• Title/Summary/Keyword: Cancer patient nursing

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A Study on the Home Nursing Care Need Trajectory of the patients with chronic illnesses after discharged from Hospital (만성질환자의 퇴원후 가정간호 요구변화 추이에 관한 조사 연구)

  • Lee, Soo-Woo;Suh, Moon-Ja;Kim, Keum-Soon;Lee, In-Sook;Lee, Eun-Sook;Kim, Myung-Ae
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.3
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    • pp.86-97
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    • 1996
  • The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

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Experimental Study for Construction of Mouth Care in Chemotherapy Patients (화학요법을 받는 암환자의 구강간호전략을 위한 연구)

  • 변영순;김애경
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.428-442
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    • 1996
  • Stomatitis is a common toxicity associated with the administration of certain cancer chemotherapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to establish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subsect were divided into three groups : control group : not gargling experimental group A : normal saline gargling (4 times a day) experimental group B : nystatine solution gargling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times(once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X/sup²test. The results are as follows : 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B.(X/sup²=0.002 P=0.001). The grade of stomatitis(mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A F=1.96 P=0.0024). In incidence of tongue change, control group, experimental group B were significantly higher than experimental group B(F=6.84 P=0.0039). In control group and experimental group A. oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.

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Disagreement of ICD-10 Codes Between a Local Hospital Information System and a Cancer Registry

  • Sriplung, Hutcha;Kantipundee, Tirada;Tassanapitak, Cheamjit
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.259-263
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    • 2015
  • Background: In the field of cancer, the ICD-10 coding convention is based on the site of a neoplasm in the body and usually ignores the morphology, thus the same code may be assigned to tumors of different morphologic types in an organ. Nowadays, all general (provincial) and center hospitals in Thailand are equipped with the hospital information system (HIS) database. Objective: This study aimed to find the characteristics and magnitude of agreement represented by the positive predictive value (PPV) of provisional cancer diagnoses in the HIS database in Pattani Hospital in Thailand in comparison with the final cancer diagnosis of the ICD-10 codes generated from a well established cancer registry in Songklanagarind Hospital, the medical school hospital of Prince of Songkla University. Materials and Methods: Data on cancer patients residing in Pattani province who visited Pattani Hospital from January 2007 to May 2011 were obtained from the HIS database. The ICD-10 codes of the HIS computer database of Pattani Hospital were compared against the ICD-10 codes of the same person recorded in the hospital-based cancer registry of Songklanagarind Hospital. The degree of agreement or positive predictive value (PPV) was calculated for each sex and for both sexes combined. Results: A total of 313 cases (15.9%) could be matched in the two databases. Some 222 cases, 109 males and 113 females, fulfilled the criteria of referral from Pattani to Songklanagarind Hospitals. Of 109 male cancer cases, 76 had the same ICD-10 codes in both hospitals, thus, the PPV was 69.7% (95%CI: 60.2-78.2%). Agreement in 76 out of 113 females gave a PPV of 67.3% (95%CI: 57.8-75.8%). The two percentages were found non-significant with Fisher's exact p-value of 0.773. The PPV for combined cases of both sexes was 68.5% (95%CI: 61.9-74.5%). Conclusions: Changes in final diagnosis in the referral system are common, thus the summary statistics of a hospital without full investigation facilities must be used with care, as the statistics are biased towards simple diseases able to be investigated by available facilities. A systematic feedback of patient information from a tertiary to a referring hospital should be considered to increase the accuracy of statistics and to improve the comprehensive care of cancer patients.

Lack of Effects of HER-2/neu on Prognosis in Colorectal Cancer: a Meta-analysis

  • Han, Jun;Meng, Qing-Yang;Liu, Xiao;Xi, Qiu-Lei;Zhuang, Qiu-Lin;Wu, Guo-Hao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5551-5556
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    • 2014
  • Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.

The Effects of Simulation-based Infection Control Training on the Intensive Care Unit Nurses' Perception, Clinical Performance, and Self-Efficacy of Infection Control (시뮬레이션기반 감염관리교육이 중환자실 간호사의 감염 관리에 대한 인식도, 임상 수행도, 자기효능감에 미치는 영향)

  • Cho, Sung Sook;Kim, Kyung Mi;Lee, Beoung Yeo;Park, Sun A
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.3
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    • pp.381-390
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    • 2012
  • Purpose: This study was conducted to examine the effects of simulation-based infection control training on the ICU nurses' perception, clinical performance, and self-efficacy of infection control. Methods: Thirty-eight nurses were assigned into two groups using a career stratified randomization. In the experimental group, the subjects received a simulation-based infection control training, whereas the control group participated in a conventional lecture-based training. Two weeks after the completion of the training sessions, the participants were evaluated for perception, clinical performance, and self-efficacy regarding the infection control. Results: The experimental group that received simulation-based infection control training showed an improvement in perceiving the infection control compared to that of the control group, but the difference was not statistically significant. In terms of the clinical performance, the experimental group and the control group scored $26.05{\pm}3.22$ and $18.53{\pm}3.37$ points respectively, demonstrating a statistical significance (p<.001). There was no significant difference between the two groups in regards to the self-efficacy. Conclusion: The developed simulation-based infection control training showed positive effects in improving clinical performance of infection control over conventional lecture-based training, confirming that a simulation-based training is an effective method in advancing the practical performance of ICU nurses.

Comparison of the Spiritual Needs of Terminal Cancer Patients and Their Primary Family Caregivers

  • Kang, Kyung-Ah;Choi, Youngsim
    • Journal of Hospice and Palliative Care
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    • v.23 no.2
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    • pp.55-70
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    • 2020
  • Purpose: This study was conducted to examine differences in Spiritual Interests Related to Illness Tool (SpIRIT) scores and the degree of spiritual needs (SNs) between patients with terminal cancer and their primary family caregivers and to compare spiritual needs between them. Methods: The study participants were inpatients with terminal cancer and their primary family caregivers at 40 national hospice centers. The final analysis included 120 SpIRIT surveys from patients and 115 from family members, and 99 SNs questionnaires from patients and 111 from family members. Data analysis was conducted using descriptive statistics, the t-test, one-way analysis of variance, and Pearson correlation coefficients. Results: There were no significant between-group differences in SpIRIT scores or SNs. The SpIRIT sub-dimensions that ranked high for both patients and primary family caregivers were "maintaining positive perspective", "loving others", and "finding meaning". The SNs sub-dimensions were ranked identically in both groups, in the order of "love and connection", "hope and peace", "meaning and purpose", respectively. In both groups, the recognition of the importance of spiritual matters and religion were major factors influencing SpIRIT scores and SNs. Conclusion: The SpIRIT scores and degree of SNs of patients with terminal cancer and their primary family caregivers were found to be very closely related, and the needs for coherence and meaning were greater than religious needs. When providing spiritual care for patients with terminal illness, family members should also be considered, and their prioritization of spiritual needs and the importance of spiritual matters and religion shall be taken into account.

Burden and Quality of Life in Terminal Cancer Patient's Family Caregivers in the area of Jeollanam-do (말기암환자 가족원의 부담감과 삶의 질: 전남지역을 중심으로)

  • Yang, Eun-Young;Kim, Young A
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.3954-3962
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    • 2015
  • Purpose: The purpose of this study was to examine the burden and quality of life among family caregivers of terminal cancer patients and the relationship of these variables. Methods: Data were collected from 80 family caregivers and analyzed using SPSS 19.0 program. Results: Burden was found to have significant relationships with age, marriage, relations with patients, living together with patients and medical expense burden(p<.05). Quality of life was found to have significant differences according to age, marriage, educational background, relations with patients and living together with patients(p<.05). Burden and quality of life showed a negative correlation(r=-.538, p<.001). Conclusion: These results suggest that more attentions and interventions such as support programs should be given to family caregivers of terminal cancer patients, which can decrease the burden of family caregivers to enhance their quality of life.

A Study on risk factors for senile dementia (노인성치매 발생요인과 돌보는 가족원의 스트레스에 관한 조사 연구)

  • 홍여신;이선자;박현애;조남옥;오진주
    • Journal of Korean Academy of Nursing
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    • v.24 no.3
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    • pp.448-460
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    • 1994
  • This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

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The Levels of Health Literacy and Related Factors among Middle-aged Adults in Seoul, Korea (서울 지역 일부 중년 성인의 건강정보이해능력(health literacy) 실태와 관련 요인에 대한 연구)

  • Kang, Soo-Jin;Lee, Tae-Wha;Kim, Gwang-Suk;Lee, Ju-Hee
    • Korean Journal of Health Education and Promotion
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    • v.29 no.3
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    • pp.75-89
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    • 2012
  • Objectives: This study was performed to identify the level of health literacy and to investigate the relationship between the health literacy and preventive health care use in middle-aged adults in Korea. Methods: A total of 315 adults aged 40 to 64 years living in Seoul participated in the study. Data were collected from December 15-24, 2010 from outpatient hospitals, clinics, workplaces and other locations in the community. Health literacy was measured using the Functional Health Literacy and Self-rated Health Literacy Questionnaires. Preventive health service use was defined as receiving screening (general health checkups, gastric and colorectal cancer, mammogram, and pap smear) and influenza vaccination. Descriptive analysis, t-test, and ANOVA were used. Results: The mean of functional health literacy was 3.87 (score range 0-6) and the self-rated health literacy was 60.08 (score range 16-80). The most difficult items of the self-rated questionnaires were patient educational materials provided by health care providers and medical forms. The most difficult items of functional health literacy were information-based, including nutritional facts and clinical schedules. Association between health literacy and preventive health service use was not found. Conclusions: Further study is necessary with larger samples and with considerations for their education level, age, and preventive health care use.

Development and Application of the Constipation Assessment Tool for Patients with Terminal Cancers (말기 암환자의 변비 사정도구 개발 및 적용)

  • Kim, Myung Ok;Park, Myung Hee;Rye, Min Ae
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.205-214
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    • 2012
  • Purpose: The purposes of this study were to develop the constipation assessment tool for identifying their bowel movement patterns, and to provide basic information for the assessment and intervention protocol on constipation for patients with terminal cancers. Methods: The study followed the steps: the first step was to build a conceptual framework based on literature review; the second step was to develop a tentative instrument by analyzing the conceptual framework and existing instruments; the third step was to test content validity and reliability; and the final step was to apply the tool to patients with terminal cancers (N=112). Results: The constipation assessment tool was consisted of total nine items; under the categories of subjective and objective data for diagnosis had 4 items, and under the initial assessment category which includes stool type, physical examination, and abdomen X-ray had 5 items. Conclusion: The constipation assessment tool developed in this study is very easy to use and useful in nursing practice, especially in hospice and palliative care setting. Particularly this tool has items on patient assessment which would be considered as an evidence for choosing nursing interventions. Based on the constipation assessment tool, the development and application of intervention protocol on constipation for patients with terminal cancers is warranted in future research.