Wonshik Chee

Gender and ethnic differences in cancer pain experience: A multiethnic survey in the United States

Background: Inconsistent findings on ethnic differences in cancer pain experience suggest the need for further studies on this topic for adequate cancer pain management. Objectives: To determine ethnic differences in cancer pain experience of four ethnic groups in the United States. Methods: A feminist perspective was used as the theoretical basis. This was a survey of a multiethnic sample of 480 cancer patients asking questions on sociodemographic characteristics and health or illness status, 3 unidimensional cancer pain scales, 2 multidimensional cancer pain scales, the Memorial Symptom Assessment Scale, and the Functional Assessment of Cancer Therapy Scale. The data were analyzed using descriptive and inferential statistics including ANOVA and hierarchical multiple regression analyses. Results: The results indicated certain ethnic differences in types of pain and symptoms that patients experienced. Also, the results demonstrated significant ethnic differences in cancer pain and functional status. Discussion: The findings suggest further in-depth qualitative exploration on cultural values and beliefs related to cancer pain in each ethnic group and national studies with a larger number of ethnic minorities on this topic.

Recruitment of research participants through the Internet.

Despite an increasing amount of Internet research, issues in recruitment for studies in this environment rarely have been discussed. The purpose of this article is to provide some future directions for participant recruitment via the Internet, based on the experiences of recruiting participants for three Internet survey studies. The issues in the recruitment process include those related to low response rates, selected groups of participants, the importance of timing, and potential ethical issues. Based on the discussion of the issues, the following suggestions are proposed for future recruitment through the Internet: use of creative motivation strategies; sensitivity to the gender, ethnicity, and socioeconomic status of potential participants; consideration of the timing of data collection; and sensitivity to potential ethical issues.

Menopausal symptoms among four major ethnic groups in the United States.

The purpose of the study was to explore ethnic differences in symptoms experienced during the menopausal transition among four major ethnic groups in the United States. This study was done via a cross-sectional Internet survey among 512 midlife women recruited using a convenience sampling. The instruments included questions on background characteristics, ethnicity-related factors, health, and menopausal status and the Midlife Women’s Symptom Index. The data were analyzed using descriptive and inferential statistics. Significant ethnic differences were found in the total number and severity of the symptoms. The most frequently reported symptoms and predictors of the total number and severity of the symptoms differed by ethnic identity. More in-depth cultural studies are needed to understand the reasons for the ethnic differences in menopausal symptom experience.

Issues in Internet survey research among cancer patients.

Considering the increasing number of cancer patients who are online, it is clear that the Internet will provide an important research medium and/or setting for oncology nurses in the near future. Despite increasing Internet usage in nursing research and practice, issues in using the Internet among cancer patients as a research tool have rarely been explored and discussed. The purpose of the article is to propose future directions for Internet research among cancer patients based on discussions of practical issues raised in an Internet survey study among 40 online cancer patients. The issues raised through the research process include (a) ethical issues, (b) recruitment issues, (c) issues in Web site development and maintenance, and (d) data entry and analysis issues. On the basis of the discussions of these issues, some future directions for Internet survey studies are proposed, including dealing with ethical issues, getting computer expertise, using motivational strategies, and using national and international approaches.

Menopausal symptom experience: an online forum study.

AIM The aim of the study was to explore the menopausal symptom experience of White midlife women. BACKGROUND Recent cross-cultural investigations have indicated important ethnic differences in menopausal symptoms and have challenged the universality of these symptoms. Currently available cultural knowledge on menopausal experience, however, is inadequate to guide appropriate and adequate care even for White women in the menopausal transition. METHOD A cross-sectional qualitative online forum study was conducted in 2007 with 23 midlife women who self-identified as non-Hispanic Whites using convenience sampling. Seven topics related to menopausal symptom experience were used to guide the online forum for 6 months. The data were analysed using thematic analysis. RESULTS The experiences of menopause caused women to redefine themselves within their busy daily life schedules. They were optimistic about their symptoms, and tried to laugh at the experience to boost their inner strength and motivate themselves to persevere. Many thought that both generational and life-style differences were much more important than ethnic differences in menopausal symptom experiences. In seeking assistance with the symptoms of menopause, women were not satisfied with the guidance of their physicians. CONCLUSION Nurses need to listen carefully to what women themselves say about their own experiences with menopausal symptoms and avoid imposing predetermined symptom management strategies. Further studies of womens perceptions of life-style influences are needed to guide symptom management. In addition, studies of generational changes in menopausal symptom experience are needed.

Midlife women's attitudes toward physical activity.

OBJECTIVE To explore attitudes toward physical activity among a multiethnic group of midlife women. DESIGN A qualitative cross-sectional study using an online forum. RECRUITMENT SETTINGS: Internet communities/groups for midlife women and for ethnic minorities. PARTICIPANTS A multiethnic group of 15 midlife women. INSTRUMENTS Ten online forum topics on attitudes toward physical activity and seven on ethnic-specific contexts. DATA ANALYSIS Thematic analysis, involving line-by-line coding, categorization, and theme extraction. RESULTS Six themes across all ethnic groups emerged from the data analysis process, although there were some ethnic differences in details related to each theme. The themes were (a) gendered experience, (b) physical activity as all body movements, (c) no time for physical activity, (d) environment matters, (e) health concerns made me do it, and (f) need a companion. CONCLUSIONS Nurses need to consider and further investigate the influence of womens multiple roles, cultural factors, and environmental factors on physical activity in order to promote physical activity of midlife women.

A feminist critique on the use of the Internet in nursing research.

With the increasing use of the Internet, the importance of incorporating this new technology in nursing research increases. Yet nursing has been slow in adopting this new technology as a research method, and the use of the Internet in nursing research rarely has been discussed and critiqued. In this article, use of the Internet in nursing research is analyzed and critiqued from a feminist perspective. The analysis indicates that use of the Internet in research frequently brings about selection biases because of a limited pool of potential participants, it usually does not provide contextual data on research encounters, it might not uncover womens subjective experiences under marginalized situations, and it tends to raise power issues related to the relationships between researchers and participants. Despite the limitations, use of the Internet in research provides better communication channels for research participants, more flexibility in time and place of data collection, and less expense for data collection. Based on the critique, feminist challenges for future use of the Internet in nursing research are proposed.

Internet cancer support groups: a feminist analysis.

Internet Cancer Support Groups (ICSGs) are an emerging form of support group on Internet specifically for cancer patients. Previous studies have indicated the effectiveness of ICSGs as a research setting or a data-collection method. Yet recent studies have also indicated that ICSGs tend to serve highly educated, high-income White males who tend to be at an early stage of cancer. In this article, a total of 317 general ICSGs and 229 ethnic-specific ICSGs searched through Google.com, Yahoo.com, Msn.com, AOL.com, and ACOR.org are analyzed from a feminist perspective. The written records of group discussions and written memos by the research staff members were also analyzed using content analysis. The idea categories that emerged about these groups include (a) authenticity issues; (b) ethnicity and gender issues; (c) intersubjectivity issues; and (d) potential ethical issues. The findings suggest that (a) researchers adopt multiple recruitment strategies through various Internet sites and/or real settings; (b) researchers raise their own awareness of the potential influences of the health-related resources provided by ICSGs and regularly update their knowledge related to the federal and state standards and/or policies related to ICSGs; and (c) researchers consider adopting a quota-sampling method.

The use of Internet cancer support groups by ethnic minorities.

Recent studies have indicated that Internet Cancer Support Groups (ICSGs) tend to serve highly educated, high-income Whites at an early stage of cancer. Why do very few ethnic minority cancer patients, especially ethnic minority women, participate in ICSGs? In this article, the possible answers to this question are explored through a literature review from a feminist perspective. The potential reasons identified through the review include (a) gender and ethnic differences in attitudes toward ICSGs, (b) gender and ethnic differences in need for help, and (c) gender- and ethnic-specific contexts. Based on the discussion, implications for future research are proposed.

Decision support computer program for cancer pain management.

The purpose of the study was to develop an initial version of computer software that could assist nurses’ decision making about cancer pain reported by women from diverse cultural groups. This cross-sectional study included two phases: (1) data collection and (2) development of computer software. Data were collected using an Internet survey and e-mail group discussions of 19 faculty members from 10 countries who were self-identified experts in oncology nursing. The data were analyzed using descriptive statistics and content analysis. The findings indicated ethnic, gender, geographic, and age differences in cancer pain descriptions. Based on the collected data, a decision support computer program for cancer pain management, including (1) a knowledge base generation module, (2) a decision-making module, and (3) a self-adaptation module, was developed. Based on the study findings, suggestions for future research and practice related to cancer pain and expert systems were proposed.