Hae Won Kim

Knowledge about human papillomavirus (HPV), and health beliefs and intention to recommend HPV vaccination for girls and boys among Korean health teachers.

The human papillomavirus (HPV) vaccination rate in Korea is very low because a school-based HPV vaccination program has not yet been introduced. This study was designed to assess HPV knowledge, compare the health beliefs toward HPV vaccination and intention to recommend HPV vaccination for girls and boys, and identify the factors influencing the intention to recommend HPV vaccination for girls and boys among Korean health teachers. A descriptive cross-sectional study design was employed, in which 757 health teachers who worked at elementary, middle, high, and special schools in Korea participated via an online survey. A self-administered, structured questionnaire was applied, which included items on sociodemographics, HPV awareness, HPV knowledge, perceived benefits, susceptibility, severity, and barriers toward HPV vaccination for girls and boys, and intention to recommend HPV vaccination for girls and boys. The rate of correct HPV knowledge items ranged from 5.2% to 89.2%; 23.4% of the health teachers answered that they had ever taught about HPV, 97% answered that both boys and girls should receive HPV vaccination, and 47.6% answered that the best time for HPV vaccination is when students are at middle school. There were differences regarding the perceived benefits (Z=-7.69, p<0.001), perceived susceptibility (Z=-3.37, p=0.001), perceived severity (Z=-4.13, p<0.001), and perceived barriers (Z=-4.90, p<0.001) toward HPV vaccination, and regarding intention to recommend HPV vaccination (Z=-15.21, p<0.001) for girls and boys. Factors associated with the intention to recommend HPV vaccination for girls were the HPV vaccination status of the health teachers children [odds ratio (OR)=4.24, 95% confidence interval (95% CI)=1.14-15.72], and the teachers Pap-test experience (OR=2.50, 95% CI=1.05-5.91), perceived benefits (OR=3.30, 95% CI=1.26-7.40), perceived susceptibility (OR=3.25, 95% CI=1.58-6.68), and perceived barriers (OR=0.51, 95% CI=0.30-0.99); these factors for boys were the health teachers career duration (OR=1.61, 95% CI=1.12-2.32), HPV knowledge (OR=1.45, 95% CI=1.01-2.09), perceived benefits (OR=3.46, 95% CI=2.27-5.26), perceived susceptibility (OR=1.55, 95% CI=1.04-2.29), and perceived severity (OR=1.71, 95% CI=1.15-2.56). General awareness of HPV should be increased and more specific information about HPV-including that related to vaccination of boys and men-should be provided for health teachers. Although a school-based HPV vaccine program has yet to be introduced in Korea, health teachers should possess general knowledge about HPV and HPV vaccination, and differences in attitudes and intentions related to HPV vaccination between girls and boys should be reduced.

Effects of Antenatal Depression and Antenatal Characteristics of Pregnant Women on Birth Outcomes: A Prospective Cohort Study

PURPOSEnThis study was done to evaluate the effects of antenatal depression on birth outcomes.nnnMETHODSnThe participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win.nnnRESULTSnLevel of antenatal depression was associated with low birth weight (χ²=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and babys weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes.nnnCONCLUSIONnThe results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy BMI≥23 kg/M² should be monitored and managed to ensure favorable birth outcomes.

Gender Differences in Knowledge and Health Beliefs Related to Behavioral Intentions to Prevent Human Papillomavirus Infection

This study assessed gender differences in human papillomavirus (HPV) awareness (including knowledge), health beliefs, and behavioral intentions to prevent infection. The participants comprised 763 and 905 sexually active men and women, respectively. Gender differences were observed in HPV knowledge, health beliefs, and sociodemographics that were significantly correlated with behavioral intentions to prevent infection. There were gender differences in the factors related to behavioral intentions to prevent HPV. In multiple regression analysis, HPV knowledge was not related to behavioral intentions, whereas perceived benefits were related to behavioral intentions consistently among men and women, while the effects of perceived barriers were inconsistent. HPV awareness was very low regardless of gender. While HPV education is urgently required for men, enhancing HPV awareness, reinforcing positive perceptions of HPV prevention, and reducing unhealthy sexual behaviors are necessary for the entire Korean population.

Development of the Pregnancy Nutrition Knowledge Scale and Its Relationship with Eating Habits in Pregnant Women visiting Community Health Center

PURPOSEnThis study was done to develop a pregnancy nutrition knowledge scale and to examine the relationships between pregnancy nutrition knowledge and eating habits in pregnant women.nnnMETHODSnWith convenient sampling, 189 pregnant women who used community health centers for their ante-natal care were recruited. Data were collected using a self administered questionnaire including items on pregnancy nutrition knowledge (18 items) developed by researcher and items on eating habits (14 items). Cronbachs alpha and exploratory factor analysis were examined to test reliability and construct validity of the scale. Pearsons correlation coefficients were used to identify the relationship between pregnancy nutrition knowledge and eating habits.nnnRESULTSnCronbachs alpha of 18 items was .80. In factor analysis using principal components, 6 factors explained 65% of the total variance. The level of pregnancy nutrition knowledge was not sufficient but correlations between pregnancy nutrition knowledge and some of eating habits were significant. Specifically, pregnancy nutrition knowledge was positively correlated with good eating habits and negatively with bad eating habits.nnnCONCLUSIONnThe pregnancy nutrition knowledge scale developed in this study is acceptable for nutrition education led by nurses. Pregnancy nutrition knowledge and eating habits are considered as major variables for ante-natal nutrition education. In future studies, explorations are needed on dietary intake and physiological indices in pregnant women, comparison of women at risk with those not at risk, and development of nutritional education programs for pregnant women.

Awareness of cervical cancer prevention among mothers of adolescent daughters in Korea: qualitative research.

Objectives Korean adolescent girls are unprepared for cervical cancer prevention due to the lack of a mandatory policy regarding human papilloma virus (HPV) vaccination and school health education regarding cervical cancer. The aim of this study was to determine how aware mothers are about cervical cancer prevention in their adolescent daughters, with a view to developing strategies for expanding primary cervical cancer prevention for adolescent girls through the mothers’ involvement. Design A qualitative design was employed. Nine mothers with adolescent daughters participated in this study and were interviewed using open-ended questions. The themes were extracted by content analysis. Setting A general living area in Seoul, South Korea. Participants The snowball method was used to select mothers. Results Five themes emerged. In general, the mothers’ awareness of cervical cancer was not clear, and they exhibited a lack of awareness of the importance of having a regular Papanicolaou screening test. The mothers recognised that they were role models for their daughters, and realised and accepted the necessity of educating their daughters regarding cervical cancer; however, they perceived barriers related to the prevention of cervical cancer in their daughters. The mothers recommended enforcing sex education in schools and the provision of financial support for HPV vaccination. Conclusions The mothers’ awareness and preparedness with respect to the prevention of cervical cancer in their adolescent daughters were low and inadequate. Mothers should be informed and motivated to play a role in the education of their daughters regarding cervical cancer prevention. Strategies for disseminating information regarding early cervical cancer prevention for adolescent girls are recommended by communicating with both the girls and their mothers and providing them with education regarding cervical cancer prevention.

The effects of an HPV education program by gender among Korean university students

PURPOSEnThis study compared the effects of an HPV education program by gender among Korean university students in terms of their knowledge of HPV, intention to prevent HPV, awareness of sexual rights, and perception of gender equality.nnnMETHODSnA quasi-experimental pre-post design was employed. 31 male and 28 female university students participated in eight sessions of an HPV prevention program for four weeks and in a self-administrative survey.nnnRESULTSnAt pre-test, the perception of gender equality and some of the intentions to prevent HPV, including the intention to make regular use of condoms, reduce the number of sexual partners, abstain from sex until marriage, and stop smoking or stay non-smoker, were lower among men than women. When these differences by gender at pre-test were taken into account using ANCOVA, education outcome measures at post-test did not differ by gender. After completing the HPV prevention program, both male and female students presented a significant increase in terms of HPV knowledge, awareness of sexual rights, and perception of gender equality. Among the intentions to prevent HPV, only male intention to recommend the Pap test to their partner and female intention to regularly seek the Pap test and pelvic examinations were significantly increased after the program.nnnCONCLUSIONnThe HPV program was effective for both genders eliminating gender differences in attitudes and prevention intentions of HPV. However, the intentions to prevent HPV did not increase significantly, and future research is warranted to better understand students perceived obstacles for practicing HPV prevention methods.

Menstrual attitudes and maternal child rearing attitudes in middle school female students

PURPOSEnThis correlational study was performed to identify the impacts of maternal child rearing attitudes on the menstrual attitudes and the determinants of positive menstrual attitudes in female middle school students.nnnMETHODSnWith convenience sampling, 198 middle school female students were recruited living in one major city and its surrounding areas in Korea. Data was collected using a self administered questionnaire including menstrual attitudes and maternal child rearing attitudes from April 1 to July 15, 2008.nnnRESULTSnAmong the Maternal child rearing attitudes, affectionate, achievement oriented and rational attitudes had positive correlations to a positive menstrual attitude, and an autonomous attitude had a negative correlation to a negative menstrual attitude. As determinants of positive menstrual attitudes, feeling of menarche, mothers response at first menstruation, and rational maternal child rearing attitudes were delineated and their explained variance for a positive menstrual attitude was 18.5%. There was no difference on menstrual attitudes by K clustering in terms of maternal child rearing attitudes.nnnCONCLUSIONnThese results support the critical role of the mother. Especially desirable maternal child rearing attitudes in relation to a positive menstrual attitude would be affectionate, achievement oriented and rational for early adolescent girls. In further studies, considerations are needed for menstruation related education and research for early adolescents and active involvement of the mother & daughter together.

[Factors associated with Human Papillomavirus related stigma, shame, and intent of HPV test].

PURPOSEnThis study was conducted to examine the factors associated with HPV (Human Papillomavirus) related stigma, shame and intent to have HPV test among adult women.nnnMETHODSnData were collected from December 1, 2009 to January 31, 2010, and participants were 324 women who visited an obstetric gynecologic clinic. They anticipated testing positive for HPV. Then HPV related stigma, shame, intent to have HPV testing and HPV knowledge were measured. Descriptive statistics, Mann-Whitney U test, Kruskal Wallis test and multivariate adjusted logistic regression were used for data analysis.nnnRESULTSnThe levels of stigma and shame were higher than average. Intent to have HPV test was high and HPV knowledge was low. Women who answered that HPV is not sexually transmitted had lower HPV stigma than did women who answered they didnt know (OR=0.20, 95%CI 0.06-0.68). Women with lower stigma showed lower intent to have HPV test than women with higher stigma (OR=0.46, 95%CI 0.26-0.82).nnnCONCLUSIONnBasic HPV information should be fully understood for women especially prior to HPV test. Normalizing HPV stigma is necessary for women who perceive HPV as sexually transmitted and women intending to have HPV test.

The health beliefs of mothers about preventing cervical cancer and their intention to recommend the Pap test to their daughters: a cross-sectional survey

BackgroundMothers have a primary role in the prevention of cervical cancer in Korea. This study aimed to determine the awareness and health beliefs of mothers about preventing cervical cancer in their daughters, their intention to recommend the Pap test to their daughters, and the factors influencing this intention.MethodsA cross-sectional survey design was employed, and the study enrolled mothers (nu2009=u20091,581) of pubescent girls aged 13 to 18xa0years who were living nationwide in Korea. The six health-beliefs variables related to preventing cervical cancer in their daughters, awareness of the importance of cervical cancer prevention methods, and the intention to recommend the Pap test to daughters were investigated. The impacts of these health beliefs of the mothers and the sociodemographic factors influencing their intention to recommend the Pap test to their daughters were assessed using multiple logistic regression analysis.ResultsAlmost one-quarter (23.7xa0%) of the mothers had talked about the Pap test, 69.2xa0% were intending to recommend the Pap test to their daughters, and 38.5xa0% considered that the Pap test could be necessary if their daughters became sexually active. The significant health beliefs influencing the intention to recommend the Pap test were the perceived barriers [odds ratio (OR)u2009=u20091.47, 95xa0% confidence interval (95xa0% CI)u2009=u20091.03–2.11] and benefits (ORu2009=u20092.25, 95xa0% CIu2009=u20091.55–3.25). The significant sociodemographic factors of mothers were their education (ORu2009=u20091.52, 95xa0% CIu2009=u20091.08–2.13), their experience of talking about the Pap test with their daughters (ORu2009=u20092.11, 95xa0% CIu2009=u20091.23–3.64), their regularity of undergoing the Pap test themselves (ORu2009=u20091.98, 95xa0% CIu2009=u20091.30–3.03), and their age when they first underwent the Pap test (ORu2009=u20091.60, 95xa0% CIu2009=u20091.43–0.82).ConclusionsThe mothers perceived HPV vaccination as the most important of the five methods for preventing cervical cancer in their daughters. Mothers perceived the importance of their daughters undergoing the Pap test regardless of the presence of HPV vaccination, and most of the mothers had an intention of recommending the Pap test to their daughters. Strategies for increasing the intention of mothers to recommend the Pap test to their adolescent daughters could be promoted by increasing their perceptions of the benefits while reducing their perceptions of barriers toward their daughters undergoing the Pap test, and by empowering active communication about the Pap test between mothers and daughters.

Effect of community‐based education to Korean mothers in relation to the prevention of cervical cancer in their daughters: A non‐randomized trial

AIMnThis study was conducted in order to examine the effects of community-based education on cervical cancer prevention in relation to South Korean mothers knowledge about the Papanicolau (Pap) test and human papillomavirus, self-confidence in communication with their daughters, and health-related beliefs about their daughters.nnnMETHODSnA quasi-experimental pre-post design was used. For the experimental group, face-to-face education was administered to 35 participants for 60u2009min. For the control group, 35 participants were taught by using standardized materials for 20u2009min.nnnRESULTSnThe experimental group showed a significant increase in Pap test knowledge, cervical cancer knowledge, and self-confidence in communication with their daughters, compared to the control group. In the post-test, the mothers in the experimental group also perceived cervical cancer as more threatening, their daughter as more susceptible to cervical cancer, Pap tests as being recommended for their daughters, and they showed a significant increase in their self-efficacy of recommending the Pap test to their daughter.nnnCONCLUSIONnCommunity-based education for mothers is effective in increasing their human papillomavirus knowledge, Pap test knowledge, improving their confidence in communication with their daughters, and in some of the health-related beliefs regarding their daughters.