• Korean Journal of Hospice Care
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• v.5 no.2
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• pp.22-32
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• 2005

Purpose : The purpose of this study were to identify the relationship of depression and pain in patients with breast cancer. Method : The data was collected from 117 breast cancer patients who were admitted at K University hospital in Busan, from January 4, to January 31, 2003 using questionnaire method. Their depression was measured using depression scale developed by Zung(1965) and translated by Song(1977) and pain was measured using the Revised Melzack Pain Scale developed by Melzack(1975). The data were analysed by the SPSS WIN 11.0 PC program using frequency and percentage, t-test, ANOVA, Pearson Correlation Coefficient. Result : The results of this study were as follows: The mean and standard deviation of the total depression score were 48±7.89 in 20(lowest)-to-80(highest) scoring system. The analysis of the depression according to general characteristics of the breast cancer patients showed correlation at Age(F=5.81, p=.000), Education level (F=7.48, p=.000), Insurance for cancer(t=6.94, p=.010), Period after Dx(F=6.85, p=.001), Duration of pain experience(F=9.74, p=.000), Surgical method(F=3.87, p=.005), Stage(F=10.31, p=.000), and Lesion site(F=20.63, p=.000). The mean and standard deviation of the total pain score were .48± .40 in 0(lowest)-to-4(highest) scoring system. The analysis of the pain according to general characteristics of the breast cancer patients showed differentiation at Education level(F=3.75, p=.007), Income per mouth(F=3.77, p=.010), Period after Dx(F=3.77, p=.002), Duration of pain experience(F=5.48, p=.000), Stage(F=10.39, p=.000), and Lesion site(F=8.10, p=.000). There was a significant positive correlation between depression and pain(r=.37, p=.000) and between depression and discomfort(r=.37, p=.000). Conclusion : Patients with breast cancer experiencing depression and pain. Increase in depression was associated with increase in pain and discomfort. Nurses must provide patients with nursing care about the occurrence of depression and interventions to deal with pain control and prevent discomfort.

• Journal of Korean Academy of Nursing
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• v.39 no.5
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• pp.683-692
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• 2009

Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

• Women's Health Nursing
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• v.9 no.4
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• pp.379-389
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• 2003

Purpose: To identify the type of disease-related stress experienced by women who received mastectomy for breast cancer using Q methodology. Method: Q sample included 30 statements obtained from literature and interviews with women with mastectomy. P sample consisted of 22 patients with mastectomy. The data were collected from November to December 2002 and analyzed using QUANL program. Result : Four types of disease-related stress experienced by women with mastectomy were found. Type 1 was manifested for a short duration following surgery and characterized by lowered self-esteem, feelings of emptiness and depression because of impaired body image. Type 2 was characterized by declined physical strength, resulting in frequent fatigue in the daily life and less intimate relationship with spouse. Type 3 was manifested by perfectionists with strong sense of self-pride who received or considered breast reconstruction surgery. Type 4 was reported by those who had long period of post-surgery. This type reported a strong sense of discomfort for wearing an artificial breast but didn't show any intention of trying breast reconstruction surgery. Conclusion: Women with mastectomy were found to experience different type of disease-related distress. Therefore, nurses should assess the type of stress the patient experiences following a mastectomy to provide appropriate nursing care.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.206-220
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• 2001

The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04$\pm$2.21), Time 2 (4.82$\pm$2.58) and Time 3(4.73$\pm$2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p〈0.01) and the opioid use (p〈0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p〈0.05) and the amount of physical care the participants received (p〈0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.

• Journal of Korean Academy of Nursing
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• v.29 no.6
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• pp.1365-1378
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• 1999

This study is a methodological research study to develop an instrument to measure in patients with cancer and to test the validity and reliability of the instrument. The research procedure was as follows : 1) The first step was to develop conceptual framework based on a comprehensive review of the literature and in-depth interviews with patients with cancer. This conceptual framework was organized in to three dimensions (the intrapersonal dimension, the significant-other and context related dimension, the transcendental dimension). Initially 59 items were adopted. 2) These items were analyzed through the index of content validity(CVI) and 53 items were selected which met more than 80% on the CVI. 3) The pretest was carried out with 87 patients with cancer. After the pretest results were analyzed by item analysis, 44 items were selected. A second test of content validity was conducted and 6 items were eliminated considering the 80% CVI. 4) To test for reliability and validity, data collection was done during the period from January 25, 1999, to February 26, 1999. The subjects for the test were 160 patients with cancer and 185 healthy persons. analysis, item analysis and multitrait-multimethod method to analyze validity. The findings are as follows : 1) The Cronbach's alpha coefficient for internal consistency was .92 for the total 38 items and .79, .82, .85, for the three dimensions in that order. 2) The item analysis was based on the corrected item to total correlation coefficient( .30 or more) and information about the alpha estimate if this item was dropped from the scale. 3) As a result of the initial factor analysis using principal component analysis and varimax rotation, one item was deleted because of factor complexity (indiscriminate factor loadings). In the secondary factor analysis, 7 factors with eigenvalue of more than 1.0 were extracted and these factors explained 56 percents of the total variance. The seven factors were labeled as 'family relationship', 'emotional condition', 'physical discomfort', 'meaning and goal of life', 'contextual stimuli', 'change of body image', 'guilt feelings'. 4) The convergence effect between this instrument and the life satisfaction scale was identified and there was significant positive correlation(r= .52, p= .00). The discriminant validity between this instrument and the depression scale(CES-D) was tested and there was significant negative correlation(r= -.50, p= .00). The instrument for accessing the suffering of patients with cancer developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessment in caring for patients with cancer.

• Korean Journal of Clinical Pharmacy
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• v.25 no.1
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• pp.56-58
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• 2015

Summary: We report the first hepatic adverse effect of tosufloxacin tosylate in a muscle invasive bladder cancer patient with normal liver functions and with scheduling to undergo a surgical operation for a neobladder. Tosufloxacin tosylate 150 mg was administered to a 57-year-old man who maintained transurethral resection of bladder tumor (TUR-BT) postoperative multiple medications. His labs presented significant increases in alanine amino transferase (ALT) and aspartate amino transferase (AST) levels with 2-week compliance of 150 mg tablet three times a day. After discontinuing tosufloxacin tosylate, the levels slowly decreased and completely returned to normal ranges without any intervention in a few weeks. The Naranjo Causality Algorithm indicates a probable relationship between increased ALT and tosufloxacin. The patient was to have the second surgical operation as scheduled after getting normal range of ATL level. Therefore, tosufloxacin should be avoided in patients at risk for having liver dysfunctions or diseases if the patients have a schedule for any operation. Background: Tosufloxacin tosylate has been shown to have favorable benefits as an antibiotic. Tosufloxacin tosylate may be considered to have the adverse effects such as nauseas, vomiting, diarrhea, abdominal pain, stomatitis, tendonitis, tendon rupture, headache, dizziness, drowsiness, insomnia, weakness, agitation including hemolysis in the event of glucose-6-phosphate dehydrogenase deficiency as other fluoroquinolones. More severe adverse reactions of tosufloxacin tosylate over the above common adverse effects of fluoroquinolones were thrombocytopenia and nephritis. It also is not well known that tosufloxacin can cause hepatic problem. Here the study reports the first hepatic reaction from tosufloxacin and might arouse heath care providers' attention to appropriate drug choice for patients.

• Women's Health Nursing
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• v.10 no.4
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• pp.301-310
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• 2004

Purpose: The purpose of this study was to develop an exercise program for postmastectomy patients. Method: This study was conducted from October, 2003 to June, 2004. The exercise program was developed based on literature review and needs assessment using focus group interviews. The subjects for the focus group interview consisted of 11 patients, 13 recovering patients, and 20 nurses from 3 hospitals. Development of the program was proceeded with analysusm design and development steps. Result: The results of the needs assessment using the focus group interview showed that the exercise program was imperative for postmastectomy patients. Based on the results, a home video tape containing 3 steps, was developed. Each step includes warming-up, stretching, the main exercise, and cool-down. Steps 2 and 3 include exercises with an elastic band, and an elastic ball. The program was modified after conducting a pre-test. A self-checklist including shoulder mobility, hand strength, arm volume and subjective comments on how they feel will be used before and after the exercise program. Conclusion: The exercise program will improve breast cancer patients' quality of life and their physical well-being. Further studies are recommended to test the effectiveness of the exercise program.

• Child Health Nursing Research
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• v.6 no.2
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• pp.249-261
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• 2000

The purpose of this study were to identify the quality of life for the mothers of hospitalized chronic pediatric patients, and to explore the factors affecting the QOL of those mothers. The subjects were 201 mothers whose children had hospitalized at one University hospital with chronic diseases. Data were collected from the December, 1997 to December, 1998. We used a revised QOL instrument consisting of 34 items, 5 point likert scale based on the Noh's QOL instrument. The revised QOL consists of six subscales, those are physical status and function, self esteem, emotional status, economic status, relationship with family members, and relationship with neighborhood. Data were analyzed by t-test, ANOVA, Pearson's correlation using SPSS-PC. The results were as follows: 1. The mean score of quality of life for the mothers of chronic pediatric patients was 100.31, and item mean was 2.95. In subscale analysis, item mean of economic status was the lowest, and that of relationship with family members was the highest. 2. Correlations between characteristics of chronic pediatric patients, their mothers and QOL of mothers were as follows; 1) Total QOL of mothers had a significant positive relationship with progressing time relapse after diagnosing and age of mothers. There was a significant negative relationship between the total QOL of mothers and number of hospitalization of their children. 2) QOL on self esteem and economic status had a significant relationship with age of pediatric patients, the time relapse after diagnosis, and age of mothers. Total number of family members and QOL on economic status showed a significant positive relationship. QOL on emotional status, economic status, and relationship with family members of mothers showed negative correlations with the number of hospitalization of their children. 3. Followings were the result of difference in QOL among different demographic cha- racteristics of the subjects. 1) QOL on economic status of mothers was significantly higher when fathers of pediatric patients had jobs. 2) Total QOL score, QOL on emotional status, and QOL on relationship with neighborhood were significantly higher when mothers of pediatric patients had spouses. 3) QOL on self esteem of mothers was significantly higher when mothers had religion. 4. Followings were the result of difference in QOL among different diagnosis of the children. 1) Total QOL score of mothers whose children had congenital heart disease was higher than that of mothers whose children had leukemia and cancer. 2) QOL on emotional status, economic status, and relationship with family members of mothers whose children had congenital heart disease were higher than those of mothers whose children had leukemia, cancer, and epilepsy.

• Journal of Korean Academy of Nursing
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• v.25 no.2
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• pp.372-389
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• 1995

The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.91-101
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• 1999

The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.