Eunice E. Lee

Depression Among Korean, Korean American, and Caucasian American Family Caregivers

This study compared depressive symptoms among Korean, Korean American, and Caucasian American female family caregivers of older persons with dementia. The sample included Korean caregivers living in Seoul, Korea (KK); Korean American (KA) caregivers living in the Chicago and Los Angeles areas; and Caucasian American (CA) caregivers from the Chicago metropolitan area. KK caregivers were more likely to be daughters-in-law, KA caregivers were more likely to be daughters, and CA caregivers were more likely to be wives or daughters. Overall, wives were more depressed than daughters and daughters-in-law. KK caregivers were the most depressed of the three cultural groups. When caregiver relationship and cultural group were examined simultaneously, KK and KA wives were most depressed, and KA daughters-in-law were least depressed. Differences in culture and social role appeared to affect depressive symptoms among these caregivers. The findings suggest a need to further examine the associations between caregivers’ relationships with their care recipients and their own emotional status.

Knowledge and Beliefs Related to Cervical Cancer and Screening Among Korean American Women

The purpose of this article is to examine knowledge and health beliefs associated with cervical cancer screening among Korean American women. A telephone survey was conducted with 189 Korean American women in the Chicago area. Age, marital status, income, knowledge of early detection method for cervical cancer, and perceived beliefs about benefits of and barriers to receiving Pap tests were all related to outcomes of ever having a Pap test and having had one in the preceding 3 years. Variables uniquely related to ever having a Pap test were education, employment status, fluency in English, and proportion of life spent in the United States. Variables uniquely related to having had the test during the preceding 3 years were having a usual source of care and regular checkups. Different intervention components are suggested for the groups of Korean American women who have never had a Pap smear and for those who have not had one in the preceding 3 years, in addition to common intervention strategies that aim to increase knowledge and perceived benefit and to decrease perceived barriers to receiving Pap tests.

Factors of Breast Cancer Screening Among Korean Immigrants in the United States

The purpose of this paper is to assess breast cancer screening rates and explore factors related to all three measures of breast cancer screening, mammography, clinical breast examination (CBE), and breast self-examination (BSE), among Korean immigrants in the United States. A telephone survey was conducted with 189 Korean women aged 40 and older in Cook County, Illinois. Of this group, 78% had had a mammogram at some point, and 38.6% had had one within the previous year. Fifty-three percent had had a CBE, while 26.1% had had one within the previous year. Whereas 58.1% had examined their breasts before, 46.3% did monthly BSE. Korean women’s breast cancer screening rates are improving even though the rates are still lower than screening rates in the United States. Having a regular check-up and being married were strongly related to all three measures of cancer screening. Further in-depth research is suggested to understand KA women’s perspectives on having access to care.

Breast Cancer Screening Beliefs among Older Korean American Women

Korean American womens breast cancer screening rates are low, and the rates among older Korean American women are even lower.This article describes health beliefs related to older Korean American womens screening behaviors, comparing them to beliefs of younger Korean American women. The 73 women age 65 and older had significantly dif-ferent health beliefs than the 114 women between ages 40 and 64. Further, older womens perceptions of the seriousness of the disease and benefits of and barriers to taking action to prevent the disease predated their screening behaviors. Interventions to change the health beliefs of older Korean American women are suggested.

The Effect of a Couples Intervention to Increase Breast Cancer Screening Among Korean Americans

PURPOSE/OBJECTIVES To assess the efficacy of Korean Immigrants and Mammography-Culture-Specific Health Intervention (KIM-CHI), an educational program for Korean American (KA) couples designed to improve mammography uptake among KA women. DESIGN A two-group cluster randomized, longitudinal, controlled design. SETTING 50 KA religious organizations in the Chicago area. SAMPLE 428 married KA women 40 years of age or older who had not had a mammogram in the past year. The women and their husbands were recruited from 50 KA religious organizations. METHODS Couples were randomly assigned to intervention or attention control groups. Those in the KIM-CHI program (n = 211 couples) were compared to an attention control group (n = 217 couples) at baseline, as well as at 6 and 15 months postintervention on mammogram uptake. MAIN RESEARCH VARIABLES Sociodemographic variables and mammography uptake were measured. Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale. Researchers asked questions about healthcare resources and use, health insurance status, usual source of care, physical examinations in the past two years, family history of breast cancer, and history of mammography. FINDINGS The KIM-CHI group showed statistically significant increases in mammography uptake compared to the attention control group at 6 months and 15 months postintervention. CONCLUSIONS The culturally targeted KIM-CHI program was effective in increasing mammogram uptake among nonadherent KA women. IMPLICATIONS FOR NURSING Nurses and healthcare providers should consider specific health beliefs as well as inclusion of husbands or significant others. They also should target education to be culturally relevant for KA women to effectively improve frequency of breast cancer screening.

Age-Related Differences in Health Beliefs Regarding Cervical Cancer Screening Among Korean American Women

Cervical cancer screening rates among older Korean American (KA) women are much lower than the rates for younger KA women, even though the overall cancer screening rates in the population continue to have one of the lowest Papanicolaou (Pap) test adherence rates compared with non-Hispanic White women. Variables based on the Health Belief Model related to cervical cancer screening were compared by age group among KA women. A telephone survey was conducted with 189 KA women living in the midwestern United States. Perceived barriers to having a Pap test predicted the outcome variable of having had Pap tests in the preceding 3 years in older KA women who were 65 or older, but not in younger women who were between 40 and 64 years old. Having physical examinations without symptoms in the preceding 2 years predicted the outcome variable in both age groups. Intervention strategies for all KA women should focus on encouraging them to receive routine physical examinations. In addition, attempts should be made to reduce perception of barriers in older KA women to improve their cervical cancer screening behaviors.

Korean American Women and Mammogram Uptake

A high percentage of Korean American (KA) women have never had a mammogram, which puts them at greater risk for late-stage breast cancer. The aim of this study was to compare health beliefs and spousal support about breast cancer and screening between KA women with and without a history of mammogram completion. Cross-sectional data were obtained from 428 non-adherent married KA women. KA women who never had a mammogram were younger, had less access to health care, had less knowledge, and had lower perceived self-efficacy, benefits, and spousal support, and higher perceived barriers to breast cancer screening compared to women who had had a mammogram. Assessing differing characteristics between the two groups of KA women may lead to a better understanding of the variables influencing mammography screening in this population and possibly increase early screening.

Lifestyle Physical Activity Behavior of Korean American Dry Cleaner Couples

OBJECTIVE The purposes of this study were to: (1) describe and compare lifestyle physical activity (leisure-time physical activity [LTPA], household physical activity [HPA], and occupational physical activity [OPA]), using both self-report and an objective measure of step counts, in self-employed Korean American married couples working together at dry cleaners, and (2) examine the relationship between self-report and objective measures of physical activity. DESIGN AND SAMPLE 70 couples participated in this cross-sectional, descriptive, face-to-face interview survey. MEASURES 2 self-reports (28-item Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire and Tecumseh Occupational Physical Activity Questionnaire) and 1 objective measure (New Lifestyles-800 pedometer) were used. RESULTS The husbands spent significantly more time than their wives in moderate- to vigorous-intensity LTPA (207 vs. 122 min/week) and OPA (2,585 vs. 1,065 min/week). Most couples (91%) met recommended levels of physical activity based on their OPA. Pedometer steps correlated significantly only with LTPA. CONCLUSIONS Study findings suggest that to increase physical activity in Korean American couples who work in a small business, moderate-intensity lifestyle physical activity interventions across LTPA, HPA, and OPA will be more successful than traditional leisure-time interventions. In addition, results suggest that there is a need for interventions that target both members of the married couple.

Evaluating Differential Item Functioning of the CES-D Scale According to Caregiver Status and Cultural Context in Korean Women.

BACKGROUND: Proper evaluation of the generalizability of an instrument is critical for its use across different social contexts such as caregiver status. OBJECTIVE: To examine the differential item functioning of the Center for Epidemiologic Studies Depression (CES-D) Scale, patterns of response to each item of the CES-D Scale attributable to caregiver status was assessed. STUDY DESIGN: Using a cross-study comparison method, a sample of 58 matched pairs of Korean American caregivers and noncaregivers was used for matched moderated regression analysis on the CES-D Scale. RESULTS: The authors identified three items that vary according to caregiver status in the present study: Item 2 (My appetite was poor), Item 4 (I felt that I was as good as other people), and Item 14 (I felt lonely). CONCLUSIONS: Beyond assessing the level of depression through total CES-D scores, it is important to examine variations in the items of the CES-D Scale across different social contexts. J Am Psychiatr Nurses Assoc, 2009; 15(4), 240-248. DOI: 10.1177/1078390309343713

Self-Report Versus Medical Record for Mammography Screening Among Minority Women

Self-report is the most common means of obtaining mammography screening data. The purpose of this study was to assess the accuracy of minority women’s self-reported mammography by comparing their self-reported dates of mammograms with those in their medical records from a community-based randomized control trial. We found that out of 192 women, 116 signed the Health Information Portability and Accountability Act form and, among these, 97 had medical records that could be verified (97 / 116 = 83.6%). Ninety-two records matched where both sources confirmed a mammogram; 48 of 92 (52.2%) matched perfectly on self-reported date of mammogram. Complexities in the verification process warrant caution when verifying self-reported mammography screening in minority populations. In spite of some limitations, our findings support the usage of self-reported data on mammography as a validated tool for other researchers investigating mammography screening among minority women who continue to have low screening rates.