Journal of Korean Academy of Nursing

Review Paper

Exploring Symptom Cluster Patterns in Adult Cancer Patients Undergoing Chemotherapy: A Systematic Review: Pan Yang, Hui-juan Mei, Hao-yu Zhao, Rong-rong Wu, Yong-qin Ge, Yin Lu; J Korean Acad Nurs 2024;54(4):478-494. Published online November 25, 2024; DOI: https://doi.org/10.4040/jkan.24041

Abstract PDF Supplementary Material ePub: Purpose
This systematic review aimed to scrutinize the progression of symptom cluster research in adult cancer patients who received primary or adjuvant chemotherapy between 2001 and 2023, providing a comprehensive understanding of clinical practice and future research.
Methods
PubMed, Ovid MEDLINE, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and Web of Science databases were searched for theme words and free words related to symptom clusters, cancer, and chemotherapy. Eligible studies were published between January 1, 2001, and May 30, 2023; adults who were diagnosed with cancer and received primary or adjuvant chemotherapy were evaluated.
Results
Twenty-eight studies were included in this review. The Memorial Symptom Assessment Scale emerged as the predominant instrument and exploratory factor analysis was the most frequently employed statistical method to identify symptom clusters. Psychological, gastrointestinal, and physical image symptom clusters were the most commonly delineated. Furthermore, the temporal stability of the symptom clusters showed varying dynamics, with psychological symptom clusters displaying relative consistency over time.
Conclusion
Interventions are needed for the most common and stable symptoms in patients with cancer undergoing chemotherapy. Future endeavors may necessitate more longitudinal studies to delve deeper into the temporal stability and dynamic variations of symptom clusters. Such investigations hold promise for advancing symptom cluster research, elucidating the underlying mechanisms, and fostering the development of targeted interventions, thereby enriching the symptom management paradigm in oncological care.

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Original Article

A Structural Model for Chemotherapy Related Cognitive Impairment and Quality of Life in Breast Cancer Patients: Jung Ran Lee, Pok Ja Oh; J Korean Acad Nurs 2019;49(4):375-385. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.375

Abstract PDF

Abstract Purpose

This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model.

Methods

The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs.

Results

The modified model was a good fit for the data. The model fit indices were χ ²=423.18 (p<.001), χ ²/df=3.38, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (β=.38, p=.002), depression and anxiety (β=.25, p=.002), and symptom experiences (β=.19, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (β=-.51, p=.001), symptom experiences (β=-.27, p=.001), menopausal symptoms (β=-.22, p=.008), and chemotherapy-related cognitive impairment (β=-.15, p=.024) had direct effects on the quality of life and these variables explained 91.3%.

Conclusion

These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.

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Review Article

Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis: Pok-Ja Oh, You Lim Kim; J Korean Acad Nurs 2018;48(2):123-142. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.123

Abstract PDF

Abstract Purpose

This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN).

Methods

PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses.

Results

Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; I²=19%).Exercis-es were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN.

Conclusion

Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

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Original Articles

An Effect of Self: Care Education and Level of Resourcefulness on Active Coping in Patients with Chemotherapy: Soon Rim Suh; Journal of Nurses Academic Society 1997;27(3):639-647. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.3.639

Abstract PDF

The purpose of this study was to identify how internal and external coping resources influenced active coping in the process of stress-coping. The model was established theoretically by comparing and integrating the following theories : Stress-Coping, Self-Care, and Resourcefulness. The subjects consisted of sixty eight patients undergoing chemotherapy(experimental group 34, control group 34) at two general hospitals from January to July, 1995, The results were as follows : After self-care education, the active coping score of the experimental group was significantly higher than that of the control group. The active coping score of the high resourcefulness group was significantly higher than that of the low resourcefulness group. The interaction effect between self-care education and resourcfulness was not significant statistically. Specifically as to such scores of seeking social support, problem-oriented strategy and self care behavior, there were significantly higher in the experimental group and high resourcefulness group than in each of the other groups. Considering them both, self-care education and resourcefulness are effective nursing strategies to promote active coping including self-care. Consequently, the synthesis and testing of theories of stress-coping, self-care, and resoucefulness in this study are mostly proven to enhance the explanation and prediction of the change of active coping including self-care. Therefore the result of this study will contribute in the development of practice theory of nursing. A further study is necessary to reevaluate the interaction effect between self-care education and resourcefulness and to identify the difference between resourcefulness and self-efficacy.

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Effects of Self-Efficacy Promotion Program on Self-Efficacy, Self-Care Behavior, and Quality of Life in Breast Cancer Patients Receiving Radiotherapy
Hea-Kyoung Ko, Geum Ja Park
Journal of Korean Oncology Nursing.2011; 11(2): 136. CrossRef

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Experimental Study for Construction of Mouth Care in Chemotherpy Patients: Young Soon Byun, Ae Kyung Kim; Journal of Nurses Academic Society 1996;26(2):428-442. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.2.428

Abstract PDF

Stomatitis is a common toxicity associated with the administration of certain cancer chemoth-erapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to estabilish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subject were devided into three groups; control group: not gargling experimental group A: normal saline gargling (4 times a day) experimental group B: nystatine solution gar-gling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times (once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X2 test. The results are as follows; 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B. (X2=0.002 P=0.001) 2. The grade of stomatitis (mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A (F=1.96 P=0.0024). 3. In incidence of tougue change, control group, experimental group B were significantly higher than experimental group B(F=6.84 P=0.0039). 4. In control group and experimental group A, oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.

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Effects of Frozen Gauze with Normal Saline on Thirst and Oral Health of the Patients with Nasal Surgery
Jin Ock Park, Young Soon Jung, Geum Ja Park
The Journal of Korean Academic Society of Nursing Education.2016; 22(1): 25. CrossRef
The Effect of Education and Communication for Self-Oral Care in Cancer Patients Undergoing Chemotherapy
Joung Hee Cheon,, Hye-Ran Lee
Health Communication, the Official Journal of Korean Academy on Communication in Healthcare.2013; 8(2): 87. CrossRef
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Chi Eun Song, Hyang Sook So, Deok Ju, Eun Jeong Kim
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The Trajectory of Fatigue and Quality of Life in Stomach Cancer Patients Receiving Chemotherapy: Young Hee Yang; Journal of Korean Academy of Nursing 2002;32(4):482-491. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.4.482

Abstract PDF

PURPOSE: This study aimed to identify the change patterns of fatigue and quality of life during consecutive chemotherapies and to determine the relationship of these two variables. METHOD: Stomach cancer patients receiving chemotherapy were recruited from a university hospital in Seoul. Each chemotherapy, subjects were asked to respond to the questionnaires regarding their fatigue and quality of life. The number of subjects who completed 4 cycles and over was 11. Fatigue was measured with Lee's tool(1999). Quality of life was measured with a tool revised by the author based on Padilla et al(1983). RESULT: Most patients were in 1st stage(5 patients) or 3rd stage(5 patients). Fatigue was revealed at its highest level in the 3rd or 4th chemotherapy and at its lowest level in the 1st or 6th chemotherapy. A quality of life appeared at its highest level in the 5th or 6th chemotherapy and the lowest level in 3rd or 4th chemotherapy. CONCLUSION: Among 6 cycles of chemotherapy, in 3-4th chemotherapy the fatigue was the highest and the quality of life were the lowest. Many patients decided to stop treatment at the same period. Therefore we can recognize cancer patients receiving chemo- therapy are in the highest risk at the time of the 3-4 th chemotherapy.

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The Nutritional Status of the Patients with Cancer during the Chemotherapies: Young Hee Yang, Sung Joon Kwon, Chang Imc Kim; Journal of Korean Academy of Nursing 2001;31(6):978-987. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.6.978

Abstract PDF

PURPOSE: The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy.
METHOD
To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy.
RESULT
93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake.
CONCLUSION
The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.

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The Relationship of Anorexia, Nausea, Vomiting, Oral Intake and Nutritional Status in Patients Receiving Chemotherapy: Young Hee Yang, Dong Sun Lee; Journal of Korean Academy of Nursing 2000;30(3):720-730. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.3.720

Abstract PDF

Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.

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Effects of Telephone Intervention as Supportive Nursing on Self-Care Practices and Qualify of Life for Gynecological Cancer Patients under Chemotherapy: Ae Sook Kim, Eun Sook Lee, Sung Hyo Kim; Journal of Korean Academy of Nursing 2007;37(5):744-753. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2007.37.5.744

Abstract PDF

Purpose

The effects of telephone intervention on self-care practices and quality of life for gynecological cancer patients under chemotherapy was investigated.

Methods

A non-equivalent control group pre-test post-test quasi-experimental design was used. The subjects were women cancer patients who had received less than two chemotherapy sessions at C university hospital of Chonnam province(26 in the experimental group: 25 in the control group). The patient's self-care practices(Na & Lee, 1999; Jang, 2004) and quality of life(Lee & Jo, 1997) were measured three times. using a questionnaire. The data was analyzed by Repeated Measures ANOVA, the Friedman test, and the Mann-Whitney test using the SPSS window version 12.0 program.

Results

This study showed that the score of self-care practices and quality of life for the experimental group under telephone counseling were higher than those of the control group.

Conclusion

This study revealed that a telephone intervention as supportive nursing care for women cancer patients under going chemotherapy was effective for self-care practices and qualify of life during the recovery period. Futhermore, this study also suggests that telephone counseling can serve as a continuing nursing supportive intervention for women cancer patients for the upcoming stages of further chemotherapy.

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Jina Son, Ha I Kang, Eun young Jung, Hae won Ryu, Kyung-Ha Lee
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Effects of Telephone-based Self-care Intervention for Gynecologic Cancer Patients Receiving Chemotherapy: A Quasi-Experimental Study
Boyeon Lee, Hyojung Park
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Knowledge and Learning Needs Related to Cancer Treatment in Gynecological Cancer Patients: Mi Sook Seo, Euy Soon Choi; Journal of Korean Academy of Nursing 2006;36(6):942-949. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.6.942

Abstract PDF

Purpose

This study was to investigate the knowledge and learning needs of chemotherapy in gynecological cancer patients.

Method

The subjects consisted of 103 gynecological cancer patients receiving chemotherapy from April 2005 to August 2005. Data was collected using a questionnaire about knowledge and learning needs of chemotherapy. The data was analyzed by t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient using SAS.

Result

Average scores of knowledge and learning needs of general treatment and care were 2.74, and 3.30 respectively. Average score of knowledge and learning needs of chemotherapy were 2.54, and 3.23 respectively. Learning needs of general treatment and care and of chemotherapy were significantly different in relation to marital status, educational level, family support, the operation, and the amount of chemotherapy received. Items with the highest level of learning needs were the symptoms of recurring illness of general treatment, and minimizing side effects of chemotherapy. There were a negative correlation between knowledge and learning needs on general treatment and a positive correlation between knowledge and learning needs on chemothearpy but there were not significant statistically.

Conclusion

The level of learning needs related to cancer treatment was high, whereas, that of knowledge was low. Therefore, when designing an educational program for gynecological cancer patients, understanding of learning needs is necessary. Also, consideration of a patient's characteristics, and a systematic and detailed educational program should be provided.

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The Effects of Chemotherapy Education Reflecting Educational Needs on Self-Care Knowledge and Performance in Female Cancer Patients: A Non-Equivalent Control Group Pretest-Posttest Design
Jin Hee Jun, Se-Na Lee
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Ji Yeong Soh, Won Chul Cha, Dong Kyung Chang, Ji Hye Hwang, Kihyung Kim, Miyong Rha, Hee Kwon
JMIR mHealth and uHealth.2018; 6(5): e115. CrossRef
Educational Needs for Sexual Health and Its Effect on Depression and the Quality of Life in Patients with Prostate Cancer
Soonyoung Oh, Eunjung Ryu
Asian Oncology Nursing.2015; 15(3): 163. CrossRef

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The Effects of Foot Reflexology on Nausea, Vomiting and Fatigue of Breast Cancer Patients Undergoing Chemotherapy: Jin Hyang Yang; Journal of Korean Academy of Nursing 2005;35(1):177-185. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.1.177

Abstract PDF

Purpose

The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy.

Method

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.

Results

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.

Conclusion

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.

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Changes on Index of Nausea, Vomiting, and Retching in Hospitalized Cancer Patients Undergoing Chemotherapy: Young Jae Kim, In Sook Cho, Hyang Sook So; Journal of Korean Academy of Nursing 2004;34(7):1326-1333. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.7.1326

Abstract PDF

Purpose

The purpose of this study was to determine the changes on Index of Nausea, Vomiting, & Retching (INVR) during a cycle of chemotherapy.

Methods

Forty-three patients hospitalized for chemotherapy at C University Hospital during a period of 5 days from March to May, 2003 were examined. Scores of INVR were measured once a day. Anxiety, anorexia, fatigue, and sleep satisfaction were measured before chemotherapy. Data was analyzed by repeated measures of ANOVA.

Results

The score of INVR increased over time during the days of hospitalization and showed a peak on the third day. The score was significantly higher on the third and consecutive cycles than on the first and second cycle. The score was significantly higher in patients in their forties and fifties rather than in their sixties. The score was higher in women than in men, and also increased as the sleep satisfaction decreased.

Conclusion

These results suggested that specific interventions for relief of nausea & vomiting were needed in middle age, women, the third chemotherapy cycle, and the third day after chemotherapy.

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Analysis of Telephone Counseling of Patients in Chemotherapy Using Text Mining Technique
Seoyeon Kim, Jihyun Jung, Heiyoung Kang, Jeehye Bae, Kayoung Sim, Miyoung Yoo, Eunyoung, E. Suh
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The Relationships among Chemotherapy-Induced Nausea and Vomiting (CINV), Non-Pharmacological Coping Methods, and Nutritional Status in Patients with Gynecologic Cancer
Haerim Lee, Smi Choi-Kwon
Journal of Korean Academy of Nursing.2017; 47(6): 731. CrossRef
Influences of Stress, Anxiety, Depression, and Personality Trait on Nausea, Vomiting, and Retching of Breast Cancer Patients Receiving Chemotherapy
Yoo Wha Bhan, Hee-Yeon Choi, Woo Sung Lim, Byung-In Moon, Nam-Sun Paik, Weon-Jeong Lim
Journal of Korean Neuropsychiatric Association.2013; 52(5): 327. CrossRef
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Young-Jae Kim, Nam-Sook Seo
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Transition of Symptoms and Quality of Life in Cancer Patients on Chemotherapy
Min Young Kim
Journal of Korean Academy of Nursing.2009; 39(3): 433. CrossRef

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The Structural Equation Model on Resilience of Breast Cancer Patients Receiving Chemotherapy: Jeong Ha Yang, Ok Soo Kim; J Korean Acad Nurs 2016;46(3):327-337. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.327

Abstract PDF

Purpose

The purpose of this study was to construct and test a structural equation model on resilience of breast cancer patients receiving chemotherapy.

Methods

Participants were 204 patients with breast cancer who received chemotherapy treatment. They participated in a structured interview, which included social support, depression, symptom experience, self-efficacy, hope, resilience, and infection prevention behaviors. Data were analyzed using SPSS/WIN 20.0 and AMOS 18.0.

Results

Lower depression (γ=-.33, p=.020) and symptom experience (γ=-.31, p=.012) and higher self-efficacy (γ=.32, p=.005) and hope (γ=.48, p=.016) were influenced by higher social support. Greater resilience was influenced by lower symptom experience (β=-.18, p=.016), higher self-efficacy (β=.49, p=.023), and higher hope (β=.46, p=.012), and these predictors explained 66.7% of variance in resilience. Greater resilience (β=.54, p=.009) made an impact on greater infection prevention behaviors. Resilience mediated the relations of symptom experience (β=-.10 p=.013), self-efficacy (β=.27, p=.006) and hope (β=.25, p=.009) with infection prevention behaviors. These predictors explained 24.9% of variance in infection prevention behaviors.

Conclusion

The findings of the study suggest that breast cancer patientsw ith greater resilience who are receiving chemotherapy participate in increased infection prevention behaviors. Further research should be conducted to seek intervention strategies that improve breast cancer patients' resilience.

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Effects of Telephone-based Self-care Intervention for Gynecologic Cancer Patients Receiving Chemotherapy: A Quasi-Experimental Study
Boyeon Lee, Hyojung Park
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Marlen Simancas Fernández, Carla Zapata Rueda, Gonzalo Galván Patrignani, Jose Carlos Celedón Rivero, Juan Hernández Padilla
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Adaptation to the disease, resilience and optimism in woman with breast cancer
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Jisoon Kim, Sukhee Ahn
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Jie Zhang, Yizhen Yin, Anni Wang, Hui Li, Juan Li, Silan Yang, Yuchen Wu, Jingping Zhang
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Hsin-Tien Hsu, Chiung-Hui Juan, Jyu-Lin Chen, Hsiu-Fen Hsieh
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Dong Rim Hyun, So Yeun Jun, Chang Wan Jun, Sue Kyung Sohn
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Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer: Jin-Hee Park, Sun Hyoung Bae, Yong-Sik Jung, Young-Mi Jung; J Korean Acad Nurs 2015;45(1):118-128. Published online February 27, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.1.118

Abstract PDF

Purpose

Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy.

Methods

Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses.

Results

At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function.

Conclusion

These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

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Wen Li, Chen Gan, Yue Lv, Shanghu Wang, Huaidong Cheng
Medicine.2017; 96(13): e6514. CrossRef
Altered network efficiency of functional brain networks in patients with breast cancer after chemotherapy
Han Xuan, Chen Gan, Wen Li, Zhonglian Huang, Longsheng Wang, Qianqian Jia, Zhendong Chen, Huaidong Cheng
Oncotarget.2017; 8(62): 105648. CrossRef
Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress
Pok Ja Oh, Jeong Hye Kim
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Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer
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Thomas Durand, Marie-Odile Bernier, Isabelle Léger, Hervé Taillia, Georges Noël, Dimitri Psimaras, Damien Ricard
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Jin-Hee Park, Sun Hyoung Bae, Young-Mi Jung
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Reliability and Validity of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire to Assess Chemotherapy-induced Peripheral Neuropathy: Hye Young Kim, Jeong Hee Kang, Hyun Jo Youn, Hyang Sook So, Chi Eun Song, Seo Young Chae, Sung Hoo Jung, Sung Reul Kim, Ji Young Kim; J Korean Acad Nurs 2014;44(6):735-742. Published online December 15, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.6.735

Abstract PDF

Abstract Purpose

This study was performed to assess the reliability and validity of the Korean version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-induced peripheral neuropathy 20 items (EORTC QLQ-CIPN20) in patients receiving neurotoxic chemotherapy.

Methods

A convenience sample of 249 Korean cancer patients, previously or currently, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. Collected data were analyzed using SPSS 21.0 and AMOS 21.0. Construct validity, known-group validity, concurrent validity, and internal consistency reliability of the Korean version of the QLQ-CIPN20 were evaluated.

Results

Factor analysis confirmed 3 dimensions of CIPN: sensory, motor, and autonomic. The factor loadings of the 20 items on the 3 subscales ranged from .38 to .85. The 3 subscale-model was validated by confirmatory factor analysis (GFI= .90, AGFI= .86, RMSR= .05, NFI= .87, and CFI= .94), and concurrent validity was demonstrated with the EORTC QLQ-C30. Furthermore, the QLQ-CIPN20 established known-group validity. The Cronbach's alpha coefficients for internal consistency of the subscales ranged from .73 to .89.

Conclusion

The Korean version of the EORTC QLQ-CIPN20 showed satisfactory construct, concurrent, and known-group validity, as well as internal reliability.

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Chronobiology International.2025; 42(2): 259. CrossRef
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Silvia Belloni, Arianna Magon, Chiara Giacon, Francesca Savioni, Gianluca Conte, Rosario Caruso, Cristina Arrigoni
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Tiffany Li, Susanna B. Park, Eva Battaglini, Madeleine T. King, Matthew C. Kiernan, David Goldstein, Claudia Rutherford
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The Journal of Internal Korean Medicine.2016; 37(4): 631. CrossRef
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Development and Validation of a Tool for Evaluating Core Competencies in Nursing Cancer Patients on Chemotherapy: Sung Hae Kim, Jae Hyun Park; J Korean Acad Nurs 2012;42(5):632-643. Published online October 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.5.632

Abstract PDF

Purpose

This study was done to develop tool to evaluate the core competencies regarding nursing cancer patients on chemotherapy, and to verify the reliability and efficacy of the developed tool.

Methods

A tool to evaluate the core competencies was developed from a preliminary tool consisting of 112 items verified by expert groups. The adequacy of the preliminary tool was analyzed and refined to the final evaluation tool containing 76 items in 8 core competencies and 18 specific competencies. The evaluation tool is in the form of a self-report, and each item is evaluated according to a 3-point scale. From September 22 to October 14, 2011, 349 survey responses were analyzed using SPSS 20.0 and the WINSTEPS program that employs the Rasch model.

Results

Results indicated that there were no inappropriate items and the items had low levels of difficulty in comparison with the knowledge levels of the study participants. The results of factor analysis yielded 18 factors, and the reliability of the tools was very high with Cronbach's α=.97.

Conclusion

The results of this study can be used for training and evaluation of core competencies for nursing cancer patients, and for standardizing nursing practices associated with chemotherapy.

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The Reliability and Validity of the Korean Version of the Indiana University Simulation Integration Rubric for Interprofessional Communication among Nursing and Medical Students
Shinhye Chae, Jae-Bum Kim, Soonyoung Shon
Journal of Korean Academy of Fundamentals of Nursing.2025; 32(1): 138. CrossRef
Development and Validation of the Short Form of Core Competencies Scale of Nursing Care for Cancer Patients Undergoing Chemotherapy
Sung Hae Kim, Seyong Lee, Sang Hee Kim, Jung Ok Choi, Gie Ok Noh
Asian Oncology Nursing.2024; 24(4): 184. CrossRef
Development of Integrated Supportive Care Nursing Competence Scale for Cancer Survivors
Eun-Jung Bae, Yun-Hee Kim
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Care Needs of Advanced Cancer Patients in a Long-term Care Hospital: Patient-Nurse Comparison
Hee-Jung Kang, Kyung-Ah Kang
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Psychometric Properties of the Korean Version of the Environmental Health Literacy Scale
Jung-Min Kwak, Ju-Hee Kim
International Journal of Environmental Research and Public Health.2022; 19(7): 4079. CrossRef
Chemotherapy administration checklist for patients receiving chemotherapy
Gitika Miglani, Ashok Kumar, Vandna Pandey, Puneet Pareek, Shrikant K. Nair
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Development of Clinical Performance Examination(CPX) using Flipped Learning
Jeong Sook PARK, Soon Yang JANG
JOURNAL OF FISHRIES AND MARINE SCIENCES EDUCATION.2017; 29(4): 987. CrossRef
Development of Program Outcome Self-Assessment Tool in Korean Nursing Baccalaureate Education
Hyun-Kyoung Kim
The Journal of Korean Academic Society of Nursing Education.2015; 21(2): 215. CrossRef
Development of Short Form of the Korean Version- the Boston Naming Test (K-BNT-15) Based on Item Response Theory
HyangHee Kim, Soo Ryon Kim
The Journal of the Korea Contents Association.2013; 13(12): 321. CrossRef

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A Meta-analysis of Chemotherapy related Cognitive Impairment in Patients with Breast Cancer: Jin-Hee Park, Sun Hyoung Bae; J Korean Acad Nurs 2012;42(5):644-658. Published online October 12, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.5.644

Abstract PDF

Purpose

The purpose of this study was to evaluate the cognitive effects of chemotherapy in patients with breast cancer.

Methods

Using several databases, prospective studies were collected up to August 2011. Of 2,106 publications identified, 12 met the inclusion criteria, and 8 studies were used to estimate the effect size of chemotherapy on cognitive impairment.

Results

Twelve studies were done since 2005 and most of the research was performed in Europe or North America. Eight studies were used to generate effect size across the cognitive domains of attention/concentration, verbal and visual memory, executive function, visuospatial skill, language, and subjective cognitive function. Each of the cognitive domains showed small effect sizes (-0.02 ~ -0.26), indicating diminished cognitive function for the chemotherapy group compared with non-chemotherapy groups.

Conclusion

Finding suggests that breast cancer patients who undergo chemotherapy may experience mild cognitive decline. Further study is needed to generate knowledge and guideline for interventions to address chemotherapy related cognitive impairment in these patients.

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The Experience of Chemotherapy Related Cognitive Impairment in Patients with Cancer
Pok Ja Oh, Ji Hyun Kim
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Effects of smart-care services program for breast cancer survivors
Bok Yae Chung, Sung Jung Hong
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Effects of compensatory cognitive training intervention for breast cancer patients undergoing chemotherapy: a pilot study
Jin-Hee Park, Yong Sik Jung, Ku Sang Kim, Sun Hyoung Bae
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Yoon Jung Kim, Sook Jung Kang
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Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress
Pok Ja Oh, Jeong Hye Kim
Journal of Korean Academy of Nursing.2016; 46(1): 19. CrossRef
QLU-C10D: a health state classification system for a multi-attribute utility measure based on the EORTC QLQ-C30
M. T. King, D. S. J. Costa, N. K. Aaronson, J. E. Brazier, D. F. Cella, P. M. Fayers, P. Grimison, M. Janda, G. Kemmler, R. Norman, A. S. Pickard, D. Rowen, G. Velikova, T. A. Young, R. Viney
Quality of Life Research.2016; 25(3): 625. CrossRef
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Daniel Sj Costa, Rebecca Mercieca‐bebber, Claudia Rutherford, Liam Gabb, Madeleine T King
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Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer
Jin-Hee Park, Sun Hyoung Bae, Yong-Sik Jung, Young-Mi Jung
Journal of Korean Academy of Nursing.2015; 45(1): 118. CrossRef

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Transition of Symptoms and Quality of Life in Cancer Patients on Chemotherapy: Min Young Kim; J Korean Acad Nurs 2009;39(3):433-445. Published online June 29, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.3.433

Abstract PDF

Purpose

The purpose of this study was to assess changes in pain, fatigue, anorexia, anxiety and quality of life (QOL) in patients with cancer who were on chemotherapy.

Methods

Symptoms and QOL were examined both before chemotherapy and after 2 cycles of chemotherapy. The participants were 76 cancer patients receiving chemotherapy in one of 7 hospitals.

Results

The patients experienced a mean of 2.22-2.23 symptoms out of 4 symptoms. Patients who were female, or suffered from breast or colorectal cancer experienced more symptoms. Fatigue at present, and most severe fatigue and anorexia in the previous 3 weeks increased significantly. Anxiety and QOL decreased significantly after 2 cycles of chemotherapy. Number of symptoms, anorexia at present, most severe anorexia in past 3 weeks, and anxiety had negative correlations. QOL before chemotherapy showed a positive correlation with QOL after 2 cycles of chemotherapy. In a regression analysis, anxiety, QOL at baseline, income, and the most severe pain in the past 3 weeks were significant predictors of QOL.

Conclusion

Physical and psychological factors were significant predictors of both QOL and each subscale, and these factors correlated with each other. These results demonstrate the needs for early assessment and intervention from the start of chemotherapy to decrease symptoms and improve QOL.

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Yeon Ok Lim, Yojin Kim, Hyunsook Yoon, Dae Young Zang, Dae Ro Choi, Kyoungwon Choi
Korean Journal of Health Education and Promotion.2018; 35(2): 73. CrossRef
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Oh Nam Ok, Min Sun Nam, Mi Sun Yi, Seon Mi Cho, Eun Ji Kim, Yun Hee Ham, In Gak Kwon
Asian Oncology Nursing.2017; 17(1): 37. CrossRef
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Misun Yi, Im-Ryung Kim, Eun-Kyung Choi, Seyoung Lee, Mikyong Kwak, Juhee Cho, Jin Seok Ahn, In Gak Kwon
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Maria Browall, Yvonne Brandberg, Salmir Nasic, Per Rydberg, Jonas Bergh, Andreas Rydén, Hanjing Xie, Irene Eriksson, Yvonne Wengström
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Seo Hee Lee, Taek-Gu Lee, Moo Jun Baek, Jang Jin Kim, Sung-Su Park, Sang-Jeon Lee
Korean Journal of Clinical Oncology.2016; 12(1): 60. CrossRef
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Kyung-Hye Hwang, Ok-Hee Cho, Yang-Sook Yoo
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Yongae Baek, Myungsun Yi
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Jeong-Sook Jeong, In-Sook Kim, Eun-Seon Lee
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Hyun Jun Kwoun, Yun Hee Shin
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Mi-Young Yang, Kyung-Min Ahn, Aeree Sohn
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Haejin Kim, Myungsun Yi
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Hea Kung Hur, Hee Young Song
The Korean Journal of Hospice and Palliative Care.2010; 13(4): 232. CrossRef

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Economic Evaluation of Gemcitabine-cisplatin Chemotherapy for Non Small-Cell Lung Cancer Patient in an Outpatient Setting: Su Hyun Min, Su-kyoung Ko, Ji Young Lim; J Korean Acad Nurs 2008;38(3):363-371. Published online June 30, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.3.363

Abstract PDF

Purpose

This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting.

Methods

A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted.

Results

Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol.

Conclusion

The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

Citations

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An Evaluation of Effects on Hypertension and Diabetes Mellitus Management of a Community-Based Nursing Care Center Using Cost-Benefit Analysis
Ji Young Lim, Jung Nam Im, In A Kim, Su Kyoung Ko
Journal of Korean Academy of Nursing Administration.2010; 16(3): 295. CrossRef

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