• Journal of Korean Biological Nursing Science
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• v.4 no.2
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• pp.69-77
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• 2002

The purpose of this study was to identify the relationship of symptom distress and natural killer cell cytotoxicity in breast cancer patients who had been radiation therapy and/or chemotherapy after surgery. Symptom distress measured by modified Lee's(1994) physical symptom questionnaire. For measuring the natural killer cell cytotoxic activity. 8ml to 10ml blood was collected from the subjects. Mononuclear cell was isolated by centrifuge of the blood and cultured by putting $Cr^{51}$, and reacted with target cell, K562 cell. Amount of $Cr^{51}$ was measured, and %lysis was calculated. The results were as follows. 1) Symptom distress score was 42.18, which is moderate symptom distress. 2) Natural killer cell cytotoxic activities were 42.18%lysis(effector : target cell ratio=100 : 1) and 28.05%lysis(effector : target cell ratio=50 : 1). 3) Correlation coefficients of symptom distress and natural killer cell cytotoxic activity were $-.134{\sim}-.461$. Though significant correlation was not found between total score of symptom distress and natural killer cell cytotoxic activity, 3('pain' 'feel hot on radiation site' and 'difficulty in breathing') of 19 symptom distress items and natural killer cell cytotoxic activity showed significant negative correlation(p<.05). These findings suggest that 1) breast cancer patients who had been radiation therapy and/or chemotherapy after surgery have moderate symptom distress and decreased natural killer cell cytotoxic activity. 2) The symptom distress was not related to natural killer cell cytotoxic activity.

• Women's Health Nursing
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• v.4 no.1
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• pp.123-138
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• 1998

The purpose of this study was to describe perimenstrual symptom severity levels and perimenstrual distress patterns of women. The study performed the discriminant analysis in which included seven factors : age, pariety, social support, menstrual socialization(mother's symptom, sister's symptom, and menstrual effect), attitude of sex role and depression. The subjects were 283 women that they were not pregnant or lactating, had at least one period in past three months, would understand the purpose of study and willingly accepted the participation. The data analysis was done by pc-SAS program after data collection from Nov. 20, 1997 to Dec. 18, 1997. The descriptive analysis was done to explore general characteristics of the subjects and the stepwise discriminant analysis was done to verify factors in relation to perimenstrual symptom severity levels(severe vs mild menstrual symptom group) and perimenstrual distress patterns(spasmodic vs congestive menstrual symptom group). The instruments were selected for this study from Interpersonal Support Evaluation List(ISEL) by Cohen and Hoberman(1983), Center for Epidemic Studies Depression(CES-D) by Radloff(1977), and Sex Role Attitude Scale by Yunok Suh(1995), Mother's symptom and sister's symptom measurements by Woods, Mitchell & Lentz(1995), and menstrual effect by Brooks-Gun & Ruble(1980). The major findings of this study are as follows : 1. Of the 283 women, 93 women(32.9%) were assessed to severe perimenstrual symptom group and 190 women(67.1%) were assessed to mild perimenstrual symptom group. Results from the stepwise discriminant analysis showed three factors, such as depression, menstrual effect, and age, significantly related to perimenstrual symptom severity and they explained 20% of the total variance. The linear discriminant equation included three factors related to perimenstrual symptom groups was showed(Z=1.445 depression+0.174 menstrual effect-0.054 age). The cutting score(Z) was 2.809. We classified the severe perimenstrual symptom group by more than the cutting score 2.809 and the mild perimenstrual symptom by less or equal than the cutting score 2.809. The correctedness of posterior probability from discriminant equation was 72% as two perimenstrual symptom group classifications. 2. Of the 264 women, 139 women(52.7%) were assessed to spasmodic perimenstrual distress group and women(47.3%) were assessed to congestive perimenstrual distress group. Results from the stepwise discriminant analysis showed two factors, such as depression, age, significantly related to perimenstrual distress groups and they explained 8% of the total variance. The linear discriminant equation included two factors related to perimenstrual distress group was showed(Z=-0.084 age-0.776 depression). The cutting score(Z) was -3.759. We classified the spasmodic perimenstrual distress group by more than cutting score -3.759 and the congestive perimenstrual distress group by less or equal than cutting score -3.759. The correctedness of posterior probability from discriminant equation was 65% as two perimenstrual distress group classifications.

• Korean Journal of Adult Nursing
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• v.15 no.1
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• pp.33-44
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• 2003

Purpose: The purpose of this study was to identify the patterns and related factors of fatigue in patients with breast cancer undergoing radiotherapy. Method: 31 women with breast cancer receiving radiotherapy were recruited from the out-patient radiologic clinic of the university hospital in Seoul, Korea over a period of 3 months. Data was collected prospectively concerning three points for $5\frac{1}{2}\;-\;6\frac{1}{2}$ weeks : before radiotherapy(T1), 2 weeks after starting radiotherapy(T2) and the completion of radiotherapy(T3). Data were analysed by repeated measure ANOVA, Pearson correlaton, and multiple regression. Result: 1. Score of fatigue increased significantly over the course of radiotherapy. 2. Score of symptom distress and emotional distress increased and functional status scores decreased significantly over time. 3. Fatigue was positively related with symptom distress and emotional distress and negatively related with functional status over the course of radiotherapy. 4. At T2, emotional distress explained 24.7% of the variation in fatigue. At T3, symptom distress(41.9%) and emotional distress(7.2%) explained the variance in fatigue. Conclusion: The results of this study provided evidence that fatigue increased over the course of radiotherapy and symptom distress and emotional distress were influencing factors of fatigue in this group. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following radiotherapy considering these factors.

• Women's Health Nursing
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• v.12 no.1
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• pp.53-60
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• 2006

Purpose: This study aimed to explore changes in symptom distress and functional status in gynecologic cancer patients during the entire treatment cycles of chemotherapy. Methods: A prospective and longitudinal study with repeated measures was designed. Symptom Distress Scale and Karnofsky Performance Status Index were included in a daily log developed for self-administration. A total of 39 patients with a mean age of 48.4 years participated. Results: The levels of symptom distress and functional status changed significantly over the six cycles. Symptom distress kept increasing until its peak at the fourth cycle, while the functional status scored lowest at the first cycle, then it improved as the cycle repeated. In each cycle, symptom distress was marked higher during the first 6 days accompanying poor functional status. However, both changes did not recover completely until the end of each cycle. Conclusion: Nursing assessment and intervention need to be provided based on these changing patterns to help cancer patients cope and adjust successfully during the long treatment period. Further studies are needed to examine the impact of the major symptoms on psychological responses, quality of life, and outcomes of the cancer treatments.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.171-176
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• 2016

Background: Much has been done to examine the psychological impact of cancer treatment, but it remains unclear to what extent anxiety and depression is related to symptom prevalence. The present study concerned the characteristics and frequency of distress as related to symptom prevalence in cancer patients undergoing chemotherapy in Malaysia. Materials and Methods: Participants were 303 consecutive adult cancer patients undergoing chemotherapy in an academic medical center. The short form Memorial Symptom Assessment Scale (MSAS-SF), which covers three domains of symptoms (global distress, physical- and psychological symptoms) was used to cross-sectionally measure symptom frequency and associated distress via self-reporting. One-way ANOVA and t-tests were used to test mean differences among MSAS-SF subscale scores. Results: Complete data were available for 303 patients. The mean number of symptoms was 14.5. The five most prevalent were fatigue, dry mouth, hair loss, drowsiness and lack of appetite. Overall, symptom burden and frequency were higher than in other published MSAS-SF studies. Higher symptom frequency was also found to be significantly related to greater distress in cancer patients undergoing chemotherapy. Conclusions: Patients undergoing chemotherapy suffer from multiple physical and psychological symptoms. Better symptom control or palliative care is needed. Greater frequency of reported symptoms may also indicate a subconscious bid by patients for care and reassurance - thus tailored intervention to manage distress should be offered.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.4
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• pp.457-465
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• 2007

Purpose: This study was done to analyze symptom distress and spiritual well-being in patients with cancer according cancer diagnosis, metastasis, treatment stage, number of hospitalizations and treatment modality. Method: The participants, 285 patients being treated in one of ten general hospitals either as in- or out-patients, completed the McCorkle and Young(1978) Symptom Distress Scale translated and adapted by Uhm(1986) and the Spiritual Well-Being Scale by Paloutzian and Ellison(1982) translated by Choi(1990). Data collection was done from June 19 to September 30, 2006. Results: For symptom distress, there were significant differences for cancer diagnosis(p=.018), metastasis(p=.000), treatment stage(p=.000), number of hospitalizations(p=.000), and treatment modality(p=.002). For spiritual well-being, the only significant difference was for cancer diagnosis(p=.002). Patients with ovarian/uterine cancer had the lowest spiritual well-being. Conclusion: For patients with cancer, symptom distress was significantly different for illness and treatment factors, in particular, stage of illness, while for spiritual well-being, patients with uterine ovarian cancer had the lowest spiritual level. These results indicate a need to develop nursing interventions to decrease symptom distress in patients according to treatment stage and to promote spiritual well-being, particularly in women with ovarian/uterine cancer.

• Asian Oncology Nursing
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• v.3 no.2
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• pp.145-154
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• 2003

Purpose: The study was to furnish basic raw materials that evaluate the efficacy of meatal care according to the form and the relative importance of symptom distress which most of cancer sufferers have been experienced. For that, an investigation of five diverse major cancer symptom distress made a comparison between symptom distress and degree of suffering. Method: Study subjects were 138 inpatients with stomach cancer, lung cancer, hepatocellular carcinoma(HCC), large intestine cancer and breast cancer, except those in the terminal-stage, in 'H' university hospital in Seoul and 'K' center in Ilsan gathered from November 20, 2002 to February 20, 2003. To measure the correlation between feeling of discomfort and agony caused by cancer, 5 point scale (from zero to four), stood on the basis of Symptom Distress Scale (SDS, Rodes & Watson, 1987), was used for this study and the Cronbach's coefficient alpha was 0.95. Accumulated data was analyzed with SPSS 10.0 for window, also used by ANOVA and Duncan's Multiple Range Test. Pearson's Correlation Analysis. Results: 1. Symptom distress of cancer patients was noted and defined in their severity-fatigue, anorexia, pain, depression, dyspepsia, changing appearance and nausea. The degree of symptom distress was fatigue, dyspepsia, depression, anorexia, pain, changing appearance and the degree of suffering was nausea, pain, anorexia, dyspepsia, vomiting, breathing difficulty, changing appearance and fatigue. 2. Examining the difference of degree of symptom distress in each cancer cases, it takes the precedence of them. First, in case of stomach cancer, depression, pain, vomiting and nausea were shown in sequence. In case of lung cancer depression, pain, sleeping problem, anxiety, changing appearance, inattentiveness and vomiting were showed in sequence, depression, changing appearance, sleeping problem, pain in case of HCC, depression, pain in case of large intestine cancer and lastly in case of breast cancer changing appearance, depression, pain and anxiety were shown in sequence. The category of the degree of symptom distress that has a signifiant difference was anorexia, activity discomfort, fatigue, constipation or diarrhea, breathing difficulty, dyspepsia, caughing, fever or chillness, scotoma and urinary disorder. Verifying the highest degree of symptom distress in each cancer cases, anorexia was 1.94(F=4.00, p<.01) in stomach cancer, activity discomfort was 0.97(F=3.08, p<.01) in lung cancer and HCC, fatigue was 2.32(F=4.64, p<.01) in HCC, constipation or diarrhea was 1.83(F=22.31, p<.001) in large intestine cancer, breathing difficulty was 1.83(F=4.00, p<.01) in lung cancer, dyspepsia was 2.69(F=9.98, p<.001) in stomach cancer, coughing was 1.53(F=20.49, p<.001) in lung cancer, fever or chillness was 1.23(F=6.88, p<.001) in lung cancer, scotoma was 1.20(F=3.02, p<.05) in lung cancer and urinary disorder was 1.54(F=11.56, p<.001) in HCC. 3. Examining the difference degree of suffering on cancer cases, the result was as follows; depression of lung cancer was 1.17(F=3.76, p<.01), anorexia of stomach cancer was 1.61(F=3.89, p<.01), constipation or diarrhea of large intestine cancer was 1.42(F=10.43, p<.001), changing appearance of breast cancer was 1.65(F=5.43, p<.001), breathing difficulty of lung cancer was 2.27(F=18.57, p<.001), dyspepsia of stomach cancer was 1.97(F=13.56, p<.001), coughing of lung cancer was 1.70(F=22.07, p<.001), fever or chillness of lung cancer was 1.13(F=4.41, p<.01), scotoma of lung cancer was 0.87(F=3.34, p<.05), anxiety of lung cancer was 0.87(F=4.50, p<.001) and urinary disorder of HCC was 1.43(F=16.71, p<.001). 4. In consequence, comparing between symptom distress and degree of suffering on cancer patients undergoing chemotherapy, lung cancer patients showed the highest feeling of discomfort following stomach cancer, HCC, breast cancer and large intestine cancer(F=2.88, p<.05). On those undergoing radiotherapy, lung cancer, HCC, breast cancer, large intestine cancer was in sequence(F=3.78, p<.05) and those resisting radiotherapy, lung cancer, HCC, stomach cancer, large intestine cancer and breast cancer was in sequence(F=2.72, p<.05). 5. Correlation between symptom distress and degree of suffering on cancer patients was generally significant. Conclusion: this study not only defines a significant correlation between symptom distress and degree of suffering but also proffers basic data to evaluate the efficient meatal care depending upon diverse spectrums of symptom distress and degree of suffering.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.723-730
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• 2015

Background: This study was performed to assess patient symptoms prevalence, frequency and severity, as well as distress and coping strategies used, and to identify the relationships between coping strategies and psychological and physical symptoms distress and demographic data of cancer patients. This cross-sectional descriptive study involved a total of 268 cancer patients with various types of cancer and chemotherapy identified in the oncology unit of an urban tertiary hospital. Materials and Methods: Data were collected using questionnaires (demographic questionnaire, Medical characteristics, Memorial Symptom Assessment Scale (MSAS) and Brief COPE scales and analyzed for demographic, and disease-related variable effects on symptom prevalence, severity, distress and coping strategies. Results: Symptom prevalence was relatively high and ranged from 14.9% for swelling of arms and legs to 88.1% for lack of energy. This latter was the highest rated symptom in the study. The level of distress was found to be low in three domains. Problem-focused coping strategies were found to be more commonly employed compared to emotion-focused strategies, demonstrating significant associations with sex, age group, educational levels and race. However, there was a positive correlation between emotion-focused strategies and physical and psychological distress, indicating that patients would choose emotion-focused strategies when symptom distress increased. Conclusions: These findings demonstrate that high symptom prevalence rates and coping strategies used render an improvement in current nursing management. Therefore development of symptoms management groups, encouraging the use of self-care diaries and enhancing the quality of psychooncology services provided are to be recommended.

• Korean Journal of Adult Nursing
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• v.21 no.3
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• pp.269-280
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• 2009

Purpose: To examine the effect of back massage on immune response, symptom distress, and mood state of patients undergoing allogeneic hematopoietic stem cell transplantation (allogeneic HSCT). Methods: Subjects were thirty-seven patients undergoing sibling allogeneic HSCT (including 16 in the experimental group and 21 in the control group). Experimental subjects participated in an intervention group of back massage for 10 minutes, once a day and 5 times a week, from one week prior to the HSCT to the third week after the HSCT or a control group. A non-equivalent pretest-posttest design was used. t-test and Repeated measures ANOVA were used to examine group differences by using SAS. Results: No significant group differences were found in Immune response (CD4+, CD8+,CD19+, CD56+) and symptom distress. The experimental group had significantly less mood state (anxiety, confusion) than the control group. Conclusion: The back massage for the patients undergoing allogeneic HSCT may be effective in altering the anxiety and confusion during hematopoietic stem cell transplantation. However, this study did not provide evidence in improving immune response and symptom distress.

• Korean Journal of Adult Nursing
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• v.17 no.5
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• pp.743-752
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• 2005

Purpose: The purposes of this study were to identify the level of total symptom distress, uncertainty, depression and ways of coping in women with endometriosis based on Mishel's model of Uncertainty in Chronic illness, and to exam the relationships among symptom distress, depression and ways of coping and the mediating effect of ways of coping between uncertainty and depression. Method: The research was used for correlational research design and data were collected with 123 women with endometriosis who live in a local area by convenience sampling. Results: The finding showed that the levels of symptom distress and uncertainty were moderate and the depression was above the middle level. There were positive relationships among symptom distress, uncertainty and depression but a negative relationship between problem focused coping and depression. The significant predictors for depression were symptom distress, uncertainty, and problem focused coping with 40% of explained variance. Problem focused coping showed mediating effect between uncertainty and depression. Conclusion: Therefore, nursing intervention for the strategy of increasing problem focused coping as well as lowering uncertainty and depression is recommended. Further study is needed to conduct a repetitive study with randomized nationwide population and to evaluate the theory with different outcomes for adaptation versus maladaptation.