This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.
Spiritual health is an important indicator in the quality of life of patients with cancer. The purpose of this study was to validate a Spiritual Health Inventory (SHI) for patients with cancer developed by Highfield (1989). The SHI was translated into Korean, back-translated into English. The study sample was 96 patients with cancer. The data were collected from September, 1999 to February, 2000 for 6 months. Statistic analysis was done with the SPSS PC+ (Version 10.0) program: descriptive statistics, factor analysis, Pearson correlation coefficient, and one-way ANOVA. The results are as follows : 1. The reliability score was examined using Cronbach's ${\alpha}$ and found to be .79. 2. Construct validity was examined using factor analysis. Four factors were identified and named : (1) Peace of mind (19.1% of variance), (2) Hope (9.7%), (3) Self-esteem (6.4%), (4) Trust (6.0%). The total of 41.2 percent of the variance. 3. The Pearson correlation coefficient score of 4 factors was between r = .24~ .42. 4. SHI was identified as multidimension, that is (1) The relationship with GOD, as absolute being, (2) the relationship with others, (3) the relationship within oneself. 5. There were differences in response in items especially related to GOD. The following recommendations can be made on the above findings : 1. Replicate with a minimum sample of 150 and test for concurrent validity. 2. Since spirituality is a dynamic concept, longitudinal study is also necessary. 3. Concept analysis using a qualitative study based on religious preference is recommended. 4. The items such as 12, 13, 15, 17, 19, 22, 24, 26 indicated conceptual ambiguity for Korean populations and further study is needed on item deletion or new items.
Purpose: The study was to develop psychoeducational intervention and identify its effect for symptom management of home cancer patient. Method: Study subjects were 24 patients in control group and 18 patients in experimental group. In experimental group, individualized psychoeducation was done after pretest and then continued to educate and consult through calling by telephone once a week for 4 weeks. The data were collected using several tools such as symptom distress by McCorkle(2000). Physical functioning, a part of Medical Outcome Study by Ware and Sherbouine(1992) and QOL- cancer patient version by Ferrell and Grant(1995) from 18th of Feb. to 30th of July. Data were analysed to ${\chi}^2$ test and t test using SAS VER8.12. Results: The mean score of symptom distress was 21.6 in experimental group and 24.2 in control group. Experimental group was shown lower score than control group. Physical functioning of experimental group was better as mean score 23.3 than 20.6 in control. Psychological wellbeing was 69.7 in experimental group and 66.1 in control group. Social wellbeing was 32.2 in experiment and 25.8 in control. Psychosocial wellbeing of experimental group was higher than control group. However there was no significant differernce between two groups among these variables. Conclusion: The psycho educational intervention was not made symptom mangement, physical functioning, and psycho social wellbeing improved but shown positive tendency. It is expected having a statistically significant finding if enlarged sample size and prolonged the intervention term in future. Therefore it is suggested psycho educational intervention study do repeatedly.
The purpose of this study was to investigate the effects of coping mechanisms on uncertainty and depression. The subjects were 71 cancer patients selected from Junbook National University Hospital, and the data collection period was from June 21 to October 19 of 2000. Uncertainty was measured by using Mishel's Uncertainty Scale, problem- focused coping, and emotional-focused coping. The data was collected by a questionnaire developed by Lee (1984), and then depression measured by using Beck's depression scale. program by Pearson Correlation Coefficients, and Path analysis. The results were as follows : 1. The mean uncertainty score was 59.17, the mean problem-focused coping score was 48.78, the mean emotional-focused coping score was 42.52. 2. The mean depression score was 15.77. 3. Uncertainty in illness was significantly related to depression (p=0.003) and emotional-focused coping (p=0.028), but uncertainty was not associated with coping mechanisms. 4. When analyzed multiple regression between uncertainty, problem-focused coping, emotional- focused coping, and depression, more specifically emotional-focused coping showed a stronger association with depression than problem-focused coping. 5. Depression was highly correlated with economic status (p=0.015), educational background (p=0.005), duration of disease (p=0.045). 6. Problem-focused coping and emotional-focused coping appeared to function as moderators instead mediators on the relation between uncertainty and depression. In addition, as a whole, uncertainty showed a significant moderating effect on depression, while problem-focused coping did on depression. Finally, limitation of present findings were discussed and implications for future studies are suggested.
The purpose of this study was to develop an education program for hospice care and to examine the effect of the program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with which terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description of content of hospice care experienced by subjects after the performance of education, put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.
Since cancer is not easily curable, patients who suffer from cancer may have physical, psychological and spiritual problems for the rest of their lives. Especially when cancer patients do not have much to live for and are placing a burden on their family they will experience more suffering emotionally as much as physically. This study was conducted to provide a basis of data for nursing intervention strategies to minimize a cancer patient`s suffering and to understand the relationship between suffering, burden and the meaning of life in cancer patients. The samples were composed of 160 cancer patients who were inpatients or outpatients of two university hospitals and two general hospitals in Seoul. Data collection were carried out from January, 25, 1999 to February, 26, 1999. The data were analyzed using a SAS program for descriptive statistics, pearson correlations, ANOVA, and Duncan tests. The results were as follows; 1. The scores on the two suffering scale ranged from 132 to 40 with a mean of 87.3(SD 17.5). The mean scores on the burden scale is 28.9(SD 6.9) and the score of the meaning of life ranged from 35 to 51 with a mean of 95.6(SD 18.4). 2. There were significant correlations between the amount of suffering and the magnitude of burden (r=.74, p=.00), the suffering and the meaning of life (r=-.59, p=.00) and the burden and meaning of life (r=-.61, p=.00). 3. In the degree of the suffering, the burden and the meaning of life were two very strong factors, the level of the suffering in cancer patients by age (F=2.64, p=.03) and education level (F=4.16, p=.00). The level of the burden in cancer patients differed by education level (F=4.70, p=.00) and type of cancer (F=2.97, p= .03). Also the level of the meaning of life in cancer patients was different by education level (F=3.55, p=.02). In conclusion, the burden and the meaning of life was identified as important variable that is contributed to reduce the suffering of cancer patients.
Purpose: The purpose of this study was to identify relationships between quality of sleep, symptom cluster, depression, environmental disorder, and quality of life among hospitalized cancer patients. Methods: The subjects were 114 patients who underwent chemotherapy for colon cancer, gastric cancer, gynecologic cancer and breast cancer. They were recruited from the cancer center of a university hospital. Data were collected from August 4th to 30th, 2011. The questionnaires included the Korean sleep scale A (quality of sleep), MDASI-K (symptom cluster), the environmental sleep disturbing scale, Zung's depression scale, and the Korean version of EORTC QLQ-C30. The collected data was analyzed by t-test, ANOVA, multiple regression analysis using the SPSS 19.0 program. Results: Functional QOL was negatively associated with symptom QOL (r=-.798, p<.001). Symptom cluster, depression, & spouse (46.3%) were the most powerful predictors for functional QOL (46.3%) and symptom QOL (53.4%). Conclusion: It is evident that oncology nurses need to evaluate two dimensions of quality of life for cancer patients, for example, functional and symptom QOL. We recommend nurses develop specific protocols for relieving physical symptoms and alleviating depression, and furthermore test the effectiveness of them.
Purpose: This study was performed to analyze the characteristics and effect sizes of intervention studies on foot-reflexo-massage applied to cancer patients. Methods: For meta-analysis, a total of 159 studies were retrieved from search engines such as RISS, nanet, KISS, richis and KoreaMed. 16 studies published from 1990 to 2010 were selected based on the inclusion criteria. The data were analyzed with the RevMan 5.0 program of Cochrane library. Results: 1) The mean score of 1 implement time on foot-reflexo-massage was 25.62 minutes, the average number of days was 4.12 days, and the total number of average intervention frequency was 4.25 times. 2) Intervention studies on foot-reflexo-massage included 9 studies on anxiety (56.3%), 7 for pain (43.8%), 5 for BP/pulse (31.3%), 5 for fatigue (31.3%), 3 for nausea/vomiting (18.8%), 3 for sleep satisfaction (18.8%), and 2 for depression (12.5%). 3) The effect sizes of the intervention studies that showed higher effect size were in order, anxiety (d=-1.76), fatigue (d=-1.43), depression (d=-1.03), nausea and vomiting (d=-0.83), pain (d=-0.77), pulse rate (d=-0.61), blood pressure (d=-0.55), and sleep satisfaction (d=0.43). Conclusion: This study suggests that foot-reflexo-massage can increase sleep satisfaction, whereas decreasing blood pressure, pulse rate, anxiety, fatigue, depression, nausea, vomiting and pain.
Pain management is a major issue in caring of cancer patients. Because pain management cancer patient of does not control effectively, it is important to educate reporting pain and using analgesics for having cancer patient's concerns and anxiety. The purpose of this study was to identify the effect of cancer pain management education on the pain and concerns of pain management in cancer patients. This study was a quasi-experimental as nonequivalent control pretest-post test design. The subjects of this study consisted of 50 (experimental group 25, control group 25) patients hospitalized in K university hospital in Busan. The data were collected from December 1, 2001 to April 12, 2002. The measurement tool for the concerns of pain management had used questionnaires interpretated by Kim(1999) developed by based Ward(1993) and pain nominal scale. The collected data were analyzed frequency, percentage, mean, SD, $X^2$-test, t-test, ANCOVA. The results of this study were as follows: 1. The 1st hypothesis : "The experimental group which had received the cancer pain management education were lower than the control group in the score of pain" was not supported (p>0.05). 2. The 2nd hypothesis : "The experimental group which had received the cancer pain management education were lower than the control group in concerns of pain management" was supported (F=5.285, p<0.01). In conclusion, the cancer pain management education can know what was effective to decrease in the concerns of pain management in cancer patients. Therefore, Pain Management Education must be positively utilized in clinical situation.
Purpose: The purposes of this study were to develop the constipation assessment tool for identifying their bowel movement patterns, and to provide basic information for the assessment and intervention protocol on constipation for patients with terminal cancers. Methods: The study followed the steps: the first step was to build a conceptual framework based on literature review; the second step was to develop a tentative instrument by analyzing the conceptual framework and existing instruments; the third step was to test content validity and reliability; and the final step was to apply the tool to patients with terminal cancers (N=112). Results: The constipation assessment tool was consisted of total nine items; under the categories of subjective and objective data for diagnosis had 4 items, and under the initial assessment category which includes stool type, physical examination, and abdomen X-ray had 5 items. Conclusion: The constipation assessment tool developed in this study is very easy to use and useful in nursing practice, especially in hospice and palliative care setting. Particularly this tool has items on patient assessment which would be considered as an evidence for choosing nursing interventions. Based on the constipation assessment tool, the development and application of intervention protocol on constipation for patients with terminal cancers is warranted in future research.
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