The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD).

A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events.

Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events.

Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.

Understanding daily life experiences of patients admitted to hospital with recurrent breast cancer.

The grounded theory method was used for this study.

Consistent comparative analysis was used throughout the study to obtain the results. Results showed that inpatients with recurrent breast cancer experience 'a co-existence of life suffering and fear of death'. The causal condition of this result was determined to be 'patient's response to cancer recurrence (acceptance/despair)', including contextual conditions such as, 'previous experience with cancer treatment', 'patient's current physical condition', and 'treatment methods for recurrent cancer'. Intervening conditions, such as 'a strong will to live', 'family support', 'moral support providers', and action/interaction strategies were found to provide patients with 'a strength to live'. Shown in these results, inpatients with recurrent breast cancer were seen to have a simultaneous 'hope for life and fear of death'.

When providing nursing services to inpatients with recurrent breast cancer, people must recognize there is a notable difference between individual patients' contextual conditions and interactive strategies. Henceforth, proper cognitive nursing must be provided which encourages patients to maintain a strong will to overcome the many hardships of treatment as well as physical nursing, such as management of side effects caused by chemotherapy.

This study was conducted to develop and to determine the effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention.

Subjects consisted of 58 CAD patients (experimental group: 30, control group: 28). The experimental group participated in an integrated symptom management program for 6 months which was composed of tailored education, stress management, exercise, diet, deep breathing, music therapy, periodical telephone monitoring and a daily log. The control group received the usual care.

The experimental group significantly decreased symptom experiences and the level of LDL compared to the control group. The experimental group significantly increased self care activity and quality of life compared to the control group. Although no significant difference was found in cardiac recurrence, the experimental group had fewer recurrences.

These results suggest that an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention can improve symptom aggravation, recurrent rate, self care activity and quality of life. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented in the overall transition period.

This study was to identify behaviors preventing the recurrence of breast cancer and the level of quality of life.

This descriptive study was conducted using a structured questionnaire from November 1, 2006 to December 25, 2006 . One hundred and twenty two women breast cancer survivors were recruited by convenience sampling.

The most frequent behavior for preventing recurrence of the breast cancer was dietary treatment (90.9%) and exercise (86.8%) was the second behavior. In addition, most of them perceived these behaviors as 'very effective' (82.8%). The degree of the quality of life of a breast cancer survivor was 5.34 point indicating a 'medium level'.

Breast cancer survivors pursued various behaviors for preventing recurrence of breast cancer. Therefore, the nursing interventions should be focused on a systematic educational approach considering healthy behaviors to prevent breast cancer recurrence for breast cancer survivors.