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"Yoo, Grace"
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Caring across generations : the linked lives of Korean American families
\"More than 1.3 million Korean Americans live in the United States, the majority of them foreign-born immigrants and their children, the so-called 1.5 and second generations. While many sons and daughters of Korean immigrants outwardly conform to the stereotyped image of the upwardly mobile, highly educated super-achiever, the realities and challenges that the children of Korean immigrants face in their adult lives as their immigrant parents grow older and confront health issues that are far more complex. In Caring Across Generations, Grace J. Yoo and Barbara W. Kim explore how earlier experiences helping immigrant parents navigate American society have prepared Korean American children for negotiating and redefining the traditional gender norms, close familial relationships, and cultural practices that their parents expect them to adhere to as they reach adulthood. Drawing on in-depth interviews with 137 second and 1.5 generation Korean Americans, Yoo & Kim explore issues such as their childhood experiences, their interpreted cultural traditions and values in regards to care and respect for the elderly, their attitudes and values regarding care for aging parents, their observations of parents facing retirement and life changes, and their experiences with providing care when parents face illness or the prospects of dying. A unique study at the intersection of immigration and aging, Caring Across Generations provides a new look at the linked lives of immigrants and their families, and the struggles and triumphs that they face over many generations\"-- Provided by publisher.
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Keeping us all whole: Acknowledging the agency of African American breast cancer survivors and their systems of social support
While all cancer patients face a bewildering array of treatments, side effects, and emotions, several researchers have shown that African American women with breast cancer experience greater stress and burdens because of unmet supportive needs associated with psychological distress, financial distress, and lower physical/functional well-being. Social support has been shown to improve health outcomes for African American breast cancer patients. The purpose of this paper is to understand the meaning of social support among African American women diagnosed with breast cancer. A total of 47 African American women with breast cancer participated in the in-depth qualitative interviews. Key findings indicate that social support was received in the context of the stability of the extended family network. Moreover, social support was received in the context of distributing the social support received among many members in their personal networks and that social support was only received on patient’s own terms. The findings of this paper provide an understanding to the inter-relational and cultural meanings of receiving support by diverse cancer patients. In addition, the findings of this paper have implications for health care professionals working with African American breast cancer patients in understanding how social support can be received.
Journal Article
Breast cancer and coping among women of color: a systematic review of the literature
Breast cancer is the most commonly diagnosed form of cancer for women regardless of race/ethnicity. Women of color are diagnosed at later stages and experience greater mortality than their White counterparts. However, there has been comparatively little research on coping with breast among racial/ethnic minorities at time of diagnosis, during treatment, or in the course of survivorship. This is despite the fact that research has repeatedly shown that distress can impact disease progression and survival. The questions asked of this systematic literature review include: (1) What is known about coping with breast cancer among major racial/ethnic groups? (2) What are the strengths and gaps in research to date? Over 120 peer-reviewed published studies (1980–2012) were reviewed. A total of 33 met criteria for inclusion including 15 quantitative, 17 qualitative, and 1 mixed methods study. The majority of studies were small sample cross-sectional studies. Only five studies were longitudinal, and two randomized-controlled intervention trials sought to improve coping among survivors. The most common topic in both quantitative and qualitative studies was spirituality and coping among African American breast cancer patients. Thirteen studies included Latinas only or in combination with other groups. Only one quantitative and one qualitative study solely addressed the Asian American population exploring coping and adjustment. In the course of this systematic literature review, we elucidate what is known about coping with breast cancer among racial/ethnic minority women and identify priorities for future research.
Journal Article
Predictors of Quality of Life among Ethnically Diverse Breast Cancer Survivors
Few studies have examined predictors of quality of life (QOL) of breast cancer survivors over time. Breast cancer survivors (
n
= 116) were asked to complete measures of QOL, mood, spirituality, and social support every 6 months from 2 to 4 years post treatment. Overall QOL at 4 years was predicted by previous physical and functional well-being, the breast cancer-specific items, and vigor and current levels of social support (Adj
R
2
= .72,
F
= 30.53,
p
< .001). Physical QOL was predicted by previous levels of physical and functional well-being and current levels of functional and social/family well-being (Adj
R
2
= .84,
F
= 44.30,
p
< .001). Functional well-being was predicted by prior levels of physical, functional, and social/family well-being and current levels of physical well-being and vigor (Adj
R
2
= .72,
F
= 3–.53,
p
< .001). Emotional well-being was predicted by previous levels of emotional well-being and current physical well-being, the breast cancer-specific items, and anxiety (Adj
R
2
= .60,
F
= 26.30,
p
< .001). Social/family well-being was predicted by previous levels of social/family well-being, social support, and confusion (Adj
R
2
= .71,
F
= 34.18,
p
< <000). The breast cancer-specific items were predicted by age, previous levels of the breast cancer-specific items, confusion, and current levels of emotional and functional well-being and spirituality (Adj
R
2
= .58,
F
= 17.57,
p
< .001). Overall and specific dimensions of QOL at 4 years were predicted by different combinations of QOL, mood, and spirituality. Interventions should be tailored to which dimensions of QOL are affected and other types of QOL as well as social support, mood, and spirituality as coping mechanisms that influence the specific dimension of QOL affected.
Journal Article
Qualitative Exploration of Sexual Health Among Diverse Breast Cancer Survivors
Although the physical and emotional impact of surgical removal of partial or complete removal of the breast as well as effects of breast cancer treatment on the individual have been well documented, little research is available on sexuality and sexual health of breast cancer survivors in a relationship context. Sexual health concerns of breast cancer survivors remain an unmet need for many. The present study consisted of qualitative interviews with 135 racially diverse, female breast cancer survivors who completed treatment to better understand their perspectives on sexual health and management of sexual problems in their potential and existing relationships after breast cancer. Key thematic findings include that breast cancer survivors have to (1) adapt to the physical and emotional traumas of breast cancer surgery and treatment, (2) navigate complicated sexual communications with potential and existing partners, and (3) negotiate intimacy and closeness without sexual intercourse with existing partners. This study demonstrates the need for healthcare providers to discuss sexual health after breast cancer with all of their patients as it is a concern that faces single and partnered breast cancer survivors months and years after treatment.
Journal Article
Centering Ethnic Studies in Health Education: Lessons From Teaching an Asian American Community Health Course
Anti-Asian racism and violence dramatically increased during the COVID-19 pandemic. As a result, recent studies and reports are showing that the health and well-being of Asian Americans are negatively affected. To address this urgent problem, the field of health education and public health must be equipped with the critical frameworks and concepts to analyze racism and White supremacy and how it affects the health and well-being of Asian Americans. We argue that using an ethnic studies lens in health education can help educators, researchers, and practitioners teach and train health educators to address racism experienced by Asian Americans during COVID-19 in relation to their health. We will discuss the elements of ethnic studies and demonstrate how to use it as a lens in understanding health disparities in the Asian American population influenced and exacerbated by the COVID-19 pandemic.
Journal Article
Older Chinese and Filipino American Immigrants with Type 2 Diabetes and their Adult Child: A Qualitative Dyadic Exploration of Family Support
Type 2 Diabetes (T2D) among older Asian American immigrants (AA) is a growing concern. Asian Americans represent 9% of diagnosed diabetes. Very little is known on how older Asian American immigrants with T2D navigate diabetes management, in particular the role of family support. This qualitative study examines Chinese and Filipino Americans, the two largest Asian subgroups in the US (4.2 million, and 3.6 million, respectively), and family support dynamics among adult children and their parents diagnosed with T2D. Ten dyads (n = 20) made up of adult children and aging parents participated in in-depth and dyadic interviews. Results indicate that family support occurs in a trajectory of stages. The following thematic patterns emerged in these dyads around support: independence, transitions, partnership, and stepping in. The findings point to various supportive stages that Asian American adult children and aging parents with T2D experience and the importance of developing supportive interventions for both adult children and aging parents at these various stages.
Journal Article
Tiwala, gaining trust to recruit Filipino American families: CARE-T2D study
Objective: Filipino Americans have greater risk for type 2 diabetes (T2D) and related complications compared to other Asian populations and non-Hispanic Whites. There are few diabetes intervention studies focused on Filipinos and limited evidence regarding the best recruitment strategies for this hard-to-reach population.Methods: This article examined barriers and facilitators to recruitment of Filipino families for the “Caring for Asian Americans through Research and Education on T2D” (CARE-T2D) study, which took place in California from June 2018 through June 2019.Results: Recruitment of 50 Filipino dyads (parent with T2D and adult child) were successfully met. Gaining trust through culturally tailored strategies was key in recruiting Filipino participants. Tiwala (gaining trust) strategies involved: 1) using Filipino staff as role models for research engagement and 2) incorporating narrative communications or “kuwentuhan” (Filipino cultural storytelling) with recruitment. Other facilitating strategies included in-person presentations at local colleges and organizations, Filipino community leaders’ support, snowball sampling, previous study participant listservs, and posting fliers on family/friends’ personal social media sites. Barriers to recruitment included research mistrust, confidentiality concerns, and risks of violating cultural values.Conclusion: To our knowledge, this is the first study to recruit Filipino family dyads. Findings will inform researchers and clinicians on how best to recruit Filipino families in community health-related research and public health programs. Ethn Dis. 2022;32(1):49-60; doi:10.18865/ed.32.1.49
Journal Article
I don’t have to explain, people understand
Background: Filipino Americans have the highest risk for obesity-related type 2 diabetes and related complications compared with all major Asian American subgroups. Identifying effective interventions to improve Filipino health outcomes are needed to reduce this health disparity.
Objective: To assess the acceptability and cultural relevance of the PilAm Go4Health program - a culturally adapted mobile health weight-loss lifestyle intervention including virtual social networking for Filipino Americans with type 2 diabetes.
Design, Setting, Participants: Qualitative semi-structured post-program interviews explored perceptions of 45 Filipino Americans with type 2 diabetes in Northern California regarding their perceptions of the acceptability and cultural relevance of PilAm Go4Health. Participants’ mean age was 57.6 years. Sixty-seven interviews were recorded, transcribed, and thematically analyzed by four independent coders.
Results: Over half (n=26, 57.8%) of the respondents found that a culturally tailored intervention program enhanced their engagement. All (n=45) of the respondents felt that mobile health technology promoted their self-efficacy. A majority of the respondents (n=29, 64.4%) expressed that they progressed from despair to self-efficacy as a result of their participation in the intervention. More than one-fourth of the participants (n=13, 28.8%) discussed that the intervention needed further cultural tailoring.
Conclusions: Overall, PilAm Go4Health — a mobile health weight-loss lifestyle intervention — was acceptable and culturally relevant for Filipino Americans with type 2 diabetes. Findings may help inform clinician and researchers on effective intervention strategies for diabetes self-management when designing interventions for diverse populations.
Ethn Dis. 2017;27(2):143-154; doi:10.18865/ed.27.2.143.
Journal Article