Association Between Health Literacy and Health Promoting Behavior (Eating Habits, Physical Activity, and Stress) of University Students / 대한지역사회영양학회지

Objectives@#This study attempted to examine the association between health literacy and health-promoting behavior, and identify the major variables that affect the health-promoting behavior of university students. @*Methods@#This was a descriptive correlation study that identified the degree of health literacy and health-promoting behavior of 248 university students (119 male and 129 female) and examined the correlation between the two and factors influencing them. The questionnaire covering health literacy comprised 66 questions, and that for health-promoting behavior comprised 10 questions covering eating habits, 3 questions about physical activity, and 10 questions involving stress. @*Results@#The score for health literacy was 41.56 ± 18.38 out of 66 points, and that for health-promoting behavior was 65.27 ± 11.21 points (27.61 ± 6.72 points for eating habits, 7.23 ± 2.56 points for physical activity, and 30.44 ± 5.61 points for stress). Health literacy and health-promoting behavior had a significant positive correlation (r = 0.175, P < 0.01). The perceived health status (β = 0.391,P < 0.001) was the most important variable in healthpromoting behavior, followed by health literacy (β = 0.236, P < 0.001). @*Conclusions@#It is necessary to develop a systematic educational strategy and implement educational programs to improve health literacy as well as encourage health-promoting behavior and thus increase the perceived health levels of university students.

Experiences of Life-Sustaining Treatment Decisions among Patients with Terminal Cancer / 한국호스피스완화의료학회지

Purpose@#The purpose of this study was to examine the life-sustaining treatment decisions of terminal cancer patients. @*Methods@#Data on 10 terminal cancer patients who decided to withhold or withdraw from treatment were collected using in-depth interviews conducted from February 8 to October 30, 2019. Data were collected until saturation was reached and then analyzed using Colaizzi’s phenomenological method. @*Results@#In this study, six thematic clusters were identified: “having complicated feelings”, “making choices to protect everyone”, “accepting and preparing for death”, “feeling distress”, “pursuing spiritual wellbeing”, and “evaluating the new system”. @*Conclusion@#When facing death, terminal cancer patients often made choices to protect their family and their dignity with uneasiness of mind when deciding to withdraw from life-sustaining treatments. Though many patients had accepted and prepared for death, they experienced distress about leaving children behind after death. They also pursued spiritual well-being to find peace after deciding to withdraw from life-sustaining treatment. In addition, participants evaluated the new system of policies pertaining to decisions on life-sustaining treatment. Thus, various approaches regarding acceptance and preparation for death, communication with family, hope, and spiritual comfort should be taken in educational interventions to assist terminal cancer patients as they decide whether to withdraw from life-sustaining treatment.

Experiences of Life-Sustaining Treatment Decisions among Patients with Terminal Cancer / 한국호스피스완화의료학회지

Purpose@#The purpose of this study was to examine the life-sustaining treatment decisions of terminal cancer patients. @*Methods@#Data on 10 terminal cancer patients who decided to withhold or withdraw from treatment were collected using in-depth interviews conducted from February 8 to October 30, 2019. Data were collected until saturation was reached and then analyzed using Colaizzi’s phenomenological method. @*Results@#In this study, six thematic clusters were identified: “having complicated feelings”, “making choices to protect everyone”, “accepting and preparing for death”, “feeling distress”, “pursuing spiritual wellbeing”, and “evaluating the new system”. @*Conclusion@#When facing death, terminal cancer patients often made choices to protect their family and their dignity with uneasiness of mind when deciding to withdraw from life-sustaining treatments. Though many patients had accepted and prepared for death, they experienced distress about leaving children behind after death. They also pursued spiritual well-being to find peace after deciding to withdraw from life-sustaining treatment. In addition, participants evaluated the new system of policies pertaining to decisions on life-sustaining treatment. Thus, various approaches regarding acceptance and preparation for death, communication with family, hope, and spiritual comfort should be taken in educational interventions to assist terminal cancer patients as they decide whether to withdraw from life-sustaining treatment.

Factors Influencing Nurses’ Performance of Care in COVID-19 Wards

Purpose@#The purpose of this study was to identify factors influencing nurses’ performance of care in COVID-19 wards. @*Methods@#The participants were 132 nurses who worked in COVID-19 wards at three hospitals, and were recruited from April 1 to May 31, 2021. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression analysis with SPSS/WIN 24.0 program. @*Results@#Nursing performance was significantly and positively correlated with ethical sensitivity (r = .75, p < .001), nursing professionalism (r = .67, p < .001), and social support (r = .67, p < .001). Nursing professionalism was positively correlated with ethical sensitivity (r = .64, p < .001) and social support (r = .55, p < .001). Multiple regression analysis for nursing performance revealed that the most significant factor was ethical sensitivity (β = .47, p < .001). Ethical sensitivity, nursing professionalism, and social support explained 66.0% of total variance in nursing performance. @*Conclusion@#Ethical sensitiviy, nursing professionalism, and social support significantly influence nurses’ performace of care in COVID-19 wards. It suggests that intervention programs should be directed at improving nurses’ ethical sensitivity, bolstering social support, and enhancing nursing professionalism.

The Development and Evaluation of a Health Literacy-Adapted Self-Management Intervention for Elderly Cancer Patients Undergoing Chemotherapy

PURPOSE: This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy. METHODS: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants' health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0. RESULTS: Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group. CONCLUSION: The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

The Development and Evaluation of a Health Literacy-Adapted Self-Management Intervention for Elderly Cancer Patients Undergoing Chemotherapy

PURPOSE@#This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy.@*METHODS@#The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants' health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0.@*RESULTS@#Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group.@*CONCLUSION@#The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

The Experience of Uncertainty in Cancer Patients Undergoing Chemotherapy

PURPOSE: The purpose of this study was to investigate the experience of uncertainty in cancer patients undergoing chemotherapy in South Korea. METHODS: Data were obtained from in-depth interviews with ten cancer patients conducted from Mar. 21 to Nov. 11, 2017. The data were collected until saturation and analyzed via Colazzi's phenomenological method. RESULTS: In this study, 6 categories were extracted: Four categories contributed to uncertainty including ‘Confusion about cancer and course of treatment’, ‘Inner conflicts’, ‘Being overwhelmed by treatment’, and ‘Unknown future’. Two categories facilitated coping with uncertainty including ‘Seeking knowledge’ and ‘Need for spiritual peace’. CONCLUSION: Uncertainty experiences for cancer patients undergoing chemotherapy in different societies is largely similar. However, some experiences seemed unique to Korean patients. Also, there is a great deal of uncertainty about the treatment outcomes and loss of treatment opportunities in cancer patients undergoing chemotherapy. The results of this study will help oncology professionals develop patient-centered psychological interventions by improving understanding of the uncertainty of cancer patients undergoing chemotherapy.

The Influencing Factors on Quality of Life among Breast Cancer Survivors / 종양간호학회지

PURPOSE: This study was aimed to identify the influencing factors on the quality of life among breast cancer survivors. METHODS: The subjects were 159 female patients who visited out-patient department (OPD) after the mass removal surgery for breast cancer and had completed adjuvant treatments such as chemotherapy, radiation therapy at a university hospital and a general hospital. Data collection was conducted using the Ferrell QOL scale, the Mishel uncertainty scale, the Fitts & Osgoods body image scale revised by Jeon & Kim. the Rosenberg self-esteem scale, and the Kang family support scale. RESULTS: The level of QOL in the participants was in the middle. There were a significant correlation between QOL, uncertainty, self-esteem, and family support. There were significant differences in QOL with the perceived health condition and the best support person. In a regression analysis, the most powerful predictor of QOL was body image (21.7%). Altogether uncertainty and perceived health condition explained 28.6% of the variance of QOL of the participants. CONCLUSION: Body image, uncertainty, and perceived health condition were important predictors of QOL. These results demonstrated the need for developing interventions to improve QOL of breast cancer survivors.