ChaeWeon Chung

Acceptance, cognitions, and resourcefulness in women with diabetes.

The coexistence of diabetes and depression occurs frequently among young and middle-age women. Unless one is resourceful, simultaneous management of the symptoms of both conditions is especially challenging. Skills constituting resourcefulness are learned throughout life and are important for the optimal performance of daily activities. Little is known about specific factors that influence resourcefulness. In this study, contextual factors (diabetic and depressive symptoms) and cognitive factors (positive cognitions and acceptance of diabetes) were examined as antecedents of learned resourcefulness in 82 women with type 2 diabetes. Regression analyses showed that depressive symptoms and positive cognitions were significant antecedents of learned resourcefulness: Positive cognitions mediated the effects of depressive symptoms on learned resourcefulness. The findings suggest the need for interventions that focus on development of positive cognitions to better promote resourcefulness in women with type 2 diabetes who are at risk for depression.

Couples' experiences of breast cancer in Korea: a descriptive qualitative study.

Background: Breast cancer is not a disease merely experienced by the diagnosed woman. Despite the increased prevalence of breast cancer in Korea, the impact of the illness on married couples has not previously been studied. Objective: This study aimed to explore the experiences of women with breast cancer and their spouses in South Korea. Methods: A descriptive, single-occasion study design was used. Fourteen participants, comprising 7 dyads, were recruited from a university-affiliated hospital breast clinic in Seoul. Inclusion criteria were that the women were married and with a diagnosis of primary breast cancer without metastasis or recurrence. Using a semistructured interview schedule, interviews were conducted in a private room. Audio-recorded data in the Korean language were translated into English and coded using an inductive content analysis method. Results: The core constructs found in the experiences of women, husbands, and couples were “Coming Into My Own Voice,” “Doing What It Takes to Keep Her Alive,” and “Learning Through Struggling,” respectively. Conclusions: The diagnosis of breast cancer caused substantial distress for the couples and was transformative for the women and their husbands. The couples were still experiencing some unresolved hardships that required open communication and mutual effort for coping. Implications for Practice: Health care practitioners should be sensitive to the cultural traditions and values that couples with breast cancer hold. After training nurse interventionists, educational counseling interventions should be launched, so as to empower the dyads.

Systematic review of exercise effects on health outcomes in women with breast cancer.

PURPOSE Exercise is commonly recommended to women after breast cancer surgery, yet it is difficult for patients and health professionals to adopt safe and beneficial types and modes of exercise. Thus studies on exercise interventions targeting women with breast cancer treatment were systematically reviewed. METHODS The review process and quality assessment of the studies followed the guideline of the National Evidence-based Healthcare Collaborating Agency. Relevant studies were obtained from electronic databases, and two trained reviewers independently analyzed the studies. Of the 902 articles sorted, 11 were selected. Then, quality assessment for each study was carried out with the Scottish Intercollegiate Guideline Network (SIGN) checklist. RESULTS Seven different types of exercise interventions were identified from 3 quasi-experimental and 8 randomized controlled trial studies. The interventions varied in duration from several days to 13 weeks, and tended to show significant effects on psychological outcomes and upper body functions within a short-term period and were effective in alleviating lymphedema at a longer 1-year point. Supervised, professional intervention had significant effects on health indicators and a higher adherence rate. CONCLUSION Well-designed exercises are effective and beneficial for improving womens physical, physiological, and psychological health outcomes after breast cancer treatment as well as to facilitate changes in exercise behaviors. The feasibility of applying intervention protocols, efficiency of interventions, and strengths of exercise protocols should be further examined.

Focused Reflection Reminiscence Group for Elders: Implementation and Evaluation

The majority of elders have at least one or more chronic conditions. Functional decline coupled with increased dependence can make elders more vulnerable to negative emotions. Reminiscence can be useful in maintaining a healthy psychological adaptation in the later years of life. This study examined the effectiveness of a specific type of reminiscence in reducing negative emotions in 32 elders residing in retirement communities. This type of reminiscence, called focused reflection, was organized into six weekly, 2-hour group sessions, each with a specific theme. Paired t tests suggested that the focused reflection program reduced symptoms of depression and anxiety but not those reflecting agitation. Overall, the participants gave high ratings to the program. Health care providers should develop focused reflection reminiscence programs to enhance the psychological well-being of elders. Further testing of the focused reflection in larger groups of elders is recommended.

Social cognitive factors predicting the health of elders

The social cognitive model of health is primarily concerned with influences on a person’s decisions to perform health behaviors. In this study, the relationships among social cognitive factors reflecting enabling skills (learned resourcefulness), internal motivation for health (health self-determinism), and help responses (coping responses) and a measure of physical and psychosocial health were examined in 137 chronically ill elders. Gender, race, and number of chronic conditions were predictors of learned resourcefulness. Learned resourcefulness was associated with the use of informal help, whereas health self-determinism was related to self-help and formal help. None of the help responses were significant predictors of health. Model testing revealed that greater resourcefulness or skill in coping with stressful situations was the most important predictor of health. Strategies are recommended to help elders achieve optimal health.

Comparisons of health conditions of immigrant and domestic women in Korea and China using propensity score matching.

We identified how the health of the growing Korean–Chinese (KC) female immigrant population differed from comparable domestic women. Using propensity score matching, we selected 227 women recruited from Korea and China; perceived health status, female cancer screening behaviors, and the Health Promoting Lifestyle Profile II were investigated. The KC women in Korea had the lowest levels of physical and mental health as well as health promoting lifestyles, but performed female cancer screenings better than other women. Considering their vulnerability, the hosting country should provide accessible health services at reasonable fees for KC women in Korea to enhance their health.

Estimated risks and optimistic self-perception of breast cancer risk in Korean women

AIM To determine womens perceived personal and comparative risks of breast cancer, and to examine the relationships with risk factors. BACKGROUND Despite the increasing incidence of breast cancer in younger women and the availability of screening, womens health behaviors have not advanced accordingly. METHODS A cross-sectional survey design utilized a convenience sample of 222 women in their 30s and 40s recruited from community settings in Seoul. Self-administered questionnaire data were analyzed by descriptive statistics, the chi-squared test, and ANOVA. RESULTS Risk perception levels differed significantly by breast cancer risk factors. Half of the women were optimistic about their breast cancer risk, while perceived personal risk did not reflect womens own risk factors and comparative risk differed only by the practice of clinical breast exam. CONCLUSIONS Womens knowledge and awareness of their breast cancer risk factors need to be improved for appropriate risk perception and health behaviors, and accurate risk estimation could be utilized to educate them in clinical settings.

Effects of Tailored Message Education About Breast Cancer Risk Appraisal for Obese Korean Women

PURPOSE/OBJECTIVES To examine the effects of tailored message education about breast cancer risk in obese Korean women. DESIGN Pretest/post-test with two comparison treatments. SETTING Rural community settings in South Korea. SAMPLE Non-random sample of 64 obese women. METHODS Based on the Health Belief Model, tailored message education involved a one-session individual approach addressing cognitive, emotional, and behavioral domains. The comparison group received a one-time standard education group session. Data on breast cancer risk factors and mammography findings were recorded. MAIN RESEARCH VARIABLES Knowledge, awareness, emotional barriers, self-efficacy, and intent to screen and prevent breast cancer. FINDINGS Compared to standard education, tailored message education showed significantly higher score changes on awareness of personal risk (F = 5.21, p < 0.05), self-efficacy for breast self-examination (BSE) (F = 5.16, p < 0.001), intent to perform BSE (F = 6.24, p < 0.05), intent to have mammography (F = 5.45, p < 0.05), and intent to prevent breast cancer with eating habits (F = 7.28, p < 0.05) and exercising (F = 12.51, p < 0.001). CONCLUSIONS Individually tailored education effectively enhanced awareness of personal risk for breast cancer, self-efficacy for BSE, and intent to screen and prevent breast cancer. IMPLICATIONS FOR NURSING Tailored message education targeting breast cancer and risk associated with obesity is useful in breast cancer screening education. Future studies should incorporate individualized messages on nutrition, exercise, and cultural barriers to reduce breast cancer risk in obese women. KNOWLEDGE TRANSLATION Individual educational strategies can effectively enhance breast cancer prevention and early screening. Public and preventive education should include a focus on cultural, cognitive, and emotional domains. For obese women, a heightened awareness and self-efficacy may influence screening behaviors.

Comparison of breast cancer risk estimations, risk perception, and screening behaviors in obese rural korean women

PURPOSE/OBJECTIVES To assess three breast cancer risk assessment tools in obese rural Korean women. DESIGN Cross-sectional survey design. SETTING Community settings in the rural region of northeastern South Korea. SAMPLE A nested cohort sample of 64 severely obese women aged 40-60 years from the Korean Genomic Regional Cohort registry. METHODS The Breast Cancer Risk Assessment Tool of the National Cancer Institute (BCRAT-NCI), Breast Cancer Risk Appraisal for Korean Women (BCRA-K), and Estimation of Individualized Probabilities of Developing Breast Cancer for Korean Women (EIPDBC-K) were used for interview data. Mammography, womens perceptions, and screening behaviors also were analyzed. MAIN RESEARCH VARIABLES Breast cancer risk assessment, mammography findings, womens perceptions of breast cancer risk, and breast cancer screening behaviors. FINDINGS A total of 5 (BCRAT-NCI), 19 (BCRA-K), and 43 (EIPDBC-K) women were at higher (above average or high) risk for breast cancer. The BCRA-K (r = 0.28, p < 0.05) and EIPDBC-K (r = 0.43, p < 0.001) correlated with mammography findings. However, the BCRAT-NCI correlated only with the BCRA-K. Womens breast self-examination (χ2 = 4.77, p < 0.05) and mammography findings (χ2 = 5.22, p < 0.05) differed according to their risk perception. CONCLUSIONS Risk assessment by the BCRA-K and EIPDBC-K was related to mammography findings. Womens perception of breast cancer risk influenced their screening behaviors. When choosing a risk assessment tool, healthcare professionals should consider the ethnic and cultural backgrounds of the target population. IMPLICATIONS FOR NURSING Healthcare professionals should use appropriate risk assessment tools in breast cancer education and counseling to help women understand their risk factors and adopt proper health behaviors.

Effects of Small-Group Education for Testicular Self-Examination on Knowledge, Self-efficacy, and Performance Intention in Male College Students

Purpose: This study examined the effects of Testicular Self-Examination (TSE) small-group education on knowledge, self-efficacy, and performance intention in male college students. Method: A non-equivalent pre-post test of quasi-experimental design was used. Out of 74 male college students selected by convenient sampling, 37 students were assigned to the experimental group and were given TSE small-group education. A 60-minute program consisted of lecture, demonstration, practice, discussion, and Q&A. Result: With an initial homogeneity between the two group, scores of knowledge about testicular cancer (p