Eunjung Ryu

The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea.

This study examined the effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. A nonequivalent, control group, pre-posttest design was used. A convenience sample of 41 nursing students were randomly assigned to experimental (n=21) and control groups (n=20). Stress was measured with the PWI-SF (5-point) developed by Chang. Anxiety was measured with Spiebergers state anxiety inventory. Depression was measured with the Beck depression inventory. The experimental group attended 90-min sessions for eight weeks. No intervention was administered to the control group. Nine participants were excluded from the analysis because they did not complete the study due to personal circumstances, resulting in 16 participants in each group for the final analysis. Results for the two groups showed (1) a significant difference in stress scores (F=6.145, p=0.020), (2) a significant difference in anxiety scores (F=6.985, p=0.013), and (3) no significant difference in depression scores (t=1.986, p=0.056). A stress coping program based on mindfulness meditation was an effective intervention for nursing students to decrease their stress and anxiety, and could be used to manage stress in student nurses. In the future, long-term studies should be pursued to standardize and detail the program, with particular emphasis on studies to confirm the effects of the program in patients with diseases, such as cancer.

Blended learning on medication administration for new nurses: Integration of e-learning and face-to-face instruction in the classroom

PURPOSE This study analyzed the effects of a blended learning program on medication administration by new nurses using a non-equivalent groups design. METHOD A medication education program using blended learning (including e-learning) was administered to 26 new nurses, while face-to-face instruction in the classroom was given to 24 new nurses. The following dependent variables were compared: degree of knowledge of medication, self-efficacy of medication administration, medication-administration ability, and satisfaction with the learning program. RESULTS The experimental, blended learning group showed a significantly higher level of knowledge of medication and satisfaction with the comprehensiveness of their medication learning, but the self-efficacy of medication administration, medication-administration ability, and other items related to their learning satisfaction did not differ significantly from that in the control group. CONCLUSION These results suggest that blended learning integrating e-learning and face-to-face instruction in the classroom is useful for enhancing medication knowledge. An e-learning program can reduce the lecturing time and cost of repeated topics such as medication, suggesting that it can be an effective component in nurse education programs.

Posttraumatic Growth, Dyadic Adjustment, and Quality of Life in Breast Cancer Survivors and Their Husbands

PURPOSE The purpose of this study was to identify whether the couple perceived breast cancer as a traumatic event, to evaluate the association among posttraumatic growth, dyadic adjustment, and quality of life and to explore the predictors affecting quality of life of the couple. METHODS A cross-sectional comparative survey design was utilized. Participants were 57 couples recruited from a national cancer center in Korea. Data were analyzed using paired t-test, McNemar test and independent t-test. On the basis of variables found to be significantly associated with quality of life, multiple regression was used to examine the simultaneous influence of multiple predictors. RESULTS Breast cancers survivors and spouses perceived breast cancer as a traumatic event (43.9% and 24.6%, respectively). The global quality of life was explained by perception as trauma (β=-19.79) and posttraumatic growth (β=0.46) in survivors, and perception as trauma (β=-18.81) and dyadic adjustment (β=0.53) in spouses. CONCLUSION Results suggest that future research should use qualitative methods to evaluate why contemplating reasons for cancer contributed to posttraumatic growth, examine other potential predictors of quality of life such as dyadic adjustment and intimacy, and identify links between posttraumatic growth and other psychological outcomes such as distress and well-being, using prospective analyses.

The Korean version of the Symptom Experience Index: A psychometric study

BACKGROUND Symptom assessment and management are vital aspects of patient care through the entire illness trajectory. Patients often experience two or more symptoms concurrently. Building global assessment capacity on symptoms holds significant promise for advancing the science of nursing. The Symptom Experience Index is a reliable and valid patient-centered health outcome measure developed in the United States to assess multiple symptoms and distress. No Korean version is available for Korean healthcare professionals and patients to promote an accurate assessment of multiple symptoms. OBJECTIVE To translate the Symptom Experience Index into Korean language and assess its psychometric properties in Korean patients and healthy adults. DESIGN A psychometric study with a cross-sectional design. SETTING Two hospitals and a large university in Seoul, Korea in 2009. PARTICIPANTS A purposive sample of 230 adult participants, including medical-surgical and oncology patients, as well as healthy university students. METHODS The English Symptom Experience Index was translated to Korean language using an integrative translation method to ensure its semantic equivalence and content validity. The Korean version was then pretested and tested using a contrast-group and test-retest method. RESULTS Semantically, no modifications to items were needed in terms of comparability of language and similarity of interpretability. Feedback on the pretest of the Korean version by 15 Korean adult patients resulted in one item deletion and one item modification. The Korean version demonstrated high internal consistency with the Cronbachs alpha coefficient: total symptom experience of 0.92, occurrence of 0.91 and distress of 0.90. Intra-class correlation coefficients demonstrated strong stability over time: total symptom experience (ICC=0.82; 95% CI=0.73-0.88), occurrence (ICC=0.77; 95% CI=0.66-0.84), and distress (ICC=0.85; 95% CI=0.77-0.89). Construct validity was supported by (1) factor analysis; (2) differences in symptom experience scores between healthy university students and patient groups; and (3) positive correlations between symptom experience scores and functional impairment. CONCLUSIONS Our study provided evidence to support psychometric properties of the Korean Symptom Experience Index. The use of the instrument can help patients who speak Korean language systematically report symptoms and assist healthcare professionals in assessing multiple symptom experience.

Risk of secondary lymphedema in breast cancer survivors is related to serum phospholipid fatty acid desaturation

PurposeSecondary lymphedema is a common irreversible side effect of breast cancer surgery. We investigated if risk of secondary lymphedema in breast cancer survivors was related to changes in serum phospholipid fatty acid composition.MethodsStudy subjects were voluntarily recruited into the following three groups: breast cancer survivors who had sentinel lymph node biopsy without lymphedema (SLNB), those who had auxillary lymph node dissection without lymphedema (ALND), and those who had ALND with lymphedema (ALND + LE). Body mass index (BMI), serum lipid profiles, bioimpedance data with single-frequency bioimpedance analysis (SFBIA), and serum phospholipid compositions were analyzed and compared among the groups.ResultsBMI, serum total cholesterol (total-C), and low-density lipoprotein cholesterol (LDL-C) and SFBIA ratios increased only in the ALND + LE. High polyunsaturated fatty acids (PUFAs) and high C20:4 to C18:2 n-6 PUFAs (arachidonic acid [AA]/linoleic acid [LA]) was detected in the ALND and ALND + LE groups compared to SLNB. The ALND + LE group showed increased activity indices for delta 6 desaturase (D6D) and D5D and increased ratio of AA to eicosapentaenoic acid (AA/EPA) compared to the ALND and SLNB groups. Correlation and regression analysis indicated that D6D, D5D, and AA/EPA were associated with SFBIA ratios.ConclusionWe demonstrated that breast cancer survivors with lymphedema had elevated total PUFAs, fatty acid desaturase activity indices, and AA/EPA in serum phospholipids. Our findings suggested that desaturation extent of fatty acid composition might be related to the risk of secondary lymphedema in breast cancer survivors.

Health-related quality of life in cancer patients between baseline and a three-year follow-up

PURPOSE The aim of the study was to identify health-related quality of life (QOL) in persons diagnosed with cancer and to determine differences between the QOL over a 3-year period. METHODS We investigated the QOL in cancer patients at baseline and 3 years later using the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) and the ECOG (Eastern Cooperative Oncology Group) Performance Status. Initially 216 participants (85 women, 131 men) were enrolled, and at the 3-year follow-up there were 126 (52 women, 74 men). RESULTS Scores on the function and symptom scales changed significantly between the baseline and the 3-year follow-up. Physical, role, and social functions improved, whereas problems with constipation worsened. The global QOL of the participants at the 3-year follow-up was lower than that of baseline, but it was not statistically significant. The QOL in cancer patients improved from the baseline to the 3-year follow-up. CONCLUSION The results could serve as a guideline for nurses interpreting the perspective of QOL in their own groups of patients, and improve the understanding of the significance of mean QOL scores and develop nursing interventions in the future.

Association between Awareness of Nutrition Labels and Menstrual Cycle Irregularity in Korean Women: The Fifth Korea National Health and Nutrition Examination Survey (2010~2012)

PURPOSE The aim of this study was to identify the relationship between awareness of nutrition labeling and menstrual cycle irregularity in women from a nationally representative sample of the Korean population. METHODS A cross-sectional analysis was performed using hierarchical multivariable logistic regression analysis models. A total of 4,324 women aged 19~54 years from the 2010~2012 Korean National Health and Nutrition Examination Survey participated in the study. The participants were classified into three groups based on self-report responses to a questionnaire about their awareness of nutrition labels: Reading, Not-Reading, and Not-Knowing Groups. RESULTS The Reading, Not-Reading, and Not-Knowing Groups comprised 46.4%, 44.9%, and 8.7% of the participants, respectively, and 53.6% of the participants had never used nutrition labels. In the Not-Knowing Group, irregular menstrual cycles for more than 3 months were significantly more common than women with irregular menstrual cycles for up to 3 months and women with regular menstrual cycles. Women in the Not-Knowing Group were more likely to exhibit menstrual cycle irregularity (adjusted odds ratio: 1.63, 95% confidence interval: 1.10~2.41) compared to women in the Reading Group after adjusting for age, body mass index, smoking status, alcohol intake, exercise regularity, stress, depression, suicidal ideation, metabolic syndrome, age at menarche, parity, and use of oral contraceptives. CONCLUSION No awareness of nutrition labeling appears to be associated with a higher prevalence of menstrual cycle irregularity in a nationally representative group of Korean women.

Developing collaborative virtual learning community for the korean community health practitioners

Community Health Post workers are mainly registered nurses. They provide first-level primary health care to the numerous underserved rural communities in Korea. The primary goal of our project is to provide technological foundation for the community health practitioners to form a virtual community that collaboratively solves problems and learns to improve their patient caring and treatment skills. The main enabling technology is a collaboratively maintained knowledge management system, which assists the community health practitioners to make appropriate diagnoses and also to determine the corresponding expected outcomes and interventions to perform given the patients symptoms. The knowledge management system includes a knowledge base, which is converted from the standardized nursing process guidelines. In addition, the knowledge management system is also used as a case retrieval system so that the community health practitioners can compare the current case in progress with the similar prior cases. We have developed a prototype system and finished a preliminary evaluation of the system.