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Impact of Bowel Function, Anxiety and Depression on Quality of Life in Patients with Sphincter-preserving Resection for Rectal Cancer
Hyun Jun Kwoun, Yun Hee Shin
J Korean Acad Nurs 2015;45(5):733-741.   Published online October 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.5.733
AbstractAbstract PDF
Purpose

This study was a descriptive survey research to identify the impact of bowel function, anxiety and depression on quality of life in patients with rectal cancer who had a sphincter-preserving resection.

Methods

articipants were 100 patients who had rectal cancer surgery at W hospital in Korea. Bowel function, anxiety & depression, and quality of life were measured using the BFI (Bowel Function Instrument), HADS (Hospital Anxiety-Depression Scale) and the FACT-C (Functional Assessment of Cancer Therapy-Colorectal).

Results

The mean scores were 39.81±5.16 for bowel function, 6.15±3.25 for anxiety, 7.24±3.13 for depression, and 72.50±13.27 for quality of life. There were significant negative correlations between quality of life and anxiety (r= -.59, p <.001) and between quality of life and depression (r= -.53, p <.001). But the correlation between quality of life and bowel function was significantly positive (r=.22, p =.025). The influence of the independent variables on the total quality of life was examined using multiple regression analysis. Anxiety (β= -.38, p =.002), bowel function (β= -.25, p =.028) and occupation (β=.16, p =.048) were identified as factors affecting quality of life. The explanation power of this regression model was 44% and it was statistically significant (F=16.53, p <.001).

Conclusion

The results of this study indicate that in order to improve the bowel function of patients after sphincter-preserving resection for rectal cancer, effective nursing interventions should be developed. As psychological problem such as anxiety and depression can relate to quality of life for these patients, nurses should work on improving the situation by providing continuous emotional nursing.

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Factors Influencing Quality of Life during Chemotherapy for Colorectal Cancer Patients in South Korea
Yongae Baek, Myungsun Yi
J Korean Acad Nurs 2015;45(4):604-612.   Published online August 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.4.604
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the levels of physical symptoms, anxiety, depression, and quality of life (QOL) during chemotherapy for colorectal cancer patients in South Korea and to identify factors influencing their QOL.

Methods

Data were collected from 144 colorectal cancer patients receiving chemotherapy during 2012 at one general hospital located in Seoul. Physical symptoms were measured by the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, and anxiety and depression were measured by the Hospital Anxiety Depression Scale. QOL was measured by the Functional Assessment of Cancer Therapy-Colorectal. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Scheffé post hoc test, Pearson correlation and stepwise multiple regression.

Results

Mean age of the participants was 56.6 and most of them were not employed. In terms of cancer stage, 38.2% were in stage 3, followed by stage 4 (34.7%). The most frequent symptom was lack of appetite, followed by sleep disturbance and fatigue. The mean score for anxiety was 5.40 with a prevalence of 23% and that of depression 8.85 with a prevalence of 64.6%. The mean score for quality of life was 81.93 out of 136 and 75.3% of the variance in QOL was explained by depression, symptoms, anxiety, treatment place, and occupational status. Depression was the strongest predictive factor.

Conclusion

Oncology professionals need to pay special attention to relieving depression as well as physical symptoms to improve QOL during chemotherapy for colorectal cancer patients.

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Cross-cultural Validation of Instruments Measuring Health Beliefs about Colorectal Cancer Screening among Korean Americans
Shin-Young Lee, Eunice E. Lee
J Korean Acad Nurs 2015;45(1):129-138.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.129
AbstractAbstract PDF
Purpose

The purpose of this study was to report the instrument modification and validation processes to make existing health belief model scales culturally appropriate for Korean Americans (KAs) regarding colorectal cancer (CRC) screening utilization.

Methods

Instrument translation, individual interviews using cognitive interviewing, and expert reviews were conducted during the instrument modification phase, and a pilot test and a cross-sectional survey were conducted during the instrument validation phase. Data analyses of the cross-sectional survey included internal consistency and construct validity using exploratory and confirmatory factor analysis.

Results

The main issues identified during the instrument modification phase were (a) cultural and linguistic translation issues and (b) newly developed items reflecting Korean cultural barriers. Cross-sectional survey analyses during the instrument validation phase revealed that all scales demonstrate good internal consistency reliability (Cronbach's alpha=.72~.88). Exploratory factor analysis showed that susceptibility and severity loaded on the same factor, which may indicate a threat variable. Items with low factor loadings in the confirmatory factor analysis may relate to (a) lack of knowledge about fecal occult blood testing and (b) multiple dimensions of the subscales.

Conclusion

Methodological, sequential processes of instrument modification and validation, including translation, individual interviews, expert reviews, pilot testing and a cross-sectional survey, were provided in this study. The findings indicate that existing instruments need to be examined for CRC screening research involving KAs.

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Effects of Individualized Nutritional Education Programs on the Level of Nutrient Intake and Nutritional Status of Colorectal Cancer Patients Undergoing Palliative Chemotherapy
Kwi Ock Park, Smi Choi-Kwon
J Korean Acad Nurs 2012;42(6):799-809.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.6.799
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of an individualized nutritional education programs on nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.

Methods

Forty patients with colorectal cancer (19 experimental and 21 control patients) were recruited from a chemotherapy ward at S University Hospital in Seoul, Korea. The experimental group received two individualized nutritional counseling sessions and two telephone counseling sessions over 6 weeks. The control group received nutritional counseling after completion of data collection. Nutritional education included general guidelines for food intake while receiving chemotherapy, dietary guidelines for patients with colorectal cancer, daily meal schedules to overcome cancer, and dietary guideline for each chemotherapy side effect. Data were analyzed using χ2-test and t-test with the SPSS program 17.0.

Results

Two group comparison revealed that the experimental group had significantly improved calorie (p=.038) and total protein intake (p=.001), and serum albumin percentage change (p=.040). Body weight did not increase but remained the same as the baseline in both groups.

Conclusion

Study results indicate that this individualized nutritional education programs are effective in enhancing nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.

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Body Fat Percentage and Natural Killer Cell Activity of Breast and Rectal Cancer Patients after Diagnosis but before Treatment
Dal Sook Kim, Myung Hee Jun
Journal of Korean Academy of Nursing 2008;38(2):321-331.   Published online April 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.2.321
AbstractAbstract PDF
Purpose

To examine the relationship between body fat percentage (BFP) and N-K cell activity (NKCA) in Korean breast and rectal cancer patients just after diagnosis.

Methods

With 35 subjects enrolled between November 2002 and May 2003, Bioelectrical Impedance Analysis was used to estimate BFP. FACS Analysis was used to measure N-K cell activity. The relationships between BFP and NKCA were identified by using curve estimation, simple regression, and multiple regression.

Results

The mean BFPs of the subjects and all the sub-groups were higher than acceptable BFPs. Both the mean NKCAs of male and female subjects were lower than that of healthy women. NKCA was explained by BFP with a 14.9% variance in the total subjects (p<.05). There were significant negative relationships between BFP and NKCA after controlling age, type of cancer, and stage of cancer while no significant relationship was found after controlling for gender. The relationships between BFP and NKCA in the sub-groups of female, breast cancer, and stage I, and II were significant. The relationships between male, rectal cancer, and the stage III, and VI sub-groups were not identified, but they revealed a mild to moderate steep in curve estimation.

Conclusion

Weight reduction could prevent the risk and advancement of breast and rectal cancer in Koreans.

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