• Korean Journal of Adult Nursing
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• v.21 no.6
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• pp.705-717
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• 2009

Purpose: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). Methods: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. Results: Two distinct clusters were identified: A gastrointestinal- fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. Conclusion: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.

• Korean Journal of Adult Nursing
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• v.28 no.3
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• pp.247-255
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• 2016

Purpose: The purpose of this study was to investigate the influencing factors on Posttraumatic Growth(PTG) in patients with colorectal cancer. Methods: Eighty patients who were diagnosed with colorectal cancer at least twelve months ago were recruited from the oncology outpatient clinic of university hospital in Y city. Participants completed four survey questionnaires: Korean versions of PTG Index, Korean versions of Cancer Coping Questionnaire, Multidimensional Scale of Perceived Social Support, and a Resilience Scale. The data were analyzed by ANOVA, Pearson-correlation coefficient, and multiple regression analysis. Results: The mean score of PTG in these patients was 51.16 indicating relatively high growth. Posttraumatic Growth had significant correlations with coping, social support, and resiliency. In addition to the variables of age and education that are found to be associated with the PTG, the PTG was significantly influenced by resilience, coping, and importance of religion. Forty-nine percent of the variations in the PTG were explained by these three variables. Conclusion: The identified factors influencing colorectal cancer related to PTG could be considered in developing nursing interventions to promote positive psychological changes in response to adversity which colorectal cancer survivors might experience.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.449-458
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• 2015

Purpose: The aims of this study were to identify the reported attitudes of older patients with cancer toward advance directives (ADs) and the factors associated with their attitudes toward ADs. Methods: The design was a cross-sectional survey. The age mean of the 130 participants were 70.8, and 66.2% of the participants were male. The data were collected at one university hospital in Seoul, South Korea during the period from October $1^{st}$ to December $5^{th}$ in 2013. The data collecting instruments were the Advance Directives Attitude Survey (ADAS) and questionnaires including socio-demographic and disease-related characteristics, family function. Results: 30.0% of the participants were aware of ADs, only 9% of them had been informed by healthcare providers. Most participants (93.1%) intended to complete ADs. The mean score of ADAS was 48.29. The stepwise linear regression analysis indicated that family function, perceived health status, period of education, and age accounted for a significant percentage (52.0%, p<.001) of the variance in participants' ADAS. The variable with the greatest effect was family function. Conclusion: The findings suggest that family function and attitude of older cancer patients need to be considered for adapting ADs to Korean health care systems. Healthcare providers should include family members in advanced care planning discussions.

• Journal of Korean Academy of Nursing
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• v.42 no.1
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• pp.105-115
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• 2012

Purpose: This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984). Methods: Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version. Results: Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer. Conclusion: The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.

• Korean Journal of Adult Nursing
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• v.23 no.6
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• pp.543-553
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• 2011

Purpose: This study was designed to explore the parental stress, behaviors and need for parental education of young women with breast cancer and how these variables are related to their children characteristics. Methods: The subjects were 110 young women with breast cancer who have a child. Data were collected using questionnaire of parenting stress, parental behaviors and need for parental education. Results: The subjects reported many unmet needs for parental education, and have the highest level of need for education related to breast cancer. Women with daughters have higher level of need for parental education compared to subjects with sons. There was a negative correlation between parenting stress and parental behaviors and between parenting stress and need of parental education. Conclusion: As these results, the development and application of parental education program for mothers with breast cancer in the future should be considered with the demographic characteristics, the social and cultural environment, parenting stress, and parental behaviors of parents and children.

• Journal of Korean Academy of Nursing
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• v.43 no.6
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• pp.801-811
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• 2013

Purpose: To investigate changes in Quality of life (QOL) and related factors in patients with thyroid cancer undergoing Radioactive Iodine remnant ablation (RAI). Methods: Data were collected longitudinally 3 times for 6 months (2 weeks post-surgery, post RAI, 3 months post RAI) in a hospital located in Seoul. Questionnaires were used to measure levels of physical symptoms, anxiety, depression, and QOL. Ninety-eight patients with thyroid cancer who had RAI were included in the analysis. Data were analyzed using SPSS (18.0). Results: Findings for the three data collection times respectfully were: mean scores for physical symptoms, 0.53, 1.21 and 0.62, patients with depression, 47%, 36.7% and 37.7%, patients with anxiety, 18.4 %, 19.4% and 20.4%, mean scores for QOL, 7.06, 7.01 and 7.28. QOL score was highest 3 months post RAI (p=.031). In the stepwise multiple regression analysis, depression and fatigue were predicting factors for low QOL at all data collection times. Dysponia was a predicting factor for low QOL post RAI and 3 months post RAI. Conclusion: To increase QOL, it is necessary to provide information in advance regarding physical & psychological symptoms and to develop nursing intervention programs to decrease depression and fatigue.

• The Korean Journal of Rehabilitation Nursing
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• v.15 no.2
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• pp.117-125
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• 2012

Purpose: The purpose of this study was to develop and validate of a knowledge scale for lymphedema in patients with breast cancer. Methods: 34 preliminary items were made according to literature review, then verified content validity, construct validity, and reliability of the scale. 28 items among them were confirmed through content analysis by 4 experts. After a preliminary test, a survey for 156 breast cancer patients was performed for confirming construct validity and reliability. The data were analyzed using factor analysis, independent t-test, and KR-20. Results: This scale had 28 items consisting of 2 categories: prevention and self-care of lymphedema. Construct validity was confirmed by known-group technique because there were some categories consisted of just one or two items, and some mismatches between categories and items in factor analysis. Women who were educated about lymphedema scored significantly higher than women who had not (t=-3.92, p<.001). Reliability was appropriate (KR-20=.81). A percentage of correct answers was 74.6%, but it was from 31.8% to 96.1%. Conclusion: The study shows that this scale is reliable and valid to measure the knowledge of lymphedema. This scale can be effective to assess and educate the patients with breast cancer.

• Journal of Korean Academy of Nursing
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• v.35 no.1
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• pp.177-185
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• 2005

purpose: The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy. Method: The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program. Results: There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times. Conclusion: Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1224-1231
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• 2006

Purpose: This study was conducted to identify comprehensive predictors of fatigue in cancer patients. Methods: One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study. Results: The hematologic indicators (WBC and Hemoglobin) were significant fo. explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant. Conclusions: From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.

• Journal of Korean Academy of Nursing
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• v.41 no.3
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• pp.285-293
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• 2011

Purpose: In this study, the effects of laughter therapy on levels of depression, quality of life, resilience and immune responses in breast cancer survivors were examined. Methods: A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=37) included breast cancer survivors who finished chemotheraphy and radiation therapy: 16 in the experiment group and 21 in the control group. Data were collected from August to November 2009. The experimental group participated in laughter therapy eight times, twice a week for 60 min per session. Questionnaires were used to me-asure pretest and posttest levels of depression, quality of life and resilience. A blood test was used to analyze changes in Total T cell, T helper, T suppressor, Th/Ts ratio, Total B cell, T cell/B cell ratio and NK cell for immune responses. Results: The results showed that laughter therapy was effective in increasing the quality of life and resilience in breast cancer survivors. but depression and immune responses did not differ significantly between the groups. Conclusion: The results of the study indicate that laughter therapy may be an effective nursing intervention to improve quality of life and resilience in breast cancer survivors.