Haeok Lee

Abstract

An estimated 2 million people are living with chronic hepatitis B virus (CHBV) in the United States and are at risk for long-term consequences such as cirrhosis, liver decompensation, and hepatocellular carcinoma. Less than 10 years ago, there was no treatment of CHBV infection, but now, new drugs have recently been approved and there is considerable new knowledge about the treatment of CHBV infection. Recently, consensus guidelines for the management of hepatitis B virus infection have been released by the National Institutes of Health and the American Medical Association, addressing the selection of patients and drugs for treatments. Determining what constitutes best practices to manage patients with CHBV is challenging and requires nurses and nurse practitioners to acquire and maintain up-to-date knowledge to understand recently approved drugs and disease management. Nurses and nurse practitioners should know how to identify patients who need treatment and how to educate, counsel, and monitor treatment adherence and side effects; these skills are crucially important. The goal of this article is to provide nurses with the most current consensus guidelines for the management of CHBV infection and their application in nursing practice to optimize treatment to enhance patient outcomes.

Abstract

Purpose: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. Methods: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. Results: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. Conclusion: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

Abstract

Chronic hepatitis B virus (HBV) infection is the leading cause of cirrhosis, liver failure, and liver cancer, and an estimated 620,000 persons die annually from HBV-related liver disease (Goldstein et al., 2005; World Health Organization, 2000). Immunization with the HBV vaccine is the most effective means of preventing HBV infection and its consequent acute and chronic liver diseases such as cirrhosis and hepatocellular carcinoma. The HBV vaccine has been used against HBV in the United States since 1982 (Centers for Disease Control and Prevention, 1982); during the last 25 years, HBV vaccine policy continued to evolve in response to public health issues and epidemiologic data. Although the number of newly acquired HBV infections has substantially declined as a result of implementation of a national immunization program, the prevalence of chronic HBV infection remains high. The purpose of this article is to review the epidemiology of HBV, provide a historical review of health policies for HBV immunization, and summarize the recent evidence-based public health guidelines for management of HBV infection in the United States.

Abstract

Purpose: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. Methods: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. Results: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. Conclusion: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.

Abstract

Both theoretical and empirical studies have documented the protective effect of religiosity and spirituality on general health in older adults in community and hospital settings; however, no study has documented the relationship between spirituality and depression among older adults living alone in communities in Korea. We tested two hypotheses: Hypothesis 1: Korean older adults living alone would be more depressed and less healthy than older adults living with family, and Hypothesis 2: Individuals who are more religious and spiritual would report a lower level of depression and a higher level of general health even when other demographic and living status variables are controlled. A descriptive, comparative, and correlational design with a convenience sampling method was conducted among community-dwelling Korean older adults in Chounbook Providence, South Korea. This study included 152 men and women older than 65 years old. Hypothesis 1 was supported as Korean older adults living alone were significantly more depressed than were older adults living with family (P < .01). However, for Hypotheses 2, only spirituality activities and Spirituality Index of Well-Being scores were significantly associated with general health and/or depression (P < .01), but there were no relationships between the variables of attendance and importance of religion with general health and depression.

Abstract

Background and Aims: Hepatitis B virus (HBV) infection is significantly higher in Asian American Pacific Islanders (AAPIs) than in the general U.S. population. People chronically infected with HBV not only have the potential for developing cirrhosis and primary hepatocellular carcinoma, but also are potential sources for infecting others. Therefore, early diagnosis of HBV infection can reduce the risk of further transmission of the virus through education and vaccination of high-risk groups. The aim of this study was to screen for current and past HBV infection in this high-risk group. Methods. A community-based participatory study was conducted between 2004 and 2007. A total of 609 Korean Americans (KA) completed HBV blood screening tests in seven Korean churches in Colorado. Current HBV infection (HBsAg), past HBV infection (anti-HBc positive), and HBV susceptibility were measured. Demographic Information, including HBV vaccination history on these groups, was obtained. Results. Korean Americans had an almost ten times higher incidence of current (4%) and past HBV infection (41%) than the general U.S population. Older individuals had a higher incidence of past HBV infection and lower immunization rate. The risk of lifetime HBV infection was less among participants younger than 30 (OR: 0.07; 95% CI: 0.02-0.21) and those who self-reported HBV vaccination (OR: 0.12; 95% CI: 0.05-0.29). Variables associated with immunity due to vaccination (anti-HBc negative but positive to anti-HBs) were, age under 30 (OR: 13.86, 95% CI: 4.68-41.05), and self-reported vaccination (OR: 8.06; 95% CI: 3.43-18.92). Conclusions. Our study findings confirm the high prevalence of HBV infection among AAPIs, specifically among AAPIs in regions where AAPIs constitute a small proportion of residents. Given the high incidence of HBV infection among these community-dwelling KA, and that the majority of HBV-infected participants were unaware of their condition, focused HBV screening should be conducted to uncover individuals with HBV.

Abstract

Purpose: To assess knowledge and attitude toward hepatitis B virus (HBV) infection among Korean immigrants in two cities in the Rocky Mountain region and to determine whether sociodemographic and cultural factors are related to the level of HBV knowledge. Methods: Community-based participatory study was conducted in five Korean churches in the Rocky Mountain region to develop baseline data on HBV infection and vaccination behavior. All documents, including announcements, brochures, consent forms, and questionnaires were in Korean and English, and trained Korean interviewers collected the surveys by reviewing the questionnaires with participants at the churches. Results: Knowledge of HBV infection was low and city of residence did not have a statistically significant impact on HBV infection knowledge. in the total sample, 62% identified transmission by sharing utensils and 21% believed that HBV was hereditary, while only 21% thought that HBV was spread through sexual contact. The majority of participants (61%) rated their English level as "minimum". Knowledge of HBV infection was found to be associated with both demographic and acculturation factors (p <.05). Conclusion: This study found not only a low level of knowledge of HBV infection but also misunderstanding of the risks of HBV infection. Knowledge of HBV infection was significantly associated with education and acculturation; therefore, culturally sensitive and group-tailored public health education for Korean and other Asian American Pacific Islanders should be developed to clarify misconceptions and misunderstandings about HBV infection.

Abstract

In Korea, as in other countries, the number of older adults is growing substantially, and the proportion of older adults is projected to be 14.3% by 2022 [Ministry of Health and Social Affairs, Republic of Korea. (2003). Yearbook of health and social affairs statistics for 2003, vol. 49. Seoul, Korea: Government Printing Office]. The number of older people who are living alone in rural areas has been sharply increasing as a result of the migration of younger adults to urban areas for employment. However, information on the health status of elders who live alone is limited. Therefore, the purpose of this study was to compare the physical, mental, and emotional health status of elders who are living alone and those living with relatives in rural areas in South Korea. A cross-sectional survey design was used, and data were collected by interviewing subjects. A two-stage cluster sampling process was utilized for those living alone (n = 110) and those living with family members (n = 102). Both groups were enrolled in KyungRo-Dangs (senior centers), which are like community centers in the province. The results indicate that elders who are living with relatives scored significantly higher on several physical and mental health parameters than elders who are living alone. However, elders who are living with relatives had a significantly higher emotional health status in almost every item than elders who are living alone. These findings suggest that interventions to increase health status, especially the emotional health of elders who are living alone, are imperative and that the intervention should be sensitive to changes in the social structure of elders who are living alone in rural areas. Further studies are needed to understand the factors that are associated with the physical, mental, and emotional health of elders who are living alone and those who are living with relatives.

Abstract

This study investigated the effects of a nurse-coordinated intervention on patients with type 2 diabetes in Korea. Fifteen patients were randomly assigned to an intervention group and 10 to a control group. The intervention was implemented for 12 weeks by telephone. Patients in the intervention group had a mean decrease of 1.2% in glycosylated hemoglobin (HbA1c) levels and those in the control group had a mean increase of 0.5%. Patients' satisfaction with care was higher in the intervention group than in the control group after the intervention. These findings indicated that the nurse-coordinated intervention could improve HbA1c levels and satisfaction with care in patients with type 2 diabetes in Korea.

Abstract

To detect the rate of hepatitis B virus (HBV) infection among Asian American Pacific Islanders (AAPIs), data on hepatitis B antigens and antibodies were collected as part of a community health fair. Two hundred seventy adults received free hepatitis B screening. The serological results of 82 Whites showed that 1.2% were positive for serum hepatitis B surface antigen (HBsAg) and 21% were positive for serum hepatitis B antibody (HBAb). Of 161 AAPIs, 4.3% were positive for serum HBsAg and 60% were positive for HBAb. Despite the limitation of design, these data provide some insight on the rate of HBV infection in AAPIs because there are no data on prevalence of HBV infection of AAPIs in the Rocky Mountain Area.