• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.4
• /
• pp.2639-2646
• /
• 2015

This study was to identify the effects of supportive nursing intervention using video-program of operating room nurses before operation on laparoscopic hysterectomy patient's anxiety. This study was nonequivalent control group pre-post test design. The data were collected from May 1 to Jun 20, 2013 and analyzed by $x^2-test$, Fisher's exact test and t-test using SPSS 20.0 program. Experimental group(who received supportive nursing intervention) and control group(who received booklet education) was respectively consisted of 25 patients who were laparoscopy hysterectomy. The anxiety(p=.002) of experimental group was significantly lower than control group. The systolic(p=.012) and diastolic(p=.045) pressure of experimental group was significantly lower than control group, but pulse wasn't. The supportive nursing intervention for preoperative patient is considered effective and useful in reducing anxiety. Further research is warranted to investigate the supportive nursing intervention long-term effect.

• Radiation Oncology Journal
• /
• v.17 no.1
• /
• pp.23-29
• /
• 1999

Purpose : To evaluate the efficacy of radiation therapy and extrafascial hysterectomy in bulky stage IB, IIA-B uterine cervix cancers. Methods and Materials : Twenty four patients with bulky stage IB and IIA-B carcinoma of the uterine cervix were treated with extrafascial hysterectomy following radiation therapy due to doubts of residual disease at Department of therapeutic radiology, Keimyung University, Dongsan Hospital, from April 1986 to December 1997 According to FIGO staging system, there were 7 patients with stage IB, 9 patients with IIA and 8 patients with IIB stage whose median age was 45. Pathologic distribution showed 16 patients with squamous cell carcinoma and 8 patients with adenocarcinoma. Seven patients had tumors that are less than 5cm in size and 17 patients had tumors with larger than 5cm. The mean interval between radiation therapy and extrafascial hysterectomy was 57 days. The radiation therapy consisted of external irradition to the whole pelvis (180 cGy/fraction, mean 4100 cGy) and parametrial boost (for a mean total dose of 5000 cGy) with midline shield (4H 10 cm), followed by intracavitary irradiation up to 7500 cGy to point A (maximum 8500 cGy). The maximum follow up duration was 107 months and mean follow up duration was 42 months. Results :Ten out of 24 patients (41.7%) had residual disease found at the time of extrafascial hysterectomies. Five year overall survival rate (5Y OSR) and five year disease free survival rate (5Y DFSR) were 63.6% and 62.5% respectively. Five year overall survival rate for stage IB and IIA was 71.4% and 50% for stage IIB. There was a significant difference in 5Y OSR and 5Y DFSR between patients with and those without residual disease (negative vs positive, 83.3% vs. 40% (P=0.01), 83.3% vs 36% (P=0.01) respectively). There was a notable tendency of better survival with adenocarcinoma than with squamous cell carcinoma (adenocarcinoma vs squamous cell carcinoma, 85.7% vs. 53.3% (P=0.1), 85.7% vs. 50.9% (P=0.1) of 5Y OSR and 5Y DFS respectivey). Total dose to A point did not make a significant difference in survival rate or the existence of residual lesion (< 7500 cGy, ${\geq}$ 7500 cOy). It was also noted that significantly more frequent local failures have occurred in patients with positive residual disease compared with negative residual disease (5/10 vs. 0/14, p=0.003), There was no death related to the treatment. Conclusion : There was no improvement of residual disease and to the overall survival rate in spite of increased total dose to point A. We conclude that there is a possible beneficial effect of radiation therapy followed by extrafaseial hysterectomy in survival for adenocarcinoma of bulky stage IB and IIA-B uterine cervix. We need to confirm this with longer follow up and with large number of patients.

• Radiation Oncology Journal
• /
• v.21 no.3
• /
• pp.199-206
• /
• 2003

Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.

• Clinical and Experimental Reproductive Medicine
• /
• v.37 no.2
• /
• pp.159-168
• /
• 2010

Objective: The purpose of this study was to evaluate the correlation between the expression pattern of vascular endothelial growth factor (VEGF) in endometrium and the pathogenesis of endometriosis by investigating VEGF expression patterns and their difference between eutopic endometrium of patients with endometriosis and that of normal controls without endometriosis. Methods: Endometrial sections were obtained from 64 hysterectomy specimens from women under age of 40, who had undergone hysterectomies and had histological evidence of endometriosis, with stage 3 and 4 according to the revised American Society for Reproductive Medicine classification. As for controls, 37 sections were gained from women diagnosed as having cervical intraepithelial neoplasia (CIN) of the uterine cervix and without evidence of pelvic endometriosis or adenomyosis during their operation. The VEGF content was evaluated immunohistochemically in the eutopic endometrium from 64 patients with endometriosis and 37 normal controls. Histological semiquantitative score (H-score) was calculated and compared between study group and control group throughout the menstrual cycle. Results: There was no significant difference in the H-score of VEGF in the eutopic endometrium between patients with endometriosis and controls without endometriosis when compared according to the same phase of the cycle, although the H-score of the study group was significantly higher in the secretory phase than the proliferative phase. Conclusion: The VEGF expression in the eutopic endometrium of women with endometriosis was not different from that of women without endometriosis. This study suggests VEGF expression in eutopic endometrium is unlikely associated with the pathogenesis of endometriosis.

• Women's Health Nursing
• /
• v.8 no.3
• /
• pp.380-388
• /
• 2002

The purpose of this Quasi-experimental design was to assess the effects of a hysterectomy on women's emotional response and ultimately, to develop a nursing protocol recommending nursing education for women undergoing a hysterectomy. The subjects at D university hospital receiving a hysterectomy,(for benign gynecological disease) were invited to participate in the study. Subjects who agreed to participate were allocated into control or experimental groups. Each group consisted of 30 women. The subjects emotional adaptation was surveyed through mood questionnaires. The data were analyzed using SAS program. The findings of the study are as follows: In the post test, the "experimental group" reported higher emotional adaptation than the "control group". Between pre and post testing, the "experimental group" showed significant improvement in emotional response; the "control group" did not. In conclusion, allocating nursing information to women both before and after undergoing a hysterectomy was confirmed as an effective nursing intervention for promoting women's emotional adaptation. Therefore, we propose a nursing protocol should be adapted recommending nursing education for women undergoing a hysterectomy.

• Women's Health Nursing
• /
• v.16 no.1
• /
• pp.60-68
• /
• 2010

Purpose: This study determined the effect of head and neck massage on anxiety, pain, and discomfort for hysterectomy patients. Methods: Subjects consisted of 48 hysterectomy patients at K hospital. Experimental group (n=23) received head and neck massage at 8 minutes per massage for five times: (at admission, before sleeping on preoperative day, at 4 hours after operation, before sleeping on operation day, before sleeping on the first postoperative day). Control group (n=25) received conventional treatment. As an effectiveness of this intervention, state of anxiety and BP was measured before sleeping on preoperative day. Pain and discomfort were measured before sleeping on the day of surgery and then on the first postoperative day. Data was analyzed descriptive statistics using $x^2$ test, Fisher's exact test, paired t-test, unpaired t-test, repeated measures ANOVA and Bonferroni multiple comparison. Results: 1. State of anxiety score and BP at post-treatment decreased significantly in the experimental group. 2. Pain score in experimental group was lower than that in control group, with no significant difference; whereas, 3. Discomfort level decreased significantly in the experimental group. Conclusion: Results indicate that head and neck massage could be an effective intervention for reducing preoperative anxiety and postoperative discomfort in hysterectomy patients.

• Women's Health Nursing
• /
• v.16 no.4
• /
• pp.409-418
• /
• 2010

Purpose: The purpose of this study was to identify the effects of a pre-operation video assisted education program on residual urine, gas passing and state anxiety in women undergoing hysterectomy. Methods: Nonequivalent control group non-synchronized design was used for the study. In the research, video assisted education program was applied to the experimental group while a similar conventional education was done to the control group. The pre-operation state anxiety and post-operation residual urine and gas discharge of both the groups were measured. The data were analyzed using SPSS. Results: The experimental group was significantly higher than control group on gas passing (t=3.04, p=.00). However the residual urine (t=0.34, p=.73) and state anxiety (t=0.81, p=.82) did not make significant differences. Conclusion: This study is very meaningful in that it developed and provided a nursing intervention can positively affect hysterectomy patients. The pre-operation video assisted education program may be an effective nursing intervention that is clinically practical and useful to reduce time of the gas passing of hysterectomy patients after the operation.

• Women's Health Nursing
• /
• v.8 no.2
• /
• pp.177-189
• /
• 2002

Sexual health education for the patients is an independent function as well as a professional responsibility of nurses. Education should be based on the needs of patients in order to be successful and effective. Therefore nurses must identify sexual health education needs of their patients. A sexual health education protocol for hysterectomy patients was developed by the researcher for this study and included physiosexual and psychosexual topics as well as the topic of sexual interaction. The subject pool was composed of 108 post op total hysterectomy patients who had undergone doing a hysterectomy 5 to 10 days previously at 5 hospitals located in the Seoul and Kyunggi-do area from July 23 to September 30, 2001. The questionnaire was composed of 60 items on sexual health education and used a Likert-type 4-point scale. Internal consistency of this questionnaire in this study was cronbach's $\alpha$=.9495 for sexual health educational needs. For data analysis, the study executed a t-test, ANOVA, and Duncan's Test, in accordance with the purpose of the study using SPSS/PC Win 10.0. The results were as follows: The need for education was highest in the psychosexual area (3.38 point) with education related to sexual interaction the lowest (3.20 point). Osteoporosis (3.75 point) was ranked overall as the highest area of educational need. The degree of educational need varied in correlation with other characteristics of the patients including age, status of marriage, duration of marriage, religion, academic career, monthly income, occupation, the number of children age of menarche, menstruation, other diseases except gynecological disease, previous genital organ operation experience, disease discovery method, pre-explanation for the hysterectomy, average sexual intercourse frequency, how to acquire sexual health information and previous sexual health education (p<.05). In conclusion, the degree of sexual health education needs of hysterectomy patients was very high. Therefore, sexual health educational programs planned according to characteristics of the participating women is necessary.

• Journal of Korean Biological Nursing Science
• /
• v.17 no.1
• /
• pp.28-36
• /
• 2015

Purpose: This study examined the effects of music therapy on pain, anxiety and length of stay of patients undergoing laparoscopic hysterectomy in the postanesthesia care unit (PACU). Methods: Sixty patients who received laparoscopic hysterectomy under general anesthesia from a PACU in a university hospital located in Cheonan city participated in this study. The experimental group (n=30) was offered the option to listen to their preferred music by using MP3 players and headphones for 30 minutes. The control group (n=30) received routine postoperative nursing care. Visual analogue scale was used to measure participants' pain and anxiety, length of stay in the PACU was examined by using their medical records. Data were collected from December 2013 to February 2014 and analyzed by descriptive statistics, ${\chi}^2$-test, Fisher's exact test, and independent t-test using SPSS version 21.0. Results: The result showed that the level of post-operative pain (t=2.44, p=.018), anxiety (t=2.37, p=.021), and the length of stay in PACU (t=3.06, p=.004) significantly decreased in the experimental group as compared to the control group. Conclusion: This study indicated that music therapy with the patients' preferred music showed positive effects. Therefore, it can be used as a therapeutic intervention for postoperative pain management of patients with laparoscopic hysterectomy.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.29 no.3
• /
• pp.121-131
• /
• 2016

Objectives: This paper was aim to report the clinical study for five cases received Korean medicine hospital treatment because of hysterectomy sequelae within 5 days after surgery.Methods: The patients having treated with hospital management, from March 1st in 2014 until March 24th in 2015, was enrolled in this study. We collected their age, chief complaint, vice complaint, diagnosis, visit days after surgery, treatment period, and etc. We treated the patients with acupuncture, moxibustion, and herbal medicine.Results: All of the cases treated with Korean medicine in this study revealed the recovery. The vice complaint also had improved.Conclusions: Korean medicine is effective on patients having variable postoperative symptoms following hysterectomy. And it is necessary to conduct an additional treatment about menopause symptoms.