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.

간호대학생의 결혼, 임신 및 낙태에 대한 태도

전명희(Jun, Myunghee),신계영(Shin, Gyeyoung),최경숙(Choi, Kyung Sook),이선애(Lee, Sun Ae),홍선우(Hong, Sun Woo) 한국간호교육학회 2014 한국간호교육학회지 Vol.20 No.2

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.

임산부의 산전 기형아 검사에 관한 지식과 정보 요구 및 낙태에 대한 태도

전명희(Jun, Myunghee),신계영(Shin, Gyeyoung),김혜경(Kim, Hye-Kyung) 한국간호교육학회 2018 한국간호교육학회지 Vol.24 No.4

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. Conclusions: 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.

최신 비침습적 산전 유전 검사(NIPT)의 임상 적용과 간호학적 의미

전명희(Jun, Myunghee),신계영(Shin, Gyeyoung),허명행(Hur, Myung Haeng),최경숙(Choi, Kyung-Sook) 한국간호교육학회 2013 한국간호교육학회지 Vol.19 No.4

Purpose: Nineteen articles were analyzed to gather opinions and nursing implications about NIPT recently launched. Methods: Nineteen articles were selected from EBSCO (eBook business collection), Google Scholar, and two Korean academic d-bases with key words ‘prenatal screening testing’, ‘prenatal genetic diagnostic testing’, NIPT or ‘cell free DNA (cfDNA)’. Authors developeda framework for analyzing the 19 articles including opinions and suggestions for future implications. Results: Eleven articles written by the first author affiliated with medicine or genetics, viewed NIPT as promising because of safety, accuracy, early detectability and cost effectiveness. Articles written by journalists or authors affiliated with history and ethics were concerned with the possible risk of ELSI (ethical, legal, social issues), erratic interpretation of test results, and lack of genetic counseling service. Conclusion: With consideration of Korean clinical, andlegal circumstances, not only pregnant women and families but also health professionals must prepare for clinical NIPT implications including updating prenatal genetic testing, counseling services, protecting ELSI and amulticultural team approach.

블로그를 통해 본 산전 기형아 검사와 양수검사에 대한 질문과 댓글 분석

전명희(Myunghee Jun),신계영(Gyeyoung Shin),최경숙(Kyung Sook Choi) 한국콘텐츠학회 2015 한국콘텐츠학회논문지 Vol.15 No.3

본 연구의 목적은 블로그에 나타난 임신 여성의 산전 기형아 검사 및 양수검사 관련 교육요구를 파악하기 위하여 총 7개의 국내 인터넷 블로그를 분석하였다. 본 연구는 두 단계로 이루어졌다. 1 단계는 2011년 10월 31일까지 6년간 7개 블로그 중 6개 블로그에 게시된 내용 중 산전 기형아 검사 389건을 통하여 연구의 분석 틀을 마련하였다. 2 단계에서는 ‘맘스홀릭 베이비’에 게시된 산전 기형아 검사에 관한 질문 100건, 양수 검사에 관한 질문 200건과 댓글 1,665건을 2011년 12월 텍스트화하고 산전 기형아 검사와 양수검사의 건수, 검사 이유 및 검사와 관련된 문제점을 분석하였다. 그 결과, 임신부들은 산전 기형아 검사와 양수검사와 관련하여 검사의 용어, 목적 및 임신 주수에 따른 검사 지식이 부족하였고, 양수 검사를 권유 받은 임신부 중 56.5%가 불안과 두려움을 호소하였다. 양수검사에 관한 찬성과 반대 건수를 분석한 결과, 찬성 보다는 반대 건수가 더 많았고, 양수검사를 권유 받은 자 중 33.9%는 양수검사를 받지 않았다. 이상의 결과에서 보듯이 의료 기관 서비스 안에서 임신 여성과 가족들에게 임신 주수에 따른 산전 기형아 검사에 관한 교육 및 지지가 강화될 필요가 있다. 이를 위하여 산전 클리닉 외래의 상담 및 교육 서비스 기능을 강화하고, 유전 상담전문가를 추가로 배치할 필요가 있으며 인터넷 보급률 증가와 현대 임신 여성이 선호하는 커뮤니케이션 방식을 고려하여 온라인 건강 정보 사이트 운영 및 콘텐츠 개발에 관심을 기울일 필요가 있다. 또한 본 연구결과는 기형아 검사 후 낙태 허용범위 기준에 대한 논의 시 기초자료로 활용될 수 있을 것이다. The purpose of this study was to identify pregnant women’s needs for information on prenatal genetic diagnosis and screening. This study is consisted of two phases. In the first phase in December 2011, six blogs featuring questions and answers on prenatal genetic diagnosis and screening were selected from four major search engines in Korea by using the keywords “prenatal genetic diagnosis,” “prenatal genetic screening”, and “amniocentesis.” An analyzing framework was constructed on the basis of 389 posts on six blogs between November 2006 and October 2011. In the second phase, the contents of the “MomsHolicbaby” blog posted from November 2010 to October 2011 were reviewed. Then, pregnant women’s questions on prenatal genetic diagnosis and screening (100 questions) and amniocentesis (200 questions with 1,665 answers) were analyzed using descriptive statistics. Among posters who had ever been recommended to undergo amniocentesis, 56.5% described feelings of anxiety, 25.5% did not know the purpose of the test, and 33.9% refused to undergo the test. Among 295 posters answering questions about amniocentesis, 61.4% disagreed with undergoing the test. The results show that there is a need for healthcare professionals to provide more educational and emotional support to pregnant women considering prenatal genetic diagnosis and screening. Providing online health information can be integrated into prenatal genetic education for pregnant women as well as nurses. In addition, prenatal women’s preferences about undergoing amniocentesis should be reflected in the current legal discussion on criteria for termination of pregnancy.

허리 척추수술환자의 수술 후 불확실성에 미치는 영향요인

전명희(Jun, Myunghee),정지영(Jung, Jiyoung),김민숙(Kim, Minsuk) 대한근관절건강학회 2012 근관절건강학회지 Vol.19 No.3

Purpose: The purpose of this study is to identify main factors affecting patients’ uncertainty following lumbar spinal surgery. Methods: A survey was conducted of a sample 155 post -operative patients in April to June 2010. Uncertainty and knowledge about self-care after spinal surgery and the back pain evaluation were measured. Data were analyzed with t-test, ANOVA, Pearson correlation, and multiple regressions. Results: The mean score of uncertainty level was 27.66±6.32. Levels of uncertainty were different by age, gender, educational level, pain duration, and number of types of pain. Uncertainty was positively correlated with knowledge of post-op self-care, back pain, and mental health. The results of multiple regression indicated that knowledge of post-op self-care and mental health were significant predictors with 35.1% of the variance in uncertainty. Conclusion: A program including post-operative self-care education and mental health promotion is required to reduce uncertainty of patients with lumbar spinal surgery.

유전체학 시대의 한국 종양 유전 간호의 과제

전명희(Jun, Myunghee),최경숙(Choi, Kyung Sook),신계영(Shin, Gyeyoung) 대한종양간호학회 2012 Asian Oncology Nursing Vol.12 No.4

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).

종양간호학회지의 국제화를 위한 2010년 게재논문 분석

전명희(Jun Myunghee),소향숙(So Hyang Sook),최경숙(Choi Kyung Sook),정복례(Chung Bok Yae),류은정(Ryu Eunjung),이동숙(Lee Dong-Suk),강정희(Kang Jeong Hee) 대한종양간호학회 2011 Asian Oncology Nursing Vol.11 No.2

Purpose: The purpose of this study was to analyze the research papers published in three nursing journals to suggest the direction for Journal of Korean Oncology Nursing (JKON). Methods: To compare JKON with Journal of Korean Academic Society of Nursing Education and Cancer Nursing, all the research papers published in those three journals, 2010 were reviewed using an analysis criteria developed by the researchers, focusing on type of research, characteristics of authors and subjects, research design, data collection and analysis methods, sample size estimation, and ethical considerations regarding data collection. Results: JKON lacked research papers which were supported by research funds, produced by multidisciplinary teams, addressing cancer survivors or patients with metastatic cancers, and written in qualitative methodologies. However, JKON showed higher ratio of research papers than the other two journals which were adapted from thesis or dissertations, describing sample size estimation process precisely, and participating subjects diagnosed with various cancers. Conclusion: The study found out that JKON is presenting well the area of oncology nursing in Korea and also has several weak points that need to be improved. The study therefore suggested several recommendations for the JKON to take the professional and global leader roles.

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.

간호사들의 항암제 취급실태와 안전수칙에 대한 인지도와 실천도

김매자(Kim Mae Ja),전명희(Jun MyungHee),최진선(Choi Jin Sun),박종순(Park Jong Sun) 대한종양간호학회 2004 Asian Oncology Nursing Vol.4 No.2

Purpose To provide basic data for establishing the policy of safe handling of Cytotoxic drugs and for building training materials and clinical guidelines for nurses handling Cytotoxic drugs Methods 255 nurses in Seoul and 257 nurses in D metropolitan area participated in the study Questionnaires were based on the safe handling guldeline for Cytotoxic drugs issued by OSHA and ONA Results: Nurses in Seoul scored higher in the cognition for safe handling guidelines of cytotoxic drugs in preparation administration, as well as total score compared with nurses in D metropolitan area The practlcal score also showed higher in nurses in Seoul in administration, disposal and total score But both groups showed low level of practical score The answers why they could not follow the guideline for Cytotoxic drugs were " don't have", "busy", and "don't know", etc Conclusion Handling of the Cytotoxic drug is very common and Important The study findings suggest that hospitals especIally in D metropolitan area should educate the nurses and supply equipments for safe handling of cytotoxic drugs Thus, repetItIve and contioual educatIOn of all nurses including experts IS needed in addition. It is necessary to supply enough protective equipment for preventing exposure to the cytotoxic drugs.