• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.327-337
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• 2016

Purpose: The purpose of this study was to construct and test a structural equation model on resilience of breast cancer patients receiving chemotherapy. Methods: Participants were 204 patients with breast cancer who received chemotherapy treatment. They participated in a structured interview, which included social support, depression, symptom experience, self-efficacy, hope, resilience, and infection prevention behaviors. Data were analyzed using SPSS/WIN 20.0 and AMOS 18.0. Results: Lower depression (${\gamma}=-.33$, p=.020) and symptom experience (${\gamma}=-.31$, p=.012) and higher self-efficacy (${\gamma}=.32$, p=.005) and hope (${\gamma}=.48$, p=.016) were influenced by higher social support. Greater resilience was influenced by lower symptom experience (${\beta}=-.18$, p=.016), higher self-efficacy (${\beta}=.49$, p=.023), and higher hope (${\beta}=.46$, p=.012), and these predictors explained 66.7% of variance in resilience. Greater resilience (${\beta}=.54$, p =.009) made an impact on greater infection prevention behaviors. Resilience mediated the relations of symptom experience (${\beta}=-.10$ p=.013), self-efficacy (${\beta}=.27$, p=.006) and hope (${\beta}=.25$, p=.009) with infection prevention behaviors. These predictors explained 24.9% of variance in infection prevention behaviors. Conclusion: The findings of the study suggest that breast cancer patients with greater resilience who are receiving chemotherapy participate in increased infection prevention behaviors. Further research should be conducted to seek intervention strategies that improve breast cancer patients' resilience.

• Journal of Korean Academy of Nursing
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• v.46 no.1
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• pp.19-28
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• 2016

Purpose: The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer. Methods: A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. ($R^2=29%$). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL ($R^2=43%$). Psychological distress had a partial mediating effect (${\beta}=-.56$, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

• Journal of Korean Academy of Nursing
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• v.40 no.4
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• pp.551-560
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• 2010

Purpose: The purpose of this present study was to develop and evaluate the psychometric properties of a needs scale for patients with cancer undergoing follow-up care (NS-C). Methods: A preliminary NS-C of 48 was derived from literature reviews and in-depth interviews with patients with cancer. Content validation of the items was established by oncology physicians and nurses. Each item was scored on a five-point Likert scale. The preliminary NS-C and Eastern Cooperative Oncology Group (ECOG) performance status questionnaires were administered to 873 patients with cancer recruited from three university hospitals. The data were analyzed using factor analysis, multidimensional scaling analysis, ANOVA, Pearson correlation coefficients, and Cronbach's alpha. Results: From the factor analysis, 25 significant items in six subscales were derived. The subscales were named physical symptoms, diet and exercise, support, relationship with health professionals, treatment/prognosis, and keeping mind under control. The NS-C also established item convergent and discriminant validity, and known-groups validity. Cronbach's alpha of the subscales ranged from .90 to .92. Conclusion: This study suggests that the NS-C is an easy, reliable and valid instrument to measure the needs of patients with cancer. Health professionals may use the NS-C for patients with cancer both in practice and research.

• The Korean Journal of Rehabilitation Nursing
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• v.9 no.1
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• pp.5-14
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• 2006

Purpose: This research was conducted to explore the relationship between spiritual well being and life attitude among breast cancer patients who were operated, and to increase understanding for wholistic nursing care. Method: With spiritual well being from quality of life questionnaire in breast cancer survivors (QOL-BR 23) of Ferrell et al (1998) and Life attitude profile (LAP) of Recker & Peacock (1981), the data were collected by research assistant in a sample of 56 women with stage 1-stage 3 breast cancer at surgery OPD after follow-up care. Result: Mean spiritual wellbeing score of subject was 5.83 (0-10) and life attitude was 4.96 (1-7). There were significant differences in life attitude according to monthly income (F=3.22, p=.03), and in spiritual wellbeing according to monthly income (F=4.16, p=.01) and religion (t=-3.67, p=.001) among demographic characteristics. There was significant difference in spiritual wellbeing according to the period passed after operation (F=2.89, p=.04) among disease characteristics. From life attitude domain, the mean score of "will to meaning" was the highest (5.30) and "existential vacuum" was the lowest (4.58). There was a significant relationship between spiritual wellbeing and "will to meaning" subscale of life attitude (r=.521, p=.000). The correlation coefficient showed r= .513 between spiritual well being and life attitude. Conclusion: Nurses could promote positive life attitude for breast cancer patients by improving spiritual well being with the encouragement of having religion expecially for long term breast cancer survivors in the process of their rehabilitation.

• Women's Health Nursing
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• v.19 no.4
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• pp.201-210
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• 2013

Purpose: The purpose of this study was to identify chemotherapy induced peripheral neuropathy, quality of life of patients with gynecologic cancer. Methods: This was a cross-sectional survey design. We collected 130 patients with gynecologic cancer. They complete a self reported questionnaire including items related neuropathy and quality of life (FACT-GOG/Ntx subscale, FACT-G scale). Results: The neuropathy score was $14.3{\pm}7.9$. The quality of life score was $64.8{\pm}16.4$. The neuropathy induced significant difference according to diabetic status, difficulties in performing household chores and willing to discontinuity of chemotherapy. And duration of cancer diagnosis, neuropathy, number of total chemo agent associated with quality of life. There was a negative correlation between number of total chemo agent and quality of life. Neuropathy independently affected quality of life. Conclusion: Chemotherapy induced peripheral neuropathy of patients with gynecologic cancer adversely affected women's quality of life and activities of daily living. To improve patient's quality of life, it is important that accurate assess and appropriately manage neuropathy in patients with gynecologic cancer.

• Journal of Korean Academy of Nursing
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• v.35 no.7
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• pp.1295-1303
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• 2005

Purpose: This study was to determine the effects of abdominal breathing training using biofeedback on stress, immune response, and quality of life. Method: The study design was a nonequivalent control group pretest-posttest, quasi-experimental design. Twenty-five breast cancer patients who had completed adjuvant chemotherapy were enrolled. The experimental group(n=12) was provided with abdominal breathing training using biofeedback once a week for 4 weeks. State anxiety, cancer physical symptoms, serum cortisol, T cell subsets(T3, T4, T8), NK cell and quality of life were measured both before and after the intervention. Result: Though state anxiety, cancer physical symptoms, and serum cortisol were reduced after 4 weeks of abdominal breathing training using biofeedback, there was no statistical significance. It showed, however, improvement in quality of life (p=.02), and T3(p=.04). Conclusion: Abdominal breathing training using biofeedback improves quality of life in breast cancer patients after a mastectomy. However, the mechanism of this beneficial effect and stress response requires further investigation with special consideration in subject selection and frequency of measurement. Nurses should consider this strategy as a standard nursing intervention for people living with cancer.

• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.731-743
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• 2017

Purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. Methods: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. Results: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (${\beta}=1.57$, p=.023) and did not use physical measures (${\beta}=-1.23$, p=.041) as coping methods were under the high risk of nutritional disorders. Conclusion: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.

• The Korean Journal of Rehabilitation Nursing
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• v.15 no.1
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• pp.39-46
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• 2012

Purpose: This study was to examine the relationship between mental health status and suicidal thinking among cancer patients. Methods: The data set of the 4th Korea National Health and Nutrition Survey (2009) was used and 230 subjects with cancers were included in the present study. Using SPSS/WIN 18.0 program, data were analyzed with descriptive statistics, ${\chi}^2$ test and logistic regression analysis. Results: About one-third of subjects had stress, symptoms of depression and suicidal thinking. Female had more suicidal thinking than male (${\chi}^2$=5.44, p=.020). In addition, subjects with high income level had more thinking about suicide compared with those in low income level (${\chi}^2$=7.54, p=.023). There was a significant difference in suicidal thinking according to the educational levels (${\chi}^2$=13.25, p=.004). In the logistic regression analysis, it was indicated that gender, depression and stress were significant predictors on suicidal thinking, accounting for 26.7~38.1%. Conclusion: From the findings in this study, it was suggested that the healthcare providers should try to improve their mental health status in order to prevent suicidal thinking among the individuals diagnosed with cancer.

• Women's Health Nursing
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• v.20 no.1
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• pp.72-82
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• 2014

Purpose: This study was conducted to investigate sexual behaviors and influencing factors affecting premenopausal women who have breast cancer and have undergone surgery. Methods: Seventy premenopausal women, ranging between 35~55 years of age, were included in this study. Sexual behaviors were evaluated using the WSBQ-F (Wilmoth Sexual Behaviors Questionnaire-Female). The in-depth interview was analyzed utilizing content analysis. Results: There were no significant differences regarding the type of surgery, age, time of marriage, education level, occupation, chemotherapy, use of Tamoxifen, and radiotherapy in the sexual activities of premenopausal women with breast cancer. However, quality-related information utilizing qualitative in-depth interviews, revealed 3 issues regarding sexual behaviors.. Participants reported physical discomfort such as vaginal dryness, dyspareunia, emotional changes such as decrease in sexual confidence, and interaction-related changes such as mandatory sexual life, sexual intimacy with one's partner, and being more active sexual behaviors. Conclusion: There were complex changes associated with sexual behavior after surgery for women with breast cancer which included various events related to stress regarding sexual behavior. Communication between women with breast cancer, their partners, and medical caregivers has a ability to maximize the sense of sexual wellbeing while minimizing the sexual crises.

• Women's Health Nursing
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• v.20 no.1
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• pp.83-91
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• 2014

Purpose: The purpose of this study was to identify relationships of resilience, Post-Traumatic Stress Disorder(PTSD), and quality of life of breast cancer patients. The findings from this study would provide baseline data needed for nursing intervention. Methods: A sample of 129 breast cancer patients was recruited from three hospitals in J and C cities in Korea. The survey was conducted with participants by utilizing self-reported questionnaires. Results: Quality of life showed statistically significant differences on religion (t=2.11, p=.033) and hobby (t=2.79, p=.006). Resilience and PTSD had a negative correlation (r=-.22, p=.010). Resilience and quality of life of the participants had a positive correlation (r=.58, p<.001), whereas PTSD and quality of life had a negative correlation (r=-.45, p<.001). Significant predictors of quality of life were resilience and PTSD. These variables explained 44.9% of the variance in quality of life. Conclusion: Findings indicate that as resilience of breast cancer patients rose higher and PTSD got lower, their quality of life increased. Based on these results, nursing interventions directed towards improving resilience and relieving PTSD is proposed.