Effects of Health Education Using Virtual Reality for Adolescents: A Systematic Review and Meta-Analysis.

PURPOSE: This study aimed to evaluate the effects of health interventions using virtual reality (VR) on improving knowledge, attitudes, and skills; and inducing behavioral change among adolescents. METHODS: This study is a systematic review and meta-analysis following PRISMA guidelines. We searched Cochrane, MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Korean databases between database inception and April 10, 2021. Based on heterogeneity, a random- or fixed-effects model was used, as appropriate, to calculate effect sizes in terms of the standardized mean difference (SMD) and odds ratio (OR). Studies were selected if they verified the effects of health education using VR on adolescents; there was an appropriate control group; and if the effects of education were reported in terms of changes in knowledge, attitudes, skills, or behaviors. RESULTS: This analysis included six studies (n = 1,086). The intervention groups showed greater responses in knowledge and attitudes (SMD = 0.57, 95% confidence interval (CI) [0.12 to 1.02]), skills related to health behavior (SMD = -0.45, 95% CI [-0.71 to -0.19]), and behavioral change after 12 months (OR = 2.36, 95% CI [1.03 to 5.41]). CONCLUSION: The results confirm the effectiveness of health interventions using virtual reality (VR). Although the analysis include a small number of studies, a case can be made for health interventions using VR to be utilized as educational methods and strategies to prevent risky behaviors among adolescents.

How do mothers with young children perceive endocrine-disrupting chemicals?: an exploratory qualitative study.

PURPOSE: Despite the health impacts of endocrine-disrupting chemicals (EDCs) beginning in the early stages of life, there is little research on the perception of EDCs among Korean mothers, who are primarily responsible for protecting children. This study aimed to explore how mothers with young children perceived EDCs for their concerns, the issues they faced, and the way they dealt with them. METHODS: An exploratory qualitative design was utilized. Twelve mothers who were recruited from snowball sampling participated in voluntary interviews. Individual in-depth interviews lasting approximately 47 to 60 minutes were recorded and transcribed verbatim. The data were analyzed using qualitative content analysis as suggested by Graneheim and Lundman. RESULTS: Four categories, 10 subcategories, and 25 condensed meaning units were identified by interpreting mothers' underlying meanings. The four categories were 'Knowledgeable yet contrasting ideas regarding EDCs,' 'Negative health impact, but more so for children,' 'Inaction or trying to minimize exposure,' and 'Need for early, reliable resources and social change.' Mothers were knowledgeable about EDCs and actively needed further education and support. While they tended to focus more on the health impact of EDCs on their children and were optimistic about their health risks, paying less attention to their preventive behaviors. CONCLUSION: Healthcare professionals must consider mothers' perceptions of EDCs in future education and interventions regarding EDCs impact on women's life stages such as puberty, pregnancy, and childrearing. Also preventive strategies that can be applied to their daily lives are needed.

Korean healthcare providers' attitude, knowledge, and behaviors regarding sexual orientation and gender identity: a cross-sectional survey.

Purpose: This study investigated Korean healthcare providers' attitudes toward sexual and gender minority (SGM) persons and their knowledge and behavior concerning the collection of data on sexual orientation and gender identity (SO/GI). Methods: In this cross-sectional, descriptive study, 137 Korean healthcare providers were recruited through convenience sampling from internet communities for medical professionals. A structured questionnaire was created using Google Surveys. The Mann-Whitney U-test, Kruskal-Wallis test, and Spearman correlation analysis were performed. Results: The sample was mostly women (80.3%) and nurses (83.9%), who overall negative attitudes toward SGM persons and low levels of knowledge and behavior with regard to the collection of patients' SO/GI data. Participants in their 20s, who were religious, and had clinical experiences in treating or providing nursing care for SGM persons had higher levels of knowledge about the collection of SO/GI data. The level of engagement in collecting SO/GI data was higher among women and in their 20s and 30s, unreligious participants, nurses, and those with less than 10 years of clinical experience. Positive attitudes toward SGM persons were associated with higher levels of knowledge, but lower levels of behavior, regarding the collection of SO/GI data. Conclusion: It is important to recognize the diversity of patients' SO/GI and to collect the corresponding information. To this end, it is necessary to develop and use a standardized SO/GI form. Healthcare providers should also receive education and training related to the health of SGM persons to resolve health problems that disproportionately affect SGM persons and related health disparities.

Learning effects of virtual versus high-fidelity simulations in nursing students: a crossover comparison.

BACKGROUND: Simulation is an alternative or complementary method for students who cannot obtain sufficient direct care experience, as they allow students to experience various clinical situations. Mixed learning is becoming increasingly common as a way to provide students with opportunities to experience real-life clinical scenarios. This study compared the learning effects of a virtual simulation and a high-fidelity simulation in a different order of presentation, with a focus on training for premature rupture of membranes in the field maternity nursing. Through this comparison, this study aimed to obtain evidence to support decision-making regarding the most effective way to utilize mixed simulation strategies. METHODS: A quasi-experimental, crossover-design study was performed with two randomly allocated groups of 26 junior nursing students each. The virtual simulation used the vSim® for nursing, and the high-fidelity simulation used a scenario developed by the research team. The learning effects were measured in terms of the problem-solving process, clinical reasoning, reflective thinking, satisfaction with the practicum, and self-confidence. The data collected with a structured questionnaire were analyzed using the Mann-Whitney test. RESULTS: The virtual simulation-first, high-fidelity simulation-second order led to significantly higher scores for reflective thinking (z = 3.53, p < .001) and self-confidence (z = 2.47, p = .013) than the other order. CONCLUSIONS: The initial application of virtual simulation seemed to improve students' thought processes, and then high-fidelity simulation seemed to allow them to perform actual practice better. Further trials of mixed learning methods are necessary to maximize learning effects in nursing education. TRIAL REGISTRATION: KCT0005767  at 2021-01-12 registered.

Effects of an action-guided intervention on optimistic bias and protective behaviors regarding endocrine disruptors in young women.

This study examined the effects of an action-guided intervention on reducing optimistic bias about reproductive health problems related to endocrine disruptors and improving protective behaviors against endocrine disruptors. A quasi-experimental design with a nonequivalent comparison group was used with a pretest and double posttest. With a convenience sample of 140 women, 60-minute online education sessions and a 30-minute booster session were provided to seven small groups, while the comparison group received a leaflet. Data were collected at baseline and 4 and 12 weeks post-intervention. Descriptive statistics, repeated-measures ANOVA, and the McNemar test were conducted. A significant difference was found in protective behaviors between the groups (F = 81.21, p < .001). The effects remained consistent over time (F = 59.96, p < .001) and there was an interaction effect of group and time (F = 41.26, p < .001). The proportion of women with optimistic bias about reproductive health problems related to endocrine disruptors was significantly lower in the experimental group than in the comparison group only at 12 weeks post-intervention (χ2 = 33.56, p = .031). Accurate knowledge and information should be provided to women to build realistic awareness of the lifestyle-related health problems caused by endocrine disruptors.

Differences in metabolic syndrome indicators by body mass index of women with endometriosis.

AIM: The study aimed to identify the relationships between metabolic syndrome indicators and BMI in women with endometriosis. DESIGN: A retrospective observational study design was utilized to analyse secondary data from a longitudinal dataset. METHODS: A total of 281,810 women diagnosed with endometriosis and aged 15 through 49 were drawn from the National Health Insurance Service-National Health Screening Cohort data of the Republic of Korea from the year 2009 to 2016. Body mass index (BMI) and five indicators of metabolic syndrome were extracted. Descriptive statistics, Cochran-Mantel-Haenszel test, chi-square test and Cochran-Armitage test were used. RESULTS: Yearly changes in abnormal waist circumference, elevated fasting blood sugar and abnormally low levels of high-density lipoprotein cholesterol were statistically significant. The risk groups of these indicators all showed statistically significant differences according to BMI. The proportions of women with abnormal findings for all indicators significantly increased as BMI increased.

Effects of a dietary modification intervention on menstrual pain and urinary BPA levels: a single group clinical trial.

BACKGROUND: Exposure to endocrine-disrupting chemicals (EDCs) occurs mainly through dietary intake. Due to current lifestyle trends, young people tend to consume fast food, to use disposable products, and to utilize convenient household items, all of which are major sources of EDCs. This study aimed to investigate the effects of a dietary modification intervention on menstrual pain and urinary bisphenol A (BPA) levels throughout three menstrual cycles in female college students who experienced severe menstrual pain. We also analyzed participants' adherence to the intervention and examined whether their level of adherence was associated with differences in the effects of the intervention. METHODS: A single-group pretest and repeated posttest experimental design was employed. Thirty female college students with a score of 5 or higher on a menstrual pain scale were recruited through convenience sampling. During three menstrual cycles, menstrual pain was scored on a 10-point scale after each cycle, and urinary BPA levels were measured from the first morning urine collected after each cycle. The intervention involved three components: small-group education, follow-up monitoring, and peer support via social network communication. Statistical analyses were conducted using Friedman one-way repeated-measure analysis of variance by ranks, non-parametric two-way analysis of variance, and the Wilcoxon signed-rank test as a post-hoc test. RESULTS: The dietary modification intervention had significant effects on menstrual pain at all three time points of menstrual cycles (χ2 = 119.64, p = 0.000) and on urinary BPA levels until the 2nd menstrual cycle (χ2 = 205.42, p = 0.000). Slightly fewer than half (43.3%) of the participants were highly adherent. Menstrual pain differed according to adherence level (F = 4.67, p = 0.032) and decreased over time through the third cycle post-intervention (F = 18.30, p = 0.000). Urinary BPA levels also decreased significantly (F = 7.94, p = 0.000), but did not differ according to adherence level. CONCLUSIONS: The dietary modification intervention was effective and sustainable for reducing menstrual pain and urinary BPA levels. Detailed information about EDCs and dietary experiences seemed to encourage the young women to become more concerned about EDCs and to perform self-protective actions. Further experimental research is suggested to examine the relationships of EDCs with various health indicators in women. TRIAL REGISTRATION: KCT0005472 at 2020-9-24 retrospectively registered.

[Effects of nursing intervention programs for women with gestational diabetes: a systematic review of randomized controlled trials]. / ìž„ì‹ ì„± 당뇨병을 가진 임산부를 위한 간호중재 프로그램의 효과: 무작위 대조군 실험연구의 ì²´ê³„ì  ë¬¸í—Œê³ ì°°.

Purpose: This study aimed to identify the effects of nursing intervention programs for women with gestational diabetes mellitus (GDM) through a critical review of recent studies. Methods: Studies related to effects of nursing intervention programs for women with GDM published in English or Korean between 2000 and 2019 were extracted from 10 electronic databases. The quality of the studies was evaluated and double-checked for accuracy by two reviewers using the Revised Cochrane Risk-of-Bias tool for randomized controlled trials. Results: Twenty studies were selected, of which 19 had a low risk of bias and one had a high risk of bias. Interventions fell into six main groups: (1) integrated interventions, (2) self-monitoring of blood glucose levels, (3) dietary interventions, (4) exercise, (5) psychotherapy, and (6) complementary therapy. This review found that nursing interventions for GDM were of many types, and integrated interventions were the most common. However, low-carbohydrate diets and blood glucose monitoring interventions did not show statistically significant results. Evidence shows that various nursing intervention programs applied to GDM improved diverse aspects of maternal, fetal, and neonatal health, including both physical and psychological aspects. Conclusion: The composition and delivery of integrated interventions continue to evolve, and these interventions affect physical and psychological indicators. Although interventions affecting physical health indicators (e.g., blood glucose levels, diet, and exercise) are important, many studies have shown that programs including psycho-emotional nursing interventions related to anxiety, depression, stress, self- efficacy, and self-management are also highly useful.

Determinants of Protective Behaviors Against Endocrine Disruptors in Young Korean Women.

PURPOSE: A convenience-oriented lifestyle in young people is accompanied by greater consumption of and exposure to endocrine disruptors, which can affect reproductive health, especially in women. We aimed to identify factors that influence protective behaviors against endocrine disruptors among female college students in South Korea. METHODS: Using a cross-sectional survey design, we recruited 199 female college students. A self-administered questionnaire was used, and data were collected at the site. RESULTS: A healthy lifestyle, information utilization, receiving peer advice on avoiding exposure to endocrine disruptors, and a history of environmental illnesses were found to be significant factors, explaining 42.0% of the variance in protective behaviors against endocrine disruptors. CONCLUSION: Health consequences of environmental hazards and importance of maintaining a healthy lifestyle need to be emphasized in young women's healthcare. Health professionals should advocate for and empower women to protect themselves against endocrine disruptors.

[Prevalence of Menstrual Disorders according to Body Mass Index and Lifestyle Factors: The National Health Insurance Service-National Health Screening Cohort in Korea, 2009~2016].

PURPOSE: This study was performed to identify the prevalence of menstrual disorders in Korean women based on body mass index (BMI) and lifestyle factors, by utilizing the Korean National Health Insurance Database. METHODS: A retrospective observational study design was used for the secondary data analysis. Data of women aged 15 to 49 years who were diagnosed with menstrual disorders were extracted from The National Health Insurance Service-National Health Screening Cohort in Korea from 2009 to 2016. The age-standardized prevalence rate of menstrual disorders was calculated using SAS version 9.4, and a Chi-square test and Cochran-Armitage test were performed. RESULTS: In total, 2,219,445 cases were extracted from the database. The prevalence of menstrual disorders significantly increased from 8.6% to 11.6% (Z=135.16, p for trend <.001) over the past eight years. In particular, it was higher in underweight women than in women with normal weight across all years (Z=-4.18~-14.72, p<.001). Moreover, statistically significant differences in the prevalence of menstrual disorders were found to be associated with drinking and smoking in all years and with physical activity levels in part (p<.05~.001). CONCLUSION: These findings present compelling evidence on the prevalence of menstrual disorders based on a national database. Since the prevalence of menstrual disorders has steadily increased and differs based on BMI and lifestyle factors, educational and clinical interventions are necessary to promote risk awareness and appropriate behavioral changes among Korean women.

Health behaviors related to endocrine-disrupting chemicals and the associated factors of adolescent Korean girls.

In this cross-sectional study, we examined the relationships among knowledge about endocrine-disrupting chemicals (EDCs), recognition of EDCs-related female reproductive illnesses, concern for the environment, perceived susceptibility to EDCs-related diseases, self- appraisal of exposure to EDCs, and health behaviors related to EDCs in adolescent Korean girls. A convenience sample of 218 girls was recruited during July and August 2015 from middle and high schools located in a city in Korea. The self-administered questionnaire incorporated four characteristics of the participants, five related factors, and a dependent variable of health behaviors. Four of the factors explained 20.4 percent of variance in health behaviors, and after controlling covariates, concern for the environment and self-appraisal of exposure to EDCs were still significant factors explaining 29.0 percent of the variance in health behaviors. However, for one factor, knowledge about EDCs, no independent contribution to health behaviors was observed. The findings indicated that education for young women should focus on enhancing their interests in the environment and awareness of environmental hazards. Further, clear and reliable guidelines to protect young women from the exposure to EDCs should be provided to adolescent girls.

Effects of tailored message education about breast cancer risk appraisal for obese Korean women.

PURPOSE/OBJECTIVES: To examine the effects of tailored message education about breast cancer risk in obese Korean women. DESIGN: Pretest/post-test with two comparison treatments. SETTING: Rural community settings in South Korea. SAMPLE: Non-random sample of 64 obese women. METHODS: Based on the Health Belief Model, tailored message education involved a one-session individual approach addressing cognitive, emotional, and behavioral domains. The comparison group received a one-time standard education group session. Data on breast cancer risk factors and mammography findings were recorded. MAIN RESEARCH VARIABLES: Knowledge, awareness, emotional barriers, self-efficacy, and intent to screen and prevent breast cancer. FINDINGS: Compared to standard education, tailored message education showed significantly higher score changes on awareness of personal risk (F = 5.21, p < 0.05), self-efficacy for breast self-examination (BSE) (F = 5.16, p < 0.001), intent to perform BSE (F = 6.24, p < 0.05), intent to have mammography (F = 5.45, p < 0.05), and intent to prevent breast cancer with eating habits (F = 7.28, p < 0.05) and exercising (F = 12.51, p < 0.001). CONCLUSIONS: Individually tailored education effectively enhanced awareness of personal risk for breast cancer, self-efficacy for BSE, and intent to screen and prevent breast cancer. IMPLICATIONS FOR NURSING: Tailored message education targeting breast cancer and risk associated with obesity is useful in breast cancer screening education. Future studies should incorporate individualized messages on nutrition, exercise, and cultural barriers to reduce breast cancer risk in obese women. KNOWLEDGE TRANSLATION: Individual educational strategies can effectively enhance breast cancer prevention and early screening. Public and preventive education should include a focus on cultural, cognitive, and emotional domains. For obese women, a heightened awareness and self-efficacy may influence screening behaviors.

Estimated risks and optimistic self-perception of breast cancer risk in Korean women.

AIM: To determine women's perceived personal and comparative risks of breast cancer, and to examine the relationships with risk factors. BACKGROUND: Despite the increasing incidence of breast cancer in younger women and the availability of screening, women's health behaviors have not advanced accordingly. METHODS: A cross-sectional survey design utilized a convenience sample of 222 women in their 30s and 40s recruited from community settings in Seoul. Self-administered questionnaire data were analyzed by descriptive statistics, the chi-squared test, and ANOVA. RESULTS: Risk perception levels differed significantly by breast cancer risk factors. Half of the women were optimistic about their breast cancer risk, while perceived personal risk did not reflect women's own risk factors and comparative risk differed only by the practice of clinical breast exam. CONCLUSIONS: Women's knowledge and awareness of their breast cancer risk factors need to be improved for appropriate risk perception and health behaviors, and accurate risk estimation could be utilized to educate them in clinical settings.

Comparisons of health conditions of immigrant and domestic women in Korea and China using propensity score matching.

We identified how the health of the growing Korean-Chinese (KC) female immigrant population differed from comparable domestic women. Using propensity score matching, we selected 227 women recruited from Korea and China; perceived health status, female cancer screening behaviors, and the Health Promoting Lifestyle Profile II were investigated. The KC women in Korea had the lowest levels of physical and mental health as well as health promoting lifestyles, but performed female cancer screenings better than other women. Considering their vulnerability, the hosting country should provide accessible health services at reasonable fees for KC women in Korea to enhance their health.

Systematic review of exercise effects on health outcomes in women with breast cancer.

PURPOSE: Exercise is commonly recommended to women after breast cancer surgery, yet it is difficult for patients and health professionals to adopt safe and beneficial types and modes of exercise. Thus studies on exercise interventions targeting women with breast cancer treatment were systematically reviewed. METHODS: The review process and quality assessment of the studies followed the guideline of the National Evidence-based Healthcare Collaborating Agency. Relevant studies were obtained from electronic databases, and two trained reviewers independently analyzed the studies. Of the 902 articles sorted, 11 were selected. Then, quality assessment for each study was carried out with the Scottish Intercollegiate Guideline Network (SIGN) checklist. RESULTS: Seven different types of exercise interventions were identified from 3 quasi-experimental and 8 randomized controlled trial studies. The interventions varied in duration from several days to 13 weeks, and tended to show significant effects on psychological outcomes and upper body functions within a short-term period and were effective in alleviating lymphedema at a longer 1-year point. Supervised, professional intervention had significant effects on health indicators and a higher adherence rate. CONCLUSION: Well-designed exercises are effective and beneficial for improving women's physical, physiological, and psychological health outcomes after breast cancer treatment as well as to facilitate changes in exercise behaviors. The feasibility of applying intervention protocols, efficiency of interventions, and strengths of exercise protocols should be further examined.

Couples' experiences of breast cancer in Korea: a descriptive qualitative study.

BACKGROUND: Breast cancer is not a disease merely experienced by the diagnosed woman. Despite the increased prevalence of breast cancer in Korea, the impact of the illness on married couples has not previously been studied. OBJECTIVE: This study aimed to explore the experiences of women with breast cancer and their spouses in South Korea. METHODS: A descriptive, single-occasion study design was used. Fourteen participants, comprising 7 dyads, were recruited from a university-affiliated hospital breast clinic in Seoul. Inclusion criteria were that the women were married and with a diagnosis of primary breast cancer without metastasis or recurrence. Using a semistructured interview schedule, interviews were conducted in a private room. Audio-recorded data in the Korean language were translated into English and coded using an inductive content analysis method. RESULTS: The core constructs found in the experiences of women, husbands, and couples were "Coming Into My Own Voice," "Doing What It Takes to Keep Her Alive," and "Learning Through Struggling," respectively. CONCLUSIONS: The diagnosis of breast cancer caused substantial distress for the couples and was transformative for the women and their husbands. The couples were still experiencing some unresolved hardships that required open communication and mutual effort for coping. IMPLICATIONS FOR PRACTICE: Health care practitioners should be sensitive to the cultural traditions and values that couples with breast cancer hold. After training nurse interventionists, educational counseling interventions should be launched, so as to empower the dyads.

Comparison of breast cancer risk estimations, risk perception, and screening behaviors in obese rural Korean women.

PURPOSE/OBJECTIVES: To assess three breast cancer risk assessment tools in obese rural Korean women. DESIGN: Cross-sectional survey design. SETTING: Community settings in the rural region of northeastern South Korea. SAMPLE: A nested cohort sample of 64 severely obese women aged 40-60 years from the Korean Genomic Regional Cohort registry. METHODS: The Breast Cancer Risk Assessment Tool of the National Cancer Institute (BCRAT-NCI), Breast Cancer Risk Appraisal for Korean Women (BCRA-K), and Estimation of Individualized Probabilities of Developing Breast Cancer for Korean Women (EIPDBC-K) were used for interview data. Mammography, women's perceptions, and screening behaviors also were analyzed. MAIN RESEARCH VARIABLES: Breast cancer risk assessment, mammography findings, women's perceptions of breast cancer risk, and breast cancer screening behaviors. FINDINGS: A total of 5 (BCRAT-NCI), 19 (BCRA-K), and 43 (EIPDBC-K) women were at higher (above average or high) risk for breast cancer. The BCRA-K (r = 0.28, p < 0.05) and EIPDBC-K (r = 0.43, p < 0.001) correlated with mammography findings. However, the BCRAT-NCI correlated only with the BCRA-K. Women's breast self-examination (χ2 = 4.77, p < 0.05) and mammography findings (χ2 = 5.22, p < 0.05) differed according to their risk perception. CONCLUSIONS: Risk assessment by the BCRA-K and EIPDBC-K was related to mammography findings. Women's perception of breast cancer risk influenced their screening behaviors. When choosing a risk assessment tool, healthcare professionals should consider the ethnic and cultural backgrounds of the target population. IMPLICATIONS FOR NURSING: Healthcare professionals should use appropriate risk assessment tools in breast cancer education and counseling to help women understand their risk factors and adopt proper health behaviors.

Context of barriers to Pap testing in Korean women.

Because efforts to increase the Papanicolaou (Pap) test rate have not been effective in Korea, there is an urgent need to identify the underlying context of the barriers to Pap testing. Twenty-three women aged 27-37 years were organized into four focus groups for a qualitative analysis of their attitudes and feelings about the Pap test. Five contextual themes of barriers were identified under the categories of "misconceptions attributable to women's experiences of Pap testing" and "issues related to the health care system." Educational and clinical implications in regard to women, health care professionals, and the health service environment were discussed to increase the Pap test rate.

Effects of a cognition-emotion focused program to increase public participation in Papanicolaou smear screening.

OBJECTIVE: Despite high incidence rates of cervical cancer in Korea, Papanicolaou (Pap) tests are not utilized as a preventive behavior. This study examined the effects of an emotion-cognition focused program on the decision of taking Pap tests in Korean women. DESIGN: A non-equivalent control group post-test only design was utilized. SAMPLE: A convenience sample was randomly assigned to either experimental (N=48) or control group (N=48) after matching for education and age. MEASUREMENTS: Knowledge of Cervical Cancer and Pap Smear Test, Champion's Health Belief Model, and Self-Efficacy Scale were used. Intention and stage of adoption to take a Pap test were measured with single items. RESULTS: Women in the experimental group had significantly higher scores on knowledge of cervical cancer (t=6.99, p<.001) and perceived benefits of Pap tests (t=2.91, p<.05), lower scores on procedural (t=-2.45, p<.05) and cognitive (t=-2.66, p<.01) barriers to testing. Improvement in self-efficacy (t=3.38, p<.01), strong intention to have the test (t=2.99, p<.01), and advanced stages of behavior adoption (chi2=12.93, p<.01) were also found. CONCLUSIONS: Women's perspectives, attitudes of health care practitioners, and clinical environment need to be considered if change is to happen in women's preventive behavior related to Pap test screening.

Effect of Taegyo-focused prenatal education on maternal-fetal attachment and self-efficacy related to childbirth.

PURPOSE: To examine the effect of Taegyo-focused prenatal classes on maternal-fetal attachment and self-efficacy related to childbirth. METHODS: Over 4 weeks, 49 women, 20 to 36 weeks of gestation participated in a prenatal program led by the nurse who developed it. In addition to Lamaze content it included; understanding ability of fetus to respond, sharing motivation, purpose of pregnancy, and preconceptions of experiencing childbirth, training in maternal-fetal interaction, writing letters and making a declaration of love to unborn baby. Using a pre-experimental design, data were collected by self-report, before and after program, using Cranley's Maternal-Fetal Attachment Scale (1981), and Shin's (1997) Labor Self-Efficacy Measurement. RESULTS AND CONCLUSION: Paired t-test showed significant changes in scores of maternal-fetal attachment (t=6.91. p<.001) and self-efficacy related to childbirth (t=10.19, p<.001). Taegyo opens the possibility of integrating Western ideas with Korean traditional health behavior. Incorporation of Taegyo into existing prenatal classes is recommended.