A Study on the Development of the Goals and Contents System of Healthy Dietary Education Program for After-School Care in Lower Grade in Elementary School / 대한지역사회영양학회지

OBJECTIVES: The study purpose is to develop a content system for a healthy dietary education program for after-school care in lower grade in elementary school. METHODS: The contents of healthy dietary education in the 2015 revised curriculum and textbooks and the major education programs related to dietary life that are currently used in elementary school education were analyzed. Focus group interviews were held with field experts related to lower grade in elementary care class. Accordingly, the structuring of the education area and the detailed education contents were systematized. RESULTS: From the analysis results, the contents of curriculum, textbook, and administrative department were classified as hygiene safety, health, and culture. The goal of the educational content system was divided into three areas: nutritional dietary life, food hygiene and health, and food culture. The subjects consisted of dietary balance, healthy body weight, digestion and absorption, food hygiene, Korean agricultural products, traditional food, and table manners. The curriculum was composed of 12 content elements. CONCLUSIONS: In order to ensure that after-school care students can grow into healthy, growth-oriented and creative talents, the role of the caring guide is important, and associated guidelines are needed in the future.

A Study on the Development of the Goals and Contents System of Healthy Dietary Education Program for After-School Care in Lower Grade in Elementary School / 대한지역사회영양학회지

OBJECTIVES: The study purpose is to develop a content system for a healthy dietary education program for after-school care in lower grade in elementary school. METHODS: The contents of healthy dietary education in the 2015 revised curriculum and textbooks and the major education programs related to dietary life that are currently used in elementary school education were analyzed. Focus group interviews were held with field experts related to lower grade in elementary care class. Accordingly, the structuring of the education area and the detailed education contents were systematized. RESULTS: From the analysis results, the contents of curriculum, textbook, and administrative department were classified as hygiene safety, health, and culture. The goal of the educational content system was divided into three areas: nutritional dietary life, food hygiene and health, and food culture. The subjects consisted of dietary balance, healthy body weight, digestion and absorption, food hygiene, Korean agricultural products, traditional food, and table manners. The curriculum was composed of 12 content elements. CONCLUSIONS: In order to ensure that after-school care students can grow into healthy, growth-oriented and creative talents, the role of the caring guide is important, and associated guidelines are needed in the future.

The Effect of a Teaching Model for Improving Undergraduate Nursing Students' Cultural Competency / 한국간호교육학회지

PURPOSE: This study evaluated the effect of a teaching model to improve cultural competency (TMCC) for Korean undergraduate nursing students. METHODS: A nonequivalent control group pretest/posttest quasi-experimental study was conducted with a convenience sample of 168 undergraduate nursing students in South Korea. The experimental group of 121 seniors was taught a 13-week teaching model in order to improve cultural competence. A control group with 47 junior students underwent nursing major courses, but did not take this teaching model. Before and after the program, students' level of cultural competency was measured using the Questionnaire for Cultural Competence (QCC) consisting of three sub-scales: “awareness and desire,” “encounter,” and “nursing skill and knowledge.” RESULTS: After the experiment, the experimental group showed significantly higher improvement in the Questionnaire for Cultural Competence in the three sub-scales of “awareness and desire,” “encounter,” and “nursing skill and knowledge” than the control group (p= < .050). CONCLUSION: A teaching model to improve cultural competence was effective in improving Korean undergraduate nursing students' cultural competency. Further studies need to be repeated in order to identify the effectiveness of the teaching model to improve cultural competency with graduate or clinical nurses.

Subjective Health and Factors of Health-related Quality of Life in Elderly Haenyo

PURPOSE: To investigate the subjective health and health-related quality of life (HRQoL) in Haenyo. METHODS: Subjects were 100 elderly Haenyo in Jeju island who belonged to a fishing-village society. Main variables were activities of daily living (ADL), instrumental ADL (IADL), the HRQoL, subjective health, and depression. Subjective health and differences of HRQoL by variables were analyzed by t-test or ANOVA using IBM SPSS Statistics 23. Hierarchical multiple regression was executed to examine the effects of the major factors on the quality of life. RESULTS: The mean age was 69.9 years, the mean period for diving career was 51.5 years, and work hours per month were 37.8. Comorbidity of diseases was 2.74, and the common health problems were osteoporosis and headache/dizziness. HRQoL was significantly different by age (F=4.52, p=.013), education (F=6.10, p=.003), muljil work years (F=3.93, p=.050), depression (t=-3.04, p=.030), subjective health state (F=30.62, p < .01), and degenerative arthritis (F=-2.38, p=.019). In the final model by hierarchical multiple regression, ADL/IADL (β=.41, p < .001), depression (β=-.29, p < .001), and subjective health (β=.43~.51, p < .001) were significant and explained 63.5% of the total variance of HRQoL. CONCLUSION: Haenyo have specific health problems different from those of elderly women in general. ADL/IADL, depression and subjective health affected their HRQoL. It is clear that Haenyos' health problems need further study to improve their health.

A Study on the Curriculum of Global Health Education / 한국간호교육학회지

PURPOSE: This study aimed to understand current global health education and suggest its future direction for Korean undergraduate nursing students. METHODS: After reviewing literature to identify key concepts applicable to global health nursing curricula, the authors analyzed global health curricula from 98 nursing colleges by using a framework that was developed for this study. RESULTS: Among the 201 nursing colleges, 98 (48.8%) schools offered one or more global health-related courses. The titles of these courses were divided into two categories: Multiculturalism and international nursing. Multicultural courses were offered mainly for freshmen (40.5%) or sophomore students (40.5%), whereas international nursing courses were offered mainly for senior students (35.9%). These courses trained nursing students to be culturally competent in providing nursing care for immigrants or foreign travelers living in South Korea. CONCLUSIONS: It is evident that interest in global health education is growing in South Korea. However, the scope and content of global health education needs to be broadened beyond multiculturalism and international nursing so that it can prepare nursing students to promote global health equity, reduce global health disparities, and work competently with globally-focused organizations.

The Relationship between Cultural Competency and the Importance of Nurses' Qualities Perceived by Undergraduate Nursing Students

PURPOSE: This study was conducted to investigate the relationship between cultural competency and the importance of nurses' qualities perceived by undergraduate nursing students. METHODS: Researchers developed two tools for this study after reviewing the related literature and conducting research team workshops: questionnaire of cultural competency and the importance of nurses' qualities. 200 nursing students were recruited in convenient sampling to respond to these questionnaires. Of nurses' 10 qualities, major affecting factors on the cultural competency were identified by stepwise multiple regression analysis. RESULTS: The nursing students perceived technical nursing skills and professional nursing knowledge as nurses' most important qualities. However, 'having a passion for patient care', 'demonstrating strong nursing profession's code of ethics??and 'teaching and research ability' were found as significant influencing factors on the variance of the cultural competency. These three factors explained 16% of the total variances of the cultural competency (F=13.98, p<.001). CONCLUSION: The educational strategies to improve cultural nursing competency need to incorporate students' expectations for the professional nurses' roles. Also, further studies need to develop reliable and valid measurement tools for cultural competency

Development and an Evaluation of Educational Program for Nurse Professionals: Cultural Competency in Cancer Prevention

PURPOSE: This study aimed to develop and evaluate a nursing educational program improving nursing professional's cultural competency in cancer prevention. METHODS: An eight-hour long educational program was developed based on several preliminary research projects, one ethnography and three quantitative projects, to identify the educational needs among nursing students and professionals in Korea. Thirty two nursing professionals were recruited for a one group pretest-posttest design. Three questionnaires were used to measure cultural nursing knowledge about cancer prevention, cultural competency and perceived importance of nurses' quality. RESULTS: After completing the educational program, the clinical nurses showed a significant change in the mean score of the cultural nursing knowledge about cancer prevention from 4.78±2.01 to 8.81±1.52 (t=-8.48, p<.001) and the level of the cultural competency from 72.47±8.96 to 83.59±8.61 (t=-6.16, p<.001). Clinical nurses' perception of 'Communication ability with patients and family members' changed from 6th to 2nd most importance but 'Having a passion for the patient care' remained the most important perceived factor of nurses' quality after completing the educational program. CONCLUSION: The educational program developed was effective in improving nursing professional's cultural competency in cancer prevention. However, it needs to be improved more to be culturally specific to multi-cultural clients.

Initiation of Pharmaceutical Care Service in Medical Intensive Care Unit with Drug Interaction Monitoring Program

OBJECTIVE: It is to evaluate the drug interaction monitoring program as a pilot project to develop a pharmaceutical care model in a medical intensive care unit and to analyze the influencing factors of drug interactions. METHOD: Electronic medical records were retrospectively investigated for 116 patients who had been hospitalized in a medical intensive care unit from October to December in 2014. The prevalence of adverse reaction with risk rating higher than 'D' was investigated by Lexi-Comp(R) Online database. The factors related with potential drug interaction and with treatment outcomes were analyzed. RESULTS: The number of patients with a potential interaction of drug combination was 92 (79.3%). Average ages, the length of stay in the intensive care unit and the numbers of prescription drugs showed significant differences between drug interaction group and non-drug interaction group. Opioids (14.4%), antibiotics (7.2%), and diuretics (7.2%) were most responsible drug classes for drug interactions and the individual medications included furosemide (6.4%), tramadol (4.9%), and remifentanil (4.5%). There were 950 cases with a risk rating of 'C' (84.6%), 142 cases with a risk rating of 'D' (12.6%), and 31 cases with a risk rating of 'X' (avoid combination) (2.8%). The factors affecting drug interactions were the number of drugs prescribed (p < 0.0001) and the length of stay at intensive care unit (p < 0.01). The patients in intensive care unit showed a high incidence of adverse reactions related to potential drug interaction. Therefore, drug interaction monitoring program as a one of pharmaceutical care services was successfully piloted and it showed to prevent adverse reaction and to improve therapeutic outcomes. CONCLUSION: Active participation of a pharmacist in the drug management at the intensive care unit should be considered.

Development and Evaluation of a Nursing Educational Program to Reduce Cancer Worry of Colorectal Cancer Patients' Family Members

PURPOSE: This study was to develop and evaluate the clinical utility of a nursing educational program to reduce the cancer worry of colorectal cancer patients' family members (RCW-FM) in Korea. METHODS: The RCW-FM was developed based on several preliminary studies: an ethnographic and two quantitative studies to understand the educational needs among Korean colorectal cancer patients and their families. A one week clinical genetic educational course for clinical cancer nurses was implemented, and the RCW-FM led by cancer genetic nurses was constructed. A one group pretest-posttest design was implicated to evaluate the change of the family members' knowledge about colorectal cancer (KCR) and the level of the reduction of cancer worry (CWR). RESULTS: The mean score for KCR significantly increased from 11.75+/-1.28 to 13.87+/-1.13 (p<.05). The mean score of CWR was 4.25+/-.89. CONCLUSION: This new RCW-FM is a satisfactory educational program for reducing the cancer worry of the colorectal patients' family members. But it needs to provide more practical, specific information including a long term perspective, tailored specifically for what Korean families want to know. It should also incorporate the preventive guidelines recommended for high risk hereditary or familial colorectal cancer.

The Attitude toward Marriage, Pregnancy and Abortion among Korean Nursing Students / 한국간호교육학회지

PURPOSE: There recurred controversies related to legal allowance of abortion since newly advancing prenatal genetic testing technology. This survey was aimed to identify the attitudes toward marriage, and pregnancy (AMP) and terminating pregnancy (ATP) among Korean nursing students. METHOD: A descriptive study was performed from October to November 2012 in South Korea. 424 nursing students responded to two types of tools developed by authors. Questionnaire for ATP is consisted of 10 items with 5-points Likert Scale. Questionnaire for AMP is 12 items containing 5 categories. RESULTS: Mean score of ATP was 36.90. Students that are enrolled in bachelor degree had a significant higher ATP. Students who are currently dating with an opposite gender showed much higher level of ATP than those are not. Lower group of delayed the time of getting marriage and pregnancy showed highest score of ATP, significantly. CONCLUSION: Individual factor must be primarily considered when assessing ATP of nursing students, for example current relationship with opposite gender and educational background, attitude toward marriage and pregnancy. Further studies are needed to identify personal factors of the young adults affecting on the ATP.

A Proposed Teaching Model to Improve Cultural Competency Care for Undergraduate Korean Nursing Students / 한국간호교육학회지

PURPOSE: The aim of this study was to propose a teaching model to improve the cultural competence care of undergraduate Korean nursing students. METHODS: A literature review was performed from 2000 through 2014 using internet to identify studies that presented nursing curricula and teaching-learning strategies in Korea. We analyzed retrieved Korean seven articles using Campinha-Bacote's ASKED model in combination with reflective experiences of authors observing classrooms in the U.S. RESULTS: Six syllabuses presented information about cultural diversity nursing concepts in Korea. A traditional lecture focused on presenting contents about cultural knowledge by an instructor in the classroom was identified as a commonly used teaching strategy. We found that cultural competency related to cultural desire, awareness, and encounter was lacking. Thus, we developed teaching model based on the Korean nursing education contexts and combined with Campinha-Bacote model to improve cultural competency in nursing. CONCLUSIONS: The proposed teaching model shows promise as a strategy for improving the knowledge, attitudes, and skills related to cultural competent for undergraduate nursing students in Korea. However, evidences that this model improves nursing students' clinical practices reflecting cultural competent care are still lacking. Future research focusing on determining teaching methods and contents in clinical practices will be most effective.

Experience of Colorectal Cancer Survival Journeys: Born Again after Going Through an Altered Self Image

PURPOSE: This microethnographic study was performed to understand the survival experiences of patients after surgical resection of colorectal cancer. METHODS: In-depth interviews of seven male and six female patients with colorectal cancer were conducted after being observed. Digital-audio recordings of the interviews were transcribed verbatim and then qualitatively analyzed. RESULTS: The survival journeys of patients with colorectal cancer surgery were described as 'born again after going through an altered self-image'. This consists of 4 phases: 'Confrontation of the cancer diagnosis', 'Fierce compliance', 'Leveling off', and 'Born again'. Their self-images were significantly altered subsequent to confronting their cancer diagnosis. While they were in the phase of fierce compliance, patients were introverted from the outside world, but upon receiving help from a substantial supportive system including family, health professionals, peer patients, and religion, their internalized self-image was reinforced. This would significantly boost the patients' morale. Finally they felt born again with an emotional and spiritual self-image. CONCLUSION: Nursing intervention should be differentiated and specified according to the specific phase of the long term colorectal cancer survival journey. Colorectal cancer patients should be provided with a specialized nursing program to improve their self-images.

A Meta-analysis of Intervention on Depression in Cancer Patients

PURPOSE: The purpose of this study was to analyze the characteristics and effect size of the intervention study applied to the depression of the cancer patient. METHODS: A total of 749 studies published from 1990 to 2011 were searched through the search databases and among them, 35 examples satisfied the inclusion criteria. Three independent researchers implemented the methodological qualitative evaluation. The data were analyzed using meta-analysis. RESULTS: For the depression of the cancer patient, 19 various interventions were applied. The size of the intervention effect that can be analyzed in terms of effect size came out as OR of the laugh therapy 8.122 (p=.073), OR of the music therapy 4.418 (p=.014), OR of the integrated therapy 4.418 (p=.015). CONCLUSION: This study suggests that the music therapy and integrated therapy is effective to the depression of cancer patients. Furthermore, in order to check the effects of intervention, we should need to include more randomized controlled studies and various intervention studies.

Cancer Worry Experiences among Colorectal Cancer Patients and Families who have a Family History of Colorectal Cancer

PURPOSE: This study aims to understand the worries that patients and families with a history of colorectal cancer experience. METHODS: From January 2011 through January 2013, in-depth interviews and observations were conducted on 3 colorectal patients and 8 family members with a family history of colorectal cancer. The data were analyzed using a micro-ethnographic research method. RESULTS: After colorectal cancer patients and families realized and concerned with their increased chance of getting cancer, Eventually this worry became a motivator causing them to adhere to cancer preventive behavior. Three types of cancer worries were identified: confrontation, uneasiness, and warning. Depending on the type of cancer risk, psychological responses and cancer preventive behavior were found to be varied according on the three types of cancer worries. Patients and families tried to change dietary habits and regulary exercise. To help ease their cancer worries, they started to search for information on colon cancers and attempted to follow recommendations. However, they found that neither detailed guidelines nor systematic management from health professionals existed for families with colon cancer patients. CONCLUSION: A cancer prevention nursing program needs to be developed based on the level of cancer risk and perceived cancer worries of clients.

A job analysis of care helpers / 보건의료교육평가

The aim of this study was to examine the roles of care helpers through job analysis. To do this, this study used the Developing A Curriculum Method (DACUM) to classify job content and a multi-dimensional study design was applied to identify roles and create a job description by looking into the appropriateness, significance, frequency, and difficulty of job content as identified through workshops and cross-sectional surveys conducted for appropriateness verification. A total of 418 care helpers working in nursing facilities and community senior service facilities across the country were surveyed. The collected data were analyzed using PASW 18.0 software. Six duties and 18 tasks were identified based on the job model. Most tasks were found to be "important task", scoring 4.0 points or above. Physical care duties, elimination care, position changing and movement assistance, feeding assistance, and safety care were identified as high frequency tasks. The most difficult tasks were emergency prevention, early detection, and speedy reporting. A summary of the job of care helpers is providing physical, emotional, housekeeping, and daily activity assistance to elderly patients with problems in independently undertaking daily activities due to physical or mental causes in long-term care facilities or at the client's home. The results of this study suggest a task-focused examination, optimizing the content of the current standard teaching materials authorized by the Ministry of Health and Welfare while supplementing some content which was identified as task elements but not included in the current teaching materials and fully reflecting the actual frequency and difficulty of tasks.

Experiences of Korean-American Women with High Risk Hereditary Breast Cancer

PURPOSE: This micro-ethnographic study aimed to understand coping experiences of Korean-American (K-A) women after diagnosis with breast cancer due to a hereditary gene mutation. METHODS: Participatory observation and in-depth interviews were performed at one breast cancer screening center in Southern California, in 2005 with eleven first generation K-A immigrant women. All transcribed interviews and field notes were analyzed using ethnographic methodology. RESULTS: K-A women's experience varied based on acculturation risk factors including: limited English speaking ability; disrupted family relationships, individualistic family values, or intergenerational communication barriers; lack of Korean speaking nurses; and Korean physicians' who lacked knowledge about hereditary breast cancer risk. These risk factors led to isolation, loneliness, lack of emotional and social support. In comparison to Korean homeland women in a similar medical situation, these K-A immigrants felt disconnected from the healthcare system, family support and social resources which increased their struggling and impeded coping during their survivorship journey. These women were not able to access self-support groups, nor the valuable resources of nurse navigator programs. CONCLUSION: Professional oncology associations for nurses and physicians have a moral obligation to support and promote knowledge of hereditary cancer risk and self-help groups for non-native speaking immigrants.

Current Issues and Tasks of Genetic Cancer Nursing in Korea

PURPOSE: The purpose of this review article is to introduce how the Korean Society of Genetic Nursing (KSGN) has evolved and tried to translate genomic knowledge to nursing practice, and then to suggest the future role of genetic nurses in Korea. METHODS: A literature review was performed and the current status of genetic counselling in Korea was explored. Then the educational and clinical experiences of the authors were incorporated. Finally, the main activities of Korean nursing for genetics were identified. RESULTS: Two types of genetic counsellor certification have been issued in Korea: one is issued by the Korean Society of Genetic Medicine, another by the Korean Society of Breast Cancer since June 2011. A few Korean nursing researchers have continuously performed research related to genetic nursing and undertook several research projects funded by the government since 2003. In February 2011, KSGN was established and is now trying to establish further international networks. CONCLUSION: Nursing genetic experts should be trained to integrate all specialties for genetic counselling, so they can provide holistic genetic services including ethical, legal, and social issues (ELSI).

The Effect of Symptom Experience and Resilience on Quality of Life in Patients with Colorectal Cancers

PURPOSE: This study aimed to investigate the influence of resilience and symptom experience on quality of life. METHODS: Seventy five patients in an active treatment stage were recruited from 2 hospitals between October and December 2010. A survey including perceived health status, physical functional status, the symptom experience index, resilience, and the functional assessment of cancer therapy-colorectal (FACT-C) was completed. RESULTS: The level of FACT-C was 86.61 (+/-18.91), which was higher than for patients with colostomy, but lower than for patients in a rehabilitation stage. Participants without physical functional limitations showed higher level of both resilience and quality of life. Participants with bad health status showed a lower level of both resilience and quality of life and higher level of symptom experience. The quality of life was related to the level of resilience (beta=.373), symptom experience (beta=-.292), and perceived health status (beta=-3.961). CONCLUSION: Proactive nursing approaches to manage symptoms and to improve perceived health status would enhance the quality of life of colorectal cancer patients. Furthermore, various strategies to strengthen the level of resilience should be developed.

Assessment of Kindergarten Principals and Teachers' Performance Degree of Foodservice Hygiene Management and Foodservice Employees' Hygiene Knowledge

This research aimed to survey foodservice hygiene management practices performed by principals and teachers as well as examine foodservice employees' hygiene knowledge in kindergartens. Surveys were administered to principals, teachers, and foodservice employees at 392 kindergartens. The total average score of six categories was 4.28 out of 5.0. Average score of the production process management category was the lowest at 3.90 while safety management was the highest at 4.69. Other average scores were as follows: facilities and equipment 4.20, personal hygiene 4.14, food ingredient control 4.35, and environmental sanitation 4.39. Teachers' foodservice hygiene management practices scored 3.8 points out of 5 on average. Hygiene knowledge of foodservice employees was also tested. The mean score of foodservice hygiene knowledge was 76.29%. The lowest scoring category was personal hygiene, suggesting that foodservice employees require more knowledge on proper personal hygiene practices. Possession rates of dish sterilizer, ultraviolet sterilizer, and hand washing facilities in the kitchen were low. These equipment installation rates should be raised accordingly. To enhance control of foodservice hygiene, kindergarten management should pay more attention to education and training related to foodservice sanitation.

Communication Patterns in Korean Families during BRCA Genetic Testing for Breast Cancer / 종양간호학회지

PURPOSE: The purpose of this micro-ethnography is to examine whether science and societal changes impact family communication patterns among a convenience sample of 16 Korean women. METHODS: The authors observed family communication in the context of a new breast cancer genetic screening and diagnostic testing program to detect BRCA gene mutations in Korean women at highest risk. RESULTS: Analysis of in-depth interviews and field notes taken during participant observation illustrated that communication patterns in families vary according to a woman's position in the family. If a grandmother tests positive for a gene mutation, her daughters make decisions on her behalf; they open and maintain the communication channel among family members. If a housewife is diagnosed with cancer and a genetic mutation, she immediately consults her husband and her sisters. The husband creates an open communication channel between his wife, his parents and his siblings. As a result, a woman's cancer is a concern for the whole family not merely a woman's secret or crisis. CONCLUSION: Cultural differences are important to consider when designing new genetic service programs in different countries.