Purposes: This study examined uncertainty and nursing need according to illness phases(phase I, II, III) in cancer patients, and investigated relationships between uncertainty and nursing need. Methods: A cross-sectional descriptive study was conducted with a sample of 121 adult cancer patients treated in two hospitals. Results: As for the total score, the uncertainty was not significantly different across the subgroups by illness phase. As for the subscale score, however, two sub-scales of the uncertainty were different across the subgroups. 'The unpredictability' was highest in illness phase I and II groups, while 'the lack of information' was highest in the illness phase III group. Nursing need as the total score was not significantly different across the subgroups by illness phase. However, all subscale scores of the nursing need were significantly different across the subgroups. Educational need was highest in the illness phase I group; physical and emotional needs were highest in the illness phase III group. Uncertainty and nursing need were not related to each other at any illness phase. Conclusion: The results suggest that nursing need and uncertainty may change across illness phases. Clinicians need to consider this pattern in caring for cancer patients.
Purpose: The purpose of this study was to explore the health-illness transition of patients with Young-Onset Parkinson's Disease (YOPD). Methods: From June to November 2011, 17 patients with YOPD who visited a neurologic clinic in a tertiary hospital participated in the study. Data were collected through in-depth interviews and analyzed using the grounded theory of Strauss and Corbin. Results: The core category of the participants' health-illness transition emerged as 'reshaping identity following uncontrollable changes'. The participants' health-illness transition process consisted of six phases in sequence: ego withdrawal, loss of role, frustration, change of thought, modification of life tract, and second life. Although most participants proceeded through the six phases chronologically, some returned to the frustration phase and then took up the remaining phases. Conclusion: The study results provide an in-depth understanding of health-illness transition experiences in the participants. These findings suggest a need to develop appropriate nursing intervention strategies according to the different phases in the health-illness transition of patients with YOPD.
Cancer has been considered a life-threatening disease and coping patterns could have a strong impact the physical and psychological health of patients and their family. The purpose of this study was to identify the change of coping patterns according to the phases of illness in the patients with cancer and their family caregivers and to compare the coping patterns of patients with those of their caregivers. The phases of illness consisted of 1st(initial) stage, 2nd(metastatic or recurred) stage and 3rd (terminal) stage based on literature. The coping methods were measured using the modified Ways of Coping Questionnaire by Lazarus & Folkman(1984). Seventy-nine patients(35 in stage 1, 31 in stage 2, and 13 in stage 3) and ninety-two caregivers (38 in stage 1, 30 in stage 2 and 24) agreed to participate from two general hospitals in Seoul and Choongnam. No significant changes were found in the coping patterns according to the phases of illness in both groups. Patients in stage 2 and caregivers in stages 2 and 3 problem-focused coping methods were significantly used more than emotion-focused coping methods. Patients in stage 1 significantly used two coping strategies that were cognitive reconstruction and emotion expression more than caregivers. Patients in stage 2 significantly used emotion-focused coping methods including minimizing threat, blame, and emotion expression excepting wishful thinking more than caregivers. We need more research to identify the relationship between the coping methods and their efficiencies through longterm observation and attempt to develope the nursing interventions that could have an improvement on positive coping methods and provide guidance on the problems the patients experience.
This descriptive study was conducted to ascertain whether the needs of patients with cancer, their caregivers and their nurses changed according to the illness phases and if the perceived needs of the three groups were different for three categories of nursing needs. At two hospitals in Seoul and Choongnam, three groups of subjects, -patients with cancer(79), caregivers(92), and nurses(72) - responded to a questionnaire consisting of items on educational need(11 items), physical need(8 items), emotional need(9 items) using a 4-point Likert scale. The patients and caregivers were selected according to the phase of the cancer (initial, intermediate or recurred, terminal phases). Finding revealed that the level of perception and degree of satisfaction of the needs were low, just around two points in patients and caregivers. Of the three categories of needs, physical needs were received the highest score and the degree of satisfaction of physical needs was also the highest. There was no significant difference between the level of perception and satisfaction of needs in patients and caregivers according to the phases of the illness and the degree of per reception and the satisfaction of the patients were not significantly different and caregivers showed the same result. There was a significant difference in the level of importance of the needs of nurses according to the phases of the cancer. They perceived emotional needs were the most important in first phase and second phase, physical needs in third phase and the educational needs were more important in the first phase than in any other phase. The degree of importance of needs was significantly lower than the degree to which needs were addressed, according to the nurses response. In a comparison of patient and caregiver's perceived degrees of need, and need satisfaction, and nurse's perceived degree of need provision, patient and caregiver scores were lower than the nurses.
Purpose: The purpose of this study was to investigate the relationship among family support, stress and quality of life according to the phases of illness in breast cancer patients. Methods: A descriptive correlational study was employed with 121 breast cancer patients. The data was collected by using self reported questionnaire. Self reported data was collected by using the Family support scale, Perceived Stress Scale (PSS), and EORTC QLQ-BR23. Phases of illness consisted 1st phase, 2nd phase, 3rd phase. Results: The score of family supporting, stress and quality of life showed a statically differences according to the phase of illness. Family supporting and stress had negative relation in the first, second and third phase. Family supporting and quality of life in function area had positive relation in the first, second phase. There was no relation between family supporting and quality of life in symptom area. Stress, quality of life in symptom area and quality of life in function area had correlation in the first, third phase. Conclusion: This study suggest that the new nursing implementation should be considered according to the phase of illness in order to improve the family supporting and quality of life and reduce the stress in breast cancer patients through this study results.
Purpose: This is a concept analysis study to evaluate family caregivers' competence in caring for individuals with mental illness. Method: A hybrid model was used to analyze through three phases scoping literature review. with family caregivers of individuals with mental illness. In the final analysis stage, the concept of caregiving competence was defined. These attributes were derived by integrating stages. Results: The characteristics of caregiving competence were identified as requesting help from the surroundings, minimizing negative effects related to diseases, skilled care, and ability to utilize community resources. The results indicate a need to promote the integration of individuals with mental illness and their families into the community by maintaining productive care. Conclusion: This study improves the accuracy and validity of caregiving competence's concept measurements.
One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was $47.3{\pm}10.2$. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ${\geq}3months$. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.
Purpose: The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. Methods: A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Results: Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. Conclusion: The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.
The main objectives of this study were to investigate the concept of family function from the perspective of the contemporary Korean family, and to construct model of change of family function with chronic illness. The hybrid model approach was applied in which three phases(theoretical phase, empirical phase, and analytic phase) of concept development were explored for family functioning. The study was conducted from 1997 to 1998. In empirical phase, two groups of purposive samples were drawn : normal family group composed of six families without ill family member, and ill family group composed of seven families of which wives have rheumatoid arthritis. Only families with child(or children) in primary or secondary schools were included in the study. The results were as follows : In theoretical phase, six dimensions of family concept were emerged : affective, structural, control, cognitive, financial, and reproductive dimension. In order to analyse the Korean normal family function in middle class with middle-aged women, financial and reproductive dimension were not included. In empirical phase, five dimensions(affective, structural, control, cognitive, and external relationship) were found from the normal family data. External relationship dimension is very important factor as a resource of the support, especially when their parents or siblings had no help or support to them. In the affective dimension, Korean family emphasized harmony and balance rather than affective expression between couples and between parents and children. They also showed common goals of the families to solve their problems to control the family members. The priority of the goals was getting into the higher education of their children or helping their unhealthy parents or family members. Six dimensions (affective, structural, control, cognitive, external relationship, and financial) of family functions were emerged from the ill family data. From the analysis of ill family data, types of restructuring house chore after wives illness were developed : (a) negociated, (b) accomodated, and (c) isolated, enduring types. Although the dimensions of family functioning identified in this study are similar to the conceptualizations that exist in the western literature, there were distinct differences in the nature of major themes and subconcepts under these family function dimensions.
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