BACKGROUND: This research compared the effectiveness of play therapy provided individually or in groups for oppositional defiant disorder (ODD) symptoms among children. METHODS: This was a randomized controlled trial that used a multi-stage random sampling method. Participants included 45 children aged 6 to 10 years old with ODD, all of whom had been referred to medical consultation centers in Ahvaz, Iran in 2012. Experimental groups consisted of 15 children receiving individual play therapy and 15 receiving group play therapy, while the control group consisted of 15 randomly selected children. Data were collected using the child behavior checklist parent report form and teacher report form, along with clinical interviews with the parents. Play therapy took place weekly for eight total sessions; individual sessions lasted 45 minutes each, while group sessions were each 60 minutes in duration. Participants were assessed in three stages, including pre-intervention, post-intervention, and at 2-month follow-up. PASW SPSS ver. 18.0 software (SPSS Inc., Chicago, IL, USA) and analysis of covariance analysis methods were used to analyze data. RESULTS: Results showed meaningful decreases in ODD symptoms in the experimental groups in comparison with the control group, based on parent reporting (P≤0.001 and F=129.40) and the teacher reports additionally showed meaningful decreases in ODD symptoms in the experimental groups compared to the control group, (P≤0.001 and F=93.14). Furthermore, the effects were maintained after 2 months. CONCLUSION: This research supports the efficacy of individual and group play therapy for the treatment of ODD in children, as well as the consistency of the effects at 2-month follow-up.
Attention Deficit and Disruptive Behavior Disorders ; Checklist ; Child Behavior ; Child ; Follow-Up Studies ; Humans ; Iran ; Methods ; Parents ; Play Therapy ; Psychotherapy

BACKGROUND/OBJECTIVES: Youth is the crucial stage between childhood and adulthood during which an individual acquires new behavior and practices including dietary habits, that may be influenced by his peers, social circle, nutrition knowledge level and other factors. The increase in awareness of young adults is of special importance from the perspective of health and prevention of obesity related chronic diseases. To measure the nutrition literacy level of university students using the Turkish version of Adolescent Nutrition Literacy Scale (ANLS). We evaluated their food habits using the Adolescent Food Habit Checklist (AFHC) tool and analysed it, if the eating habits were affected by nutrition literacy level. SUBJECTS/METHODS: A cross-sectional descriptive study was conducted on randomly selected 276 students studying in the Faculty of Health Sciences of Istanbul Aydin University, Turkey. Data was collected by means of ANLS and AFHC tools by face to face interview method. SPSS statistical sofware (IBM SPSS Statistics 19) was used to analyse the obtained data. RESULTS: Participants comprised of 47.1% males and 52.9% females with mean age of 20.0 ± 1.60 years. Mean body mass index (BMI) was determined as 22.4 ± 3.76 (23.6 ± 3.63 males 21.3 ± 3.57 females). Functional, interactive and critical nutritional literacy scores for male participants were 22.49 ± 5.71, 17.45 ± 4.84, and 28.28 ± 7.13 respectively (total 64.98 ± 10.15). For females the values were 24.66 ± 5.13, 20.17 ± 4.28, and 32.20 ± 5.65 (total 69.72 ± 8.59) respectively. For all the three sub-categories of nutrition literacy, the scores acquired by females were significantly higher than males (P < 0.001). In the AFHC tool, the mean score acquired by males were 9.26 ± 4.18 whereas for females it was 10.37 ± 3.40 significantly higher as compared to males (P = 0.007). CONCLUSIONS: The food habits of female participants were better than males; in accordance with their nutrition literacy status. It may be concluded that food habits are influenced by nutrition literacy and therefore stress much be given to increase the nutrition awareness among children youth as well as adults.
Adolescent ; Adult ; Body Mass Index ; Checklist ; Child ; Chronic Disease ; Eating ; Female ; Food Habits ; Humans ; Literacy ; Male ; Methods ; Obesity ; Turkey ; Young Adult

OBJECTIVES: This study was conducted to evaluate the gender differences in stress-coping methods that affect stress responses in graduate medical students.METHODS: The participants were 209 students of C medical school in Daejeon, Korea. Stress response was measured using the Stress Response Inventory. Coping methods were measured through the Ways of Coping Checklist and Problem-solving Style Scale. Data were analyzed using T-Tests, a correlation analysis, and stepwise multiple regression analysis.RESULTS: The mean±standard deviation score of the stress response inventory was 23.56±20.20 in males and 32.34±23.44 in females. The stepwise multiple regression analysis revealed the following factors related to stress response: helplessness, problem-solving control, approach style in males and helplessness, social readjustment rating scale, problem-solving confidence in females. No relationship between stress-coping style and academic performance was found in both genders.CONCLUSION: Hopelessness seemed to be the main reason for the stress response in medical students of both genders. We also found differences in coping methods affecting the stress response by genders. Future studies need to identify more such factors that lead to differences in coping methods and help adapt to stress in medical education.
Adaptation, Psychological ; Checklist ; Education, Medical ; Education, Medical, Graduate ; Female ; Humans ; Korea ; Male ; Methods ; Schools, Medical ; Stress, Psychological ; Students, Medical

BACKGROUND: The clinical practice examination (CPX) was introduced in 2010, and the Seoul-Gyeonggi CPX Consortium developed the patient-physician interaction (PPI) assessment tool in 2004. Both institutions use rating scales on classified sections of PPI but differ in their scoring of key components. This study investigated the accuracy of standardized patient scores across rating scales by comparing checklist methods and verified the concurrent validity of two comparable PPI rating tools. METHODS: An educational CPX module dyspepsia case was administered to 116 fourth-year medical students at Hanyang University College of Medicine. One experienced standardized patient rated exams using two different PPI scales. She scored checklists composed of 43 items related to the two original PPI scales through video clips of the same students. From these checklists, we calculated Pearson's correlation coefficient. RESULTS: The correlations of total PPI score between the checklist and rating scale methods were 0.29 for the Korean Medical Licensing Examination (KMLE) tool and 0.30 for the consortium tool. The correlations between the KMLE and consortium tools were 0.74 for checklists and 0.83 for rating scales. In terms of section scores, the consortium tool showed only three significant correlations between the two methods out of seven sections and the KMLE tool showed only two statistically significant correlations out of five sections. CONCLUSION: The rating scale and checklist methods exhibited a weak relationship in the PPI assessment, but a high correlation between assessment tools using the same method. However, the current rating scale requires modification by reorganizing key scoring components through factor analysis.
Behavior Rating Scale ; Checklist* ; Dyspepsia ; Education, Medical ; Educational Measurement ; Humans ; Licensure ; Methods ; Physician-Patient Relations ; Students, Medical ; Weights and Measures

OBJECTIVES: This study aimed to develop the attention-deficit hyperactivity disorder (ADHD)-After School Checklist (ASK) to evaluate the severity of ADHD symptoms and self-management ability in children and adolescents in South Korea. Additionally, we evaluated the reliability and validity of the scale. METHODS: We developed the ASK to evaluate the effect of ADHD psychopathologies on self-management and interpersonal impulsivity. We investigated the reliability and validity of the scale with 1349 parents (male 56.9%; 1202 parents of non-ADHD children, 147 parents of children with ADHD) in Seoul and Gyeonggi Province, Korea. RESULTS: According to the construct validity test using principal constant analysis with the varimax rotation method, two factors explained 60.7% of the cumulative variance in ASK scores. Cronbach's alpha for the whole scale was 0.71. There was no statistical difference between mean ASK scores at test and retest. Mean total ASK scores of the ADHD group were significantly higher than those of the non-ADHD group (p < 0.001). CONCLUSION: The ASK can be used as a reliable and valid tool to evaluate not only self-management capability of children and adolescents with ADHD in their academic and everyday life, but also their impulsiveness in interpersonal relationships.
Adolescent ; Checklist* ; Child ; Gyeonggi-do ; Humans ; Impulsive Behavior ; Korea ; Mass Screening ; Methods ; Parents ; Reproducibility of Results ; Self Care ; Seoul

OBJECTIVES: Immunization is considered one of the most successful and cost-effective public health interventions protecting communities from preventable infectious diseases. The Korean government set up a dedicated workforce for national immunization in 2003, and since then has made strides in improving vaccination coverage across the nation. However, some groups remain relatively vulnerable and require intervention, and it is necessary to address unmet needs to prevent outbreaks of communicable diseases. This study was conducted to characterize persistent challenges to vaccination. METHODS: The study adopted a qualitative method in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus group interviews were conducted with 15 professionals in charge of vaccination-related duties. The interviews were conducted according to a semi-structured guideline, and thematic analysis was carried out. Data saturation was confirmed when the researchers agreed that no more new codes could be found. RESULTS: A total of 4 main topics and 11 subtopics were introduced regarding barriers to vaccination. The main topics were vaccine hesitancy, personal circumstances, lack of information, and misclassification. Among them, vaccine hesitancy was confirmed to be the most significant factor impeding vaccination. It was also found that the factors hindering vaccination had changed over time and disproportionately affected certain groups. CONCLUSIONS: The study identified ongoing unmet needs and barriers to vaccination despite the accomplishments of the National Immunization Program. The results have implications for establishing tailored interventions that target context- and group-specific barriers to improve timely and complete vaccination coverage.
Checklist ; Communicable Diseases ; Disease Outbreaks ; Focus Groups* ; Humans ; Immunization ; Immunization Programs ; Korea* ; Methods ; Public Health ; Qualitative Research ; Vaccination*

OBJECTIVE: This study examined the association between the wave form in quantitative electroencephalography (QEEG) and the cognitive and behavioral characteristics measured by the Korean version of Wechsler Intelligence Scale for Children 4th edition (K-WISC-IV), Korean version of the attention deficit/hyperactivity disorder Rating Scale (K-ARS), and Korean version of Child Behavior Checklist (K-CBCL) in children diagnosed with ADHD. METHOD: A retrospective cross-sectional study was performed on children aged 8 to 13 years, who were diagnosed with ADHD at Samsung Medical Center from November 2011 to March 2017. A total of 57 ADHD children were selected by a medical chart review. Their QEEG findings and psychological test results, including K-WISC-IV, K-CBCL, and K-ARS (n=42), were collected. The QEEG was analyzed by the ranges of Hz: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–25 Hz) and transformed to the z-scored relative power. The collected data were analyzed using Pearson and Partial correlation analysis. RESULTS: The Letter-Number Sequencing scores of K-WISC was positively correlated with fronto-central alpha. The hyperactivity/impulsivity scores of K-ARS were positively correlated with the theta/beta ratio. Among the items of K-CBCL, social immaturity was positively correlated with delta and theta, and negatively correlated with alpha. Social competence was negatively correlated delta and theta, and positively correlated with alpha. CONCLUSION: These results suggest that the resting state QEEG results of children with ADHD may reflect their cognitive and behavioral characteristics, especially in working memory/executive function, hyperactivity/impulsivity, and sociality.
Checklist ; Child ; Child Behavior ; Cross-Sectional Studies* ; Electroencephalography* ; Humans ; Intelligence ; Methods ; Psychological Tests ; Retrospective Studies* ; Social Skills

PURPOSE: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. METHODS: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. RESULTS: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were 36.44±4.82, 13.44±1.71, and 42.32±5.05, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. CONCLUSION: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.
Adult ; Checklist ; Clinical Competence ; Humans ; Judgment* ; Methods ; Nursing* ; Patient Simulation ; Pneumonia ; Respiratory System ; Students, Nursing* ; Suction*

PURPOSE: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses.METHODS: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics.RESULTS: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift.CONCLUSIONS: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.
Checklist ; Classification ; Critical Care ; Humans ; Intensive Care Units ; Methods ; Nursing Care ; Nursing Staff ; Nursing

OBJECTIVES: This study was conducted to evaluate the nutrition quotient (NQ) by gender and understand which factors influence NQ in preschool children. METHODS: Subjects were 245 children (110 boys, 135 girls) aged 4-6 years and their parents. The questionnaire composed of demographic characteristics, eating behavior factors and the NQ questions. The NQ consisted of 19 food behavior checklist items and all items were grouped into 5 factors: balance, diversity, moderation, regularity, and practice. Inbody J05, a measurement device that measures individual's body composition was used to measure children's anthropometric data. All data were statistically analyzed by SPSS program (Ver. 20) and the statistical differences in variables were evaluated by Student t-test, chi2-test, One-way ANOVA and Duncan's multiple range test. RESULTS: The total NQ score of the subjects was 65.3. The NQ score of girls (67.0) was significantly higher than that of the boys (63.2) (p<0.01). The girls' average scores of NQ factors including diversity (p<0.01) and practice (p<0.05) were higher than those of the boys. The analysis of related-factors influencing NQ scores showed that there was a significant difference among the groups according to feeding methods during infancy (p<0.05), breast feeding group being the highest. Furthermore, the NQ score showed a significant difference depending on how to correct children's unbalanced diet as well as parents' nutrition knowledge. The NQ score of obesity group tended to be lower than that of underweight group although there was no significant difference. CONCLUSIONS: Overall results indicated that the girls had better quality of diet and eating habits than the boys. Children and their parents need proper nutrition education and counseling to correct children's eating habits and to improve diet quality in kindergartens and in children care centers.
Body Composition ; Breast Feeding ; Checklist ; Child ; Child, Preschool* ; Counseling ; Diet ; Eating ; Education ; Feeding Behavior ; Feeding Methods ; Female ; Humans ; Obesity ; Parents ; Thinness