Analysis of Telephone Counseling of Patients in Chemotherapy Using Text Mining Technique

Purpose@#The purpose of this study was to analyze the frequency and relevance of frequent keywords using text mining analysis for symptom-related telephone counseling of patients undergoing chemotherapy, and to understand the current status and characteristics of the nursing intervention. @*Methods@#442 cases of telephone counseling of patients undergoing chemotherapy were collected. The symptoms were classified and separated according to the contents of the consultation between the nurse and the counseling participants. Using the python library, frequency words were extracted, and the generation of word co-occurrence matrices was analyzed through social network analysis. @*Results@#For the four cancers to be analyzed (breast, colorectum, stomach, lung), the common frequent words of nurse and counseling participants were ‘medical staff (uilyojin)’, ‘medical treatment (jinlyo)’, ‘treatment (chilyo)’, ‘other hospital (tabyeongwon)’, ‘prescription (cheobang)’. In the analysis of social networks, words with highly betweenness centrality, which appear in common, almost matched those of frequent words. @*Conclusion@#In this study, it was possible to extract the most frequent words by cancer type from the contents of telephone counseling with cancer patients and to understand the current status and context of the actual telephone counseling focusing on each keyword.

Predictive Factors of the Regular Mammography Screening among Korean Chinese Women in Korea

Purpose@#This study was performed to identify predictors of the regular mammography screening of Korean Chinese women in Korea. @*Methods@#244 Korean Chinese women living in Suwon and Seoul-Gyeonggi area participated in the survey. In this study, a total of six measurement tools were used, including knowledge about breast cancer and mammography, Eastern cultural views, and health belief model subfactors. Predictors of the regular mammography screening were analyzed by binary logistic regression analysis. @*Results@#Only 48.77% of participants underwent regular mammography screening. Participants who underwent regular mammography screening had a longer period of stay (OR 1.1, 95% CI 1.02~1.17), had medical insurance (OR 24.38, 95% CI 2.78~213.55), had more knowledge (OR 1.2, 95% CI 1.04~1.39), subscribed to fewer Asian cultural views (OR 0.97, 95% CI 0.95~0.99), and confronted fewer barriers (OR 0.96, 95% CI 0.93~0.99) than those who did not. @*Conclusion@#Regarding the mammography screening, it was found that for Korean-Chinese women, having insurance had a greater influence than cultural background. For Korean-Chinese women, insurance was linked to practical economic matters and this seems to have undoubtedly affected the conduct of mammography screening.

The Lived Experience of Body Alteration and Body Image with Regard to Immediate Breast Reconstruction among Women with Breast Cancer

Purpose@#The purpose of this study was to explore the lived experience of body alteration and body image with regard to immediate breast reconstruction among women with breast cancer. @*Methods@#Data were collected from July to December 2020 through individual in-depth interviews with 15 women who had undergone immediate breast reconstruction due to breast cancer. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis. @*Results@#The following four theme clusters emerged. First, “revalued meaning of breasts due to cancer” illustrated the fact that cancer removal surgery brought the participants to reconsider the meaning of their breasts. Second, “had no choice but breast reconstruction” demonstrated the participants’ decision-making process of not wanting to lose breasts. Third, “unsatisfied breasts despite reconstruction” portrayed the distress due to the unexpected surgical outcomes. Finally, “restarted everyday routines with the altered body” described the healing process of the participants by accepting their changed body. @*Conclusion@#In Korea, where family-centeredness and fidelity are highly valued, women perceived their breasts not only as a symbol of femininity but as the mediator connecting the self to family. Despite the distress related to imperfect breasts, the participants were thankful for their reconstructed breasts. Breast reconstruction helped them return to daily life as the psychological trauma of breast cancer was healed. The participants rebuilt their body image by accepting their scarred new body. This may allow health professionals to provide constructive and culturally appropriate counseling in advance by providing insight into women’s perception of their body image with regard to breast reconstruction.

Lived Experiences of Korean Young Adults After Heart Transplantation: A Phenomenological Approach

Purpose@#This study aimed to explore and describe the lived experience of young adult heart transplant recipients in Korea. @*Methods@#Fifteen young adult heart transplant recipients participated in this qualitative study. Data were collected from March to August 2019 through in-depth individual interviews and analyzed using Colaizzi's phenomenological method. @*Results@#Their experiences about the arduous journey of heart transplant surgery and life after surgery were captured in four themes: (1) unwelcome rebirth without vitality, (2) facing unreachable ordinary tasks in life, (3) lifestyle bordering between burdensome and self-valued, and (4) finding the true meaning of a newly given life. @*Conclusion@#Young adult heart transplant recipients struggled with the burdens of their health problems, which impacted their employment and relationships. The participants' lifelong challenges and psychological turbulence identified in this study provide guidance for health-care providers to understand this population.

The Lived Experience of Body Alteration and Body Image with Regard to Immediate Breast Reconstruction among Women with Breast Cancer

Purpose@#The purpose of this study was to explore the lived experience of body alteration and body image with regard to immediate breast reconstruction among women with breast cancer. @*Methods@#Data were collected from July to December 2020 through individual in-depth interviews with 15 women who had undergone immediate breast reconstruction due to breast cancer. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis. @*Results@#The following four theme clusters emerged. First, “revalued meaning of breasts due to cancer” illustrated the fact that cancer removal surgery brought the participants to reconsider the meaning of their breasts. Second, “had no choice but breast reconstruction” demonstrated the participants’ decision-making process of not wanting to lose breasts. Third, “unsatisfied breasts despite reconstruction” portrayed the distress due to the unexpected surgical outcomes. Finally, “restarted everyday routines with the altered body” described the healing process of the participants by accepting their changed body. @*Conclusion@#In Korea, where family-centeredness and fidelity are highly valued, women perceived their breasts not only as a symbol of femininity but as the mediator connecting the self to family. Despite the distress related to imperfect breasts, the participants were thankful for their reconstructed breasts. Breast reconstruction helped them return to daily life as the psychological trauma of breast cancer was healed. The participants rebuilt their body image by accepting their scarred new body. This may allow health professionals to provide constructive and culturally appropriate counseling in advance by providing insight into women’s perception of their body image with regard to breast reconstruction.

Lived Experiences of Korean Young Adults After Heart Transplantation: A Phenomenological Approach

Purpose@#This study aimed to explore and describe the lived experience of young adult heart transplant recipients in Korea. @*Methods@#Fifteen young adult heart transplant recipients participated in this qualitative study. Data were collected from March to August 2019 through in-depth individual interviews and analyzed using Colaizzi's phenomenological method. @*Results@#Their experiences about the arduous journey of heart transplant surgery and life after surgery were captured in four themes: (1) unwelcome rebirth without vitality, (2) facing unreachable ordinary tasks in life, (3) lifestyle bordering between burdensome and self-valued, and (4) finding the true meaning of a newly given life. @*Conclusion@#Young adult heart transplant recipients struggled with the burdens of their health problems, which impacted their employment and relationships. The participants' lifelong challenges and psychological turbulence identified in this study provide guidance for health-care providers to understand this population.

Development of Caring as a Human Science: 50 Years of History of the Korean Society of Nursing Science

Purpose@#This year 2020 marks the 50th anniversary of the founding of the Korean Society of Nursing Science (KSNS). This study wasaimed to explore development of caring and describe the 50 years of history of KSNS within the sociocultural context of Korea regardingacademic footsteps, meanings, and implications for the future. @*Methods@#This study used a historical research methodology using a literaturereview and bibliometric analysis. Relevant literature was reviewed and the published abstracts in the Journal of Korean Academy ofNursing (JKAN) were analyzed using VOSviewer. @*Results@#Birth control and family planning in the 1970s was the main research topic. In the1980s, the development of nursing concepts, theories, and philosophies was the mission of KSNS to extend the disciplinary boundary. In the1990s, the progress of KSNS to become one of the woman-dominant healthcare professionals was the mission in the given period. Expandingthe frontiers of KSNS to the extent of global standards was the undertaking of the nursing scholars in the 2000s. Lastly, in the 2010s,the quality and quantity improvement of KSNS and JKAN is expected to make our future even prosperous. The map visualization of the 50years of research accumulation showed the comparable opposition of quantitative vs. qualitative research methodologies, equation modeling,and instrument development. @*Conclusion@#These clusters of research demonstrates the efforts to make nursing evidence by Koreannursing scholars for the last five decades. The growth in the slope of KSNS and outcomes of JKAN are to carry on to an unimaginable extentin the future.

Analysis of Research Topics and Trends in the Journal of Korean Academy of Nursing to Improve Its International Influence

Purpose@#The purpose of this study was to analyze articles published in the Journal of the Korean Academy of Nursing (JKAN) between 2010 and 2019, along with those published in three international nursing journals, to improve JKAN’s international reputation. @*Methods@#The overall characteristics of JKAN’s published papers and keywords, study participants, types of nursing interventions and dependent variables, citations, and cited journals were analyzed. Additionally, the keywords and study designs, publication-related characteristics, journal impact factors (JIF), and Eigenfactor scores of International Journal of Nursing Studies (IJNS), International Nursing Review (INR), Nursing & Health Sciences (NHS), and JKAN were analyzed and compared. @*Results@#Among the four journals, JKAN’s score was the lowest in both the journal impact factor and Eigenfactor score. In particular, while the JIF of INR and NHS has been continuously increasing; JKAN’s JIF has remained static for almost 10 years. The journals which had cited JKAN and those which JKAN had cited were mainly published in Korean. @*Conclusion@#JKAN still has a low IF and a low ranking among Social Citation Index (E) journals during the past 10 years, as compared to that of four international journals. To enhance JKAN’s status as an international journal, it is necessary to consider publishing it in English and to continuously improve the conditions of other publications.

The Meanings of Hands among Clinical Nurses in a Tertiary Hospital / 중환자간호학회지

PURPOSE: The purpose of this study was to explore and describe the meanings of hands among clinical nurses.METHODS: A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis.RESULTS: A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included “meaning as an instrument,” “meaning of infection control,” and “meaning of caring.”CONCLUSION: Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.

Comparison of Symptoms, Depression, Intimacy, and Quality of Life According to Treatment Duration in Men with Prostate Cancer Undergoing Androgen Deprivation Therapy

PURPOSE: This study was conducted to identify the differences in symptoms, depression, intimacy and quality of life (QOL), and the factors influencing QOL in men with prostate cancer undergoing androgen deprivation therapy (ADT). METHODS: This study used a cross-sectional, descriptive research design. Data were collected using a self-report questionnaire from 122 men with prostate cancer undergoing ADT. The data collection period was from November 19, 2018 to February 25, 2019. Data were analyzed using t-tests, χ2 tests, Fisher's exact tests, 4-way ANOVA and multiple regression. RESULTS: The mean age of the men was 70.3±7.3. There were statistically significant differences in urinary, bowel, sexual and hormonal symptoms according to treatment duration (F=23.74, p<.001). Factors influencing QOL explained 55% of the variance (adjusted R2=.55, p<.001). These factors were depression (β=−.52, p<.001), intimacy (β=.23, p=.001), ADT duration (β=−.17, p=.011), economic status middle (β=.23, p=.006), high (β=.29, p=.001) and sleep (β=.15, p=.023). CONCLUSION: The study found an association between ADT duration and symptoms, and the factors influencing QOL of participants. It provides a base for future research direction on ADT and patient QOL.

The Effects of an Interactive Nursing Skills Mobile Application on Nursing Students' Knowledge, Self-efficacy, and Skills Performance: A Randomized Controlled Trial

PURPOSE: Clinical nursing practice is important because it helps nursing students experience realities of clinical nursing that cannot be learned through theoretical education. This study aimed to evaluate the effect of an interactive nursing skills mobile application for nursing students. METHODS: Sixty-six senior nursing students were randomly assigned to experimental or control groups. The experimental group used an interactive nursing skills mobile application for 1 week. The control group was provided with a mobile application containing noninteractive nursing video contents for 1 week. Before (pre-test) and 1 week after (post-test) using the mobile application, participants' knowledge of clinical nursing skills, self-efficacy of nursing practice, and nursing skills performance were assessed. RESULTS: The experimental group showed a significantly higher value for knowledge after 1 week of treatment via their mobile application than the control group (t = 3.34, p = .001). In addition, they showed significantly improved self-efficacy before and after intervention (t = 2.46, p = .017) than the control group. The experimental group's nursing skills performance was also significantly enhanced after intervention (t = 7.05, p < .001), with a significant difference in the degree of improvement (t = 4.47, p < .001). CONCLUSION: The interactive learner-centered nursing education mobile application with systematic contents was an effective method for students to experience practical nursing skills. Developing and applying a mobile application with other nursing contents that can be effectively used across all range of nursing students is recommended.

Experience of Violence from the Clients and Coping Methods Among Intensive Care Unit Nurses Working in a Hospital in South Korea

PURPOSE: It is difficult to develop a good defense system that can prevent nurses from experiencing physical and verbal violence from patients and families in intensive care units, which are closed spaces. This study aimed to identify intensive care nurses' experience of violence from patients and families and investigate their coping methods, if there are any, in a tertiary hospital in South Korea. METHODS: This study used a mixed methods design using both a survey for collecting quantitative data and individual interviews for a qualitative one. A total of 200 intensive care nurses participated in the survey, with 30 of them taking part in individual interviews. Survey data were analyzed using SPSS 21.0 program, and qualitative data were analyzed by qualitative content analysis method. RESULTS: In the survey, 99.5% of the nurses reported that they had experienced violence from the patients, and 67.5% of the nurses reported that they had experienced violence from their visitors (families or relatives). Verbal violence were reported more than physical ones. They showed moderate or severe responses to violence, scoring an average of 2.98 ± 0.63 of 5. The qualitative data were analyzed to draw four themes, eight categories, and 17 subcategories. The four themes were perception of violence, coping with violence experience, coping resources, and caring mind after violence experience. CONCLUSION: While intensive care nurses experience unpredicted violence from patients and their visitors, they fail to cope well with the experience. The safe working environment of intensive care units is expected to contribute to quality care and an improvement of expertise in nursing.

The Effect of Patient-centered CPR Education for Family Caregivers of Patients with Cardiovascular Diseases

PURPOSE: For cardiovascular patients, family caregivers play a vital role in daily nursing and cardiac emergencies. This study aimed to evaluate the effect of patient-centered CPR education (PCE) for family caregivers of patients with cardiovascular diseases. METHODS: Fifty-four participants were randomly assigned to the PCE or control group. The PCE group received tailored counseling on overall cardiovascular disease information and CPR followed by interactive instructor-guided CPR training and re-education follow-up by telephone 2 weeks later. The control group received only video-based CPR self-education and booklets. Cardiovascular disease and CPR knowledge and self-efficacy were measured before (pre-test), immediately after (post-test 1), and 4 weeks after the PCE (post-test 2). CPR skills and performance were measured pre-test and at post-test1. RESULTS: The PCE group demonstrated significant improvements in knowledge (F=91.09, p<.001), self-efficacy (F=15.19, p<.001) and CPR skills and performance (F=8.10, p=.008), as well as significant differences over time (knowledge: F=364.25, p<.001; self-efficacy: F=1162.28, p<.001; CPR skills and performance: F=1798.81, p<.001). There were significant group-by-time interactions for knowledge (F=8.10, p=.001), self-efficacy (F=4.30, p=.019) and CPR skills and performance (F=4.81, p=.036) by repeated measures ANOVA. CONCLUSION: This is the first study to demonstrate the effects of a patient-centered intervention with CPR education tailored for patients' and family caregivers' preferences, needs, and lifestyles. The results of this study encourage the use of tailored, patient-centered interventions in cardiovascular nursing practice.

Sickness Experiences of Korean Registered Nurses at Work: A Qualitative Study on Presenteeism

PURPOSE: Presenteeism is a relatively new concept in nursing describing the condition within which registered nurses (RNs) come to work while they are sick. The purpose of this study was to explore and describe presenteeism experiences among RNs in South Korea. METHODS: In this constructivist grounded theory study, a focus group interview (FGI) technique was utilized for data collection. A total of 20 RNs at one hospital in Chuncheon city joined in three different FGIs. Semistructured questions were asked in reference to their sickness experience in the workplace. Data analysis was conducted according to the constructivist grounded theory methodology. RESULTS: All participants had experiences of presenteeism. The overriding theme was "having no caring for nurses leads to losing one's nursing mind". The participants reported that due to either their personal preference or peer pressure they showed up to work, but they felt sad and their pride was hurt by the fact that there was no caring for them from other nurses. This emotional exhaustion often led to the loss of compassion and the resignation of nursing staff. CONCLUSIONS: Care for nurses in the workplace is necessary for RNs to make their presenteeism experience positive and even effective.

The Influence of Stress, Spousal Support, and Resilience on the Ways of Coping among Women with Breast Cancer

PURPOSE: The purpose of this study was to investigate the influence of stress, spousal support, and resilience on the types of coping among women with breast cancer. METHOD: Using a cross-sectional survey design, a total of 120 participants, diagnosed with breast cancer, had a mass removal surgery, and were fluent in Korean, were recruited at a cancer center in Seoul, Korea. Self-reported questionnaires of stress, spousal support, resilience, and ways of coping were administered upon the permission from the original developers. Data were analyzed using SPSS 22.0 Win program. RESULT: Ways of coping was positively correlated with spousal support, resilience, and stress. Positive correlations were found between problem-focused coping, spousal support, and resilience. Positive correlations were found between emotion-focused coping with stress and resilience. Hierarchical multiple regressions revealed that spousal support had significant moderating effect on the relationship between stress and emotion-focused coping. CONCLUSION: Women perceived their diagnosis and surgery as more stressful, they more like to use emotion-focused coping. Women with more spousal support and resilience were found to use problem-focused coping more. Based on the findings of this study, a tailored intervention for women with breast cancer for improving their coping is expected in future research.

The Patients' Experiences of the Diagnosis and Pre-Treatment Period of Breast Cancer / 기본간호학회지

PURPOSE: To date most research related to patients with breast cancer has discriminately investigated the status within or after the treatment although the patients demand holistic nursing care from the time of diagnosis. Thus, the purpose of this study was to investigate the trajectory of breast cancer diagnosis and patients' experiences in the pre-treatment period. METHOD: This qualitative study used qualitative thematic analysis. Nineteen Korean women who were diagnosed with breast cancer within the last 6 month participated in the study. Individualized interviews were conducted with each participant in a cancer center in K city. The interviews were tape-recorded, transcribed, and analyzed using the thematic analysis process. RESULTS: The overriding theme was "the scattered life in an unforeseen swirl", which illustrates the participants' unexpected crisis with confusion and emotional distress. Two subthemes included "falling into an unavoidable journey", and "staggering in a muddle with urgency". The categories were "unexpected probability", "nagging nodularity", "ominous presentiment", "emotional upheaval", "bad thought intrusion", and "a sense of urgency". CONCLUSION: Patients in the pre-treatment period encountered utter emotional distress and a sense of urgency after being diagnosed breast cancer. Strategies to develop nursing care for patients in this period and nursing implications are discussed.

Thrown in a Different World: The Later Lives of Korean Elderly in an American Nursing Home / 성인간호학회지

PURPOSE: Increasing numbers of Koreans have immigrated to the United States since the late 1960s. The first generation of Korean immigrants or their parents become old and institutionalized in American nursing home setting. Although the Korean elders would experience many cultural differences in the nursing home, no study to date has investigated their everyday lives on how they live through their later lives within a different cultural environment from their own. METHODS: Using ethnographic methodology, the purpose of this paper was to illustrate Korean residents' experiences and daily lives in a nursing home located in an east coastal city in the U.S. Participant observation, filed notes, semi-structured interviews were utilized by means of data collection. Eighteen Korean residents were observed, and five of them and two nurses participated in informal qualitative interviews. RESULTS: The overriding theme from the findings is "thrown in a different world." Three sub-themes include "constant struggles in making themselves understood", "dealing with culturally inappropriate nursing care," and "maintaining their own ways of life". CONCLUSIONS: The discovered themes reflect culturally isolated lives of the participants and open a venue for designing a culturally congruent nursing care for Korean elders living in the U.S. nursing homes.

The Risk of Malnutrition, Depression, and the Perceived Health Status of Older Adults / 간호학회지

PURPOSE: The purpose of this study was to investigate the risk of malnutrition and its relationship with depression and perceived health status. METHODS: A total number of 154 elderly over 60 years participated in the study through a community elderly center. The risk of malnutrition was measured by NSI (Nutritional Screening Initiative), depression by CES-D, and health status by a self-rated Likert scale. RESULTS: About one fourth (22.7%) of the subjects had a high risk, and 31.2% had a moderate risk of getting malnutrition. Regarding depression, 34.4% (53 elderly) of the subjects had a high risk. Overall health status had a mean of 3.46 within the range of 1 to 5. In relation to demographic factors, female elderly (chi-square=6.68, p= .04), aged younger than 75 years old (chi-square=8.60, p= .01), and having co-morbidity (F=9.81, p= .001) were significantly related to a high risk of malnutrition. Having a higher depression score, higher number of co-morbidity, and lower perceived health status were significantly related to a higher risk of becoming malnourished. CONCLUSION: The elderly's risk of getting malnutrition was significantly related to their depression and perceived health status. With these findings nursing interventions focusing on these factors should be developed in order to improve the elderly's multidimensional well-being.