OBJECTIVES: Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. METHODS: Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. RESULTS: Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. CONCLUSIONS: We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.
Breast ; Breast Neoplasms* ; Delayed Diagnosis* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Logistic Models ; Mammography ; Marriage* ; Mass Screening ; Mortality ; Psychology* ; Risk Factors ; Time-to-Treatment

BACKGROUND: VIM-2 type metallo-beta-lactamase (MBL) producing strains are presently spreading to Pseudomonas spp., Acinetobacter spp. and even to Enterobacteriaceae such as Serratia marcescens, Enterobacter cloacae and Klebsiella pneumoniae in Korea. Recently we determined the phenotype and the genotype of three MBL-producing Providencia rettgeri isolated from urinary specimen of three patients with neurosurgical ward, and analyzed the blaVIM-2 containing integron of a P. rettgeri CBU852. METHODS: EDTA-disk synergy test was used for the screening of MBL, and the PCR for blaIMP-1, blaVIM-1 and blaVIM-2 was performed. The minimal inhibitory concentration of those isolates was determined by broth microdilution method, and the genomic DNA fingerprinting analysis was performed by random amplified polymorphic DNA (RAPD). The sequence of the blaVIM-2 containing integron was determined. RESULTS: Three P. rettgeri with reduced imipenem susceptibility showed the positive EDTA-disk synergy test and blaVIM-2 was detected by PCR. Antimicrobial susceptibility test showed the resistance to all beta-lactams tested, ciprofloxacin and aminoglycoside such as gentamicin, tobramycin and amikacin, indicating multidrug resistance of those isolates. RAPD analysis showed the identical DNA fingerprint of those three isolates. The novel class 1 integron, including aacA4, blaVIM-2, orf "ii" and orf "iii", was detected in a P. rettgeri CBU852. CONCLUSIONS: In this study, the multidrug resistant P. rettgeri CBU852 had blaVIM-2 containing novel class 1 integron. The emergence of blaVIM-2 producing P. rettgeri could compromise the use of carbapenem in treatment of infections caused by MBL producing bacteria. To our knowledge, this is the first report that VIM-2 MBL gene has been detected in P. rettgeri.
Acinetobacter ; Amikacin ; Animals ; Bacteria ; beta-Lactams ; Ciprofloxacin ; DNA ; DNA Fingerprinting ; Drug Resistance, Multiple ; Ecthyma, Contagious ; Enterobacter cloacae ; Enterobacteriaceae ; Genotype ; Gentamicins ; Humans ; Imipenem ; Integrons ; Klebsiella pneumoniae ; Korea ; Mass Screening ; Phenotype ; Polymerase Chain Reaction ; Providencia* ; Pseudomonas ; Serratia marcescens ; Tobramycin

Purpose: The purpose of this study was to gain insights into empathy, cyberbullying, and cybervictimization among Filipino adolescents. Methods: The participants were 168 junior high school students in the 7th to 10th grades at a public high school in Cavite Province, Philippines. Data were collected on demographic characteristics, the Basic Empathy Scale, and Revised Cyber Bullying Inventory-II scores. The data were analyzed in SPSS using descriptive statistics (frequency and mean), the independent t-test, bivariate correlation, and one-way analysis of variance. Results: The degree of empathy did not show a statistically significant relationship with cyberbullying (r=-.07, p=.359) but did show a significant relationship with cybervictimization (r=.18, p=.025). Furthermore, cyberbullying had a statistically significant association with cybervictimization (r=.60, p<.001). Conclusion Although empathy does not necessarily affect cyberbullying, higher levels of empathy were found among cyberbullying victims. However, an alarming result of this study is the possibility that victims may become cyberbullies. Therefore, we should highlight empathy as part of efforts to prevent cyberbullying and to solve various cyber-related problems. Since cyberbullying and cybervictimization are closely related, it is important to focus on this relationship and to make multilateral efforts to ensure that cyberbullying does not lead to other negative issues.

Purpose: The purpose of this study was to review pain alleviation intervention for Korean pediatric inpatients with reference to Kolcaba’s Theory of Comfort. Methods: Whittemore and Knafl’s integrative review methods were used. Articles published in Korean or English were identified through electronic search engines and scholarly web sites. Scientific, peer-reviewed articles published between 2006 and 2019 were included in this review. Twenty-seven articles that met the inclusion criteria were analyzed. Results: Among the 27 selected studies, three were descriptive, while 24 were interventional studies related to pain alleviation interventions. Pain alleviation interventions showed three attributes: identifying pain triggers and the child’s response to pain, effective strategies for pain relief, and nurses’ competence in pain management. Conclusion The three attributes of pain alleviation interventions using the theory of comfort shown in this study were identified as important factors for obtaining evidence-based data on how to enhance the comfort of hospitalized pediatric patients. In addition, the attributes of pain alleviation interventions should be considered for hospitalized pediatric patients and their family members.

Purpose: This study investigated intentions and attitudes towards future parenthood and awareness of fertility among university students in South Korea. Methods: The participants comprised 166 female and male undergraduate students enrolled at five universities. A cross-sectional survey was conducted from May to July 2019 using the Korean version of the Fertility Awareness Questionnaire and Attitudes of Parenthood. The data were analyzed using descriptive statistics based on participants' general characteristics, the x2 test to identify differences in intentions, and the t-test to evaluate attitudes towards parenthood and awareness of fertility in female and male students. Results: Both female and male students desired to have two children, but they lacked awareness about fertility. The possibility of combining work and having children, along with the availability of childcare resources, impacted the desire for parenthood. Male students tended to consider parenthood as less impactful on their lives and careers than female students. Social structures might also impact the decision to have children. Conclusion It is important to provide health education emphasizing fertility awareness and parenthood in young adulthood so participants can consider these facts in advance. In addition, the government should provide resources for couples making parenthood decisions.

A clinical isolate of Klebsiella pneumoniae K7746 produced the extended-spectrum beta-lactamase (ESBL) SHV-12. A 6.6 kb BamHI fragment containing the blaSHV-12 gene of K7746 strain was cloned into pCRScriptCAM vector resulting in the recombinant plasmid p7746-C1. The restriction map of 3.6 kb inserted DNA and sequences immediately surrounding blaSHV-12 of p7746-C1 were homologous to plasmid pMPA2a carrying blaSHV-2a. In addition, both blaSHV-12 and blaSHV-2a were expressed from a common hybrid promoter made of the -35 region derived from the left inverted repeat of IS26 and the -10 region from the blaSHV promoter itself. The results indicate that blaSHV-12 and blaSHV-2a may have evolved from a common ancestor in the sequential order of blaSHV-2a first, followed by blaSHV-12. Furthermore, by the PCR mapping method using primers corresponding to the IS26 and blaSHV, the association between IS26 and blaSHV was studied in 12 clinical isolates carrying blaSHV-2a, 27 clinical isolates carrying blaSHV-12, and 5 reference strains carrying blaSHV-1 to blaSHV-5. All 39 strains carrying blaSHV-2a or blaSHV-12 were positive by the PCR, providing confirmative evidence that IS26 has been involved in the evolution and dissemination of blaSHV-2a and blaSHV-12. But 5 reference strains carrying blaSHV-1 to blaSHV-5 were negative by the PCR. Therefore, we concluded that the molecular evolutionary pathway of blaSHV-2a and blaSHV-12 may be different from that of other blaSHV-ESBL, e.g., blaSHV-2, blaSHV-3, blaSHV-4, and blaSHV-5.
beta-Lactamases ; Clone Cells ; DNA ; Klebsiella pneumoniae ; Plasmids ; Polymerase Chain Reaction

OBJECTIVES: The aim of this study was to investigate continuously on how a short-term family psychoeducation program for schizophrenia would change the emotional stress and the knowledge of the family members. METHODS: Subjects were the family members who participated in the short-term family psychoeducation program for schizophrenia. The participants were asked to fill out self-reporting forms for 3 times-before commencing the 6-week family education, immediately after completing the program, and 3 months after completing the program respectively. RESULTS: A total of 46 subjects participated, and 20 of them responded to all questionnaires. Three months after the completion of psychoeducation, depression and anxiety subscale score among the General Health Questionnaire-28 decreased by 2.60 (p=0.04) and 2.20 (p=0.04) respectively. In caregiver burden criterion, the score decreased by 9.45 (p=0.04) in 3 months after completing the education. In knowledge about schizophrenia test, the score increased by 2.60 score (p<0.001), and this result was maintained after 3 months. CONCLUSION: It was found that a short-term family education program for schizophrenia was effective not only in improving the knowledge on the disease but also in reducing anxiety and depression, and this effect was maintained immediately after the psychoeducation and so was it as time passed as well.
Anxiety ; Caregivers ; Depression ; Education ; Humans ; Surveys and Questionnaires ; Schizophrenia* ; Stress, Psychological

OBJECTIVE: To identify attachment insecurity as an associative factor with unresolved psychological distress 1 year after surgery in the early breast cancer (BC) population. METHODS: One-hundred fourteen participants completed the Hospital Anxiety and Depression Scale (HADS) and the Experiences in Close Relationship (ECR-M36) questionnaire within 1 week (baseline) and at 1-year post-surgery (follow-up). Participants were categorized into the distress and the non-distress groups based on a HADS-total score cut-off of 15. Logistic regression analysis revealed predictive factors of distress at follow-up. RESULTS: At baseline, 53 (46.5%) participants were found to be in the distress group. The degree of distress decreased over 1 year (p= 0.003); however, 43 (37.7%) showed significant remaining distress at follow-up. Baseline scores of the ECR-M36 avoidance [odds ratio (OR)=1.045, 95% confidence interval (CI)=1.002–1.090] and HADS-total (OR=1.138, 95% CI=1.043–1.241) were predictors of distress at follow-up. CONCLUSION: A substantial proportion of early BC patients suffer distress even one-year after surgery. Avoidant attachment appeared to be an influential factor on distress in early BC patients. Moreover, the finding that initial distress level could predict one at 1-year post-operation warrant a screening and management of distress along with BC treatment.
Anxiety ; Breast Neoplasms* ; Breast* ; Depression ; Follow-Up Studies* ; Humans ; Logistic Models ; Mass Screening

Purpose: The purpose of this study was (a) to synthesize studies of condom use among South Korean college students, and (b) to appraise the quality of each article using Gough's weight of evidence. Methods: Studies published in English and Korean were searched in electronic databases using the terms "student or college student or university student or undergraduate", "condom", and "Korea*". Results: Twenty studies met the inclusion criteria, showed appropriate quality, and were therefore selected for review. The variables related to condom use were measured in terms of condom-related factors, factors related to non-condom-related knowledge and attitudes, and other factors. Knowledge, attitudes, and self-efficacy were associated with condom use, and there were differences in condom-related factors among men and women. Conclusion Based on these findings, it was confirmed that sexual education is needed for both men and women to promote condom use. Education on condom use should not only focus directly on condoms, but should also address other aspects of knowledge and attitudes to influence health beliefs. In addition, developing educational programs targeting adolescents and parents will have a positive effect on college students' condom use.

Purpose: This study presents a translation, cultural adaptation, and psychometric evaluation of two instruments of the Fertility Awareness and Attitudes Towards Parenthood (FAAP) questionnaire (Conditions and Life changes) for use in South Korea. Methods: This methodological study included 166 university students for psychometric evaluation in the sixth step. The first five steps included forward translation, backward translation, committee review, assessment of content validity, and a pre-test. In the sixth step, psychometric properties, including internal consistency, construct validity, and criterion validity, were evaluated. Exploratory factor analysis and confirmatory factor analysis were conducted to identify the structure of the tool and to assess its validity. Results: The Korean version showed acceptable internal consistency. Cronbach's ⍺ was .73 for FAAPC-conditions and .83 for FAAP-Life changes. FAAP-Conditions showed a four-factor structure (social conditions, relationship with partner, external environment, and child-rearing support) and FAAP-Life changes had a two-factor structure (reward and burden). In the confirmatory analysis, CMIN/DF, TLI, IFI, SRMR, CFI, and RMSEA were satisfactory. Conclusion This study provided preliminary evidence of the acceptability, reliability, and validity of the Korean version of the FAAP questionnaire in university students in South Korea. Nonetheless, further evaluation among Korean young adults is warranted to validate this instrument.