A study on the reliability and validity of the Korean version of the parenting outcome expectancy scale for parents of elementary school students

Introduction

Many parents do not engage in active discussions with their children about sexuality. This can contribute to negative sexual and reproductive health outcomes among youth. To foster a healthy environment for sexual activity, it is crucial for parents to provide comprehensive sex education to their children at home. This study aims to cross-culturally adapt and evaluate the psychometric properties of a Korean version of the Parenting Outcome Expectancy Scale to measure the sexual communication abilities of parents of elementary school students in South Korea.

Method

The study participants were parents of elementary school students between 6 to 13 years old. We used exploratory and confirmatory factor analyses to examine the reliability and validity of the 23-item Korean version of the Parenting Outcome Expectancy Scale.

Results

The study confirms the reliability and validity of the scale, comprising five factors and 22 items, for the evaluation of the outcome expectancy of communication about sex between parents and their children. Results also demonstrate that talking about sex is still a challenge for many parents.

Discussion

This instrument can help parents prepare for sex communication with their children and for sexual education, potentially yielding a positive effect on children's sexual health and parental satisfaction.

Effect of gonadotropin-releasing hormone agonist monotherapy and combination therapy with growth hormone on final adult height in girls with central precocious puberty

This study aimed to compare clinical parameters, including final adult height (FAH), in girls with central precocious puberty treated with gonadotropin-releasing hormone agonists (GnRHa) with and without growth hormone (GH). This retrospective study reviewed data of 210 girls with precocious puberty who had reached FAH in a long-term trial of GnRHa treatment. The subjects were divided into the GnRHa treatment group (n = 188), and the combined GnRHa + GH treatment group (n = 22). Chronological age, bone age, height, height standard deviation score, predicted adult height (PAH), FAH, Tanner stage, and hormone levels were assessed during the treatment period. At the start of treatment, PAH was 156.35 ± 6.34 cm in the GnRHa monotherapy group and 150.41 ± 5.32 cm in the GnRHa + GH group (P < 0.001). At the end of treatment, PAH was 166.25 ± 5.26 cm in the GnRHa group and 164.07 ± 4.99 cm in the combined GnRHa + GH treatment group, which had increased compared to the start of treatment. The FAH in the GnRHa group and GnRHa + GH combination group were 161.07 ± 4.78 cm and 159.63 ± 3.8 6 cm, respectively, without significant difference. In addition, the height gain (FAH-PAH) was significantly higher in the GnRHa + GH group than the GnRHa group (9.22 ± 6.03 cm vs. 4.72 ± 5.01 cm, P < 0.001). In girls with central precocious puberty, the height gain in the FAH compared to PAH at the start of treatment was significantly higher with the GnRHa + GH combination treatment.

Perceptions and Treatment of Precocious Puberty: A Questionnaire Survey among Caregivers in South Korea

This study aims to provide the basis for developing complementary and alternative treatment approaches for precocious puberty (PP) by examining caregivers' awareness, along with their preferences and expectations from various treatments. It included data collected between July 2019 and March 2020, from 175 caregivers of children who were undergoing or had undergone treatment for PP. The questionnaire comprised 53 questions on the awareness, acquisition of information, perceptions of treatments, and concerns about PP, as well as awareness of habit management (HM) and children's actual habits. The collected data were analysed using the Chi-square test, t-tests, and one-way analysis of variance. The caregivers responded that PP could be recognized on the basis of breast development (79.8%) in girls and hair and body odor (73.1%) in boys. However, 86.9% of respondents were getting inaccurate information from the Internet. With respect to PP treatment approaches, 16% of respondents hoped to manage PP through conventional treatment (CT), 21.1% preferred traditional Korean medicine (TKM), and 62.3% preferred HM. Expectations of the effectiveness were highest in HM, followed by CT and TKM. Only the TKM group had statistically significant higher expectations than the nontreatment experience group (F = 4.566, p=0.004). The caregivers were concerned about the side effects and high costs of CT. Around 43% of respondents had difficulties with the management of their children's diet, 64.6% with exercise, and 57.1% with smart device usage. Clinicians should be aware of caregivers' information acquisition patterns, preferences and expectations of various treatments, and their concerns. Considering these results, clinicians should try to establish more appropriate treatment plans for children with PP.

Effects of gonadotropin-releasing hormone agonist treatment on final adult height in boys with idiopathic central precocious puberty

PURPOSE

There are few reports on the therapeutic effects of gonadotropin-releasing hormone agonists in boys with central precocious puberty, and studies reported in Korea are very rare. We aimed to assess the significance of clinical factors and the effects of gonadotropin-releasing hormone agonist treatment on final adult height in boys diagnosed with central precocious puberty.

METHODS

We retrospectively evaluated the medical records of 18 boys treated for idiopathic central precocious puberty between 2007 and 2018 at Chosun University Hospital. Gestational age, birth weight, and parental height were assessed at the initial visit. Chronological age, bone age, bone age/chronological age ratio, height and height standard deviation scores, predicted adult height, body mass index, and hormone levels were assessed during the treatment period.

RESULTS

At the time of diagnosis, the chronological age was 9.9±0.6 years, the bone age was 11.6±1.0 years, and the bone age/chronological age ratio was 1.20±0.1. The bone age/chronological age ratio decreased significantly to 1.12±0.1 at the end of treatment (P<0.05). The luteinizing hormone/follicular stimulating hormone ratios were 3.4±1.2, 0.6±0.4, and 0.6±1.0 at the start of treatment, after 1 year of treatment, and at the end of treatment, respectively. After gonadotropin-releasing hormone agonist treatment, the final adult height reached 172.0±4.8 cm compared to the target height range of 171.0±4.0 cm.

CONCLUSION

In boys with central precocious puberty, gonadotropin-releasing hormone agonist treatment improved growth potential.

[Mothers' Experiences of Caring for Children with Precocious Puberty: A Q-Methodological Approach]

PURPOSE

This study explored experiences of mothers caring for children with precocious puberty.

METHODS

Q-methodology was used for analyzing individual subjectivity. Seventy Q-statements were selected and scored by 50 participants on an 11-point scale. The collected data were analyzed using the PC QUANL program.

RESULTS

The following eight types of care experiences of mothers of children with precocious puberty were identified: Type I-1: hypersensitive and best-result oriented, Type I-2: treatment burden, Type II-1: treatment-oriented, Type II-2: self-blame, Type III-1: accepting and compliant, Type III-2: treatment confused, Type IV-1: serious and engaged, and Type IV-2: naturalism-oriented.

CONCLUSION

These results can help develop specific education programs based on types of care experiences for the promotion of care among mothers of children with precocious puberty.

Time Points for Gonadotropin-Releasing Hormone Stimulation Test Results in Korean Children

The gold standard for the laboratory diagnosis of central precocious puberty is based on the measurement of luteinizing hormone (LH) after gonadotropin-releasing hormone (GnRH) stimulation. We sought to investigate the laboratory data for GnRH stimulation testing using samples collected from Korean children at different time points. Sampling times were at the basal time point (0) and 15, 30, 45, 60, 90, and 120 min after GnRH stimulation. Pubertal response was defined as occurring when the peak LH concentration was 5 IU/L or more and rose to at least 2 times the basal LH concentration after GnRH stimulation. During the study period, 19,990 test results from 1958 Korean children (1841 females aged 1.3-8.9 years and 117 males aged 7.3-9.9 years) were obtained. Among the 1958 children, 1232 (62.9%) showed pubertal responses. The receiver operating characteristic curve that demonstrated the greatest area under the curve (AUC) among all examined time points was 45 min after GnRH stimulation in males (AUC 0.982, 95% CI 0.938-0.998) and 60 min in females (AUC 0.975, 95% CI 0.967-0.981). The combination of 45 min and 60 min showed the greatest AUC (0.996, 95% confidence interval 0.991-0.998), with a sensitivity level of 99.1% and a specificity of 100% for all children. The results of this study provide a possibility for a reduction in sampling time points (45 min and 60 min) to identify the presence of a pubertal response after GnRH stimulation in Korean children.

Association between Dietary Habits and Parental Health with Obesity among Children with Precocious Puberty

Precocious puberty, resulting in various physical, mental, and social changes, may have negative consequences for children and their families. In this study, we investigated whether there were differences between parental obesity, children's and parent's awareness of body shape, and dietary habits according to obesity levels in children with precocious puberty. A total of 193 children (93.3% girls) diagnosed with precocious puberty were classified into three groups according to their obesity levels. Negative body shape awareness and dissatisfaction were significantly higher in the obese group than in the normal-weight group, and parents were more likely to perceive their children as fat than the children themselves. In addition, the obesity rate of parents in the obese group was higher, and the body mass indexes of children and parents were significantly correlated. The nutrition quotients (NQs) were revealed to be significantly lower in the obese group with significantly lower scores. The significant factors related to obesity were the awareness of a fatty body image and dissatisfaction, obesity of the parents, and the NQ. The results show that obese children with precocious puberty were more vulnerable to negative lifestyle, family environment, and self-esteem effects than their normal-weight peers. Therefore, various interventions, such as environmental management, psychological support, and nutrition education, are needed that focus on the obesity and health conditions of children with precocious puberty.

Effect of a Social Support Program for Mothers of Children with Precocious Puberty: A Preliminary Quasi-Experimental Study

PURPOSE

The purpose of this study was to evaluate the effects of a social support program on the stress, anxiety, guilt, and life satisfaction levels among Korean mothers of children with precocious puberty.

DESIGN AND METHODS

A non-equivalent control group and a non-synchronized design were used in this quasi-experiment study. Thirty-four mothers (divided into equal-sized experimental and control groups), 32-47 years of age, with children aged 6-11 years old, were recruited from a pediatric outpatient department at a national university hospital. The experimental group was involved in four sessions of a 4-week social support program. Descriptive statistics were used for demographic characteristics. Chi-square tests and t-tests were used to evaluate group differences.

RESULTS

The program significantly reduced mothers' stress and guilt and significantly increased their life satisfaction. No significant differences in changes in anxiety were reported between the groups.

CONCLUSIONS

This study confirms that the social support program was a useful nursing intervention for Korean mothers of children with precocious puberty, which can be extensively applied to help mothers in similar situations.

PRACTICE IMPLICATIONS

The preliminary study findings may inform healthcare professionals to develop effective interventions to promote psychosocial well-being of mothers of children with precocious puberty through strengthening their social support and to further improve the quality of life of children with precocious puberty and their families.