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암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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Development of Cancer Patient Guide for Nausea & Vomiting Management in Chemotherapy (항암화학요법을 받는 암 환자의 오심, 구토관리를 위한 환자용 지침 개발)

  • Yi, Ji-Eun;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.570-581
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    • 2010
  • Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

Case Report of Advanced Gastric Cancer Patient Treated with Hang-Am Plus (항암플러스 투여 후 호전된 진행성 위암 환자 증례보고)

  • Park, Jae-Woo;Yoo, Hwa-Seung;Cho, Chong-Kwan;Lee, Yeon-Weol
    • Journal of Haehwa Medicine
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    • v.19 no.2
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    • pp.153-158
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    • 2011
  • Objective : To investigate the therapeutic effects of HangAm-Plus (HAP) on advanced gastric cancer patient. Methods : A 53 year old male patient diagnosed with advanced gastric cancer (T3N3M1) was admitted to EWCC (East-West Cancer Center) on Nov. 20008. He had refused to go through the standard cancer regimen after having total gastrectomy on Jul 2008. The patient was treated with HAP (3,000 mg/day) for the period of 11 months from Nov 27th, 2008 to Oct 10th, 2009. Computed tomography (CT) and endoscopy were used to evaluate the disease progression of the patient. Results : HAP treatment was well tolerated by the patient. Patient has shown 25 months of stable disease condition up until now. Conclusion : This case study supports HAP's potential efficacy in treating advanced gastric cancer patients.

Cancer Pain Relieved by Acupuncture on a Patient with Colorectal Cancer: Single Case Report (대장암 환자의 암성 통증에 사암침법을 적용하여 통증 감소를 보인 증례 1례)

  • Song, Ji-Yeon;Jerng, Ui-Min;Jeong, Jong-Soo;Park, Jae-Woo;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.14 no.1
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    • pp.37-44
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    • 2009
  • Most of patients who have cancer still suffer from various forms of pain that significantly impact their quality of life. Cancer pain is a difficult problem for clinicians because analgesic drugs do not always procure complete relief. Acupuncture has been used as complementary treatment of cancer pain. We report a patient with colorectal cancer who suffer from cancer pain. The patient underwent chemotherapy, radiotherapy and opioid therapy. However, the patient insisted on being treated for his continuous pain with oriental medical treatment. The patient was treated with acupuncture(especially SAAM acupuncture) for 2 months, additional herbal medication was administered. After those treatments, the patient showed remarkable improvement in terms of intensity and severity of cancer pain. Further study will be needed in order to determine the long-term efficacy of acupuncture on cancer pain.

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A case of breast cancer Patient Treated with Allergen Removed Rhus Verniciflua Stokes(ARV) (알러젠 제거(除去) 옻나무 추출물(抽出物) 투여(投與)로 호전(好轉)된 유방암(乳房癌) 환자 1례)

  • Kim, Cho-Young;Park, Jae-Woo;Jung, Hyun-Sik;Choi, Won-Cheol;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.12 no.1
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    • pp.67-73
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    • 2007
  • Breast cancer is common in West and Incidence of breast cancer has increased in Korea. According as conventional western medical treatment, breast cancer patient received MRM(modified radical mastectomy) and anti cancer chemotherapy. In this case report, We introduce a case of breast cancer patient who showed lung metastasis(metastatec adenocarcinoma) after MRM(modified radical mastectomy) 4 years before the diagnosis of relapse. After lung metastasis of breast cancer, the patient received 4th chemotherapy and refused to get more conventional western medical treatment including chemotherapy. After 24 month of traditional oriental medical treatment using allegen removed Rhus Verniciflua Stokes(ARV), however, the size of cancer mass decreased and the patient showed improved condition. Further case study will be needed in order to determine the effect of ARV on breast cancer patient.

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A Case Report of Advanced Gastric Cancer Patient Treated with Bojungikgi-tang Gamibang (절제불가능한 위암의 위장관 출혈에 대한 보중익기탕 가미방 투여 1례)

  • Lee, Hyun-Il;Jerng, Ui-Min;Jeong, Jong-Soo;Lee, San-Hun;Choi, Won-Cheol;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.14 no.1
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    • pp.29-35
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    • 2009
  • Approximately 10 percent of advanced stomach cancer patients have internal bleeding in their stomach. It is crucial to treat internal bleeding since it severely deteriorates patient's condition, and disturbs process of chemotherapy. There are hemostatic agents and dressing, radiotherapy, endoscopic ligation and coagulation, surgical methods to treat bleeding. However, these methods cannot be executed in some cases in which patient is in terminal stage or not in desirable condition to take these treatments. We are going to introduce a case of advanced gastric cancer patient having stomach bleeding who made a choice to take oriental medical treatments. The patient was on third stage of stomach cancer, had 3200cc of blood transfusion for five times. After diagnosed as not being able to have resection, he started to oriental medical treatments to stop bleeding. From March 28, 2009 to April 16, 2009, we administer 120cc Bojungikgi-tang gamibang to the patient in 90minutes after each meal. During 19days of having Bojungikgi-tang gamibang, we observed that the patient needed significantly lower amount blood transfusion, to 640cc. The patient improves in performance, and was able to eat more. Despite of short period of observation, this case indicates that Bojungikgi-tang gamibang treatment to the patient could work as hemostat, further improved quality of patient's life.

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Case Report of the Pancreatic Cancer Patient after Pancreatoduodenectomy who is Taking the HangAm-Plus to Anti-metastasis and Preventing Recurrence (췌장암의 외과적 절제술 후 항암플러스로 항전이 및 재발 방지 중인 환자 증례보고)

  • Kim, Jong-Min;Park, Jae-Woo;Yoo, Hwa-Seung;Lee, Yeon-Weol;Cho, Chong-Kwan
    • Journal of Korean Traditional Oncology
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    • v.16 no.1
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    • pp.33-39
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    • 2011
  • Objective : To investigate the anti-metastasis and preventing relapses of HangAm-Plus (HAP) on pancreatic cancer patient. Methods : A 49 year old male patient diagnosed with pancreatic cancer (T3N0M0) was admitted to EWCC (East-West Cancer Center) on Jul. 21st 2008. He had operated pylorus preserving pancreatoduodenectomy (PPPD) and came to the anti-metastasis and preventing relapses on pancreatic cancer patient. The patient was treated with HangAm-Plus (HAP) (3,000 mg/day) for the period of 33 months from Jul. 21st, 2008 to Apr. 7th, 2011. Tumor markers (CEA and CA19-9) were used to evaluate the disease progression of the patient. Positron Emission Tomography (PET) and Computed Tomography (CT) were also followed up. Results : HAP treatment was well tolerated by the patient. Patient has shown 33 months of disease free survival until now. Conclusion : This case study supports HAP's potential efficacy in the anti-metastasis and preventing relapses of pancreatic cancer patient.

A Case of Recurrent Gastric Cancer Patient Treated with Dokhwaljihwang-tnggami for Nausea and Vomitting - A Gastric Cancer Patient's Case (재발한 위암 환자의 오심 구토에 독활지황탕가미를 처방한 1례)

  • Jeong, Seong-Kook;Song, Jeong-Mo
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.4
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    • pp.425-431
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    • 2013
  • Objectives The purpose of this case study was to evaluate the effects of Sasang Constitutional diagnosis and treatment of recurrent gastric cancer patient. Methods Nausea and vomiting of recurrent gastric cancer patient was diagnosed Soyangin Emheooyol Pattern based on their Nature & Emotion, physical characteristics, symptoms. He was medicated dokhwaljihwang-tanggami. Results and Conclusions Nausea and vomiting of recurrent gastric cancer patient who was treated with Dokhwaljihwang-tanggami showed improvement in nausea vomiting appetite loss and general condition. This case study describe the effectiveness on Nausea and vomiting of Recurrent Gastric Cancer Patient by using Dokhwaljihwang-tanggami.

Effects of Doctor-patient Communication on Quality of Life among Breast Cancer Patients in Southern China

  • Zhou, Qin;Shen, Ji-Chuan;Liu, Ying-Zhi;Lin, Guo-Zhen;Dong, Hang;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5639-5644
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    • 2014
  • Objective: This study aimed to determine effects of doctor-patient communication on the quality of life among breast cancer survivors in 16 communities in southern China. Methods: Multistage random sampling was to use to recruit 260 females from the Guangzhou Cancer Registry Database who were diagnosed with breast cancer. A questionnaire provided data on the doctor-patient communication (including the doctor's attitude, the patient's participation with the medical decision and information about the disease) and QOL (quality of life), as measured using FACT-B. Univariate analysis, non-conditional logistic regression was used to evaluate the associations between the doctor-patient communication and QOL. Results: Females who received good attitudes from doctors demonstrated higher FACT-B (OR=4.65, 95% CI: 1.68-12.86), social well-being (OR=5.88, 95% CI: 2.16-16.05), emotional well-being (OR=4.77, 95% CI: 1.92-11.88), and functional well-being ((OR=5.26, 95% CI: 1.90-14.52) compared to the females who encountered worse attitudes from their doctor, adjusting for age, education, marriage, employment, family income, years since diagnosis, TNM stage, radiation therapy, chemotherapy and side effects, particularly when the TNM stage was 0-II and the patients exhibited no side effects. Regardless of the length of time after diagnosis, doctors' good attitudes resulted in higher QOL scores. Conclusions: This study demonstrated that the doctor-patient communication has a significant association with the QOL of breast cancer survivors, mainly dependent on the doctors' attitude. Effective intervention is required to develop optimal doctor-patient communication.

Optimizing Nutrition Support in Cancer Care

  • Menon, Kavitha Chandrasekhara
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2933-2934
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    • 2014
  • Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.