Impact of Symptom Clusters on the Quality of Life in Lung Cancer Patients Undergoing Chemotherapy

Purpose@#This study was to identify the impact of symptom clusters on the quality of life in lung cancer patients undergoing chemotherapy. @*Methods@#Data were collected from 154 lung cancer patients receiving chemotherapy at two tertiary hospitals located in Daegu and Seoul, Korea. The data were analyzed using factor analysis, multiple regression analysis. @*Results@#The most frequently reported symptoms included ‘can’t enjoy life,’ ‘not satisfied with quality of life right now,’ ‘short of breath,’ and ‘fatigue.’ The symptoms that inconveniences patients the most are ‘can’t enjoy life,’ ‘difficulty breathing’, and ‘not satisfied with quality of life right now.’ The quality of life score was 82.58 (0~132). Factor analysis showed that four distinct symptom clusters were identified: fatigueconcern-dissatisfaction of life cluster, dyspnea-weight loss cluster, nausea-anorexia cluster, and treatment side effect cluster. The finding supported the existence of the symptom cluster and Karnofsky Performance Status affected the quality of life of lung cancer patients. The fatigue-concern-dissatisfaction of life cluster showed 56% of explanatory power. @*Conclusion@#Based on the results of this study, it is necessary to manage the characteristics of each lung cancer patient’s symptoms cluster and to develop a strategy that can improve the quality of life.

Development of the Cognitive Function Scale for Breast Cancer Patients

PURPOSE: This is the methodological study to develop the cognitive function scale for breast cancer patients. METHODS: Study was consisted with 1st and 2nd items developing and testify for reliability and validity of them. 94 breast cancer patients in 2 university hospitals and 1 general hospitals responded to a questionnaire that assessed cognitive function scale. Collected data were analysed using the program SPSS/PC Win 21.0. Structural validity was determined factor analysis and convergent validity. This method yielded Cronbach's α value as an internal consistency for the reliability. RESULTS: Factor analysis resulted in six factors and 24 items accounted for 76.31% of the variance. Cronbach's α of scale developed was high as a .95. CONCLUSION: The developed cognitive function scale in breast cancer patients scale has reliability and validity as linear analogue scale witch quantitatively measure the subjectivity. Over these results, providing the way on an assessment in cognitive function in effect for breast cancer patients, it is supposed to contribute the development of nursing knowledge about the cognitive function in breast cancer patients.

The Effects of Hospice Unit Practice Education on Spiritual Well-being, Attitude to Death, and Hospice Awareness of Nursing Students

PURPOSE: The purpose of this study was to examine the effect of hospice unit practice education on spiritual well-being, attitude to death, and hospice awareness of nursing students. METHODS: This study used a one group pre-posttest research design. The participants were 29 nursing students attending D university located in Y City. All students participated in 2 weeks of hospice unit practice education. The hospice unit practice education program consisted of 90 hours. Data collection was performed from March 2 to April 30, 2015. 2 weeks. The data were analyzed using frequency, and paired t-tests, with the SPSS 21.0 program. RESULTS: The results of this study were as followings; the score of existential well-being, attitude to death, necessary of pain and symptom control were significantly increased after hospice unit practice education. CONCLUSION: Based on these results, hospice unit practice education is effective for improving spiritual well-being, attitude to death, and hospice awareness of nursing students. These results provide basic data to develop future nursing practice curriculum.

Impact of Climacteric Symptoms and Fatigue on the Quality of Life in Breast Cancer Survivors: The Mediating Effect of Cognitive Dysfunction

PURPOSE: The purpose of this study was to test hypothetical model of quality of life (QOL) in breast cancer survivors and to test the mediating effects of cognitive dysfunction. METHODS: This study was conducted from December 1st, 2013 to February 28th, 2014. 164 breast cancer survivors were recruited from A, D, and Y city in Korea. The instruments used in this study were climacteric symptoms, fatigue, cognitive dysfunction, and the QOL scales. Data were analyzed using descriptive statistics, correlation, and pathway. RESULTS: Cognitive dysfunction was directly affected by climacteric symptoms and fatigue. QOL was directly affected by fatigue, However climacteric symptoms and cognitive dysfunction did not effect on QOL directly. Impact of climacteric symptoms on QOL, mediating effect of cognitive dysfunction was not confirmed. In addition, effect of fatigue on the QOL, the mediating effect of cognitive dysfunction was not. CONCLUSIONS: Effects of climacteric symptoms on QOL was not mediated by cognitive dysfunction, Furthermore effects of fatigue on QOL was not mediated by cognitive dysfunction.

Comparison of Climacteric Symptoms and Cognitive Impairment in Breast Cancer Survivors and Healthy Women

PURPOSE: This study was to compare climacteric symptoms and cognitive impairment in breast cancer survivors (n=51) and healthy women (n=51). METHODS: This study was conducted from January 4th, 2012 to February 16th, 2012. We individually matched healthy women to breast cancer survivors based on age and education, and assessed a questionnaire regarding climacteric symptoms and cognitive impairment. Data were analyzed by using chi2, t-test, and Pearson correlation with the SPSS/Win 12.0 program. RESULTS: The average score for the climacteric symptoms (19.71) was significantly different (t=-2.78, p=.006) to the average for the breast cancer survivors (15.53). The average cognitive impairment score for the breast cancer survivors (86.37) was significantly different (t=-2.45, p=.016) to the average score for the healthy women (67.92). The climacteric symptoms score showed a significant relationship with cognitive impairment. CONCLUSION: These results support that adjuvant chemotherapy and anti-hormone therapy are associated with climacteric symptoms and adverse cognitive effects in breast cancer survivors.

Factors Affecting Sexual Function of Breast Cancer Women After Receiving Cancer Treatment

PURPOSE: The purpose of this study was to identify factors affecting sexual function in breast cancer women after receiving cancer treatment. METHODS: The participants were 152 patients treated at medical center. Data were collected through a structured questionnaire from 'October 4th to December 30th', 2011. The instruments used in this study were sexual function, pain, fatigue, body image, depression, anxiety, stress and spousal support. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression with the SPSS 18.0. RESULTS: The mean score of sexual function was 14.37. The lowest score among sexual function was arousal. The scores of sexual function was significantly different by age, menopause, tumor stage. There were significant correlations between sexual function, pain, body image, fatigue and depression. In multiple regression analysis, factors affecting sexual function were identified as age, tumor stage, pain, body image and fatigue that explained 62.5% of the variance. CONCLUSION: The findings indicate that it is necessary to develop a more effective sexual function improvement program for breast cancer women after receiving cancer treatment.

Effects of Pain, Sleep Disturbance, and Fatigue on the Quality of Life in Patients with Pancreatic Cancer Undergoing Chemotherapy

PURPOSE: The purpose of this study was to assess pain, sleep disturbance, fatigue, and the quality of life and to identify the impact of pain, sleep disturbance and fatigue on the quality of life in patients with pancreatic cancer undergoing chemotherapy. METHODS: Data were collected from June to July, 2010. Participants were recruited from Y university hospital in Seoul. Research instruments included numeric rating scale for pain, Functional Assessment Chronic Illness Therapy-Functional Well-Being (FACIT-FWB): General Factor 5 (GF5) for sleep disturbance, Functional Assessment of Cancer Therapy-General (FACT-G) for quality of life, and FACT-Fatigue for fatigue. RESULTS: The quality of life for cancer patients had a significant relationship with pain, sleep disturbance, and fatigue. The significant factors influencing quality of life were pain, sleep disturbance, and fatigue that explained 52.6% of the variance. CONCLUSION: Patients with pancreatic cancer undergoing chemotherapy experienced pain, fatigue, and sleep disturbance which led to a negative effect on quality of life. The results suggest that intervention program to improve quality of life could reduce pain, fatigue, and sleep disturbance of pancreatic cancer patients undergoing chemotherapy.

Cognitive Function in Breast Cancer Patients Receiving Adjuvant Chemotherapy

PURPOSE: This study reviewed articles related to breast cancer, cognitive function and chemotherapy available in 4 databases. METHODS: The researcher reviewed 32 pieces of literature that were published between January 2001 and November 2011. RESULTS: Within the last decade, several studies have investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have reported inconsistent results regarding whether chemotherapy affects cognitive function. Approximately half of the studies reported subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and others did not. CONCLUSION: Breast cancer patients receiving adjuvant chemotherapy showed the most deterioration and the most persistent decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Especially, that chemotherapy may impair memory, executive function, attention and visuospatial function in women with breast cancer.

Impacts of Fatigue, Pain, Anxiety, and Depression on the Quality of Life in Patients with Breast Cancer

PURPOSE: This study was conducted to identify the impact of fatigue, pain, anxiety and depression on the quality of life (QOL) among breast cancer patients. METHODS: This study was conducted from July 12th to July 20th, 2010. One hundred and fifty breast cancer patients were recruited from D city in Korea. The instruments used in this study were the fatigue, pain, anxiety, depression and the quality of life scales for patients with breast cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the SPSS/WIN 12.0 program. RESULTS: The quality of life for cancer patients showed a significant relationship with fatigue, pain, anxiety and depression. The significant factors influencing quality of life were fatigue, pain, anxiety and depression that explained 65.6% of the variance. CONCLUSION: Patients with breast cancer experienced fatigue, pain, anxiety and depression which led to a negative effect on quality of life. The results suggest that intervention programs to reduce fatigue, pain, anxiety and depression could improve the quality of life for breast cancer patients.

A Symptom Cluster Analysis of Breast Cancer Patients Using a Mediation Model

PURPOSE: This study was conducted to test whether sleep disturbance mediates the effect of pain on fatigue, whether fatigue mediates the effect of pain on depression, and whether fatigue mediates the effect of sleep disturbance on depression. METHODS: This study was conducted from September 12th to December 20th, 2011. One hundred eighty-eight breast cancer patients were recruited from D city and S city in Korea. The instruments used in this study were the pain, sleep disturbance, fatigue, and depression scales. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and mediation pathway with the SPSS 12.0 and AMOS 20.0 programs. RESULTS: There was correlation among pain, fatigue, sleep disturbance, and depression. Mediation analyses indicated that pain influences fatigue. sleep disturbance, and depression directly as well as indirectly. Sleep disturbance influences fatigue and depression directly, also fatigue influences depression directly. But sleep disturbance had no direct effect on depression. CONCLUSION: Significant correlations among the four symptoms supported the existence of the symptom cluster. Effects of pain on fatigue was partially mediated by sleep disturbance, also effects of pain on depression was partially mediated by fatigue. However, the effects of sleep disturbance on depression was fully mediated by fatigue.

Experiences of Changes in Cognitive Function for Women treated with Chemotherapy for Breast Cancer / 여성건강간호학회지

PURPOSE: The purpose of this study was to describe the experiences of the process of the change in cognitive function for women treated with chemotherapy for breast cancer. METHODS: There were ten participants in total in this study. Data were gathered utilizing in-depth interviews over 3 times from September 2010 to January 2011. Data were analyzed by employing Strauss and Corbin's (1998) grounded theory methodology. RESULTS: Findings indicate that causal conditions of these results were 'side effects of chemotherapy' and 'menopausal state', including contextual conditions as, 'mental fatigue' and 'anxiety about recurrence'. The core category was identified as 'confronting with unexpected chaos'. Intervening conditions were 'support from other people', 'lack of information on cognitive impairment'. Interaction strategies were 'changing the habit of life', 'making efforts for living life' and 'seeking for medical information'. Consequences of the process were 'physical restriction', 'difficulty in social life', 'disturbed working ability' and 'psychological distress'. CONCLUSION: The results of this study show that nurses should recognize there is a notable difference between individual patient's contextual conditions and interactive strategies. Furthermore educational information and individualized intervention should be provided to improve cognitive function for women with breast cancer.

Literature Review of Cognitive Developmental Interventions on Patients with Breast Cancer undergoing Chemotherapy / 종양간호학회지

PURPOSE: The purpose of this study was to analyze the trend of cognitive developmental interventions on patients with breast cancer who underwent chemotherapy. METHODS: The researcher searched databases and selected 17 literatures using chemotherapy, breast cancer, cognitive function and intervention as searching key words. Searched databases included Ovid, Pubmed, Proquest and Medline and data collection period was from January 2000 to May 2010. RESULTS: Interventions for patients with breast cancer have been continuously developed and frequent research topics included breast cancer, chemotherapy, quality of life, and cognitive function. In terms of study design, four research articles were pre-experimental study designs, one was case study, and the rest of studies were nonequivalent pretest-posttest control group design. Effects of intervention were examined in only 5 studies among 17. The interventions were not found to have direct effects in cognitive improvement. CONCLUSION: It is needed to figure out the mechanism of cognitive deterioration of the patients with breast cancer who underwent chemotherapy. And nursing interventions needs to be developed in order to hold up the cognitive downhill and help their cognitive rehabilitation.

Analysis of a Trend of Instrument Usage to Assess Cognitive Function of Breast Cancer Patients Undergoing Chemotherapy / 종양간호학회지

PURPOSE: This study analyzed recent trends of instrument usage assessing cognitive function of breast cancer patients undergoing chemotherapy. METHODS: The researcher collected 64 studies outside the country that were published between January 1996 and August 2010. RESULTS: There was no study on the instrument assessing all domains of cognitive function in breast cancer patients undergoing chemotherapy. Most instruments assessing cognitive function of breast cancer patients have been used for patients with dementia, depression, and/or organic brain damage. Also the objective neuropsychological tests such as the grooved pegboard for the psychomotor area, RCFT copy in visuospatial skill area and the WAIS-III block design have low sensitivity for measuring cognitive function in breast cancer patients, thus they are not good for applying to breast cancer patients. CONCLUSION: There is a need to develop an instrument which has good sensitivity and specificity for measuring the cognitive function of the breast cancer patients who experienced cognitive impairment after chemotherapy treatment. In addition, the developed instrument needs to be accessible and feasible in any nursing clinical setting for the purpose of accurate assessment and evaluation of the cognitive function among breast cancer patients.

Fatigue and Quality of Life of Korean Cancer Inpatients / 한국호스피스완화의료학회지

PURPOSE: The purpose of this study was to identify the relationship between fatigue and quality of life (QOL) of Korean cancer inpatients. METHODS: The data were collected from May to August 2007. Study subjects were recruited at D, Y and A university hospitals in Daegu and Kyungpook, Korea. The research instruments utilized in this study were fatigue (FACT-F) and quality of life (FACT-G) in Korean version 4. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation using SPSS Win 12.0 program. RESULTS: Fatigue of subjects showed a significant difference according to the type of treatment, change in weight, performance status, exercise, and sleep. The QOL of subjects showed a significant difference according to the purpose of treatment, change in weight, performance status, exercise, and sleep. The mean score of fatigue was 22.48 and the mean score of QOL was 55.52. The fatigue was negatively related to QOL, physical well-being, emotional well-being, and functional well-being. CONCLUSION: The results suggest the needs for intervention in order to reduce fatigue and to improve QOL of cancer inpatients.

Development of a Critical Thinking Disposition Scale for Nursing Students / 간호학회지

PURPOSE: The purpose of this study was to develop a critical thinking disposition scale for nursing students. METHOD: The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year. These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's alpha with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools. RESULT: There were 35 final items which were sorted into 8 factors. The factors were identified as 'intellectual integrity(6 items)', 'creativity(4 items)', 'challenge(6 items)', 'open-mindedness(3 items)', 'prudence(4 items)', 'objectivity(4 items)', 'truth seeking(3 items)' and 'inquisitiveness(5 items)'. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was .892 and the factors' ranged from .562-.836. CONCLUSION: The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.