• 제목/요약/키워드: 암환자 간호

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유방암환자 대상 국내 간호중재 연구 분석 (Analysis of Nursing Intervention Studies on Patients with Breast Cancer in Korea)

  • 최경숙;김미숙;이인자;한상영;박정애;이주현
    • 종양간호연구
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    • 제11권1호
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    • pp.74-82
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    • 2011
  • Purpose: This study was performed to systematically review the recently published nursing intervention studies. Methods: The literature was identified through the Korean Education and Research Information Service (KERIS), the Korean Information Service System (KISS), and National Assembly Library websites. Key words such as breast cancer, nursing, and intervention were used. The factors analyzed are as follows: 1) the characteristics of studies and study populations, 2) the classification of interventions, 3) outcome indicators and their effects, and 4) effective interventions. Results: Thirty two studies were included. Seventeen studies used a single intervention such as aerobic dance, TaiChi, foot massage, aromatherapy, or a stress-reduction method. Fifteen studies used combined interventions, including education, exercise, counseling, support, yoga or meditation. The data on 47 outcome indicators and their effects were segregated into psycho/spiritual outcomes, stress coping, physical outcomes, cardiorespiratory function, symptom management, arm and shoulder functions, fatigue, and quality of life. Some interventions had positive effects on stress, fatigue, and functions of shoulder. Conclusion: Various interventions are available for breast cancer patients, and some have had positive effects. However, more studies are required to develop evidence-based practice guidelines for nursing interventions.

호스피스 병동과 일반병동의 말기암환자의 간호중재 비교 (A Comparison of Nursing Interventions with Terminal Cancer Patients in a Hospice Unit and General Units)

  • 노유자;한성숙;용진선;송민선;홍진의
    • 성인간호학회지
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    • 제14권4호
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    • pp.543-553
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    • 2002
  • Purpose: The purpose of the study was to compare symptoms, medical therapies, and nursing interventions with terminal cancer patients during the last four weeks of their lives in a hospice unit and general units. Method: For the descriptive survey study, data were collected by reviewing the medical records of 243 patients who died of terminal cancer at K hospital in Seoul. The data was analyzed by using Chi-square test and t-test. Result: The study findings are summarized as follows: There were higher frequencies in physical symptoms of constipation, itching sensation, pain, sleeping disturbance, soreness and dysuria for those patients in the hospice unit than those patient in general units. All emotional symptoms were recorded significantly higher for those patients in the hospice unit than those in general units. Regarding the major medical interventions, pain management was used more significantly for those patients in the hospice unit, but antibiotic therapy and resuscitation were used more significantly for those patients in general units. Conclusion: The hospice unit provided more comprehensive nursing interventions including psychological, spiritual, and family cares as well as physiological care for terminal cancer patients. The facts showed that those patients who would need hospice care in general units should be referred to the hospice unit at an appropriate time.

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노인 암환자의 건강정보 이해능력을 반영한 항암화학요법 자기관리 프로그램 개발 및 평가 (The Development and Evaluation of a Health Literacy-Adapted Self-Management Intervention for Elderly Cancer Patients Undergoing Chemotherapy)

  • 김윤선;태영숙;정귀임
    • 대한간호학회지
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    • 제49권4호
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    • pp.472-485
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    • 2019
  • Purpose: This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy. Methods: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants' health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0. Results: Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group. Conclusion: The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

노인 암환자의 자아통합감 회복 경험: 근거이론 접근 (Experiences of Ego Integrity Recovery in Elderly Cancer Patients: Grounded Theory Approach)

  • 최한교;염혜아
    • 대한간호학회지
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    • 제49권3호
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    • pp.349-360
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    • 2019
  • Purpose: This study was conducted to derive a substantive theory on lived experiences of elderly cancer patients. Methods: The data were collected from February to March 2018 through in-depth personal interviews with 14 elderly cancer patients. The collected data were analyzed based on Corbin and Strauss's grounded theory. Results: The core category was "the journey to find balance in daily lives as a cancer patient by recovering disturbed ego integrity." The core phenomenon was "shattered by suffering from cancer," and the causal conditions were "physical change" and "limitations in daily life." The contextual conditions were "decreased self-esteem," "feelings of guilt toward the family," and the sense of "economic burden." The participants' action and interaction strategies were "maintaining or avoiding social relations," "seeking meaning of the illness," "falling into despair," and "strengthening the willingness to battle the cancer." The intervening conditions were "support from health care providers and family," "dissatisfaction with health care providers," "spiritual help from religion," and "the improvement or worsening of health conditions." The consequences were "having a new insight for life," "living positively along with cancer illness," and "the loss of willingness to live." A summary of the series of processes includes the "crisis stage," "reorganizing stage," and the "ego integration stage." Conclusion: This study explored the holistic process of ego integrity impairment and the recovery experience of elderly cancer patients. This study is expected to be used as a basis for the development of nursing interventions that can support patients when coping with all stages of their cancer illness trajectory.

유방암 환자의 항암화학요법 관련 인지기능 변화와 삶의 질의 구조모형 (A Structural Model for Chemotherapy Related Cognitive Impairment and Quality of Life in Breast Cancer Patients)

  • 이정란;오복자
    • 대한간호학회지
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    • 제49권4호
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    • pp.375-385
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    • 2019
  • Purpose: This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model. Methods: The Participants consisted of 250 patients who were ${\geq}19$ years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. Results: The modified model was a good fit for the data. The model fit indices were ${\chi}^2=423.18$ (p<.001), ${\chi}^2/df=3.38$, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (${\beta}=.38$, p=.002), depression and anxiety (${\beta}=.25$, p=.002), and symptom experiences (${\beta}=.19$, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (${\beta}=-.51$, p=.001), symptom experiences (${\beta}=-.27$, p=.001), menopausal symptoms (${\beta}=-.22$, p=.008), and chemotherapy-related cognitive impairment (${\beta}=-.15$, p=.024) had direct effects on the quality of life and these variables explained 91.3%. Conclusion: These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.

일회용 약물주입기로 가정에서 항암치료 중인 대장암 환자의 삶의 질 (Quality of Life in Colorectal Cancer Patients at Home 5-Fluorouracil Chemotherapy with Disposable Elastomeric Infusion Pumps)

  • 이충은;김나영;박미희;이윤정;김진라;백민주;김효진;변은성;길윤경;김희정
    • 임상간호연구
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    • 제28권1호
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    • pp.76-87
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    • 2022
  • Purpose: The purpose of this study was to examine the psychological distress related to quality of life (QoL) of patients with colorectal cancer receiving 5-fluorouracil (5-FU) chemotherapy at home with disposable Elastomeric infusion pumps. Methods: In this study, 179 colorectal outpatients were recruited between September 2019 and January 2021. National Cancer Center Psychological Symptom Inventory scores, general self-efficacy, and the EORTC QLQ-C30 scores were measured. Data were analyzed using Independent t-test, One-way ANOVA with Bonferroni post hoc analysis, and hierarchical multiple linear regression with the SPSS/WIN 26.0 programs. Results: The overall prevalence of psychological distress was 52.0% in colorectal patients. In multiple regression, psychological distress (β=-.20, p=.005), appetite loss (β=-.20, p=.001), chemotherapy cycles (β= .19, p=.002), fatigue (β=-.16, p=.035), physical functioning (β=-.16, p=.024), and emotional functioning (β=-.15, p=.025) were significant factors of QoL, and the final model explained 45.0% of the total variance of QoL. Conclusion: Supporting patients toward decreased psychological distress and increased physical and emotional functioning, especially in the first or second cycle of chemotherapy, could be used to improve their QoL. To consider the thresholds for clinical importance, it is necessary to increase the interpretation of psychological distress in clinical practice and further research.

한국어판 '암 환자가 인식하는 간호의 질 측정도구'의 타당도와 신뢰도 (Validity and Reliability Test of the Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale)

  • 강지영;강혜영;김나년;이미정;김유진;김주현;여수정;서윤예;서은영
    • 성인간호학회지
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    • 제28권2호
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    • pp.191-201
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    • 2016
  • Purpose: The purpose of this methodological study was to examine the validity and reliability of a translated Korean version of The Oncology Patients' Perception of the Quality of Nursing Care Scale. Methods: The translated scale was pilot tested and then administered to 360 patients with cancer. Exploratory and confirmatory factor analyses were utilized to assess the factor structure. Internal consistency reliability was determined using coefficient ${\alpha}$. Results: Two of the 40 items were deleted with a principal component method of exploratory factor analysis because they did not meet the factor-loading criterion. The 38 items were again analyzed and, four factors were validated (KMO=.96, Bartlett ${\chi}^2=10809.81$, df=780, p<.001). The four factors accounted for 60.9% of the variance. Factor loadings of the scale on the four subscales ranged from .65 to .91. The scale showed reliable internal consistency with a Cronbach's ${\alpha}$, total 38 items (${\alpha}=.96$) in four subscales: individualization (18 items, ${\alpha}=.96$), proficiency (10, .91), responsiveness (7, .90), and coordination (3, .80). Conclusion: The findings of this study demonstrate that the scale has satisfactory construct validity and reliability to measure quality of cancer nursing care from the patient's perspective in Korea.

암 환아 가족의 아동 호스피스 요구도 (The Need for Child Hospice Care in Families of Children with Cancer)

  • 강경아;김신정;김영순
    • Journal of Hospice and Palliative Care
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    • 제7권2호
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    • pp.221-231
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    • 2004
  • 목적: 본 연구는 암환아 가족의 호스피스 요구도를 파악하여 앞으로 암 환아 간호시, 대상자의 요구에 적절한 호스피스 간호를 제공하기 위한 목적으로 시도되었다. 방법: 자료수집은 2004년 2월부터 7월까지 서울의 2개 대학병원에서 암으로 진단 받고 입원한 아동의 가족 104명을 대상으로 하였다. 대상자의 아동 호스피스 요구도를 측정하기 위해서는 아동 호스피스에 대한 국내 외 문헌고찰과 아동 호스피스 전문가와 관련자, 암 환아 가족 20명을 대상으로 면담하여 개발한 암 환아 가족의 아동 호스피스 요구 측정도구[10]를 사용하였다. 결과: 1. 대상자의 아동 호스피스 요구 정도는 4점 만점에 $2.77{\sim}4.00$점의 범위로 평균 3.41점(.38)으로 높게 나타났다. 각 요인에 따른 요구정도는 아동의 정서적 간호 말기 주요 신체적 증상의 조절, 2차적인 생리적 문제의 조절, 가족이 어려움 수용, 죽음준비를 위한 영적 돌봄의 순으로 나타났다. 2. 대상자의 일반적 특성에 따른 아동 호스피스의 요구 정도는 아동 어머니의 연령(F==4.980, P=.009), 형제나 친척 중 암 환자의 유무(t=2.423, P=.017)에 따라서만 유의한 차이가 있었다. 즉, 대상자의 아동 호스피스 요구정도는 어머니의 연령이 $36{\sim}40$세인 경우가 요구 정도가 가장 높고 35세 이하인 경우가 가장 낮았으며 형제나 친척 중 암 환자가 있는 경우가 없는 경우보다 요구 정도가 더 높았다. 결론: 아동 호스피스에 대한 암 환아 가족의 요구 정도는 정서적, 신체적, 사회적, 영적 돌봄의 순으로 나타나 가족이 자녀의 죽음을 앞두고 자녀의 신체적 증상관리와 함께 자신의 죽음에 대한 이해가 어려운 자녀의 불안과 두려움을 경감시켜주기 원하는 부모의 특성이 파악되었다. 또한 호스피스에 대한 요구도는 높았으나 자녀에 대한 호스피스 돌봄의향은 낮게 나타나 암 환아 부모들이 적극적인 치료와 호스피스에 대한 양가감정을 가지고 있음을 유추해 볼 수 있었다. 본 연구의 결과는 암 환아 가족들을 위해 간호사가 제공해야 하는 호스피스 돌봄의 방향을 제시하고 있다고 생각되며 이를 위해서는 호스피스 관련 기관뿐만 아니라 국가적 차원의 아동 호스피스에 대한 관심과 지원이 요구된다고 생각한다.

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재가 암환자의 통증, 통증관리 장애정도 및 통증관리 만족도 (Degree of Pain, and Barriers and Satisfaction with Pain Management among Home Care Cancer Patients)

  • 문영미;함옥경;김정희;임지영
    • 한국보건간호학회지
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    • 제22권2호
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    • pp.177-185
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    • 2008
  • Purpose: To investigate the degree of pain, and to identify barriers to and satisfaction with pain management, in an effort to provide baseline data for effective pain management interventions. Methods: The study design was descriptive and correlational. A total of 100 cancer patients who were cared for at home participated in this study. Questions regarding self-rated pain, as well as barriers to and satisfaction with pain management were included in the study instruments. The data were collected by nurses using a face-to-face interview method in May of 2008. Results: Thirty six percent of the participants were in their 70's and 18.0% suffered from cancer of the large intestine. The usual degree of pain was reported as 3.43 out of 10 points, and the study patients were generally moderately satisfied with their pain management (M=$3.15{\pm}0.78$; range, 1-5). The mean barrier score was $3.24{\pm}0.52$ (range, 1-5) and concerns regarding the progress of cancer was the most highly evaluated barrier. There was a negative relationship between the degree of pain and satisfaction with pain management, and between barriers to and satisfaction with pain management. Conclusion: The precise evaluation of pains is crucial to the proper management of pain, and the education and promotion of proper pain management practices may help to overcome barriers to pain management for cancer patients.

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항암화학요법 환자의 정보요구 분석 (Informational Needs of Cancer Patients Receiving Chemotherapy)

  • 한경자;이은옥;김매자;하양숙;박영숙;송미순;정재원;박성희;문미혜
    • 종양간호연구
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    • 제4권2호
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    • pp.135-142
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    • 2004
  • Purpose: To examine informational needs of cancer patients receiving chemotherapy. Methods: A cross-sectional survey design was utilized. The sample was 198 cancer patients receiving chemotherapy for a diagnosis of stomach or lung cancer at a university hospital. A modified version of Toronto Informational Needs Questionnaire was applied. Results: Subjects reported highest informational needs in prognosis dimension, followed by the treatment dimension including side effects and alternative therapy. Information about medical tests and follow-up care after the treatment was also in great need. Dimensions of support for patients/family and sexuality were low in need. The degree of informational needs was negatively correlated with patient's age and number of children. Differences were found in informational needs according to the educational level employment status, and gender of the patients, while diagnosis and treatment options did not make differences in informational needs. Conclusion: Health care professionals need to perceive informational needs of cancer patients receiving chemotherapy, and to provide them with information especially in the area of prognosis and treatment. Informational intervention would be effective when it is given with consideration of patient's characteristics.

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