Sociodemographic characteristics associated with indications for surgical menopause in women: a retrospective study

SUMMARY OBJECTIVE: The aim of this study was to evaluate the surgical menopause indications and sociodemographic characteristics of women. METHODS: In this retrospective study, we analyzed the sociodemographic characteristics of women with indications for surgical menopause in 2010-2020. The R Version 4.1.1 (2021-08-10) software and logistic regression analysis were used to evaluate the data. RESULTS: A total of 704 women's data were obtained in this study. Surgical menopause indications were found to stem from bleeding (46.0%), cancer (28.3%), cancer risk (18.9%), and other causes (6.8%). Surgical menopause indications originating from cancer were increased by 0.08 times (95%CI 0.01-0.68) due to smoking, 0.45 times (95%CI 0.23-0.88) due to regular drug use, and 0.36 times (95%CI 0.19-0.69) due to the presence of chronic disease (p<0.05). CONCLUSION: More than half of the women with surgical menopause indications were between 41 and 46 years of age. Additionally, 54.9% of the women had a chronic disease. Therefore, it is recommended to plan preventive health services for morbidity and mortality risks that may develop due to surgical menopause.

Development of Lower Extremity Lymphedema Nursing Practice Protocol for Patients Following Gynecologic Cancer Treatment

PURPOSE: This study aimed to develop and evaluate the lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. METHODS: Thirteen web-sites were searched for eligible clinical practice guidelines (CPGs) and eleven databases were searched to identify evidence to develop a lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. RESULTS: Based on the inclusion and exclusion criteria, eight CPGs and ninety-six studies, two guidelines and eight studies were identified as evidence. The protocol development group consisted of ten experts who have at least five years' experience in the related area. A lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment was developed including forty-three recommendations in five domains. Significant differences were found in nurses' pre and post knowledge and confidence on lower extremity lymphedema prevention and management. CONCLUSION: Nurses and other professionals could utilize this evidence based lower extremity lymphedema nursing practice protocol and apply it to patients undergoing gynecologic cancer treatment.

Efficacy of palonosetron plus dexamethasone in preventing chemotherapy-induced nausea and emesis in patients receiving carboplatin-based chemotherapy for gynecologic cancers: a phase II study by the West Japan Gynecologic Oncology Group (WJGOG 131) / 부인종양

OBJECTIVE: Palonosetron is effective for the management of acute and delayed chemotherapy-induced nausea and vomiting (CINV). While emetogenic carboplatin-based chemotherapy is widely used to treat gynecologic cancers, few studies have evaluated the antiemetic effectiveness of palonosetron in this setting. METHODS: A multicenter, single-arm, open-label phase II trial was conducted to evaluate the safety and effectiveness of palonosetron in controlling CINV in patients with gynecologic cancer. Chemotherapy-naïve patients received intravenous palonosetron (0.75 mg/body) and dexamethasone before the infusion of carboplatin-based chemotherapy on day 1. Dexamethasone was administered (orally or intravenously) on days 2–3. The incidence and severity of CINV were evaluated using the patient-completed Multinational Association of Supportive Care in Cancer Antiemesis Tool and treatment diaries. The primary endpoint was the proportion of patients experiencing complete control (CC) of vomiting, with “no rescue antiemetic medication” and “no clinically significant nausea” or “only mild nausea” in the delayed phase (24–120 hours post-chemotherapy). Secondary endpoints were the proportion of patients with a complete response (CR: “no vomiting” and “no rescue antiemetic medication”) in the acute (0–24 hours), delayed (24–120 hours), and overall (0–120 hours) phases, and CC in the acute and overall phases. RESULTS: Efficacy was assessable in 77 of 80 patients recruited. In the acute and delayed phases, the CR rates the primary endpoint, were 71.4% and 59.7% and the CC rates, the secondary endpoint, were 97.4% and 96.1%, respectively. CONCLUSION: While palonosetron effectively controls acute CINV, additional antiemetic management is warranted in the delayed phase after carboplatin-based chemotherapy in gynecologic cancer patients (Trial registry at UMIN Clinical Trials Registry, UMIN000012806).

The impact of malnutrition on survival in patients with gynecologic cancer undergoing chemotherapy / 한국영양학회지

PURPOSE: Malnutrition is a major concern in patients with gynecologic cancer receiving chemotherapy. The aim of this study was to evaluate the prognostic significance of malnutrition in patients with gynecologic cancer undergoing chemotherapy. METHODS: A prospective, observational study was conducted on a total of 99 subjects who were treated at a tertiary hospital in Korea. Data regarding demographic, clinical, nutritional, and psychological characteristics at baseline and survival were obtained. RESULTS: Performance status, nutritional status, depression, and annual income were significantly different between survivors and non-survivors. Multivariate Cox modeling after adjusting for other factors showed that a malnourished status in patients with gynecologic cancer undergoing chemotherapy was a significant and independent negative influencing factor for survival. CONCLUSION: These findings provide evidence that adequate nutritional assessment and intervention may assist in improving survival in patients with gynecologic cancer undergoing chemotherapy.

Development of a Web-based Sexual Health Program for Women Undergoing Treatment for Gynecologic Cancer and Their Partners

PURPOSE: The purpose of this study was to develop a web-based sexual health program for women undergoing treatment for gynecologic cancer and their partners, and to evaluate the validity of the developed program. METHODS: A web-based sexual health program was developed and evaluated: analysis (needs assessment on 23 patients and content analysis through literature review and web search), design, development, implementation, and evaluation. RESULTS: The web-based sexual health program for women undergoing treatment for gynecologic cancer and their partners was structured with sexual life, sexual response cycle, change of sexual function, sexual dysfunction related to treatment, and useful method for sexual dysfunction. This program included a video to improve for understanding and a bulletin board to promote bi-directional interactions between program users and providers. Experts and users rated this program in terms of efficacy, convenience, design, relevance, and usefulness. This program contents were found appropriate and satisfactory to both experts and users. CONCLUSION: This web-based sexual health program for women undergoing treatment for gynecologic cancer and their partners would contribute to sexual health promotion for gynecologic cancer women and their partners.

Effects of Lifestyle Intervention on Fatigue, Nutritional Status and Quality of Life in Patients with Gynecologic Cancer

PURPOSE: The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. METHODS: A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. RESULTS: Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. CONCLUSION: Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.

Relationships among Malnutrition, Depression and Quality of Life in Patients with Gynecologic Cancer receiving Chemotherapy

PURPOSE: The purpose of this study was to identify nutritional status, and relationships among malnutrition, depression and quality of life in patients with gynecologic cancer who were receiving chemotherapy. METHODS: For this study a descriptive cross-sectional design was used. Participants were 111 women who were enrolled and agreed to undergo a face-to-face interviews including administration of the structured questionnaires: Patient-Generated Subjective Global Assessment (PG-SGA), Beck Depression Inventory (BDI), Simplified Nutritional Appetite Questionnaire (SNAQ), and Functional Assessment of Cancer Therapy-General (FACT-G). RESULTS: Mean body mass index was 23.3 and mean body weight was 56.5 kg. Sixty-three (57%) of the 111 patients were malnourished according to the PG-SGA. The malnourished patients showed higher levels of depression and lower quality of life compared to the non-malnourished patients. In addition, malnutrition was associated with BMI level, depression, appetite and quality of life. CONCLUSION: The findings indicate that the prevalence of malnutrition is high and malnutrition in patients with gynecologic cancer influences depression and adversely affects the quality of life of these women. To improve the patient's quality of life, nutritional assessment and appropriate management is important to decrease malnutrition in patients with gynecologic cancer.

Characteristics and Quality of Life in Gynecologic Cancer Patients with Chemotherapy-induced Peripheral Neuropathy

PURPOSE: The purpose of this study was to identify chemotherapy induced peripheral neuropathy, quality of life of patients with gynecologic cancer. METHODS: This was a cross-sectional survey design. We collected 130 patients with gynecologic cancer. They complete a self reported questionnaire including items related neuropathy and quality of life (FACT-GOG/Ntx subscale, FACT-G scale). RESULTS: The neuropathy score was 14.3+/-7.9. The quality of life score was 64.8+/-16.4. The neuropathy induced significant difference according to diabetic status, difficulties in performing household chores and willing to discontinuity of chemotherapy. And duration of cancer diagnosis, neuropathy, number of total chemo agent associated with quality of life. There was a negative correlation between number of total chemo agent and quality of life. Neuropathy independently affected quality of life. CONCLUSION: Chemotherapy induced peripheral neuropathy of patients with gynecologic cancer adversely affected women's quality of life and activities of daily living. To improve patient's quality of life, it is important that accurate assess and appropriately manage neuropathy in patients with gynecologic cancer.

Effect of PLISSIT Model Sexual Health Enhancement Program for Women with Gynecologic Cancer and Their Husbands

PURPOSE: The purpose of this study was to examine effects of the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model sexual health enhancement program on, and development in, sexual function, sexual distress, marital intimacy, and subjective happiness of women with gynecologic cancer and their husbands. METHODS: The comprehensive program (4 session, 90 minutes per session) was developed based on the PLISSIT model. Participants were 43 couples, 21 assigned to the experimental group who attended the 4-week program, and 22 to the control group. Sexual function, sexual distress, marital intimacy, subjective happiness of the women, marital intimacy, subjective happiness of husbands were determined by a questionnaire that was completed by the participants before and after the program. The control group received the intervention post experiment. Chi-square test, t-test, Fisher's exact test were used to test the effectiveness of the program. RESULTS: Post intervention results showed significant differences between the groups for sexual function, sexual distress, and marital intimacy in the women and for subjective happiness in the husbands. CONCLUSION: Results indicate that the sexual health enhancement program is effective in improving sexual function, lowering sexual distress, increasing marital intimacy, and subjective happiness in women with gynecologic cancer and their husbands.

The ON-Q pain management system in elective gynecology oncologic surgery: Management of postoperative surgical site pain compared to intravenous patient-controlled analgesia

OBJECTIVE: The goal of this study was to compare postoperative surgical site pain in gynecologic cancer patients who underwent elective extended lower midline laparotomy and managed their pain with either the ON-Q pain management system (surgical incision site pain relief system, ON-Q pump) or an intravenous patient-controlled analgesia pump (IV PCA). METHODS: Twenty gynecologic cancer patients who underwent elective extended lower midline laparotomy were divided into two groups. One group received a 72-hour continuous wound perfusion of the local anesthetic ropivacaine (0.5%, study group) into the supraperitoneal layer of the abdominal incision through the ON-Q pump. The other group received intravenous infusion pump of patient-controlled analgesia (fentanyl citrate 20 mg/mL . kg+ondansetron hydrochloride 16 mg/8 mL+normal saline). Postoperative pain was assessed immediately and at 6, 24, 48, 72, and 96 hours after surgery using the visual analogue scale. RESULTS: Postoperative surgical site pain scores at 24, 48, and 72 hours after surgery were lower in the ON-Q group than the IV PCA group. Pain scores at 24 hours and 48 hours after surgery were significantly different between the two groups (P=0.023, P<0.001). Overall painkiller administration was higher in the ON-Q group but this difference was not statistically significant (5.1 vs. 4.3, P=0.481). CONCLUSION: This study revealed that the ON-Q pain management system is a more effective approach than IV PCA for acute postoperative surgical site pain relief after extended lower midline laparotomy in gynecologic cancer patients.

Relationships between Side Effects, Depression and Quality of Sleep in Gynecological Cancer Patients Undergoing Chemotherapy / 여성건강간호학회지

PURPOSE: This study was to identity the relationships between the side effects of depression and quality of sleep among gynecological cancer patients undergoing chemotherapy. METHODS: The data was collected from 113 patients at two general hospitals within B metropolitan city. The instruments used to collect the data for the study was the 'Side Effect Scale' developed by Kwon, Young-eun; 'Depression scale' developed by Oh, Se-man, and the 'Quality of Sleep Scale' developed by Oh, Song & Kim. RESULTS: Results showed that the mean of side effects was 39.75+/-9.99, mean of depression was 9.63+/-3.93 and mean of 'quality of sleep' was 36.99+/-6.66. The quality of sleep variable showed statistically significant differences for the variables: age (F=3.203, p=.026), cancer insurance (t=-2.278, p=.025), and perceived physical condition (F=3.152, p=.047) respectively. The relationship between side effects and quality of sleep showed a low negative, but significant correlation (r=-.327, p<.001). The relationship between depression and quality of sleep also showed a low negative correlation (r=-.365, p<.001). CONCLUSION: This study shows that it is necessary to develop nursing intervention programs because it can successfully improve the quality of sleep of gynecological cancer patients undergoing chemotherapy.

Relationships between Side Effects, Depression and Quality of Sleep in Gynecological Cancer Patients Undergoing Chemotherapy / 여성건강간호학회지

PURPOSE: This study was to identity the relationships between the side effects of depression and quality of sleep among gynecological cancer patients undergoing chemotherapy. METHODS: The data was collected from 113 patients at two general hospitals within B metropolitan city. The instruments used to collect the data for the study was the 'Side Effect Scale' developed by Kwon, Young-eun; 'Depression scale' developed by Oh, Se-man, and the 'Quality of Sleep Scale' developed by Oh, Song & Kim. RESULTS: Results showed that the mean of side effects was 39.75+/-9.99, mean of depression was 9.63+/-3.93 and mean of 'quality of sleep' was 36.99+/-6.66. The quality of sleep variable showed statistically significant differences for the variables: age (F=3.203, p=.026), cancer insurance (t=-2.278, p=.025), and perceived physical condition (F=3.152, p=.047) respectively. The relationship between side effects and quality of sleep showed a low negative, but significant correlation (r=-.327, p<.001). The relationship between depression and quality of sleep also showed a low negative correlation (r=-.365, p<.001). CONCLUSION: This study shows that it is necessary to develop nursing intervention programs because it can successfully improve the quality of sleep of gynecological cancer patients undergoing chemotherapy.

Quality of Life in Gynecological Cancer Patients During Chemotherapy / 여성건강간호학회지

PURPOSE: This study was to measure the quality of life(QOL) and to identify the related factors in gynecological cancer patients during chemotherapy. METHOD: The subjects of this study were the patients who had undergone a hysterectomy and were admitted for chemotherapy at S university hospital between November 2006 and April 2007. Data was collected from 106 gynecological cancer patients with the use of a structured questionnaire which measured the QOL(FACT-G), body image, the presence of anxiety & depression, uncertainty, and family support. The data was analyzed by the SPSS win 12.0 program. RESULTS: The mean FACT-total score was 62.1(+/-16.7) (range; 26-107). Positive correlations were found between QOL and body image(r= .67, p= .00), and QOL and family support(r= .32, p= .00), whereas there were negative correlations between QOL and anxiety(r= -.54, p= .00), QOL and depression(r= -.70, p= .00), and QOL and uncertainty(r= -.59, p= .00). Fifty seven precent of the variance in subjective overall QOL can be explained by depression, body image, and uncertainty(Adj R2= .57, F=47.00, p= .00). CONCLUSION: Our patients had a relatively low QOL score. Factors significantly affecting quality of life were depression, body image and uncertainty. Nursing interventions, therefore, should be focused on improving QOL in gynecological cancer patients during chemotherapy, particularly so in patients with depression, uncertainty or poor body image.