The Effects of a Comprehensive Education Program on Knowledge, Self-Efficacy, and Coping Style among Newly Diagnosed Patients with Breast Cancer

PURPOSE: The purpose of the study was to identify the effect of a comprehensive education program on knowledge, self-efficacy for self-management, and coping style among newly diagnosed patients with breast cancer. METHODS: This study used a one group pretest-posttest design. Data were collected from April to September, 2010 at a cancer-specific hospital in Goyang, Korea. One hundred forty three women received a comprehensive education program consisting of 3 sessions composed of 8 themes was conducted by several experts (nurses, doctors, dietitians and clinical psychologists) for 3.5 hours a day for 3 days (1 day before and 2 days after the operation). RESULTS: This study showed that knowledge and self-efficacy for self-management significantly increased after education (p<.001). In terms of coping style, however, only the subscale, 'anxious preoccupation', significantly improved (p=.001) among 5 subscales of coping style after education. CONCLUSION: A comprehensive education program for newly diagnosed patients with breast cancer was effective for increasing the knowledge and self-efficacy for self-management of breast cancer, in addition to decreasing the coping style of 'anxious preoccupation'. However, it did not improve other coping style. Therefore, other strategies for improving coping style are needed.

Development and Validation of a Knowledge Scale for Patients with Breast Cancer (KS-Br) / 종양간호학회지

PURPOSE: The purpose of this study was the development and validation of knowledge scale for patients with breast cancer (KS-Br) in Korea. METHODS: The process included the construction of a conceptual framework, generation of preliminary items, and the test of validity and reliability of the scale. Thirty-seven items were developed through an evaluation process by 10 experts and 24 items were finally confirmed through item analysis. Psychometric testing was performed with a convenient sample of 303 women with breast cancer. The data was analyzed using independent t-test, Pearson's correlation, and calculation of KR-20. RESULTS: Participants averaged 70.8% correct on the test. The KS-Br has 24 items consisting of 5 categories: incidence of breast cancer, diagnosis and treatment, symptom management, sexuality, and maintenance of daily life. Validity was supported by the use of content validity, known-group technique, and criterion-related validity. Women who had undergone education intervention scored significantly higher than women who had not (p<.001). KS-Br scores were significantly correlated with those of Mishel's Illness Uncertainty Scale (r=-.214, p<.001). Internal consistency of the KS-Br was appropriate (KR20=.805). CONCLUSION: This study reveals that the KS-Br is reliable and valid scale to measure the knowledge of breast cancer. Therefore, this scale can be effectively utilized to assess the knowledge of patients with breast cancer regarding their disease.

Symptom Clusters in Patients with Breast Cancer / 성인간호학회지

PURPOSE: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). METHODS: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. RESULTS: Two distinct clusters were identified: A gastrointestinal-fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. CONCLUSION: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.