Hee Soon Kim

Randomized Pilot Test of a Simultaneous Stage-Matched Exercise and Diet Intervention for Breast Cancer Survivors

PURPOSE/OBJECTIVESnTo investigate the feasibility and preliminary effects of a simultaneous stage-matched exercise and diet (SSED) intervention in breast cancer survivors.nnnDESIGNnRandomized, controlled trial.nnnSETTINGnOncology outpatient treatment clinics at the National Cancer Center in South Korea.nnnSAMPLEn45 women with breast cancer who completed their cancer therapy.nnnMETHODSnParticipants were assigned to the SSED intervention group (n = 23) or a control group (n = 22). Participants in the SSED group received a 12-week individualized intervention promoting prescribed exercise and a balanced diet through stage-matched telephone counseling and a workbook.nnnMAIN RESEARCH VARIABLESnProgram feasibility, behavioral outcomes (stage of motivational readiness for exercise and diet, physical activity, and diet quality), and quality-of-life (QOL) outcomes (functioning and global QOL, fatigue, anxiety, and depression).nnnFINDINGSnParticipant evaluations of the SSED intervention indicated that it was feasible and acceptable. All women felt that the overall intervention contents were appropriate, and 95% believed that the intervention helped to promote healthy behaviors. Objective data also supported the SSED interventions feasibility (i.e., 91% completed the trial and 100% of intervention calls were received). When compared to control, the SSED intervention group showed significantly greater improvement in motivational readiness for exercise and diet, emotional functioning, fatigue, and depression.nnnCONCLUSIONSnPreliminary results suggest that the SSED intervention delivered via telephone counseling and workbook is feasible and beneficial for positive behavioral and QOL outcomes.nnnIMPLICATIONS FOR NURSINGnNurse-led lifestyle interventions may improve QOL for cancer survivors.

Integrating Evidence-Based Practice into RN-to-BSN Clinical Nursing Education

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p < 0.05), and the barriers to research utilization scores decreased significantly after the EBP clinical practicum. The results highlight the effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum.

Middle-aged women's awareness of cholesterol as a risk factor: Results from a national survey of Korean Middle-aged Women's Health Awareness (KomWHA) study

BACKGROUNDnDyslipidemia, a risk factor for cardiovascular disease (CVD), is more prevalent in middle-aged women than in men of the same age in Korea. This study, the first national survey that focused on cholesterol in Korean women, aimed to: (1) assess their awareness and knowledge of cholesterol, (2) evaluate their risk reduction behavior, and (3) examine differences in these variables among geographical regions in Korea.nnnMETHODSnA questionnaire survey study was conducted in a randomly selected national sample of 1304 Korean women, aged 40-64 years in 3 geographic regions.nnnRESULTSnHigh cholesterol was identified as a cause of CVD by 54.4% of respondents, however, 95.4% did not know their own values. Only 4.1% of respondents were aware of desirable level of total cholesterol. Eight percent of respondents perceived correctly the meaning of high-density lipoprotein cholesterol (HDL-C) as good cholesterol. And 32.9% had cholesterol check at least once a year. No significant regional differences were found in womens awareness and knowledge on cholesterol. No smoking (93.6%), low salt diet (52.5%) and weight management (50.6%) were the most prevalent risk reduction behaviors. Women in the rural area performed less risk reduction behaviors than those in urban area.nnnCONCLUSIONSnGiven the low level of awareness and knowledge about cholesterol in these women, nurses need to increase their education about cholesterol and risk reduction behaviors of CVD for middle-aged Korean women, particularly those in rural area. To resolve identified disparities in womens risk reduction behaviors between the rural and urban area, a national-level health policy can result in a successful effort to promote womens awareness of cholesterol and risk reduction behaviors for the cardiovascular health of the public.

Reduced serum total osteocalcin is associated with central obesity in Korean children.

BACKGROUNDnRecently, osteocalcin (OC), an osteoblast-derived hormone, has been suggested as a new link between obesity and insulin resistance in humans. However, few studies regarding the relationship between OC and obesity in Asian children have been published. We investigated the association of OC with adiposity, insulin resistance and metabolic syndrome (MetS) in Korean children.nnnMETHODSnTwo hundred and nine (100 boys, 109 girls) children (age: 9.78 ± 1.05 years, body mass index (BMI): 22.27 ± 5.34 kg/m(2)) participated in this cross-sectional study. Anthropometric parameters, insulin resistance, lipid profiles, total OC, and an inflammatory marker, C-reactive protein (CRP), were measured. MetS phenotype was also determined.nnnRESULTSnSerum total OC levels were significantly lower in overweight or obese children (76.96 ± 27.08 ng/ml vs. 66.91 ± 21.39 ng/ml, p = 0.020) and it was negatively associated with body fat after controlling for age, gender and BMI. Serum total OC concentrations were significantly lower in participants with central obesity or at least two components of MetS driven by waist circumference than they were in those with none. Stepwise linear regression results also showed that serum total OC was partially explained by age, gender, waist-to-hip ratio, and fasting glucose.nnnCONCLUSIONSnThis study supported a negative association between serum total OC and adiposity in children. OC may be associated with childhood central obesity; however, further research using more accurate measurements is needed to identify the association between these variables.

Posture management program based on theory of planned behavior for adolescents with mild idiopathic scoliosis.

PURPOSEnThe purpose of this study was to evaluate the effects of a devised posture management program based on the Theory of Planned Behavior in adolescents with mild idiopathic scoliosis.nnnMETHODSnA quasi-experimental study was conducted. It involved a nonequivalent comparison group design with pretest and posttest. Forty-four female adolescents with mild idiopathic scoliosis participated; data from 35 participants (20 for the test group, 15 for the control group) were used for the final analyses. The devised posture management program ran for 6 weeks. Posture management behavioral determinants (attitude, subjective norms, perceived behavioral control, and behavioral intention) as cognitive outcomes and muscular strength and flexibility as physical outcomes were measured three times: at baseline, week 6 and week 8. Cobbs angle as another physical outcome was measured twice: at baseline and week 8. Descriptive analysis, repeated measures analysis of variance and t test were used for data analyses.nnnRESULTSnAttitude, perceived control, and behavioral intention were consistently enhanced by the posture management program. The intervention increased flexibility and muscular strength and decreased Cobbs angle, which reduced spinal curvature. Frequency of posture management exercise showed a gradual increase in the test group.nnnCONCLUSIONnThe results indicate that the posture management program is effective in maintaining posture management behavior in adolescents with mild idiopathic scoliosis for both cognitive and physical outcomes. The posture management program should be helpful in expanding the role of school nurses in improving the health status of adolescents with mild idiopathic scoliosis.

The effect of predominant breast-feeding on the risk of obesity in Korean preschool children

The purpose of this study was to investigate the prevalence of predominant breast-feeding practices based on the criteria given by the World Health Organization and to identify the association between predominant breast-feeding during infancy and the development of obesity during preschool in South Korean children. This study employed a nonexperimental, retrospective study design. Five hundred and twenty-eight preschool children aged three to six years and their mothers were recruited. Twenty-seven percent of the participants engaged in predominant breast-feeding; on average they fed predominantly breast milk for the first 6.7 months. After adjusting for child and maternal characteristics, children who had mixed feeding were 1.68 times more likely to become obese than those who were predominantly breast-fed. In this study, it was identified that predominant breast-feeding has a positive effect on maintaining healthy body weight in Korean preschoolers. While encouraging predominant breast-feeding is only a part of the solution, it is an effective and important first step toward preventing preschool obesity.

Parent Involvement Intervention in Developing Weight Management Skills for both Parents and Overweight/Obese Children

PURPOSEnThe purpose of the study was to evaluate a parent involvement intervention for childhood obesity intended to increase parents skills in managing childrens weight-related behavior and to improve child-parent relationships. Many studies reported on parental influence on childhood obesity, emphasizing parent involvement in prevention and management of childhood obesity.nnnMETHODSnA randomized controlled trial was conducted. Forty-two parents of overweight/obese children were recruited from four cities and randomized to the experimental group or control group. The parental intervention was provided only to parents in the experimental group and consisted of weekly newsletters and text messages for a period of 5 weeks. Exercise classes and nutrition education were provided to all children. Lifestyle Behaviour Checklist and the Child-Parent Relationship Scale (CPRS) were used for measurement of parent outcome. For the child outcome, dietary self-efficacy, exercise frequency, and body mass index were measured. A mixed-design analysis of variance was performed with city location entered as a random effect.nnnRESULTSnAfter the intervention, CPRS of parents and dietary self-efficacy of children showed an increase in the experimental group (p < .05). Intervention effects differed significantly according to the city location regarding the control efficacy of parents and dietary self-efficacy of children (p < .05).nnnCONCLUSIONSnThe results support the effectiveness of the parent involvement intervention in promoting child-parent relationship and dietary self-efficacy of children. However, a 5-week parent involvement intervention was not sufficient to produce significant changes in childrens body mass index. Further research is needed to investigate effects of parent involvement intervention with long-term evaluation.

Estimation of Effects of Factors Related to Preschooler Body Mass Index Using Quantile Regression Model

PURPOSEnThe purpose of this study was to investigate Korean preschoolers obesity-related factors through an ecological approach and to identify Korean preschoolers obesity-related factors and the different effects of ecological variables on body mass index and its quantiles through an ecological approach.nnnMETHODSnThe study design was cross-sectional. Through convenience sampling, 241 cases were collected from three kindergartens and seven nurseries in the Seoul metropolitan area and Kyunggi Province in April 2013 using self-administered questionnaires from preschoolers mothers and homeroom teachers.nnnRESULTSnResults of ordinary least square regression analysis show that mothers sedentary behavior (p < .001), sedentary behavior parenting (p = .039), healthy eating parenting (p = .027), physical activity-related social capital (p = .029) were significant factors of preschoolers body mass index. While in the 5% body mass index distribution group, gender (p = .031), preference for physical activity (p = .015), mothers sedentary behavior parenting (p = .032), healthy eating parenting (p = .005), and teachers sedentary behavior (p = .037) showed significant influences. In the 25% group, the effects of gender and preference for physical activity were no longer significant. In the 75% and 95% group, only mothers sedentary behavior showed a statistically significant influence (p < .001, p = .012 respectively).nnnCONCLUSIONnEfforts to lower the obesity rate of preschoolers should focus on their environment, especially on the sedentary behavior of mothers, as mothers are the main nurturers of this age group.