Age and Gender Differences in Fall-Related Factors Affecting Community-Dwelling Older Adults.

BACKGROUND: Falls are one of the major adverse events affecting older adults that can result in serious injuries. Hospitalizations and deaths because of fall-related injuries have been increasing. Nevertheless, there is a dearth of studies examining the physical condition and current exercise habits of older adults. Moreover, studies analyzing the role of factors related to fall risk by age and gender in large populations are also scarce. PURPOSE: This study was designed to investigate the prevalence of falls among community-dwelling older adults and elucidate the effects of age and gender on the related factors using a biopsychosocial model. METHODS: This cross-sectional study utilized data from the 2017 National Survey of Older Koreans. On the basis of the biopsychosocial model, the biological factors related to falls included chronic diseases, number of medications, visual difficulties, activity of daily living (ADL) dependence, lower-limb muscle strength, and physical performance; psychological factors included depression, cognitive ability, regular smoking, alcohol consumption, nutritional status, and exercise; and the social factors included educational level, annual income, living conditions, and instrumental ADL dependence. RESULTS: Of the 10,073 older adults surveyed, 57.5% were women and approximately 15.7% had experienced falls. The results of the logistic regression showed that, in men, falls were significantly associated with taking more medications and being able to climb 10 stair steps; in women, falls were significantly associated with poor nutritional status and instrumental ADL dependence; and in both genders, falls were significantly associated with greater depression, ADL dependence, and the presence of more chronic diseases and negatively associated with physical performance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results suggest that practicing kneeling and squatting is the most effective strategy for reducing fall risk in older adult men and that improving nutritional status and strengthening physical ability is the most effective strategy for reducing fall risk in older adult women.

Effects of on-campus and off-campus smartphone overdependence prevention programs among university students.

PURPOSE: To evaluate effects of self-determination theory-based on-campus and off-campus prevention programs on smartphone overdependence among university students. METHODS: This was a pre-posttest quasi-experimental study with a nonequivalent control group. Seventy-eight students were recruited as participants. They were allowed to choose either an experiment group or a control group (CG). On-campus smartphone overdependence prevention program was provided to participants in experimental group 1 (EG1), while on-campus program combined with off-campus prevention camp was provided to those in experimental group 2 (EG2). Instruments used in this study included a smartphone overdependence self-diagnosis scale, a basic psychological needs scale, and a self-regulation ability scale. Data collection was performed at baseline, immediately after intervention, at one month and three months after intervention. Data were analyzed using mixed analysis of covariance (ANCOVA). Focus group interview (FGI) was performed for qualitative evaluation. RESULTS: After the intervention, smartphone overdependence and basic psychological needs exhibited significant interactions between group and time. Smartphone overdependence scores decreased in EG1 and EG2, but increased in CG (F = 4.56, p = .001). Basic psychological needs improved in EG1 and EG2, but deteriorated in CG (F = 5.04, p = .009). FGIs reveaaled that participants strived to control their smartphone usage through individual efforts and by interacting with new friends in college even after completing the program. CONCLUSION: In this study, on-campus only program and combined intervention of on- and off-campus programs were both effective in maintaining and managing smartphone use. However, participants perceived that the off-campus program provided an opportunity to apply the theory learned on-campus to the real world.

Effects of Life Skill Training on the School Violence Attitudes and Behavior Among Elementary School Children.

This study evaluated a life skill training program on school violence given to elementary school children. A quasi-experimental study was conducted, and a 12-week intervention was implemented targeting 70 students aged between 10 and 11 years. The instruments included peer competency, attitudes toward school violence, experience of school violence, and the Self-Control Rating Scale. The data were analyzed using repeated measure analysis of variance. A significant difference was observed between the groups over time on peer competency (F = 4.17, p = .020), attitudes toward school violence (F = 6.02, p = .004), and violence experience as a victim (F = 3.49, p = .036) and as a perpetrator (F = 3.87, p = .026). In the experimental group, the mean scores for peer competency increased compared to the control group, whereas school violence experience decreased at the posttests. A 12-week program of life skill training offered to children was effective in promoting peer competency and attitudes toward school violence, while decreasing the experience of school violence.

Level of Acculturation and Acculturative Stress Perceived by Asian Immigrant Women Married to South Korean Men.

INTRODUCTION: Married immigrant women experience cultural conflicts due to different values, and customs. This study examined the factors associated with the acculturation and acculturative stress of Asian immigrant women in South Korea. METHOD: A cross-sectional descriptive study was performed. A total of 142 participants were recruited from Incheon Multicultural Centers in 2016 using a convenience sampling method. Acculturation and acculturative stress were measured by Suinn-Lew Self-Identity Acculturation Scale and Social Attitudinal Familial Environment. The data were analyzed using analysis of variance and multiple regression analysis. RESULTS: Time since immigration was negatively associated with the level of acculturation, while alcohol consumption (p < .050). Some demographic variables (age, religion, anxiety, and time since immigration) were associated with acculturative stress (p < .050). DISCUSSION: These findings can help health care providers to increase their awareness and be more sensitive when providing services to these women.

Influence of group resilience on job satisfaction among Korean nurses: A cross-sectional study.

PURPOSE: This study examined whether the individual and organisational factors of ecological systems theory are associated with job satisfaction among nurses in South Korea. BACKGROUND: Nursing shortages and high turnover rates are a global issue in healthcare settings, and job satisfaction is significantly associated with the turnover intention of nurses. Therefore, efforts to promote job satisfaction are needed to decrease the high turnover rates among nurses and promote care quality and patient safety. DESIGN: A cross-sectional study was performed. This paper adhered to the STROBE guidelines. METHODS: A sample of 438 nurses working in five secondary or tertiary hospitals was surveyed. The study instruments included work-life balance, resilience, insomnia and job satisfaction. RESULTS: Using multilevel analysis, both individual and organisational factors were associated significantly with job satisfaction, and variance at the group level accounted for 19.98% of the total variance of job satisfaction. Among the individual factors, marital status and work-life balance were significantly associated with job satisfaction. At the organisational level, the group mean resilience score was significantly associated with job satisfaction (p < .05). CONCLUSION: The psychosocial characteristics of individual nurses and their affiliated groups (nursing units) were significant in explaining the job satisfaction of nurses. RELEVANCE TO CLINICAL PRACTICE: Both individual-focused and group-focused interventions are needed to improve job satisfaction and decrease the turnover intention.

Concomitants of menopause-specific quality of life in premenopausal and post-menopausal women living in South Korea.

The present study investigated the concomitants of menopause-specific quality of life among premenopausal and postmenopausal women. Based on the Wilson and Cleary model of quality of life, this cross-sectional study recruited 329 women of age 40-65 years following operational convenience. The study was conducted in the office of the Korea Population, Health and Welfare Association (KPHWA) in Incheon, South Korea. Data collected on sociodemographic characteristics, social support, biological/physiological characteristics, the Pittsburgh Sleep Quality Index (PSQI-K), and self-rated health. Menopause-specific quality of life questionnaire (MENQOL) was used in this study. Hierarchical multiple linear regression analysis was performed. The study found that social support and self-rated health were negatively correlated with MENQOL in premenopausal women, while the income level and self-rated health were negatively associated with MENQOL in postmenopausal women. Sleep quality was positively correlated with MENQOL in both premenopausal and postmenopausal women. The study results indicate the need for tailored approaches based on menopausal status. Especially, social support may help improve the MENQOL of premenopausal women, while in postmenopausal women, improved sleep quality may enhance their menopause-specific quality of life.

Efficacy of Cognitive Behavioral Treatment for Insomnia: A Randomized Controlled Trial.

This study examined the effects of cognitive behavioral treatment for insomnia. A randomized controlled trial was performed on 44 women. The intervention included one group session of sleep hygiene education and four individual sessions of counseling. The instruments included the Insomnia Severity Index, Pittsburgh Sleep Quality Index, the Center for Epidemiological Studies Depression Scale, and Menopausal quality of life. The data were analyzed using repeated measure MANOVA, followed by repeated measure ANOVA. Repeated measure MANOVA showed that time had a significant main effect on the anthropometric variables (body mass index, waist circumference, and blood pressures) and revealed significant main effects of the group and time on the psychosocial variables (sleep quality, insomnia, depressive symptoms, and quality of life) (p < .05). Repeated measure ANOVA results indicated a significant effect of the group on insomnia and sleep quality (p < .05). Overall, the intervention was effective in improving insomnia and poor sleep quality.

Evaluation of the Interaction Model of Client Health Behavior-based multifaceted intervention on patient activation and osteoarthritis symptoms.

PURPOSE: This study evaluated a multifaceted intervention for osteoarthritis symptoms. METHODS: A cluster randomized controlled trial was conducted with a convenience sample of 90 patients aged between 45 and 82 years, who were recruited from three Community Health Posts (CHPs). The CHPs were randomized into two experimental groups (E1 and E2) and one control group (C). The intervention included health education and counseling combined with exercise classes based on the Interaction Model of Client Health Behavior. Trained community health nurse practitioners led the intervention. Stretching exercise (E1) and walking (E2) combined with muscle strengthening exercise were provided. The instruments included the Patient Activation Measure (PAM), Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), Stanford Health Assessment Questionnaire Disability Scale (HAQDS), and Center for Epidemiologic Studies Depression Scale (CES-D). The HAQDS was measured using an ordinal scale, and Likert scales were used for the other instruments. Chi-square test and analysis of covariance were used; P values <.05 were considered significant. The study was conducted in 2014. RESULTS: The groups were similar at the baseline (P > .05) except for joint pain and patient activation (P < .05). At post-test, the changes in the mean scores were significant for joint pain and stiffness, and physical functioning. E2 with walking exercise showed better improvements in joint pain and physical functioning than the other groups (P < .01). CONCLUSIONS: Eight sessions of multifaceted intervention improved the osteoarthritis symptoms. Follow-up studies will be needed to determine the intermediate and long-term effects of the multifaceted intervention.

Screen Time and Cardiovascular Risks Among Middle-Aged Women.

BACKGROUND: Screen time is a marker of sedentary behavior that threatens the health of women. Extended screen time is associated with depression, insomnia, cardiovascular disease, and decreased quality of life. OBJECTIVE: In this study, we examined the factors associated with screen time and whether screen time is associated with the physiological and psychosocial health of middle-aged women. We applied a psycho-socioeconomic biobehavioral model of health and studied the outcomes of cardiometabolic biomarkers, insomnia, and quality of life. METHODS: Secondary data analysis was performed using data from a cross-sectional study conducted with 423 women between 40 and 65 years of age. Socioeconomic, physiological, psychosocial, and behavioral characteristics were measured. Self-reported screen time during the past week was measured using an ordinal scale. The data were analyzed using multivariate analysis of covariance, analysis of covariance, and logistic regression analysis. RESULTS: Twenty-four percent of subjects had at least 3 hours per day of screen time on weekdays, whereas 30.7% had at least 3 hours per day on weekends. Older women, unemployed women, and those who do not perform regular exercise were more likely to have at least 3 hours per day of screen time (P < .05). Screen time was associated with total cholesterol and low-density lipoprotein cholesterol levels, insomnia, and menopause-specific quality of life (P < .05). CONCLUSIONS: Based on a psycho-socioeconomic biobehavioral framework, we found that screen time is associated with the physiological and psychosocial health of women independent of socioeconomic and biobehavioral variables. Efforts to reduce the amount of screen time targeting middle-aged women will help improve cardiometabolic biomarkers and quality of life.

Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea.

PURPOSE: To examine the prevalence of depressive symptoms and differentiate factors associated with them in urban and rural areas by applying the Ecological Models of Health Behavior. METHODS: We employed a cross-sectional design and convenience sample of 460 female adolescents. The instruments included the Adolescent Mental-Health Problem-Behavior Questionnaire (AMPQ-II) and the Beck Depression Inventory (BDI). RESULTS: Depressive symptoms were confirmed in 15.7% of urban adolescents and 22.9% of rural adolescents (p<.05). In the urban group, perception of health and stress associated with school performance were significantly associated with depressive symptoms. In the rural group, academic/internet related problems and rule violations were significantly associated with depressive symptoms (p<.05). General life happiness, worry/anxiety, and mood/suicidal ideation were common factors in both urban and rural areas (p<.05). CONCLUSION: Multiple factors were associated with depressive symptoms, and those significant factors differed between urban and rural female youths. Accordingly, tailored approaches are required considering urban and rural differences. The approaches should include intrapersonal, interpersonal, and organizational levels of interventions.

Behavioral and psychosocial factors associated with suicidal ideation among adolescents.

Suicidal ideation poses a serious threat to the well-being of adolescents and is the strongest risk factor for suicide. Indeed, Korea ranks first among Organisation for Economic Cooperation and Development countries regarding the age-standardized suicide rates. In the present study, we examined multiple levels of factors associated with the suicidal ideation of adolescents in Korea by applying the Ecological Models of Health Behavior. A cross-sectional study was conducted with a convenience sample of 860 adolescents. The instruments included the Beck Depression Inventory and the Adolescent Mental Health and Problem Behavior Questionnaire. The data were analyzed using hierarchical multiple regression. Sixteen percent of participants reported suicidal ideation. Intrapersonal (sleep disturbance, Internet game addiction, destructive behavior, and depressive symptoms) and interpersonal factors (family conflicts and peer victimization) were associated with suicidal ideation. Because multiple factors were associated with suicidal ideation among adolescents, both intrapersonal (sleep disturbance, Internet game addiction, and depression) and interpersonal factors (family conflicts and peer problems) should be considered in the development of suicide-prevention programs. These programs could include campaigns changing the norms (permissive attitudes toward school violence) and the development of strict and rigorous school non-violence policies.

Behavioral Characteristics and Cardiovascular Disease Risks Associated With Insomnia and Sleep Quality Among Middle-Aged Women in South Korea.

Insomnia is the most common sleep problem in women. Increasing evidence suggests an association between insomnia and cardiovascular disease (CVD). However, information is limited on lifestyle and socio-environmental factors associated with sleep problems in women. In this study directed by Social Cognitive Theory, we examined the personal, behavioral, socio-environmental, and CVD risk factors associated with sleep characteristics (insomnia and sleep quality) in middle-aged women using a cross-sectional design. The study instruments included the Insomnia Severity Index (ISI), the Pittsburg Sleep Quality Index (PSQI), the Center for Epidemiological Studies Depression Scale (CES-D), and measures of social support and behavioral characteristics. Blood was drawn to assess serum glucose and lipids, and BMI was measured. Data were analyzed using hierarchical multiple regression and analysis of covariance (ANCOVA). Of 423 middle-aged women, 25% experienced insomnia (ISI ≥ 10) and 41.3% reported poor sleep quality (PSQI ≥ 5). Lesser education (≤middle school), more depressive symptoms, more screen time (≥ 3 hours/day), and severe stress were associated with greater severity of insomnia and/or poorer sleep quality. Total and LDL cholesterol levels were higher in women with insomnia than normal sleepers, whereas the BMI was higher in those who reported poor sleep quality. Because personal, behavioral, and socio-environmental factors were significantly associated with insomnia and poor sleep quality, multifactorial approaches should be considered in developing sleep interventions and reducing cardiovascular risk. © 2017 Wiley Periodicals, Inc.

Socioeconomic and Behavioral Characteristics Associated With Metabolic Syndrome Among Overweight/Obese School-age Children.

BACKGROUND: Obesity in children comprises a significant public health concern in Korea. As with increased prevalence of overweight and obesity among children, risk factors for metabolic syndrome (MetS) have also increased in this population. OBJECTIVE: The purpose was to examine behavioral and socioeconomic factors that were associated with biomarkers of MetS among overweight/obese school-age children. METHODS: A cross-sectional study was conducted, and a convenience sample of 75 overweight/obese school-age children participated. Socioeconomic and behavioral characteristics, anthropometric measurements, and physiologic examinations were studied. The data were analyzed using an analysis of covariance and logistic regression. RESULTS: Metabolic syndrome was diagnosed in 27.8% of our population. Severe stress was significantly associated with elevated systolic blood pressure (P < .05). Among the family characteristics, children's perception of family income (wealthy and very wealthy) and mother's education level (high school or less) were associated with diagnoses of MetS in children (P < .05). CONCLUSIONS: The results indicated that certain socioeconomic and behavioral characteristics were associated with risk factors of MetS, and therefore, interventions to modify these risk factors are needed to promote the healthy development of overweight/obese school-age children.

The Influence of Social Structure on Cancer Pain and Quality of Life.

The aim of this study was to investigate whether social structure is associated with cancer pain and quality of life using the Social Structure and Personality Research Framework. This study was a secondary analysis of data from 480 cancer patients. The measurements included socioeconomic variables, self-reported cancer pain using the McGill Pain Questionnaire-Short Form (MPQ-SF), and quality of life measured using the Functional Assessment of Cancer Therapy Scale (FACT-G). The data were analyzed using moderated multiple regression. Cancer pain and quality of life differed significantly with income. The associations between income and pain and quality of life were significant only for the high education group (≥ partial college), and these associations were greater for Caucasians than for their counterparts ( p < .05). When developing interventions, nurses should consider the influence of socioeconomic variables on pain and quality of life while considering possible moderating factors such as education.

Factors Associated With Medication Adherence Among Medical-Aid Beneficiaries With Hypertension.

The purpose was to examine factors associated with medication adherence among medical-aid beneficiaries with hypertension using the Expanded Behavioral Model of Health Services Utilization. A cross-sectional study was conducted with a convenient sample of 289 patients. The instruments included scales to measure medication adherence, health literacy, general self-efficacy, and pros and cons of chronic disease management. Data collection was performed between February and March 2011. A hierarchical regression analysis was performed. The study found that 25.6% to 34.6% had low motivation and low knowledge regarding medication adherence. Those with higher health literacy and higher self-efficacy scores were more likely to have higher medication adherence, whereas widowed and those who perceived more cons of chronic disease management were more likely to have lower medication adherence than their counterparts (p < .05). Interventions incorporating significant factors associated with medication adherence are required to enhance medication adherence and to prevent complications associated with medication non-adherence.

Transtheoretical Model Based Exercise Counseling Combined with Music Skipping Rope Exercise on Childhood Obesity.

PURPOSE: The purpose was to evaluate the effects of a transtheoretical model (TTM) based exercise counseling offered with music skipping rope exercise on components of the TTM (stages of change, decisional balance, and self-efficacy), body mass index, glucose, and lipid profile of overweight/obese children in Korea. METHODS: This study used a nonequivalent pretest and posttest experimental study design. A total of 75 overweight/obese children participated in the study. Eight sessions of exercise counseling combined with music skipping rope exercise for 12 weeks were offered for children in the experimental group, while one session of exercise counseling with music skipping rope exercise for 12 weeks was offered for children in the control group. Outcomes were measured at baseline, and 6 months after the intervention. RESULTS: After the intervention, self-efficacy significantly improved among children in the experimental group (p = .049), while these children maintained their baseline BMI at 6-month follow-up (p > .05). Among children in the control group, BMI significantly increased (p < .05). Fasting blood sugar significantly increased for both groups after the intervention (p < .05). However, a greater increase was observed for the control group. CONCLUSIONS: Our study partially supports the hypothesis that a TTM-based exercise intervention is effective in maintaining BMI and improving self-efficacy of overweight/obese children. The TTM-based counseling combined with exercise classes has potential to control weight among overweight/obese children, while involvement of parents and children in the development of the theory-based intervention may generate further benefits regarding health and well-being of overweight/obese children.

Parent Involvement Intervention in Developing Weight Management Skills for both Parents and Overweight/Obese Children.

PURPOSE: The purpose of the study was to evaluate a parent involvement intervention for childhood obesity intended to increase parents' skills in managing children's weight-related behavior and to improve child-parent relationships. Many studies reported on parental influence on childhood obesity, emphasizing parent involvement in prevention and management of childhood obesity. METHODS: A randomized controlled trial was conducted. Forty-two parents of overweight/obese children were recruited from four cities and randomized to the experimental group or control group. The parental intervention was provided only to parents in the experimental group and consisted of weekly newsletters and text messages for a period of 5 weeks. Exercise classes and nutrition education were provided to all children. Lifestyle Behaviour Checklist and the Child-Parent Relationship Scale (CPRS) were used for measurement of parent outcome. For the child outcome, dietary self-efficacy, exercise frequency, and body mass index were measured. A mixed-design analysis of variance was performed with city location entered as a random effect. RESULTS: After the intervention, CPRS of parents and dietary self-efficacy of children showed an increase in the experimental group (p < .05). Intervention effects differed significantly according to the city location regarding the control efficacy of parents and dietary self-efficacy of children (p < .05). CONCLUSIONS: The results support the effectiveness of the parent involvement intervention in promoting child-parent relationship and dietary self-efficacy of children. However, a 5-week parent involvement intervention was not sufficient to produce significant changes in children's body mass index. Further research is needed to investigate effects of parent involvement intervention with long-term evaluation.

[Factors associated with Self-Rated Health in Metabolic Syndrome and Relationship between Sleep Duration and Metabolic Syndrome Risk Factors].

PURPOSE: Purpose was to explore associations between sleep duration and metabolic syndrome (MS) risks, and to determine factors associated with self-rated health (SRH) of adults with MS compared to other adults. METHODS: This is a secondary data analysis based on the Fifth Korea National Health and Nutrition Examination Survey KNHANES V (N=12662). Study instruments included sleep duration, MS risk factors, SRH and health-related quality of life (HRQoL). RESULTS: Mean age of participants was 43.68±12.26 years. Fifty-eight percent were women, and 18.3% were identified as having MS. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and SRH were significantly different according to sleep duration (p<.05) among all participants. In the non MS group, male gender, younger age (19~30 and 41~50 age brackets) upper income level, sufficient sleep duration, and high density lipoprotein (HDL) were positively associated with SRH, whereas, lower education levels (≤middle school), glucose level, and waist circumference were negatively associated with SRH (p<.05). In the MS group, lower income, lower education levels (≤middle school), glucose level, and waist circumference were negatively associated with SRH, whereas, having an occupation was positively associated with SRH (p<.05). CONCLUSION: Results suggest that tailored approaches are required for prevention and control of MS and sleep duration of each individual should be considered rather than applying standardized guidelines. However, as sleep quality was not included in the analysis, further investigations regarding influence of sleep quality on MS and SRH and controlling for other lifestyle and health behavior factors are required.

Racial/Ethnic Differences in Cardiovascular Symptoms in Four Major Racial/Ethnic Groups of Midlife Women: A Secondary Analysis.

Ethnic minority midlife women frequently do not recognize cardiovascular symptoms that they experience during the menopausal transition. Racial/ethnic differences in cardiovascular symptoms are postulated as a plausible reason for their lack of knowledge and recognition of the symptoms. The purpose of this study was to explore racial/ethnic differences in midlife women's cardiovascular symptoms and to determine the factors related to these symptoms in each racial/ethnic group. This was a secondary analysis of the data from a larger study among 466 participants, collected from 2006 to 2011. The instruments included questions on background characteristics, health and menopausal status, and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics, including Poisson regression and logistic regression analyses. Significant racial/ethnic differences were observed in the total numbers and total severity scores of cardiovascular symptoms (p < .01). Non-Hispanic Asians had significantly lower total numbers and total severity scores compared to other racial/ethnic groups (p < .05). The demographic and health factors associated with cardiovascular symptoms were somewhat different in each racial/ethnic group. Further studies are needed about possible reasons for the racial/ethnic differences and the factors associated with cardiovascular symptoms in each racial/ethnic group.

Consistency and Accuracy of Multiple Pain Scales Measured in Cancer Patients From Multiple Ethnic Groups.

BACKGROUND: Standardized pain-intensity measurement across different tools would enable practitioners to have confidence in clinical decision making for pain management. OBJECTIVES: The purpose was to examine the degree of agreement among unidimensional pain scales and to determine the accuracy of the multidimensional pain scales in the diagnosis of severe pain. METHODS: A secondary analysis was performed. The sample included a convenience sample of 480 cancer patients recruited from both the Internet and community settings. Cancer pain was measured using the Verbal Descriptor Scale (VDS), the visual analog scale (VAS), the Faces Pain Scale (FPS), the McGill Pain Questionnaire-Short Form (MPQ-SF), and the Brief Pain Inventory-Short Form (BPI-SF). Data were analyzed using a multivariate analysis of variance and a receiver operating characteristic curve. RESULTS: The agreement between the VDS and VAS was 77.25%, whereas the agreement was 71.88% and 71.60% between the VDS and FPS, and VAS and FPS, respectively. The MPQ-SF and BPI-SF yielded high accuracy in the diagnosis of severe pain. Cutoff points for severe pain were more than 8 for the MPQ-SF and more than 14 for the BPI-SF, which exhibited high sensitivity and relatively low specificity. CONCLUSION: The study found substantial agreement between the unidimensional pain scales and high accuracy of the MPQ-SF and the BPI-SF in the diagnosis of severe pain. IMPLICATIONS FOR PRACTICE: Use of 1 or more pain screening tools that have validated diagnostic accuracy and consistency will help classify pain effectively and subsequently promote optimal pain control in multiethnic groups of cancer patients.