Journal of Korean Academy of Nursing

Research Paper

Validity and Reliability of the Korean Version of Assessment of Health Literacy in Breast and Cervical Cancer Screening: Shin, Hye Sook , Chi, Eunlim , Han, Hae-Ra; J Korean Acad Nurs 2021;51(6):769-781. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21108

Purpose
Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening—Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C).
Methods
A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension.
Results
During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale.
Conclusion
These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans’ health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.

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Original Articles

Korean Immigrant Women's Meanings of Breast, Breast Cancer, and Breast Cancer Screenings: Eunyoung Eunice Suh; Journal of Korean Academy of Nursing 2006;36(4):604-611. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.4.604

Abstract PDF

Purpose

Koreans are one of the fastest growing Asian populations in the U.S. since 1960s. In Korean immigrant women (KIW), breast cancer was reported as the most frequently diagnosed cancer. However, their screening rates for breast cancer are lower than national guidelines; it is assumed that underlying cultural schemas of breast, breast cancer, and its screening modalities exist and need to be studied. This study was aimed to investigate cultural meanings of breast, breast cancer, and breast cancer screenings in KIW.

Methods

Using cultural models theory from cognitive anthropology, naturalistic qualitative methodology was utilized. Three focus group interviews with fifteen KIW were conducted. Thematic analysis with constant comparison technique was performed eliciting units of meaning, categories, and themes.

Results

The cultural schema of the meaning of breast is “mother who is breast-feeding her baby,” with two themes of “balance in size,” and “shyness.” Regarding breast cancer, three themes, i.e., “indifference,” “fear,” and “uncertainty” are emerged. “Lack of information about screening modalities” is the overarching schema with reference to breast cancer screenings.

Conclusions

The findings of this study demonstrate unique cultural models of KIW related to breast cancer and its screenings, which are critical to understand and penetrate their barriers to breast cancer screening.

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The Lived Experience of Body Alteration and Body Image with Regard to Immediate Breast Reconstruction among Women with Breast Cancer
Jeonghee Ahn, Eunyoung E Suh
Journal of Korean Academy of Nursing.2021; 51(2): 245. CrossRef
Understanding breast cancer screening behaviors of Korean American women in sociocultural contexts
Ga-Young Choi, Eun Koh, Sam Choi, Ji-Young Cho
Social Work in Health Care.2017; 56(1): 45. CrossRef
Effectiveness of an Ongoing, Community-Based Breast Cancer Prevention Program for Korean American Women
Eun Koh, Ga-Young Choi, Ji Young Cho
Health & Social Work.2016; 41(1): 51. CrossRef
Cultural Competence in Qualitative Interview Methods with Asian Immigrants
Eunyoung E. Suh, Sarah Kagan, Neville Strumpf
Journal of Transcultural Nursing.2009; 20(2): 194. CrossRef

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A Path Analysis on Factors Influencing Second Primary Cancer Screening Practices in Stomach, Colon, and Breast Cancer Survivors: Young Hee Yang; J Korean Acad Nurs 2014;44(2):139-148. Published online April 30, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.2.139

Abstract PDF

Purpose

This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors.

Methods

Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0.

Results

The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon).

Conclusion

It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.

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