Purpose Atopic dermatitis (AD) in adolescents has received less attention than AD in infants and children. However, AD can persist or worsen after school age and affect health-related quality of life (HRQoL) beyond adolescence. This study aimed to examine HRQoL and its associated factors among adolescents with AD, guided by Roy’s Adaptation Model.
Methods This cross-sectional study was conducted between May and August 2023 and included adolescents aged 13–18 years with AD. Data on symptom experience, body image, peer relationships, self-management, HRQoL, and general and disease-related characteristics were collected using self-report questionnaires and electronic medical records. Data were analyzed using descriptive statistics, the independent t-test, analysis of variance, Pearson correlation analysis, and multiple regression analysis.
Results A total of 97 adolescents with AD participated in the study, including 60 males (61.9%) and 37 females (38.1%). Participants were aged 13–18 years, with a mean age of 15.8±1.7 years. HRQoL was negatively correlated with symptom experience and positively correlated with body image, peer relationships, and self-management. Multiple regression analysis showed that allergen sensitization, symptom experience, and self-management were significantly associated with HRQoL, explaining approximately 40.0% of the variance.
Conclusion Symptom experience and self-management were identified as key factors associated with HRQoL among adolescents with AD. Interventions aimed at reducing symptom burden and promoting active self-management are essential for improving HRQoL. These findings highlight the need to support adolescents’ independence and underscore the importance of personalized education and effective self-management programs.
Purpose This study aimed to identify ecological risk and protective factors associated with membership in latent classes characterized by heterogeneous associations between parental adverse childhood experiences (ACEs) and the intergenerational transmission of child maltreatment (ITCM).
Methods This secondary analysis used data from the 2017 Family with Children’s Life Experience Survey. Participants were parents who had a spouse and children younger than 18 years. Guided by Belsky’s ecological model, the covariates were categorized as parent-, family/household-, and community-level contextual factors. Latent class regression was used to identify classes with differing associations between parental ACEs and child maltreatment, and multinomial logistic regression was used to examine factors associated with class membership.
Results Three classes were identified: the “None-ACE-Association” class (58.5%), the “Partial-ACE-Association” class (23.3%), and the “Comprehensive-ACE-Association” class (18.2%). Factors across multiple ecological domains differentiated class membership. Acceptance of corporal punishment significantly distinguished the None-ACE-Association class from the Partial-ACE-Association class. In comparisons involving the Comprehensive-ACE-Association class, membership was significantly associated with several parent- and family/household-level factors, including depressive symptoms, parenting stress, partner violence/control, and family relationship quality. Significant associations were also observed for the number of children, the age group of the youngest child, and residential area.
Conclusion Distinct latent class profiles characterized by heterogeneous associations between parental ACEs and child maltreatment support the need for tailored, risk-stratified prevention strategies. Combining the assessment of parental ACEs with the assessment of modifiable factors could improve early identification and inform nursing and community-based interventions intended to interrupt the ITCM.
Purpose To describe the process of systematically developing an integrated health promotion program for school-age children from vulnerable families.
Methods In this study, we applied the first three steps—analysis, design, and development (ADD)—of the analysis, design, development, implementation, and evaluation (ADDIE) model. The analysis step involved a literature review and needs assessment. In the design step, program components were considered and a program draft was developed. The program content was modified based on expert validation in the development step. The preliminary program was administered in the implementation step, and the final program was confirmed in the evaluation step.
Results The program contents were based on the literature review, needs assessment, and Ryan’s integrated theory of health behavior change. The content was valid, and the educational material was appropriate for school-age children from vulnerable families. The finalized program consists of six sessions to promote physical, psychological, and social health using individual/group and face-to-face/online methods, including two that involve both parents and children.
Conclusion This study presents a detailed description of how the program was developed and illustrates the critical elements that should be considered during similar program development. The effect of this program on health promotion behavior should be examined in future research.
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Purpose The rising prevalence of smartphone overdependence among adolescents and its detrimental impact on mental health have become a growing concern. This study aimed to investigate the association between smartphone overdependence and the mental health of Korean adolescents.
Methods Participants were drawn from the 16th Korea Youth Risk Behavior Web-based Survey conducted in 2020. The dependent variable as smartphone overdependence, while the main exposure of interest was mental health, encompassing generalized anxiety disorder (GAD), perceived stress, sources of perceived stress, perceived loneliness, and perceived depressive symptoms. The study employed the Rao-Scott chi-square test and multiple logistic regression using IBM SPSS version 26.0.
Results The participants comprised 54,948 adolescents aged 13 to 18 years. Among them, 25.1% (n=13,775) were categorized as smartphone overdependence group. Specifically, 20.3% of adolescents who reported GAD ≥10 and 22.5% of those who reported experiencing high levels of perceived loneliness were identified as smartphone overdependent. The GAD increased a risk of smartphone overdependence by 2.61 times (95% confidence interval [95% CI]: 2.46–2.77). Perceived loneliness was associated with 1.98-fold (95% CI: 1.87–2.09) increased risk of smartphone overdependence. Additionally, conflict with peers was found to increase the risk of smartphone overdependence by 4.63-fold (95% CI: 3.89–5.52), followed by conflict with parents (odds ratio [OR]: 4.52, 95% CI: 3.84–5.31), and family environment (OR: 4.52, 95% CI: 3.75–5.46).
Conclusion The findings underscore a significant association between smartphone overdependence and mental health in Korean adolescents. Healthcare services to improve their emotional coping and interpersonal skills are necessary.
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Methods The hybrid model by Schwarz-Barcott and Kim was used to analyze the characteristics of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards.
Results Transfer anxiety was defined by the following attributes: 1) stress concerning the adaptation process, 2) concern about the child’s condition worsening due to the parent’s caregiving, and 3) involuntary changes in daily life due to the treatment. Transfer anxiety has the following antecedents: 1) uncertainty; 2) a lack of knowledge about the illness, medical devices, and caregiving; and 3) a lack of social support. It resulted in 1) caregiver burden, 2) a decrease in the capacity for coping with caregiving, 3) delays in the child’s physical and psychological recovery, and 4) decreased quality of life.
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Purpose The purpose of this study was to examine the correlation between a flexible parental visiting environment and parental stress in neonatal intensive care units (NICUs).
Methods The study participants included 60 parents of premature infants in NICUs. Structured questionnaires and interviews, as well as observations by researchers using a caregiving behavior checklist, were used to measure the flexibility of the parental visiting environment and parents' stress levels. Quantitative and qualitative data were collected concurrently and were initially analyzed as separate data sets. Data collection extended from March 11, 2018 to June 30. 2018 and the data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, and Pearson correlation coefficients.
Results There was a negative correlation (r=-.30, p=.021) between parental stress and the total number of visits in 7 days. We also found that the average duration of each visit and the number of caregiving behaviors performed by parents were positively correlated (r=.73, p<.001).
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Purpose We aimed to identify factors influencing physical activity in adolescents with complex congenital heart disease.
Methods We recruited 92 adolescents with complex congenital heart disease from a tertiary medical center in Seoul, measured their levels of physical activity, and identified factors that influenced their physical activity levels using the Global Physical Activity Questionnaire, the New York Heart Association classification, congenital heart disease complexity, the Self-Efficacy Scale, and the Parental Bonding Instrument scale. Stepwise multiple linear regression was used to determine factors influencing physical activity.
Results Total physical activity was higher in males than in females (t=4.46, p<.001). Adolescents who participated in school physical education classes engaged in more physical activity than those who did not (t=6.77, p<.001). Higher self-efficacy (β=.41, p<.001), male gender (β=.37, p<.001) and participation in school physical education classes (β=.19, p=.042) were associated with a higher likelihood of engagement in physical activity.
Conclusion It is necessary to develop nursing interventions that enhance self-efficacy in order to promote physical activity in adolescents with complex congenital heart disease. Physical activity should also be promoted in an individualized manner, taking into account gender, disease severity, and parental attitude.
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Purpose The purpose of this study was to investigate associations between self-management and diabetes knowledge, diabetesrelated attitudes, family support, and self-efficacy in adolescents with type 1 diabetes mellitus based on the information-motivation- behavior skills model.
Methods Data collection was conducted between March 18 and September 30, 2018. Patients (N=87) aged 12 to 19 years were recruited from the outpatient clinic of S children’s hospital and an online community for patient with type 1 diabetes mellitus. Data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearsons correlation, and hierarchical multiple linear regression with SPSS IBM 23.0, with the two-tailed level of significance set at 0.05.
Results The mean score of self-management in adolescents with type 1 diabetes mellitus was 61.23±10.00 out of 80. The regression analysis showed that self-efficacy and family support significantly explained 56.9% of the variance in self-management (F=21.38, p<.001). Self-efficacy (β=.504, p<.001) and family support (β=.188, p<.001) were significant predictors of self-management.
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Purpose The purpose of this study was to investigate the needs for pediatric palliative care (PPC) among parents of children with complex chronic conditions (CCCs) and to investigate differences in the needs for PPC according to their general characteristics.
Methods A cross-sectional survey was conducted between March 28 and May 18, 2018. Parents (N=96) who had a child under 18 years with a CCC were recruited. Data were analyzed using descriptive statistics, independent t-test, and one-way ANOVA.
Results The overall average need for PPC was 3.58±0.33 out of 4.00. In terms of care for the subjects' children, the highest need was physical care, followed by psychosocial and spiritual care. In the sub-dimensions, preservation of physical function received the highest score. Of the items, the highest need was for seizure control. In terms of care for the subjects themselves, the highest need was for psychosocial care, followed by bereavement and spiritual care. In the sub-dimensions, communication received the highest score. Of the items, the highest need was for smooth communication with medical staff. Differences in needs for PPC according to participants’ general characteristics were not statistically significant.
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