Development of Child and Adolescent Psychiatric Nursing Practice in Korea, 1980-2000

Journal of Child and Adolescent Psychiatric Nursing, Apr-Jun 2004 by Im, Sook-Bin, Kim, Jung-Lim, Ju, Se-Jin, Kwon, Mi-Kyung, Et al

PROBLEM. Although the need for mental health services for children and youth is on the rise in Korea, there are no data available regarding the current status of psychiatric nurses working with children and adolescents.

METHODS. Descriptive statistics were used to analyze questionnaires from 324 respondents.

FINDINGS. Only 5% of psychiatric nurses in Korea are working at child and adolescentspecific programs. The level of nurses' roles and functions vary from simple to specialized.

CONCLUSIONS. More effort should be put into networking among nurses to exchange updated information and to share nursing strategies and strengthen college education for further specialization and expansion of nursing roles in the various settings.

Search terms: Adolescent psychiatric nursing, child psychiatric nursing, professional issues

The U.N.-sponsored "Year of the Child" in 1979 saw an initial movement toward child and adolescent psychiatric nursing in Korea. From 1980, the division of child and adolescent psychiatry was introduced and the provision of clinical service started. Before 1980, children with mental illnesses were treated in the same way as adult patients (Seoul National University Hospital, 1990), and there were no specialized psychiatric services for children and adolescents.

With the start of specialized child psychiatric services, child care professionals recognized that a multidisciplinary approach was essential for mentally ill children and that the nurse was a key person to take care of them (Hong, 1980). Such recognition prompted the beginning of child-adolescent psychiatric nursing practice (College of Nursing, Seoul National University, 1997; Kim, Kim, Park, & Im, 1982).

While outpatient treatment in child psychiatry has gradually been extended across Korea since 1980, childadolescent psychiatric nursing practices in Korea did not greatly expand. Since the inpatient wards for children and adolescents have not increased during this period, not many nurses could experience working with children and adolescents.

However, understanding children's growth and development and their psychopathology greatly helped to understand adults' psychopathologic progress, including the process of their mental growth. This was virtually the first step to understand human beings. The U.S. Office of Technology Assessment (1986) noted that many untreated youth would develop into seriously mentally ill adults. Therefore, more roles and active functions of nurses were expected in health promotion and prevention.

Many critical problems occur in Korea in relation to child rearing and parental roles-for instance, incidents related to unwanted pregnancy are increasing, more people are giving up parental roles, and there is inadequate or inappropriate childrearing, changes in gender roles and attitude, and excessive emphasis on academic achievements. These phenomena, which result from modernization and rapid changes in social structures and cultural values, are expected to persist in the 21st century, giving warning of dangers facing child-adolescent mental health. Professional psychiatric nursing will be in great demand to help families in crisis, which is attributable to individualism (self-centeredness) and the decline of the nuclear family, and reduced family size (Hong, 1999). With such a change in family structure, the young have less experience in dealing with different ages and less support from grandparents and uncles/aunts when in conflict with their parents. Thus, child-adolescent psychiatric nursing is in demand to meet such a social need.

Nursing education is still focused more on hospitalcentered rather than community-based nursing. Childadolescent psychiatric nursing occupies only a small portion of credits in the curricula of nursing colleges. It is not known precisely how many nurses are engaged in child-adolescent psychiatric nursing, what they do, and in which settings they work. Our study is based on a survey of actual conditions, tracing the development of nursing practice, in an attempt to define roles and functions of child-adolescent psychiatric nurses to meet social demand and changes. In this attempt, we became aware of current conditions and problems in child-adolescent psychiatric nursing and worked to find solutions to them. The objectives of the study were to:

1. Identify the current status of child-adolescent psychiatric nursing in Korea.

2. Describe the developing progress of child-adolescent psychiatric nursing from 1980 to 2000.

3. Assess child-adolescent psychiatric nursing practices in the hospital setting.

Methods

The survey was done to identify the current status and trace the development of child-adolescent psychiatric nursing practice. The authors developed a questionnaire based on a literature review (Pothier, 1984). The questionnaires included general characteristics of subjects, work experience in child-adolescent psychiatric nursing, the motive for their choice of child-adolescent psychiatric nursing, current job condition, types of client problems, rewarding aspects and difficulties as a child-psychiatric nurse, and knowledge source for the job. Also included were target clients, number of participating nurses, the contents of programs, nursing roles and functions, and limitations in operating program.