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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
AbstractAbstract PDFSupplementary MaterialePub
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 Articles
Motherhood Ideology and Parenting Stress according to Parenting Behavior Patterns of Married Immigrant Women with Young Children
So-Hyun Moon, Miok Kim, Hyeun Na
J Korean Acad Nurs 2019;49(4):449-460.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.449
AbstractAbstract PDF
Abstract Purpose

This study aims to provide base data for designing education and counseling programs for child-raising by identifying the types, characteristics and predictors of parenting behaviors of married immigrant women.

Methods

We used a self-report questionnaire to survey 126 immigrant mothers of young children, who agreed to participate, and who could speak Korean, Vietnamese, Chinese, Filipino, or English, at two children's hospitals and two multicultural support centers. Statistical analysis was conducted using descriptive analysis, K-means clustering, χ 2 test, Fisher's exact test, one-way ANOVA, Schéffe's test, and multinominal logistic regression.

Results

We identified three clusters of parenting behaviors: ‘affectionate acceptance group’ (38.9%), ‘active engaging group’ (26.2%), and ‘passive parenting group’ (34.9%). Passive parenting and affectionate acceptance groups were distinguished by the conversation time between couples (p=.028, OR=5.52), ideology of motherhood (p=.032, OR=4.33), and parenting stress between parent and child (p=.049, OR=0.22). Passive parenting was distinguished from active engaging group by support from spouses for participating in multicultural support centers or relevant programs (p=.011, OR=2.37), and ideology of motherhood (p=.001, OR=16.65). Ideology of motherhood was also the distinguishing factor between affectionate acceptance and active engaging groups (p=.041, OR=3.85).

Conclusion

Since immigrant women's parenting type depends on their ideology of motherhood, parenting stress, and spousal relationships in terms of communication and support to help their child-raising and socio-cultural adaptation, it is necessary to provide them with systematic education and support, as well as interventions across personal, family, and community levels.

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Nurse-Patient Interaction Patterns and Patient Satisfaction in the Emergency Department
Eun Jung Kim
J Korean Acad Nurs 2010;40(1):99-109.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.99
AbstractAbstract PDF
Purpose

The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department.

Methods

For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction.

Results

Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern.

Conclusion

The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.

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Identification and Validation of Symptom Clusters in Patients with Hepatocellular Carcinoma
Myung Sook Cho, In Gak Kwon, Hee Sun Kim, Kyunghee Kim, Eunjung Ryu
J Korean Acad Nurs 2009;39(5):683-692.   Published online October 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.5.683
AbstractAbstract PDF
Purpose

The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma.

Methods

This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters.

Results

Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression.

Conclusion

Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

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Anger Expression Type and Mental Health in Middle Aged Women
Il-Rim Choi
J Korean Acad Nurs 2009;39(4):602-612.   Published online August 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.4.602
AbstractAbstract PDF
Purpose

The purpose of this study was to identify type of anger expression and mental health in middle aged women.

Methods

From August to October 2005, survey data were collected by using the State Trait Anger Expression Inventory and Symptom Check List-90-Revision (SCL). Participants (1,442) were classified into four types of anger expression by K-mean cluster analysis. For collecting interview data for content analysis, 18 participants (4-5 participants from each type of anger expression) were recruited. The interview data were collected between March and September 2006.

Results

The average score of the state anger of middle-aged women was 11.95, and that of the trait anger was 18.75. The average anger expression scores were 12.72 for Anger-In, 13.45 for Anger-Out, and 18.51 for Anger-Control. The average SCL scores were 45.03 for somatization, 42.23 for obsessive-compulsiveness, 42.44 for interpersonal sensitivity, 42.45 for depression, 42.40 for anxiety, 42.62 for hostility, 44.44 for phobic anxiety, 43.65 for paranoid ideation, and 43.08 for psychoticism. The anger expression types identified in this study were 1) anger-out in secret, 2) anger-control with a patience, 3) anger-out with suppression, and 4) low anger expression type. The psychosomatic symptom scores were the highest in type III (anger-out with suppression), and the lowest in type IV (low anger expression type).

Conclusion

This study can be helpful in assisting middle aged women to control their anger effectively and may contribute to the improvement of their mental health.

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