The purpose of this study was to examine the effect of supportive nursing one stress reaction of breast cancer patients undergoing chemotherapy. The nonequivalent control group pre-test/post-test design was used for this experimental study. The subjects were 32 patients who were receiving chemotherapy after mastectomies at K hospital in Taegu from June, 1994 to June 1995. Among 32 subjects, 16 were placed in the experimental group and 16 in the control group. The experimental and control groups were tested for general characteristics, trait anxiety, health locus of control, family support, state anxiety, hopelessness, physical stress, and anxiety behavior. Collected data was analyzed by means of a chisquare test and a t-test for the comparative analysis of the general characteristics and homogeneity of subjects. ANOVA, and MANOVA were used for testing the hypothesis. Reliability of the tools were analyzed using the Pearson Correlation coefficient. The results of this study were as follows : 1. The hypothesis ; The stress reaction of the experimental group which took supportive nursing was lower than the stress reaction of the control group ; this was supported statistically. The main variable influenced in stress reaction was hopelessness. Supportive nursing for breast cancer patients, who are receiving chemotherapy, was especially effective in the reduction of hopelessness compared to state anxiety, physical stress, and anxiety behavior. 2. An analysis of the difference on stress reaction, according to the frequency of supportive nursing between the control and experimental group showed the level of hopelessness of the experimental group was lower than the control group after four supportive meeting sessions. But there was no statistical difference in state anxiety, physical stress, and anxiety behavior. In conclusion, this study supported utilization of supportive care as well as demonstrating the effectiveness of the System-Developmental Stress Model developed by Chrisman and Riehl-Sisca.
PURPOSE: The purpose of this study was to determine the effects of exercise program
on cardiopulmonary functions and shoulder joint functioning in breast cancer patients who
under- went radiation therapy after surgery. METHOD: Subjects in the experimental
group(N=12) participated in an exercise program for eight weeks. The Exercise program
consisted of shoulder stretching, arm weight training, and walking on treadmill. Maximal
oxygen uptake(o2max), maximal running time, shoulder joint range of motion, and
shoulder functional assessment were determined before and after the exercise program.
Baseline sociodemographic and medical data were compared between experimental group
and control group using the Fisher's exact test and Mann- Whitney U test. For effects
of the exercise program, repeated measures ANOVA were used. RESULT: 1) Following
the exercise program for eight weeks, both o2 max and maximal running time tended
to increase in experimental group comparing with the control group. 2) Shoulder
abduction, extension and flexion of the operated upper extremity in the experimental
group comparing with control significantly increased after the exercise program(p<0.05).
3) Shoulder flexion of the normal upper extremity in the experimental group comparing
with control significantly increased after the exercise program(p<0.05). CONCLUSION: The
results
suggest that the exercise program for breast cancer patients undergoing radiation
therapy after breast surgery can improve shoulder functions and increase
cardiopulmonary functions, which are maximal oxygen uptake and maximal running time.
The purpose of the present study is to identify the mediation effect of hope between fatigue and psychosocial adjustment in women with breast cancer. The framework for this study was guided by concepts and propositions derived from the theoretical and empirical literature on fatigue, hope and adjustment. The design of this study is a descriptive correlation study using a cross-sectional design. One hundred and twenty two outpatients with early breast cancer, receiving post-surgical radiation therapy or chemotherapy, were selected from three major medical centers in Seoul, Korea. A packet including PABCF (Psychosoical Adjustment to Breast Cancer Factor), revised RPFS (Revised Piper Fatigue Scale), HHI (Herth Hope Index), and self-addressed return envelope was given to the participants at seven to eight weeks post surgery. The questionnaires were to be completed at home and returned to the researcher by mail. The obtained data were analyzed using three regression equations guided by Baron and Kenny (1986); first, hope was regressed on fatigue; second, psychosocial adjustment was regressed on fatigue; and third, psychosocial adjustment was regressed on fatigue and hope, simultaneously. In the first equation, fatigue explained 4% of the variance in hope. In the second equation, fatigue explained 47% of the variance in psychosocial adjustment. In the last equation, hope and fatigue significantly explained the variance in psychosocial adjustment. Therefore, all conditions for the test of mediation effect of hope were satisfied. For the test of the mediation effect, the beta coefficients of fatigue on psychosocial adjustment on the second and third regression equations were compared. The beta coefficients were decreased from .69 (p < .001) on the second regression equation to .63 (p < .001) on the third regression equation. Thus, the hypothesis of this study was supported. As a result of this study, the negative Influence of fatigue on psychosocial adjustment is dampened through the mediator effect of hope in women with breast cancer. Therefore, when planning care for the adverse effect of fatigue on psychosocial adjustment, oncology nurses should consider hope as a mediator between fatigue and psychosocial adjustment to breast cancer.
This study examined what characteristics and variables predict participation in support groups for women with breast cancer.
282 women with breast cancer from 4 hospitals located in Busan were included in the study. Data was measured on each participant from September 2006 to February 2007. Data was collected using structured researcheradministered sheets and analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis.
The clients reported medium levels of illness perception, anxiety and depression, stress with coping, social support and self-efficacy. 48.9% of women with breast cancer participated in support groups. Significant influencing factors on the participation in support groups were 'operation time(+)', 'illness perception(+)', 'social support(-)', and 'self-efficacy(+)' Those variables explained 73.4%.
It is necessary to develop a strategy or promoting program for promotion of illness perception and self-efficacy of women with breast cancer. Thus, it is essential to provide participation to a support group to a women with breast cancer.
This study was to identify predictors of quality of life in breast cancer patients. Physical and pscyhological factors like stress, mood, and fatigue with sociodemographic factors like education, income, job and stage of disease were used to predict quality of life.
One hundred eleven patients with breast cancer participated in this study? The functional Assessment of Cancer Therapy-Breast(FACT-B) was used to assess quality of life.
The mean age of the patients was 46.7 years. The FACT-B mean score was 89.89 (SD:17.31) Education, income, job and stage of disease were significantly associated with QOL. In a regression analysis, mood, income, and fatigue were significant predictors for QOL: where as, stress was not significant. Among the subscales of QOL, physical well-being, functional well-being, emotional well-being, and the breast cancer subscale were included as predictors of QOL
Physical and psychological factors were strong predictors of QOL. These results demonstrate the need for interventions to improve QOL in breast cancer survivors.
Koreans are one of the fastest growing Asian populations in the U.S. since 1960s. In Korean immigrant women (KIW), breast cancer was reported as the most frequently diagnosed cancer. However, their screening rates for breast cancer are lower than national guidelines; it is assumed that underlying cultural schemas of breast, breast cancer, and its screening modalities exist and need to be studied. This study was aimed to investigate cultural meanings of breast, breast cancer, and breast cancer screenings in KIW.
Using cultural models theory from cognitive anthropology, naturalistic qualitative methodology was utilized. Three focus group interviews with fifteen KIW were conducted. Thematic analysis with constant comparison technique was performed eliciting units of meaning, categories, and themes.
The cultural schema of the meaning of breast is “mother who is breast-feeding her baby,” with two themes of “balance in size,” and “shyness.” Regarding breast cancer, three themes, i.e., “indifference,” “fear,” and “uncertainty” are emerged. “Lack of information about screening modalities” is the overarching schema with reference to breast cancer screenings.
The findings of this study demonstrate unique cultural models of KIW related to breast cancer and its screenings, which are critical to understand and penetrate their barriers to breast cancer screening.
The purpose of this study was to investigate the effects of a rehabilitation program on physical health, physiological indicators and quality of life in breast cancer mastectomy patients.
The subjects included thirty-one patients with breast cancer (17 in the experimental group and 14 in the control group). The subjects in the experimental group participated in a rehabilitation program for 10 weeks, which was composed of an exercise program, teaching, counseling and support for 2 sessions per week.
There was a significant increase in flexion, internal rotation and external rotation but no significant increase in extension in the experimental group compared to the control group. The total cholesterol, triglyceride, HDL, LDL, and CD56 in the experimental group compared to the control group was not significantly decreased after the rehabilitation program. Compared to the control group, quality of life in the experimental group was significantly improved and fatigue in that group was significantly decreased after the rehabilitation program.
The 10-week rehabilitation program showed a large affirmative effect on physical health, physiological indicators and quality of life in breast cancer mastectomy patients.
This study was to determine the effects of abdominal breathing training using biofeedback on stress, immune response, and quality of life.
The study design was a nonequivalent control group pretest-posttest, quasi-experimental design. Twenty-five breast cancer patients who had completed adjuvant chemotherapy were enrolled. The experimental group(n=12) was provided with abdominal breathing training using biofeedback once a week for 4 weeks. State anxiety, cancer physical symptoms, serum cortisol, T cell subsets(T3, T4, T8), NK cell and quality of life were measured both before and after the intervention.
Though state anxiety, cancer physical symptoms, and serum cortisol were reduced after 4 weeks of abdominal breathing training using biofeedback, there was no statistical significance. It showed, however, improvement in quality of life (p=.02), and T3(p=.04).
Abdominal breathing training using biofeedback improves quality of life in breast cancer patients after a mastectomy. However, the mechanism of this beneficial effect and stress response requires further investigation with special consideration in subject selection and frequency of measurement. Nurses should consider this strategy as a standard nursing intervention for people living with cancer.
The purpose of this study was to identify direct, mediating, and moderating relationships of mood disturbance, symptom experience, and attentional function in Korean women with breast cancer based upon a middle-range theory of unpleasant symptoms.
This study used a cross-sectional, correlational design. A convenience sample of 125 women receiving chemotherapy for breast cancer was recruited from a university hospital in South Korea. The women completed questionnaires on mood disturbance, symptom experience, and attentional function using the Linear Analogue Self-Assessment Scale, the Symptom Experience Scale, and the Attentional Function Index, respectively.
Each mood disturbance and symptom experience showed a significant relationship with attentional function. Symptom experience did not act as a mediator between mood disturbance and attentional function, but it did act as a moderator: patients with a higher level of mood disturbance exhibited a lower level of attentional function when their symptoms were at the level of medium, but not when their symptoms were either high or low.
This suggests that clinical interventions for attenuating the influence of mood disturbance on attentional function may be effective only in women experiencing medium level of symptoms.
The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy.
The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program.
There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times.
Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy.
The purpose of this study was to explore the relationship of uncertainty, hope and quality of life in patients with breast cancer.
The subjects of the study were 113 breast cancer patients treated at 3 university hospitals in Daegu and Busan from June 1 to September 30, 2003. Uncertainty was measured by the Mishel Uncertainty in Illness Scale (MUIS), Hope was measured by Nowotny's Hope Scale, and quality of life by Ro's Korean Quality of Life(QOL). Data was analyzed with the SPSS program by t-test, ANOVA, Spearman's rank correlation and Multiple Regression Analysis.
The scores of uncertainty were negatively correlated with hope and QOL(all p's<0.05). Uncertainty revealed that there was a negative correlation among subitems of hope such as confidence, relationship with others, possibility of future, and inner motivation(r=-.333, p=.000; r=-.230, p=.015; r=-.260, p=.006; r=-.291, p=.003). Uncertainty also showed a negative correlation among subitems of QOL such as emotional status, self esteem, and relationship with family(r=-.29, p=.004; r=-.326, p=.000; r=-.197, p=.044), whereas hope revealed a positive correlation among subitems of QOL such as emotional status, self esteem, relationship with neighbor, and relationship with family(r=.243, p=.011; r=.487, p=.000; r=.29, p=.001; r=.29, p=.001). The score of uncertainty was low in graduate school students and subjects using problem solving as a coping method. However, the score of hope was high in college students and subjects using a problem solving method, and the score of QOL was high in professionals.
Based on the study results, breast cancer patients experienced living with uncertainty and maintaining hope. Thus the study's findings can be useful in directing a comprehensive nursing care plan to improve QOL of breast cancer patients.
This cross-sectional survey was undertaken to examine the differences of BSE (breast-self examination) performance and health beliefs between Korean and Korean-American women and to identify which factors influence the BSE based on the HBM variables.
The study subjects were recruited from both Korea(189 women) and Cleveland in Ohio, USA(146 women). The HBM variables were measured using a reliable and valid Health Belief Model Scale. The subjects were also asked whether or not they did a BSE in the last year.
The Korean-American women who performed the BSE was statistically higher than that of Korean women. Regarding to the BSE-related health belief, the scores of benefits, confidence, and health motivation was significantly higher in Korean-American. After controlling for living places, age, education, and job, barriers and confidence variables significantly explained the BSE performance of Korean and Korean-American women.
There was a differences in BSE-related health belief and performance between Korean and Korean-American women. Among health belief variables, barriers and confidence were core variables predicting the BSE performance of Korean and Korean-American women together.
The purpose of this study was to identify whether the couple perceived breast cancer as a traumatic event, to evaluate the association among posttraumatic growth, dyadic adjustment, and quality of life and to explore the predictors affecting quality of life of the couple.
A cross-sectional comparative survey design was utilized. Participants were 57 couples recruited from a national cancer center in Korea. Data were analyzed using paired t-test, McNemar test and independent t-test. On the basis of variables found to be significantly associated with quality of life, multiple regression was used to examine the simultaneous influence of multiple predictors.
Breast cancers survivors and spouses perceived breast cancer as a traumatic event (43.9% and 24.6%, respectively). The global quality of life was explained by perception as trauma (β=-19.79) and posttraumatic growth (β=0.46) in survivors, and perception as trauma (β=-18.81) and dyadic adjustment (β=0.53) in spouses.
Results suggest that future research should use qualitative methods to evaluate why contemplating reasons for cancer contributed to posttraumatic growth, examine other potential predictors of quality of life such as dyadic adjustment and intimacy, and identify links between posttraumatic growth and other psychological outcomes such as distress and well-being, using prospective analyses.
This purpose of this study was to develop and validate a Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B).
The SESSM-B was developed and validated as follows: Item generation, pilot study, and tests of validity and reliability. Twenty-one items were developed through evaluation by 10 experts and 13 items were finally confirmed through item analysis and factor analysis. Psychometric testing was performed with a convenience sample of 303 women with breast cancer. Data were analyzed using factor analysis, Pearson correlation coefficients, and Cronbach’s alpha.
Five factors evolved from the factor analysis, which explained 69.8% of the total variance. The first factor ‘coping with psycho-informational demand’ explained 17.2%, 2nd factor ‘maintenance of healthy lifestyle’ 14.5%. 3rd factor ‘management of side-effects' 13.3%, 4th factor ‘therapeutic compliance’ 12.8%, and 5th factor ‘sexual life’ 11.9%. SESSM-B also demonstrated a concurrent validity with health-related quality of life scale, EORTC QLQ-C30 & BR23. The internal consistency, Cronbach’s alpha, was .78, and reliability of the subscales ranged from .61 to .79.
The results of this study suggest that the SESSM-B is an easy, reliable, and valid instrument to measure self-efficacy for self-management of breast cancer.
Purpose of this study was to examine the effects of the Mindfulness Meditation program on perceived stress, ways of coping, salivary cortisol level, and psychological stress response in patients with breast cancer.
This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants in this study were 50 patients who had completed breast cancer treatment (experimental group, 25, control group, 25). The experimental group received the Mindfulness Meditation program for 3 hours/session/ week for 8 weeks. Data were analyzed using χ2-test and t-test for subject homogeneity verification, and ANCOVA to examine the hypotheses.
The experimental group had significantly lower scores for perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response compared to the control group. However, no significant differences were found between two groups for the scores on problem focused stress coping.
According to the results, the Mindfulness Meditation program was useful for decreasing perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response. Therefore, this program is an effective nursing intervention to decrease stress in patients with breast cancer.
This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984).
Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version.
Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer.
The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.
In this study, the effects of laughter therapy on levels of depression, quality of life, resilience and immune responses in breast cancer survivors were examined.
A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=37) included breast cancer survivors who finished chemotheraphy and radiation therapy: 16 in the experiment group and 21 in the control group. Data were collected from August to November 2009. The experimental group participated in laughter therapy eight times, twice a week for 60 min per session. Questionnaires were used to me-asure pretest and posttest levels of depression, quality of life and resilience. A blood test was used to analyze changes in Total T cell, T helper, T suppressor, Th/Ts ratio, Total B cell, T cell/B cell ratio and NK cell for immune responses.
The results showed that laughter therapy was effective in increasing the quality of life and resilience in breast cancer survivors. but depression and immune responses did not differ significantly between the groups.
The results of the study indicate that laughter therapy may be an effective nursing intervention to improve quality of life and resilience in breast cancer survivors.
Understanding daily life experiences of patients admitted to hospital with recurrent breast cancer.
The grounded theory method was used for this study.
Consistent comparative analysis was used throughout the study to obtain the results. Results showed that inpatients with recurrent breast cancer experience 'a co-existence of life suffering and fear of death'. The causal condition of this result was determined to be 'patient's response to cancer recurrence (acceptance/despair)', including contextual conditions such as, 'previous experience with cancer treatment', 'patient's current physical condition', and 'treatment methods for recurrent cancer'. Intervening conditions, such as 'a strong will to live', 'family support', 'moral support providers', and action/interaction strategies were found to provide patients with 'a strength to live'. Shown in these results, inpatients with recurrent breast cancer were seen to have a simultaneous 'hope for life and fear of death'.
When providing nursing services to inpatients with recurrent breast cancer, people must recognize there is a notable difference between individual patients' contextual conditions and interactive strategies. Henceforth, proper cognitive nursing must be provided which encourages patients to maintain a strong will to overcome the many hardships of treatment as well as physical nursing, such as management of side effects caused by chemotherapy.
To examine the relationship between body fat percentage (BFP) and N-K cell activity (NKCA) in Korean breast and rectal cancer patients just after diagnosis.
With 35 subjects enrolled between November 2002 and May 2003, Bioelectrical Impedance Analysis was used to estimate BFP. FACS Analysis was used to measure N-K cell activity. The relationships between BFP and NKCA were identified by using curve estimation, simple regression, and multiple regression.
The mean BFPs of the subjects and all the sub-groups were higher than acceptable BFPs. Both the mean NKCAs of male and female subjects were lower than that of healthy women. NKCA was explained by BFP with a 14.9% variance in the total subjects (p<.05). There were significant negative relationships between BFP and NKCA after controlling age, type of cancer, and stage of cancer while no significant relationship was found after controlling for gender. The relationships between BFP and NKCA in the sub-groups of female, breast cancer, and stage I, and II were significant. The relationships between male, rectal cancer, and the stage III, and VI sub-groups were not identified, but they revealed a mild to moderate steep in curve estimation.
Weight reduction could prevent the risk and advancement of breast and rectal cancer in Koreans.
This study was to identify behaviors preventing the recurrence of breast cancer and the level of quality of life.
This descriptive study was conducted using a structured questionnaire from November 1, 2006 to December 25, 2006 . One hundred and twenty two women breast cancer survivors were recruited by convenience sampling.
The most frequent behavior for preventing recurrence of the breast cancer was dietary treatment (90.9%) and exercise (86.8%) was the second behavior. In addition, most of them perceived these behaviors as 'very effective' (82.8%). The degree of the quality of life of a breast cancer survivor was 5.34 point indicating a 'medium level'.
Breast cancer survivors pursued various behaviors for preventing recurrence of breast cancer. Therefore, the nursing interventions should be focused on a systematic educational approach considering healthy behaviors to prevent breast cancer recurrence for breast cancer survivors.