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Original Articles
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
AbstractAbstract 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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Predicting Quality of Life in People with Cancer
Pok Ja Oh
Journal of Nurses Academic Society 1997;27(4):901-911.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.901
AbstractAbstract PDF

The purpose of this study is to provide a basis for nursing intervention strategies to promote quality of life in cancer patients. Therefore the study is designed to evaluate the effectiveness of perceived health status, self-esteem, health locus of control, self-efficacy, perceived susceptibility/severity, health promoting behaviors, and hope for quality of life. The sample was composed of 164 stomach cancer patients who visited outpatient clinics at a university hospital in Seoul. The following instruments were used in the study after some adaptation : Lawstone and others' Health Self-rating Scale, Rosenberg's Self-esteem Scale, Wallston and others' Multidimensional Health Locus of Control Scale, Sherer and Maddux's Self-efficacy Scale, Moon's Health Beliefs Scale, Welker and others' Health Promoting Lifestyle Profile, Nowotney's Hope scale and Noh's Quality of Life Scale. Data were analyzed using a SAS program for Pearson correlation coefficients descriptive correlational statistics and stepwise multiple regression. The results are as follows : 1. The scores on the quality of life scale ranged from 115 to 243 with a mean of 177.84(SD : 25.35). The mean scores(range 1-5) on the different dimensions were : emotional state 3.37 ; economic life 3.47 ; physical state and function 3.52 ; self-esteem 3.66 ; relationship with neighbors 3.73 ; family relationships 3.80. 2. There was a significant correlation between all the predictive variables and the quality of life(r=.20 -.65, p<.01). 3. Stepwise multiple regression analysis showed that : 1) Self-esteem was the main predictor of quality of life and accounted from 46.9% of the variance in quality of life. 2) Perceived health status, hope and perceived susceptibility/severity accounted for 11.8%, 8.3%, 1.5% of the variance in quality of life respectively. 3) Self-esteem, perceived health status, hope and perceived susceptibility/severity combined accounted for 68.5% of the variance in quality of life. In conclusion, self-esteem, perceived health status, hope and perceived susceptibility / severity were identified as important variables in the quality of life of cancer patients.

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Effects of a Program to Promote Self-Efficacy and Hope on the Self: Care Behaviors and the Quality of Life in Patients with Leukemia
Pok Ja Oh, Eun Ok Lee, Young Sook Tae, Dong Choon Um
Journal of Nurses Academic Society 1997;27(3):627-638.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.627
AbstractAbstract PDF

Most patients having leukemia suffer severely from emotional turmoil due to the generalized perception that cancer will be fatal. The conventional chemotherapy results in side effects such as severe bone marrow depression which interfere with self-care management, vital for improvement in their condition. Bandura's theory of the self-efficacy suggests that self-efficacy can be enforced by performance attainments, vicarious experiences, verbal persuasion and the release of emotional arousal. Self-efficacy can be enforced by a program of vicarious experiences and verbal persuasion, while the emotional arousal can be relieved through a hope promotion program. If once self-efficacy increases, the patient's self-care behaviors and the quality of life will also increase. The purpose of this study was to empirically test the effects of a program, to promote self-efficacy and hope, on self-care behaviors and quality of life in patients having leukemia. In this study, three types of approaches to enhance self-efficacy and hope were used : 1) a 20-minute long slide/tape for vagarious experiences ; 2) a 10-minute long telephone call coaching for verbal persuasion ; and 3)two booklets for information about the symptoms of leukemia and treatment modalities and hope promotion. Thirsty one patients were recruited in the experimental group and 29 in the control group with a nonequivalent pretest-posttest design. The subjects were patients with leukemia undergoing chemotherapy. Sherer and Maddux's self-efficacy scale, Nowotny's hope scale, and Padilla's quality of life scale were employed with some modifications. A self-care behavior scale was developed by the researchers. Statistical analyses including paired t-test, Chi-square, ANCOVA and ANOVA, were used. The results are as follows : The levels of self-efficacy, self-care behavior and quality of life were higher in the experimental group than in the control group after four weeks of intervention(F=28.71, P=.0001 ; F=63.35, P=.0001 ; F=16.57, P=.0001). After ten weeks of intervention, all of the dependent variables(self-efficacy, self-care behavior, hope and quality of life) in the experimental group were higher than in the control group(F=74.12, P=.0001 ; F=108.34, P=.0001 ; F=13.11, P=.001 ; F=43.52, P=.0001). In conclusion, self-care behavior and quality of life increased mainly through an increase an increase in self-efficacy, while increases in hope took more time and effort.

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A Structural Model for Health Promotion and Quality of Life in People with Cancer
Pok Ja Oh
Journal of Nurses Academic Society 1996;26(3):632-652.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.3.632
AbstractAbstract PDF

It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle in addition to a series of other carcinogens increases the incidence of various neoplasmic diseases. Therefore the importance of a lifestyle that minimizes such an impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is related to personal lifestyle and as there is a possibility of its recurrence, patients with stomach cancer need to lead a healthy lifestyle. Also the quality of life which patients experience is negatively affected by the side effects of treatments and the possibility of recurrence. Therefore an effective nursing intervention to enhance quality of life and encourage healthy lifestyle is needed. The purpose of this study is to provide a basis for nursing intervention strategies to promote health and thus enhance quality of life. A hypothetical model for this purpose was constructed based on Pender's Health Promotion Model and Becker's Health Belief Model, with the inclusion of some influential factors such as hope for quality of life and health promoting behavior. The aims of study were to: 1) evaluate the effectiveness of patient's cognitive-perceptual factors on health promoting behaviors and quality of life; 2) examine the causal relationships among perceived benefit, perceived barrier, perceived susceptibility and severity, internal locus of control, perceived health status, hope, health concept, self efficacy, self esteem, health promoting behaviors and quality of life; 3) build and test a global hypothetical model. The subjects for this study were 164 patients who were being treated for stomach cancer were approached in the outpatient clinic on a University Hospital. The data from the completed questionnaires were analyzed using Linear Structural Relationships (LISREL). The results of research are as follows: 1) Hypothetical model and the modified model showed a good fit to the empirical data, revealing considerable explanational power for health promoting behaviors(54.9%) and quality of life(87.6%) 2) Self efficacy and hope had significant effects on health promoting behaviors. Of these, hope was affected indirectly through self efficacy and self esteem. 3) Perceived health status, hope and self esteem had significant direct effect on the quality of life. Of these variables, perceived health status was the most essential factor affecting general satisfaction in life. 4) Self-efficacy, as a mediating variable, was positively affected by perceived benifit and hope. 5) Self-esteem, as a mediating variable, was positively affected by perceived health status and hope. 6) Hope was the main variable affecting self efficacy, self esteem, health promoting behaviors and quality of life. The derived model in this study could effectively be used as a reference model for further study and could suggests a direction for nursing practices.

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Predicting Health-Promoting Behaviors in Patients with Stomach Cancer
Pok Ja Oh
Journal of Nurses Academic Society 1995;25(4):681-695.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1995.25.4.681
AbstractAbstract PDF

It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle in addition to a series of other carcinogens increases various neoplasmic diseases. Therefore the importance of lifestyle that minimizes such impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is related to the Korean lifestyle and as there's a possibility of its recurrence, people with stomach cancer need to lead a healthy lifestyle. The purpose of this study is to provide a basis for nursing intervention strategies to promote health promoting behaviors that are constructive to a healthy lifestyle. A multivariate model was constructed based on the Pender's health promotion model and Becker's health belief model by including influential factors such as hope. The sample was composed of 164 patients with stomach cancer who visited outpatient clinics of a university hospital in Seoul. The following instruments were used in the study after some adaptation: Wallston and others' multidimensional health locus of control scale Laffrey's health conception scale, Lawston and others' health self-rating scale, Walker and others' health promotion lifestyle profile and Rosenberg's self esteem scale. In addition Moon's health belief scale was used with some modification. For self efficacy, the present author constructed a self-efficacy scale based on previous research. The above mentioned instruments were tested in a pilot study with 24 patients with stomach cancer. The reliabilities of instruments were tested with Cronbach's alpha(0.574~0.949). Data were analyzed using a SAS program for Pearson correlation coefficients, descriptive correlational statistics and stepwise multiple regression. The results are as follows: 1. The scores on the health promoting behavior scale ranged from 55 to 145 with a mean of 107.91 (S. D: 16.50). The mean scores(range 1?) on the different dimensions were nutrition 3.14, exercise 2.48, stress management 2.69, health responsibility 2.65, interpersonal relationship 2.87 and self actualization 2.85. 2. There were significant correlations among all the predictive variables and the health promoting behavior (r=.20- .55, p<.01) 3. Stepwise multiple regression analysis showed that: 1) Hope was the main predictor and accounted for 29.8% of the total variance. 2) Self efficacy, perceived barriers and self esteem accounted for an additional 14.6% of the total variance. 3) Hope, self efficacy, perceived barriers and self esteem altogether accounted for 44.3% of the total variance. In conclusion, hope, self efficacy, perceived barriers and self esteem were identified as important variables that contributed to promote health promoting behavior.

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The Experience of Spirituality
Pok Ja Oh, Kyung Ah Kang
Journal of Korean Academy of Nursing 2001;31(6):967-977.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.6.967
AbstractAbstract PDF

PURPOSE: This study explored and described the living spiritual experience and was attempted to gain an understanding of spirituality. This was done by eliciting participants' verbal descriptions of their experiences.
METHOD
Data was obtained from in-depth interviews with one cancer patient, one pastor, and three missionaries after obtaining informed consent from each. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed using Colaizzi's phenomenological method. Sandelowski's evaluation criteria for qualitative research, such as reliability, suitability and auditability, were also used to establish reliability and validity of this study.
RESULT
The five major theme clusters that designated the essence of the spiritual experience, "spiritual awareness," "interconnectedness," "love," "transcendent energy," "purpose and meaning in life," emerged from the analysis.
CONCLUSION
This study revealed that spirituality was activated by awareness through introspection and interconnectedness with a Supreme Being. The interconnectedness with a Supreme Being played an important role in harmonious relationships with others and self. It also resulted in revealing the other beneticial attributes of spirituality. Love, the core concept of the interconnectedness, worked as a transcendent energy. Also, the ability to see beyond reality and resulted in finding meaning in life and accomplishing well being.

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Spirituality: Concept Analysis
Pok Ja Oh, Kyoung Ah Kang
Journal of Korean Academy of Nursing 2000;30(5):1145-1155.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1145
AbstractAbstract PDF

The purpose of this study is to explore the concept spirituality and to gain understanding of nursing intervention that may improve spiritual well-being. The concept analysis framework developed by Walker and Avant (1995) was used to clarify the concept. In the study, 'Harmonious Interconnectedness', 'Transcendence', 'Integrative Energy' and 'Purpose and Meaning in Life' emerged as the critical attributes of spirituality. The first attribute, 'harmonious Inter- connectedness', has three categories including intrapersonal, (self), interpersonal (others/ nature) and transpersonal (the Supreme Being). The second attribute, 'Transcendence', is defined as the ability to extend one's own self beyond the limits of usual experiences and to achieve new perspectives. This attribute is demonstrated by 'coping with situations', to 'self-healing', and 'transformation'. The third attribute of spirituality is 'Integrative Energy', which integrates all dimensions and acts as a creative and dynamic force that keeps a person growing and changing. 'Integrative Energy is also defined as an inner resource that gives a sense of empowerment. Therefore the highly spiritual person demonstrate 'inner peace', 'growing', 'inner strength,' and 'well-being'. The fourth attribute 'Purpose and Meaning in Life' represents a sense of connectedness with one's inner values and with a greater purpose in life. It is demonstrated by 'hope' and 'a powerful life'. In this study, the antecedents of the spirituality represented as 'spirit' and its potential enablers were 'Introspection/reflection', 'Interconnectedness with all living things', and an 'Awareness of a Higher-Power'. The consequences of this concept may be described as 'physical, psychosocial, and spiritual well-being'. Empirical referents of this are 'purposeful life' 'self-worth' 'hope' 'love' 'service' 'forgiveness' 'trust/belief' 'inner peace' 'self-actualization' 'religious practices' 'transformation' 'inner strength' and 'coping'. In conclusion, spirituality can be defined based on these critical attributes. Spirituality is a dynamic, integrative energy based on a feeling of harmonious interconnection with self, others and a higher power. Through it, one is enabled to transcend and to live with meaning and purpose in life.

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A Correlation Study of Suffering, Burden and Meaning of Life in Cancer Patients
Kyoung Ah Kang, Pok Ja Oh
Journal of Korean Academy of Nursing 2000;30(2):331-341.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.331
AbstractAbstract PDF

Since cancer is not easily curable, patients who suffer from cancer may have physical, psychological and spiritual problems for the rest of their lives. Especially when cancer patients do not have much to live for and are placing a burden on their family they will experience more suffering emotionally as much as physically. This study was conducted to provide a basis of data for nursing intervention strategies to minimize a cancer patient`s suffering and to understand the relationship between suffering, burden and the meaning of life in cancer patients. The samples were composed of 160 cancer patients who were inpatients or outpatients of two university hospitals and two general hospitals in Seoul. Data collection were carried out from January, 25, 1999 to February, 26, 1999. The data were analyzed using a SAS program for descriptive statistics, pearson correlations, ANOVA, and Duncan tests. The results were as follows; 1. The scores on the two suffering scale ranged from 132 to 40 with a mean of 87.3(SD 17.5). The mean scores on the burden scale is 28.9(SD 6.9) and the score of the meaning of life ranged from 35 to 51 with a mean of 95.6(SD 18.4). 2. There were significant correlations between the amount of suffering and the magnitude of burden (r=.74, p=.00), the suffering and the meaning of life (r=-.59, p=.00) and the burden and meaning of life (r=-.61, p=.00). 3. In the degree of the suffering, the burden and the meaning of life were two very strong factors, the level of the suffering in cancer patients by age (F=2.64, p=.03) and education level (F=4.16, p=.00). The level of the burden in cancer patients differed by education level (F=4.70, p=.00) and type of cancer (F=2.97, p= .03). Also the level of the meaning of life in cancer patients was different by education level (F=3.55, p=.02). In conclusion, the burden and the meaning of life was identified as important variable that is contributed to reduce the suffering of cancer patients.

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The meaning of Quality of Life for Bone Marrow Transplant Survivors
Pok Ja Oh
Journal of Korean Academy of Nursing 1998;28(3):760-772.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.3.760
AbstractAbstract PDF

The purpose of this study was to explore the concept of quality of life for bone marrow transplant (BMT) survivors and to gain understanding of nursing interventions that may improve QOL in this population. The data was gathered from 32 BMT survivors using seven open-ended questions. The items were based on previous research of Ferrell et al., (1992) . Content analysis was performed on written responses to seven questions regarding BMT and QOL. The results were as follows : 1. The meaning of QOL for BMT survivors were "being heart", "being able to take a role", "having relationships", "self-accomplishment", "peace of mind", "spiritual well -being", "economic stability" and "being alive". 2. The impact of BMT on physical well-being were "skin impairment", "digestive problems", "Infections ", "fatigue/weakness". "arthralgia", "eye dryness", "weight gain", "amenorrhea" and "hand trermor" 3. The impact of BMT on psychological well-being were "fear of recurrence", "fence of peace" and "hope". 4. The impact of BMT on socioeconomic status were "financial burden", "limitation of social activities" and "fence of withdrawal ". 5. The impact of BMT on spiritual well -being were "dependency on Supreme Being", "spiritual arousal" and "spiritual maturity". The findings of the study will be useful in constructing a instrument to measure QOL in BMT and in understanding the conceptual basis of QOL for the BMT population.

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The Effect of Web-based Multimedia Contents for a Course of Physical Examination and Health Assessment
Pok Ja Oh, Il Ok Kim, Sung Rae Shin, Hoe Kyung Jung
Journal of Korean Academy of Nursing 2005;35(5):810-816.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.5.810
AbstractAbstract PDF
Purpose

This study was to test the effectiveness of Web-based multimedia contents for Physical Examination and Health Assessment on learning achievement.

Method

Multimedia contents based on Jung's teaching and learning structure model were used to enhance learning achievement. Learning achievement was measured by the knowledge of Physical Examination and Health Assessment. The participants of this study were students in a BSN and RN-BSN program in a university located in Seoul. 59 students in the experimental group received lectures using web-based multimedia contents and 75 students in the control group received regular lectures.

Results

The mean score of the degree of educational achievement in the experimental group(mean=31.09) was significantly higher than in the control group(mean=25.55)(t=-3.883, p=.000).

Conclusion

These web-based multimedia contents were found to maximizethe effectiveness of the teaching process when used as a teaching aid, and yet kept the strength of a face to face teaching learning method. This program is recommended as part of a main text, vital teaching aid or cyber lecture materials in nursing schools and in health care educational institutions.

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Spirituality: Concept Analysis Based on Hybrid Model
Pok Ja Oh, Kyung Ah Kang
Journal of Korean Academy of Nursing 2005;35(4):709-720.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.4.709
AbstractAbstract
Purpose

The purpose of this study was to obtain a clearer understanding of spirituality and examine the process of spirituality through defining the meaning and attributes of spirituality.

Method

Concept analysis was done in the three phases, theoretical phase, fieldwork phase, and analytical phase suggested in the Hybrid Model. Five people participated in the fieldwork phase.

Results

Spirituality is activated through self-awareness which occurs as spirit being activated through self-introspection, and through restoration of the relationship with Supreme Being. This interconnectedness with Supreme Being has an absolute impact on one's harmonious interconnectedness with self and neighbors, thus leads all the critical attributes of spirituality to be revealed. The core energy of this harmonious interconnectedness is love. When activated, it has a great impact on an individual as integrative energy, leads one to go beyond everyday experience as well as to have new perspectives, and to live a satisfactory life in every aspect.

Conclusion

The results of this study suggest that promotion of connectedness is the most important element in spiritual nursing interventions. The results can also be used effectively in developing spirituality assessment scales and theory.

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Development of Web-based Multimedia Content for a Physical Examination and Health Assessment Course
Pok Ja Oh, Il Ok Kim, Sung Rae Shin, Hoe Kyung Jung
Journal of Korean Academy of Nursing 2004;34(6):994-1003.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.6.994
AbstractAbstract PDF
Purpose

This study was to develop Web-based multimedia content for Physical Examination and Health Assesment.

Method

The multimedia content was developed based on Jung's teaching and learning structure plan model, using the following 5 processes : 1) Analysis Stage, 2) Planning Stage, 3) Storyboard Framing and Production Stage, 4) Program Operation Stage, and 5) Final Evaluation Stage.

Results

The web based multimedia content consisted of an intro movie, main page and sub pages. On the main page, there were 6 menu bars that consisted of Announcement center, Information of professors, Lecture guide, Cyber lecture, Q&A, and Data centers, and a site map which introduced 15 week lectures. In the operation of web based multimedia content, HTML, JavaScript, Flash, and multimedia technology(Audio and Video) were utilized and the content consisted of text content, interactive content, animation, and audio & video. Consultation with the experts in context, computer engineering, and educational technology was utilized in the development of these processes.

Conclusions

Web-based multimedia content is expected to offer individualized and tailored learning opportunities to maximize and facilitate the effectiveness of the teaching and learning process. Therefore, multimedia content should be utilized concurrently with the lecture in the Physical Examination and Health Assesment classes as a vital teaching aid to make up for the weakness of the face-to-face teaching-learning method.

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A Study on the Projected Workforce of Nephrology Clinical Nurse Specialist(CNS) in Korea
Pok Ja Oh, Sung Rae Shin
Journal of Korean Academy of Nursing 2003;33(2):284-292.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.2.284
AbstractAbstract PDF
Purpose

The purpose of this study was to study the projected workforce of nephrology CNS in Korea.

Method

Need models, ratio methods and expert opinion were used for projecting needs for the nephrology CNS.

Result

In 2001, there are 28,046 ESRD(end stage of renal disease)patients, 304 renal replacement centers and 1695 nephrology nurses in Korea. the hemodialysis patients per hemodialysis nurse was 12. The number of nephrology CNS required to meet the demand for caring of ESRD patients in 2002, 2005 and 2020 was estimated at 616, 837 and 3105, respectively. 47 ESRD patients per nephrology CNS was revealed as a workforce standard before 2005. After 2005, It was 31 ESRD patients per nephrology CNS.

Conclusion

This study founded the need to project future increments and development in supply of qualified nephrology CNS.

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Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer
Pok Ja Oh, Jung Ran Lee
J Korean Acad Nurs 2016;46(3):420-430.   Published online June 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.3.420
AbstractAbstract PDF
Purpose

The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer.

Methods

A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis.

Results

CRCI was directly affected by cancer symptoms (β=.19, p=.004) and fatigue (β=.56, p<.001)(R2=47.2%). Depression was directly affected by fatigue (β=.48, p<.001) and CRCI (β=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI.

Conclusion

Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.

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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
J Korean Acad Nurs 2016;46(1):19-28.   Published online February 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.1.19
AbstractAbstract PDF
Purpose

The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer.

Methods

A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation.

Results

The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R2=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R2=43%). Psychological distress had a partial mediating effect (β= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001).

Conclusion

Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

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Disturbance in ADL from Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Cancer Patients: The Mediating Effect of Psychological Distress
Kyung Yeon Kim, Seung Hee Lee, Jeong Hye Kim, Pok Ja Oh
J Korean Acad Nurs 2015;45(5):661-670.   Published online October 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.5.661
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the mediation of psychological distress in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life in order to provide a basis for planning nursing interventions to improve the quality of life in cancer patients.

Methods

A purposive sample of 130 patients treated with chemotherapy were recruited in the cross-sectional survey design. Data were collected using self-report questionnaires. The instruments were the Chemotherapy Induced Peripheral Neuropathy Assessment Tool (CIPNAT), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G).

Results

The mean score for disturbance in ADL from chemotherapy induced peripheral neuropathy was 3.30. Overall quality of life was 2.48. The mean score was 1.04 for psychological distress. The prevalence was 35.4% for anxiety and 47.7% for depression. There were significant correlations among the three variables, disturbance in ADL from chemotherapy induced peripheral neuropathy, psychosocial distress, and quality of life. Psychosocial distress had a complete mediating effect (β= -.74, p <.001) in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life (Sobel test: Z= -6.11, p <.001).

Conclusion

Based on the findings of this study, nursing intervention programs focusing on disturbance of ADL management, and decrease of psychological distress are highly recommended to improve quality of life in cancer patients.

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Effect of School-based Peer Leader Centered Smoking Prevention Program
Sung Rae Shin, Pok Ja Oh, Hye Kyung Youn, Sun Hwa Shin
J Korean Acad Nurs 2014;44(6):649-659.   Published online December 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.6.649
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and evaluate a school-based peer leader centered smoking prevention program.

Methods

Non-equivalent control group with a pre/post-test design was used. Students (n=174) in two boys' junior high schools located in D city, Korea participated with 85 being selected for the experimental group and 89 for the control group. Five sessions were given to the experimental group and a 50 minute lecture to the control group. Knowledge, attitude, non-smoking intention, and non-smoking efficacy were measured for the both experimental and control group at two weeks before the program and one month after the program was completed. Data were analyzed using χ2-test, Fisher's exact test, independent t-test and paired t-test with the SPSS 21.0 program.

Results

The experimental group showed higher overall knowledge, negative attitude toward smoking, and higher non-smoking intention and efficacy. After receiving the school based peer leader centered smoking prevention program scores for attitude toward smoking and non-smoking efficacy increased in the experimental group were higher than in the control group.

Conclusion

The school-based peer leader centered smoking prevention program needs longitudinal evaluation, but from this study, there is an indication that this program can be used with junior high school students and effectively change students' attitude toward smoking and promote non-smoking efficacy.

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Review Articles
Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis
Pok Ja Oh, Sung-Rae Shin
J Korean Acad Nurs 2014;44(5):471-483.   Published online October 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.5.471
AbstractAbstract PDF
Purpose

This study was done to evaluate the effects of dignity interventions on depression, anxiety and meaning of life in terminally ill patients.

Methods

PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms indicating dignity intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.2.11 program of Cochrane Library.

Results

Twelve clinical trials met the inclusion criteria with a total of 878 participants. Dignity intervention was conducted for a mean of 2.2 weeks, 2.8 sessions and an average of 48.7 minutes per session. Effect sizes were heterogeneous and subgroup analysis was done. Dignity interventions had a significant effect on depression (ES=-1.05, p<.001, I2=15%) and anxiety (ES=-1.01, p<.001, I2=0). For meaning of life, dignity interventions were effective (ES=-1.64, p=.005) and effect sizes were still heterogeneous.

Conclusion

Results support findings that dignity interventions can assist terminal ill patients in reducing emotional distress and improving meaning of life. Further well-designed dignity studies will lead to better understanding of the effects of treatments on spiritual well-being.

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Effects of Psychosocial Interventions on Cortisol and Immune Parameters in Patients with Cancer: A Meta-analysis
Pok Ja Oh, Eun-su Jang
J Korean Acad Nurs 2014;44(4):446-457.   Published online August 29, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.4.446
AbstractAbstract PDF
Purpose

This study was done to evaluate the effects of psychosocial interventions on cortisol and immune response in adult patients with cancer.

Methods

MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and domestic electronic databases were searched. Twenty controlled trials (11 randomized and 9 non-randomized trials) met the inclusion criteria with a total of 862 participants. Methodological quality was assessed using the Cochrane's Risk of Bias for randomized studies and the Risk of Bias Assessment tool for non randomized studies. Data were analyzed using the RevMan 5.2.11 program of Cochrane library.

Results

Overall, study quality was moderate to high. The weighted average effect size across studies was -0.32 (95% CI [-0.56, -0.07], p=.010, I2=45%) for cortisol concentration, -0.62 (95%CI [-0.96,-0.29], p<.001, I2=0%) for T lymphocyte (CD3) and -0.45 (95%CI [-0.74, -0.16], p=.003, I2=0%) for Th lymphocyte (CD4) numbers. Psychosocial interventions were not effective for Tc lymphocyte (CD4), NK cell, monocyte, and cytokine response.

Conclusion

Although these results provide only small evidence of successful immune modulation, they support the conclusion that psychosocial interventions can assist cancer patients in reducing emotional distress and improving immune response.

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Original Articles
Meta- analysis of Psychosocial Interventions to Reduce Pain in Patients with Cancer
Pok Ja Oh, Suk Jung Han
J Korean Acad Nurs 2013;43(5):658-668.   Published online October 15, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.5.658
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Abstract Purpose

The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients.

Methods

Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library.

Results

Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected.

Conclusion

This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.

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Task Analysis of Korean Geriatric Care Managers
Pok Ja Oh, Il Ok Kim, Young Hye Kim, Sung Rae Shin, Kyoung Soon Lee, Suk Jung Han
Journal of Korean Academy of Nursing 2006;36(5):770-781.   Published online August 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.5.770
AbstractAbstract PDF
Purpose

This study was designed to create a job description for Korean geriatric care managers and examine performance frequency, importance, and difficulty of task elements.

Method

The sample consisted of 38 geriatric care managers and professors who performed duties related to geriatric care management at community based-facilities in Korea. A survey method was used, and the questionnaire included frequency, importance, and difficulty of task elements in job descriptions using the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviation were conducted to examine the subject's general characteristics, frequency, importance, and difficulties of task performance.

Result

The job descri ption of geriatric care managers revealed 10 duties, 34 tasks, and 105 task elements. On all ten duties, the average performance frequency, importance, and difficulty was 2.55, 2.21 and 2.43 respectively.

Conclusion

The job description of geriatric care managers includes duty, task, and task elements and the definition of a completed job. Thus we recommend a data based trial to confirm and validate the information gathered.

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A Survey on Frequencies of Smoking Cessation Intervention for Patients Among Clinical Nurses
Sung Rae Shin, Pok Ja Oh
Journal of Korean Academy of Nursing 2006;36(1):144-150.   Published online February 28, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.1.144
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Purpose

This study was conducted to 1) find out the characteristic of smoke related characteristics of nurses. 2) find out the frequency of Smoking cessation intervention delivered by nurses. 3) compare the differences in mean scores of smoking cessation interventions by general characteristics.

Method

The survey questionnaire was mailed out to nurses who were working at the randomly selected hospitals throughout the country from November 28, 2003 to February 15, 2004.

Result

0.6% of nurses were current smokers 40.7% of nurses have attended smoking cessation education. Nurses who were older, had masters degree, had oncology experience, higher position, participated in smoking cessation education, and had smoking related disease among family members were variables related to higher frequencies in delivering tobacco interventions.

Conclusion

Although nurses are in an important position in delivering tobacco interventions and provide resources, their participation in consistent delivery of an intervention is less than desirable. To help nurses to participate in the assessment of tobacco use and interventions for cessation, the development of educational program is necessary.

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