Hee Sun Kang

The Effect of a Sexual Life Reframing Program on Marital Intimacy, Body Image, and Sexual Function among Breast Cancer Survivors

Background: Despite increasing awareness related to sexual health for breast cancer survivors, health care providers are passive in addressing their sexual issues. Objective: The aims were to develop and investigate the effect of a sexual life reframing program on marital intimacy, body image, and sexual function (interest, dysfunction, and satisfaction) among breast cancer survivors. Methods: Breast cancer survivors participated in this quasi-experimental study. The sexual life reframing program focused on the physical, psychological, and relational aspects of sexual health elements, and it consisted of 6 weekly 2-hour sessions. Results: The participants reported poor body image and sexual function. There were no statistically significant differences in marital intimacy, body image, sexual interest, and sexual dysfunction following the program, although all the variables in the intervention group were improved. The sexual life reframing program was effective in increasing sexual satisfaction among breast cancer survivors. Conclusion: This study suggests that the quality of sexual life in breast cancer survivors could be improved with the sexual life reframing program provided as part of supportive group care. This program may be more effective if targeted at couples rather than survivors only and if delivered earlier and for a longer period. Implications for Practice: The sexual life reframing program offers an opportunity to facilitate small-group dynamics that lay the ground for further contacts leading to earlier recognition of sexual problems and active involvement for sexual health improvement for breast cancer survivors and nurses. It could be utilized for survivor education or support groups to increase sexual satisfaction.

Relationships of Acculturative Stress, Depression, and Social Support to Health-Related Quality of Life in Vietnamese Immigrant Women in South Korea:

Purpose: Promoting the health-related quality of life (HRQOL) is an important aim of nursing care for immigrant women. The aim of this study was to evaluate the level of HRQOL and its relationships with social support, acculturative stress, and depression among Vietnamese immigrant women. Method: A total of 216 Vietnamese immigrant women residing in South Korea participated in the study. Participants completed a series of questionnaires, including measures of social support, acculturative stress, depression, and HRQOL. For statistical analyses, a path analysis was applied. Results: Social support, acculturative stress, depression, and HRQOL were interrelated. Acculturative stress and depression directly influenced the mental health component of HRQOL, whereas social support indirectly influenced HRQOL through acculturative stress and depression. Only depression directly influenced the physical health component of HRQOL. Conclusion: Results suggest that social support and acculturative stress are related factors in preventing depression and promoting HRQOL, especially mental health, among Vietnamese immigrant women.

A best‐evidence review of intervention studies for minimizing resistance‐to‐care behaviours for older adults with dementia in nursing homes

AIM To conduct a best-evidence review of non-pharmacological interventions for resistance-to-care behaviours of nursing home residents with dementia in a personal-care context. BACKGROUND Resistance to care is a major source of staff burnout in nursing homes and it is also a safety issue for the staff. DESIGN Best-evidence review. DATA SOURCES We searched for non-pharmacological intervention studies published from 1990-2012, written in English. REVIEW METHODS The search identified 19 intervention studies that examined the effects of interventions to reduce the resistance-to-care behaviours of nursing home residents with dementia in a personal-care context. These 19 papers met the quality assessment requirements of the critical appraisal criteria for experimental studies, which were published by the Joanna Briggs Institute. RESULTS Only three studies were RCTs and the rest were quasi-experimental. The sample size ranged from 7-127. Nine music interventions, such as pre-recorded music played to a group or playing a residents preferred music, during his or her personal care, resulted in significant reductions in resistance-to-care behaviours. Resistance-to-care behaviours also were significantly reduced in three of four bathing interventions that focused on person-centred care. In the ability-focused interventions, only two out of five studies reported significant reductions in resistance-to-care behaviours. CONCLUSION Non-pharmacological interventions are options to consider to reduce resistance-to-care behaviours in older people with dementia, even though the evidence level is low, given the lack of alternatives. More randomized controlled trials are recommended to confirm the effects of non-pharmacological interventions during personal care.

Reynolds Adolescent Depression Scale – Second Edition: initial validation of the Korean version

AIM This paper is a report of a study conducted to test the validity and reliability of the Reynolds Adolescent Depression Scale - Second Edition in Korean culture. BACKGROUND Depression is a significant mental health problem in adolescents. The Reynolds Adolescent Depression Scale - Second Edition has been shown to be a useful tool to assess depression in adolescents, with extensive research on this measure having been conducted in western cultures. Measures developed in western cultures need to be tested and validated before being used in Asian cultures. METHOD The participants were a convenience sample of 440 Korean adolescents with a mean age of 13.78 years (sd = 0.95) from grades 7 to 9 in three public middle schools in South Korea. A cross-sectional design was used. Back-translation was used to create the Korean version, with additional testing for cultural meaning and comprehension. The data were collected at the end of 2004. RESULTS Internal consistency reliability for the Korean version of the Reynolds Adolescent Depression Scale - Second Edition was 0.89, with subscale reliability ranging from 0.66 to 0.81. Evidence for criterion-related, convergent and discriminant validity for the Korean version of the Reynolds Adolescent Depression Scale - Second Edition was found. Confirmatory factor analysis supported the 4-factor structure of Reynolds Adolescent Depression Scale - Second Edition. CONCLUSION Our results support the validity and reliability for the Korean version of the Reynolds Adolescent Depression Scale - Second Edition as a measure of depression and suggest that it can be used to screen students and to evaluate the effectiveness of preventive interventions in school settings.

Factors Associated with Social Isolation in Older Adults using Senior Welfare Centers

PURPOSE The purpose of this study was to investigate the factors associated with social isolation in older adults using a senior welfare center. METHODS This study was a cross-sectional survey. Data was collected from June to August 2006 using a questionnaire. A total of 248 older adults responded. RESULTS About one third (34.9%) of participants responded they felt socially isolated. There were statistically significant differences in living, religion, family and belongingness social support, loneliness, depression, family function, perceived health status, and number of chronic illnesses between socially isolated and non isolated groups. However, factors influencing social isolation were family function (OR=0.954, CI=0.926-0.982), loneliness (OR=1.042, CI=1.002-1.083), depression (OR=1.041, CI=1.002-1.081), and number of chronic illness (OR=1.657, CI=1.153-2.382). CONCLUSION We found that some older adults were feeling socially isolated even though the senior welfare center was a good place to meet people. The findings of this study indicated that older adults suffering from social isolation need special attention and may benefit from interventions which promote health and social interactions. Further studies are needed to develop and evaluate an intervention program for this population.

Stages of Change: Korean Women's Attitudes and Barriers Toward Mammography Screening

The positive and negative aspects of breast cancer screening were measured to gain insight into the barriers that prevent Korean women from participating in mammography screening. Breast cancer screening behaviors, attitudes, and barriers were identified from a convenience sample of 328 Korean women recruited in Seoul, Gyeonggi, and Jeju, South Korea. Pros, cons, and decisional balance constructs of the transtheoretical model of behavior change were used to identify stages of change in attitude related to mammography screening. There were significant differences in pros (F = 5.175, p = .001) and cons (F = 3.357, p = .012) across the five stages of change for mammography. Participants indicated that the major barriers to mammography screening were, in order of frequency, the belief that an absence of symptoms meant there was no need for a breast examination, the high cost of breast cancer screening, lack of time, lack of information, embarrassment, fear about x-rays and test results, reliance on breast self-examination (BSE), and discomfort or pain. The benefits of breast cancer screening should be emphasized among Korean women.

An Integrative Review of Cybercivility in Health Professions Education.

Although incivility in higher education has been widely described, little evidence exists regarding incivility among health professions students in online environments. This study aims to integrate literature on cybercivility in health professions education. The extent to which health professions students and faculty experience cyberincivility, the direct and indirect effects and actions taken after cyberincivility, and themes that guide facilitation of cybercivility are discussed. Efforts to prevent cyberincivility can be achieved through focused education on cybercivility, development of clear policies related to its consequences, and formulation of guidelines for both student and faculty behavior online.

The Effects of Cognitive-Behavioral Therapy on Depression, Anger, and Self-Control for Korean Soldiers

This quasi-experimental study examined the effects of cognitive-behavioral therapy (CBT) to control depression, anger, and self-control in soldiers from South Korea. Using a pretest-posttest design, the sample was composed of an experimental group (n = 16) and a control group (n = 12). The experimental group participated in four sessions of CBT. No significant differences were found between the groups with regard to demographic characteristics. Changes in the variables after the intervention were analyzed using Wilcoxons signed-rank sum test. The depression scores decreased significantly after the intervention (z = -3.05, p = 0.002); whereas, the scores of state-trait anger and self-control did not change. In the control group, none of the outcome variable scores changed significantly. The results indicate that the developed CBT program might be an effective modality to decrease the depression of soldiers who are in military service.

Human papilloma virus vaccination: perceptions of young Korean women.

AIM This paper is a report of a descriptive study of young Korean womens perceptions of use of the human papilloma virus vaccine. BACKGROUND In Korea, cervical cancer is one of the leading cancers in women, and the rate of human papilloma virus infection is increasing. A national media campaign has recently begun to promote human papilloma virus vaccination. However, research addressing the acceptability of this vaccine to women in Korea has been limited. METHOD Twenty-five Korean women, 21-30 years of age, participated in seven focus groups. The data were collected in 2007. FINDINGS Participants were concerned about the potential harmful effects of the human papilloma virus vaccine, a possible increase in unsafe sexual behaviours, and the high cost of the vaccine, which is not covered by health insurance. They suggested group vaccination at-cost or free of charge. They discussed ambivalence about the vaccination, the need for more information about the vaccine, and questions about its effectiveness. Most preferred to wait until more people have been vaccinated. CONCLUSION There is a need for more aggressive dissemination of information about the safety and efficacy of the human papilloma virus vaccine. More reasonable cost, insurance coverage, or free vaccination using a group approach might increase young Korean womens acceptance and use of the human papilloma virus vaccine.

Body esteem is a mediator of the association between physical activity and depression in Korean adolescents

PURPOSE This study examined whether body-esteem would mediate the association between physical activity and depression in adolescents. METHODS A total of 848 Korean high school students aged 15 to 18years completed a questionnaire on body-esteem, physical activity recall, and depression. Path analysis was used to test mediating effects of body-esteem on the association between physical activity and depression. RESULTS Girls showed a significantly higher level of depressive symptoms than boys. Boys showed significantly higher levels of physical activity and body-esteem than girls. Body-esteem mediated the relation of physical activity with depression. CONCLUSIONS Physical activity might reduce the risk of depression in addition to supporting body-esteem in adolescents. Interventions that reinforce healthy body-esteem and encourage physical activity would help prevent depression in adolescents. Future studies should examine the effects of programs addressing physical activity and body-esteem among adolescents with depressive symptoms.