Purpose: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). Methods: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. Results: Two distinct clusters were identified: A gastrointestinal- fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. Conclusion: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.
Purpose: This study was to explore the hope structures of the newly diagnosed cancer patients by examining the relationships between hope and the three concepts of 'Personal Spirit', 'Risk' and 'Authentic Caring' which composed the multidimensions of the Nekolaichuk and Bruera's hope model. Methods: Data was collected via survey from 32 newly diagnosed cancer patients. The perceived meaning of life (PML) for 'personal spirit', perceived confidence in cure (PCC) for 'risk', and perceived family support (PFS) and perceived support from medical team (PSM) for 'authentic caring' were adapted from the definitions of the concepts in the model. Hope, PML, and PCC were measured with VAS. PFS and PSM were measured with Korean version of 'Cobb's family support scale', which was modified by Kang. Pearson correlation coefficients were used to identify the relationships among the concepts. Results: The significant relationships were revealed between hope and PCC (p<.001), hope and PML (p<.001), PML and PCC (p<.001), PFS and PML (p=.030), and PSM and PML (p=.047). Conclusion: The newly diagnosed cancer patients experience hope in different ways. The cancer patients' hope immediate after diagnosis, however, is most likely to be experienced as seeking balance between uncertainty about cancer treatment and the meaning of life.
Purpose: This study investigated the effect of a structured group intervention on knowledge about lung cancer, self efficacy and quality of life for family caregivers of patients with lung cancer using a nonequivalent control groupquasi-experimental design. Methods: Subjects were 11 family caregivers for both the control and the experimental group. The experimental group participated in once a week for 2-hour session for 4 weeks. Four topics of educational program were lung cancer and treatment, side effects of treatments, symptoms management, and health management. Every session consisted of lecture, sharing experiences, and meditating time. Quality of life was measured using Jang(1996)'s tool. The tools for knowledge and self-efficacy were developed by the authors. Results: After the intervention, the experimental group showed higher self-efficacy in caring for the patients than did the controls. However, there were no significant differences in knowledge about lung cancer and quality of life between the two groups. Conclusion: Findings indicate that the group intervention would be effective for family caregivers of lung cancer patients.
Despite the advances in cancer therapy in the last 20 years, cancer continues to be a life-threatening illness, and the newly diagnosed individual faces a crisis that emphasized his or her mortality. Patients who suffer from cancer may have psychological problems, especially depression. Most tend to seek the meaning of suffering when continuing pain was experienced. Then the search for meaning, which is one of the primary needs of humans, begins. This meaning is "unique and specific" to the individual, and it must be fulfilled by the individual alone. This study was conducted to provide a basis of data for a nursing intervention program to minimize a cancer patient's suffering and to understand the relationship between life satisfaction, depression, and the meaning of suffering in cancer patients. The sample was composed of 160 cancer patients who were inpatients or outpatients of three general hospitals in Seoul. Data collections were carried out from February 25th to April 20th of 2000. The data was analyzed using a SAS program for descriptive statistics, Pearson Correlations, ANOVA, and Duncan tests. The results were as follows: 1. The scores on the depression scale ranged from 20 to 65 with a mean of 40.76 (SD 9.6) The mean score on the suffering scale was 97.72 (SD 12.7), and the score of the life satisfaction ranged from 15 to 37 with a mean of 25.51 (SD 5.2). 2. There were significant correlations between the amount of life satisfaction and depression (r=-.61, P=.00), the life satisfaction and the meaning of suffering (r=.30, p=.00), and the depression and the meaning of suffering (r=-.24, p=.00). 3. The factors influencing the depression in patients with cancer are age (F=2.52, p=.04) and education level (F=3.98, p=.00). The level of the meaning of suffering in cancer patients differed by education level (F=4.13, p=.00). Also, the level of the life satisfaction in cancer patients differed by education level (F=2.72, p=.04). In conclusion, the correlation between the depression, the meaning of suffering, and life satisfaction can be used as a concrete and practical datum for the development of nursing intervention. This may assist patients with cancer, overcome their suffering and lead to a hopeful life by understanding the meaning of suffering.
Background: Cancer is a major health problem due to the aging population with increasing deaths. Family functioning is affected by cancer diagnosis and treatment. The aim of this study was to comparative analysis of the perception of family functioning by heads of families with and without cancer members during illness, focusing on changes or probable changes. Materials and Methods: This comparative study was conducted on two groups (families with a member of the cancer and controls without a family member with cancer). The families were of patients referred to the clinics and hospitals of Imam Khomeini, Taleghani and Omid of Urmia city, the number of samples being 148 for cases and 176for the control group. To collect the data, valid and reliable family functioning (FAD) was applied, a 60-item questionnaire with seven dimensions, with heads of families. To analyze the data SPSS- 23 Software was used for descriptive and analytical statistics. Significance level was defined p <0.05. Results: Among the seven items : problem solving, communication, roles, emotional response, emotional involvement, behavior control and overall functioning, only differences for average scores of problem-solving were statistically significant. Discussion: Contrary to common perception of severe damage for family functioning in families with cancer members, results of this study indicate that functioning in terms of family caregivers is more or less similar to that of the families with other diseases. Only in problem-solving item do these families experience more difficulty. Conclusion: According to the research findings, in nursing from families with cancer patient, it is recommended to focus more on the problem-solving item of the families.
Aims: To identify the psychosocial adjustment of Turkish patients with breast cancer and the effects of perceived social support on their adjustment. Materials and Methods: The sample comprised 100 volunteering patients diagnosed with breast cancer in the last six months reporting to the Outpatient Chemotherapy Unit at the Medical Faculty Hospital in northern Turkey. The data for the study were collected through the Descriptive Information Form, the Psychosocial Adjustment to Illness Scale-Self-reflection (PAIS-SR) and the Cancer-Specific Social Support Scale and analyzed via SPSS 16.0 for Windows. Descriptive statistics, Chi square test, ANOVA and correlation were used to evaluate data. Results: There was a negative significant correlation between mean scores in the sub-scales of the social support scale and the ones in the sub-scales of the psychosocial adjustment to illness scale (p<0.05). Similarly, there was a negative significant correlation between confidence support and health care orientation as well as adjustment to social environment. Likewise, emotional support was in a negative significant correlation with health care orientation, adjustment to domestic environment, extended family relationships and adjustment to social environment. Conclusions: It was concluded that social support for patients with breast cancer had an influence on their psychosocial adjustment to illness. Holistic care should be given to breast cancer patients by oncology nurses especially in the first six months of treatment. It could be concluded that patients should be accompanied by their family/relatives in treatment and care following their diagnosis with breast cancer, that their family should be made more aware of the fact that the patient should be physically and psychologically supported, that patients with breast cancer should be provided with domiciliary care, and that they should be encouraged to participate in social support groups.
Oh, Eui Geum;Sung, Ji Hyun;Park, Young-Su;Lee, Hyun Joo;Kim, Yu Kyung
Journal of Korean Clinical Nursing Research
/
v.22
no.2
/
pp.194-204
/
2016
Purpose: The purpose of this study was to identify physiological functional status and unmet care needs among patients with chronic pulmonary disease, colorectal cancer, and strokes after discharge. Methods: A crosssectional study was conducted with 224 patients diagnosed with aforementioned diseases from January to July in 2014 in two different tertiary hospitals in Seoul and its suburban area. Physiological functional status and unmet care needs were collected using Karnofsky Performance Status (KPS) Scale and Problems After Discharge Questionnaire-English version(PADQ-E) respectively. Data were analyzed using SPSS/WIN 21.0 program. Results: Patients with chronic pulmonary disease and colorectal cancer showed a low level of physiological functional status (mean: 77.20 and 77.60 out of 100 respectively) and a high level of unmet care needs (mean 2.23 and 2.63 out of 4 respectively). Stroke patients showed a high level of unmet care needs in the category of 'counseling', 'physical complaints', and 'instructions'. Physiological functional status was significantly associated with unmet care needs in all three patient groups and it showed a significant effect on unmet care needs in patients with stroke. Conclusion: The results showed that patients after discharge were still having insufficient functional status and various unmet care needs. The results of this study suggest a development of nursing care service for patients with chronic diseases after discharge.
Purpose: The purpose of this study was to identify the stress and the coping methodes in the cancer patients and their caregivers. Method: The stress method was measured by V AS(Visual Analogue Scale). The coping methodes was measured using the modified Ways of Coping Questionnaire. The phases of patient illness consisted of Ist(initial) stage, and 2nd(recurred) stage and 3rd(terminal) stage based on Lewandowski & Jones(1988) method. The data were collected by a survey of convenience sampling of 257 cancer patients and 196 of their caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test. Result: The stress level of cancer patients was lower than their caregivers. The cancer patients used emotion-focused coping mode than problem-focused coping mode. The caregivers problem-focused coping mode over emotion-focused coping mode. In the problem-focused coping mode, the caregivers significantly used two coping strategies that were ‘positve cope’, ‘information seeking’ more than patients. In emotion-focused coping mode, the caregivers significantly used one coping strategies that was ‘wish’ more than patients. The patients tended to used two coping strategies that were ‘blame’ and ‘emotion expression’ more than the caregivers. Conclusion: Further study needs to be done to positively identify these coping methods and develop interventions to assist patients and their caregivers.
Purpose: This study was to identify the effects of hope intervention on hope and depression of cancer patients staying at home. Methods: The study design was a randomized control group design. The subjects consisted of forty cancer patients randomly selected who were registered at S-Gu Public Health Center. Hope intervention, which was composed of hope assessment, hope objective setting, positive self identity formation, therapeutic relationships, spiritual & transcendental process improvement, positive environmental formation and hope evaluation, was provided from November 20, 2006 to January 26, 2007. Results: The 1-1 hypothesis, "The experimental group which received hope intervention will have a higher score of hope than the control group", was supported(t=-3.253, p= .003). The 1-2 hypothesis, "The experimental group which received hope intervention will have a higher level of hope index than the control group", was supported (t=-4.001, p= .000). Therefore the 1st hypothesis, "The experimental group which received hope intervention will have a higher level of hope than the control group" was supported. The 2nd hypothesis, "The experimental group which received hope intervention will have a lower level of depression than the control group", was not supported (t=1.872, p= .070). Conclusion: Hope intervention is an effective nursing intervention to enhance hope for patient with cancer.
Purpose: This study was to assess the degree of infection prevention behaviors at home, and a relationship between those behaviors and barrier factors among cancer patients undergoing chemotherapy. Method: The data were collected from 92 cancer patients who were undergoing chemotherapy with more than two kinds of immunosuppressive agents at G university hospital in J city from February 17 to April 4, 2003. The instruments were the infection prevention behavior scale developed by researchers and the barrier factor scale by Gu et al. (2003). The data were analysed using mean, standard deviation, t-test, ANOVA, and Pearson's correlation coefficient by SPSS program. Results: The mean score of the behaviors for infection prevention was 2.61 of 4. The highest score was on the subscale 'rest and exercise', and the lowest score was on the subscale 'monitoring sign and symptom of infection'. And a negative correlation(r= -.208, p= .023) was found between infection prevention behaviors and barrier factors. The barriers correlated to infection prevention behaviors were mainly 'no habits' and 'no interest'. Conclusion: It seems that the degree of the behaviors for infection prevention was not performed enough to prevent infection among cancer patients. And there was negative relationship between infection prevention behaviors and barriers. We suggest to develop a nursing intervention program to enhance infection prevention behaviors through reducing the barrier factors.
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