• Journal of Korean Academy of Nursing
• /
• v.44 no.2
• /
• pp.139-148
• /
• 2014

Purpose: This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors. Methods: Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0. Results: The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon). Conclusion: It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.

• Journal of Korean Academy of Nursing
• /
• v.46 no.3
• /
• pp.420-430
• /
• 2016

Purpose: The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer. Methods: A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis. Results: CRCI was directly affected by cancer symptoms (${\beta}=.19$, p=.004) and fatigue (${\beta}=.56$, p<.001)($R^2=47.2%$). Depression was directly affected by fatigue (${\beta}=.48$, p<.001) and CRCI (${\beta}=.27$, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI. Conclusion: Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.

• Journal of Society of Preventive Korean Medicine
• /
• v.17 no.3
• /
• pp.129-141
• /
• 2013

Objectives : Anorexia is the primary symptom impinging cancer patients' Quality of Life. It is usually accompanied by gastrointestinal symptoms(GI symptoms). Thus, to measure anorexia symptom precisely, assessing anorexia and GI symptoms together is recommended. This study was designed to analyze cancer-related anorexia assessment tools, extract GI symptoms included in these tools and investigate usefulness of instruments in clinical trials. Methods : Instruments were selected by searching PubMed, PROQOLID database. We analyzed instruments by number of items, assessment method, type of question, GI symptoms. Results : 9 instruments were selected to assess cancer-related anorexia symptom. Most tools adopt Likert scale as response scale and 'during past week' as recall period. Assessment method of all 9 instruments is the self-administration. Questions measuring anorexia are able to be sorted into 3 forms (frequency, severeness, distress of anorexia symptom). Among the GI symptoms, nausea is included in all 9 instruments. In clinical trials of cancer-related anorexia, Edmonton Symptom Assessment Scale(ESAS) and Functional Assessment of Anorexia/Cachexia Therapy Questionnaire(FAACT) were selected as endpoint measure. Conclusions : The result showed that FAACT is the only specialized tool to assess cancer-related anorexia. To measure cancer-related anorexia precisely, the need to develop new instrument exists.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7107-7110
• /
• 2013

Malignant bowel obstruction (MBO), an occasional complication in patients with advanced urological cancer, causes gastrointestinal symptoms such as nausea and vomiting leading to suffering which severely impairs quality of life (QOL). Drug therapy, especially octreotide, a synthetic analog of somatostatin, is reportedly effective in controlling the symptoms of MBO. In the present study, we administered octreotide to urological cancer patients with MBO and evaluated the improvement of subjective symptoms, oral intake, and nasogastric intubation. Fourteen terminally ill urological cancer patients suffering with MBO were included (age range 55-92, 10 male, 4 female). Octreotide was administered at $300{\mu}g/day$ to those patients subcutaneously as a continuous injection. Significant improvements in subjective symptoms were observed in thirteen patients (92.8%), and ten patients (71.4%) were able to resume oral intake. Four patients required nasogastric drainage before the administration of octreotide, but nasogastric intubation was discontinued in all these cases after the use of octreotide. Early initiation of octreotide resulted in better improvement of MBO symptoms, and no adverse event was observed in any of the patients. These results revealed that $300{\mu}g/day$ dose of octreotide is safe and effective for managing gastrointestinal symptoms of terminally ill urological cancer patients with MBO. We also recommend starting the treatment with ocreotide as soon as MBO is diagnosed.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.3
• /
• pp.1091-1095
• /
• 2015

Cancers can be detected in early stages through awareness of suspicious symptoms or by specific actions undertaken by individuals or participation in medical checks or screening programmes. The present research had three objectives: to assess the knowledge of Romanian women who have relatives with cancer with regard to cancer symptoms and detection methods; to identify socio-demographics factors influencing their level of knowledge; provide information regarding the attitudes of women from the study regarding medical help-seeking in case of any symptom which might be associated with cancer. This cross-sectional study was performed in an oncological hospital from Cluj-Napoca, Romania. It involved 160 women aged 18-70 years, who had relatives with cancer. An anonymous questionnaire was filled in by the participants. The results showed that around 10% of the study sample recognized all the 8 listed symptoms associated with cancer and all the 7 listed methods for cancer detection. The results of the linear regression analyses show that the level of knowledge regarding both symptoms and methods for detection was higher among younger women (B=-0.390, p<0.01, respectively B=-0.260; p<0.01), among those living in urban areas (B=0.872, p<0.01, respectively B=0.676; p<0.01) and those having higher educational level (B=0.883, p<0.001, respectively B=0.536; p<0.001). The majority of the participants agreed with the importance of looking for medical help within weeks up to one month in case that a symptom which might be associated with cancer was observed. The study underlines the necessity that much more information should be given to women who have relatives with cancer about what they can do to detect cancer in an early stage. This is especially needed for older women, women living in rural areas and women having a lower educational level.

• Korean Journal of Adult Nursing
• /
• v.17 no.2
• /
• pp.208-218
• /
• 2005

This study was conducted to develop and evaluate guidelines for cancer patients' symptoms management such as nausea/vomiting, fatigue, constipation, diarrhea, and oral mucositis. Based on the literature review, assessment path to identify each stage of five symptoms were also developed. Guidelines for symptom management of each stage of the symptoms were developed. Guidelines then were evaluated by a panel of experts. Finally, 95 cancer patients were recruited and asked to use the guidelines for their symptom management. Levels of understanding of and satisfaction with assessment path and management guidelines were surveyed. Prevalence rate of five symptoms varied ranging from 20% (diarrhea) to 47% (nausea/vomiting). Regarding the level of understanding of each symptom most of the cancer patients indicated that they were easy and sufficient. Regarding the easiness of use of the symptom management guidelines, most of cancer patients indicated that they were easy to use. Regarding the nursing intervention on each symptom, most of cancer patients indicated that they were easy and helpful. More information was added with feedback from the patients. The result of this study has implications on development of customized patient education materials based on assessment path and symptom management guidelines.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.7
• /
• pp.3129-3133
• /
• 2012

Diagnosis and treatment procedures in cancers and resulting anxiety negatively affect the individual and the family. Particularly treatment methods may generate psychological symptoms. The aim of this study was to determine the level of such symptoms in Turkish gynecologic cancer patients receiving chemotherapy. A total of 41 patients who were referred to our gynecologic oncology research clinic between January-March 2012, receiving 3 months or more chemotherapy and who agreed to participate were enrolled in study. All the data were collected using a personal information form, Edmonton Symptom Assesment System and State-Trait Anxiety Inventory. Patients received highest point average from fatigue symptom ($6.53{\pm}2.67$) and lowest point average from dyspnea ($1.53{\pm}3.03$) according to Edmonton Symptom Assesment System. The mean State Anxiety score of patients was $43.1{\pm}9.77$ and mean Trait Anxiety score was $46.7{\pm}7.01$. Comparing symptoms of patients and mean State Anxiety score it was found that there was a statistically significant corelation with symptoms like pain (p<0.05), sadness (p<0.001), insomnia (p<0.05), state of well being (p<0.001) and dyspnea (p<0.05). Similarly comparing symptoms of patients and mean Trait Anxiety score demonstrated significant correlations for fatigue (p<0.05), sadness (p<0.01), insomnia (p<0.01) and state of well-being (p<0.01). As a result, patients with gynecological cancers experienced symptoms related to chemotherapy and a moderate level of anxiety. In accordance, appropriate interventions should recommended for the evaluation and improvement of anxiety and symptoms related to treatment in cancer patients.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.6
• /
• pp.2529-2532
• /
• 2014

Background: Cervical cancer is the second most common cancer among females and also the most preventable. In the literature there is abundant evidence that awareness regarding cervical cancer and its prevention is low in the developing countries. Medical students are the future health professionals and can play an important role in increasing awareness among the general population. To assess the knowledge regarding symptoms, risk factors and prevention of cervical carcinoma among medical students in th Kingdom of Saudi Arabia, the present study was planned. Materials and Methods: This cross-sectional study was conducted using a self-administered questionnaire with students at the College of Medicine, King Faisal University, Al-Ahsa, KSA, from December 2012 to May 2013. Results: The responses of 188 students (males 111, females 77) in their second, third, fourth, and fifth years were recorded and used in the data analysis. The majority of the students were not aware of the early warning signs, symptoms and risk factors. On average, only 43.7% males and 56% of females were aware about the early signs and symptoms whereas 51.4% males and 57.8% females had knowledge about the risk factors of cervical cancers. Some 55% males and 46.8% females were unable to select the correct answer regarding human papilloma virus (HPV) infection as the cause of cervical cancer. Majority of the students (67%) were not aware about the availability of vaccine against HPV. Conclusions: Lack of knowledge regarding early signs and symptoms, risk factors and prevention of cervical cancer was observed in the present study.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.3
• /
• pp.1905-1909
• /
• 2013

Objective: The aim of the current study was to evaluate changes in treatment outcomes in terms of health-related quality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosis of colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patients were investigated using a repeated measures framework. Methods and Materials: A cohort study was performed of 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoL and symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis. Results: The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4 years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery; some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEE showed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatment period. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females, patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patients had more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms over time. Conclusion: The patients' HRQoL, pain, and symptoms significantly improved over the 6-month treatment period. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoL and symptom burden in colorectal cancer patients.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.19
• /
• pp.8135-8142
• /
• 2014

Background: Breast cancer is the most common cancer in Iranian women and usually features delayed presentation and late diagnosis. Interpretation of symptoms, as the most important step, has a significant impact on patient delay in seeking treatment. There is a dearth of studies on symptom appraisal and the process leading to seeking help in breast cancer patients. This study explored the perceptions and experiences of Iranian women with self-detected possible breast cancer symptoms. Materials and Methods: A qualitative method was conducted involving in-depth semi-structured interviews with 27 Iranian women with self-discovered breast cancer symptoms. Participants were purposefully selected from women who attended Cancer Institute of Tehran University of Medical Sciences during June 2012 to August 2013. The audiotaped interviews were transcribed and analyzed using conventional content analysis with MAXQDA soft ware version 10. The trustworthiness of the study was verified by prolonged engagement, member validation of codes, and thick description. Results: The main concepts emerging from data analysis were categorized in four categories: symptom recognition, labeling of symptoms, interactive understanding, and confronting the fear of cancer. Symptom recognition through breast self-examination, symptom monitoring and employing prior knowledge distinguished normal from abnormal symptoms and accompanied with perception of being at risk of breast cancer led to symptom labeling. Social interaction by selective disclosure and receiving reassurance from a consultant led to confirmation or redefinition of the situation. Perceived seriousness of the situation and social meanings of breast cancer as a stigmatized and incurable illness associated with loss of femininity were reasons for patient worries and fear. Conclusions: This study emphasized that entangled cognitive, emotional and socio-cultural responses affecting understanding of symptom seriousness require further investigation. It is suggested that programs aimed at shortening patient delay in breast cancer should be focused on improving women's knowledge and self-awareness of breast cancer, in addition to correcting their social beliefs.