Effects of smart-care services program for breast cancer survivors / 한국간호교육학회지

Purpose@#The purpose of this study was to examine the effects of a smart-care services program for breast cancer survivors on cognitive function and physical health. @*Methods@#A quasi-experimental control group pretest posttest design was used. Subjects were recruited in D city, and data were collected from July 2017 to February 2018. The experimental group (n=24) participated in the smart-care services program, whereas the control group (n=26) received conventional management. The smart-care services program consisted of addressing cognitive function problems arising from chemotherapy, diet, exercise, headeck massage and self-monitoring using smartphone applications and smart bands. All participants underwent assessments at baseline, at 6 weeks, and at 12 weeks. Data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation), a chi-squared test, t-test, and repeated measures ANOVA. @*Results@#After the smart-care services program, significant differences were found between the groups in cognitive function (F=18.91, p<.001) and sleep time (F=9.25, p<.001). No significant differences were found between the groups in caloric consumption after the program. @*Conclusion@#The smart-care services program significantly improved the level of cognitive function and sleep time for breast cancer survivors. The use of this smart-care services program for breast cancer survivors might be an effective nursing intervention tool for improving cognitive function and health behaviors.

Effects of smart-care services program for breast cancer survivors / 한국간호교육학회지

Purpose@#The purpose of this study was to examine the effects of a smart-care services program for breast cancer survivors on cognitive function and physical health. @*Methods@#A quasi-experimental control group pretest posttest design was used. Subjects were recruited in D city, and data were collected from July 2017 to February 2018. The experimental group (n=24) participated in the smart-care services program, whereas the control group (n=26) received conventional management. The smart-care services program consisted of addressing cognitive function problems arising from chemotherapy, diet, exercise, headeck massage and self-monitoring using smartphone applications and smart bands. All participants underwent assessments at baseline, at 6 weeks, and at 12 weeks. Data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation), a chi-squared test, t-test, and repeated measures ANOVA. @*Results@#After the smart-care services program, significant differences were found between the groups in cognitive function (F=18.91, p<.001) and sleep time (F=9.25, p<.001). No significant differences were found between the groups in caloric consumption after the program. @*Conclusion@#The smart-care services program significantly improved the level of cognitive function and sleep time for breast cancer survivors. The use of this smart-care services program for breast cancer survivors might be an effective nursing intervention tool for improving cognitive function and health behaviors.

Influencing Factors on the Family Caregivers' Burden of Inpatients with Acute Stroke / 한국간호교육학회지

PURPOSE: The purpose of this study was to explore the influencing factors on the family caregivers burden who have has inpatients with acute stroke. METHODS: Subjects were 126 family caregivers who have has inpatients with acute stroke. Data were collected by questionnaires. The collected data were analyzed by t-test, ANOVA, Scheffe's test, Pearson's coefficients and multiple regression. RESULTS: The Anxiety of family caregivers was identified as a determinant of family caregivers burden who have has inpatients with acute stroke by the multiple regression analysis (β=.58, p<.001). Gender and low cognitive function of inpatients were significantly related to family caregivers burden. And knowledge about care (r=−.27, p=.002) was correlated with anxiety significantly. CONCLUSION: The family caregivers burden is not only an important issue for nursing but also major nursing problem to be addressed nurses. Family caregivers with acute stroke inpatients feel more anxiety than family caregivers with other illnesses. The anxiety of family caregivers is important especially to the family caregivers who have to care acute stroke inpatients to reduce their burden.

The Meaning of Dignified with Death / 한국호스피스완화의료학회지

PURPOSE: We explored Koreans' perception of the meaning of death with dignity that Korean people. METHODS: A phenomenological research methodology was applied. A total of 13 participants were sampled based on their age and gender. Participants were interviewed in depth from September 2015 through February 2016. Colaizzi's phenomenological analysis method was used for data analysis. To establish the validity of the study, we evaluated its realistic value, applicability, consistency and neutrality of the qualitative evaluation criteria of Lincoln and Guba. RESULTS: Koreans' perception of death with dignity was structured as 19 themes, nine theme clusters and four categories. The four categories were “comfortable death”, “good death”, “resolving problems before death”, and “death with good reputation”. The theme clusters were “death without pain”, “death submitting to one's fate”, “death that is not ugly”, “leaving good memories to others”, “dying in a way we want”, “death after proper settling of things”, “dealing with chronic resentment before death”, “death after living a good life”, and “death with recognition”. CONCLUSION: For Koreans, death with dignity meant not burdening others, settling things right and leaving good memories to their families and friends. Such perceptions can be applied to hospice care for terminally ill patients.

Mobile Health for Breast Cancer Patients: A Systematic Review

PURPOSE: The purpose of this study was to evaluate the effect of smart health care service in the breast cancer patients through a systematic review. METHODS: For the study, 10 studies were selected by using PubMed, ScienceDirect, ProQuest, CINAHL, RISS4U, KISS, DBpia and the National Assembly Library. The Risk of Bias Assessment Tool was used by two reviewers to evaluate independently the quality of the selected articles. RESULTS: 10 studies for the analysis of the effect of smart health care service using mobile applications on breast cancer patients since 2000 were found. The purpose of mobile based intervention was to check whether post-operative outpatient follow up could be substituted with mobile apps to measure and monitor weight loss or weight management, sleep, mood, depression and mental state, exercise, uncertainty management and feedback. CONCLUSION: Although mobile research is still limited, it may be sufficient to monitor the symptoms of breast cancer patients and to provide dietary and exercise interventions. This study suggests that various mobile apps can be used for breast cancer patients in various situations. Future study is recommended for repeated intervention studies on the effect of apps.

The Effect of Diet Intervention in Breast Cancer: A Meta-analysis

PURPOSE: The purpose of this study was to evaluate the effect of diet intervention in breast cancer patients through meta-analysis. METHODS: For the study purpose, 18 studies were selected using PubMed, ScienceDirect, ProQuest and CINAHL. Meta-analysis was performed using a random effects model, and the effect size on outcome variables in breast cancer were calculated. RESULTS: The effect size for body mass index, body weight, energy intake from fat (%), and energy intake of diet intervention was −0.75 (95% CI:−1.22~−0.27), −0.93 (95% CI:−1.58~−0.28), −0.82 (95% CI:−1.11~−0.52), and −1.10 (95% CI:−1.85~−0.34). For heterogeneity, moderator analysis was performed using intervention type and intervention duration. As a result of the moderator analysis, BMI, body weight, energy intake from fat (%), and energy intake were not statistically significant on intervention type and intervention duration. But, only BMI had a significant difference on intervention duration (p=.013). CONCLUSION: Further research is needed to determine whether exercise intervention will be included in nutritional intervention for breast cancer patients. Also, even if the duration of the intervention is less than six months, a strategy for sustaining long-term intervention effects will be needed.

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.

Impact Factors for Health of Family Caregivers of Hospice Patients / 한국호스피스완화의료학회지

PURPOSE: This study was conducted to explore predictors of health status of family caregivers of hospice patients. METHODS: This study included 118 family caregivers of patients who were admitted to the hospice ward of three general hospitals in D city. The collected data were analyzed by frequency, percentage, t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using the SPSS WIN 18.0 program. RESULTS: The mean score for overall health of family caregivers was 2.68 (+/-0.42). Mean scores for variables related to health were 2.55 (+/-0.37) for sleep quality, 1.91 (+/-0.41) for anxiety and 2.78 (+/-0.33) for hope. Variables such as sleep quality, gender, anxiety and hope explained 59.8% of variance among family caregivers' health conditions. CONCLUSION: These results suggest the need for nurses to search for ways to promote health of hospice patients' family caregivers, such as improving the quality of sleep, easing their anxiety and encouraging hope.

Nurses' Knowledge of and Attitudes toward Pediatric Palliative Care of Korea / 한국호스피스완화의료학회지

PURPOSE: The aim of this research was to explore nurses' knowledge of and attitudes toward pediatric palliative care (PPC) in Korea. METHODS: A descriptive cross-sectional design was used. A total of 196 participants were recruited from the ELNEC-PPC course held in Seoul, Korea. All participants completed a 20-item survey questionnaire which assessed knowledge of and attitudes toward PPC using a 7-point Likert scale. RESULTS: Nurses' knowledge of PPC correlated with their educational level and work experience in the pediatric unit and hospice care unit. The work experience in the pediatric unit, career length in PPC and completion of palliative education course made differences in the attitudes toward PPC. Married nurses scored significantly higher on the parental rights in determining palliative care service for their child, and nurses with master's degree or higher showed a higher level of understanding of and attitudes toward the differences between PPC and adult palliative care. CONCLUSION: The factors influencing nurses' knowledge of and attitudes toward PPC need be considered to develop a pediatric palliative training program.

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.

Prioritization of Research Topics of Korean Oncology Nurses

PURPOSE: The aim of this study was to determine the prioritization of research topics by Korean oncology nurses. METHODS: A descriptive and cross-sectional survey was conducted via the website of the Korean Oncology Nursing Society, with participation sought by email from all of its members. RESULTS: Overall, 'pain' and 'quality of life' were the most important among the 74 topics, 'cancer prevention' was ranked 47th, while 'informatics' and 'telehealth' were ranked 62nd and 72nd, respectively. Korean oncology nursing research needs to be expanded to include community-based cancer prevention. In addition, research on informatics and telehealth in the oncology nursing area is necessary given the current dramatic changes in the implementation of information technology in medical services. CONCLUSION: These findings may contribute toward the development of a Korean oncology nursing research agenda and the provision of information to funding agencies with respect to setting the priorities of oncology nursing research.

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.

Correlates Influencing Cognitive Impairment in Breast Cancer Patients receiving Chemotherapy

PURPOSE: The purpose of this study was to identify correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. METHODS: Study subjects consisted of 102 breast cancer patients who received chemotherapy. Subjects were the members of a breast cancer self-help group. Data were collected using structured self-reporting questionnaires including scales of cognitive impairment, physical status, fatigue, quality of life, emotional status, sleeping, family support, and menopausal symptoms. Statistical Package for Social Sciences was used for statistical analyses. RESULTS: Breast cancer patients receiving chemotherapy appeared to show a high level of cognitive impairment. Among demographic characteristics, the effects of economic status and family type on cognitive impairment were found to be statistically significant. Among disease related characteristics, the effect of duration of chemotherapy on cognitive impairment was statistically significant. Menopausal symptoms were positively associated with cognitive impairment. The model including postmenopausal symptoms and caregiver type explained about 66% of variability in cognitive impairment. CONCLUSION: These findings highlight the importance of contextual factors in understanding cognitive impairment in breast cancer patients receiving chemotherapy and can be used to develop appropriate, effective nursing interventions.

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.

Distress of the Patients with Ostomy / 종양간호학회지

PURPOSE: The purpose of this study was to explore and describe the distress of the patients with ostomy. METHODS: A descriptive research design was adopted for data collection and analysis. Six patients with ostomy participated in the study. The consent from the participants was obtained for ethical protection. Data were collected from July 31, 2009 to January 10, 2010 using in-depth interview technique. Krippendorff's content analysis method was utilized for data analysis. RESULTS: Eight categories and 26 themes were extracted from the data which illustrated the lived distress of the patients with ostomy. The categories were "do not have any freedom to eat whatever I wish to eat", "uncontrolled defecation", "have to live through tough situation", "keep stoma in suspense", "disgusting ostomy", "can not live with comfort", "easily take a pessimistic view", and "see how the wind blows in daily family life". CONCLUSION: Ostomates were affected by the distress of having an ostomy in their physical, psychological, social and spiritual life. Individualized and continued nursing education program has to be developed in hospital and community settings in order to improve the quality of life of the ostomates.

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.

Psychometric Evaluation of Uterine Cervical Cancer Screening Embarrassment Questionnaire among Korean Women: Complementary Use of Rasch Model / 여성건강간호학회지

PURPOSE: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. METHODS: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. RESULTS: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. CONCLUSION: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.

The Effect of Empowerment on Nursing Performance, Job Satisfaction, Organizational Commitment, and Turnover Intention in Hospital Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to explore the effect of empowerment on nursing performance, job satisfaction, organizational commitment and turnover intention in hospital nurses. METHODS: The subjects were 345 nurses at a general hospital in D city. Data were collected by structured questionnaire from January 10 to February 15, 2009. Data were analyzed by using descriptive statistics, ANOVA, Scheffe's test, and Pearson correlation coefficient, multiple regression by SPSS win 17.0 program. RESULTS: The mean scores were 3.60(+/-.43) of empowerment, 3.80(+/-.38) of nursing performance, 3.49(+/-.55) of job satisfaction, 4.70(+/-.74) of organizational commitment, and 2.34(+/-.84) of turnover intention. Empowerment was correlated with nursing performance, job satisfaction, and organizational commitment positively, but correlated with turnover intention negatively. As a result of multiple regression, empowerment has 34.3% of the explanatory power on nursing performance, 24.0% on job satisfaction, 30.7% on organizational commitment, and 15.6% on turnover intention. CONCLUSION: Empowerment was a critical variable affecting nursing job performance, job satisfaction, organizational commitment, and turnover. Also, if various variable - active and adequate child-care support system, provided conditions continue to study, and adequate and appropriate compensation for nursing performance - affecting empowerment are managed, nurses' empowerment level will rise at the same time.

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.