The Postnatal Care Experiences among First Time Chinese Immigrant Mothers Living in Korea

PURPOSE: This study was to explore the postnatal care experiences among first time Chinese immigrant mothers living in Korea. METHODS: Data were collected by focus group interviews with 12 first time Chinese immigrant mothers utilizing 3 focus groups. After obtaining written informed consent from all participants, each session of the focus group was audio-recorded and transcribed verbatim. Data were analyzed by content analysis to identify major themes. RESULTS: Four major themes for postnatal care experiences were extracted from the data as follows. 1) Range over traditional, modern, Korean or Chinese postnatal care, 2) Struggle with newborn care, 3) Another struggle with breastfeeding, and 4) Difficulties in becoming a mother as an immigrant. CONCLUSION: Based on their postpartum care experiences, it is concluded that participants requested more professional practical and individualized education/training for successful breastfeeding and newborn care. Health care providers need to develop and implement integrated support and mentoring programs that include information and peer support system for the first time Chinese immigrant mothers living in Korea. This would decrease the difficulties of becoming a mother.

Systematic Review of Quantitative Research related to Maternal Adaptation among Women Immigrants by Marriage in Korea

PURPOSE: This study aimed to describe knowledge status of current research related to maternal adaptation of women immigrants by marriage in Korea. METHODS: Eighteen quantitative current researches published from January, 2006 to August, 2014 that met the inclusion and exclusion criteria. These 18 articles finally selected for systemic review from 5,168 articles. All current researches included the mother within one year after childbirth and one variable related to maternal adaptation at least. RESULTS: Variables related to psychological adaptation (48.1%) were mostly studied. In detail, parenting stress (17.3%) and parenting competency (15.4%) were frequently surveyed. Also, social support (7.7%), husband rearing support (5.8%) of relational adaptation, and acculturation (3.8%) of cultural adaptation were importantly studied. In addition, frequently used instruments for each study variable were analyzed and evaluated. As major results, parenting stress and parenting efficacy were significantly influenced by social support or husband rearing support and acculturation, and had an effect on parenting behaviors. Various maternal education programs were effective in improving maternal role confidence or parenting efficacy and decreasing parenting stress. CONCLUSION: Nursing intervention programs for improving maternal adaptation should focus on decreasing parenting stress and increasing parenting efficacy by improving social support and acculturation level of women immigrants by marriage in Korea.

Comparison of Self-esteem, Perceived Life Satisfaction, Depression and Aggression According to Experience of Suicidal Impulse in Adolescents

PURPOSE: The purpose of this study was to compare self-esteem, perceived life satisfaction, depression and aggression according to the experience of suicidal impulse in adolescents. METHODS: Data were collected from 249 middle and high school students in J city. The constructed questionnaires included items on self-esteem, perceived life satisfaction, depression and aggression. RESULTS: Self-esteem, perceive life satisfaction, depression, and aggression differed significantly between the suicidal impulse group and non-suicidal impulse group. The suicidal impulse group experienced lower self-esteem (OR=3.27), higher depression (OR=12.38) and higher aggression (OR=5.72) than the non-suicidal impulse group. CONCLUSION: The findings indicate that integrated and effective interventions are needed to prevent suicidal attempts by adolescents who had experiences of suicidal impulse. Information on the cognitive, psychological and social characteristics of adolescents must be considered when developing the interventions.

Effects on Nursing Students of Cognition-Behavior Integrated Breast Cancer Prevention Education Using an Interchangeable Nodule Model / 여성건강간호학회지

PURPOSE: The study was done to examine the effects of cognition-behavior integrated breast cancer prevention education, in which a breast model with interchangeable nodules was utilized, on the self-competency of nursing students in performing breast cancer education. METHODS: A nonequivalent control group non-synchronized design was used. A traditional lecture intervention was provided for 49 3rd year college of nursing students (control group) while the integrated breast cancer prevention education was given to 47 3rd year students in the same college one year later (experimental group). The integrated breast cancer prevention education was developed by the research team to strengthen the competency of cognitive and behavioral components in education on breast cancer. RESULTS: Effects of the intervention were found to be significant through all study variables: knowledge about breast cancer (t=7.79, p <.001), breast cancer risk awareness (t=2.05, p <.05), self-competency of breast self-exam (t=8.27, p <.001), and intention to teach breast self-exam (t=3.87, p <.001). CONCLUSION: The integrated breast cancer prevention education was useful to improve not only knowledge about breast cancer but competency in performing breast examination for nursing students who acquired technical skills from various simulation nodules. As the program helped the students to be prepared as confident educators, future application of the module is recommended for academic curricula.

Validation of the Algorithm for Bio-signal Data in Home-health Management Systems / 대한의료정보학회지

OBJECTIVE: The purpose of this study was to verify the algorithm on bio-signals for a home-health management system. METHODS: A methodological study was done to verify the blood pressure and blood sugar algorithm to deliver tailored patient information. The verifying process was as follows: Step 1; development of the algorithm through a literature review, Step 2; programming the algorithm using Microsoft SQL Server 2005 and Visual Studio 2005, Step 3; Reviewing of the algorithm by examining results from the home-health management system and experts' evaluation Step 4; evaluating the agreement of the algorithm by comparison between results from the home-health management system and intended results using bio-signal data set, and completion of the algorithm. RESULTS: Discordance rate between results from the home-health management system and intended results for blood pressure and blood sugar were 5.72% and 2.04%, respectively. Also, discordance rate between results from the home-health management system and experts' evaluation of blood pressure and blood sugar were 30.38% and 20.41%, respectively. All discordance were revised until all the researchers reached agreement. CONCLUSION: The home-health management system with an accurate algorithm on bio-signals can contribute to promote clients' health and reduce the cost of medical services.

Women's Cancer Screening According to Body Mass Index in a Cohort of Rural Korean Women

PURPOSE: This study was done to examine the difference in cancer screening with mammography and Papanicolaou smear according to Body Mass Index (BMI). METHODS: The participants in this study were 5,912 women ages 40 to 69 yr, selected from the Korean Genomic Regional Cohort in Kangwon province. Mammography and Papanicolaou smear were assessed by questionnaire and body weight (kg) and height (m) measured to calculate BMI. RESULTS: The distribution of BMI was as follows: low weight (1.5%), normal weight (31.1%), over weight (24.6%), mildly obese (36.4%) and severely obese (6.3%). After adjusting for age, education and monthly income, compared with normal weight women, overweight women (odds ratio [OR]=1.283, 95% confidence interval [CI]=1.089-1.513) and mildly obese women (OR=1.214, 95% CI=1.048-1.406) were less likely to have had mammography. In contrast to mammography, cancer screening with Papanicolaou smear was not significantly different by BMI. CONCLUSION: Obese women in rural areas are less likely to screen for breast cancer by using mammography than non obese women. To ensure regular screening for breast cancer, health care providers need to give scrupulous care to obese women and remove barriers originated from obesity. Also, educational and clinical implications are considered to increase the Papanicolaou smear rate.

Development of an Integrated Breast Health Program for Prevention of Breast Cancer among Middle-aged Women / 여성건강간호학회지

PURPOSE: This study was done to develop an integrated breast health program for prevention and early detection of breast cancer, integrating primary and secondary prevention factors using cognitive-behavioral strategies. METHODS: This methodological study conducted as follows; Selection of components for the program through a literature review, survey to identify women's knowledge and risk perception of breast cancer and diet, and building prototype for the program using discussion based on findings. Using structured questionnaires, interviews were done with 130 women aged 40-59 who lived in a rural area. RESULTS: Primary prevention (diet pattern, knowledge about breast cancer, and risk perception) and secondary prevention (early detection behaviors) factors were identified through the literature review. The survey showed that women lack knowledge and awareness about the risks of breast cancer, and have a low compliance rate for early detection behavior. Based on these results, a program was developed utilizing counseling and models to provide education and practice related to diet, breast cancer, and early detection behaviors. CONCLUSION: Use of this integrated and tailored breast health program with women at risk will contribute to better breast health, but further study is needed to verify the effects.

A Descriptive Study for Developing a Program to Promote Compliance with Regular Breast Self-Examination(BSE) / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify knowledge, facilitators, and barriers of breast self -examination(BSE) in Korean couples for developing a continuous regular BSE promotion program. METHOD: This descriptive study was undertaken with a focus group methodology including 27 couples of husbands and wives recruited by convenience-sampling. Data transcribed from audiotapes was analyzed to identify common themes. RESULTS: Knowledge of breast cancer and BSE included 'the risk factors of breast cancer', 'prevention of breast cancer', and 'how to do BSE'. Facilitators to BSE included 'self, health professional, and spouse-facilitating factors'. Barriers to BSE included 'cognitive, psychological, informational, and physical barriers'. CONCLUSION: To promote compliance with BSE among women, tailored programs according to the stage of change of BSE adoption are crucial, not only reflecting the specific needs of the individual by the stage of change, but also utilizing husbands as facilitators.

Analysis of Published Papers and their Keywords in the Korean Journal of Women Health Nursing (2003-2006) / 여성건강간호학회지

PURPOSE: This research was aimed to explore the major subjects and research theme and to classify characteristics of the key words in recent Korean Journal of Women Health Nursing. METHOD: With survey design, whole 103 published papers during 2003-2006 were analyzed with structured analysis form; research subjects, research methodology, data analysis, and key words of the published papers were classified and extracted. Various theme was founded and classified to 9 domains. RESULT: Most of the research subjects were women. Eighty-eight percent of papers conducted quantitative research; 83% chose convenience sampling and 69% used survey design, while experimental design was 29%. Key words were categorized 9 domains: demographic, health related concept, health behavior(intervention), sex-related, life event, disease, et al. Among 9 domains, health related concept, especially psycho-social topics such as depression, anxiety, stress were mostly studied and then physiologic topics such as labor pain, fatigue, and menstrual symptoms. CONCLUSION: Most of the subjects were women and the most common domain studied was health related concepts in Korean Journal of Women Health Nursing. And key words and topics were on women's health issues. We can conclude that Korean Journal of Women Health Nursing has published by her own philosophy.

Effects of Action Oriented Breast Self-examination(BSE) Education on Knowledge, Self-efficacy, and Performance Competence in Nursing Students / 여성건강간호학회지

PURPOSE: This study was undertaken to test effects of action oriented BSE education on knowledge, self- efficacy, and performance competence in nursing students. METHODS: A non-equivalent pre-posttest of time serial quasi-experimental design was used to prevent diffusion of the experiment. Out of 53 nursing students selected by convenient sampling in the third grade at a nursing college, 27 students were randomly assigned to the control group and were first given a traditional lecture on BSE. For the experimental group of 26 students action oriented BSE education consisted of lectures, demonstrations with breast models, and BSE skill practice by micro teaching. RESULTS: There was no significant difference in general and BSE-related characteristics between the two groups. Scores of the experimental group in knowledge, self-efficacy, and performance after the intervention were significantly higher than those of the control group. CONCLUSIONS: Results showed that action-oriented BSE education was effective in increasing knowledge, self-efficacy and performance competence in nursing students. Education for students should incorporate strategies reinforcing confidence by practicing actual BSE skills as well as acquiring knowledge of BSE, so that students can become competent and practical cancer prevention educators.

Study of Cohort Construction for Development of Early Alarm System (EMS) for Breast Cancer: based on women living in a rural area / 성인간호학회지

PURPOSE: 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. METHOD: Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). RESULTS: 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. CONCLUSION: On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.

Risk Factors and Early Screening Behavior for Breast Cancer in Rural Women / 여성건강간호학회지

PURPOSE: The aim of this study was to identify risk factors for breast cancer and early screening behavior in women in the community. METHOD: The participants were 125 women residing in W city. Data was collected using an instrument developed by the researchers. Analysis was done using descriptive statistics, and the x2 test. RESULT: For risk based on the Gail Model, age (above 50 years) had a distribution of 24.8%, first degree family history, 4.9%, age at first full term pregnancy, 13.8%, and benign breast cancer history, 4.9%. For risk based on other common risk factors, menopause had a distribution of 20.7%, did not breast feed, 15.4%, history of HRT, 7.3%, meat preference, 35.0%, and history of smoking or drinking, 2.4% and 43.5%, respectively. There was a significant difference in BSE and mammography screening behavior (x2=22.5, p< .00), but no difference in distribution of risk factors and screening behavior. CONCLUSION: For effective prevention of breast cancer, it is necessary to develop an instrument for risk assessment and, through assessment, select women at high risk. It is also necessary to provide education and appropriate recommendations on screening behavior.

Predictors of Mammography Participation Among Rural Korean Women Age 40 and Over / 간호학회지

PURPOSE: The study was conducted to identify predictors of mammography screening for rural Korean women according to 'Stage of Change' from the Transtheoretical Model which, along with the Health Belief Model, formed the theoretical basis for this study. METHODS: A cross-sectional descriptive design was utilized. Through convenience sampling 432 women were selected from 2 rural areas. Data were collected by survey. Health beliefs constructs were measured with Champion's HBM Scale-Korea version. Mammography participation was measured using the Stage of Mammography Adoption Scale developed by Rakowski, et al. (1992). RESULTS: The most frequent stage of mammography adoption was 'contemplation' (40.5%). Predictors of stage of mammography adoption included 'mammogram recommended by health professional' (beta=0.59, t=16.12, p=.000), 'perceived benefits' (beta=0.09, t=2.21, p=.050), 'perceived susceptibility' (beta=0.09, t=1.98, p=.050), and 'perceived barriers' (beta= 0.07, t= -2.05, p=.041). 'Mammogram recommended by health professional' demonstrated the greatest association with having a mammogram. CONCLUSION: Health professionals play key roles in improving mammography participation and should recognize the importance of their role in cancer prevention and be more actively involved in education and counseling on prevention of breast cancer.

A Study of Knowledge, Attitudes, and Importance of Sexuality in the Aged / 여성건강간호학회지

PURPOSE: The purpose of this research was to identify knowledge of, attitude toward, and the importance of, sexuality in the elderly. METHOD: By convenience sampling, 152 elderly people aged 60 and over who registered at 3 elderly schools located in W city were selected. Knowledge and attitude toward sexuality were measured with ASKAS. Perceived importance toward sexuality was measured with an instrument developed by the investigator. Data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson's correlation. RESULTS: Elderly males, elderly couples, and elders perceiving themselves as healthy reported higher scores in knowledge on and the importance of sexuality. Elderly males, elders with higher education, and elders perceiving themselves as healthy showed a more acceptable attitude toward sexuality. The higher knowledge of sexuality, the more acceptable the sexuality. The higher knowledge of and more acceptable attitude toward sexuality, the higher significance of sexuality. CONCLUSIONS: Sexuality is an important issue in elderly life. To improve knowledge, positive views of sexuality, recognition of its importance, education and consulting programs on sexuality need to be developed, reflecting characteristics of the elderly. These programs should be provided not only to the elderly but also to people caring for the elderly and their families.

Needs Assesment of Potential Users for Tele-health Surveillance System / 대한의료정보학회지

OBJECTIVE: This study was undertaken to assess the potential users' needs for a tele-health surveillance system and to develop a program that reflects the clients' needs. METHODS: A descriptive study was conducted using interviews with a questionnaire during home visitations. Four hundred subjects from residences two affluent areas of Korea were selected by convenience sampling. RESULTS: Through the tele-health surveillance system, they wanted to manage diseases such as heart disease(23.0%), cancers(20.5%) and endocrine diseases(17.5%). The highest score for areas of the tele-health surveillance system was cancer screening. The most highly preferred reporting system was immediate reporting of the screening results by a personal digital assistant with a tailored health management system that reflects their own bio-signals. CONCLUSION: Potential users want to manage their health in disease prevention and health promotion as well as treating diseases. These aspects should be considered in the development and utilization of a tele-health surveillance system.

Development and Application of a Web-Based Tailored Nutrition Management Program and Change in Knowledge of Nutrition and Eating Habits in Elementary Students / 대한의료정보학회지

OBJECTIVE: This study was undertaken to develop and apply a web-based tailored nutrition management program for elementary school students. METHODS: One group pretest, posttest design was used with a random sample of 5th and 6th grade students in two elementary schools out of the 20 elementary schools in W city. The web-based nutrition program was developed based on previous studies and existing web sites related to nutrition education and management. It consisted of a combination of web-based step-by-step self-checkups and web-based instructions on knowledge of nutrition, eating habits, and perception and satisfaction with body shape etc. Students completed web-based questionnaires on knowledge of nutrition and eating habits at baseline and three weeks later. Data were analyzed using descriptive statistics and paired t-test. RESULTS: Knowledge of nutrition and practice of correct eating habits increased significantly after the students completed the web-based program. CONCLUSION: These results suggest that a web-based nutrition management program is effective for nutrition education for children in terms of accessibility, compliance, and client-initiative.

Difference of Decisional Balance and Confidence in the Stage of Adoption for Breast Self Exam in Married Women / 성인간호학회지

PURPOSE: The purpose of this study was 1) to classify the stage of adoption 2) to compare the decisional balance and confidence by stage of adoption 3) to identify factors influenced the stage of adoption for breast self exam. METHOD: A comparative study using a survey method with convenience sample of 143 women was used. Decisional balance and confidence was measured using the CHBMS-K. Stage of adoption for BSE was measured by a single item modified by the researchers based on the Rakowski et al (1992). RESULT: 1) The number of women in each stage of adoption for BSE was as follows; maintenance phase, 7.7% (n=11), action phase, 49.0% (n=70), contemplation phase, 35.0% (n=50) and pre- contemplation phase, 8.4%(n=12). 2) The mean difference in the decisional balance (F=4.32, p=.006) and confidence (F=13.85, p=.000) according to the stage of BSE adoption was statistically significant. 3) Prevention education and confidence accounted for 32% of variance in BSE. CONCLUSION: Assessment of decisional balance and stage of adoption for BSE can guide planning for cancer prevention education. We must educate women to have confidence in BSE. Further, it is important to urge women to continually practice BSE.

Factors Related to the Stage of Mammography Screening in Married Korean Women / 성인간호학회지

PURPOSE: The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). METHOD: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. RESULTS: According to the stage of adoption of mammography, 17.4% of the women were in pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption (R2=26%). CONCLUSION: Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.

Factors Related to the Stage of Mammography Screening in Married Korean Women / 성인간호학회지

PURPOSE: The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). METHOD: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. RESULTS: According to the stage of adoption of mammography, 17.4% of the women were in pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption (R2=26%). CONCLUSION: Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.

Content Analysis of the Experience of Preceptors in Clinical Education for Senior Student Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.