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RISS 인기검색어
- 검색키워드
- 저자 : Gwen Anderson (검색결과 6 건)
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Communication Patterns in Korean Families during BRCA Genetic Testing for Breast Cancer
Gwen Anderson,Jun Myunghee(전명희),Choi Kyung Sook(최경숙) 대한종양간호학회 2011 Asian Oncology Nursing Vol.11 No.3
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.
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Models of Genetic Counseling Services and Quality Assurance: A Theoretical Inquiry
전명희,Anderson, Gwen. 한국간호교육학회 2011 한국간호교육학회지 Vol.17 No.3
The goal should be to design patient care services with a view to provide the best model of care for the patient and not merely focus on models that are ideal for clinicians or genetic researchers. Quality assurance means that services are evaluated for their effect on patients and families. This paper fills a gap in the literature because criteria for determining which model(s) might be most effective in certain patient populations, or clinical contexts has not been addressed in the literature. The authors identify new concepts that reflect a patient-centered perspective of quality assurance. Researchers have measured patient outcomes before, during, and after genetic services to demonstrate cost effectiveness,patient satisfaction, knowledge gained, effect on treatment and genetic testing decisions, psychological effect of risk communication and other variables. However, without a clear understanding of the organizational structure of current service models, it is impossible to know which ones might be better than others, or whether certain models best serve specific populations. The authors invite discussion and debate to fill a gap in the literature about the relationship between models of service and patient outcomes. Consequently, in Korea it is necessary to establish research evidence to demonstrate improved patient and family outcomes due to nurse’s involvement in delivering cancer genetic risk information and testing. This is necessary to establish the educational program for nursing genetics and demonstrate the competence of nurses in providing these services and the most feature of transdisciplinary team model, counselor as a scientific expert as well as personhood expert who takes the time to be with, listen to and respond sensitively and compassionately as patients and family members try to understand and make the best possible decisions given the current state of science and medical practice. Also this model reflects careful cultural sensitivity. It must consider family oriented culture not individualism. 유전 위험 사정과 상담서비스가 임상실무에 널리 적용되어 감에 따라, 다양한 비용효율면에서 다양한 상담서비스 모델을 사정하고, 대상자의 임상 요구와 건강문제를 해결하는데 어떤 모델이 유용한 지 확인할 필요가 있다.본 연구의 목적은114건의 현장 관찰과 문헌고찰을 통하여3가지 유전상담 모형을 분석하였다.유전의학 전문가 모델, 유전상담사 모델, 임상연구전문가 모델을 중심으로 각 모델의 구조,전문가의 역할 및 기능,목표, 물리적 세팅, 교육도구 등을 분석하였다. 각 모형 안에서 환자에게 기대되는 결과 면에서 질적 서비스가 보장되는지 확인하기 위하여 이론적 분석을 실시하였다.본 연구를 통하여 각 모형의 상담 전, 중,후 환자 만족,지식 변화, 상담 효과 및 커뮤니케이션 효과 등을 분석하였지만, 결론적으로 상담서비스가 이루어지고 있는 기관의 구조를 충분히 고려하지 않은 상태에서 최상의 서비스 모델을 제시하기 어려울 것임을 논의하였다.
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Models of Genetic Counseling Services and Quality Assurance
Jun, Myunghee(전명희),Anderson, Gwen(구웬 앤더슨) 한국간호교육학회 2011 한국간호교육학회지 Vol.17 No.3
유전 위험 사정과 상담서비스가 임상실무에 널리 적용되어 감에 따라, 다양한 비용효율 면에서 다양한 상담서비스 모델을 사정하고, 대상자의 임상 요구와 건강문제를 해결하는데 어떤 모델이 유용한 지 확인할 필요가 있다. 본 연구의 목적은 114건의 현장관찰과 문헌고찰을 통하여 3가지 유전상담 모형을 분석하였다. 유전의학 전문가 모델, 유전상담사 모델, 임상연구전문가 모델을 중심으로 각 모델의 구조, 전문가의 역할 및 기능, 목표, 물리적 세팅, 교육도구 등을 분석하였다. 각 모형 안에서 환자에게 기대되는 결과 면에서 질적 서비스가 보장되는지 확인하기 위하여 이론적 분석을 실시하였다. 본 연구를 통하여 각 모형의 상담 전, 중, 후 환자 만족, 지식 변화, 상담 효과 및 커뮤니케이션 효과 등을 분석하였지만, 결론적으로 상담서비스가 이루어지고 있는 기관의 구조를 충분히 고려하지 않은 상태에서 최상의 서비스 모델을 제시하기 어려울 것임을 논의하였다.
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고위험 유전성 유방암을 지닌 한국계 미국 여성의 질병경험
최경숙(Choi Kyung Sook),전명희(Jun Myunghee),Gwen Anderson 대한종양간호학회 2012 Asian Oncology Nursing Vol.12 No.2
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.
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