**1. Introduction**

Complementary and Alternative Medicine (CAM), which is not considered to be part of conventional medicine, is a compilation of knowledge, skills, and practices which are based on the theories, beliefs, and experiences indigenous to different cultures and used for health maintenance and in the prevention, diagnosis, improvement, or treatment of physical and mental illness [1–3]. CAM approaches include natural products (e.g., herbs, vitamins and minerals and probiotics), and mind body practice such as yoga, meditation, chiropractic, acupuncture, relaxation techniques, tai chi, qigong, and hypnotherapy [4]. The use of CAM is increasing in many countries of the world [5]. Approximately 88% of the member states of the World Health Organization (WHO) are using CAM through the development of national policies, laws, regulations, and applied programs [6]. In East-Asian countries such as South Korea and China, traditional medicine has been the form of medical care treating the diseases of the people. Currently, it is still taking a crucial part in health care along with conventional medicine (CM) [7,8]. In East-Asian countries such as China, Korea, and Taiwan, traditional medicine practitioners are considered as doctors, as is the case with the doctors who provide CM [9,10]. Traditional Korean medicine (TKM)

**Citation:** Kim, J.; Park, J.-K.; Park, J.-Y.; Lee, E.-J.; Sung, S.-H. The Use of Traditional Korean Medicine (TKM) by Children: A Correlational Study between Parent's Perception and Their Children's Use Reported by Parents. *Healthcare* **2021**, *9*, 385. https://doi.org/10.3390/ healthcare9040385

Academic Editors: Manoj Sharma and Kavita Batra

Received: 17 February 2021 Accepted: 26 March 2021 Published: 1 April 2021

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**Copyright:** © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

doctors use acupuncture, electro-acupuncture, pharmacopuncture, herbal medicine, chuna, cupping, moxibustion, and other forms of intervention to treat their patients [11]. In Korea, 14% of the total population and 7.6% of those in their 20 s or younger, are using TKM, and 10% of the total male population and 18.1% of the total female population visited TKM clinics [12]. The purpose of using TKM was treating a disease (94.1%), improving health (18.4%), and cosmetic purposes (4.0%) [13].

Health in the pediatric or juvenile period has an impact on adulthood health, education, achievement, and economic performance. Therefore, the health of children and teenagers is of paramount importance [14,15]. Additionally, parents' experience with using medical services can have varying effects on their children [16]. Some well-known factors impacting the health and the usage of medical services during pediatric and juvenile periods include respective family structure, parental education level, and their social- status [17–22].

In the field of traditional Chinese medicine (TCM), Loh [23] surveyed 300 parents who visited TCM clinics, and 84.3% of their children used TCM clinics, while 80.3% of them reported that they used both TCM clinics and CM clinics. Yeh [24] used the National Health Insurance data of Taiwan to analyze the overall usage of TCM and reported that about 20% of the children under 20 used TCM clinics. In the field of TKM, Choi [25] conducted a survey of 300 parents who used the TKM clinic and had a child under 19. As a result of the said survey, it was resulted that 81% of the children experienced and visited TKM clinics for the purpose of treating respiratory disease (21.6%) gastrointestinal disease (10.6%,), and skin disease (9.2%). Park [26] surveyed 702 parents who used daycare centres and reported that 55.3% of the children's age from 1 to 13 used TKM clinics, mainly for the purpose of treating respiratory disease (34.5%), gastrointestinal disease (17.2%), and skin disease (13.8%). As such, the previous studies on the usage of traditional medicine among children or adolescents under 20, were mainly conducted as cross-sectional studies. In three studies [23,25,26], the study samples were not representative of the general population of the country. Yeh [24] used the representative data of the general population of Taiwan. However, the study was intended to investigate the usage of TCM in the entire population, including children.

An assessment of TKM usage has been undertaken by Statistics Korea, as a certified national statistic every 3 years since 2008. This assessment covers all household members of the sample families who are at least 19 years old, providing a representative sample of the country [13]. In order to effectively integrate TKM into the healthcare system, it is necessary that policies are developed and implemented based on accurate statistics of TKM. To fulfil this requirement, the national survey on TKM use data from 5000 Korean participants was used in order to examine the correlation between parental awareness of TKM use and the use of TKM by their children.
