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Family Stress, Perceived Social Support, and Coping of Mothers Who have a Child Newly Diagnosed with Congenital Heart Disease.

Young Ran TAK

Korean Journal of Child Health Nursing.2001;7(4):451-460.

Congenital heart disease is now estimated to be the most prevalent chronic illness in children. The overall purpose of study is to enhance our understanding of mother's perception of family stress, perceived social support, and coping who has a child newly diagnosed with congenital heart disease. In this investigation, the relationship between family stress, perceived social support, and coping within the context of a acute, non life- threatening chronic illness in the situation of newly diagnosed as Rolland's typology of chronic illness. The study employed data from a subset of a large longitudinal study, children's chronic illness: parents and family adaptation conducted by M. McCubbin (5 R29 NR02563) which was funded by the NIH. The subject for this study were 92 mothers who have a child under age 12 who was newly diagnosed with congenital heart disease within the last 3-4 months. Results form correlational and regression analysis revealed that perceived social support operated as a resiliency factor between family stress and coping of mothers. Child and family characteristics appeared to be important predictors of perceived social support and mother's coping. Therefore, the findings provide an incremental contribution to the explanation of effects for perceived social support and may challenge resiliency model in previous literature. Further, these findings suggest that perceived social support and coping are both influencing in the resiliency of relatively high risk groups of families who has a child with congenital heart disease.
Child* ; Chronic Disease ; Family Characteristics ; Financial Management ; Heart Defects, Congenital* ; Humans ; Longitudinal Studies ; Mothers* ; Parents ; Child Health

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The Lived Experience of Mothers about Rearing of School Children With Cerebral palsy.

Kyoung Seon BAEK

Korean Journal of Child Health Nursing.2001;7(4):434-450.

This study is designed to understand the meaning and nature of raising children with cerebral palsy. It researches the experience of mothers of schoolchildren with cerebral palsy by the research method of hermeneutic phenomenology. The study was conducted from November 10, 1999 to December 20, 2000. When children with cerebral palsy usually show symptoms in the early stage of cerebral palsy, mothers do not take children to a doctor for diagnosis. And, most of mothers have a difficult time to accept the reality; they usually respond to the initial diagnosis with shock, reproach, and deny. When mothers start recognizing the reality, they consider that their children have cerebral palsy due to the their mismanagement during pregnancy, delivery, nursing, and initial treatment. They shelter their children from view and feel guilty that they cannot afford to try folk remedies for their children. As time passes, mothers face conflicts between families in diverse ways. Families put the blame on genetic effects. Mothers-in-law give their daughters-in-law a hard time, husbands shift the responsibility of raising children onto their wives, and trouble arises between families-in-law and mothers native families. When children grow up, it is physically difficult for mothers to take care their children. In addition, they suffer from all the troubles in family due to childrens handicap. Mothers try the diverse methods of bringing up children. However, they start getting tired of raising children as they experience failures and financial difficulties. Mothers feel collapsed recalling the ways of raising children. They feel anxiety, miserable, lonely, and worrying when they think how children would attend school, make friends, and live in the future. In this stage, mothers do their best to raise their children with hope. They tend to compare their children with others without handicap and spend money and time in attempting all the treatments. When mothers and children join the society at school, they find that the society does not understand disabled people, teachers show inconsiderate attitude, friends avoid them, and children hardly follow classes. Such experiences make mothers feel angry and frustrated. However, when children adapt to school, mothers see the possibility that children could accomplish schoolwork. They appreciate teachers help and others consideration. Mothers place appropriate expectations on their children and help them to prepare for the future. I would make following suggestions based on the results. 1. As a primary basic course of rehabilitation nursing intervention, solution-centered nursing intervention system should be developed. The intervention needs to be based on the understanding of mothers, who raise children with cerebral palsy, through in-depth interview. 2. Advance researches on the development of individual nursing intervention should be conducted. Individual nursing intervention needs to prevent and release actual pain focusing on mothers raising children with cerebral palsy. 3.Integrated curriculum that help children with cerebral palsy lead a normal school life with ordinary children should be developed. 4.Basic research on using of facilities and effective application of service volunteer to help children with cerebral palsy in school needs to be conducted.
Anxiety ; Cerebral Palsy* ; Child* ; Curriculum ; Diagnosis ; Friends ; Hope ; Humans ; Medicine, Traditional ; Mothers* ; Nursing ; Pregnancy ; Rehabilitation Nursing ; Shock ; Spouses ; Volunteers ; Child Health

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The Lived Experience of Mothers of Children with Muscular Dystrophy.

Sang Eun OH

Korean Journal of Child Health Nursing.2001;7(4):421-433.

The purpose of this phenomenological study was to understand the lived experience of mothers of children with muscular dystrophy. The participants were 11 mothers recruited by snowball sampling, who agreed with the objectives of the research and could verbally communicate with the researcher and who lived with their sons who had muscular dystrophy. Data collection was done through in-depth interviews with participants in their own homes. Each interview took 50 to 120 minutes. All of the interviews were audiotaped and then transcribed. Data were analyzed using Colaizzi's (1978) method of phenomenology. From the transcripts 109 significant sentences and phrases were selected and 13 clusters of themes were categorized from 67 significant statements. These results were integrated into the essential structure of the lived experience of mothers of children with muscular dystrophy. 1.Anxious and relying on chance due to indefinite diagnosis. 2. Only able to cry with shock because of son's fatal disease. 3.Seeing the future as dismal and feeling resentment that this disease in transmitted through the mother. 4.Feeling caught between a husband who is distancing himself from his family and the family which is disintegrating. The author would like to thank Dr. Kasil Oh at Yonsei University, College of Nursing for her guidance, 5.Feeling like a sinner for transmission of genetic disease(Feeling guilt for conceiving a son with a genetically transmitted fatal disease). 6. Empathizing with other suffers of muscular dystropy and their parents in their grief and helping to dissipate their heavy feelings. 7. Deciding to sacrifice self as a way of taking responsibility for giving birth to a handicapped son. 8.Losing hope (feeling despair) as son's condition deteriorates in spite of all attempts to help him. 9.Wishing to die with son who becomes progressively immobile. 10. Accumulating Han, because of rising Hwa(anger), and becoming sick both mentally and physically. 11.Seeing events as destiny and finding self-control through faith. 12.Finally, giving up sacrificing self for son and becoming concerned(involved) with other children in the family. 13.Feeling fear at son's impending death. This is the first research on the experience of Korean mothers of children with muscular dystrophy. In applying the phenomenology research method, this study not only helps health professionals understand the experience of these mothers in the Korean patriarchal social system, but the researcher, as a nurse, can share their agony and grief through identification of their inner world through in-depth personal interviews. The results obtained in this study will not only help in the development of family nursing practice for families with genetically transmitted diseases but also prepare basic data for family nursing practice in the Korean sociocultural context.
Child* ; Data Collection ; Diagnosis ; Disabled Persons ; Family Nursing ; Grief ; Guilt ; Health Occupations ; Hope ; Humans ; Mothers* ; Muscular Dystrophies* ; Nursing ; Parents ; Parturition ; Shock ; Spouses ; Child Health

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The Effects of Phone Counseling on Maternal Role in Primiperous Mothers.

So Jeong KANG

Korean Journal of Child Health Nursing.2001;7(4):405-420.

The main purpose of this study was to identify the effect of phone counseling carried out to promote the role of the primiperous mothers. The data were collected from march 20 to may 30, 1998. The subjects for the study were the mothers of 60 first bon neonates admitted to and discharged from Sam-sung Medical Center's neonatal ward. Thirty subjects were assigned to the experimental group and thirty to the control group. A measure of maternal identity as well as level of self confidence in taking care of an infant after giving birth was taken. Informational supportive nursing was then provided to the mothers through phone counseling for a total of four times at 2~3 days, 7~8days, 12~13days and 18~1days after discharged. The level of self confidence in taking care of an infant was then remeasured. The control group was not provided with supportive nursing through phone counseling instead the level of confidence in taking care of an infant was measured at 3 weeks. Taking previous study documentary evidence into consideration the researcher developed a supportive nursing telephone counseling program that provided both informational and emotional support suitable to primiperous mothers. A semantic differential scale developed according to Osgood and translated and adapted by Koh Hyo-Jung was used as the maternal self identity measurement tool. The tool used to measure self confidence in taking care of infant was the developed by Bak Mi Suk which includes 13 items from Pharis's self confidence scale The data were analyzed using x2-test, t-test and paired t-test. The result of the study are as follows 1. First hypothesis The level of self confidence in taking care of an infant for the group of primiparas who received phone counseling in the postpartum period would be higher than that of the primiparas who did not receive phone counselling : As the experimental group's level of self confidence in taking care infants was significantly higher than that of the control group this hypothesis is accepted 2. Second hypothesis The level of maternal identity will be higher for the group of primiparas who received phone counseling than that of primiparas who did not received phone counseling As the experimental group's level of maternal identity was significantly higher than that of the control group this hypothesis is accepted In looking at the results of the study as a whole, it can be concluded that emotional and informational nursing support provided through phone counselling is an effective strategy in promoting the role of new mothers.
Counseling* ; Humans ; Infant ; Infant, Newborn ; Mothers* ; Nursing ; Parturition ; Postpartum Period ; Semantic Differential ; Telephone ; Child Health

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Children with Epilepsy: Quality of Life and Management.

Yeong Hee SHIN

Korean Journal of Child Health Nursing.2004;10(2):225-232.

The purpose of this article is to describe the overview of current medical treatments of childhood epilepsy in Korea and to review several recent nursing researches related to quality of life problems, especially psychological functioning in children with epilepsy and the stress of the family. The prognosis of childhood epilepsy has been improved considerably and about 80% of patients can now be expected to achieve complete seizure control by the antiepileptic drug treatment. Even for the intractable epilepsy, with the combination of ketogenic diet program and antiepileptic drug therapy or surgical treatment, the prognosis became very much better than before. The majority of research has reported that children with epilepsy were experiencing quality of life problems. They are at risk for impaired functioning, compared to either general population controls or to other chronic illness groups such as asthma and diabetes. The ultimate goal of providing care to children with epilepsy is to control seizures while facilitating an optimal quality of life for the child as well as the family. Recommendations are included for future research and intervention programs for children, parents and our society.
Asthma ; Child* ; Chronic Disease ; Drug Therapy ; Epilepsy* ; Humans ; Ketogenic Diet ; Korea ; Nursing Research ; Parents ; Population Control ; Prognosis ; Quality of Life* ; Seizures ; Child Health

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Effects of Nonnutritive Sucking on Behavioral State in Preterm Infants.

Hee Sun SHIN

Korean Journal of Child Health Nursing.1998;4(2):305-313.

The purpose of study was to examine the effect of nonnutritive sucking(NNS) on behavioral state in preterm infants. Fourteen infants(gestational age 28-35 weeks, M=31.86 ; birth weights 1095-2275g, M=1694g) admitted to NICU, serving as their controls were randomly administered 5 min of nonnutritive sucking and a control condition. Behavioral state was measured using the Anderson Behavioral State Scale(ABSS). Heart rates were obtained for each infant before and during NNS and bottle feeding. Data collection was done by 3 experienced nurses in NICU 2 times a day for consecutive 4 days for each subject. Interrater reliability were .80-.90. The findings were as follows : 1. Preterm infants averaged active restless states 58.93% in the preintervention phase and 27.32% in the NNS phase. Inactive awake states were 3.57% in the preintervention phase and 34.64% in the NNS phase. 2. There were significantly more positive changes to inactive awake states for the NNS intervention, Z=-2.35, p=.01. 3. There was no statistically significant difference in heart rate change between NNS intervention and control condition, z=-1.15, p=.24. 4. The rates of feeding success determined by finishing prescribed amount of milk by bottle feeding within 15 minutes were 83.94% in NNS intervention and 89.29% in control condition. The findings from this study confirmed that NNS is effective for behavioral state modulation and inducing optimal state for feeding in preterm infant. The NNS intervention in nursing practice may help the transition of preterm infants for nipple feeding.
Birth Weight ; Bottle Feeding ; Data Collection ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Milk ; Nipples ; Nursing ; Weights and Measures ; Child Health

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Experience of Siblings of Children with Cancer.

Na Young CHEON

Korean Journal of Child Health Nursing.1998;4(2):294-304.

Illness is a situational crisis which affects entire family members. Children have different experiences and responses when their sibling has a cancer. There are many studies on sibling experiences to childhood cancer which have many problems in the USA. The main purpose of this study is to describe sibling experiences to childhood cancer accurately and coprehensively by collecting data from sibling to provide the data to develop nursing interventions for the families with childhood cancer. The data was collected from October 1 to November 6, 1995. A total of ten siblings with childhood cancer were interviewed. The meaningful contents were classified and categorized to four areas. Theses areas include knowledge and perception related to illness, changes in family life, changes in school life, and siblings' marturation. The results of this study were as follows : 1. Knowledge and perception related to childhood cancer : Children had limited knowledge about illness and expressed the desire to know more about sibling's illness. 2. Changes in family and school life : Children expressed loneness, emptiness, sadness, depression about separation with the mother and sibling, family mood change, leisure activities and financial difficulties. Many children reported that their school performance had suffered since sibling's illness. 3. Maturation of children : Some positive outcomes related to having a sibling with a cancer are maturation, increased affection for the sibling, empathy for their parents. The results of this study indicate that it is important to develop comprehensive nursing intervention programs for the families with a childhood cancer.
Child* ; Depression ; Empathy ; Humans ; Leisure Activities ; Mothers ; Nursing ; Parents ; Siblings* ; Child Health

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The Anxiety of Mothers with Leukemic Children.

Sun Nam PARK ; Young Im MOON ; Ho Ran PARK ; Sun Hee CHOI

Korean Journal of Child Health Nursing.1998;4(2):286-293.

The purpose of this study was to investigate the level of anxiety for the mothers of leukemic children and to provide the fundamental data for the better performance of caring to them. The subject were 292 mothers : 100 mothers whose children had a leukemia, 80 mothers whose children had taken a tonsillectomy, 112 mothers whose children with medical disease except cancer. The data were collected through the state-Trait Anxiety Inventory of Spilberger and analyzed by t-test, ANOVA, Scheffe test. The results were as follows ; 1. The state anxiety mean score of mothers with leukemic children was 54.16. 2. The state anxiety of mothers with leukemic children was higher than that of the rest (F=8.00, P=0.0004). 3. There was no significant difference in anxiety of mothers with leukemic children in relation to leukemic children's and their mother's general characteristics.
Anxiety* ; Child* ; Humans ; Leukemia ; Mothers* ; Tonsillectomy ; Child Health

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Uncertainty, Self-Efficacy & Coping in Parents' of Children with Cancer.

Won Oak OH ; Eun Sook PARK

Korean Journal of Child Health Nursing.1998;4(2):274-285.

Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the aggressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale(28item, 4 likert scale), Shere's Self-Efficacy Scale)17item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist)34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation co-efficient. Results of this study are summarized as follows : 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as : lack of clarity(2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured from 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be influenced significantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high(Mn 2.78). The degree of coping related to be influenced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001). From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.
Child* ; Health Personnel ; Humans ; Nursing ; Parents ; Parturition ; Prognosis ; Uncertainty* ; Child Health

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The Changes in Children's Sleeping Patterns caused by Hospitalization.

Mun Hee PARK ; Ae Ran LEE

Korean Journal of Child Health Nursing.1998;4(2):265-273.

The purpose of this study was to identify the children's sleeping patterns, such as the sleeping hours and the nature of sleep disruptions following hospitalization and its accompanying factor. The data were collected from December, 1997 to March, 1998 using a questionnaire developed by researchers. The subjects were 76 children in a hospital. The results of this study were summarized as follows : 1. The average sleeping hours(sleep duration) at night were 10 hours and 10 minutes and 9 hours and 9 minutes before and after hospitalization respectively. There was a significant difference(P<0.01). 2. The mean bed time(sleep onset) was 10:22 pm and 10:28 pm before and after hospitalization respectively. There was no significant difference. 3. The mean hour of rising(sleep termination) was 7:54 am 7:08 am before and after hospitalization respectively. There was a significant difference(P<0.01). 4. The mean number of sleep disruption was 0.72 and 1.94 before and after hospitalization respectively. There was a significant difference(P<0.01). The sleep disruptions were influenced by crying of other children(53.9%), lights(28.9%) nursing procedures(18.4%), noise of TV(17.1%) and noise of visitors(15.8%).
Child ; Crying ; Hospitalization* ; Humans ; Noise ; Nursing ; Child Health ; Surveys and Questionnaires

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