Validity and Reliability of the Korean Version of Assessment of Health Literacy in Breast and Cervical Cancer Screening

Purpose@#Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening—Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C). @*Methods@#A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension. @*Results@#During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale. @*Conclusion@#These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans’ health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.

Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review

PURPOSE: The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes. METHODS: A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses. RESULTS: 29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents. CONCLUSION: Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

Factors Related to Risk of Cardiovascular Disease Among Older Korean Chinese With Hypertension

PURPOSE: The purpose of this study was to assess the prevalence of cardiovascular disease (CVD) risk factors among older Korean Chinese with hypertensiondone of the most underserved and understudied ethnic minority groups in China. In addition, factors underlying the risk of CVD were examined. METHODS: A total of 334 participants were recruited at the Community Health Service Center in Yanji, China. Data regarding socioeconomic, health-related, psychosocial, and other CVD risk factors were collected between June and October 2009. In this cross-sectional study, factors related to the risk of CVD were assessed by multivariate logistic regression; the Framingham Risk Score was used to measure the risk of CVD. RESULTS: The prevalence of dyslipidemia, diabetes, and current smoking were 75.4%, 6.6%, and 23.1% respectively. Participants who lived alone were twice as likely to have a high risk of CVD (10-year risk of CVD > or =15%; odds ratio [OR], 2.00; 95% confidence interval [CI], 1.13e3.54). Those with a higher education level and greater knowledge about hypertension were at 57% and 62% reduced risk for CVD (OR, 0.43; 95% CI, 0.21e0.92 and OR, 0.38; 95% CI, 0.15-0.95, respectively). CONCLUSION: Future intervention should include strategies to addressing social isolation and also focus on older Korean Chinese with low education. Knowledge enhancement program is warranted for the prevention of CVD in this population.

Psychometric Evaluation of Hill-Bone Medication Adherence Subscale

PURPOSE: Medication adherence is an essential part of the management and control of high blood pressure (HBP). Although the Hill-Bone Medication Adherence (HBMA) scale is one of the most frequently used instruments for measuring HBP medication adherence, the psychometric properties of the scale have never been tested among Korean Americans, a population that experiences a disproportionately high prevalence of HBP. Therefore, the objective of this study is to validate a Korean version of the HBMA subscale (HBMA-K). METHOD: We used two, independent samples of Korean Americans (KAs) (combined n = 525) who participated in community-based intervention trials for HBP control. To develop the HBMA-K, the original scale was translated into Korean and then back translated into English. Reliability was assessed by calculating the Cronbach's alpha. Exploratory factor analysis (EFA) was done to assess construct validity. We also calculated the Pearson's correlation coefficients between the scale and theoretically driven variables such as blood pressure, knowledge, and HBP belief to test concurrent validity. RESULTS: The EFA revealed a one-factor solution with eight items, explaining 35.4% of the variance. Cronbach's alpha was .80. The 8-item HBMA-K scale was significantly associated with systolic blood pressure (BP) (r = .18, p < .01), diastolic BP (r = .24, p < .01), HBP knowledge (r = -.13, p < .01), and HBP belief score (r = -.18, p < .05). CONCLUSIONS: The 8-item HBMA-K scale is a valid and reliable instrument for measuring medication adherence among KAs with HBP. It can be easily administered at community and clinical settings to screen hypertensive patients with low medication adherence.

Knowledge, Behaviors and Prevalence of Reproductive Tract Infections: A Descriptive Study on Rural Women in Hunchun, China

PURPOSE: The aim of the study was to assess the prevalence, knowledge and behavior about reproductive tract infections (RTIs) among rural Chinese women in Hunchun, China. METHODS: The study employed a cross-sectional research design with a convenience sample of 190 participants who had received microfinancing. Data were collected by trained research staff, utilizing face to face interviews and physical examinations. RESULTS: About 1 in 5 participants (20.3%) had had more than 5 pregnancies and 26.7% had had 3 or more abortions. More than half (57.3%) of study participants had an RTI at the time of examination, and 92.3% reported having had at least one RTI symptom. Nearly half (49.6%) of the women who exhibited RTI symptoms reported no utilization of any healthcare services. Age, number of pregnancies, RTI knowledge, and behavior were found to be significant correlates in the sample. CONCLUSIONS: The prevalence of RTI among low-income rural Chinese women were extremely high, indicating the urgent need for effective and culturally sensitive health education, particularly targeted to the poor rural population.

Improving Access to Mental Health Services for Korean American Immigrants: Moving Toward a Community Partnership Between Religious and Mental Health Services

Korean Americans (KAs) with psychiatric service needs underutilizes the mainstream mental health services in United States (US). Barriers to mental health service access among KAs reflect their unique heritage and culture. More than two-thirds of KAs identify themselves as Christians, and Korean clergy have influential roles in daily lives of vast majority of KAs. By working with the Korean clergy, a small voluntary organization such as the Association of Korean American Psychiatrists could provide invaluable assistance in removing the barriers to mental health services for KAs.

Fatigue and the Related Factors in Well Women / 성인간호학회지

Fatigue is the subjective sense which people experience and use commonly in their lives. Although factors regards with fatigue have been explored in specific population, minimal study has been devoted to exploring associated variables generally healthy women. This descriptive study examined the relationship of demographic factors and depressions to subjective fatigue among women in the community who have no critical health problems. From June 15 to July 15, 1996, a convenience sample of 255 adult women completed the questionnaire which was developed by the author on the basis of Yoshitake's(1978) and Zung(1965), respectively. Pearson's correlation, t-test, ANOVA and Mann-Whitney test were used to analyze the data with SPSS/PC+ 5.0 for Windows. The results were as follows ; 1) Average fatigue score of the subjects was 12.57(+/-7.15)(range 0~30). Fatigue scores by area were neuroperceptive fatigue(4.81+/-2.90), physical fatigue(3.99+/-2.46) and mental fatigue(3.71+/-2.91) in order. Subjects with the fatigue scores more than 20 were forty four, 17.2 percent of total subjects. 2) Average depression score was 46.1(+/-6.96)(range 16~64), which was not so high. 3) Statistically significant relationship was noted between fatigue and depression scores(r=-.6747, p<.001) that means the more depressive, the more be fatigued. Correlations with respective fatigue area and depression were mental fatigue(r=-.6833, p<.001), neuroperceptive fatigue(r=-.5293, p<.001) and physical fatigue(r=-.5189, p<.001) in order. 4) Presence of disease revealed as the statistically significant variable affecting fatigue scores(t=-4.31, p<.001). Other variables such as age, marriage and job, however, had no statistically significant effect on the fatigue scores. Fatigue can meaningfully undermine quality of life in women who are accustomed to leading active lives. Fatigue is disabling, and a serious symptom to those who suffer from it. It is important for health providers as well as the women to recognize that there exits the relationship between fatigue and depression. Further investigation is necessary to facilitate adequate resolution of the clients' problem from fatigue leading to diminishment of the significance.