conducted to explore the child-rearing experiences of mothers with early adolescents in Korean multicultural families. Methods: The participants were six mothers with early adolescents in Korean multicultural families. Data were collected through in-depth interviews. The main question was, "Could you tell me about your child-rearing experiences with your adolescent child?" The data were analyzed using qualitative content analysis. Results: Four categories resulted from the analysis of child-rearing experiences of mothers with early adolescents in Korean multicultural families, as follows: "separation between myself and others", "distance between myself and my adolescent child", "making efforts to bridge the gap between myself and others", and "trying to connect with my adolescent child closely". Conclusion These findings indicate that mothers in Korean multicultural families made many efforts to bridge the gap between themselves and other people, and tried to connect with their children closely. The findings of this study emphasize specific aspects of how mothers with early adolescents experienced child-rearing in Korean multicultural families.

Objective: The aim of this study was to develop a Korean version of the Thinking About Life Experiences (TALE-K) scale and to analyze the characteristics of autobiographical memory function (AMF) in community-dwelling older adults. Methods: To develop TALE-K, a translation and back-translation procedure followed by an understanding test was performed. Then, a survey was conducted to examine the associations of AMF with psychosocial variables using TALE-K, Index of Well-Being (IWB), Meaning in Life Scale for older adults, Revised UCLA Loneliness Scale, Medical Outcomes Study Social Support Survey, and Brief Resilience Scale. Results: Data from 75 community-dwelling older adults were used for the final analysis. The average scores of all three sub-scales of TALE-K were below 3 points (less frequent than occasionally). The correlation results showed that TALE-K total score was significantly associated with IWB and the Meaning in life scale for older adults. The multiple linear regression results present-ed that higher AMF was significantly associated with higher IWB, along with having siblings, higher meaning in life and resilience,and lower loneliness. Conclusion Including a validation study of TALE-K, studies for understanding the characteristics of AMF in older adults using TALE-K are needed.

PURPOSE: This study was conducted to evaluate cognitive ability in preschoolers born prematurely and to investigate related factors.METHODS: A prospective, longitudinal study was conducted with 64 children at 5–6 years of corrected age (CA) (second follow-up) among 76 children who had been assessed at 2.0~3.5 years of CA (first follow-up) from a sample of 343 preterm infants born from 2008 to 2010. To evaluate each child's cognitive ability, during a home visit, we used the Kaufman Assessment Battery for Children-II (KABC-II) at the second follow-up. To explore factors related to cognitive ability, we measured children's hemoglobin level at the second follow-up and used the data collected in our previous study, including the Bayley Scale of Infant Development-II (BSID-II) at the first follow-up.RESULTS: The mean total KABC-II quotient was 117.0±14.4. The 5-minute Apgar score (β=.29, p=.006), hemoglobin level (β=.22, p=.032), and the mental development index quotient of the BSID-II (β=.51, p<.001) were statistically significant predictors of the KABC-II quotient in multiple linear regression analysis.CONCLUSION: The cognitive function of young children born prematurely was influenced by early neurodevelopment and factors reflecting their health status, such as anemia and a low 5-minute Apgar score.
Anemia ; Apgar Score ; Child ; Child Development ; Cognition ; Follow-Up Studies ; House Calls ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Linear Models ; Longitudinal Studies ; Premature Birth ; Prospective Studies

According to the World Health Organization, for medical schools to fulfill their obligation of social accountability, it is necessary for medical education, research, and service areas to ref lect the healthcare system’s relevance, quality, cost-effectiveness, and equity. This study utilized Boelen and Heck’s (1995) social accountability grid model to analyze the degree to which the Accreditation Standards of Korean Institute of Medical Education and Evaluation 2019 (ASK2019) standards apply the World Federation for Medical Education’s (WFME) standards. The social accountability characteristics of the former were compared to those of the WFME, the Liaison Committee on Medical Education, and the Australian Medical Council. Experts with experience and certification in medical education and evaluation classified the ASK2019 standards according to the grid model, evaluated social accountability perspectives, and categorized them according to the process, content, and outcome. Of the 92 standards, 61 (66.30%) were selected as social accountability standards; these encompassed all areas. There was a particular focus on outcome-related areas, such as “mission and outcomes,” “student assessment,” “educational evaluation,” and “continuous improvement.” Education and quality were the most common (33, 54.11%), followed by 18 standards related to education and relevance. However, the standards on cost effectiveness and equity corresponding to education, research, and service were significantly insufficient. As a result of classification using a logic model, many criteria were incorporated into the process, producing results similar to those of international accreditation institutions. Therefore, to fulfill medical schools’ social accountability, it is necessary to develop cost effectiveness and equity standards with reference to grid models and expand them beyond education to include research and service areas. Developing content and outcome standards is also required.