Purpose: The present study was to investigate sleep disturbance and related variables in patients undergoing hemopoietic stem cell transplantation(HSCT) on the day of admission, before HSCT, and of discharge, respectively. Method: A total of 52 HSCT patients were recruited from an university hospital from August 2002 to August 2003. The patients were asked to complete a set of sleep disturbance questionnaires. Result: The scores of sleep disturbance-related physical and emotional subscales on the day before HSCT and on the day of discharge were significantly higher than that on the day of admission. However, the score of a emotional subscale was not significantly different during the hospitalization for HSCT. About 10% of the variance of sleep disturbance was explained by the length after diagnosis on the day of admission, and 59.4% was by the type of disease, religion, gender, educational level on the day before HSCT. About 40.7% was by family income, gender, and the frequency of administration on the day of discharge. Conclusion: Nursing staffs should care for HSCT patients with more interest to reduce variables disturbing sleep. Especially, more careful nursing interventions have to be considered at the time of the day before HSCT and the time of discharge.
The purpose of this study was to use as a basic data to develop suitable nursing intervention program and decide an appropriate intervention time after assessing shoulder range of motion in postmastectomy from 2 weeks to 3 month. 147 patients are chosen as study subject among patients who were in recovery of 2weeks, 1month, 2months and 3 months after surgical operation which is modified radical mastectomy. Data were collected at oncology medicine local and general surgery local in Seoul National University Hospital from May, 2003 to October, 2003. The range of motion of the shoulder(flexion, extension, abduction, internal rotation, external rotation) were examined. Analysis of data that shoulder range of motion average and standard deviation, percentage of the unaffected side and affected side compare with normal shoulder range of motion. Paired t-test was adopted to analyze the difference between affected side and unaffected side. Conclusion from this study is as following, 1. The most serious problem was external rotation (0.56%) and internal rotation is the next (19.9%) in 5 kinds of shoulder range of motion in 2 weeks after surgical operation 2. There was no difference in internal rotation after post operation 3 months but there were differences and shown to recover more than 90% in flexion and abduction. Also shoulder function incresed in flextion less than 80% and more than 80% in external rotation. As this study finding was shown that shoulder range of motion did not get back perfectly except of internal rotation and extension in point of 3 months after breast cancer surgical operation. External rotation was specially shown the lowest result so it is needed to exercise for improving their physical functioning recovery in postmastectomy patients. And it is suggested to study for helping to postmastectomy patients' physical and psycosocial functions with the early rehabilitation program which is based on these results.
The purpose of this study is to provide the basic data to improve the QOL in patients suffering from female cancers. Subjects of this study were consisted 255 persons who admitted or visited three university hospitals. The instruments used for this study included "the Quality Of Life Scale(QOL)" developed by National Conference on Cancer Nursing and successively amended by Kwon(1990), "Anger in" developed by Spielberger(1988) and successively amended by Chon(1997). The collected data were analyzed using a SPSS 11.0 for PC. To find out significant factors of Anger in & QOL in patients with Female Cancer patients, Frequency, Percentage, t-test, ANOVA, Scheffe-test, Pearson's correlation coefficients were conducted. The main findings : Anger in score was a little low & QOL score was middle. Several characteristics of the subjects were identified to differenti ate the "Anger in" and "QOL". Age status(F=2.64, p=0.05), education status(F=2.73, p=0.04), Health insurance(t=2.27, p=0.00) and cancer insurance status(t=2.97, p=0.00) was significant factors of the "Anger in". Education status(F=2.64 p=0.05), Occupation status (t=2.90, p=0.00), Monthly income (F=3.23 p=0.01), Stage of disease(F=9.23 p=0.00), Perceived health status(F=73.61 p=0.00), Perceived fatigue status(F=11.26 p=0.00) was significant factors of the "QOL". In conclusion, Anger in score was a little low & QOL sore was moderate. The degree of Anger in and quality of life were significantly negative correlated. Therefore, It is needed strategies for intervention of 'Anger in' to improve the QOL in female cancer patients. The significant characteristics of related to "anger in" & QOL should consider in sociopsychogical nursing intervention.
Purpose: The purpose of this study was to compare the improvement and maintenance effects of foot reflexology (FR) on sensations after breast cancer surgery with those of lavender foot bath (LFB). Methods: Using a single-blind design, both 18 women to receive 20-min FR by trained experts and 14 women to soak feet in $40^{\circ}C$ foot tub water with 5 drop lavender essential oil, 15-min were intervened every two days. Repeated measures were taken pre 1st-(baseline-4th op. day), pre 3rd-(2nd data), and pre 5th-intervention (3rd data) with following up at 1-week after 5th intervention (4th data). The reliable translated Korean version of Baron's Breast Sensation Assessment Scale was used to assess sensations after breast cancer surgery (SABCS) characterized by prevalence, frequency, severity, and distress. Results: A significant difference between baseline and the 3rd, and a decrease tendency from baseline to the 3rd were observed for the severity and distress in FR and for the prevalence and severity in LFB. A significant or important decrease tendency between the 3rd and the 4th were observed for the severity and distress in FR and for the severity in LFB. Conclusion: Iterative FR has the improvement and maintenance effects on the severity and distress while LFB has only those on the severity.
Purpose: This study aimed to evaluate the effectiveness of continuous nutritional education and oral mucositis management on the nutritive status of patients who received hematopoietic stem cell transplantation (HSCT). Methods: After randomly allotting 72 patients who received HSCT to either an experimental group or a control group, intensive and continuous care for preventing malnutrition was conducted in the experimental group while usual routine care was conducted in the control group. The changes of the body scale, blood chemistry profile, oral intake calories, nausea and vomitus, and oral stomatitis scores were measured at three points during their hospitalization using a oral assessment guide and nutrition analysis program: admission, HSCT, and discharge day. The differences between the scores of two groups were analyzed by repeated measures analysis of covariance. Results: The number of total lymphocytes was significantly improved in the experimental group after transplantation (p<.001). Nausea and vomiting score was significantly decreased in the experimental group during the conditioning regimen (p<.001). Conclusion: It was found that continuous nutritional education and oral mucositis control is an effective intervention by improving immune condition. Further investigations concerning direct examination of oral intake with controlling the effect of the chemotherapy are needed to ultimately discern the impact of varying oral nutrition patterns during HSCT.
Purpose: The purpose of the study was to develop an educational program reflecting the educational needs of Hospice Smart Patient service providers. Method: The description, goal, curriculum, method, and process evaluation of the educational program were constructed based on Modified Tyler-type Ends-Means Model followed by the analysis of current curriculum and needs of service providers. Results: The curriculum was constructed based on hospice volunteer program currently offered in Korea and the recommendations of hospice service volunteers and experts. A total of 90 hr was required to complete the curriculum that was composed of 'Introduction to cancer', 'Treatment and treatment complications of cancer', 'Post-treatment nutritional care', 'Helpful information', 'Introduction to hospice and palliative care', 'Comprehension of life and death', 'Holistic hospice and palliative care', 'How to communicate as a smart patient', 'Hospice and ethics', 'Pediatric hospice', 'Bereavement management', and 'Clinical practicum'. Conclusion: It is necessary to implement the developed educational program and evaluate its effectiveness, as well as making the service available to a greater number of cancer patients.
Purpose: The purpose of study was to identify how patients experienced chemotherapy-induced peripheral neuropathy (CIPN) and quality of life related to CIPN. Methods: This was a descriptive research. We collected data from 105 patients with chemotherapy-induced peripheral neuropathy. They completed a self-reported questionnaire including Eastern Cooperative Oncology Group (EORTC) CIPN20 and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Results: In the study, duration of peripheral neuropathy was 9.4 month and 54.3% of patients used pharmacological or non-pharmacological interventions. Patients reported the highest score for sensory scale and it's score was $38.74{\pm}20.24$. The scores for motor scale and autonomic scale were $21.95{\pm}19.19$ and $26.61{\pm}21.0$ respectively. This showed that patients more suffered from sensory neuropathy than any other domain of neuropathy. The most frequently selected two items were 'did you have tingling fingers or hands?' and 'did you have tingling toes or feet?'. Conclusion: The results of this study will provide useful information for chemotherapy-induced peripheral neuropathy.
Purpose: This study was conducted to develop the telecommunication guideline that was possible to make the immediate, logical decisions and to evaluate the possibility of the use by verifying it from the specialists' group. Methods: Telecommunication guideline was designed with selected six symptoms which were pain, dyspnea, nausea/vomiting, diarrhea, fever, and cough based on the results of literature. Results: This study showed that the patients understood well about the contents of the questions, examination, and education. Also, 85% of them fulfilled the guidelines of the adjustment and more of them were satisfied with the results shown to all of them compared to the previous telecommunication. And 95% of them replied that the information from the telecommunication was more useful than any other information sources related to the information of cancer and self management that were used previously. Conclusion: The telecommunication was considered to complement the weakness during the time the cancer patients spent at home after the treatments. Also, it was expected to be a role as an immediate and comprehensive method of decision making and a passage for information supply which was considered the specialty of individual patient related to an inquiry of the self management.
Purpose: This survey was aimed to examine the current dietary restrictions practices for neutropenic patients among hospitals with 500 and more beds. Methods: Self-administered questionnaires were sent to 100 head or charge nurses of oncology or hemato-oncology wards by mail during October 2009, and 51 questionnaires were returned. The data were analyzed with descriptive statistics using SPSS (WIN version 12.0). Results: Of the hospitals surveyed, 47.1% (n=24) had guidelines on the dietary restrictions, and 80.4% (n=41) placed patients with neutropenia on restricted diets. The major decisional criteria of the dietary restriction was absolute neutrophil count (30.5%) and cooking status (29.2%). The most commonly restricted foods were raw fish or fresh meat (98.0%), uncooked intestine (98.0%), raw eggs (98.0%), draught beer (96.1%), and fresh fruits or vegetables (86.3%). Conclusion: The results showed variation in pattern of dietary restrictions and lower rate of guideline among hospitals, so that the need for the standard dietary restriction guideline is high. However, the role of diet in the development of infection in neutropenic patients is still unclear, which makes it difficult to establish dietary restriction guideline. Therefore, additional research are required to identify the relationship between dietary factors and infections.
Purpose: The purpose of this study was to provide the basic data for development of nursing intervention to decrease the uncertainty in cancer patients having chemotherapy through promoting their spiritual health and identifying the relationship between spiritual health and uncertainty. Method: 174 cancer patients who were admitted for chemotherapy at hospital were recruited from the 7th March to the 10th April, 2006. Two instruments have been used for this study. One was Highfield's Spiritual Health Inventory and the other was Mishel's MUIS(Mishel Uncertainty in Illness Scale). The collected data was analyzed by frequency, percentage, mean value, average mean, standard deviation, t-test, Scheffe's test, ANOVA and Pearson Correlation Coefficients with the SPSS PC 12.0 program. Results: The average mean value of the spiritual health $3.50{\pm}\;.48$ and the uncertainty was $1.91{\pm}\;.46$. It meant that the relationships between spiritual health and uncertainty were shown to have a moderately negative correlation(r=-.489, p= .000). This means that the greater is the spiritual health, the less is the patient's uncertainty. Conclusions: It was identified that cancer patients having chemotherapy had moderate spiritual health and uncertainty, and negative correlation between spiritual health and uncertainty. Therefore, it will be necessary for the development of spiritual nursing intervention strategies to relieve the uncertainty among cancer patients having chemotherapy.
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