Purpose
Atopic dermatitis (AD) is prevalent among children and often requires family members to assume significant management responsibilities. Family management affects the child’s disease prognosis and health as well as the family’s functioning and overall quality of life. This integrative study aimed to identify the impact of AD on children and their families and examine child- and family-related factors that influence family management.
Methods
Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), a systematic search was conducted across five electronic databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Web of Science, Research Information Sharing Service, and Korean Information Service System) for studies published between 2000 and May 2024. Studies were screened using predefined inclusion and exclusion criteria, and the Mixed Methods Appraisal Tool was used to evaluate methodological quality.
Results
In total, 1,144 records were identified, and 14 studies met the inclusion criteria. The findings indicate that the impact of AD extends to both children, who experience psychological distress, sleep disturbances, impaired academic performance, and negative self-image, and families, who face treatment challenges, disrupted routines, and economic burden. Factors influencing family management were categorized into child-related factors (developmental stage and disease severity) and family-related factors (family burden, social support, coping strategies, and concerns regarding topical steroid use).
Conclusion
Family management of pediatric AD is shaped by a complex interplay of child- and family-related factors. Therefore, interventions should be designed to strengthen coping resources, enhance social support, and reduce the management burden, promoting child well-being and family resilience.

Purpose
It is essential to investigate the users’ needs in developing user-centered, family-based applications (apps) for managing childhood obesity.
Methods
This study conducted focus group interviews with ten parents, ten children, and four app developers to investigate the need to develop a family-based mobile app for childhood obesity. The interview period was from July 17 to August 30, 2023. The data were analyzed using thematic analysis.
Results
The results highlighted 31 key themes critical to family-based app development, including the need for comprehensive content promoting healthy lifestyle habits, tailored expert support, and motivational factors for app engagement, which were categorized as intrinsic, extrinsic, and social motivations and technological features. Participants also highlighted potential challenges, such as app usability issues and the need for a user-friendly interface. The pivotal role of parents in guiding and supporting their children’s health behaviors was emphasized, particularly in creating a supportive environment that encourages sustained engagement with the app.
Conclusion
These findings provide a comprehensive understanding of the needs and preferences of parents, children, and app developers in managing childhood obesity. Emphasis on integrating healthy lifestyle content, providing expert support, and incorporating motivational strategies is crucial for the app’s success. Additionally, addressing potential difficulties and recognizing the pivotal role of parents are essential considerations. These insights will inform the design and development of a user-centered mobile app that supports families in managing childhood obesity.

Purpose
This study aimed to identify the effects of pediatric nurses’ perception of patient safety culture and their partnership with patients’ parents on pediatric patient safety nursing activities.
Methods
This descriptive study was conducted over a two-month period, from October to November 2022, utilizing self-reported questionnaires. The study included 165 nurses, each having at least 6 months of working experience in wards where children were admitted. These nurses were selected from 13 pediatric specialty hospitals, general hospitals, and university hospitals across seven regions. The data analysis was performed using the SPSS/WIN 26.0 program (IBM Corp.) for descriptive statistics, t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis.
Results
The average scores for awareness of patient safety culture, partnership with patients’ parents, and pediatric patient safety nursing activities were 3.37±0.41, 3.94±0.41, and 4.50±0.38, out of 5 points respectively. The factors influencing pediatric patient safety nursing activities were identified as a partnership with patients’ parents (β=.41, p<.001). Among hospital-related characteristics, safety management committee (β=.16, p=.029) and safety management regulations (β=.17, p=.016) were also analyzed as factors influencing patient safety nursing activities. These factors accounted for 29.2% of the explanatory power for pediatric patient safety nursing activities.
Conclusion
Based on the above study results, we found that to promote safe nursing activities for pediatric patients, developing and implementing training programs that enhance partnerships with patient’s parents was imperative, and establishing work regulations and a safety management committee to systematically manage safety management tasks was deemed important.

Citations

• Nurses’ experiences of children’s fall accidents in South Korea: a phenomenological study
  Hye Jin Kim, Hyun Young Koo
  Child Health Nursing Research.2026; 32(1): 39.     CrossRef

Purpose
This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes.
Methods
A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed.
Results
The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified.
Conclusion
The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

Citations

• Effectiveness of peer-based interventions among adolescents with type 1 diabetes: A systematic review
  Hilda N. Kumoji Ayamsegna, Jill M.G. Bally, Shelley Spurr, Shelley Peacock
  Journal of Pediatric Nursing.2026; 86: 90.     CrossRef

Purpose
Preventing missed care is important in neonatal intensive care units (NICUs) due to neonates’ vulnerabilities. This study examined missed care and its influencing factors among NICU nurses.
Methods
Missed care among 120 Korean NICU nurses was measured using a cross-culturally adapted online questionnaire. The frequency of missed care for 32 nursing activities and the significance of 23 reasons for missed care were collected.
Results
All participants had missed at least 1 activity, missing on average 19.35 activities during a typical work-day. The most common missed item was “provide developmental care for the baby”. The most common reason for missed care was “emergency within the unit or deterioration of one of the assigned patients”. The final regression model explained 9.6% of variance in missed care. The average daily number of assigned patients receiving inotropes or sedation over the last month influenced the total number of missed care items.
Conclusion
Missed care was affected by nurses’ workload related to the number of patients taking medication. Frequently missed activities, especially those related to developmental care, require patience and time, conflicting with safety prioritization and inadequate working conditions. NICU nurses’ working conditions should be improved to ensure adequate time for nursing activities.

Citations

• Status Quo and Real Experience of Missed Nursing Care in ICUs: A Scoping Review
  Runfang Guo, Yiling Li, Jie Jing, Qin Yang, Hejia Wan, Wanwan Qiao
  Nursing in Critical Care.2026;[Epub]     CrossRef
• A mixed-methods systematic review of factors affecting missed nursing care in intensive care
  Huimiao Jing, Xue Bai, Weiguang Wen, Ni Yang, Jie Zhai, Yingli Gao
  Intensive and Critical Care Nursing.2026; 93: 104344.     CrossRef
• Altruism and Missed Nursing Care Among Intensive Care Nurses: A Descriptive Correlational Study
  Sümeyye Akçoban, Betül Tosun
  Journal of Evaluation in Clinical Practice.2026;[Epub]     CrossRef
• Job satisfaction, work environment, and burnout as predictors of missed nursing care in pediatric units: A descriptive cross-sectional study
  Sinem Ozmen, Havva Arslan Yurumezoglu
  Journal of Pediatric Nursing.2025; 81: e1.     CrossRef
• The effect of nursing workload and patient acuity on missed nursing care among NICU nurses in northern Jordan
  Raeda AbuAlRub, Nagham Abdullateef Mahmmoud, Heyam Fawaz Dalky, Abdullah Alkhawaldeh
  Journal of Neonatal Nursing.2025; 31(3): 101653.     CrossRef
• Missed nursing care and its causes and effects on moral distress in neonatal intensive care nurses
  Burcu Bakırlıoğlu, Bengü Çetinkaya, Rabia Nur Teki
  Nursing in Critical Care.2025;[Epub]     CrossRef
• Missed care in neonatal intensive care unit: effect of electronic reminders
  Bahrami Fereshteh, Azizzadeh Forouzi Mansooreh, Nematollahi Monirsadat, Kalisch Beatrice, Bagherian Behnaz
  BMC Pregnancy and Childbirth.2025;[Epub]     CrossRef
• Nurses experiences with an intervention enhancing skill-mix in Kenyan neonatal units with severe workforce deficits: A qualitative study
  Nancy Odinga, Caroline Waithira, Justinah Maluni, Gloria Ngaiza, Vincent Kagonya, Onesmus Onyango, Abdulazeez Imam, David Gathara, Michuki Maina, Kenneth Karumba, Fred Were, Sebastian Fuller, Mike English, Edna Mutua, Sassy Molyneux, Caroline Jones, Dorot
  International Journal of Nursing Studies.2025; 171: 105202.     CrossRef
• Pediatri kliniklerinde çalışan hemşirelerin karşılayamadıkları bakım gereksinimlerinin incelenmesi
  Ayşe Zişan Olcay, Rana Yiğit
  Mersin Üniversitesi Sağlık Bilimleri Dergisi.2025; 18(2): 132.     CrossRef
• Fading connections: A phenomenological study of oncology nurses’ experiences of Missed Nursing Care during an infectious disease outbreak
  Mahsa Pourshaban, Atefeh Allahbakhshian, Hadi Hasankhani, Federica Canzan,
  PLOS One.2025; 20(11): e0336174.     CrossRef
• The relationship between resilience and missed nursing care in neonatal intensive care units: a cross-sectional study in Iran
  Fatemeh Khoshnavay Fomani, Mahdie Pasha Zanoosi, Mohammad Mehdi Rajabi
  BMC Research Notes.2025;[Epub]     CrossRef
• Mapping the Contributing Factors to Missed Nursing Care in Hospital Settings During a Global Health Crisis: A Systematic Scoping Review
  Mahsa Pourshaban, Atefeh Allahbakhshian, Majid Purabdollah, Jacopo Fiorini
  Journal of Nursing Management.2025;[Epub]     CrossRef
• Pediatrik ve Yenidoğan Birimlerde Karşılanmamış Hemşirelik Bakımı: Kapsamlı Bir Literatür Derleme
  Sinem Özmen, Havva Arslan Yürümezoğlu
  İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri F.2024; 9(2): 281.     CrossRef
• Title Missed Nursing Care and Its Associated Factors: An Integrative Review
  Mohammad Yeganeh, Fatemeh Salmani
  Medical-Surgical Nursing Journal.2024;[Epub]     CrossRef
• Investigating the Quality of Nursing Records and its Relationship to Missed Care by Neonatal Intensive Care Nurses
  L Hajtaghi, M Arshadi, M Rahkar Farshi
  Journal of Health and Care.2024; 25(3): 279.     CrossRef
• Evaluation of missed nursing care in neonatal intensive care units: A cross-sectional study
  Dominika Kohanová, Branislav Malý, Daniela Bartoníčková, Katarína Žiaková
  Journal of Neonatal Nursing.2023; 29(5): 791.     CrossRef
• Qualitative evaluation of missed nursing care in neonatal intensive care units in a teaching hospital in Jordan
  Rania Ali Albsoul, Muhammad Ahmed Alshyyab, Rana Yaser Albayyari, Dana Hani Alselaibi, Salsabil Awni Flefil, Laila Hussam Jardaneh, Sohayla Yaseen Fayiz Dababseh, Baraa Ayed Al Odat, Fatima Abdulsattar Alkubaisi, Majd Hussein AlKhawaldeh, Gerard FitzGeral
  Journal of Pediatric Nursing.2023; 73: e277.     CrossRef
• Exploring Missed Nursing Care in the NICU: Perspectives of NICU Nurses in Saudi Arabia’s Eastern Health Cluster
  Nasreen Alsalem, Fatima Abu Rashid, Saleh Aljarudi, Mohammed I. Al Bazroun, Roqayah Mirza Almatrouk, Fatimah M. Alharbi, Lames Al Mansour, Nahid Baker Abuzaid
  Pediatric Reports.2023; 15(4): 571.     CrossRef

Purpose
This study aimed to develop a mobile-based self-management health alarm (MSHA) program for modifying obese children's lifestyle based on the information-motivation-behavioral skills (IMB) model and to test its feasibility.
Methods
A methodological study for the development of the MSHA program and pilot study with a one-group pretest-posttest design for feasibility testing was conducted. The MSHA program was designed to provide obesity-related information (I), monitor daily diet and exercise, provide motivational text messages (M), and enhance healthy diet and exercise skills (B) via a mobile-based web platform. In the feasibility test, six obese children participated in the 4-week program, and the number of days per week that they achieved their goals and differences in metabolic components were assessed. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test.
Results
Participants successfully achieved their diet and exercise goals≥5 days per week. Body mass index (z=-1.99, p=.046), waist circumference (z=-2.20, p=.028), and triglyceride levels (z=-2.21, p=.027) significantly decreased.
Conclusion
The MSHA program showed positive effects on health behaviors and metabolic syndrome risk. The program may be effective in improving metabolic syndrome in obese children by promoting self-health management behaviors.

Citations

• Development and pilot evaluation of a theory-based self-care program for late school-aged children with atopic dermatitis: a quasi-experimental study in South Korea
  Da-Jeong Kum, Kyung-Sook Bang
  Child Health Nursing Research.2026; 32(1): 66.     CrossRef
• Communicating physical activity messages with adolescents: what works? A scoping review with stakeholder consultation
  Caera L Grady, Elaine Murtagh, Kwok Ng, Enrique García Bengoechea, Catherine B Woods
  International Journal of Behavioral Nutrition and .2025;[Epub]     CrossRef
• Health self-management programs for adolescents and young adults with chronic medical condition transitioning from pediatric to adult care: a scoping review
  Yi Qi, Lin Xia, Yifan Chen, Ting Yi, Yiwen Hu, Ziling Xie, Yan Wang, Chaoqun Dong
  European Journal of Pediatrics.2025;[Epub]     CrossRef
• Theory-Based Mobile Self-Management Interventions and Behavior Change Techniques for Type 2 Diabetes Patients: A Scoping Review
  Heeae Moon, Sun-Kyung Hwang
  Korean Journal of Adult Nursing.2025; 37(4): 368.     CrossRef
• Development and validation of the information-motivation-behavioural skills model-based human immunodeficiency virus education kit for adolescents in Malaysia
  Wan Nur Syamimi Wan Mohamad Darani, Aimi Nadira Mat Ruzlin, Zahir Izuan Azhar, Xin Wee Chen
  Scientific Reports.2024;[Epub]     CrossRef
• Healthier School Systems for Learners: Government Role in Fostering Holistic Interventions
  Nsikakabasi Samuel George, Deborah Oluwaseun Shomuyiwa, Molly Unoh Ogbodum, Francis Ima Imoke, Alicja Domagała
  Journal of Education and Community Health.2024; 11(2): 112.     CrossRef

Purpose
The purpose of this integrative review was to synthesize previous research on perceptions of school health care among school-aged children and adolescents with chronic diseases.
Methods
This study was performed in accordance with Whittemore and Knafl's stages of an integrative review (problem identification, literature search, data evaluation, data analysis, and presentation of the results). Four databases (PubMed, CINAHL, Embase, and Web of Science) were used to retrieve relevant articles.
Results
Eighteen articles were included in this review. We identified five thematic categories: peer-related issues, a safe school environment, self-perception of an existing disease, self-management, and a supportive school environment.
Conclusion
It is necessary to establish a school health care system with a supportive environment for children and adolescents with chronic diseases.

Citations

• Factors associated with healthcare transition readiness for adolescents with chronic conditions: A cross-sectional study
  Hye Seung Hong, YeoJin Im
  Journal of Child Health Care.2025; 29(3): 658.     CrossRef
• A Phenomenological Study of the Lived Illness Experience of Adolescents with Chronic Glomerular Disease
  Sug Young Lee
  Children.2025; 12(12): 1671.     CrossRef
• Research Trends in Family-Centered Care for Children With Chronic Disease
  YeoJin Im, Sunyoung Jung, YoungAh Park, Jeong Hee Eom
  CIN: Computers, Informatics, Nursing.2024; 42(7): 504.     CrossRef
• An Integrated Review of Health Care in Child and Adolescent Cancer Survivors Based on Roy’s Adaptation Model
  Hye Jin Kim, Eunjoo Lee
  Asian Oncology Nursing.2024; 24(2): 82.     CrossRef
• Comparative study on health behaviors among adolescents with chronic allergic disease before and during COVID-19 using data from the Korean Youth Health Panel Surveys
  Sunyeob Choi, Hyewon Shin, Dian Susmarini
  BMC Public Health.2024;[Epub]     CrossRef

Purpose
The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem- solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit.
Methods
The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0.
Results
The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem- solving ability, and confidence in clinical performance.
Conclusion
The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses’ practices.

Citations

• Development and Pilot Usability Evaluation of Mobile VR-Based Simulation Training Content for Emergency Response to Premature Infant Care
  Ki-Hong Kim, Ah Rim Kim
  Journal of Digital Contents Society.2026; 27(3): 725.     CrossRef
• Enhancing nurse-parent partnership for NICU nurses by investigating multi-modal learning with a hybrid simulation approach that integrates metaverses and real-world training
  Hee Young Kim, Soon Hyun Myung, In Young Cho
  Nurse Education in Practice.2025; 84: 104294.     CrossRef
• Development and Evaluation of a Simulation Training Program for Neonatal Intensive Care Unit Nurses on Severe Respiratory Emergency among Extremely Low Birth Weight Infants
  Youngae Song, Jaehee Lee, Jiyoon Kang, Heekyung Kang, Junghee Lee, Inkyung Bong
  Journal of Korea Society for Simulation in Nursing.2025; 13(1): 15.     CrossRef
• Comparative Evaluation of 3 Neonatal Simulators for Neonatal Resuscitation and Airway Obstruction Skills in Medical Students
  Irma Manjavidze, Lia Otiashvili, Dali Chitaishvili, Pirdara Nozadze
  Sage Open Pediatrics.2025;[Epub]     CrossRef
• Development and Effectiveness of a Rapid Cycle Deliberate Practice Neonatal Resuscitation Simulation Program: A Quasi-Experimental Study
  Sun-Yi Yang, Yun-Hee Oh
  Healthcare.2024; 12(1): 104.     CrossRef
• Development and Evaluation of Infection Control Nursing Simulation Education Program for Nurses in a NICU
  Min-hee Cho, Sunghee Kim
  Journal of Korea Society for Simulation in Nursing.2024; 12(2): 1.     CrossRef
• Implementation of a simulation-based education for mothers in managing respiratory emergencies in the neonatal intensive care unit
  Heemoon Lim, Hyejung Lee
  Journal of Neonatal Nursing.2023; 29(4): 662.     CrossRef
• Simulation Training Needs of Nurses for Nursing High-Risk Premature Infants: A Cross-Sectional Study
  Sun-Yi Yang
  Healthcare.2022; 10(11): 2197.     CrossRef
• Simulation-Based Education Improves Mothers’ Confidencein Managing Respiratory Emergency Situations
  Hee-moon Lim, hyejung Lee
  SSRN Electronic Journal .2022;[Epub]     CrossRef
• Educational needs for practicing neonatal intensive care among Korean nursing students
  Hyun Young Koo, Bo Ryeong Lee
  Child Health Nursing Research.2021; 27(4): 339.     CrossRef
• Developing Nursing Standard Guidelines for Nurses in a Neonatal Intensive Care Unit: A Delphi Study
  Hanna Lee, Da-Jung Kim, Jeong-Won Han
  Healthcare.2020; 8(3): 320.     CrossRef

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.
Conclusion
It is necessary to develop individual interventions to improve self-efficacy and family support for adolescents with type 1 diabetes mellitus to help them enhance their self-management.

Citations

• A Pilot Randomized Control Trial to Prevent HIV/STIs in Hispanic Young Heterosexual Couples
  David Pérez-Jiménez, Patricia Noboa-Ortega, José A. Maldonado-Martínez
  Hispanic Journal of Behavioral Sciences.2025; 47(3): 255.     CrossRef
• Effectiveness of Pharmacist-Delivered Caregiver Education on Medication Use in a Type 1 Diabetes Camp for Children and Adolescents
  Hyeon Su Kim, Eunji Kim, Ji Eun Lee, Won Hye Choi, In Hye Gu, Eun Jung Hwang
  The Journal of Korean Diabetes.2025; 26(2): 122.     CrossRef
• Factors influencing the perception of shared decision-making among parents of children with type 1 diabetes mellitus: A cross-sectional study guided by the Ottawa Decision Support Framework
  In Hyeong Choi, In Young Cho
  Journal of Pediatric Nursing.2025; 85: 346.     CrossRef
• Factors affecting health promotion behavior of school-aged children in South Korea: a cross-sectional study
  Bo Ra Lim, Dong Hee Kim, Chung Min Cho
  Child Health Nursing Research.2025; 31(3): 165.     CrossRef
• Preferences for Text Messaging Supports During Youth Transition to Adult Mental Health Services: Theory-Informed Modified e-Delphi Study
  Negar Vakili, Janet A Curran, Roisin Walls, Debbie Phillips, Alanna Miller, Christine Cassidy, Lori Wozney
  JMIR Formative Research.2024; 8: e51690.     CrossRef
• User evaluation of a mobile education application for the management of metabolic syndrome among cancer survivors
  Ji-Su Kim, Minhae Kim, Yeji Seo
  European Journal of Oncology Nursing.2023; 63: 102276.     CrossRef
• Managing the unmanageable through interdependence in adolescents living with type 1 diabetes and their parents: A constructivist grounded theory
  Pamela Farthing, Jill M.G. Bally, Marie Dietrich Leurer, Lorraine Holtslander, Munier A. Nour, Donna Rennie
  Journal of Pediatric Nursing.2022; 67: e191.     CrossRef
• Psychometric Evaluation of the Korean Version of PROMIS Self-Efficacy for Managing Symptoms Item Bank: Item Response Theory
  Mona Choi, Chang Gi Park, Soomin Hong
  Asian Nursing Research.2022; 16(4): 187.     CrossRef
• The effects of diabetes knowledge, self-efficacy, and depression on self-management in older patients with diabetes in the community: A cross-sectional study
  Hyeok Gyu Park, Myoung Jin Kwon
  Journal of Korean Gerontological Nursing.2022; 24(4): 389.     CrossRef
• Effect of Information-Motivation-Behavioral Model Based on Protection Motivation Theory on the Psychological Resilience and Quality of Life of Patients with Type 2 DM
  Xiaoli Yao, Linlin Zhang, Jiwei Du, Lei Gao
  Psychiatric Quarterly.2021; 92(1): 49.     CrossRef
• What Affects Quality of Life for People with Type 1 Diabetes?: A Cross-Sectional Observational Study
  Mi-Kyoung Cho, Mi-Young Kim
  International Journal of Environmental Research an.2021; 18(14): 7623.     CrossRef

Purpose
This study aimed to identify the effects of the mother-medical staff partnership on mothers’ condition management ability for children with chronic allergic diseases.
Methods
A total of 109 Korean mothers caring for a child with a chronic allergic diseases, identified according to the allergic march, such as food allergy, atopic dermatitis, allergic rhinitis, and allergic asthma, were recruited from the pediatric department of a general hospital in Seoul through convenience sampling. Data were collected using structured self-reported questionnaires from August 1, 2017 to October 31, 2017. and analyzed by descriptive statistics and multiple regression using SPSS version 22.0.
Results
The Mother-medical staff partnership had a statistically significant effect on mothers’ condition management ability for children with chronic allergic diseases (p<.05). Among the general characteristics, satisfaction with nursing services had a statistically significant effect on mothers’ condition management ability (p<.05).
Conclusion
In conclusion, strategies to support children with chronic allergic diseases, as well as their caregivers, should consider the mother-medical staff partnership as part of a family-centered approach.

Citations

• Impact of Pediatric Nurses’ Nursing Professionalism on Quality of Nursing Care: Double Mediating Effect of Clinical Decision Making and Pediatric Nurse-Parent Partnership
  Jung-Eun Lee, Mi-Young Choi
  Journal of Korean Academy of Nursing Administratio.2024; 30(1): 55.     CrossRef
• Effects of Anxiety, Parenting Efficacy, and Partnership With Nurses on the Caring Behaviors of Mothers of Hospitalized Children
  Yu Jin Hong, Hyeon Ok Kim
  Journal of Korean Maternal and Child Health.2024; 28(3): 111.     CrossRef
• Ecological factors affecting first-time mothers’ satisfaction with Sanhujoriwons (postpartum care centres) from South Korea: a cross-sectional and correlational study
  Ju-Eun Song, Soyeon Lee, Min Kyong Lee, Hyun-Ju Chae
  BMC Pregnancy and Childbirth.2023;[Epub]     CrossRef
• Patient-Nurse Partnerships to Prevent Medication Errors: A Concept Development Using the Hybrid Method
  Hee-Ja Jeong, Eun-Young Park
  International Journal of Environmental Research an.2022; 19(9): 5378.     CrossRef
• Factors influencing the quality of nursing care as perceived by mothers of hospitalized children in South Korea
  Ina Jin, Hun Ha Cho
  Child Health Nursing Research.2021; 27(3): 266.     CrossRef
• Tracing the Use of the Family Management Framework and Measure: A Scoping Review
  Kathleen A. Knafl, Janet A. Deatrick, Agatha M. Gallo, Beth Skelton
  Journal of Family Nursing.2021; 27(2): 87.     CrossRef

Purpose
This study of secondary analysis aims to compare family management style according to severity in children with atopic dermatitis.
Methods
A 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.

Citations

• Factors influencing the family management of children with atopic dermatitis: an integrative review
  Sunyeob Choi, Hyewon Shin
  Child Health Nursing Research.2025; 31(4): 187.     CrossRef
• Research Trends of Randomized Controlled Trials on Herbal Medicine Treatment for Atopic Dermatitis-Focusing on CNKI
  Geum-Jin Yang, Eun-hee Jo, Su-Jin Kang, Jieun Hong, Yu-Hwa Shim, Ju-Hyun Lee, Min-cheol Park
  Journal of Physiology & Pathology in Korean Medici.2020; 34(2): 102.     CrossRef
• Effects of the Mother-Medical Staff Partnership on Mothers’ Condition Management Ability for Children with Chronic Allergic Diseases
  Hae Kyoung Son, Hyo Bin Song, Dong Hee Kim
  Child Health Nursing Research.2018; 24(1): 101.     CrossRef

Purpose
The purposes of this study were to explore knowledge, barriers, and self-efficacy in relation to pain management practice, and to identify factors influencing pain management practice in pediatric nurses.
Methods
A descriptive correlational study was conducted. The participants were 237 pediatric nurses from a metropolitan city. Data were analyzed using t-test or analysis of variance and Pearson correlation and multiple regression analyses.
Results
The mean percentage of correct answers on the children’s pain management knowledge scale was 58.8%. Child and parent related factors were the main barriers for pain management. Self-efficacy to assess children’s pain across developmental stages was particularly low. Pain management practices for assessing pain and non-pharmacological interventions were relatively low. Factors significantly affecting children’s pain management practice were current conditions of work department and self-efficacy in pain management, and these factors accounted for 37.5% of the variance in pain management practice.
Conclusion
The results suggest that an integrative education program needs to be developed to improve self-efficacy in children’s pain management practice. Moreover, good communication, building cooperative relationships with children and parents, and a more active role by pediatric nurses are required to carry out more effective pain management.

Citations

• Implementation and Evaluation of a Pediatric Pain Assessment Educational Program (PPAEP) for Nurses in a Resource‐Limited Setting: A Pilot Study
  Abigail Kusi Amponsah, Charles Kumi Hammond, Victoria Bam, Douglas Gyamfi, Jerry Armah, Dorothy Wilson, Faithful Annobil, Daniel Ba‐Eebu Badengo, Charlotte Boachie Danquah, Joana Kyei Dompim, Anna Axelin, Faith Nawagi, Snighda Mukherjee
  Paediatric and Neonatal Pain.2026;[Epub]     CrossRef
• The prediction of nursing students’ knowledge and self-efficacy in pediatric pain management
  Bahise Aydın, İlknur Bektaş, Murat Bektaş
  BMC Nursing.2025;[Epub]     CrossRef
• Effects of nurse’s knowledge and self-efficacy on nursing performance in pediatric intravenous fluid management in South Korea: a descriptive study
  Se-Won Kim, Mi-Young Choi
  Child Health Nursing Research.2024; 30(4): 288.     CrossRef
• Development and evaluation of a web-based acute pain management education program for Korean registered nurses: A randomized controlled trial
  Jebog Yoo, Jennie C. De Gagne, Hye Jin Kim, Juyeon Oh
  Nurse Education in Practice.2019; 38: 7.     CrossRef
• Factors Affecting Nursing Interventions for Pain among Nurses in Neonatal Intensive Care Unit
  Eun-Hee Kim, Mi-Young Choi
  Child Health Nursing Research.2017; 23(2): 179.     CrossRef

Purpose
This study was done to identify the level of knowledge and practice of self-management on asthma of school-aged children and to provide data for the development of an intervention program to improve self-management on asthma.
Methods
The participants were 100 school-aged children who were treated currently for asthma in J city located in G province. Data were collected from 25th August to 30th October 2014.
Results
The mean scores were 14.37 of 20 for self-management knowledge (percentage of correct answer 71.9%), 21.65 of 30 for self-management practice. There were significant differences in knowledge according to grade, diagnosed age, food allergy, education on asthma and hardship in school life, and in practice according to gender and economic status, hardship in school life and experience of first-aid on asthma. There were positive correlations between knowledge and practice.
Conclusion
Results indicate that school-aged children’ knowledge and practice in self-management of asthma were not sufficient enough to perform accurate management of asthma. Therefore, to improve self-management ability of school-aged children to manage effectively asthma, educational strategies that focus on increasing knowledge need to be developed.

Citations

• Concept Analysis of Self-management in Children with Chronic Kidney Diseases through Walker and Avant’s Method
  Sug Young Lee
  Journal of Korean Academy of Fundamentals of Nursi.2025; 32(1): 105.     CrossRef
• Development of a Sexual Abuse Prevention Education Program for Elementary School Students Using a Hybrid Application
  Shin-Jeong Kim, So-Ra Kang, Jung Min Lee
  Child Health Nursing Research.2018; 24(1): 109.     CrossRef
• Self-Management Experiences of the Adolescents with Chronic Kidney Disease
  Sug Young Lee, Heesun Shin
  Journal of Korean Academy of Nursing.2018; 48(3): 266.     CrossRef

Purpose
The study purposes were to explore school nurses’ experience, perceived barriers, and education needs in diabetes management at school.
Methods
This study was a cross sectional study and the study participants were recruited conveniently at continuing education seminars for school nurses at Incheon Metropolitan City.
Results
Data for 101 school nurses were analyzed. The nurses were all women and their mean age was 46.9±9.3 years. About 66% of them had experience with children with diabetes at school. The school nurses reported that 74.6% of the students tested their blood glucose by themselves, the school clinic was the most common place for blood glucose tests (47.8%) and insulin injections (50.8%) and the nurses knew students’ diagnosis through the student health survey (58.2%). About half of the nurses (53.7%) reported that glucagon should be available at school and 49.2% were willing to inject glucagon when necessary. The most frequently reported barrier in diabetes management was role confusion (6.0±1.3) and the most common educational need was emergency responses (5.9±1.4).
Conclusions
School health policy for diabetes management and diabetes resources are necessary to minimize role confusion of school nurses, improve emergency response, and facilitate health promotion activities in diabetes management.

Citations

• Navigating Role Challenges in School Healthcare Partnerships With Families: A Qualitative Study
  Ju-Yeon Uhm, Seok-Yeong Hong, Yangmi Kim
  Western Journal of Nursing Research.2026; 48(2): 121.     CrossRef
• School nurses' competency in supporting students with type 1 diabetes: A mixed methods systematic review
  Ju-Yeon Uhm, Suhee Kim
  Nurse Education Today.2025; 146: 106554.     CrossRef
• Perception and utilisation of information and communication technology (ICT) in the management of diabetes in children: Insights from health students in Indonesia
  Mustamu Cherry
  Scripta Medica.2024; 55(1): 33.     CrossRef
• An Integrated Review of Health Care in Child and Adolescent Cancer Survivors Based on Roy’s Adaptation Model
  Hye Jin Kim, Eunjoo Lee
  Asian Oncology Nursing.2024; 24(2): 82.     CrossRef
• Educational needs of school health teachers caring for students with type 1 diabetes: An analysis using the Borich needs assessment and the locus for focus models
  Heewon Seok, Ju-Yeon Uhm
  The Journal of Korean Academic Society of Nursing .2024; 30(4): 347.     CrossRef
• School Health Teachers as Partners in Diabetes Caring: Maternal Perspectives
  Ju-Yeon Uhm, Mi-Young Choi
  Western Journal of Nursing Research.2023; 45(10): 942.     CrossRef
• Factors Included in T1DM Continuing Education for Korean School Nurses: A Systematic Review
  Eun-Mi Beak, Yeon-Ha Kim
  International Journal of Environmental Research an.2021; 18(4): 1620.     CrossRef
• Frequency of Self-Monitoring of Blood Glucose during the School Day Is Associated with the Optimal Glycemic Control among Korean Adolescents with Type 1 Diabetes
  Eun Young Joo, Ji-Eun Lee, Hee Sook Kang, Shin Goo Park, Yong Hee Hong, Young-Lim Shin, Min Sohn
  Diabetes & Metabolism Journal.2018; 42(6): 480.     CrossRef

PURPOSE
Effects of information on management practices for children suffering from respiratory communicable diseases and their parents were investigated. METHODS: The experimental group consisted of 30 children who were in-patients suffering from a respiratory communicable disease and their parents. During their hospitalization, for 30 min each day, the children and their parents received education that included information about disease management including symptoms, prevention and environmental hygiene. The information was developed using illustrations and photoshop. The control group consisted of 30 children who were in-patients and their parents. They received the usual nursing care without any of the above education. The instruments used in this study were the bibliographies of respiratory disease management. chi2 test, independent t-test, and Mann-Whitney U test with SPSS 11.5 were used to analyze the data. RESULTS: Significant differences between the experimental and control groups were found for management of symptoms (Z=4.350, p<.001) and environmental hygiene (Z=4.033, p=.000), but not for prevention (Z=4.033, p=.149). CONCLUSION: The results indicate that providing information was effective for management practice of symptoms and environmental hygiene, but not for prevention management for the children and their parents. Therefore programs should be developed to promote prevention management.

Citations

• Factors influencing the caregiving performance of mothers of hospitalized toddlers with acute respiratory diseases: A path analysis
  Han Hye-Yul, Kim Shin-Jeong, Ellis Kevin Wayne, Kang Kyung-Ah
  Journal of Child Health Care.2018; 22(4): 591.     CrossRef
• Knowledge and Practice Level of Infection Management for Child Guardians with Respiratory Infections after H1N1 Diffusion (2009)
  Mi Kyung Park, Young Sook Ko, Kyung Im Park
  Journal of Korean Academy of Child Health Nursing.2011; 17(1): 1.     CrossRef

PURPOSE
The purpose of this study was to provide a critical assessment of evidence-based Korean pediatric research that can inform clinical practicability of, and future research on distraction interventions for pediatric procedural pain management.
METHODS
A critical review of evidence-based Korean pediatric research was conducted. Databases were searched to identify research that included an evaluation of a distraction intervention as an intervention for pediatric procedural pain management. The search yielded 68 studies.
RESULTS
From these studies, 14 were included for this review and all were recently published (2003-2014). Quasi experimental designs were most frequently used (n=12) and for 71.4% the focus was preschoolers. Audiovisual techniques were the most common form of distraction. In most studies clinical utility of the distraction intervention was not examined. Fairly consistent reductions in behavioral measures of pain in association with the distraction intervention were found but less consistent results were found for physiological measures.
CONCLUSION
Lack of methodological rigor limits the evidence for distraction interventions to reduce pain and fear experienced by children during painful procedures. Further research to analyze the cost and time-effectiveness and to identify consumer and provider satisfaction with distraction interventions is needed to determine whether distraction interventions are clinically relevant.

Citations

• Effect of Distraction Intervention for Needle-Related Pain and Distress in Children: A Systematic Review and Meta-Analysis
  Mi-Kyoung Cho, Mi-Young Choi
  International Journal of Environmental Research an.2021; 18(17): 9159.     CrossRef
• RETRACTED: Smartphone Interventions Effect in Pediatric Subjects on the Day of Surgery: A Meta-Analysis
  Li Li, Jianping Ma, Dan Ma, Xiaokang Zhou
  Frontiers in Surgery.2021;[Epub]     CrossRef
• An Integrative Review of Korean Nursing Studies on Pediatric Tonsillectomy
  Kyoung Eun Yu, Jin Sun Kim
  Child Health Nursing Research.2017; 23(4): 416.     CrossRef
• Effects of Active and Passive Distraction Intervention on Pain Responses of Preschool Children during Immunization
  Eun-Seon Im, Jin-Sun Kim
  The Journal of the Korea Contents Association.2016; 16(12): 102.     CrossRef
• Effects of a Smart Phone Individualized Distraction Intervention on Anxiety in Pre-Op Pediatric Patients
  Kyoung-A Lee, Mi-Kyung Kwon, Hae-Won Kim, Ji-Eun Lim, Chang-Ok Pyo, Chan-Sook Park
  Child Health Nursing Research.2015; 21(2): 168.     CrossRef

PURPOSE
Study purposes were to exam effects of self-care education for children with type 1 diabetes on their diabetes management behaviors and to explore the relationship among diabetes management behaviors, knowledge, self-efficacy and clinical variables.
METHODS
This study was a one group quasi-experimental study. Study participants were children with type 1 diabetes and attended a four hour self-care education of a diabetes camp. Data were collected using structured questionnaires including Diabetes Management Behavior Scale (DMBS), Michigan Diabetes Research and Training Center's Brief Diabetes Knowledge Test and Self-Efficacy for Diabetes Self-Management.
RESULTS
The mean age of the participants was 12 (+/-2.3) years. After the education, their DMBS and knowledge improved, but the improvement was not statistically significant (t=1.758, p=.101; t=0.528, p=.606). Two areas of DMBS, daily prevention behaviors and modification of care plan, were associated with study variables. Daily prevention behaviors were associated with duration of diabetes (r=.653, p=.008), HbA1c (r=.563, p=.038) and having a complication (r=-2.788, p=.015). Modification of care plan was associated with age at diagnosis (r=-.552, p=.033).
CONCLUSION
Children with type 1 diabetes could improve some parts of their diabetes management behaviors even after a short diabetes camp.

Citations

• Tecnologias educacionais para familiares e crianças com diabetes tipo 1: revisão de escopo
  Patricia Carli Morgado, Liliane Faria da Silva, Rosane Cordeiro Burla de Aguiar, Juliana Rezende Montenegro Medeiros de Moraes, Tatiane Marinz de Souza Luquez, Euzeli da Silva Brandão, Michelle Darezzo Rodrigues Nunes, Isabelle de Freitas Lopes, Débora Câ
  Revista da Escola de Enfermagem da USP.2024;[Epub]     CrossRef
• Educational technologies for families and children with type 1 diabetes: a scoping review
  Patricia Carli Morgado, Liliane Faria da Silva, Rosane Cordeiro Burla de Aguiar, Juliana Rezende Montenegro Medeiros de Moraes, Tatiane Marinz de Souza Luquez, Euzeli da Silva Brandão, Michelle Darezzo Rodrigues Nunes, Isabelle de Freitas Lopes, Débora Câ
  Revista da Escola de Enfermagem da USP.2024;[Epub]     CrossRef
• Effects of Virtual Reality Program on Glycated Hemoglobin, Static and Dynamic Balancing Ability, and Falls Efficacy for Diabetic Patients: A Systematic Review and Meta-Analysis
  Yi-Rang Yim, Myung-Haeng Hur
  Journal of Korean Academy of Fundamentals of Nursi.2023; 30(2): 155.     CrossRef
• Illness Experiences of Adolescents with Type 1 Diabetes
  Ji Eun Kim, Ilaria Campesi
  Journal of Diabetes Research.2022; 2022: 1.     CrossRef
• Factors Affecting the Self-Management of Adolescents with Type 1 Diabetes Mellitus based on the Information-Motivation-Behavioral Skills Model
  Hooyun Lee, Eun Kyoung Choi, Heejung Kim, Ho-Seon Kim, Hee-Soon Kim
  Child Health Nursing Research.2019; 25(2): 234.     CrossRef
• Blood Glucose Control and Related Factors at a Camp for Korean Children and Adolescents with Type 1 Diabetes
  Narae Kang, Jieun Lee, Dong-Ho Park, Soo-Kyung Lee, So-Young Nam, Sanghyun Lee, Mincheol Kim, Heesook Kang, Euiyeon Kim, Misoon Kim, Min Sohn
  Comprehensive Child and Adolescent Nursing.2018; 41(1): 58.     CrossRef
• School Nurses’ Management for Children and Adolescents with Diabetes
  Heesook Kang, Youngmee Ahn, Ji Eun Lee, Min Sohn
  Child Health Nursing Research.2015; 21(2): 176.     CrossRef

PURPOSE
The purpose of this study was to investigate caregivers' knowledge, concerns, and management of children with febrile convulsions (FC).
METHODS
A descriptive correlation study was conducted with 133 caregivers whose children had been diagnosed with a FC. A self-administered questionnaire was used for data collection. Descriptive statistics, t-test, one-way analysis of variance and Pearson's correlation were used for data analysis.
RESULTS
The mean percent of correct answers related to knowledge was 48.5%. Many caregivers believed that FC causes brain damage and did not know that risk of subsequent epilepsy in FC is rare. Levels of concern about FC were high. Caregivers were highly concerned about further FC attacks in the night and tended to worry that Febrile children were apt to get a fever. Many caregivers used management practices which are not recommended for FC in children. There was a statistically significant negative correlation between caregivers' knowledge and concerns about FC. There was also a positive correlation between caregivers' knowledge and management of FC.
CONCLUSION
Findings suggest that improvements are needed in caregivers' knowledge and management of FC. Caregivers' concerns related to misconception need to be addressed. Development and evaluation of educational interventions on changing caregivers' management of FC are recommended.

Citations

• Korean Childcare Providers’ Knowledge, Attitudes, Concerns, and Practices of Febrile Convulsions
  Won-Oak Oh, Yoo Jin Heo, Min Hyun Suk, Anna Lee
  International Journal of Environmental Research an.2021; 18(9): 4855.     CrossRef
• Febrile seizure: What information can caregivers access through YouTube?
  Juyeon Oh, Sun Young You
  Seizure.2021; 91: 91.     CrossRef
• Knowledge and Practice of Fever Management by Mothers of Preschool Children at Home
  Hye Rim Park, In Soo Kwon
  Child Health Nursing Research.2017; 23(2): 127.     CrossRef
• Factors Affecting Daycare Center Teachers’ Management of Childhood Fever
  Song I Park, Jin Sun Kim
  Child Health Nursing Research.2016; 22(4): 289.     CrossRef

PURPOSE
This study was done to evaluate the effects of Yoga exercise on improvements in physical flexibility, posture management behavior, and self-efficacy in adolescents.
METHOD
In this study, the design was a quasi-experimental research design with a one group pretest-posttest design. Participants were 32 students from one high school in Busan Metropolitan City, Korea, who did not engage in regular aerobic exercise and were willing to participate in this study. Yoga exercise was conducted for 70 minutes twice a week for 15 weeks. The data were collected from March 16 to June 22, 2004. The data were analyzed using descriptive statistics, and paired t-test with SPSS Win 12.0.
RESULTS
Trunk flexibility, posture management behavior, and self-efficacy significantly increased after the yoga exercise.
CONCLUSION
Yoga exercise is recommended as a useful nursing intervention that could help prevent spinal-curvature-related disorders among adolescents.

The aim of the study is to analyze and evaluate the Child Health Management Service that was promoted as a part of Mother-Child Health Guidance Project by the Public Health Center of BukCheju-gun in 1999, to reflect the problems needed to be improved, and, thus, to present the integral program model for the Child Health Management Service that guides childhood health, regarded as the foundation of that of the adulthood period, to the optimum level. The common results of the evaluation of the Child Health Management Service of BukCheju-gun public health center are as below: 1. In the aspect of public information, the existing simple material and method of public information was not effective. 2. The opportunities for the necessary training and education to develop the persons concerned and their ability for the Child Health Management were not enough. 3. The environment under which the service, aimed to promote Child's health, was carried out was not clearly divided from that of the services related with the prevention and treatment of disease. And the service environment for the child health was threatening to the clients. 4. Still, the actual result was pursued more than the quality management, while carrying out the project. With the reflection of the above result, the research has presented the program model of Child Health Management Program for the next. The main concept of the model is, through the establishment of the network for information offerings and effective convergence of a variety of opinions for the community around the Public Health Center and for the correct evaluation of the project and the reflection of the result from it, to achieve the ultimate goal of the optimal growth and development of the childhood by expanding the support necessary for carrying out Child Health Management Program more effectively.

This study was performed to understand pediatric pain management status and nurses' knowledge and attitudes toward it. In addition, it aimed to provide basic data in order to establish effective nursing intervention strategies by confirming the barriers of effective pain management in practice. The subjects were 195 nurses working in pediatric units(general pediatric unit, oncology unit, neonatal unit, neonatal ICU, pediatric ICU) of 8 university hospitals and one general hospital. Data was collected by the questionnaire from the 3rd of August to the 20th of September in 1999. The instrument developed by Sanna(1999) to measure nurses' knowledge and their attitudes and the other tool by Cleeland(1984) to evaluate barriers in effective pain management was used. Results of this study are summarized as follows : 1. Most nurses learn about the pain management knowledges from through regular curriculum of nursing school(62.0%). And almost nurses(90.8%) don't used to utilize pain assessment tool, but the "Faces Rating Scale" is the most frequently used by nurses. 2. The use of pain medication(65.6%) is most frequently taken by nurses as pain management and is followed by massage (55.9%), distraction(27.7%). 3. Nurses' knowledge level is moderate (Mn=3.07). Nurses don't seem to understand pediatric physical development (Mn= 2.86), psychological development(Mn=2.94) well, meanwhile they seem relatively quite knowledgeable about the way pain emerges. 4. Nurses' attitudes toward pain is based on behavioral and physiological responses to pain. They believe 'changes in behavior are a way of assessing pain in child' and 'acute pain increases the number of respiration'. Nurses are ready to accept pediatric pain, but are not positive in adopting pain intervention in practice. 5. The barriers of effective pain management are inadequate assessment of pain and pain relief(81.5%), ineffective incorporation among health professionals(80%), and lack of equipment or skills(80.0%).