Purpose: The purpose of this study was to describe and understand the meaning of cancer survivors' life experience after being discharged from the primary cancer treatment. Methods: Data were collected through a tape-recorded in-depth interview from six participants living in Gyeonggi province from September 2007 to January 2008. The analysis of the data was made through the phenomenological analytic method suggested by Colaizzi. Results: Thirteen themes regarding the survivors' life experience were found. From these thirteen themes, six major theme were emerged. The six major theme included 'keeping his/her mind comfortable', 'going ahead with new hope', 'accepting for his/her existing burden', 'maintaining a good health for a new life', 'improving the strength and relationship among the family member', and 'being faithful to his/her religion'. Conclusions: The results of this study would help oncology nurses to understand the cancer survivors' life and to develop a quality of life improvement program for physical, psychosocial, and spiritual aspects of nursing.
The purposes of this study were to evaluate symptom experience and quality of life (QOL) and to identify the predictors of QOL among breast cancer survivors. Methods: A cross-sectional study was conducted on 200 disease-free breast cancer survivors at two hospitals between December 2007 and July 2008. Functional Assessment of Cancer Therapy Scale-B, Memorial Symptom Assessment Scale-short Form and The Linear Analogue Self Assessment Scale were used to assess symptom experience and QOL in these patients. Data were analyzed using the Pearson correlation, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. Results: The mean score of QOL for breast cancer survivors was 95.81 (${\pm}18.02$). The highest scores among physical and psychological symptoms were sexual interest and anxiety. Year since treatment completion was significantly associated with QOL in sociodemographic variables. Physical and psychological symptoms have a significant negative association with QOL. The results of the regression analyses showed that physical and psychological symptoms were statistically significant in predicting patients' QOL. Conclusion: Symptom experience and QOL are essential variables that should be acknowledged when delivering health care to breast cancer survivors. More attention to the reduction and management of psychological distress could improve QOL among breast cancer survivors.
Purpose: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. Methods: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. Results: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. Conclusion: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.
Purpose: To determine impacts of psychological distress, gender role attitude, and housekeeping sharing on quality of life of gynecologic cancer survivors. Methods: Subjects completed questionnaires consisting of four measurements: FACT-G (ver. 4) for quality of life, anxiety and depression from SCL-90-R for psychological distress, gender role attitude, and housekeeping sharing. A total of 158 completed data sets were analyzed by descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using SPSS 21.0 program. Results: Quality of life was significantly and negatively correlated with psychological distress (r=-0.64, p<.001), but not with gender role attitude (r=-0.14, p=.820) or housekeeping sharing (r=0.08, p=.350). Psychological distress was significantly and positively correlated with gender role attitude (r=0.25, p<.010). Factors that significantly impacted quality of life were type of cancer (t=2.27, p=.025), number of treatment methods (t=2.58, p=.011), education level (t=3.33, p<.001), and psychological distress (t=-9.96, p<.001). Conclusion: Nursing interventions that can relieve psychological distress need to be developed for gynecologic cancer survivors. Nurses need to put priority on ovarian cancer survivors who have low education level with multiple treatment methods when performing nursing interventions to improve the quality of life of gynecologic cancer survivors.
This study investigated multidimensional body image, self-esteem, clothing benefits sought, and Body Image After Breast Cancer (BIABC) within surgical subgroups among breast cancer survivors. The study applied the questionnaire survey method and the main research was conducted through an online survey. The respondents included 207 breast cancer survivors between the ages of 30 and 59, each of whom received the Multidimensional Body-Self Relations Questionnaire (MBSRQ). Self-esteem, clothing benefits sought, examination, and demographic variables were measured using a 5-point Likert scale. The main results of this study are outlined below. For clothing benefit sought, six factors were formulated-pursuit of self-expression/social approval, function/health, compensation, femininity, fashion, and camouflage-and BIABC was defined by the four factors of body stigma/vulnerability, transparency, limitation and cancer concern. While MBSRQ and self-esteem did not show a statistically significant difference between groups differentiated by the surgical methods experienced, those who underwent mastectomies scored slightly lower than members of the other groups. Moreover, the reconstruction after mastectomy group showed the highest mean on self-expression/social approval, compensation, femininity and entire clothing benefits sought, followed by the lumpectomy group and mastectomy group. The lumpectomy group was found to have more positive BIABC than the mastectomy group. In particular, the mastectomy group showed a lower body stigma/vulnerability mean than the other groups. This study is meaningful in that it improves our understanding of the body image of breast cancer survivors and provides basic knowledge for developing products and marketing strategies for breast cancer survivors as consumers.
Purpose: This study aimed to analyze physical activity as measured by the International Physical Activity Questionnaire (IPAQ) and an actigraph in breast cancer survivors, as well as to identify their intention to participate in a physical activity program. Methods: Breast cancer patients who had been diagnosed for more than six months (N=135) at a university hospital participated from June 2012 to May 2013. Physical activity was measured using the Korean version of the IPAQ-Short Form and Actigraph GT3X plus an accelerator for seven consecutive days. Data analyses were conducted using the SPSS WIN 19.0 program. Results: Mean total physical activity was 2298.21 metabolic equivalent task (MET)-min/week as assessed by IPAQ and 150,140.57 counts/day as measured by an actigraph. There were statistically significant correlations between moderate physical activity from IPAQ and light intensity of physical activity from the actigraph (r=.735, p<.001), vigorous physical activity from IPAQ and vigorous intensity of physical activity from the actigraph (r=.871, p<.001), total physical activity from IPAQ and light intensity of physical activity from the actigraph (r=.825, p<.001), respectively. Most (80.7%) cancer survivors reported a positive attitude toward physical activity and 57.8% expressed a willingness to participate in a physical activity program. More than half (60%) of the subjects preferred walking, 80.6% preferred more than 30 minutes of exercise, and 57.1% wanted to engage in physical activity three times a week and preferred home-based activities. Perceived barriers included fatigue, lack of strength and pain. Conclusion: It is necessary to consider intensity, personal preferences, and patient-perceived barriers when developing physical activity programs for breast cancer survivors.
Purpose: This study investigated the associations between physical activities (PAs) and the health-related quality of life (HRQOL) and perceived health status (PHS) of cancer survivors. We further examined the interaction effects of PAs and covariates on HRQOL and PHS. Methods: Data sets were obtained from the 2014-2018 Korea National Health and Nutrition Examination Survey. The subjects were 1,349 cancer survivors aged over 18 years old. Data were analyzed using R 4.0.3 and SPSS 18.0. Logistic regression analysis was conducted considering only the main terms, or including additional interaction terms between PAs and covariates. Results: Moderate and high PAs showed significantly improved HRQOL related to self-care domain, euro quality of life-5 dimension index, and PHS. Interaction analysis revealed that high PAs resulted in improved HRQOL associated with self-care and pain/discomfort in cancer survivors having depression. Moreover, for low- and middle-income levels, higher PAs served to improve HRQOL associated with depression/anxiety. In contrast, higher PAs rather reduced HRQOL for the high-income group. Conclusions: To improve HRQOL, we recommend PAs higher than the moderate level for cancer survivors. In case of cancer survivors having depression or belonging to the high-income group, it is necessary to manage individual PAs considering the interaction effects.
Purpose: The purpose of this study was to identify factors influencing the quality of working life of cancer survivors (QWL-CS) after return to the workplace. Methods: Data were collected from 154 cancer survivors from May 16 to June 23, 2018. Participants were selected as candidates from two different hospitals in the metropolitan area and snowball sampling was used in parallel. The data were analyzed by SPSS 21.0 using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: Mean score of QWL-CS was $4.39{\pm}0.59$. QWL-CS was negatively correlated with fatigue, and job stress: however, it was positively correlated with workplace spirituality. The factor that had the greatest influence on the QWL-CS was job stress (${\beta}=-.36$, p<.001), followed by fatigue (${\beta}=-.35$, p<.001), workplace spirituality (${\beta}=.35$, p<.001), number of currently cancer treatment (${\beta}=-.15$, p=.009), and number of children (${\beta}=.12$, p=.031). The explanatory power of models was 54%. Conclusion: Effective and practical intervention programs for increasing the quality of working life are required to be provided to cancer survivors after return to the workplace in accordance with job stress, fatigue, workplace spirituality, and general characteristics of cancer survivors such as number of currently cancer treatments and number of children.
Purpose: This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL. Methods: This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors' Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation. Results: The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (${\beta}=.55$, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001). Conclusion: The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.
Purpose: The purpose of this study was to identify the influence of depression, optimism and posttraumatic growth on health-related quality of life in female breast cancer survivors received adjuvant chemotherapy. Methods: In total, 115 female breast cancer survivors participated in this descriptive correlational study. The participants answered self-report questionnaires. Data were collected from 1 June 2020 to 10 June 2020, and were analyzed using descriptive statistics, the t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression with SPSS for Windows ver. 24.0. Results: The mean age of the breast cancer survivors was 45.83 years. The mean score for the degree of health-related quality of life was 81.85 out of 148 points. Participants' scores for health-related quality of life differed significantly based on economic status (F=5.36 p=.006) and hobbies (t=-3.37, p=.001). Health-related quality of life was negatively correlated with depression (r=-.73, p<.001), and positively correlated with optimism (r=.65, p<.001) and posttraumatic growth (r=.28, p=.002). Depression (𝛽=-.55, p<.001) was the most significant factor that affects health-related quality of life, followed by optimism (𝛽=.29, p<.001), and post-traumatic growth (𝛽=.12, p=.048), which together accounted for 62.2% (F=63.61, p<.001) of the variance. Conclusion: It is necessary to develop educational programs for breast cancer survivors to reduce depression, increase optimism and post-traumatic growth, and improve the health-related quality of life. By adapting these programs, positiveness may increase and this may lead to improvement of health-related quality of life for breast cancer survivors.
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