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Flora Colonization and Oral Glucose Levels During the Early Postnatal Period in High-Risk Newborns.

Young Mee AHN ; Min SOHN ; Yong Hoon JUN ; Nam Hee KIM

Child Health Nursing Research.2016;22(4):379-389. doi:10.4094/chnr.2016.22.4.379

PURPOSE: A longitudinal study was conducted to explore flora colonization and oral glucose high-risk newborns during the first 7 days after birth. METHODS: Oral secretions of hospitalized newborns were obtained for microbial cultures and glucose test at days 1-7 after birth. RESULTS: Among the total 112 newborns, 40% were girls and 73% were premature. Mean gestational age was 34.4±3.2 weeks and weight was 2,266±697.5 grams. The most common flora included Streptococcus (28.2%), Methicillin-resistant Staphylococcus aureus (MRSA, 10.9%), Staphylococcus (6.0%) and Coagulase- Negative Staphylococcus (CNS, 4.0%). The average oral glucose level was 29.2±23.0mg/dl~58.2±39.5mg/dl. Newborns with higher oral glucose than serum (crude odds ratio [ORc] =1.75; 95% confidence interval [CI] =1.03-2.97), phototherapy (ORc=3.30; 95% CI=2.29-4.76) and prone position (ORc= 2.04; 95% CI=1.13-3.69) were more likely to be colonized. Having oral tubes (ORc=0.42; 95% CI=0.29-0.59), parental nutrition (ORc=0.21; 95% CI=0.13-0.32) and antibiotics (ORc=0.51; 95% CI=0.36-0.73) had protective effects. For oral glucose statistical significances existed on time effect among newborns with Streptococcus (F=9.78, p=.024), MRSA (F=7.60, p=.037) or CNS (F=11.15, p=.019) and interaction between time and colonization among newborns with all of four flora (F=2.73, p=.029) or colonization with only Staphylococcus (F=2.91, p=.034). CONCLUSION: High-risk newborns develop flora colonization at an early period of life. Their clinical features were associated with types and time of oral flora colonization. They need close monitoring and multifaceted intervention to improve oral environment and infection control.
Anti-Bacterial Agents ; Colon* ; Female ; Gestational Age ; Glucose* ; Humans ; Infant, Newborn* ; Infection Control ; Longitudinal Studies ; Methicillin-Resistant Staphylococcus aureus ; Mouth ; Odds Ratio ; Parents ; Parturition ; Phototherapy ; Prone Position ; Staphylococcus ; Streptococcus

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Influence of Perceived Attachment Security and Social Support on Somatic Symptoms in Late School-Aged Children Using a School Health Clinic.

Yu Jin PARK ; Yeo Jin IM

Child Health Nursing Research.2016;22(4):370-378. doi:10.4094/chnr.2016.22.4.370

PURPOSE: The purpose of this study was to examine current status of somatic symptoms of late school-aged children using the school health clinic and to investigate the influence of perceived attachment security and social support on their somatic symptoms. METHODS: For this descriptive study, self-report questionnaires were completed by fifth and sixth graders attending 'A' elementary school in Gyeonggi-do. Data from 216 students were included. Data analysis included descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression analysis. RESULTS: Most frequent somatic symptoms were headache, fainting, backache, numbness in a body part, and muscle ache in that order. More frequent somatic symptoms were reported by girls, students who recognized their family SES as low, students who used school health clinic often and students who were dissatisfied with school life. Somatic symptom showed negative correlations with attachment stability and perceived social support from family and teachers. In the regression analysis, the variables; low attachment stability, female gender, and low satisfaction with school affected more frequent somatic symptoms. CONCLUSION: Careful monitoring of late school-aged children expressing frequent somatic symptoms is required. Intervention programs to improve attachment security and satisfaction with school should be developed for school children, especially girls, presenting with somatic symptoms.
Back Pain ; Child* ; Female ; Gyeonggi-do ; Headache ; Humans ; Hypesthesia ; Parent-Child Relations ; Psychosomatic Medicine ; School Health Services* ; Statistics as Topic ; Syncope

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Factors Influencing Fatigue in Mothers of Hospitalized Children.

Hee Seung SONG

Child Health Nursing Research.2016;22(4):363-369. doi:10.4094/chnr.2016.22.4.363

PURPOSE: Fatigue in mothers of hospitalized children is an important component for her child's health. This study was done to identify factors influencing fatigue in mothers of hospitalized children. METHODS: A descriptive correlation study design was used. Participants were 157 mothers of hospitalized children in a university hospital located in one city. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression. RESULTS: Mean score for fatigue in mothers of hospitalized children was 2.11±0.53. There were significant differences in scores for fatigue in these mothers according to education, sleep satisfaction, and family support. Multiple regression analysis showed that the important factors related to fatigue in mothers of hospitalized children were parenting stress (β =.44), hours of sleep (β =-.25), and age (β =-.21). These factors explained 38% of the total variance. CONCLUSION: Research results suggest that nursing interventions for mothers of hospitalized children are needed in order to improve the comfort and health of the mothers and facilitate the recovery of their child.
Child ; Child, Hospitalized* ; Education ; Fatigue* ; Humans ; Mothers* ; Nursing ; Parenting ; Parents ; Statistics as Topic

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Effects of Massage Therapy on Feeding Intolerance and Physical Growth in Premature Infants.

Hyun Young SEO ; Young Hae KIM ; Sung Ju KIM

Child Health Nursing Research.2016;22(4):355-362. doi:10.4094/chnr.2016.22.4.355

PURPOSE: The purpose of this study was to identify effects of Massage therapy on feeding intolerance and physical growth in premature infants. METHODS: This study was conducted in the NICU of U university hospital, from June to December 2014. A quasi experimental design was used. A total of 60 premature infants were randomly assigned into two groups of 30 infants each. Infants of control group were given conventional treatment, while infants of experimental group given conventional treatment plus massage therapy. Massage therapy was performed for 15 minutes, 60 min before feeding, 3 times per day for 21 times over 7 days. The number of feedings withheld for feeding intolerance, number of gastric residuals, number of fecal excretions and physical growth variables (weight, height) were measured. RESULTS: After the intervention, number of fecal excretions and weight gain in the experimental group were significantly higher than that of the control group. Also, number of gastric residuals in the experimental group was lower than that of the control group. CONCLUSION: Massage therapy laid the basis for nursing intervention to promote feeding tolerance and physical growth in premature infants.
Enteral Nutrition ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Massage* ; Nursing ; Research Design ; Weight Gain

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A Survey of Smartphone-Based Health Education Needs for Parents.

Shin Jeong KIM ; Jung Min LEE ; Hye Young MIN

Child Health Nursing Research.2016;22(4):346-354. doi:10.4094/chnr.2016.22.4.346

PURPOSE: The purpose of this study was to investigate the use of smartphones to address parents' educational needs. METHODS: The participants were parents of children under 18 years old, Participants were 347 parents (222 mothers, 125 fathers). Data were collected from August, 15 to September, 2, 2016 using self-report questionnaire. Data were analyzed using descriptive statistics, t-test and ANOVA with the SPSS WIN 21.0 program. RESULTS: Parents had an average score of 3.30 (±.41) for the need to have smartphone health education. Among the educational subcategories, 'child and family' showed the highest average for educational needs (3.40, ±.57). According to the demographic characteristics of the participants, there were significant difference in parents' age (t=4.354, p=.014), and parents' who have received health education versus parents who have not (t=2.483, p=.014). CONCLUSION: Findings indicate that the smartphone may be an effective educational method for parents.
Child ; Health Education* ; Humans ; Methods ; Mothers ; Parents* ; Smartphone

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Health in Optimal Fitness and its Related Factors in Young Korean Children Born Prematurely.

Sangmi LEE ; Min SOHN ; Shinjeong KIM ; Sunha CHOI ; Yonghoon JUN ; Youngmee AHN

Child Health Nursing Research.2016;22(4):336-345. doi:10.4094/chnr.2016.22.4.336

PURPOSE: This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory. METHODS: A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together. RESULTS: For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (≥21days; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (≥38; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (≥35 years; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all. CONCLUSION: Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.
Case-Control Studies ; Child* ; Growth and Development ; Head ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Investments ; Length of Stay ; Logistic Models ; Mothers ; Premature Birth

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Development and Implementation of a Feeding Protocol for Infants in a Pediatric Cardiac Intensive Care Unit.

Ju Yeon UHM ; Hyojin LEE

Child Health Nursing Research.2016;22(4):326-335. doi:10.4094/chnr.2016.22.4.326

PURPOSE: It is crucial to provide adequate enteral nutrition for postoperative recovery, wound healing and normal growth in infants in pediatric cardiac ICUs. This study was done to develop a feeding protocol using the vaso-active inotropic (VAI) score and to evaluate the impact of nutritional outcomes following the new feeding protocol for infants who underwent cardiac surgery. METHODS: This study consisted of three phases. First, a feeding protocol was developed based on a literature review. Second, ten experts rated the content validity. Third, a comparison study was conducted to evaluate the impact of the new feeding protocol. Data were analyzed using SPSS Version 20. RESULTS: Twenty-nine infants were enrolled in the pre-protocol group, and 22 infants in the post-protocol group. Patients in the 2 groups were similar. Time to reach feeding goal was significantly decreased from 56.0 (27-210) hours to 28.5 (10-496) hours in the post-protocol group (Z=-4.22, p<.001). Level of enteral feeding knowledge among nurses increased significantly after implementation of the protocol. CONCLUSION: The feeding protocol using VAI score facilitates the achievement feeding goal to decrease feeding interruptions and help nurses in their practice. Larger studies are necessary to examine clinical outcomes following the implementation of this feeding protocol.
Critical Care* ; Enteral Nutrition ; Heart Defects, Congenital ; Humans ; Infant* ; Intensive Care Units* ; Thoracic Surgery ; Wound Healing

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Critical Discussion on Smoking During Pregnancy as a Form of Fetal Abuse: An Approach to Advocate for Fetal Right to Life.

Youngmee KIM ; Kap Chul CHO

Child Health Nursing Research.2016;22(4):317-325. doi:10.4094/chnr.2016.22.4.317

PURPOSE: Smoking during pregnancy contributes to the risk of negative health outcomes in mothers and babies. The purposes of this study were to review the harmful effects of maternal smoking during pregnancy on fetal and child development, to discuss if maternal smoking should be criminalized as a form of child abuse, and to explore advocating for fetal rights. METHODS: A variety of published literature and legal documents including the Korean constitution, criminal laws, and children's welfare laws were reviewed and critically analyzed. RESULTS: Women who smoke during pregnancy are more likely to experience abortion related to placental dysfunction. Their unborn risk premature birth, fetal growth restriction, low birth weight, neurobehavioral disturbances, and/or other complications and newborn babies are also at risk for complications. The advocates for fetal rights can assert that maternal smoking should be regarded as a crime. CONCLUSION: Findings show that maternal smoking during pregnancy is a major risk factor for many adverse pregnancy outcomes. Effective strategies and health policies for smoking cessation during pregnancy are required to protect pregnant women and their babies.
Child ; Child Abuse ; Child Development ; Constitution and Bylaws ; Crime ; Criminal Law ; Female ; Fetal Development ; Health Policy ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Jurisprudence ; Mothers ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women ; Premature Birth ; Risk Factors ; Smoke* ; Smoking Cessation ; Smoking* ; Value of Life*

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A Comparative Study of Family Management Style According to Severity of Childhood Atopic Dermatitis.

Hae Kyoung SON ; Hee Soon KIM

Child Health Nursing Research.2016;22(4):309-316. doi:10.4094/chnr.2016.22.4.309

PURPOSE: This study of secondary analysis aims to compare family management style according to severity in children with atopic dermatitis. METHODS: convenience sample of 109 Korean mothers caring for a child with atopic dermatitis, were recruited from the pediatric departments of two general hospitals in Seoul. Data were collected from November 1, 2015 to February 28, 2016. A structured self-report questionnaire was used. Data were analyzed using descriptive statistics, correlation analysis, and one-way ANOVA with IBM SPSS Version 22.0. RESULTS: For family management style, condition management effort, family life difficulty, and view of condition impact were significantly different according to the severity of the atopic dermatitis in these children. CONCLUSION: The findings indicate that family management strategies to enhance care of children with atopic dermatitis as well as members of the family should include these significant variables in a family-centered approach.
Child ; Dermatitis, Atopic* ; Hospitals, General ; Humans ; Mothers ; Seoul

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Perception and Barriers to Kangaroo-Mother Care Among Neonatal Intensive Care Unit Nurses.

Sun Kyung JEONG ; Tae Im KIM

Child Health Nursing Research.2016;22(4):299-308. doi:10.4094/chnr.2016.22.4.299

PURPOSE: To investigate the perception and barriers of Kangaroo-Mother Care (KMC) among nurses in Neonatal Intensive Care Units (NICU). METHODS: Participants were 131 nurses working in NICU who completed self-report questionnaires which included information regarding perception, barriers, and practice of KMC. Collected data were analyzed using SPSS 18.0 program for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients. RESULTS: Of the participants, 33.6% reported the practice of KMC in their NICU, with 75.6% wanting to receive training in KMC and 31.3% having received KMC education. Most of the participants agreed that KMC enhances attachment, parental confidence, and effective breast feeding but they reported a negative perception in providing KMC for premature infants weighing less than 1000 grams or intubated premature infants. Major barriers to practicing KMC were safety of infants, possible work overload for nurses, as well as absence of consistent guidelines. Barriers to KMC among nurses who received the KMC training were lower than nurses who did not receive the KMC training (t=-2.11, p=.037). CONCLUSION: Education program and standardized clinical practice protocol should be developed to foster the positive perception and to reduce nurse barriers to KMC.
Breast Feeding ; Education ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care Units ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal* ; Kangaroo-Mother Care Method* ; Parents

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