• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.731-743
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• 2017

Purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. Methods: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. Results: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (${\beta}=1.57$, p=.023) and did not use physical measures (${\beta}=-1.23$, p=.041) as coping methods were under the high risk of nutritional disorders. Conclusion: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7321-7326
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• 2014

Background: Sexual health and function frequently are overlooked by healthcare professionals despite being identified as an essential aspect of patient care. Patients with cancer have identified sexuality issues as being of equal importance to other quality-of-life issues. Objectives: The aim of this study was to determine the views and attitudes of oncology nurses caring for cancer patients regarding sexual counseling. Participants and Methods: A descriptive cross-sectional study was conducted on the web site of the Turkish Oncology Nurses Association. With the participation of 87 nurses from oncology departments, the study determined that most nurses do not evaluate and counsel patients regarding their sexual problems and many difficulties prevent them from focussing on sexual health. The most important reasons for ignoring sexual counseling were the absence of routine regarding sexual counseling in oncology departments, the belief that the patient may become ashamed and the nurses' self-evaluation that they have insufficient skills and education to counsel in this subject. Conclusions: The most important variables in sexual evaluation and counseling are long years of service in the profession and a postgraduate degree.

• Women's Health Nursing
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• v.29 no.4
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• pp.257-262
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• 2023

• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.886-898
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• 2020

Purpose The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.

• Journal of Home Health Care Nursing
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• v.14 no.1
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• pp.31-41
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• 2007

Purpose: This study was designed to evaluate the effect of home care nursing intervention with parenteral hydration and IV anti-emetic therapy on distress, nutritional status, anxiety, depression and QOL in gynecologic cancer patients who were undergoing combination chemotherapy. Methods: Quasi-experimental design was used to test the intervention. Changes of result variables were measured to evaluate effects of the intervention. variables consisted of serum lab results(auto analytic equipment for lab), symptom distress Scale(McCorkle & Young, 1978; Song et al., 2000), nutritional status(body weight, circumference of upper arm, serum protein, serum albumin, oral intake per day), anxiety(Spielberger, 1972; Kim & Shin, 1978), depression(Zung, 1965; Kim, 1995) and QOL(Padilla et al., 1983; Lee & Jo, 1996). Subjects were selected among gynecologic cancer patients(EG 15 patients and CG 15 patients) by convenient sampling. Data collection was done from June to Nov. in 2000. Data were analyzed by Chi-test and Mann-whitney U test using SPSS Win 10.0. Result: Hypothesis 1, the EG receiving this intervention equals to lab test(Hb & ANC, GOT & GPT, BUN & Cr) the CG, was supported(u=69.50 p=.074; u=94.50, p= .455; u= 89.50, p= .339; u=106.50, p= .803; u=75.00, p= .119; u=97.50, p= .523). Hypothesis 2, the EG has less symptom distress than the CG, was also supported(u=43.50, p= .004). Hypothesis 3, the EG has higher nutritional status than the CG, was partially supported on daily oral intake (u=59.00, p= .025). Hypothesis 4, the EG has less anxiety than the CG, was rejected(u=86.50, p= .280). Hypothesis 5, the EG has less depression than the CG, was rejected(u=203.50, p= .228). and the last hypothesis 6, the EG has higher QOL than the CG was supported (u=51.50, p= .011). Conclusion: Home care nursing intervention undergone in this study was found to be effective to reduce patients' symptom distress and to improve their oral intake and QOL.

• Women's Health Nursing
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• v.11 no.1
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• pp.58-66
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• 2005

Purpose: The purpose of this study was to identify the patterns of activities of daily living (ADL) functional status and to examine the relationships between sense of coherence(SOC), depression, and uncertainty in gynecologic cancer patients who were receiving chemotherapy. Method: A prospective, longitudinal design with repeated measures was utilized. Women reported depression, SOC, and uncertainty at the beginning of the first cycle of chemotherapy, and they recorded ADL functional status everyday for two consecutive treatment cycles. the The instruments used were the Karnofsky Performance Status Index, Orientation to Life Questionnaire, Beck Depression Inventory, and Mishel Uncertainty in Illness Scale-Adult Form. Result: Data from 42 women showed that the ADL functional status during the second cycle was better than that of the first cycle with significant improvement each week. However, it did not completely recover to the baseline level even three weeks after the treatment ended in both cycles. SOC was correlated with depression(r=-.64, p<.001) and uncertainty(r=-.62, p<.001). Uncertainty was related to depression (r=.66, p<.001) and to functional status during the second cycle(r=-.45, p<.05), while the scores of the functional status during the two cycles were not related. Conclusion: Changing patterns and level of functional status during the treatment phase would be useful information for cancer patients to prepare coping strategies for positive health outcomes.

• Women's Health Nursing
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• v.17 no.3
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• pp.215-224
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• 2011

Purpose: This study was to investigate the effect of music therapy as intervention on peripheral neuropathic pain and anxiety of gynecologic cancer patients who were undergoing paclitaxel chemotherapy. Methods: Hospitalized 62 patients were assigned to an experimental group (n=30) and a control group (n=33) in this quasi-experimental study. The experimental group participated in music therapy that includes listening, singing and song writing during 1 hour. The peripheral neuropathic pain, anxiety and depression were examined as pre-intervention evaluation by using pain scale, anxiety scale (20 questions) and depression scale (20 questions) in both groups. There were no further treatments for the control group while the experimental group involved in music therapy. The peripheral neuropathic pain and anxiety were evaluated in both groups as post-intervention evaluation. Results: Outcomes were verified through hypothesis testing. The level of peripheral neuropathic pain and anxiety in the experimental group was decreased, compared to the control group. Conclusion: According to the study, music therapy is a beneficial intervention that reduces peripheral neuropathic pain and anxiety in gynecologic cancer patients. These findings are encouraging and suggest that music therapy can be applied as an effective intervention for minimizing chemotherapy related symptoms.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4053-4056
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• 2013

Background: Colposcopy is the gold standard procedure for evaluating cervical cytological abnormalities. Although it is essentially a minimally invasive intervention, referral for colposcopy may cause significant distress on patients. In this study, we aimed to determine if pre-procedural anxiety levels have a significant association with procedure related pain and discomfort in women undergoing colposcopy for evaluation of abnormal cervical cytology. We also assessed the impact of various clinical factors on anxiety, pain and discomfort in these patients. Materials and Methods: This prospective study was performed at the gynecologic oncology department of Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey between January and June 2013. After taking informed consent, State-Trait Anxiety Inventory (STAI) form and a 14-item questionnaire were filled for women who were admitted to our outpatient colposcopy unit for evaluation of abnormal cervical cytology. STAI scores were calculated for each participant. Immediately after the procedure, visual analog scale (VAS) scores for procedure-related pain and discomfort were obtained. Associations between STAI and VAS scores were investigated using correlation analyses. The effect of various contributing factors on anxiety, pain and discomfort were evaluated with linear regression analysis. The p values less than 0.05 were considered statistically significant. Results: A total of 222 women met the inclusion criteria within the study period. Mean patient age was $38.5{\pm}9.6$. Median state and trait anxiety scores were 47 and 46, respectively. Median VAS scores for pain and discomfort were 4 for both variables. State anxiety had a significant correlation with procedure related discomfort (p=0.02). Colposcopy related pain VAS scores were significantly affected by state anxiety level, marital status and prior gynecological examination (p<0.05). Colposcopy related discomfort VAS scores were significantly affected by state anxiety level, marital status, prior gynecological examination and educational status. Conclusions: Additional measures should be implemented in women that carry higher risk for experiencing pain and discomfort. Social, cultural and lifestyle issues may also affect women's experiences during colposcopy, therefore further studies are needed to define specific determining factors in various populations.

• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.83.1-83.10
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• 2018

Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6053-6057
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• 2014

Aim: To determine utility of the frozen section (FS) in the operative management of endometrial pre-malignant lesions. Materials and Methods: We retrospectively analyzed patients who underwent abdominal hysterectomy with preoperative diagnosis of complex atypical endometrial hyperplasia (CAEH) and simple endometrial hyperplasia (SEH) between May 2007 and December 2013. Frozen and paraffin section (PS) results were compared. Sensitivity, specificity, the positive predictive value (PPV), the negative predictive value (NPV) and the accuracy in predicting EC on FS were evaluated with 95% confidence intervals (CIs) for each parameter. The correlation between FS and PS was calculated as an ${\kappa}$ coefficient. Results: Among 143 preoperatively diagnosed CAEH cases, 60 (42%) were malignant and 83 (58%) were benign in PS; and among 60 malignant cases diagnosed in PS, 43 (71%) were "malignant" in FS. Sensitivity, specificity, PPV and NPV for FS were 76%, 100%, 100% and 87.5%, respectively. Conclusions: We found that FS is reliable and applicable in the management of endometrial hyperplasias. It is important that the pathologist should be experienced because FS for endometrial pre-malignant lesions has significant inter-observer variability. The other conclusion is that patients with the diagnosis of EH, especially those who are postmenopausal, should undergo surgery where FS investigation is available.