Purpose Education on infant safe sleep practices has been known to reduce the risk of sleep-related sudden unexpected infant death. Since sleep environments may vary across sociocultural contexts, infant safe sleep education needs to reflect specific sociocultural settings. This study aimed to develop an educational Protocol for Infant Safe Sleep (PISS) for primary caregivers in Korea that considers parenting behaviors and cultural characteristics. Methods This study was conducted in three key methodological steps: (1) retrieval, defining, and systematic classification of PISS content; (2) the structural formulation of the content as an educational protocol; and (3) content validation. For the first step, a literature review was conducted, along with an analysis of educational materials from institution websites related to infant safe sleep and online parenting communities. Field observations were also conducted to identify relevant Korean culture characteristics. Based on these findings, the PISS was developed. Content validity index was assessed by six professionals, and the results were reflected into the educational program. Results The PISS intervention provided an educational video and booklet and enhanced learning via phone counseling and educational kit, which comprised an illustrated safe sleep sticker and a calendar-style activity diary. The educational content consisted of (1) sleep location, (2) sleep position, (3) bedding, (4) clothes and temperature, and (5) other considerations. Conclusion This study developed the PISS, an intangible educational intervention based on Korean sociocultural characteristics and specific guidelines for primary caregivers. Future research should evaluate the effectiveness of this program in promoting safe sleep practices.
Purpose To analyze the general, clinical, and sedation-related characteristics of pediatric inpatients who received procedural sedation from pediatric sedation nurses, and to identify the incidence of sedation-related adverse events and sedation failure. Methods The medical records of 585 patients under 18 years who were hospitalized in the pediatric wards of a tertiary hospital and received procedural sedation from pediatric sedation nurses from April to September 2023 were retrospectively reviewed. Data were analyzed using chi-square and t-tests. Results Among the 585 participants, 59.3% were male, and the median age was 38 months. The main departments were hemato-oncology (17.9%), neurology (16.1%), and thoracic surgery (11.8%). A total of 671 procedures were performed; the main ones were echocardiography (18.3%), computed tomography (15.1%), and magnetic resonance imaging (14.0%). 84.6% of the patients experienced no adverse events. The main adverse event was oxygen desaturation (13.2%), with interventions including oxygen supplementation (12.1%) and airway repositioning (4.6%). Adverse events occurred significantly more often in patients in American Society of Anesthesiologists class III–IV (χ2=15.35, p<.001), neurology patients (χ2=7.10, p=.008), patients undergoing spinal tapping (χ2=9.49, p=.002), patients undergoing multiple procedures (χ2=7.64, p=.006), and those receiving combined oral and intravenous sedation (χ2=53.82, p<.001). Conclusion Procedural sedation provided by pediatric sedation nurses was performed safely and effectively for pediatric inpatients with various characteristics. Further research is necessary to assess pediatric sedation nurses’ current sedation practices across various medical institutions and clinical settings.
Purpose This study compared healthy lifestyle (HLS) practices and awareness regarding the use of chatbots (A-uC) for health management between childhood and adolescent cancer survivors (CACSs) and their parents, with the aim of assessing the feasibility of tailored artificial intelligence (AI) chatbot-based interventions for holistic survivorship care. Methods A descriptive comparative design was employed involving 80 CACSs and 80 parents (N=160) recruited through the Korean Pediatric Cancer Foundation. HLS practices were assessed using a validated seven-domain instrument encompassing physical activity, nutrition, interpersonal relations, stress management, positive life perspective, health responsibility, and spiritual health. A-uC was evaluated using an extended technology acceptance model-based tool. Responses to the open-ended question addressing unmet HLS practices were analyzed using latent Dirichlet allocation topic modeling. Results No significant differences were observed between CACSs and parents in overall HLS (CACSs: 3.16±0.80; parents: 3.18±0.36, p=.74). While perceptions across most A-uC domains did not differ significantly, parents demonstrated a significantly higher “intention to use” chatbots for health management than CACSs (p=.03). The mean A-uC scores exceeded 4 (out of 5) in both groups, reflecting positive perceptions of chatbot-based HLS support. Topic modeling identified “exercise,” “healthy diet,” and “regular lifestyle” as common unmet areas. Conclusion CACSs and their parents share largely concordant views on HLS and A-uC, with a strong interest in chatbot interventions. These findings underscore the potential of tailored AI chatbot programs to address unmet lifestyle needs and promote holistic survivorship care.
Purpose This study aimed to explore nurses’ experiences with hospitalized children’s fall accidents. The findings are intended to provide foundational data for developing strategies to strengthen patient safety for children. Methods Participants were purposively sampled. The sample consisted of eight nurses working in the pediatric departments of hospitals located in Daegu and Seoul in South Korea. All participants had experienced at least one fall accident involving a hospitalized child within the past year. Data were collected through in-depth interviews conducted between February 1 and April 30, 2025. The collected data were analyzed using Colaizzi’s phenomenological analysis method. Results The data analysis revealed four themes and 12 subthemes, which were derived from 111 significant statements and reflect pediatric ward nurses’ experiences with inpatient fall incidents. The four themes were: “encountering fall risks beyond nurses’ control,” “ineffective fall education and formalized safety practices,” “limitations of assessment tools and the growth of reflective practice,” and “moving toward comprehensive fall prevention and management strategies.” Conclusion Nurses recognized that the risk of pediatric falls was often beyond their control, and that fall prevention education did not always translate into practice. Reflective analysis of fall incidents, age- and patient-specific fall nursing interventions, and the establishment of an integrated support system are needed for effective fall prevention and management. These findings are expected to provide basic data to guide nursing care that prevents fall accidents and improves children’s patient safety.
PURPOSE:This study aimed to identify differences in perceived task performance, task importance, and educational needs for novice-level tasks among neonatal intensive care unit (NICU) nurses with varying levels of clinical experience and to provide foundational data for developing systematic educational programs to strengthen the competencies of novice nurses. METHODS:Participants were recruited from the NICUs of three hospitals-one university-affiliated hospital and two general hospitals located in B Metropolitan City, South Korea. Using convenience sampling, 116 staff nurses with at least 3 months of NICU experience were surveyed between March and November 2025. For comparative analysis, participants were divided into three career groups based on their NICU experience: <3 years, 3-9 years, and ≥9 years. Data were analyzed using descriptive statistics, analysis of variance, and the Scheffé test with IBM SPSS ver. 25.0, and importance-performance analysis (IPA) was conducted to prioritize educational needs. RESULTS:Across all career groups, the "direct nursing performance" domain showed the highest task performance. Novice nurses with <3 years of experience reported significantly higher performance in central line care and transfusion management than those with ≥9 years of experience. The IPA identified central line management, and transfusion management as priority areas for improvement, while vital sign monitoring, respiratory surveillance and discharge education for parents were common educational needs regardless of experience level. CONCLUSION:Educational programs for novice NICU nurses should focus on strengthening patient safety-related competencies and should be progressively structured with simulation and case-based learning to enhance clinical performance.
Purpose North Korean refugee women face multiple vulnerabilities during pregnancy and early childrearing due to fragmented support and limited familiarity with Korea’s health and welfare systems. Existing research has examined isolated barriers. This study used a service design approach to explore their maternal–infant care experiences and identify structural discontinuities across the care pathway. Methods Data were collected from North Korean refugee mothers and service providers from April to August 2024. A service design approach using user journey mapping, thematic analysis, and service blueprinting was employed to examine user actions, emotional trajectories, frontline interactions, and backstage and interagency processes. Results Five structural issues were identified: fragmented information, cross-institutional access barriers, cultural and emotional isolation, discontinuity in interagency linkage, and provider resource constraints. These issues accumulated along the pathway, increasing emotional burden, delaying timely care, and reinforcing avoidance behaviors. Misalignment between user needs and multi-agency processes was also evident. Conclusion Maternal and infant care challenges among North Korean refugee women stem from structural fragmentation rather than individual factors. Based on these findings, the NK Mom Care Navigator—a pathway-based, culturally responsive service design model—is proposed to strengthen continuity of care and enhance equitable maternal–infant support for vulnerable refugee families.
Purpose This pilot study aimed to develop and conduct an initial evaluation of a self-care improvement program for older school-aged children with atopic dermatitis (AD). Methods A quasi-experimental, non-equivalent control group pretest-posttest design was used with 20 children in grades 4–6 diagnosed with AD. The experimental group (n=12) received a 5-week Information-Motivation-Behavioral Skills (IMB)-based program, which included five 40-minute sessions for children and one 50-minute session for mothers. The control group (n=8) received usual care. Data was collected at baseline, immediately after the intervention, and 4 weeks post-intervention. Outcome variables included AD knowledge, motivation for AD self-care, self-efficacy for managing AD, self-care behaviors, and AD severity. Generalized estimating equations were used for analysis. Results Time-by-group interaction effects were observed for AD knowledge (p<.001), personal motivation (p=.011), self-efficacy (p=.034), self-care behaviors (p=.027), and AD severity (p=.039). Improvements in knowledge, motivation, and self-efficacy persisted through follow-up, while changes in self-care behaviors and AD severity were significant only at posttest. Conclusion This study provides preliminary evidence that an IMB-based self-care program can improve knowledge, motivation, and self-efficacy in children with AD, leading to better self-care behaviors and reduced symptom severity. These findings support the feasibility and potential usefulness of a structured, theory-based intervention. Further fully powered trials are needed to confirm effectiveness and identify strategies for maintaining long-term outcomes.
Purpose Simulation-based education plays a critical role in nursing by allowing students to acquire clinical competencies in a safe and controlled environment. However, current evaluation tools for simulation scenarios often lack standardization, resulting in inconsistencies when assessing the effectiveness of such programs. Methods This study aimed to develop a comprehensive Nursing Simulation Scenario Evaluation Tool using the Real-Time Delphi method. A panel of 10 experts in nursing and simulation education participated in two rounds of surveys. The evaluation criteria were derived from the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice and relevant literature. Survey items were refined through expert consensus using content validity ratios and coefficient of variation values. The finalized tool was further enhanced with artificial intelligence (AI)–based evaluation capabilities to support objective and systematic assessment. The tool was registered and patented in the Republic of Korea (Korean Intellectual Property Office Registration No. 10-2024-0051234) to acknowledge its innovation and technical merit. Results The process resulted in an evaluation tool comprising eight key domains and 36 items, covering scenario structure, learning objectives, preparation, script development, debriefing, facilitation, expected outcomes, and scenario validity. A Kendall’s coefficient of concordance of 0.739 indicated strong agreement among the experts. Conclusion This study successfully developed a standardized and validated tool to improve the reliability and effectiveness of simulation-based education in nursing. The tool addresses a key gap in current educational practices and enhances consistency in evaluating nursing simulation scenarios. Future studies should focus on validating its application across diverse educational environments.
Purpose The purpose of this study was to explore the in-depth perceptions of newborn care among North Korean refugee women through focus group interviews. This research aims to provide foundational data for developing newborn care education programs tailored for North Korean refugee women preparing for motherhood. Methods This qualitative study employed focus groups to investigate perceptions of neonatal care among North Korean refugee women of childbearing age (20–45 years old). Conducted from August to September 2022, the sessions included five non-pregnant women and four who were currently pregnant. Results Both pregnant and non-pregnant women expressed ambivalent feelings, characterized by a blend of expectation and fear regarding childrearing. Pregnant women articulated specific parenting strategies and viewed childrearing as a more tangible responsibility in light of physical changes and social isolation. In contrast, non-pregnant women expressed vague aversion and anxiety about the lack of information and support systems, stating that they could only endure childrearing with adequate external support. Notably, pregnant women emphasized the psychological conflict stemming from disrupted self-realization and shifts in their identities as mothers. Conclusion This study revealed differences in childrearing perceptions among North Korean refugee women based on their pregnancy status. It underscores the necessity for developing customized education programs that consider life stages and psychological readiness, as well as the importance of establishing social support systems.
Purpose To explore nurses’ perceptions of end-of-life care in neonatal and pediatric intensive care units, focusing on the components, facilitators, and challenges of such care in daily practice. Methods A qualitative descriptive study was conducted. Data were collected from June to October 2023 through semi-structured individual interviews with 17 nurses from the neonatal and pediatric intensive care units of four tertiary general hospitals in a metropolitan area of South Korea, and were analyzed using thematic analysis techniques. Results We identified three themes and nine subthemes: (1) supporting families’ emotional and relational closure, (2) perceiving relational and systemic support as enabling end-of-life care, and (3) feeling constrained by systemic and practical challenges. Participants perceived fostering an emotional connection with the child, ensuring opportunities for meaningful farewell, and supporting emotional acceptance of death as ways to support families’ emotional and relational closure with their child. Although relational and systemic support, such as collaborative teamwork, clear communication, shared planning, and structured tools, enabled compassionate care, participants also felt unprepared, burdened by heavy workloads, and hindered by environmental barriers. Conclusion The findings highlight that delivering quality end-of-life care in neonatal and pediatric intensive care units requires supporting families’ emotional needs, strengthening relational and systemic support, and addressing practical challenges. Further research is needed to develop and test practical strategies (e.g., specialized education in compassionate communication, standardized protocols, and supportive care environments) that can improve the quality of end-of-life care for neonatal and pediatric patients and their families.
Purpose This study aimed to examine whether perceived parental alienation mediates the relationship between parental and adolescent depressive symptoms, and, if so, whether parents’ subjective health moderates this indirect effect. Methods This cross-sectional study utilized secondary data from the 2021 wave of the Panel Study on Korean Children, enrolling 541 parent–child dyads. Parental depression was measured using the Kessler Psychological Distress Scale-6, a self-rated health item, the Korean version of the Center for Epidemiological Studies Depression Scale for Children, and a 6-item perceived alienation scale. Descriptive statistics, Pearson correlations, and variance inflation factor checks were conducted, followed by mediation and moderated mediation analyses using PROCESS Models 4 and 7 with 10,000 bootstraps in IBM SPSS ver. 27.0. Results Parental depression did not directly predict adolescent depression (B=.02, t=.87) but was significantly related to perceived alienation (B=.16, p<.001), which in turn predicted higher adolescent depression (B=.20, p<.001). The indirect effect of alienation was also significant (B=.039; 95% confidence interval, 0.005–0.066). Subjective health moderated the depression–alienation link (interaction B=.19, p<.001), with stronger indirect effects observed among parents with better health. Conclusion Parental depression symptoms indirectly increase adolescent depression through perceived alienation, particularly when parents viewed their health positively. These results suggest that interventions targeting parental mental health and fostering open-family communication may help reduce adolescent depression.
Purpose In this study, we aimed to compare the effects of two distraction interventions—DistrACTION Cards and Buzzy—on pain relief in children undergoing intravenous infusions in the emergency department. Methods A quasi-randomized controlled trial was conducted in children aged 4–6 years receiving intravenous infusions in a single emergency department. Participants were assigned to the DistrACTION Cards group (n=31), Buzzy group (n=30), or control group (n=31). Pain was assessed using the pulse rate, Faces Pain Rating Scale, and Face, Legs, Activity, Cry, Consolability scale. Results Both distraction interventions significantly reduced observed pain (Face, Legs, Activity, Cry, Consolability scores) compared to that in the control group. The DistrACTION Cards group showed significantly lower pain scores than the control group during the procedure (p<.05) and demonstrated a consistent trend of pain reduction across all phases. Self-reported pain scores (Faces Pain Rating Scale) after the procedure were significantly lower in both intervention groups compared to those in the control group (p<.05); however, no significant differences were found in the extent of change between groups. No significant group differences were observed in pulse rate. Conclusion Both DistrACTION Cards and Buzzy effectively reduced intravenous infusion-related pain in preschool children. DistrACTION Cards showed greater consistency than Buzzy in pain reduction as measured by the Face, Legs, Activity, Cry, Consolability scale, suggesting they may be considered as a preferred option in clinical practice. Further research in diverse clinical settings is needed to confirm these findings.
Purpose This pilot study aimed to develop a virtual reality (VR) nursing simulation for pediatric pneumonia care tailored to the Korean clinical context and evaluate its educational effectiveness for nursing students. Methods A single-group pretest–posttest design was employed with 20 senior nursing students from April to May 2025. The intervention was a 70-minute VR nursing simulation of pediatric pneumonia care, structured with pre-briefing, a main scenario, and debriefing. Data were collected on participants’ knowledge of pediatric pneumonia, clinical judgment (Nursing Clinical Judgment Scale), and simulation effectiveness (Simulation Effectiveness Tool-Modified) before and after the intervention. Usability (User Experience Questionnaire) and qualitative feedback were collected after the intervention. Pre-post comparisons were performed using paired t-tests. Results The program did not yield a statistically significant change in knowledge scores (p=.893). However, there were significant improvements in the mean scores for clinical judgment (p<.001) and simulation effectiveness (p=.013). A qualitative analysis revealed that, while the participants found the experience immersive and realistic, they also reported operational difficulties, indicating the need for usability improvements. Conclusion The VR nursing simulation is a promising pedagogical tool for enhancing nursing students’ clinical judgment and perceived learning effectiveness in a Korean pediatric context. The findings suggest that, while the intervention was effective in improving practical reasoning, future iterations should focus on reinforcing knowledge acquisition and optimizing user experience to maximize the educational impact.
Purpose This study aimed to evaluate the effects of a virtual reality (VR) program and simulation training on nursing students’ ability to measure vital signs in children. Methods This mixed-methods study, which included a randomized controlled trial and a qualitative study, was conducted from June 12 to November 15, 2023. Forty-four nursing students from a university in South Korea were randomly assigned to either the experimental or control group. The experimental group first participated in a VR program focused on measuring vital signs in children, followed by a high-fidelity simulation training. The control group received the training in the reverse order. The participants’ knowledge, confidence in practice, and satisfaction with the practice were analyzed using the repeated-measures analysis of variance. VR learning experiences were analyzed through qualitative content analysis. Results Both the experimental and control groups showed significant increases in knowledge and confidence in practice after the interventions compared to baseline. However, there were no significant differences in changes in knowledge, confidence in practice, and satisfaction with practice between the two groups. Three themes were identified from the nursing students’ experiences with VR learning: ‘realistic learning training,’ ‘overcoming learning limitations,’ and ‘perceiving drawbacks.’ Conclusion The VR program was as effective as high-fidelity simulation training in improving nursing students’ ability to measure children’s vital signs. Moreover, VR program offered additional benefits in addressing limitations of simulation-based learning. These findings suggest that VR program can serve as a valuable educational tool to enhance pediatric nursing skills.
Purpose Because fever is a common symptom in children, parents must have accurate knowledge and management ability about it to be able to provide appropriate management. This study aimed to develop a fever management education program, incorporating case-based simulation practice for parents of hospitalized children, and examine its effects on knowledge of fever in children, anxiety related to fever, and self-efficacy in child fever management. Methods A quasi-experimental, non-equivalent control group pretest-posttest design was employed. A total of 50 parents participated, with 24 and 26 in the experimental and control groups, respectively. The experimental group received both theoretical lectures and case-based simulation practice, whereas the control group received only theoretical lectures. Results No statistically significant differences were observed between the groups regarding knowledge of fever or anxiety related to fever immediately after the intervention or at the 4-week follow-up. However, the experimental group showed a significant improvement in self-efficacy in fever management from pre- to post-intervention. Conclusion The findings suggest that fever management education incorporating case-based simulation practice, in addition to theoretical instruction, could potentially enhance parents’ confidence in managing childhood fever. Developing simulation-based educational interventions that enhance long-term effectiveness, can be feasibly integrated into hospital settings, and provide practical and accessible approaches is essential to support parents in effectively managing fever in real-life situations.
Purpose This study aimed to identify distinct subjective viewpoints regarding the perceived effects of energy drink consumption among South Korean male high school students. Methods Using Q methodology, a concourse of statements was developed through interviews and literature reviews, and refined into 35 Q samples. Forty male high school students were recruited via snowball sampling to reflect diverse consumption patterns and attitudes. Participants sorted the Q samples using a forced distribution procedure. Data were analyzed using the PC-QUANL program. Results Four distinct groups of male adolescents were identified based on their perceived effects of energy drink consumption: (1) effect-oriented experience sharers, (2) ambivalent recognizers of experience, (3) alternative-seeking evaluators, and (4) emotionally reactive responders. These groups’ perceptions were shaped by peer influence, personal consumption experiences, and levels of self-regulation. Conclusion By typifying the subjective perceptions of Korean male high school students regarding energy drink consumption, this study provides a foundational understanding of how adolescents interpret and respond to such health behaviors. These insights can guide the development of tailored health education programs that address the unique needs and attitudes of each group.
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 This study aimed to identify the factors affecting the health promotion behavior of school-aged children informed by the Information-Motivation-Behavioral Skills Model. Methods A cross-sectional study was conducted with 209 fifth- and sixth-grade elementary school students from Seoul, selected through convenience sampling. Data were collected from March 13 to 31, 2023, using a self-administered questionnaire. The questionnaire included validated tools that measured health literacy, attitude toward health behaviors, social support, self-efficacy, and health promotion behavior. Data were analyzed using descriptive statistics, Pearson’s correlation, and stepwise multiple regression, using IBM SPSS/WIN ver. 29.0. Results The factors influencing the health promotion behavior of school-aged children were social support (β=.43, p<.001), attitude toward health behaviors (β=.27, p<.001), interest in health (high interest group) (β=.14, p=.003), self-efficacy (β=.13, p=.014), and health literacy (β=.10, p=.026). The explanatory power of the model was 63% (F=68.37, p<.001). Conclusion Based on the results of this study, it is highly recommended to develop and apply health education and health promotion programs that consider health literacy, attitude toward health behaviors, social support, self-efficacy, and interest in health to foster school-aged children’s health promotion behavior.
