Myunghee Jun

Breast cancer screening for Korean women must consider traditional risks as well as two genetic risk factors: genetic polymorphisms and inheritable gene mutations.

Asian women worldwide have increasing rates of breast cancer due to acculturation which may be altering, gene to gene and/or, genetic and environmental interactions at the cellular level. The purpose of this integrative review is to alert nurses and physicians to rising rates of breast cancer among Korean women and to a need for breast health screening programs in the United States that are more culturally responsive and attentive to the effects of acculturation and genetic risk factors. A comprehensive review of the English and Korean literature pertaining to rising incidence of breast cancer among Korean women in their homeland and in the United States is retraced since 1983. Korean women in Korea and in the United States face similar barriers to cancer screening services. Korean women need knowledge about the effect of acculturation on breast cancer risk and patterns of familial inheritance of breast cancer. Screening is especially important among younger women (younger than age 35), those with a strong family history, and women in community settings where acculturation has its greatest impact. Nurse clinicians and researchers who aim to improve breast cancer screening among minority women must pay closer attention to these risk factors and design culturally competent services and evaluation research. In the United States and Korea, Korean nurses are needed to specialize in breast cancer screening as well as cancer genetic risk assessment and genetic counseling.

A Follow up Study for Elderly`s Disabilities in Performing Activities of Daily Life (ADL) after Lumbar Spinal Surgery

Purpose: This follow up study was performed to survey the problem in performing ADLs at home after surgery. Method: Twenty elderly patients were assessed 3 times; from the time of hospitalization for surgery until 3 weeks after discharge. Measuring tools are numeric rating scales (NRS) for pain and 3 questionnaires developed by the authors to measure difficulties in ambulation, performing indoor ADLs, and emotional status. Pearson correlation, variance analysis and descriptive statistics were used to analyze the data. Result: The level of pain significantly decreased after surgery, but the difference between pain at the time of discharge and that of 3 weeks after discharge were not significant. Pain showed a positive relationship with emotional difficulties. Elderly with a higher education, family caregiver, and regular exercise showed a lower level of emotional difficulties. Conclusion: Comprehensive approaches for chronic pain including physical, psychological, and social aspects should be considered when caring for the elderly with spinal surgery. In addition, home care nursing interventions should include an exercise program to promote adaptation and rehabilitation after discharge.

Factors Affecting Post-operative Uncertainty of the Patients Undergone Lumbar Spinal Surgery*

Abstract Purpose: The purpose of this study is to identify main factors affecting patients’ uncertainty following lumbar spinal surgery. Methods: A survey was conducted of a sample 155 post -operative patients in April to June 2010. Uncertainty and knowledge about self-care after spinal surgery and the back pain evaluation were measured. Data were analyzed with t-test, ANOVA, Pearson correlation, and multiple regressions. Results: The mean score of uncertainty level was 27.66±6.32. Levels of uncertainty were different by age, gender, educational level, pain duration, and number of types of pain. Uncertainty was positively correlated with knowledge of post-op self-care, back pain, and mental health. The results of multiple regression indicated that knowledge of post-op self-care and mental health were significant predictors with 35.1% of the variance in uncertainty. Conclusion: A program including post-operative self-care education and mental health promotion is required to reduce uncertainty of patients with lumbar spinal surgery.

Models of Genetic Counseling Services and Quality Assurance: A Theoretical Inquiry

유전 위험 사정과 상담서비스가 임상실무에 널리 적용되어 감에 따라, 다양한 비용효율 면에서 다양한 상담서비스 모델을 사정하고, 대상자의 임상 요구와 건강문제를 해결하는데 어떤 모델이 유용한 지 확인할 필요가 있다. 본 연구의 목적은 114건의 현장관찰과 문헌고찰을 통하여 3가지 유전상담 모형을 분석하였다. 유전의학 전문가 모델, 유전상담사 모델, 임상연구전문가 모델을 중심으로 각 모델의 구조, 전문가의 역할 및 기능, 목표, 물리적 세팅, 교육도구 등을 분석하였다. 각 모형 안에서 환자에게 기대되는 결과 면에서 질적 서비스가 보장되는지 확인하기 위하여 이론적 분석을 실시하였다. 본 연구를 통하여 각 모형의 상담 전, 중, 후 환자 만족, 지식 변화, 상담 효과 및 커뮤니케이션 효과 등을 분석하였지만, 결론적으로 상담서비스가 이루어지고 있는 기관의 구조를 충분히 고려하지 않은 상태에서 최상의 서비스 모델을 제시하기 어려울 것임을 논의하였다.

Survey on Prehospital Services for Acute Traumatic Hand Injury and Patient Satisfaction

Purpose: This study surveyed how victims with acute traumatic hand injuries received pre-hospital care and how satisfied they were with that care. Method: A total of 100 adults were interviewed using a questionnaire at one microsurgical clinic in Korea. Results: Only 12 patients (12.0%) were transported by the ambulance and the others by private or company`s vehicles. Only 9 patients (9.0 %) were able to get appropriate first response from the EMTs or industrial health providers at the scene of the accidents. The mean time required for transportation from the scene of the accident to the operation room of the microsurgical clinic was minutes. Most of the patients were satisfied with the pre-hospital care provided by the EMT or industrial health providers but dissatisfied with that provided by lay persons. Conclusion: This study demonstrates that there is a lack in the first response provided at the scene and the activation of EMS (Emergency Medical System) for acute hand injury. It is necessary to educate the public about the appropriate first response and rapid transportation to the appropriate microsurgical clinic.

Are the Economic and Convenient Anthropometric Estimations Reliable Tools for Assessing Body Fat of University Students

Purpose: The purpose of the study was to examine whether anthropometric estimations can be reliable methods to assess body fat of university students, by identifying the relationship between anthropometric estimates, which have been thought to be not reliable but economic, and Bio-electric impedance analysis (BIA), which has been known to be reliable but expensive. Method: Twenty-one male and 20 female university students were recruited. The in Body 3.0 scale and GIF-891DX were used for BIA. Body fat was estimated with 12 circumferences, 9 skin-fold thicknesses (SFT), and applying 4 equations (Kim`s, , Siri`s and Wilmore`s). Their relationships were examined by Pearson Correlation. Result: 11 circumferences and 9 SFT in the male while 5 circumferences and 3 SFT in the female correlated with the body fat on BIA(p