PURPOSE: Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in renal failure. The aim of this study is to evaluate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center. MATERIALS AND METHODS: Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified. RESULTS: A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5+/-14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3+/-21.1 days between access creation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012). CONCLUSION: Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.
Arm* ; Arteriovenous Fistula ; Catheterization ; Central Venous Catheters ; Diabetes Mellitus ; Dialysis* ; Fistula ; Humans ; Male ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Transplants

PURPOSE: The purpose of this micro-ethnography is to examine whether science and societal changes impact family communication patterns among a convenience sample of 16 Korean women. METHODS: The authors observed family communication in the context of a new breast cancer genetic screening and diagnostic testing program to detect BRCA gene mutations in Korean women at highest risk. RESULTS: Analysis of in-depth interviews and field notes taken during participant observation illustrated that communication patterns in families vary according to a woman's position in the family. If a grandmother tests positive for a gene mutation, her daughters make decisions on her behalf; they open and maintain the communication channel among family members. If a housewife is diagnosed with cancer and a genetic mutation, she immediately consults her husband and her sisters. The husband creates an open communication channel between his wife, his parents and his siblings. As a result, a woman's cancer is a concern for the whole family not merely a woman's secret or crisis. CONCLUSION: Cultural differences are important to consider when designing new genetic service programs in different countries.
Anthropology, Cultural ; Breast ; Breast Neoplasms ; Diagnostic Tests, Routine ; Female ; Genes, vif ; Genetic Counseling ; Genetic Services ; Genetic Testing ; Health Communication ; Humans ; Nuclear Family ; Parents ; Siblings ; Spouses

PURPOSE: The purpose of this review article is to introduce how the Korean Society of Genetic Nursing (KSGN) has evolved and tried to translate genomic knowledge to nursing practice, and then to suggest the future role of genetic nurses in Korea. METHODS: A literature review was performed and the current status of genetic counselling in Korea was explored. Then the educational and clinical experiences of the authors were incorporated. Finally, the main activities of Korean nursing for genetics were identified. RESULTS: Two types of genetic counsellor certification have been issued in Korea: one is issued by the Korean Society of Genetic Medicine, another by the Korean Society of Breast Cancer since June 2011. A few Korean nursing researchers have continuously performed research related to genetic nursing and undertook several research projects funded by the government since 2003. In February 2011, KSGN was established and is now trying to establish further international networks. CONCLUSION: Nursing genetic experts should be trained to integrate all specialties for genetic counselling, so they can provide holistic genetic services including ethical, legal, and social issues (ELSI).
Breast Neoplasms ; Certification ; Financial Management ; Genetic Counseling ; Genetic Services ; Genetics ; Genomics ; History of Nursing ; Korea ; Nursing ; Nursing Research ; Oncology Nursing* ; Professional Role

PURPOSE: This micro-ethnographic study aimed to understand coping experiences of Korean-American (K-A) women after diagnosis with breast cancer due to a hereditary gene mutation. METHODS: Participatory observation and in-depth interviews were performed at one breast cancer screening center in Southern California, in 2005 with eleven first generation K-A immigrant women. All transcribed interviews and field notes were analyzed using ethnographic methodology. RESULTS: K-A women's experience varied based on acculturation risk factors including: limited English speaking ability; disrupted family relationships, individualistic family values, or intergenerational communication barriers; lack of Korean speaking nurses; and Korean physicians' who lacked knowledge about hereditary breast cancer risk. These risk factors led to isolation, loneliness, lack of emotional and social support. In comparison to Korean homeland women in a similar medical situation, these K-A immigrants felt disconnected from the healthcare system, family support and social resources which increased their struggling and impeded coping during their survivorship journey. These women were not able to access self-support groups, nor the valuable resources of nurse navigator programs. CONCLUSION: Professional oncology associations for nurses and physicians have a moral obligation to support and promote knowledge of hereditary cancer risk and self-help groups for non-native speaking immigrants.
Acculturation ; Asian Americans ; Breast ; Breast Neoplasms ; California ; Delivery of Health Care ; Emigrants and Immigrants ; Family Relations ; Female ; Humans ; Loneliness ; Mass Screening ; Moral Obligations ; Risk Factors ; Self-Help Groups ; Survival Rate

PURPOSE: This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries. METHODS: A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels. RESULTS: The experimental group showed significant decrease in uncertainty (p=.028), increased knowledge (p=.038), and partially decreased pain (p=.003-.331). Partial muscle strength increased significantly (p=.021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p=.002, p=.004). CONCLUSION: Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.
Activities of Daily Living ; Aged ; Body Mass Index ; Disabled Persons/*psychology ; Female ; Health Services for the Aged/*utilization ; Humans ; Male ; Middle Aged ; Muscle Strength ; Pain Measurement ; Psychiatric Status Rating Scales ; Questionnaires ; Spinal Injuries/*surgery ; Stress, Psychological ; Uncertainty

PURPOSE: This study aims to understand the worries that patients and families with a history of colorectal cancer experience. METHODS: From January 2011 through January 2013, in-depth interviews and observations were conducted on 3 colorectal patients and 8 family members with a family history of colorectal cancer. The data were analyzed using a micro-ethnographic research method. RESULTS: After colorectal cancer patients and families realized and concerned with their increased chance of getting cancer, Eventually this worry became a motivator causing them to adhere to cancer preventive behavior. Three types of cancer worries were identified: confrontation, uneasiness, and warning. Depending on the type of cancer risk, psychological responses and cancer preventive behavior were found to be varied according on the three types of cancer worries. Patients and families tried to change dietary habits and regulary exercise. To help ease their cancer worries, they started to search for information on colon cancers and attempted to follow recommendations. However, they found that neither detailed guidelines nor systematic management from health professionals existed for families with colon cancer patients. CONCLUSION: A cancer prevention nursing program needs to be developed based on the level of cancer risk and perceived cancer worries of clients.
Colonic Neoplasms ; Colorectal Neoplasms* ; Early Detection of Cancer ; Food Habits ; Health Occupations ; Humans ; Methods ; Nursing

PURPOSE: This study was to develop and evaluate the clinical utility of a nursing educational program to reduce the cancer worry of colorectal cancer patients' family members (RCW-FM) in Korea. METHODS: The RCW-FM was developed based on several preliminary studies: an ethnographic and two quantitative studies to understand the educational needs among Korean colorectal cancer patients and their families. A one week clinical genetic educational course for clinical cancer nurses was implemented, and the RCW-FM led by cancer genetic nurses was constructed. A one group pretest-posttest design was implicated to evaluate the change of the family members' knowledge about colorectal cancer (KCR) and the level of the reduction of cancer worry (CWR). RESULTS: The mean score for KCR significantly increased from 11.75+/-1.28 to 13.87+/-1.13 (p<.05). The mean score of CWR was 4.25+/-.89. CONCLUSION: This new RCW-FM is a satisfactory educational program for reducing the cancer worry of the colorectal patients' family members. But it needs to provide more practical, specific information including a long term perspective, tailored specifically for what Korean families want to know. It should also incorporate the preventive guidelines recommended for high risk hereditary or familial colorectal cancer.
Colonic Neoplasms ; Colorectal Neoplasms* ; Early Detection of Cancer ; Education, Nursing ; Humans ; Korea ; Nursing*

PURPOSE: This study identifies correlations among information needs and knowledge about prenatal genetic screening and diagnosis (I-PGSD & K-PGSD), and attitude toward terminating pregnancy (ATP) among pregnant women in South Korea. METHODS: A descriptive survey was conducted from January 2013 to April 2014 in South Korea. 222 pregnant women responded to three questionnaires developed by the authors. The questionnaire for I-PGSD consisted of 19 questions; 18 questions for K-PGSD; and 10 questions for ATP. RESULTS: Mean scores were 80.46±11.73 for I-PGSD; 14.86±3.74 for K-PGSD; and 33.71±6.13 for ATP. The ATP score was positively correlated with the I-PGSD and K-PGSD scores, but statistically significant with only I-PGSD (p=.006). I-PGSD scores were higher than average on three genetic syndromes (Down, Patau, and Edwards syndrome), on management after the diagnosis of positive fetal aneuploidy, and on test result interpretation after the amniocentesis and level II fetal ultrasonogram. CONCLUSION: In light of current legal and moral controversy regarding terminating pregnancy and rapidly advancing prenatal genetic testing technology, more prenatal genetic education for nurses and nursing students who teach pregnant women is needed. In addition, more professional counseling services provided by trained nurses are also required.
Adenosine Triphosphate ; Amniocentesis ; Aneuploidy ; Counseling ; Diagnosis* ; Education ; Female ; Genetic Testing* ; Humans ; Korea* ; Pregnancy* ; Pregnant Women* ; Students, Nursing ; Ultrasonography

This paper is a critical review of descriptive phenomenological methodology in Korean nursing research. We propose constructive suggestions for the improvement of descriptive phenomenological methodology in light of Husserl's phenomenological approaches. Methods: Using the key words of 'phenomenology,' 'experience,' and 'nursing,' we identify and analyze 64 Korean empirical phenomenological studies (selected from 282 studies) published in 14 Korean nursing journals from 2005 to 2018. The PubMed and the Korea Citation Index were used to identify the studies. Results: Our analysis shows that all the reviewed articles used Giorgi's or Colaizzi's scientific phenomenological methodology, without critical attention to Husserl's philosophical phenomenological principles. Conclusions: The use of scientific phenomenology in nursing research, which originated in North America, has become a global phenomenon, and Korean phenomenological nursing research has faithfully followed this scholarly trend. This paper argues that greater integration of Husserlian phenomenological principles into scientific phenomenological methodology in nursing research, such as participant-centered bracketing and eidetic reduction, is needed to ensure that scientific phenomenology lives up to its promise as a research methodology.

PURPOSE: There recurred controversies related to legal allowance of abortion since newly advancing prenatal genetic testing technology. This survey was aimed to identify the attitudes toward marriage, and pregnancy (AMP) and terminating pregnancy (ATP) among Korean nursing students. METHOD: A descriptive study was performed from October to November 2012 in South Korea. 424 nursing students responded to two types of tools developed by authors. Questionnaire for ATP is consisted of 10 items with 5-points Likert Scale. Questionnaire for AMP is 12 items containing 5 categories. RESULTS: Mean score of ATP was 36.90. Students that are enrolled in bachelor degree had a significant higher ATP. Students who are currently dating with an opposite gender showed much higher level of ATP than those are not. Lower group of delayed the time of getting marriage and pregnancy showed highest score of ATP, significantly. CONCLUSION: Individual factor must be primarily considered when assessing ATP of nursing students, for example current relationship with opposite gender and educational background, attitude toward marriage and pregnancy. Further studies are needed to identify personal factors of the young adults affecting on the ATP.
Adenosine Triphosphate ; Genetic Testing ; Humans ; Korea ; Marriage* ; Pregnancy* ; Surveys and Questionnaires ; Students, Nursing* ; Young Adult