Eun-Hyun Lee

Review of the Psychometric Evidence of the Perceived Stress Scale

PURPOSE The purpose of this study was to review articles related to the psychometric properties of the Perceived Stress Scale (PSS). METHODS Systematic literature searches of computerized databases were performed to identify articles on psychometric evaluation of the PSS. RESULTS The search finally identified 19 articles. Internal consistency reliability, factorial validity, and hypothesis validity of the PSS were well reported. However, the test-retest reliability and criterion validity were relatively rarely evaluated. In general, the psychometric properties of the 10-item PSS were found to be superior to those of the 14-item PSS, while those of the 4-item scale fared the worst. The psychometric properties of the PSS have been evaluated empirically mostly using populations of college students or workers. CONCLUSION Overall, the PSS is an easy-to-use questionnaire with established acceptable psychometric properties. However, future studies should evaluate these psychometric properties in greater depth, and validate the scale using diverse populations.

Translation and validation of Champion's Health Belief Model Scale with Korean women

The Champion’s Health Belief Model Scale (CHBMS) is a reliable and valid instrument developed for American women to measure beliefs about breast cancer and breast self-examination. The purpose of this study is to translate the CHBMS into Korean and to validate the scale among Korean women. The CHBMS was translated using a back-translation technique. A convenience sample of 264 women was recruited from a continuing education center, a community health center, and a university in 3 South Korean cities. The participants were asked to complete the translated Korean version of the CHBMS questionnaire. The data obtained were analyzed using a principal component analysis with varimax rotation for construct validity. Loading criterion was set at .45. Cronbach’s alpha was computed for the reliability of the scale. From the analysis, two items from the Benefits domain and four items from the Motivation domain were deleted from the original scale. Thus, the final Korean version of the CHBMS (CHBMS-K) consisted of 36 items that were clustered to 6 subscales: susceptibility (5 items), seriousness (7 items), benefits (4 items), barriers (6 items), confidence (11 items), and motivation (3 items). Cronbach’s alpha reliability coefficients for the 6 subscales ranged from .92 to .72. The CHBMS-K was found to be reliable and valid in scale for use with Korean women. It can be used in planning and testing interventions to improve breast self-examination beliefs and practice.

Development and validation of a Functional Dyspepsia‐Related Quality of Life (FD‐QOL) scale in South Korea

Background:  Quality of life (QOL) in patients with functional dyspepsia in South Korea has never been studied, mostly due to the lack of a psychometrically validated disease‐specific instrument for measuring the QOL. The aim of the present study was to develop and validate a QOL scale for patients with functional dyspepsia.

Breast self-examination performance among Korean nurses.

The purpose of this study was to identify factors associated with breast self-examination (BSE) among Korean nurses, based upon the Health Belief Model. Results, which revealed that only 40% of the participants performed BSE the preceding year. Nurses who perceived a higher susceptibility to breast cancer, fewer barriers to performance, higher confidence in BSE performance, and who had a higher level of knowledge about BSE and breast cancer were more likely to perform BSE. The author recommends considering these four predictors when staff development educators plan programs to enhance nurses’ BSE performance.

A Structural Equation Model Linking Health Literacy to Self-efficacy, Self-care Activities, and Health-related Quality of Life in Patients with Type 2 Diabetes.

PURPOSE Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. METHODS A cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. RESULTS The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R(2) values, the final model accounted for 20.0% of the variance in self-efficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. CONCLUSIONS This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients.

Clinical evaluation of the computerized Chronic Urticaria-Specific Quality of Life questionnaire in Korean patients with chronic urticaria

Background.  Chronic urticaria (CU) is a common skin disorder that affects the well‐being and quality of life (QOL) of patients. Recently, we developed and validated a questionnaire for measuring QOL in Korean patients with CU, called the Chronic Urticaria‐Specific Quality of Life (CU‐QOL) questionnaire.

[Trends in nursing research in Korea: research trends for studies published from the inaugural issue to 2010 in the Journal of Korean Academy of Nursing and the journals published by member societies under Korean Academy of Nursing Science].

PURPOSE The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. METHODS A total of 6890 studies were analyzed using descriptive statistics. RESULTS Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9%) as dependent variables. CONCLUSION The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.

Development and Evaluation of an Asthma-Specific Quality of Life (A-QOL) Questionnaire

Background. Few health-related quality of life (HRQOL) studies of asthma patients have been conducted in Korea, mainly due to the lack of a psychometrically validated asthma-specific instrument. Objective. The aims of the present study were to develop and evaluate an instrument for assessing HRQOL in Korean asthma patients (asthma-specific quality of life, [A-QOL]). Methods. Items were generated using in-depth interviews and a review of the literature and were subsequently reviewed by a panel of experts. Content-validated items were evaluated psychometrically with the aid of 422 asthma patients who were recruited from university hospitals in South Korea. The participants were asked to complete a preliminary A-QOL questionnaire (comprising the content-validated items), the Asthma Control Test, the Center for Epidemiologic Studies-Depression Survey (CES-D), and the Short Form-36 Health Survey. The Global Initiative for Asthma Guideline classification was also used to classify the severity of asthma. The psychometric properties of the data were analyzed. Results: Thirty-six preliminary items were generated, from which factor analysis extracted a six-factor solution. Six of the items were not loaded significantly on any of the factors, such that they were not heterogeneous items. Multi-trait scaling analysis supported item convergence and discriminant validity. The A-QOL was associated significantly with the CES-D. Patients with controlled asthma had higher A-QOL scores than those whose asthma was not controlled. The quality of life measured by the A-QOL was more sensitive than that measured by the generic Short Form-36 Health Survey. The values of Cronbachs alpha for the subscales of the A-QOL were all greater than 0.70. The responsiveness of all subscales, excluding the “environmental distress” subscale, was established. Conclusions. The A-QOL is an easily applied tool that exhibits good psychometric properties for asthma patients. The A-QOL questionnaire is valid for and can be used reliably in both practice and clinical trials.

Quality of Life after Epilepsy Surgery in Korea

Background and purpose Temporal changes in the quality of life (QOL) and the underlying factors after epilepsy surgery might be specific to Korea, where social stigma toward patients with epilepsy is still pronounced. Methods The seizure characteristics, number of antiepileptic drugs (AEDs), and the presence of stigma, anxiety, and depression were assessed before and after surgery (at 6 months and around 2 years) in 32 surgery patients and 32 nonsurgery patients. The QOL was compared between these groups using the Epilepsy Surgery Inventory-55 questionnaire. The factors affecting QOL were also evaluated. Results The scores in the mental, physical, and role-functioning domains were significantly higher at 6 months (all p<0.01) and around 2 years (all p<0.01) than at baseline in the surgery group but not in the nonsurgery group. The factors related to QOL differed at the two follow-up times, with seizure freedom being important at 6 months, and AEDs and depression being important at around 2 years. Conclusions A marked increase in QOL in our population was observed after epilepsy surgery. Although the small sample limits the interpretation of the results, the QOL change in our surgery patients shows similar trends to those reported in Western countries. A full understanding of underlying factors related to QOL might aid the development of optimal strategies for improving the long-term postsurgery QOL in this population.

Analysis of Trends and Contents of Nursing Doctoral Dissertations in Korea

PURPOSE This study aimed to identify contents and trends of Korean nursing doctoral dissertations in terms of research methodology and theoretical characteristics. METHODS The design of the study was descriptive study and a total of 1,089 quantitative studies completed between 1982 and 2010 were reviewed using the analytical framework developed by the researchers. RESULTS The majority of studies utilized the experimental design (51.5%) and the others were survey design (38.8%) and methodological design (5.0%). Study subjects were shown as patients (45%), care givers (11.2%), ordinary persons (40.6%) and others (3.2%). There were growing trends in experimental design and patients as subjects. The prevailing data collection settings were hospitals (45.8%) and community (27.8%). The theoretical frameworks that studies were based on were the existing theories (37%) and a newly developed theoretical framework by a researcher (25.2%). a framework derived from other studies by the researcher (25.2%). Majority of studies (78.5%) employed a single theory as a theoretical framework. However, 31.8% of studies had no theoretical framework based on. CONCLUSION Findings of this study provided the opportunities to shed new light on the current status of Korean doctoral dissertation and to deliberate on the future direction of nursing studies in Korea.