An Investigation of the Effect of Virtual Reality on Alleviating Anxiety in Patients With Breast Cancer Undergoing Radiation Therapy: A Randomized Controlled Trial.

PURPOSE: The aim of this study was to evaluate the anxiety-reducing effects of virtual reality (VR) on patients with breast cancer undergoing adjuvant radiation therapy (RT). METHODS AND MATERIALS: This randomized controlled trial was conducted among patients with breast cancer receiving RT at a single institution. Of 196 enrolled and randomized patients, 97 were assigned to a VR explanation group (intervention) and 99 were assigned to the standard-of-care group (control). Anxiety levels were measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) as the primary endpoint and the State-Trait Anxiety Inventory (STAI) and Linear Analogue Scale Assessment (LASA) as secondary endpoints. Knowledge of the RT procedure, patient satisfaction, and time spent for counseling were also assessed. RESULTS: Intervention significantly reduced patient anxiety immediately, not only on the primary endpoint, APAIS, but also on the STAI and LASA anxiety scales. Specifically, in the intervention group, there were immediate reductions of 26.0%, 16.1%, and 55.8% for APAIS, STAI, and LASA, respectively, whereas in the control group, the respective reductions were 8.1%, 8.5%, and 13.7%. Among the 3 anxiety scales, long-term anxiety reduction was observed only when anxiety was measured by LASA. Subgroup analyses showed that the effect on anxiety did not differ based on the physician, baseline anxiety level, use of hormone therapy, or health literacy. The intervention also significantly improved knowledge of the RT procedure (81.9/100 vs 76.8/100; P = .006) and patient satisfaction with the explanation manner (6.56 vs 5.72; P < .001) compared with the control group. CONCLUSIONS: Immersive VR applied to the current procedure reduces anxiety during RT planning for patients with breast cancer. Further research is necessary to investigate the long-term effects of VR on anxiety.

[The reliability and validity of a Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) in Korean college students].

PURPOSE: This study was to test the reliability and validity of a Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) in Korean college students. METHODS: The DRSEQ-R was designed to assess an individual's belief in their ability to refuse drinking alcohol by Oei et al. (2005) and consisted of three factors (social pressure, opportunity, and emotional relief). A methodological study design with an exploratory factor analysis for validity and correlation coefficients for reliability was used. DRSEQ-R was translated into Korean and a translation equivalency was obtained. DRSEQ-R was tested with a sample of 201 college students in Korea. The subjects consisted of 106 males and 95 females. Principal component factor analysis was used for construct validity and Cronbach's alpha was used to evaluate for internal consistency of the instrument. RESULTS: The factor analysis showed three factors explaining 66.3% of total variance and the corresponding factors were emotional relief (48.01%), drinking contextual opportunity (11.18%), and social pressure (7.14%). The internal consistency was acceptable (Cronbach's alpha=.937). All three factors of DRSEQ-R negatively correlated with alcohol dependency and a heavy drinker showed a lower DRSEQ-R than a moderate drinker. CONCLUSION: Based on the findings, DRSEQ-R is a reliable and valid instrument to measure for drinking refusal self-efficacy in Korean college students.

[Alcohol experience, alcohol knowledge, and alcohol expectancy in early adolescents].

PURPOSE: This study was to explore the prevalence of alcohol experiences and to identify the expectancy on the effects of alcohol and alcohol knowledge in early adolescents. METHOD: The cross-sectional survey of 1854 students from seven middle schools in one district of Seoul was conducted by convenience sampling. Alcohol experience and early onset of alcohol use were measured by the Youth Risk Behavior Survey. Alcohol expectancy was measured by an Alcohol Effects Questionnaire. RESULT: Over sixty five percent of adolescents reported that they had previous drinking experiences. The participants with no alcohol drinking experience had a lower level of alcohol knowledge than those with experience(t=2.73, p=.007). In expectancy on effects of alcohol, girls had a more positive alcohol expectation than boys(t=-2.54, p=.011). Alcohol knowledge negatively correlated with alcohol expectancy(r=-.40 p=.000). In regression of alcohol expectancy, gender and alcohol knowledge were significant predictors explaining 17%. CONCLUSION: The results support that alcohol expectancy is an important link with early drinking experiences and alcohol knowledge, focusing on the importance of gender differences. Therefore, an alcohol prevention program in early adolescence is needed and should be focused on multidimensionality of the alcohol expectancy with developmental and psychosocial factors for early adolescents.

[The effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children].

PURPOSE: The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. METHODS: Thirty-two participants (BMI>or=85 percentile or relative obesity>or=10) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM-intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gym-based exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits(diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. RESULTS: The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. CONCLUSION: This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.

[Family resiliency factors for the adaptation of family who have a congenital heart disease].

PURPOSE: The purpose of this study was to explore the relationships of family strain, perceived social support, family hardiness, and family adaptation and identify the family resiliency factors for the adaptation of families who have a child with congenital heart disease. METHOD: The sample consisted of 90 families who had a child diagnosed with congenital heart disease and completed surgical treatment. Data was collected from parents using a questionnaire. RESULTS: Results from path analyses revealed that family strain had a direct effect on both perceived social support and family hardiness, and an indirect effect on family adaptation. Also, the findings revealed that perceived social support had a direct effect on both family hardiness and family adaptation, and family hardiness had a direct effect on family adaptation. Thus, these results indicated that perceived social support and family hardiness had a mediating effect on family strain. CONCLUSION: Findings provide the evidence for the theoretical and empirical significance of perceived social support and family hardiness as family resiliency factors for family adaptation. Clinical implications of these findings might be discussed in terms of family-centered nursing interventions for the families who have a child with congenital heart disease based on an understanding of family resiliency for adaptation.

[Depressive symptoms and related risk factors in old and oldest-old elderly people with arthritis].

PURPOSE: This study was to investigate the prevalence of depressive symptoms and risk factors in elderly people (old vs oldest-old) with arthritis. METHODS: The Korean Longitudinal Study of Aging (KLoSA) was used with a sample of 1,084 elderly people with arthritis aged 65 or above. RESULTS: We found that the prevalence of depressive symptom was greater for oldest-old people (66.7%) compared to old people (56%). Significant differences between old people and oldest-old people were found for education, living with spouse, number of generation, regular exercise, body mass index (BMI), ADL limitation, self-rated health, and depression. Significant differences existed between depression and non-depression in terms of all variables except region and BMI among old people. But, among the oldest people, ADL limitation and self-rated health showed differences. The Logistic regression analysis revealed that religion, medical comorbidity, ADL limitation, self-rated health were significantly associated with depressive symptoms in old people. But, in oldest-old people, none of the variables were associated with depressive symptoms. CONCLUSION: The findings show that there are age differences in depression and related factors in elderly people with arthritis. Longitudinal studies, which covered depressive symptom severity and which are controlled for a large number of potential confounders, will need to complement the results of this study in the future.

[Prevalence of cardiovascular risk factors in school-aged children].

OBJECTIVES: This study was conducted to assess the distribution of cardiovascular risk factors (serum lipid profiles, BMI, blood pressure, fasting blood sugar) and evaluate the risk profile of CVD by the clustering of the cardiovascular risk factors in school-aged children in the Kyoung-Gi area. METHODS: The study sample consists of 208 11 year-old children (51.4% boys, 48.6% girls) who participated in a cross-sectional screening of cardiovascular risk factors. We surveyed their socio-demographic characteristics, measured the anthropometric variables and analyzed the biochemical markers. RESULTS: Of the cardiovascular risk factors, the percentage risk of the BMI, dyslipidememia and hypertension were highest. The prevalence rates of total cholesterol and LDL-cholesterol in girls was higher than in boys. Also, the associations of the BMI, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, systolic and diastolic blood pressures were highly significant. In addition, the proportion of subjects with 1, 2, 3 and 4 or more risk factors were 29.3, 12.5, 2.9 and 1.9%, respectively; therefore, a total of 97 subjects (46.6%) had at least one more risk factor. CONCLUSIONS: From these findings, we concluded that the rates of hypercholesterolemia, cardiovascular risk groups and obesity prevalence of these groups were relatively high. These data provide further evidence that the early intervention for cardiovascular health prevention and promotion in school-aged children is necessary at the population level.