Haeok Lee

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

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.

Abstract

Recent advances in telecommunications technology have created opportunities to enhance the quality of health care services through telehealth, the use of telecommunications and information technologies to deliver health care. However, the diverse technologies and applications encompassed by telehealth have tended to confuse discussions of the effectiveness of these programs. An interactive voice response system (IVRS) is a simple, yet effective telehealth application that improves access to health care by continuing care beyond the hospital setting, with specially tailored programs that are easily accessible to patients around the clock. Often described as a telephone connected to a "talking computer," an IVRS allows patient interaction for data collection or to deliver recorded telephone messages related to medication compliance or behavior modification. Despite easy access to touchtone telephone services and growing familiarity with IVRS, many health care providers are unaware of these programs. This paper reviews the infrastructure of IVRS technology and its uses in health care.

Abstract

Most public education about the clinical symptoms of MI and the appropriate response to those symptoms has been designed to reach educated segments of the white population based on data gathered from white men. As a result, AAs and Korean-Americans may be less alert to chest pain, less likely to relate this symptom to heart attack, and less likely to seek treatment promptly. Our findings provide a race-specific database on CHD risk factors and types of MI symptoms, which should be of particular interest to the trauma and emergency care nurse as well as to the coronary care nurse. AAs and Koreans experienced chest pain as frequently as whites, but AAs experienced the atypical symptoms of dyspnea and fatigue more often, and Koreans experienced dyspnea, perspiration, and fatigue more often than whites. This information can be helpful in developing public education programs on MI that are sensitive to our increasingly diverse population. In the acute and critical care setting, these data assist the nurse to recognize that "classic" signs and symptoms of acute MI may not be classic for all racial and ethnic groups. This awareness can lead to more culturally sensitive assessment tools and educational interventions, earlier recognition of acute MI with more appropriate triage decisions, more aggressive treatment, and a reduction in morbidity and mortality of these high-risk groups.

Abstract

A descriptive design with repeated measures was used to describe patterns of fatigue, emotional stress, and left ventricular (LV) function among 22 patients with myocardial infarction (MI) from day 5 postadmission to day 21 postadmission for the MI. The severity of fatigue in patients with MI during the subacute period ranged from 32 to 44 on the 100-mm Visual Analogue Scale for Fatigue. Severity of fatigue and depression remained the same; however, LV function improved (p < .01) and patients experienced more energy (p < .01) and less anxiety (p < .01) in the third week following MI. Researchers observed five different fatigue patterns: decreasing fatigue, increasing fatigue, unchanged low fatigue, unchanged-high fatigue, and a curvilinear fatigue pattern. The finding of five different fatigue patterns after an MI suggests that all patients with MI should not be treated as a uniform group assumed to have decreasing fatigue with the passage of time.

Abstract

This study examined prehospital delays and clinical symptoms of myocardial infarction (MI) in blacks and whites and the relationship between longer delays and types of clinical symptoms. The convenience sample included 128 patients, admitted consecutively, with acute MI. Data on types of clinical symptoms of MI and treatment-seeking behavior were collected on day 2 or 3 after admission, using face-to-face semistructured interviews. The total mean delay time differed significantly between blacks and whites (16 hours vs. 8.8 hours, p < .05). Although the frequency of chest pain was similar in both blacks and whites (78% vs. 77%), more than twice as many blacks as whites presented with symptoms of dyspnea (56% vs. 24%, p < .01) and fatigue (32% vs. 17%, p < .05). There was an interactive effect of race-ethnicity and types of symptoms on delay (p < .05) was present. Delay times for whites with chest pain were shorter than for whites without chest pain. Delay times for blacks with dyspnea were significantly shorter than for blacks without dyspnea, although delay times did not differ between whites with and without dyspnea.

Abstract

Growing evidence suggests that advance directives (ADs) are often ineffective. Further explanation of how these documents are viewed by the public, the expectations of how decisions about treatment are made, and, in particular, patients’ understanding of how ADs are actually used in the clinical setting, are warranted. This article details a descriptive study in which patients - were int e rviewed, during hospital stays, about their beliefs and understanding of advanced directives, as well as the processes used in completing them. The study was undertaken in a community hospital located in a rural area in the Midioest. Findings show that many patients were able to clearly articulate what an AD means in terms of making their choices known. However, misconceptions were found in patients’ understanding of ADs and only 467r reported discussing their ADs with a physician. Strategies for effective implementation of education programs related to ADs are detailed here.

Abstract

This study was designed to increase our understanding of the clinical symptoms of myocardial infarction (MI) and the response to symptoms by patients with MI in order to improve the clinical management of MI. A comparative and correlational design was used. The sample consisted of 132 patients over the age of 30 who were diagnosed with an acute MI. All subjects were recruited by convenience sampling. Demographic data were collected by questionnaire; a semistructured interview obtained information on delay time and the context at the onset of acute clinical symptoms; and medical record review was used to collect data on clinical characteristics. The questionnaires and interview were administered at 24 to 72 hr after admission, and the medical record was reviewed during hospitalization and after discharge. Black MI patients experienced symptoms of dyspnea and fatigue significantly more often than White MI patients. The mean prehospital delay time was also significantly longer for Black MI patients (p < .05). Our findings indicate that Blacks more often experience atypical symptoms of MI and prolonged delays in seeking treatment for MI. Further exploration of the factors involved in delays and the relationships between types of symptoms and delay time are needed.