Breast and cervical cancer screening for risk assessment in Cambodian women.

The estimated mortality rates for breast and cervical cancer in Cambodia are high, perhaps because the Cambodian population lacks information about their detection and prevention. This cross-sectional study assessed the distribution of cervical cancers among and the behavioural and clinical characteristics of Cambodian women. It comprised 1039 Cambodian women who were interviewed between August 2013 and January 2016; the interviews were conducted in person using structured questionnaires. Among the participants, 801 (77.2%) and 709 (68.3%) had heard of cervical cancer and cervical cancer detection tests, respectively. However, 830 (80.2%) had never undergone a Pap smear, and 633 (60.9%) had never heard of breast self-examination. Despite the high mortality rates for breast and cervical cancer in Cambodia, only a small percentage of the participants had risk factors (e.g. smoking, alcohol consumption) for female cancers. A nationwide survey of the knowledge, attitudes and practices related to female cancers is recommended.Impact StatementWhat is already known on this subject? The estimated incidence and mortality rates of breast and cervical cancers in Cambodia are high. How much Cambodian women know about these cancers and whether they are receptive to cancer screening are questions requiring further study.What do the results of this study add? To our knowledge, this is the first study to describe the female cancer-related behavioural and clinical characteristics of Cambodian women. We show that rural Cambodian women are mostly unaware of breast and cervical cancer screening and that only a small percentage had risk factors for these cancers, despite the high incidence of these cancers in Cambodia.What are the implications of these findings for clinical practice and/or further research? Our findings potentially aid the design of programmes that increase awareness of breast and cervical cancers in Cambodia. Such programmes would be expected to reduce the incidence and mortality rates of these cancers in this country. Nationwide screening programmes for female cancers should be implemented in Cambodia.

Effect of a mind-body therapeutic program for infertile women repeating in vitro fertilization treatment on uncertainty, anxiety, and implantation rate.

PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.

The effect of a sexual life reframing program on marital intimacy, body image, and sexual function among breast cancer survivors.

BACKGROUND: Despite increasing awareness related to sexual health for breast cancer survivors, health care providers are passive in addressing their sexual issues. OBJECTIVE: The aims were to develop and investigate the effect of a sexual life reframing program on marital intimacy, body image, and sexual function (interest, dysfunction, and satisfaction) among breast cancer survivors. METHODS: Breast cancer survivors participated in this quasi-experimental study. The sexual life reframing program focused on the physical, psychological, and relational aspects of sexual health elements, and it consisted of 6 weekly 2-hour sessions. RESULTS: The participants reported poor body image and sexual function. There were no statistically significant differences in marital intimacy, body image, sexual interest, and sexual dysfunction following the program, although all the variables in the intervention group were improved. The sexual life reframing program was effective in increasing sexual satisfaction among breast cancer survivors. CONCLUSION: This study suggests that the quality of sexual life in breast cancer survivors could be improved with the sexual life reframing program provided as part of supportive group care. This program may be more effective if targeted at couples rather than survivors only and if delivered earlier and for a longer period. IMPLICATIONS FOR PRACTICE: The sexual life reframing program offers an opportunity to facilitate small-group dynamics that lay the ground for further contacts leading to earlier recognition of sexual problems and active involvement for sexual health improvement for breast cancer survivors and nurses. It could be utilized for survivor education or support groups to increase sexual satisfaction.

Empirical test of an explanatory theory of postpartum fatigue in Korea.

AIM: This paper is a report of a study designed to test an explanatory theory of postpartum fatigue. BACKGROUND: Postpartum fatigue is influenced by various factors and affects a mother's performance. A full understanding of postpartum fatigue is very important for developing effective nursing strategies to reduce postpartum fatigue and enhance mothers' performance. METHODS: Healthy postpartum women were recruited from five medical centers and one midwifery office in urban area in Korea (n = 291) by convenience sampling. Data were collected at 4- to 8-week follow-up visits after childbirth in 2006, using a self-report questionnaire. The proposed fatigue theory incorporated postpartum fatigue, postpartum depression, sleep quality, childcare stress, unsatisfactory feeding, social support, infant difficulty and satisfaction with Sanhujori, the Korean traditional postpartum care provided for 3 weeks following delivery by non-professional caregivers. Structural equation modelling was used to test the explanatory theory of postpartum fatigue. RESULTS: The modified fatigue theory showed good fit and high compatibility with the empirical data. In the final explanatory theory, postpartum depression and sleep quality directly affected postpartum fatigue, while childcare stress and the cultural phenomenon of Sanhujori had indirect effects on postpartum fatigue, via postpartum depression and sleep quality respectively. CONCLUSION: These findings suggest the potential role of comprehensive nursing focused on decreasing postpartum depression and improving sleep quality as a way to decrease postpartum fatigue. Also, nursing strategies for decreasing childcare stress and enhancing Sanhujori satisfaction may be helpful in reducing postpartum fatigue in Korean mothers.

Effects of acupressure on dysmenorrhea and skin temperature changes in college students: a non-randomized controlled trial.

BACKGROUND: Complementary and alternative therapies may be adopted as nursing interventions to alleviate dysmenorrhea and improve productivity, creativity, work performance, and quality of life. OBJECTIVES: This study aimed to evaluate the efficacy of San Yin Jiao (SP6) acupressure as a non-pharmacologic nursing intervention for dysmenorrhea and identify its effects on temperature changes in two related acupoints as an explanatory mechanism of chi circulation. DESIGN: A non-equivalent control group pre and post-test design was employed to verify the effects of SP6 acupressure on skin temperature and dysmenorrhea. SETTING AND PARTICIPANTS: Young college women with primary dysmenorrhea were recruited from classrooms at two universities in Korea and 58 eligible participants were allotted to either a SP6 acupressure group or placebo group that received light touch on the SP6 acupoint. METHODS: The experimental group received acupressure treatment within the first 8h of menstruation, and severity of dysmenorrhea and skin temperature changes in the Zhongwan (CV2) and Qugu (CV12) acupoints were assessed prior to and 30 min, 1, 2, and 3h following treatment. RESULTS: There was a significant difference in severity of dysmenorrhea between the two groups immediately after (F=18.50, p=0.000) and for up to 2h (F=8.04, p=0.032) post treatment. Skin temperature was significantly elevated at 30 min after acupressure at the suprapubic CV2 acupoint in the experimental group compared to the control group. Temperature elevation was also noted at the epigastric CV12 acupoint post treatment but group differences were not significant, indicating that SP6 acupressure relieves dysmenorrhea primarily by temperature elevation in the CV2 pathway. CONCLUSIONS: Acupressure to the SP6 meridian can be an effective non-invasive nursing intervention for alleviation of primary dysmenorrhea, with effects lasting 2h post treatment.

Context of barriers to Pap testing in Korean women.

Because efforts to increase the Papanicolaou (Pap) test rate have not been effective in Korea, there is an urgent need to identify the underlying context of the barriers to Pap testing. Twenty-three women aged 27-37 years were organized into four focus groups for a qualitative analysis of their attitudes and feelings about the Pap test. Five contextual themes of barriers were identified under the categories of "misconceptions attributable to women's experiences of Pap testing" and "issues related to the health care system." Educational and clinical implications in regard to women, health care professionals, and the health service environment were discussed to increase the Pap test rate.

Effects of a cognition-emotion focused program to increase public participation in Papanicolaou smear screening.

OBJECTIVE: Despite high incidence rates of cervical cancer in Korea, Papanicolaou (Pap) tests are not utilized as a preventive behavior. This study examined the effects of an emotion-cognition focused program on the decision of taking Pap tests in Korean women. DESIGN: A non-equivalent control group post-test only design was utilized. SAMPLE: A convenience sample was randomly assigned to either experimental (N=48) or control group (N=48) after matching for education and age. MEASUREMENTS: Knowledge of Cervical Cancer and Pap Smear Test, Champion's Health Belief Model, and Self-Efficacy Scale were used. Intention and stage of adoption to take a Pap test were measured with single items. RESULTS: Women in the experimental group had significantly higher scores on knowledge of cervical cancer (t=6.99, p<.001) and perceived benefits of Pap tests (t=2.91, p<.05), lower scores on procedural (t=-2.45, p<.05) and cognitive (t=-2.66, p<.01) barriers to testing. Improvement in self-efficacy (t=3.38, p<.01), strong intention to have the test (t=2.99, p<.01), and advanced stages of behavior adoption (chi2=12.93, p<.01) were also found. CONCLUSIONS: Women's perspectives, attitudes of health care practitioners, and clinical environment need to be considered if change is to happen in women's preventive behavior related to Pap test screening.

[Development of college students' condom attitude scale].

PURPOSE: The aim of this study was to design and evaluate a scale for measuring the attitudes toward condom use in sexual relationships. METHOD: A questionnaire was administered to 631 college students using a convenience sampling method. The psychometric properties (reliability and validity) were evaluated. RESULT: As a result of the item analysis, 16 items were selected and the internal consistency alpha coefficient was .88. Results indicated that the condom attitude scale is composed of three factors: Interruption of sexual pleasure; Protection; and Image. The three factors accounted for 59.54% of the variance in the total scale. Also, condom attitude was statistically significant (t=7.389, p=.000) between consistent condom users and inconsistent users. CONCLUSION: The results demonstrate that condom attitudes are multidimensional, and the reliability and validity of the scale was supported.

[Differences of cesarean section rates according to San-Yin-Jiao(SP6) acupressure for women in labor].

PURPOSE: The purpose of this study was to explain differences of cesarean section rates according to San-Yin-Jiao(SP6) acupressure for women in labor. METHOD: A nonequivalent control group pre test--post test design was used to explain differences of cesarean section rates according to SP6 acupressure. The participants were 209 women who were assigned to one of three groups SP6 acupressure(n=86), SP6 touch(n=47), and control group(n=76). For 30 minutes, the SP6 acupressure group received SP6 acupressure,and the SP6 touch group received SP6 touch for the duration of each uterine contraction. The Control group was encouraged to deep breath and relax for the duration of each uterine contraction for 30 minutes. RESULT: The rates of cesarean section were 12.8%, 29.8%, and 22.4% for the SP6 acupressure group, SP6 touch group, and control group respectively. There was a significant difference among groups (p=0.049). Cesarean section rates were significantly different between the SP6 acupressure and non-SP6 acupressure group(p=0.035). CONCLUSION: This finding shows that 30 minutes of SP6 acupressure was effective in decreasing the cesarean section rate. Therefore, SP6 acupressure during labor could be applied as an effective nursing intervention.

Effect of Taegyo-focused prenatal education on maternal-fetal attachment and self-efficacy related to childbirth.

PURPOSE: To examine the effect of Taegyo-focused prenatal classes on maternal-fetal attachment and self-efficacy related to childbirth. METHODS: Over 4 weeks, 49 women, 20 to 36 weeks of gestation participated in a prenatal program led by the nurse who developed it. In addition to Lamaze content it included; understanding ability of fetus to respond, sharing motivation, purpose of pregnancy, and preconceptions of experiencing childbirth, training in maternal-fetal interaction, writing letters and making a declaration of love to unborn baby. Using a pre-experimental design, data were collected by self-report, before and after program, using Cranley's Maternal-Fetal Attachment Scale (1981), and Shin's (1997) Labor Self-Efficacy Measurement. RESULTS AND CONCLUSION: Paired t-test showed significant changes in scores of maternal-fetal attachment (t=6.91. p<.001) and self-efficacy related to childbirth (t=10.19, p<.001). Taegyo opens the possibility of integrating Western ideas with Korean traditional health behavior. Incorporation of Taegyo into existing prenatal classes is recommended.

Commercial sex workers'condom use behavior in Korea.

PURPOSE: With the continuous spread of the AIDS virus and other sexually transmitted diseases (STDs) throughout Asia, it has become imperative for HIV/AIDS prevention outreach programs to stress the need for using prophylactics as one form of protection. This is particularly true for commercial sex workers. This pilot study was conducted to investigate the rate of condom use among the commercial sex workers in Korea and reasons why they frequently do not wear condoms during sexual intercourse. METHODS: Fifty female commercial sex workers who worked in the Yong San area were recruited while outreach was performed and forty eight responses were analyzed due to two incomplete questionnaires. The data were collected on June 28, 2004 as part of an outreach program for condom use promotion. RESULTS: The subjects ranged in age from 21 to 45 years. Nearly half of the subjects (47.9%) did not consistently use condoms. The major reason for not using protection was clients' reluctances for using condoms. When condoms were used, the subjects preferred lubricant-rich and less painful condom during intercourse. CONCLUSION: Due to the inconsistent use of condoms, it is clear that many commercial sex workers and clients are susceptible to sexually transmitted diseases. Therefore, it is important to not only educate commercial sex workers, but also to educate their pimps and clientele about the importance of condom use. In general, it is recommended that practical strategies and a policy for condom use promotion be developed.

An experimental study of students' self-learning of the San-Yin-Jiao pressure procedure using CD-ROM or printed materials.

A CD-ROM and printed material on San-Yin-Jiao pressure to lessen labor pain for women were developed as formal didactic instruction using the same content. A prospective, randomized, double-blind study was conducted to compare self-learning outcomes using the software and the printed materials. Eighty third-year student nurses were randomly allocated to either the CD-ROM group or printed material group. A test was administered after 1 week of study time. A p value of < .05 was considered statistically significant. Results showed no significant differences between the two groups in self-learning measures. Text-based learning seems to be a convenient educational method because it can be used at any time in any place. However, with more time and facilities available, CD-ROMs may be as effective as traditional learning methods and can be an alternative tool.

[Effects of SP-6 acupressure on dysmenorrhea, cortisol, epinephrine and norepinephrine in the college students].

PURPOSE: The purpose of this study was to identify effects of the SP-6 acupressure on dysmenorrhea, and level of cortisol, epinephrine and norepinephrine in the college students. METHOD: Data were collected from May 1 to August 31, 2002. A total of 58 students from two universities participated in the study. Both groups were pretested before the intervention for three variables, the intensity of dysmenorrhea, level of cortisol, epinephrine and norepinephrine. Then, SP-6 acupressure was provided for 20 minutes for students in the experimental group. The instruments used in this study included the Visual Analogue Scale developed by Johnson(1974), Menstrual Attitudes Questionnaire Scale developed by Brooks-Gunn & Ruble(1980), and Stress scale developed by Cheun and Kim(1990). RESULT: There were statistically significant differences in the intensity of dysmenorrhea at the time immediately after, 30 minutes after, one hour after, and two hours after the intervention. The experimental group had a lower intensity than the control group. There was a statistically significant difference in level of norepinephrine at the time 30 minutes after the intervention with the experimental group. CONCLUSION: The SP-6 acupressure reduced the subjective perception of dysmenorrhea and the levels of norepinephrine. It was found out that the lasting period of 20 minutes of the SP-6 acupressure was two hours for college students.

[Effects of a sexual assertiveness training program in high school girls].

PURPOSE: This study was done to develop an applicable training program for high school girls on sexual assertiveness. METHOD: The design combined methodological study and non-synchronized quasi experimental study designs. The participants were 174 high school girls from two schools. Two questionnaires were used, one consisted of 23 questions on self efficacy and the other, of 22 items on sexual assertiveness. The SPSS 10.0 program was used for data analysis. Experimental group 1(3 hour program) and experimental group 2(6 hour program) were received on sexual assertiveness. The sexual assertiveness program was carried out by members of the research team. There were no differences in demographic characteristics between control group, experimental group 1, and experimental group 2. RESULT: There was no significant increase in self efficacy scores in experimental group 1 over the control group, but there was a significant increase in sexual assertiveness scores in the experimental group 1 over the control group. There was an increase in self efficacy scores in experimental group 2 over the control group, but it was not significant. There was a significant increase in sexual assertiveness scores in experimental group 2 over the control group. There was no significant increase in self efficacy scores in the experimental group 2 over the experimental group 1, and there was no significant increase in sexual assertiveness scores in experimental group 2 over the experimental group 1. CONCLUSION: The results show that a 3 hour program was as effective as a 6 hour program for sexual assertiveness. Therefore, it is advisable to use a 3 hour program for clinical convenience. But further study is needed to determine the lasting effect on sexual assertiveness.

[Sexual autonomy in college students].

PURPOSE: This study was to add to the understanding of sexual autonomy in college students in Korea. A descriptive survey design was used. METHOD: The participants in this study were 1,865 college students from 13 colleges, The questionnaire consisted of 15 items on general characteristics and 13 items measuring sexual autonomy. The SPSS 10.0 program was used for data analysis. RESULT: The global score for sexual autonomy was relatively high at 55.24 with a possible range of 13-65. The item on sexual autonomy with the highest score were, 'I can prevent repeated STD infections' and the item with the lowest sexual autonomy score was 'I can speak clearly about having intercourse'. Factors related to sexual autonomy were identified as gender, parents' attitude, year in university, experience with STD prevention and experience with pregnancy prevention. The score for sexual autonomy was lower in male college students (p=.000), students whose parents' attitudes to sex were vague, first year students (p=.000), students who had little experience with prevention of STDs (p=.002), students who had little experience with prevention of pregnancy (p=.001). CONCLUSION: The results showed that in setting priorities for sex education the following groups of students should be given first priority, male students, students whose parents' attitudes to sex were vague, first year students, students who have not had experience with prevention of STDs, and students who have not had experience with prevention of pregnancy.

Relationship between the intention to repeat a papanicolaou smear test and affective response to a previous test among Korean women.

The purposes of this descriptive cross-sectional study were to describe (1). women's affective (emotional) responses before, during, and after a Papanicolaou smear test and after receiving the test result and (2.) the difference in affective response between women who did or did not intend to repeat the Papanicolaou smear test in the future. The theory of reasoned action was used as the theoretical basis for this study. Participants were selected by convenience sampling and included 515 women aged 24 to 69 years who had a previous Papanicolaou smear test, did not have cervical cancer, and who agreed to participate. Affective response was measured with an instrument developed by Park. Intention to repeat the Papanicolaou smear test was measured with a single question on intention of repeating the Papanicolaou smear test. Women with intention to repeat the Papanicolaou smear test showed higher apprehension after the test ( = 2.695, =.04) and higher positive affective responses such as feeling relieved, great, and comfortable after receiving the test result ( = 3.014, =.003). This result suggests that women with the intention to repeat the test are more concerned with the test result and that emotional relief after confirming normal findings is an important motivator for repeating the Papanicolaou smear test.