Purpose: The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. Methods: A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. Results: Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. Conclusion: Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.
The purpose of the present study is to identify the mediation effect of hope between fatigue and psychosocial adjustment in women with breast cancer. The framework for this study was guided by concepts and propositions derived from the theoretical and empirical literature on fatigue, hope and adjustment. The design of this study is a descriptive correlation study using a cross-sectional design. One hundred and twenty two outpatients with early breast cancer, receiving post-surgical radiation therapy or chemotherapy, were selected from three major medical centers in Seoul, Korea. A packet including PABCF (Psychosoical Adjustment to Breast Cancer Factor), revised RPFS (Revised Piper Fatigue Scale), HHI (Herth Hope Index), and self-addressed return envelope was given to the participants at seven to eight weeks post surgery. The questionnaires were to be completed at home and returned to the researcher by mail. The obtained data were analyzed using three regression equations guided by Baron and Kenny (1986); first, hope was regressed on fatigue; second, psychosocial adjustment was regressed on fatigue; and third, psychosocial adjustment was regressed on fatigue and hope, simultaneously. In the first equation, fatigue explained 4% of the variance in hope. In the second equation, fatigue explained 47% of the variance in psychosocial adjustment. In the last equation, hope and fatigue significantly explained the variance in psychosocial adjustment. Therefore, all conditions for the test of mediation effect of hope were satisfied. For the test of the mediation effect, the beta coefficients of fatigue on psychosocial adjustment on the second and third regression equations were compared. The beta coefficients were decreased from .69 (p < .001) on the second regression equation to .63 (p < .001) on the third regression equation. Thus, the hypothesis of this study was supported. As a result of this study, the negative Influence of fatigue on psychosocial adjustment is dampened through the mediator effect of hope in women with breast cancer. Therefore, when planning care for the adverse effect of fatigue on psychosocial adjustment, oncology nurses should consider hope as a mediator between fatigue and psychosocial adjustment to breast cancer.
Purpose: This purpose of this study was to develop and validate a Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B). Methods: The SESSM-B was developed and validated as follows: Item generation, pilot study, and tests of validity and reliability. Twenty-one items were developed through evaluation by 10 experts and 13 items were finally confirmed through item analysis and factor analysis. Psychometric testing was performed with a convenience sample of 303 women with breast cancer. Data were analyzed using factor analysis, Pearson correlation coefficients, and Cronbach's alpha. Results: Five factors evolved from the factor analysis, which explained 69.8% of the total variance. The first factor 'coping with psycho-informational demand' explained 17.2%, 2nd factor 'maintenance of healthy lifestyle' 14.5%. 3rd factor 'management of side-effects' 13.3%, 4th factor 'therapeutic compliance' 12.8%, and 5th factor 'sexual life' 11.9%. SESSM-B also demonstrated a concurrent validity with health-related quality of life scale, EORTC QLQ-C30 & BR23. The internal consistency, Cronbach's alpha, was .78, and reliability of the subscales ranged from .61 to .79. Conclusion: The results of this study suggest that the SESSM-B is an easy, reliable, and valid instrument to measure self-efficacy for self-management of breast cancer.
Purpose: The purpose of this study was to examine the association among change in the sensation of the arms, the range of motion in the shoulders and depression in breast cancer patients. Method: This is a descriptive study on correlation. The participants were 132 patients who had been diagnosed with breast cancer and had mastectomy at a university hospital, and had participated in a breast cancer self-help group. The degree of depression was assessed by SCL-90-R scores. Collected data were analyzed with SPSS 12.0 for windows. Results: The participants complained of 'heaviness' as the most frequent and serious symptom of change in the sensation of the arms. 'Completely zip up the dress with a back-fastening zipper' was the most difficult motion of the shoulders. Participants who were in a worse stage of disease were in a worse condition in shoulder functions, and on a higher degree of depression. The degree of change in sensation and shoulder functions showed a positive correlation with each other, and both of them showed a negative correlation with the degree of depression. Conclusion: Sensation and motion change in the arms and the shoulders were common phenomena that affected depression in patients who had mastectomy. Nurses should consider not only depression but also discomfort of the arms and the shoulders for patients with mastectomy.
Purpose: This is a descriptive correlation study purposed to provide basic data for comprehensive nursing care by analyzing the relationship between the burden and the quality of life of family caregivers of cancer patients treated with chemotherapy. Methods: As for the subjects of this study, 66 family caregivers who take care of cancer patients hospitalized and treated with chemotherapy participated in the research. The tool of this study was a structured questionnaire including questions concerning burden(19 items) and the quality of life(33 items). Collected data were analyzed using SPSS PC+ program through descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: 1) The mean score of burden was 2.6383. The mean score of quality of life was 3.3034. These score show that family caregivers perceive a moderate level of burden and the quality of life. 2) Family caregivers' burden was significantly related to symptoms in the cancer patient (r= 0.3501, P=0.0042) and family caregivers(r= 0.5340, P=0.0001). Family caregivers' quality of life was significantly related to symptoms in the cancer patient(r= -0.3528, P=0.0039) and family caregivers(r= -0.5472, P=0.0001). According to the result of examining' the relationship between burden and the quality of life, there was a statistically negative correlation(r= -0.6326, P=0.0001). 3) 'Family income after the onset of the patient' was the most important predictor of the burden of family caregivers($R^2$=0.158). 'Usual relationship with the patient' was the most important predictor of the quality of life of family caregivers($R^2$=0.138). Conclusions: The results presented above indicate that we must consider burden of family caregivers and symptoms experienced by them in order to improve the quality of life of family caregivers of cancer patients treated with chemotherapy.
Purpose: This study was to identify the effects of hope intervention on the hope and quality of life of cancer patients staying at home. Method: The study adopted the randomized control group design. The subjects consisted of randomly selected forty cancer patients who were registered at S-Gu Public Health Center. Hope intervention which was composed of hope assessment, positive self identity formation, hope objective setting. therapeutic relationship and spiritual & transcendental process improving, and hope evaluation was provided from October 22, 2007 to November 30, 2007. Result: Hypothesis 1-1 "The experimental group that received hope intervention will have a higher score of hope than the control group", was supported(t=-3.108, p=.004). Hypothesis 1-2 "The experimental group that received hope intervention will have a higher level of hope index than the control group". was supported(t=-4.219. p=.000). Therefore, Hypothesis 1 "The experimental group that received hope intervention will have a higher level of hope than the control group" was supported. Hypothesis 2 "The experimental group that received hope intervention will have a higher level of quality of life than the control group", was not supported(t=-1.726, p=.092). Conclusion: Hope intervention is an effective nursing intervention to enhance hope for patients with cancer staying at home.
Cancer survivor's self-help group may promote psychosocial adjustment in cancer patients. Self-transcendence has been shown to be related with crisis and adjustment in women with breast cancer. The purpose of this study is to determine the effectiveness of self-transcendence promoting program to facilitate self-transcendence, physical, and emotional well-being in women with breast cancer. Thirty patients who received mastectomy were recruited, but 9 subjects of experimental group and 14 subjects of control group participated in this study. Subjects of experimental group attended the self-help group for self-transcendence once a week for 6 weeks. Each session of program was proceeded for 2hours and the program contained activities for promoting self-transcendence, stress management, communication skill, exercise and relaxation, symptom management, and family support. Data were collected by self-reporting questionnaires within seven days after mastectomy and after the program was finished in experimental group, within 7 days after mastectomy and after 3 months in control group. Self-transcendence was assessed using the self-transcendence scale (STS) developed by Reed. Physical well being was assessed using Symptom distress scale (SDS) developed by McCorkle and Young and emotional well being was assessed using Profile of mood states (POMS). As a result, no significant differences were found between both groups in changes of self-transcendence, emotional well-being, and physical well-being. Self-transcendence score was significantly decreased in control group (p =0.16). But that of experimental group showed no decrease. In conclusions, when the self-transcendence promoting program is provided to the patients with breast cancer, it can be helpful for promoting self- transcendence. For the further study, repeated research with appropriate sample size and more intensive nursing intervention to promote self-transcendence is suggested. And reassessment after 6 months is recommended for testing long term effects of the program.
The purpose of this study is to compare the sexual behaviors of breast cancer survivors (BCS) with women without breast cancer (WWBC) and provide basic data to develop education program for patients before surgery. The study sample included 215 subjects: 140 women without breast cancer and 75 women diagnosed at least six months previously with breast cancer. Data were collected using the Wilmoth's Sexual behaviors Questionnaire-F that consisted of 50 items measuring sexually: communication, sexual techniques, sexual responses, body scare, self-touch, relationship quality, and masturbation. All items were scored on a 6-Likert scale with high scores reflecting high levels of the specific sexual behaviors. The reliability of this instrument was .91(Cronbach‘s alpha). Data were collected during the period from September 1 to September 30, 2001. The collected data were analyzed using t-test, Chi-square, ANCOVA with SPSSwin program. The scores of a sample of WWBC were compared to those of BCS and the scores of BCS were compared by type of surgery and period since surgery. The results were as follows: 1. No differences in sexual behaviors were found between BCS and WWBC, but, differences were found in communication, sexual technique, and relationship quality depending on the period since surgery. 2. Mean Score of BCS' communication in sexual behaviors was significantly lower than that of the WWBC. 3. Sexual behaviors scores of BCS with Menopause, lumpectomy, long duration since surgery showed significantly higher than that of the others. In conclusions, BCS returned to the normal sexual behaviors according to period since surgery. The program of the sexual counseling for patients before surgery should consider this result in the future.
Purpose: The aim of this study was to investigate the differences in emotional response and coping pattern by age among cancer patients. Method: As descriptive research, from November 2000 to April 2001, data was collected with semi-structured questionnaire to 90 adult cancer patients, and analyzed using quantitative analysis. Result: Most emotional response at the time of diagnosis of cancer is despair in 20-39years & more than 60 years, and Impact in 40-59years. In emotional response during treatment by age, there were most much hope in 20-39 years, fear in 40-59years, and acceptance in more than 60years. In difficulties by age during treatment, there were most much mental burden in 20-29years, problems about occupation/finance in 40-59years, and physical discomfort related to treatment in more than 60 years. Resolution of difficulties of treatment shows avoidance in 20-39years, active participation in 40-59years and compliance in more than 60 years. Coping pattern during treatment was positive thinking in 20-39years, refreshment in 40-59years, and despair/avoidance in more than 60 years. Coping with treatment & progress shows in 20-39years maintenance of current health, 40-59years impossible to recover, more than 60year health recovery. Conclusion: Nursing could be considered emotional response and coping pattern according to age.
Purpose: The purpose of this study was to investigate the of laughter therapy on depression, anxiety, and stress among patients underwent radiotherapy. Methods: Participants in the study were comprised of 60 breast cancer outpatients who received radiotherapy. Thirty-one of the patients were assigned in the experimental group and the other 29 patients made up the control group. Laughter therapy was consisted of the delivery of information and active motion resulting in laughter. We provided laughter therapy 4 times for 2 weeks. Each session lasted 60 min. The experimental group received laughter therapy intervention as a group. An average attendance frequency per person was 2.7. To evaluate the effect of laughter therapy, the degrees of depression and anxiety were measured by Hospital Anxiety and Depression (HAD) and stress was measured by the Brief Encounter Psychosocial Instrument (BEPSI). Data analysis included a 2-test, t-test, and Fisher's exact test using SPSS 12.0 and SAS 8.0. Results: There was significant decrease in the degrees of depression, anxiety, and stress in the experimental group compared to those in the control group (p<.01, p=.04, and p<.01, respectively). Conclusion: This study provides evidence that laughter therapy is an effective intervention in improving depression, anxiety, and stress in breast cancer patients.
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