Min Ah Kim

Psychological Distress in Adolescent and Young Adult Survivors of Childhood Cancer in Korea

This study examined psychological distress levels, their differences across groups based on sociodemographic and medical variables, and risk factors for significant distress in adolescent and young adult childhood cancer survivors in Korea. Participants consisted of 223 Korean survivors of childhood cancer between 15 and 39 years of age. Psychological distress was measured using the Brief Symptom Inventory–18. A series of t tests, binomial proportion tests, analysis of variance, and univariable and multivariable logistic regressions were used. One fifth of the participants were classified as psychologically distressed. Significant levels of psychological distress were associated with age, economic status, and time since diagnosis. The results indicate a greater need for monitoring and follow-up care related to psychological health in childhood cancer survivors. Outreach and collaboration with health care professionals to increase mental health referrals could provide opportunities to address the needs of childhood cancer survivors in terms of their psychological well-being.

Life after cancer: how does public stigma increase psychological distress of childhood cancer survivors?

BACKGROUND Public stigma is a major source of stress for cancer survivors. However, factors that buffer or exacerbate the negative effects of public stigma on psychological distress have not been elucidated. OBJECTIVE This study examined how perceived public stigma affects psychological distress as mediated by cancer disclosure, internalized reactions to stigma, and social support availability. DESIGN Cross-sectional study. SETTINGS The study was conducted in South Korea. PARTICIPANTS The study sample was 223 adolescent and young adult survivors of childhood cancer diagnosed before the age of 19 and currently between 15 and 39 years old. METHODS Psychological distress was assessed using the Brief Symptom Inventory-18. Structural equation modeling was used with 1000 bootstrap samples. RESULTS The goodness of model fit was acceptable. Public stigma perceived by cancer survivors influenced psychological distress via cancer disclosure, internalized shame, and social support availability. Higher levels of perceived public stigma predicted higher levels of internalized shame and self-blame and lower levels of social support availability, which subsequently increased psychological distress. Higher levels of perceived public stigma predicted lower levels of disclosure about cancer history and experiences. Cancer disclosure indirectly ameliorated psychological distress by reducing internalized shame. CONCLUSIONS This study offers evidence that cognitive and social factors play important roles in mediating the effects of perceived public stigma on psychological distress in Korean cancer survivors. A greater understanding of factors that influence psychological distress may help psychosocial oncology service providers to identify childhood cancer survivors in need of psychosocial services and provide them with appropriate resources and interventions.

Perceived long-term and physical health problems after cancer: Adolescent and young adult survivors of childhood cancer in Korea

PURPOSE This study aims to examine the impact of perceived health problems after cancer on perceived physical and mental functioning among adolescent and young adult (AYA) survivors of childhood cancer in Korea. METHOD Participants were 225 cancer survivors who were diagnosed before the age of 19, are currently between 15 and 39 years old, and had completed cancer treatment. Each participant completed structured questionnaires. Data were analyzed using descriptive analyses, independent sample t-tests, and multivariate linear regression analyses. RESULTS A majority (73.1%) of the Korean AYA cancer survivors reported at least one health problem. Growth issues ranked as the most frequently reported; followed by chronic fatigue, vision, learning/memory issues, and weak bones. Those with learning/memory and chronic fatigue issues reported both lower physical and mental functioning. The greater number of health problems the survivors reported was associated with the lower levels of their perceived physical and mental functioning after controlling for age, gender, cancer type, cancer recurrence, and time since diagnosis. CONCLUSION Perceived health problems were prevalent among childhood cancer survivors and were significant in assessing physical and mental functioning. Although late effects after treatment for childhood cancer have been well documented internationally, this study is unique in that it helps understand cancer survivors treated in Korea and raises awareness in Korean society.

The Experiences of Korean Young Adult Survivors of Childhood Cancer A Photovoice Study

Photovoice was used to understand the impact of childhood cancer on Korean young adult survivors. Seven survivors of childhood cancer (currently aged 20–27 years), diagnosed before the age of 19 and with cancer treatment completed, participated in five sessions. The participants took photographs that captured their group’s weekly topics and participated in discussions about their feelings and experiences. Fifty-six photo images with narratives on the survivors’ experiences were produced on these four participant-selected themes: Relationships With Others, Stigma, Overcoming Difficulties, and The Future. This study on Korean childhood cancer survivors sheds light on their perspectives about the impact of cancer. Using an innovative methodology that takes the participants’ point of view, this study contributes to the literature on young adult cancer survivors’ quality of life and their psychosocial adjustment. The results can inform educational programs and increase public awareness by providing survivors’ schoolteachers and peers with knowledge about childhood cancer.

Experiences of peer exclusion and victimization, cognitive functioning, and depression among adolescent cancer survivors in South Korea.

Adolescents who reenter school after treatment for cancer may face certain challenges, such as social exclusion by their peers and difficulties in cognitive functioning, due to the cancer treatment and its psychosocial sequelae. Such challenges may have an impact on their mental health. This cross-sectional study examined the impact of peer exclusion–victimization and cognitive functioning on depression among adolescent survivors of childhood cancer. A total of 175 adolescent survivors of childhood cancer between the ages of 13 and 19 years completed a self-reported questionnaire. Their mean age was 15.33 years (SD = 1.65), the mean time since diagnosis was 7.97 years (SD = 3.91), and 49.7% experienced at least 1 kind of peer exclusion in school. Multiple regression analysis was conducted to examine the effects of survivors’ experiences related to peer exclusion–victimization and cognitive functioning on depression, controlling for demographic (age and gender) and cancer-related (cancer type, time since diagnosis, recurrence) characteristics. The model with peer exclusion–victimization and cognitive functioning as predictors accounted for 27.9% of the variance in depression. More experiences in peer exclusion–victimization (&bgr; = .200, p = .024) and lower cognitive functioning (&bgr; = –.465, p < .001) were associated with greater levels of depression. Understanding the impact of survivors’ experiences of peer exclusion–victimization and cognitive functioning on their mental health will help professionals to provide appropriate counseling services to moderate peer exclusion–victimization as well as resources for academic performance for those cancer survivors at risk for depression.

Why did I get cancer? Perceptions of childhood cancer survivors in Korea

ABSTRACT This study explored whether and how childhood cancer survivors in Korea ask and resolve the question of what may have caused their cancer. Thirty-one childhood cancer survivors participated in in-depth interviews about their self-questioning process in this regard. The findings indicate that Korean childhood cancer survivors pondered this question alone due to the stigma attached to cancer in the family and society. Their answers included internal factors (doing “bad things,” having unhealthy eating habits, engaging in magical thinking, having a stress-prone personality, or having a biological susceptibility) or external factors (stressors, random events, the environment, or medical conditions). How they perceived the cause of cancer had an impact on aspects of their current lives. Psychosocial care standards or guidelines are needed in regard to the provision of a safe environment in which Korean cancer survivors and their parents can share their perceptions and process their thoughts.

When does compassion fatigue hit social workers? Caring for oncology patients in Korea

Understanding compassion fatigue is vital to supporting the health and well-being of oncology psychosocial service providers and oncology patients. This study aims to examine when compassion fatigue is experienced and how it is dealt with by medical social workers providing psychosocial care for oncology patients. A purposeful sample of 12 medical social workers was recruited; each participant was working at a hospital and providing psychosocial care for oncology patients in Korea. Through in-depth qualitative interviews, the following themes emerged regarding oncology social workers’ experiences with compassion fatigue: (1) when compassion fatigue hits me (when bonding with clients, when facing a client’s death, when facing organizational hurdles, when feeling inadequate) and (2) how I deal with compassion fatigue (communicating with others, setting professional boundaries, finding ways to help myself, creating grief rituals, building professional identity). Implications and psychosocial interventions that may help reduce oncology social workers’ compassion fatigue are discussed.

Resilience and Pediatric Cancer Survivorship in Cultural Context

Children with cancer experience significant changes in their lives throughout the phases of survivorship. This chapter highlights our insights on the cultural aspects of resilience that occur in pediatric cancer survivorship based on our Korean Childhood Cancer Survivorship Study. We argue that resilience processes should be understood within the cultural contexts in which the cancer survivor’s beliefs and values are embedded. We present a Culturally Directed Model of Resilience Work and discuss the interplay between culture and four factors that influence resilience: social connections; confronting cancer; coping; and growth. Understanding the role that culture plays in resilience is critical for health researchers and clinicians who are working to develop effective services and interventions for children with cancer, and their families.

Exploring Social Service Providers’ Perspectives on Barriers to Social Services for Early Adjustment of Immigrant Adolescents in South Korea

Recently arrived immigrant adolescents experience difficulties in adjusting to school in South Korea. However, the existing social services do not meet their psychosocial needs. This study investigates the perspectives of social service providers about challenges in providing services for immigrant adolescents early in their adjustments. We conducted qualitative, in-depth interviews with 27 South Korean social service providers. We identified barriers to social services, categorized into three themes: (1) Initial Contact Phase; (2) Service Delivery Phase; and (3) Structural Challenges. We suggest interventions concerning work-related stress for the social service providers, family-level involvement, diversity training, and integrated and collaborative immigration services. An examination of social service providers’ challenges in working with immigrant adolescents is a necessary first step toward the development of programs and policies.

Understanding social exclusion and psychosocial adjustment of North Korean adolescents and young adult refugees in South Korea through Photovoice

A growing number of North Korean refugees residing in South Korea face significant challenges in cultural adjustment. However, psychosocial adjustment of North Korean young refugees is not fully understood. To address this research gap, this study explores the life experiences of 10 North Korean adolescent and young adult refugees who resettled in South Korea. Using Photovoice as a participatory research tool consisting of individual interviews, group discussions, and visual representations, six major themes emerged: friends, what we have lost, the world we live in, culture, life goals, and values. Participants reported experiencing social exclusion and peer discrimination as barriers to successful adjustment in South Korea. They also defined their new homeland as a place where competition, material wealth, and social status are highly valued, while traditional values and nature are shunned. Despite these barriers, all of the participants have made efforts to adapt to their new homeland and create new life goals with support from the group home where the participants resided in South Korea. Recognizing and understanding complex issues related to psychosocial adjustments of these refugees can inform the development of culturally relevant psychosocial interventions that foster a sense of belonging and promote coping mechanisms for these young people.