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Research Papers
Association between Resilience, Professional Quality of Life, and Caring Behavior in Oncology Nurses: A Cross-Sectional Study
Jeon, Misun , Kim, Sue , Kim, Sanghee
J Korean Acad Nurs 2023;53(6):597-609.   Published online December 31, 2023
DOI: https://doi.org/10.4040/jkan.23058
AbstractAbstract PDF
Purpose
The degree of caring behavior of oncology nurses is a crucial factor in the care provided to patients with cancer. In this study, we aimed to investigate factors related to oncology nurses’ caring behavior, including their resilience and professional quality of life.
Methods
A cross-sectional descriptive study was conducted with 107 oncology nurses at an urban tertiary hospital from May 18 to 24, 2015. We used a self-report questionnaire to measure resilience, professional quality of life, and degree of caring behavior. Data analysis included descriptive statistics, correlations, and multiple regression analysis using SPSS/WIN 20.0.
Results
Oncology nurses presented with low levels of resilience and caring behavior, and high levels of compassion satisfaction, burnout, and secondary traumatic stress. There was a statistically significant relationship between the degree of caring behavior, resilience (r = .43, p < .001), compassion satisfaction (r = .51, p < .001), and burnout (r = - .42, p < .001), as well as between secondary traumatic stress and burnout (r = .34, p < .001). Factors associated with oncology nurses’ degree of caring behavior were compassion satisfaction (t = 6.00, p < .001) and educational level (t = 3.45, p = .001).
Conclusion
This study demonstrates that oncology nurses’ degree of caring behavior is related to their professional quality of life and education. These findings suggest that enhancing oncology nurses’ healthy coping strategies at both the individual and organizational levels can further develop holistic nursing care. Additionally, it is necessary to examine the factors affecting nurses’ compassion satisfaction and to try to promote this aspect.
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Internal Structure of the Health-Related Quality of Life Instrument with 8-Items in a Nationally Representative Population
Lee, Eun-Hyun
J Korean Acad Nurs 2023;53(3):359-369.   Published online June 30, 2023
DOI: https://doi.org/10.4040/jkan.23007
AbstractAbstract PDF
Purpose
This study evaluated the internal structure (structural validity, internal consistency, and measurement invariance) of the Health-Related Quality of Life Instrument with Eight Items (HINT-8), developed to measure Korean people’s health-related quality of life.
Methods
A secondary analysis was conducted using data from the Korea National Health and Nutrition Examination Survey, involving 6,167 adults aged over 18 years. The structural validity of the HINT-8 was assessed using exploratory graph analysis and confirmatory factor analysis. Internal consistency and measurement invariance were analyzed using McDonald’s omega (ω) and multigroup confirmatory factor analysis, respectively.
Results
The HINT-8 had a single dimension and good internal consistency (ω = .804). The one-dimension HINT-8 ex-hibited matric invariance but not scalar invariance across sociodemographic groups (sex, age, education, and marital status). Further, it exhibited scalar or partial scalar invariance across medical condition groups (hypertension, diabetes, depressive symptoms, and cancer).
Conclusion
The study finds that the HINT-8 demonstrated satisfactory structural validity and internal consistency, indicating its suitability for practice and research. However, the HINT-8 scores cannot be compared across different groups regarding sex, age, education, and marital status, as the interpretation varies within each sociodemographic category. Conversely, interpretation of the HINT-8 is consistent for individuals with and without hypertension, diabetes, depressive symptom, and cancer.
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Factors Affecting the Quality of Life in Low-Income Older Adults with Sarcopenia: A Cross-Sectional Study
Nho, Ju-Hee , Kim, Eun Jin
J Korean Acad Nurs 2023;53(1):1-11.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22126
AbstractAbstract PDF
Purpose
This study aimed to identify the factors influencing quality of life (QoL) of low-income older adults (LOAs) with sarcopenia.
Methods
A convenience sample of 125 older adults was recruited from Jeonbuk Province, South Korea. Data were collected using a self-report questionnaire that included nutritional status, the Depression Anxiety Stress Scale-21, and the World Health Organization Quality of Life Instrument-Older Adults Module. Additionally, grip strength and appendicular skeletal muscle mass, were evaluated, along with the short physical performance battery.
Results
Sarcopenia and severe sarcopenia were observed in 43.2% and 56.8% of participants, respectively. Using multiple regression analysis, depression (β = - .40, p < .001), nutritional status (β = .24, p = .003), and anxiety (β = - .15, p = .042) were identified as factors affecting the QoL of the older adults in low-income groups with sarcopenia, the explanatory power of these variables was 44%.
Conclusion
The results of this study can be used to develop a nursing intervention program and establish policies to improve depression, anxiety, and nutritional status to enhance QoL of LOAs with sarcopenia.
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Structural Equation Modeling for Quality of Life of Mothers of Children with Developmental Disabilities: Focusing on the Self-Help Model
Yang, Mi Ran , Yu, Mi
J Korean Acad Nurs 2022;52(3):308-323.   Published online June 30, 2022
DOI: https://doi.org/10.4040/jkan.22013
AbstractAbstract PDF
Purpose
This study aimed to construct and test a predictive model for the quality of life (QOL) in mothers of children with developmental disabilities (DB). The hypothesized model included severity of illness, distress, uncertainty, self-help, and parenting efficacy as influencing factors, QOL as a consequence based on the Braden’s Self-Help Model.
Methods
The data were collected through a direct and online surveys from 206 mothers in 8 locations, including welfare or daycare centers, developmental treatment centers, and The Parents’ Coalition for the Disabled located in two provinces of Korea. Data were analysed using SPSS/WIN 23.0 and AMOS 21.0 program.
Results
The fit indices of the predictive model satisfied recommended levels; χ2 = 165.79 (p < .001), normed χ22 /df) = 2.44, RMR = .04, RMSEA = .08, GFI = .90, AGFI = .85, NFI = .91, TLI = .93, CFI = .95. Among the variables, distress (β = - .46, p < .001), parenting efficacy (β = .22, p < .001), and self-help (β = .17, p = .018) had direct effects on QOL. Severity of illness (β = - .61, p = .010) and uncertainty (β = - .08, p = .014) showed indirect effects. The explanatory power of variables was 61.0%.
Conclusion
The study results confirm the utility of Braden’s Self-Help Model. They provide a theoretical basis for improving QOL in mothers of children with DB. Nursing intervention strategies that can relieve mothers’ distress and uncertainty related to disease and enhance parenting efficacy and self-help behavior should be considered.
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Effects of the Advanced Practice Nurse-Led Psychoeducational Program for Colorectal Cancer Survivors
Kim, Hye Kyung , Yoo, Yang-Sook
J Korean Acad Nurs 2022;52(3):245-260.   Published online June 30, 2022
DOI: https://doi.org/10.4040/jkan.21207
AbstractAbstract PDF
Purpose
This study aimed to investigate the effects of an advanced practice nurse-led psychoeducational program on distress, anxiety, depression, coping with cancer (CWC), health promotion behavior (HPB), and quality of life (QOL) among colorectal cancer survivors.
Methods
This study was designed as a quasi-experimental study with a non-equivalent control group pretest-posttest. The participants were survivors of colorectal cancer who underwent follow-up care. There were 39 survivors: 19 in the experimental group and 20 in the control group. The experimental group performed a psychoeducational program for 120 minutes per session, once a week for a total of six weeks, while the control group received routine education and counseling. Distress, anxiety, depression, CWC, HPB, and QOL were investigated before, immediately after, and 4 weeks after the intervention. The data were analyzed with SPSS/WIN ver. 24.0, using repeated measures ANOVA.
Results
There were significant interactions between time and group for distress and anxiety. In addition, CWC interacted with the total of CWC and interpersonal coping, and QOL interacted with the total of QOL and functional status. However, there were no significant differences in the depression or HPB scores.
Conclusion
Based on the results of this study, we expect that this program can be used as an effective intervention for colorectal cancer survivors.
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Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy
Shin, Jee Hye , Choi, Ja Yun
J Korean Acad Nurs 2021;51(3):334-346.   Published online June 30, 2021
DOI: https://doi.org/10.4040/jkan.21019
AbstractAbstract PDF
Purpose
The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy.
Methods
The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes.
Conclusion
The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.
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Predictive Model for Quality of Life of the Older Men Living Alone
Kim, Su Jin , Jeon, Gyeong-Suk
J Korean Acad Nurs 2020;50(6):799-812.   Published online December 31, 2020
DOI: https://doi.org/10.4040/jkan.20087
AbstractAbstract PDF
Purpose
This study aimed to construct and test a predictive model that explains and predicts the quality of life in older men living alone.
Methods
A self-report questionnaire was used to collect data from 334 older adult men living along aged 65 years or over living in Jeollanam-do provinces. The endogenous variables were depression, self-rated health, instrumental activity of daily life, health promotion behaviors, the number of social participation activities and quality of life. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs.
Results
The final model with 14 of the 8 analysed paths showed a good fit to the empiri cal data: χ2= 173.26(p < .001, df = 53),normed χ2= 3.27, GFI = .92, NFI = .90, CFI = .93, TLI = .89, RMSEA = .08 and SRMR = .06. Activities had direct effect on quality of life of older men living alone and social support had both direct and indirect effects. Meanwhile, function and socioeconomic status showed only indirect effects.The variables included in the eight significant paths explained 83.7% of variance in the prediction model.
Conclusion
Instrumental activities of daily living and social support effect directly on quality of life in the older men living alone. Findings suggest that health care providers including community nurses need to provide social support as well as empowerment programs of instrumental activities of daily living and health promotion for improving quality of life of the older men living alone.
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Original Articles
A Structural Equation Model of Health-Related Quality of Life among Older Women Following Bilateral Total Knee Replacement
Lee, Hyun Ok , Yoo, Jae Soon
J Korean Acad Nurs 2020;50(4):554-570.   Published online August 31, 2020
DOI: https://doi.org/10.4040/jkan.19216
AbstractAbstract PDF
Purpose
This study aimed to develop and test a structural equation model of health-related quality of life among older women following bilateral total knee replacement based on a literature review and Wilson and Cleary’s model of health-related quality of life.
Methods
One hundred ninety three women who were diagnosed with osteoarthritis, were older than 65 years, and were between 13 weeks and 12 months of having a bilateral total knee replacement were recruited from an outpatient clinic. Data were collected from July 2017 to April 2018 using a structured questionnaire and medical records. Data were analyzed using SPSS/WIN 22.0, AMOS 22.0, and Smart PLS 3.2.4.
Results
The fitness of the hypothetical model was good, with coefficients of determination (R2 ) ranging between .28 and .75 and predictive relevance (Q2 ) between .26 and .73. The standardized root mean square residual of the model fit indices for the hypothetical model was .04; which explained 64.2% of physical and 62.5% of mental health-related quality of life. Self-efficacy, symptom status, functional status, and general health perceptions had a significant direct effect on physical health-related quality of life, while social support, symptom status, and general health perceptions had a significant direct effect on participants’ mental-health-related quality of life.
Conclusion
To improve the physical and mental quality of life of older women who receive bilateral knee replacement, nursing-based intervention strategies that reduce symptoms, improve functional status, and increase health perceptions, self-efficacy, and social support are needed. The most important factor is the symptom status.
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Validity and Reliability of the Korean Version of the Menopause-Specific Quality of Life
Park, Jin-Hee , Bae, Sun Hyoung , Jung, Young-Mi
J Korean Acad Nurs 2020;50(3):487-500.   Published online June 30, 2020
DOI: https://doi.org/10.4040/jkan.20049
AbstractAbstract PDF
Purpose
This study aimed to evaluate the validity and reliability of the Korean version of Menopause-Specific Quality of Life (MENQOL).
Methods
The MENQOL was translated into Korean according to algorithm of linguistic validation process. A total of 308 menopausal womenwere recruited and assessed using the Korean version of MENQOL (MENQOL-K), the World Health Organization Quality of Life BriefVersion (WHOQOL-BREF), and Center for Epidemiological Studies Depression Scale (CES-D-K). In estimating reliability, internal consistencyreliability coefficients were calculated. Validity was evaluated through criterion validity and construct validity with confirmatory factor analysesusing SPSS 23.0 and AMOS 25.0 software.
Results
In item analyses, the “increased facial hair” symptom was excluded because of thelow contribution of MENQOL-K. The confirmatory factor analysis supported good fit and reliable scores for MENQOL-K model, and thefour-factor structure was validated (x2=553.28, p <.001, NC=1.84, RMSEA=.05, AGIF=.85, AIC=765.28). The MENQOL-K consists of 28 itemsin 4 domains, including vasomotor (3 items), psychosocial (7 items), physical (15 items), and sexual subscales (3 items). There was an acceptablecriterion validity with moderately significant correlation between MENQOL-K and WHOQOL-BREF. The Cronbach’s a for the 4subsacles ranged from .80 to .93.
Conclusion
The MENQOL-K is a valid and reliable scale to measure condition-specific quality of life forperimenopausal and postmenopausal women. It can be used to assess the impact of menopausal symptoms on the quality of life of Koreanwomen in clinical trials.
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Review Article
A Meta-Analysis on the Effects of Mind-Body Therapy on Patients with Irritable Bowel Syndrome
Choi, Eun Hui , Kim, Moon Ja , Lee, Eun Nam
J Korean Acad Nurs 2020;50(3):385-400.   Published online June 30, 2020
DOI: https://doi.org/10.4040/jkan.19224
AbstractAbstract PDF
Purpose
Previous randomized controlled trials (RCT) found that mind-body therapy can improve the health outcomes of patients with irritablebowel syndrome (IBS). The purpose of this meta-analysis was to identify the combined effects of mind-body therapy on patients’ IBSsymptoms, quality of life, anxiety, and depression.
Methods
A systematic literature search was conducted using various databases such asPubMed, EMBASE, CINAHL CENTRAL, DBpia, RISS, and KISS. The primary outcome variables were IBS symptoms and quality of life; the secondaryoutcome variables were anxiety and depression. Comprehensive Meta-Analysis version 3.0 was used to analyze the extracted data.The effect size was calculated using standardized mean difference (SMD) and 95% confidence interval (CI).
Results
Eleven final RCTs wereused for this meta-analysis. Mind-body therapy was found to have a significant effect on the IBS patients’ symptoms (SMD, -0.63; 95% CI,-0.77 to -0.48), quality of life (SMD, 1.03; 95% CI, 0.40 to 1.66), anxiety (SMD, -0.28; 95% CI, -0.47 to -0.09), and depression (SMD,-0.31; 95% CI, -0.06 to -0.12).
Conclusion
This meta-analysis reveals that mind-body therapy significantly improves IBS patients’ symptoms,quality of life, anxiety, and depression. The results suggest that, in the future, appropriate mind-body therapy should be applied toKoreans suffering from IBS. Moreover, the therapy’s long-term effects should be assessed.
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Original Articles
Development and Effects of Smartphone App-Based Walking Exercise Program for Taxi Drivers: Based on Bandura’s Self Efficacy Theory
Choi, Yun Ha , Chae, Min-Jeong
J Korean Acad Nurs 2020;50(2):242-254.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.242
AbstractAbstract PDF
Purpose
The purpose of this study was to examine the effects of smart-phone app-based walking exercise programs for taxi drivers on self-efficacy and outcome expectations for exercise, health-related quality of life, walking as an exercise, and physiological indexes.
Methods
A nonequivalent control group with a pre-post-test design was used. The subjects were recruited in G metropolitan city. Subjects were assigned to the experimental (n=31) or control groups (n=30). The smart phone app-based walking exercise program consisted of educations via the app, twelve short message services, and one individual telephone counseling session, which was spread over 12 weeks.
Results
Self-efficacy, outcome expectations, and health-related quality of life had significantly higher pre-post test differences in scores in the experimental group. Additionally, blood pressure, body mass index, and waist circumference had significantly decreased prepost- test difference levels in the experimental group. Walking as an exercise (which consisted of days walked, number of steps walked, and amount of time walked) had significantly increased in the experimental group after 7~12 weeks in the period following the intervention program rather than 1~6 weeks after the program.
Conclusion
The smart phone app-based walking exercise program based on the self-efficacy theory demonstrates a significant effect on improving self-efficacy, outcome expectations physical activities, and health-related quality of life for taxi drivers. Therefore, it is recommended to actively use the program as a tool to promote self-efficacy, physical activities, and health behaviors in taxi drivers.
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Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life
Yeonjung Lim, Haejung Lee, Do Hyung Kim, Yeong Dae Kim
J Korean Acad Nurs 2020;50(1):66-80.   Published online January 31, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.1.66
AbstractAbstract PDF
Abstract Purpose:

This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.

Methods:

This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ2 test, Fisher’s exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE).

Results:

There were significant differences between the two groups regarding SEE (χ2=13.53, p=.009), PA (χ2=9.51, p=.049), functional status (χ2=10.55, p=.032), and 6MWD (χ2=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.

Conclusion

The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

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Latent Class Analysis for Health-Related Quality of Life in the Middle-Aged Male in South Korea
Youngsuk Cho, Dong Moon Yeum
J Korean Acad Nurs 2019;49(1):104-112.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.104
AbstractAbstract PDF
Purpose

This study aimed to identify types of quality of life (QoL) based on the 5 dimensions of EQ-5D and predict factors affecting types of QoL.

Methods

This study was a secondary analysis using data from the Korean Health Panel Survey- II(2012). Participants were 2,071 middle-aged men who had completed the additional survey in 2012 and the data were analyzed using SPSS 20.0 and Mplus 5.21 for latent analysis.

Results

Three latent classes of QoL were identified: serious (2.4% of the sample), threatened (15.5%), and stable types (82.0%). The types and characteristics of QoL among the latent classes differed. On comparing latent type 1 with latent type 2, the socioeconomic status (p<.05), employment status (p<.05), and subjective health status (p<.001) were found to be significant. On comparing latent type 1 with latent type 3, the socioeconomic status (p<.05), current smoking status (p<.001), and subjective health status (p<.001) were found to be significant. On comparing latent type 2 with latent type 3, the socioeconomic status (p<.05), subjective health status (p<.001), stress (p<.001) were found to be significant.

Conclusion

The results showed significant heterogeneity in types of QoL and the predictors of QoL by types were different. These findings provide basic information for developing nursing interventions to improve QoL. Specific characteristics depending on the subtypes should be considered during the development of interventions.

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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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Mediation Effect of Self-Efficacy on the Relationship between Perceived Self-Management Support and Health-Related Quality of Life among Cancer Survivors
Bo Gyeong Lee, Tae Sook Lee, Soo Hyun Kim
J Korean Acad Nurs 2019;49(3):298-306.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.3.298
AbstractAbstract PDF
Abstract Purpose

This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL.

Methods

This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors’ Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation.

Results

The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (β=.55, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001).

Conclusion

The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.

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The Effect of the Intergenerational Exchange Program for Older Adults and Young Children in the Community Using the Traditional Play
Min-Jung Choi, Kyeong-Yae Sohng
J Korean Acad Nurs 2018;48(6):743-753.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.6.743
AbstractAbstract PDF
Abstract Purpose

This study aimed to explore the effects of a community-based first and third Intergenerational Exchange Program (IGEP) on older adults’ health-related quality of life (HRQoL), loneliness, depression, and walking speed, and on 4~5-year-old preschool children's learning-related social skills.

Methods

This study employed a non-equivalent control group pre-post-test design. The experimental group included 42 older adults and 42 children who participated in the IGEP for 8 weeks, and the control group included 39 older adults. The experimental group participated in the IGEP once a week for 8 weeks. It comprised a traditional play program based on the intergroup contact theory.

Results

Compared to the control group, there was a significant increase in scores on the HRQoL-Visual analogue scale (VAS) and a decrease in loneliness and depression in older adults in the experimental group (p<.05). Children who participated in the IGEP showed an improvement in their learning-related social skills (p<.001).

Conclusion

These results confirm that the IGEP is an effective intervention to improve HRQoL-VAS, loneliness, and depression among older adults and learning-related social skills among preschool children in the community.

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Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer
Jin-Hee Park, Mison Chun, Yong Sik Jung, Sun Hyoung Bae, Young-Mi Jung
J Korean Acad Nurs 2018;48(6):669-678.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.6.669
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer.

Methods

A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast.

Results

Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group.

Conclusion

These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

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Structural Equation Model of Health-Related Quality of Life in School Age Children with Asthma
Yunsoo Kim, Ho Ran Park
J Korean Acad Nurs 2018;48(1):96-108.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.96
AbstractAbstract PDF
Abstract Purpose

This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary.

Methods

Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support. The endogenous variables were asthma self-efficacy, asthma symptom control, perceived health status, parental quality of life, and children's quality of life. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed.

Results

Eighteen of the twenty-four hypotheses selected for the hypothetical model were attentive and supported statistically. Quality of life was explained by asthma self-efficacy, asthma symptom control, perceived health, parental quality of life, and asthma knowledge with 83.5%.

Conclusion

Strategies for promoting self-efficacy and enforcing asthma knowledge will be helpful for the improvement of health-related quality of life with school-aged asthmatic children.

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Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy
Yeong Kyong Oh, Seon Young Hwang
J Korean Acad Nurs 2018;48(1):50-58.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.50
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Abstract Purpose

The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients.

Methods

This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis.

Results

Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (b=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (b=.17, p=.026), social well-being (SWB) (b=.49, p=.010), and functional well-being (FWB) (b=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (b=-.07, p=.024), SWB (b=-.19, p=.008), and FWB (b=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB.

Conclusion

Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.

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Effects of Active Mandibular Exercise for Mouth Opening Limitation Patients after Maxillomandibular Fixation Release: A Non-Randomized Controlled Trial
Hyo Jin Jang, Myung Hee Kim
J Korean Acad Nurs 2018;48(1):26-37.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.26
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Abstract Purpose

The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release.

Methods

The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth.

Results

The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group.

Conclusion

The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

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The Effects of Mobile Social Networking Service-Based Cognitive Behavior Therapy on Insomnia in Nurses
Ji Eun Kim, Suk-Sun Kim
J Korean Acad Nurs 2017;47(4):476-487.   Published online August 31, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.4.476
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Purpose

This study aimed to examine the effects of cognitive behavior therapy for insomnia (CBT-I) based on the mobile social networking service (SNS) on dysfunctional beliefs and attitudes about sleep, sleep quality, daytime sleepiness, depression, and quality of life among rotating-shift nurses in a hospital in Korea.

Methods

A nonequivalent control group pre-post test design was used. The participants included 55 nurses with rotating three-shift work (25 in the experimental group and 30 in the control group). For the experimental group, CBT-I using mobile SNS was provided once a week for 60 minutes over six weeks. Data were analyzed using descriptive statistics, χ2-test, independent samples t-test, and Mann-whitney U test with the SPSS 21.0 program.

Results

In the homogeneity test of the general characteristics and study variables, there were no significant differences between the two groups. Nurses in the experimental group had significantly lower scores on dysfunctional beliefs and attitudes regarding sleep and sleepiness than nurses in the control group. Nurses in the experimental group had significantly higher scores on sleep quality and quality of life than nurses in the control group.

Conclusion

These findings indicate that using the mobile SNS-based CBT-I is feasible and has significant and positive treatment-related effects on rotating-shift nurses' irrational thoughts and beliefs in association with sleep, sleep quality, daytime sleepiness, and quality of life. These contribute to expanding our knowledge of rotating-shift nurses' sleep issues and their preferences for intervention.

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Correlational Study on Management of Menopause, Marital Satisfaction, and Quality of Life in Middle-aged Women
Jung Hee Yeo
Journal of Korean Academy of Nursing 2004;34(2):261-269.   Published online April 6, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.2.261
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Purpose

This study was to examine the correlations among management of menopause, marital satisfaction, and quality of life in middle-aged women.

Method

The sample was 158 middle-aged women who were 40-64 years. Data were collected from June 14 to July 10, 2003 using questionnaires and were analyzed by using the SPSS 10.0 PC+ program.

Result

The level of marital satisfaction was related positively to the level of quality of life(r=.504, p<.01) and management of menopause(r=.315, p<.01). In addition, there were significant correlations between the level of quality of life and management of menopause(r=.251, <.01). In stepwise multiple regression analysis, 25.9% of the variance in quality of life was explained by marital satisfaction.

Conclusion

Marital satisfaction and management of menopause serve to improve the quality of life of middle-aged women. It is necessary to develop an effective intervention program to improve marital satisfaction and management of menopause.

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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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A Study on Self-esteem, Coping Type and the Quality of Life in Mothers of Handicapped Children
Mi Kyung Sim
Journal of Nurses Academic Society 1997;27(3):673-682.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.673
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The purpose of this study was to examine the relationship between self-esteem and quality of life(QOL) and between coping type and quality of life (QOL) in mothers of handicapped children and further to identify the level of self-esteem and quality of life of the subjects. The subjects of this study were the 51 mothers of handicapped children who were registered in two special schools in Taejon. The data were collected using a questionnaire and the period of the data collection was from April 18th to May 26th, 1997. The instruments for this study were Resenberg's self-esteem scale, Folkman and Lazarus's Ways of Coping Checklist(WCC) and the quality of life scale designed by Ro, You Ja. The results were analyzed using SPSS/PC+. Data analysis included the descriptive correlational statistics of ANOVA, Pearson Correlational Coefficient, and t-test. The results are as follows : 1. The level of self-esteem showed a mean score 34.51 and the level of QOL, a mean score 137.55. An Active type of coping was used more often than a passive one. 2. The level of self-esteem differed according to monthly income and was significantly higher in mothers of children with acquired handicaps than those of children with congenital handicaps. The level of QOL differed according to monthly income. 3. There was positive correlation between health status and self-esteem(r=.355, p<.05), and between health status and QOL(r=.367, p<.01). 4. Test for hypothesis ; Hypothesis 1, "The higher the level of self-esteem in mothers of handicapped children, the higher their level of quality of life will be." was supported(r=.755, p<.001). Hypothesis 2, "The QOL level for the active coping group as compared to the passive coping group will be higher." was not supported.

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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
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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 Quality of Life in Individuals with Rheumatoid Arthritis
Hyun Soo Oh, Young Ran Kim
Journal of Nurses Academic Society 1997;27(3):614-626.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.614
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The main purposes of the study were to develop and test a model which explains the dynamic relationship among factors reported as affecting to the quality of life of individuals with rheumatoid arthritis and to examine the relationship between self-help response and quality of life. Data for the study were collected from March 1996 to December 1996 from 153 female patients who regularly visited a clinic for people with rheumatism. The Patients were introduced to the investigators by nurses who worked at that clinic, and then the investigator interviewed the patients for 30 to 40 minutes to collect the data. Instruments used in the study were modified self-report questionnaires from the ones which were already developed in previous studies of from related literature. Data analysis were performed using LISREL(Lineal Structural Relations) 8 Program to test whether the proposed hypothesized model fit the collected data. To test fitablity of the hypothesized model both a general fit measure and a detailed fit measure were used. Based on the test results from the various fit measures, the hypothesized model was found to be well suited to the real data. As characteristics related to illness becomes severe, the feasibility for uncertainty about the illness tend to increase, but, the direct effects from the illness characteristics(such as level of physical symptoms, sense of social-psychologic change, limitations of action) as they are related to the other intrinsic variables(self-efficacy or self-help behavior and quality of life), were found to be not significant. It was found that uncertainty had a direct effect on self-efficacy but did not have a direct effect on self-help behavior or quality of life. Also, it is noted that self-efficacy had a positive effect on self-help behavior and quality of life and there was a bilateral relationship between self-efficacy and self-help behavior. Lastly, the hypothesis proposed from the theoretical model in this study was supported basis of the results that self-help behavior provides both direct and positive effects to quality of life. Particularity, since a bilateral relationship was also found between self-help behavior and quality of life in the modified model, as self-help behavior increased, so did quality of life. And, reversely, as quality of life increased, so did self-help behavior. In conclusion, the results of this study suggest that focusing on both acquirement and reinforcement of adjustment factors or self-help behavior is more efficient than focusing on the characteristics of illness in establishing the strategies for improving quality of life of individuals with rheumatoid arthritis.

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Changes in Fatigue and the Quality of Life of Cancer Patients Receiving Radiotherapy
Eun Sook Lee, Jucia Jo
Journal of Nurses Academic Society 1997;27(3):489-502.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.489
AbstractAbstract PDF

Quality of life(QOL) and fatigue in cancer patients receiving the radiotherapy was assessed. The subjects were 46 cancer patients who daily attended the radiotherapy department. Assessment was done on four occasions ; the first assessment was done on the treatment simulation visit, the second one was four week after treatment started, the third one at the completion of treatment and the last assessment was done between six and eight week following treatment. The results are as follows : The fatigue scores of the patients at each stage of assessment ranged from 5.49 points to 7.67 points and highest score was recorded at the third assessment hat is, at the completion of treatment. The fatigue points showed an increase from the 1st. to 3rd. stage. However, at the 4th. stage, fatigue points decreased to the level at the first stage, fatigue points decreased to the level at the first stage of assessment. QOL were assessed in three areas namely, physical, emotional and social/functional. The QOL scores in the physical area showed the highest score, followed by social/functional and emotional areas. The QOL scores decreased gradually to the third. stage of assessment thereafter recovered to the level of the first. stage. Correlation between QOL and fatigue scores during the treatment indicated that the level of QOL decreased as the level of fatigue increased. In particular, fatigue persisted after completion of the treatment and showed a significantly negative correlation with QOL. The present study strongly suggests that a strategy to restore the emotional well being level of the patient should be devised in order to improve QOL and reduce fatigue of patients receiving radiotherapy.

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A Study, on the Quality, of Life, Family, Support and Hope of Hospitalized and Home Care Cancer Patients
Kae Wha Jo, Myung Ja Kim
Journal of Nurses Academic Society 1997;27(2):353-363.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.353
AbstractAbstract PDF

With the occurrence of cancer, most cancer patients experience various emotional changes such as anxiety, depression, and emotional shock. Especially in our country, cancer has been recognized as an incurable disease resulting in death. The number of cancer patients increases daily. But as the survival rate of cancer patients is also increasing, there is a need to find the better methods of nursing care for cancer patients. The purposes of this paper are as follows : 1) To understand family support and hope and quality of life for the cancer patient both during hospitalization and at home. 2) To determine the relationship between family support, hope and quality of life. To examine the problems, we used a questionnaire and obtained data form the records of 45 home care and 94 hospitalized(in 3 university hospitals) Patients in Taegu area from the period of June 15 to August 15, 1996. SPSS /PC was used for the data analysis and the statistical methods used were the T-test and ANOVA. The results of this paper are as follow : 1 ) In the aspect of family support, there is no difference between hospitalized and home care cancer patients(t=1.63, P>0.01 ). 2) In the aspect of hope, hospitalized cancer patients have a higher score than home care cancer patients (t=3.08, P>0.01 ) 3) In the aspect of quality of life, hospitalized cancer patients have a higher score than home care patients(t=2.96, P<.01). 4) There is a correlation between quality of life and hope with a correlation coefficient r=0.5199 and P=0.000. In addition. the correlation coefficient between quality of life and family support is 4179 with P =0.000. 5) The family support of the cancer patient is influenced by sex(F=9.1863, P<0.01), education(F=4.3641, P<0.01) and the level of life (F=5.5002, P<0.01 ). 6) The hope of cancer patients is influenced by the number of hospitalizations (F=3.6413, P<.05), education(F=B.01 13, P<.01 ) and the level of life (F=5.0649, P <.01 ). 7) The quality of life of cancer patients is influenced by the number of hospitalization( F=5.1167, P<0.05), education( F=3.1590, P<0.01 ) and the level of life (F=5.6942, P<1.01 ).

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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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An Effect of Muscle Strengthening Exercise Program on Muscle Strength, Pain, Depression, Self-efficacy, and Quality of Life of Patients with Knee Osteoarthritis
Mi Ra Lee
Journal of Nurses Academic Society 1996;26(3):556-575.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.3.556
AbstractAbstract PDF

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

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