Journal of Korean Academy of Nursing

Review Papers

Exploring Symptom Cluster Patterns in Adult Cancer Patients Undergoing Chemotherapy: A Systematic Review: Pan Yang, Hui-juan Mei, Hao-yu Zhao, Rong-rong Wu, Yong-qin Ge, Yin Lu; J Korean Acad Nurs 2024;54(4):478-494. Published online November 25, 2024; DOI: https://doi.org/10.4040/jkan.24041

Abstract PDF Supplementary Material ePub: Purpose
This systematic review aimed to scrutinize the progression of symptom cluster research in adult cancer patients who received primary or adjuvant chemotherapy between 2001 and 2023, providing a comprehensive understanding of clinical practice and future research.
Methods
PubMed, Ovid MEDLINE, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and Web of Science databases were searched for theme words and free words related to symptom clusters, cancer, and chemotherapy. Eligible studies were published between January 1, 2001, and May 30, 2023; adults who were diagnosed with cancer and received primary or adjuvant chemotherapy were evaluated.
Results
Twenty-eight studies were included in this review. The Memorial Symptom Assessment Scale emerged as the predominant instrument and exploratory factor analysis was the most frequently employed statistical method to identify symptom clusters. Psychological, gastrointestinal, and physical image symptom clusters were the most commonly delineated. Furthermore, the temporal stability of the symptom clusters showed varying dynamics, with psychological symptom clusters displaying relative consistency over time.
Conclusion
Interventions are needed for the most common and stable symptoms in patients with cancer undergoing chemotherapy. Future endeavors may necessitate more longitudinal studies to delve deeper into the temporal stability and dynamic variations of symptom clusters. Such investigations hold promise for advancing symptom cluster research, elucidating the underlying mechanisms, and fostering the development of targeted interventions, thereby enriching the symptom management paradigm in oncological care.

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Effect of Auriculotherapy on Musculoskeletal Pain: A Systematic Review and Meta-Analysis: Choi, Sun Yeob , Kim, Yeo Ju , Kim, Bomi; J Korean Acad Nurs 2022;52(1):4-23. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21121

Purpose
The aim of this study was to evaluate the effect of auriculotherapy on musculoskeletal pain in adults.
Methods
A total of 885 studies were retrieved from nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS). Sixteen studies were selected for meta-analysis, which satisfied the inclusion criteria and the evaluation of risk of bias. Demographic data, auriculotherapy types, intervention characteristics, auricular points, and outcomes related to pain (subjective pain scale, and amount of analgesic) were extracted from all included studies. The effect size of auriculotherapy was analyzed through comprehensive meta analysis 3.0, and the presence of publication bias was analyzed through a funnel plot and Egger’s regression.
Results
The results of the meta-analysis (n = 16) revealed that the auriculotherapy was significantly superior to the control group on present pain in adults (Hedges’ g = - 0.35, 95% Confidence Interval [CI] = - 0.55~- 0.15). According to the results of subgroup analysis, the effect size of auricular acupuncture therapy (Hedges’ g = 0.45, 95% CI = - 0.75~- 0.15) was higher than the auricular acupuncture (Hedges’ g = 0.27, 95% CI = - 0.53~0.00): the longer the intervention period, the greater the effect size.
Conclusion
In this study, auriculotherapy demonstrates a significant reduction in musculoskeletal pain in adults. Therefore, it is necessary to refine the curriculum to include auriculotherapy as a nursing intervention to relieve musculoskeletal pain in adults and encourage its use in clinical settings.

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Hyunseo Sim, Younghee Park
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Yuna Cho, Eunmi Cho, Eunseol Cho, Yeonju Chae, Eunkyung Choi, Hyeongyeong Yoon
Pain Management Nursing.2025; 26(1): e59. CrossRef
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The effects of auricular acupressure on blood pressure, stress, and sleep in elders with essential hypertension: a randomized single-blind sham-controlled trial
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Research Paper

Effects of a Cognitive Behavior Therapy Program for Patients with Fibromyalgia Syndrome: A Randomized Controlled Trial: Kong, Kyoung Ran , Lee, Eun Nam; J Korean Acad Nurs 2021;51(3):347-362. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21025

Abstract PDF

Purpose
This study developed a cognitive behavioral therapy program aimed at altering the physical condition, emotions, and behaviors of fibromyalgia patients, and confirmed the program’s clinical applicability. The program was developed by analyzing previous studies conducting in-depth interviews with fibromyalgia patients, drawing on cognitive behavior theory to establish the program contents, recruiting experts to test its validity, and conducting a preliminary survey.
Methods
To confirm the program’s effect, this study used a randomized controlled trial design. The participants were outpatients diagnosed with fibromyalgia in Dong-A University Hospital, Busan. The 30 patients in the experimental group took part in the program, which comprised 8 sessions (90 to 120 minutes) based on cognitive behavior theory, delivered over 8 weeks. Hypothesis testing was carried out using the repeated measures ANOVA.
Results
The analysis revealed significant differences between the experimental and control groups in positive automatic thoughts, pain, fatigue, depression, and interpersonal relationships. However, there was no significant difference between the groups in terms of sleep disorders and negative automatic thoughts.
Conclusion
This program is a positive effect on physical condition, emotions, and behaviors. It is thus expected to be used to help fibromyalgia patients improve their disease conditions.

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Original Article

Effects of Oral Gargling with Aroma Solution in Psychiatric Inpatients: A Non-Randomized Controlled Trial: Jung, Yun Ah , Kim, Hee Sook; J Korean Acad Nurs 2020;50(2):200-209. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.200

Abstract PDF

Purpose
The purpose of this study was to examine the effects of oral gargling with an aromatic solution on xerostomia, objective oral status, and oral health-related quality of life in psychiatric inpatients.
Methods
A nonequivalent control group with a non-synchronized design was used in this study. The experimental group (n=34) received oral gargling with an aroma solution, while the control group (n=33) gargled with 0.9% normal saline. Dependent variables were measured at pre-, post-, and follow-up test. Data were analyzed using an c2-test, Fisher’s exact probability test, t-tests, and repeated measures ANOVA using SPSS/WIN v.21.0.
Results
After the intervention, significant differences were revealed in xerostomia (F=15.30, p <.001), objective oral status (F=38.44, p <.001), and oral health-related quality of life (F=62.70, p <.001) with an interaction effect between group and time.
Conclusion
These findings indicate that gargling with an aroma solution is more effective than 0.9% normal saline for the oral health of psychiatric inpatients. Therefore gargling with an aroma can be safely recommended as a brief, economical, and positive intervention in clinical settings.

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The impact of aromatherapy-based oral care on oral conditions, salivary pH, and halitosis in older adults with dementia: Pilot study
Ae Kyung Chang, Bo kyoung Kim, Ah Young Kim
Geriatric Nursing.2023; 53: 109. CrossRef

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Review Article

Effects of Aromatherapy on Sleep Quality: A Systematic Review and Meta-Analysis: Mi-Eun Kim, Ji Hee Jun, Muyng-Haeng Hur; J Korean Acad Nurs 2019;49(6):655-676. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.655

Abstract PDF

Purpose

The purpose of this study was to investigate the effects of aromatherapy on sleep quality.

Methods

This is a systematic review of randomized controlled trial studies (PROSPERO registration number CRD42017064519). In this study, the PICO were adults and the elderly, aromatherapy intervention, a comparative intervention with the control and placebo oil groups, and sleep. The selected articles were in English, Korean, and Chinese.

Results

The results of the meta-analysis showed that the effect sizes of the experimental group were 1.03 (n=763, SMD=1.03, 95% CI 0.66 to 1.39) (Z=5.47, p<.001). In the aromatherapy intervention group, the effect size of sleep was statistically significant (Q_B=9.39, df=2, p=.009), with a difference of 0.77 for inhalation, 1.12 for oral intake and 2.05 for massage. A post-analysis showed that the effect of massage on sleep was significantly greater than the inhalation method. The regression coefficient of the intervention period, B=0.01 (Z=1.43, p=.154), also showed that the longer the intervention period, the larger the effect size; however, it was not statistically significant.

Conclusion

A total of 23 literature analyses showed that aromatherapy is effective in improving quality of sleep, and the massage method is more effective in improving quality of sleep than the inhalation method. A meta-ANOVA showed that the aromatherapy intervention affected the high heterogeneity of the effect size. Thus, future research with stricter control in methods and experimental procedures is necessary.

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Original Articles

The Effects of Oral Cryotherapy on Oral Mucositis, Reactive Oxygen Series, Inflammatory Cytokines, and Oral Comfort in Gynecologic Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial: Nayeon Shin, Younhee Kang; J Korean Acad Nurs 2019;49(2):149-160. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.149

Abstract PDF

Purpose

The purpose of this study was to examine the effects of oral cryotherapy on oral mucositis, reactive oxygen series, inflammatory cytokines, and oral comfort in patients undergoing chemotherapy for gynecologic cancers.

Methods

Participants were randomly assigned to the experimental group (n=25, receiving oral cryotherapy during chemotherapy) and the control group (n=25, receiving the usual care consisting of 0.9% normal saline gargles three times before meals). Oral mucositis was assessed using the oral assessment guide, while oral comfort was assessed using the oral perception guide. Reactive oxygen series was measured as total oxidant stress, and the level of two inflammatory markers, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), were examined. The data were analyzed using t-test, chi-square test, Fisher's exact test, Mann-Whitney U-test, and repeated measures analysis of variance.

Results

There was a significant difference in the oral mucositis score, reactive oxygen series score, TNF-α level, and oral comfort score between the two groups, and there were significant changes over time and in the group-by-time interactions. There was a significant difference in the IL-6 score between the two groups, but there were no significant changes over time or in the group-by-time interactions.

Conclusion

The study results revealed that oral cryotherapy was more effective than the usual care regime of normal saline gargles for reducing oral mucositis, reactive oxygen series, and inflammatory cytokines and for improving oral comfort in gynecologic cancer patients undergoing chemotherapy.

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The Development and Evaluation of a Health Literacy-Adapted Self-Management Intervention for Elderly Cancer Patients Undergoing Chemotherapy: Yoon Sun Kim, Young Sook Tae, Kwuy-Im Jung; J Korean Acad Nurs 2019;49(4):472-485. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.472

Abstract PDF

Abstract Purpose

This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy.

Methods

The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants’ health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0.

Results

Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group.

Conclusion

The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

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The Effect of Group Education Reflecting Unmet Needs on Knowledge of Chemotherapy for Patients and Their Families Undergoing Chemotherapy: A One Group Pre-Post Design
Seyoung Lee, Hoyoung Kim, Nayeon Kim, Misun Yi, Ayoung Lee, Seonmi Cho, Minsun Nam, Juhee Cho
Asian Oncology Nursing.2024; 24(1): 42. CrossRef
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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

Abstract 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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The Effects of an Acceptance-Commitment Therapy Based Stress Management Program on Hospitalization Stress, Self-Efficacy and Psychological Well-Being of Inpatients with Schizophrenia: Jae Woon Lee, Jae Hyun Ha; J Korean Acad Nurs 2018;48(4):443-453. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.443

Abstract PDF

Abstract Purpose

The purpose of this study was to construct an acceptance-commitment therapy (ACT)-based stress management program for inpatients with schizophrenia and to examine its effects on hospitalization stress, self-efficacy, and psychological well-being.

Methods

A non-equivalent control group pretest-posttest design was used. Participants were 44 inpatients with a diagnosis of schizophrenia. The experimental group (n=22) received the ACT-based stress management program twice a week for a total of four weeks. The control group (n=22) received the usual care from their primary health care providers. The study was carried out from August 7 to September 1, 2017, and data were analyzed using IBM SPSS/WIN 22.0 with a Chi-square test, Fisher's exact test, and an independent t-test.

Results

The experimental group showed a significant decrease in hospitalization stress (t=5.09, p<.001) and an increase in self-efficacy (t=2.44, p=.019). However, there was no significant difference in psychological well-being between the two groups (t=0.13, p=.894).

Conclusion

The results of this study suggest that the ACT-based stress management program can be used as an effective mental health nursing intervention for hospitalization stress and self-efficacy for inpatients with schizophrenia.

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Effects of Group Rational Emotive Behavior Therapy on the Nurses’ Job Stress, Burnout, Job Satisfaction, Organizational Commitment and Turnover Intention: Hye-Lyun Kim, Sook-Hee Yoon; J Korean Acad Nurs 2018;48(4):432-442. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.432

Abstract PDF

Abstract Purpose

This study aimed to develop a Group REBT program with group counseling for nurses and test the effect of group counseling on their job stress, burnout, job satisfaction, organizational commitment, and turnover intention.

Methods

A quasi-experimental study with nonequivalent control group design was employed to identify the effect of the Group REBT program on nurses’ job stress, burnout, job satisfaction, organizational commitment, and turnover intention. Data were collected from 47 participants from two hospitals. The data from the experimental (n=23) and control (n=24) groups were analyzed from January 5 to April 3, 2015. The Group REBT program was conducted eight tmes in all, once a week, with each session lasting 180 minutes. The effect of experimental intervention was measured for each group using a series of structured questionnaires at each of the phases: Pre-intervention, post-intervention (immediately after intervention), and post-intervention (four weeks after intervention). Following this, the significance of the changes in the scores was tested.

Results

The scores of the experimental group, which received the Group REBT program, were compared with those of the control group; the hypotheses were supported in terms of job stress (F=8.85, p<.001), burnout (F=5.62, p=.022), job satisfaction (F=2.70, p=.042), organizational commitment (F=2.97, p=.048), and turnover intention (F=4.60, p=.012).

Conclusion

The Group REBT program was shown to be an effective intervention that could reduce nurses’ job stress and burnout and increase job satisfaction and organizational commitment. Therefore, the Group REBT program can be adopted by nursing organizations to strategically decrease nurses’ turnover intention.

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The Effects of Laughter Therapy Program on Perceived Stress, and Psycho-Neuro-Endocrino-Immuno Responses in Obese Women: Do Young Lee, Myung Sun Hyun; J Korean Acad Nurs 2018;48(3):298-310. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.298

Abstract PDF

Abstract Purpose

The purpose of this study was to examine the effects of the laughter therapy program on perceived stress and psycho-neuro-endocrine-immune responses in obese women.

Methods

A nonequivalent control group with a pretest-posttest design was used. The participants (n=60), whose age ranged from 30 to 50 years (pre-menopausal and body mass index of over 25 kg/m²), were assigned to the experimental group (n=24) or control group (n=26). The experimental group was provided with the laughter therapy program (12 sessions) for 6 weeks.

Results

There were significant differences in perceived stress, psychological stress response, fasting blood sugar, interleukin-6, and tumor necrosis factor alpha between the two groups after the program. However, there were no significant differences in normalized low frequency (norm LF), normalized high frequency (norm HF), LF/HF ratio, and cortisol between the two groups after the program.

Conclusion

It was found that the laughter therapy program had positive effects on some variables in terms of perceived stress and psycho-neuro-endocrine-immuno responses. It is suggested that the laughter therapy in this study can provide the direction for developing a program for obese women.

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Review Article

Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis: Pok-Ja Oh, You Lim Kim; J Korean Acad Nurs 2018;48(2):123-142. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.123

Abstract PDF

Abstract Purpose

This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN).

Methods

PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses.

Results

Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; I²=19%).Exercis-es were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN.

Conclusion

Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

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Original Articles

Effects of Aromatherapy on Stress Responses, Autonomic Nervous System Activity and Blood Pressure in the Patients Undergoing Coronary Angiography: A Non-Randomized Controlled Trial: Eun Jeong Song, Mi Young Lee; J Korean Acad Nurs 2018;48(1):1-11. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.1.1

Abstract PDF

Abstract Purpose

The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG).

Methods

A non-equivalent control group with a pretest-posttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney U Test and repeated-measures analysis of variance.

Results

Significant interactions in the high frequency of ANS (F=5.58, p=.005) were observed between group and time. Stress index (z=2.14, p=.016), systolic blood pressure (z=4.14, p<.005), and diastolic blood pressure (z=3.28, p=.001) were significantly different between the experimental and control groups after 4 hours of treatment II.

Conclusion

The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.

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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

Abstract PDF

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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Review Article

Effects of Psychoeducational Intervention for Cancer Survivors: A Systematic Review and Meta-Analysis: Jin-Hee Park, Sun Hyoung Bae; J Korean Acad Nurs 2017;47(2):143-163. Published online April 28, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.2.143

Abstract PDF Supplementary Material

Purpose

This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors.

Methods

Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs.

Results

Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress.

Conclusion

Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

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Original Articles

The Effects of prompted Voiding Therapy on Urinary Incontinence Control of Elderly Patients: Kyung Ja Lee, Mi Kyung Kim, Hee Young Song; Journal of Nurses Academic Society 1997;27(4):943-952. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.4.943

Abstract PDF: This study was done to analyze the effects of prompted voiding therapy on urinary incontinence in elderly patients in an elderly care hospital. Specifically, this study looks to evaluate the effects of prompted voiding as an intervention for improving independent voiding and also identified the relationship of urinary continence to cognitive, emotional, and physical factors. The study was based on a pre-experimental design used to evaluate the effects of prompted voiding therapy on an experimental group without a control group. An experimental group of 143 patients was selected through convenience sampling from patients in an elderly care hospital. The data was collected from November 4 to December 14, 1996. Prompted voiding therapy is a behavioral therapy for managing incontinence and it is applied to patients who are cognitively impaired and dependent. In this study, the patients were asked at each designated time whether or not they had to urinate. If they answered yes, they were either given a bedpan or were assisted to the bathroom, and if the patient answered no, their diaper was checked to determine whether or not it was wet. The results were then recorded on the patients urinary voiding record. The urinary voiding score based on the model presented by Burton(1984), Burke and Walsh(1992), Chenitz, Stone and Salisbury(1991 was modified and used as a tool in this study. After forty six out of the total of 143 patients were selected for interviews through random sampling the levels of cognitive functions, mental depression and ADL(activities of daily life) within the given time frame were measured. In this study, the cognitive function was measured using the scale developed by Kabhn, Goldfarb, Pollack and Peck(1960), elderly mental depression, using the tool developed by Sheikh and Yesavage(1986), and the ADL(activities of daily living, through the Barthel Index. The data was analyzed through SPSS windows for descriptive statistics, repeated measured ANOVA and Pearson's correlation. According to the results of the study, the application of the prompted voiding therapy can improve the voiding pattern of patients. It was shown especially that incontinence could be controlled by the intervention developed according to the individual voiding pattern. In terms of the relationship between cognitive function, mental depression and ADL and the voiding function score, a close correlation was not found. It was shown that urinary incontinence can be improved through therapy even though patients have problems with their cognitive, mental and physical functions.

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An Effect of Nursing-Logotherapy on Purpose in Life and Finding Meaning, and Hope of the patients of Mental Illness: Jong Ji Lee; Journal of Nurses Academic Society 1997;27(4):727-739. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.4.727

Abstract PDF

The purpose of this study was to present an effective nursing intervention for helping the patients of mental illness by determining the effect of nursing-logotherapy on purpose in life and finding meaning, and hope of the patients of mental illness by developing and applicating program of nursing-logotherapy. The data was collected from March to September in 1995, and its subjects were the patients of mental illness who was appropriate to the standard of this study among the patients of mental illness who hospitalized into Neuro-Psychiatric ward of M. and B. hospital located in Pusan area. They were all 60 subjects, thirty of them for an experimental group and the rest for a control group. The research design was an equivalent control group pre-test and post-test design as an quasiexpe-rimental research and the conceptual framework was an interpersonal model. The data analysis was computerized by using SP-SS/PC+ and hypothesis testing was done with 2-way ANCOVA and simple correlation. Results were summarized as follows : 1. There were significant changes of purpose in life and finding meaning in an experimental group before and after treatment and a control group before and after. 2. There were significant changes of hope in an experimental group before and after treatment and a control group before and after. 3. The positive correlation between purpose in life and finding meaning and hope of the patients of mental illness were observed. Consequently, nursing-logotherapy could significantly increase the purpose in life and finding meaning, and of hope, so it could be said an effective nursing intervention for helping the healing of the patients of mental illness.

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An Effect of Self: Care Education and Level of Resourcefulness on Active Coping in Patients with Chemotherapy: Soon Rim Suh; Journal of Nurses Academic Society 1997;27(3):639-647. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.3.639

Abstract PDF

The purpose of this study was to identify how internal and external coping resources influenced active coping in the process of stress-coping. The model was established theoretically by comparing and integrating the following theories : Stress-Coping, Self-Care, and Resourcefulness. The subjects consisted of sixty eight patients undergoing chemotherapy(experimental group 34, control group 34) at two general hospitals from January to July, 1995, The results were as follows : After self-care education, the active coping score of the experimental group was significantly higher than that of the control group. The active coping score of the high resourcefulness group was significantly higher than that of the low resourcefulness group. The interaction effect between self-care education and resourcfulness was not significant statistically. Specifically as to such scores of seeking social support, problem-oriented strategy and self care behavior, there were significantly higher in the experimental group and high resourcefulness group than in each of the other groups. Considering them both, self-care education and resourcefulness are effective nursing strategies to promote active coping including self-care. Consequently, the synthesis and testing of theories of stress-coping, self-care, and resoucefulness in this study are mostly proven to enhance the explanation and prediction of the change of active coping including self-care. Therefore the result of this study will contribute in the development of practice theory of nursing. A further study is necessary to reevaluate the interaction effect between self-care education and resourcefulness and to identify the difference between resourcefulness and self-efficacy.

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Hea-Kyoung Ko, Geum Ja Park
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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

Abstract 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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The Effect of Music Therapy on Anxiety in Neurotic Patients: So YaJa Kim, Keum Sun Han; Journal of Nurses Academic Society 1996;26(4):889-902. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.4.889

Abstract PDF

The purpose of this study was to identify the effects of music therapy on anxiety in neurotic patients. The subjects of the study were 41 patients that had been diagnosed as having anxiety disorder, neurotic depression, or somatization disorder and were admitted to one general hospital in Seoul. The 41 research subjects were assigned to an experimental (22 clients) and a control (19clients) group. Data were gathered from September. 25, 1995 to December. 15, 1995 using a questionnaire and physiological measurement tool. Data were analyzed with the SAS package using frequency, t-test, paired t-test and Pearson correlation coefficients. The results of this study are as follows; 1. There were significant differences between two groups on systolic and diastolic blood pressure, and pulse rate after treatment. In the experimental group, Systolic and diastolic blood pressure, and pulse rate decreased significantly after Music Therapy. 2. There were no significant differences between the two groups on the pre and post psychological anxiety score. But, after music therapy, experimental group had a lower psychological anxiety score than the control group. From these results, it is concluded that the music therapy can be effective in decreasing anxiety in neurotic patients.

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Effect of Music Therapy as Intervention on Peripheral Neuropathic Pain and Anxiety of Gynecologic Cancer Patients Undergoing Paclitaxel Chemotherapy
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Experimental Study for Construction of Mouth Care in Chemotherpy Patients: Young Soon Byun, Ae Kyung Kim; Journal of Nurses Academic Society 1996;26(2):428-442. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.2.428

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Stomatitis is a common toxicity associated with the administration of certain cancer chemoth-erapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to estabilish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subject were devided into three groups; control group: not gargling experimental group A: normal saline gargling (4 times a day) experimental group B: nystatine solution gar-gling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times (once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X2 test. The results are as follows; 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B. (X2=0.002 P=0.001) 2. The grade of stomatitis (mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A (F=1.96 P=0.0024). 3. In incidence of tougue change, control group, experimental group B were significantly higher than experimental group B(F=6.84 P=0.0039). 4. In control group and experimental group A, oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.

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Abstract PDF

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The Effects of Exercise Therapy and Exercise-Behavior Modification Therapy on Obesity, Blood Lipids, and Self-esteem of the Obese Middle-aged Women: In Hong Kim; Journal of Korean Academy of Nursing 2002;32(6):844-854. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.6.844

Abstract PDF

PURPOSE: To examine the effect of the exercise therapy, and exercise-behavior modifi- cation therapy on obesity, blood lipids and self-esteem of the obese middle-aged women. METHOD: A total of 35 middle-aged women (BMI: over 30) were selected for this research. Walking at a 50% intensity was administered 4 days a week for 12 weeks, while the behavior modification therapy performed for 60~90 minutes per week for 12 weeks. RESULT: Body weight and BMI has significantly reduced in the case of EG and E.BG. The result of comparing body weight between groups showed significant difference between EG and CG, and E.BG and CG whereas BMI showed significant difference between EG and CG only. TC, TG, LDL-C, %TC/HDL-C have shown significant decrease in EG and E-BG, while HDL-C displayed significant increase in EG and E.BG. And HDL-C showed significant decrease in CG. As for comparison between groups, significant difference was noted in EG and CG, and E.BG and CG at TC, HDL-C, LDL-C, and in EG and CG at %TC/HDL-C. Self-esteem displayed significant increase in EG and E.BG; however, there was no significant different in CG. As for comparison between groups, there was significant difference noted in E.BG and CG only. CONCLUSION: The results showed that the exercise therapy and the exercise-behavior modification therapy were effective in changing obesity, blood lipids and self-esteem of the obese middle-aged women.

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Effects of Group Art Therapy Program on Body Image and Self-esteem in College Women: Kil Soo Chung, Seoung Eun Lee; Journal of Korean Academy of Nursing 2002;32(5):743-755. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.5.743

Abstract PDF: PURPOSE: The purpose of the study was to determine the effects of the 8-week, 16-session group art therapy program on body image and self-esteem in college women. METHOD: Data collected by self-reported questionnaires from 58 college women in Inchon who were selected by criteria of this study, from the 6 of March to 10 of May, 2002. The 11 experimental group participated in a 8-week group art therapy program. Descriptive statistics, homogeneity test, hypothesis, and reliability test were performed statistically by utilizing SPSS PC+ 8.0 program. RESULT: 1. 'The experimental group showed significantly higher scores in body image than the comparison group. 2. No significant differences were found between two groups in self-esteem. CONCLUSION: The findings showed the possibility of applying group art therapy as an effective intervention for clients with negative body image to improve their body image.

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The Trajectory of Fatigue and Quality of Life in Stomach Cancer Patients Receiving Chemotherapy: Young Hee Yang; Journal of Korean Academy of Nursing 2002;32(4):482-491. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.4.482

Abstract PDF

PURPOSE: This study aimed to identify the change patterns of fatigue and quality of life during consecutive chemotherapies and to determine the relationship of these two variables. METHOD: Stomach cancer patients receiving chemotherapy were recruited from a university hospital in Seoul. Each chemotherapy, subjects were asked to respond to the questionnaires regarding their fatigue and quality of life. The number of subjects who completed 4 cycles and over was 11. Fatigue was measured with Lee's tool(1999). Quality of life was measured with a tool revised by the author based on Padilla et al(1983). RESULT: Most patients were in 1st stage(5 patients) or 3rd stage(5 patients). Fatigue was revealed at its highest level in the 3rd or 4th chemotherapy and at its lowest level in the 1st or 6th chemotherapy. A quality of life appeared at its highest level in the 5th or 6th chemotherapy and the lowest level in 3rd or 4th chemotherapy. CONCLUSION: Among 6 cycles of chemotherapy, in 3-4th chemotherapy the fatigue was the highest and the quality of life were the lowest. Many patients decided to stop treatment at the same period. Therefore we can recognize cancer patients receiving chemo- therapy are in the highest risk at the time of the 3-4 th chemotherapy.

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Effects of Aromatherapy on the Stress Response of College Women with Dysmenorrhea during Menstruation: Sun Hee Han, Myung Haeng Hur, Ji Yeon Kang; Journal of Korean Academy of Nursing 2002;32(3):317-326. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.3.317

Abstract PDF

PURPOSE: The purpose of this study was to verify the effect of aromatherapy on the stress response in menstrual period. METHODS: A randomized, single-blind, pretest- posttest design was used. The study subjects were 60 college women with dysmenorrhea and they were randomized into 3 groups, experimental, 1st control(placebo) and 2nd control group. The researchers massaged treatment oil(3% dilution essential oil of Lavender, Clary sage and Rose) into the abdomen of experimental group. The placebo group used almond oil(carrier oil) instead, and the 2nd control group did not give any treatment. Baseline data including pre- treatment stress response score were obtained on the first day of usual period. Aromatherapy provided for about 7 days until the next cycle began. Post-treatment stress responses were measured by 94 item SOS(symptom of stress) scale on the first day of the cycle. RESULTS: As a results, the stress response score of experimental group was significantly lower than two control groups. And there was no significant difference in stress responses of two control groups. CONCLUSION: The results show aromatherapy using selected essential oils to be an effective intervention for stress response during menstruation.

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The Nutritional Status of the Patients with Cancer during the Chemotherapies: Young Hee Yang, Sung Joon Kwon, Chang Imc Kim; Journal of Korean Academy of Nursing 2001;31(6):978-987. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.6.978

Abstract PDF

PURPOSE: The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy.
METHOD
To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy.
RESULT
93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake.
CONCLUSION
The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.

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Typological Study on Attitudes of Alternative Therapy Among Cancer Patients: Jin Kyung Kim, Boon Han Kim, Mi Hyang Lee, Hwa Jeong Kang; Journal of Korean Academy of Nursing 2000;30(7):1718-1728. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.7.1718

Abstract: The purpose of this study is to identify and classify the different types of cancer patients who use alternative therapies, to understand their subjective frameworks in using such alternative therapies. The results of this study provided the subjective information on five types of attitudes towards alternative therapies and described characteristics of five types from 30 cancer patients. The "Dependent to Others" (the first type) decided to use alternative therapy because they were influenced by the experiences of others and invocations of the family (especially spouse) or close relatives. In general, they did not believe that it will cure the diseases but generally thought it was not harmful and it may be better than doing nothing. There were a group of patients who chose to use alternative therapy with vague hope and belief. These patients decided to try alternative methods with their own convictions and confidences because they have personally seen or heard about some people who had been cured miraculously. This group of patients was grouped as "Belief in Effects (second type)." Although, there is a very little chance for miracles, "Expecting for Effects (third type)" believed alternative therapy will strengthen immune systems, help with feces and urine, change physical constitutions, slow down the progression of cancerous cell, have no side-effects, and expects to have practical effects and uses. The fourth group of patients thought foods in alternative therapies were same as general foods, therefore, it was easy to take, did not expect miracles to happen but considered the alternative therapy as supplementary treatments. This "Supplementary for Effects (fourth type)" patients thought it was their duty to do everything possible. The last type was "Expecting for Miraculous Effects (fifth type)." The patients in this group were devastated and thought of alternative treatments as the last hope for miracles. They thought it would relieve their physical pains, reduce the chance of side effects from chemical treatments, help them for comfortable and painless death, and considered it as the last possible option with expecting for miracles. The result of this study has implications to provide practical and concrete guidelines for caring and nursing cancer patients using alternative therapies. It will be used as a tool to work on independent for nursing intervention. Furthermore, the result of study will provide practical guidelines to help develop better tools and nursing intervention strategies to nurse cancer patients.

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Effect of Aromatherapy Massage on the Mood, the Milk ejection Reflex, and the Immunoglobulin A of the Breast Milk of Mothers with a Cesarean Section Delivery: Sung Hee Lee; Journal of Korean Academy of Nursing 2000;30(5):1357-1367. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.5.1357

Abstract: The purpose of this quasi-experimental study was to explore the effect of aromatherapy massage on the mood, the milk ejection reflex, and the immunoglobulin A of the breast milk of mothers who gave birth through a Cesarean section delivery. Twenty mothers who had Cesarean section were selected as an experimental group, and twenty-two were in the control group. Lavander and Rosemary oil mixed with Jojova carrier oil was used to massage the back, both axillar and breasts. Aromatherapy massage was done once a day for 20 minutes by the researcher. Each session consisted of 4 minutes for warm-up, 14 minutes for massage and 2 minutes for closure. The levels of IgA within the breast milk was analyzed by an immunoturbidimeter assay (Cobas INTEGRA, Roche, Swiss) before and after aromatherapy massage. Mood and milk ejection reflex were measured by self-reports at the same time. The data were analyzed using SPSS 7.5 and the hypotheses were tested by ANCOVA and the Pearson coefficient correlation. The results were as follows: 1) Score of mood increased significantly after the use of aromatherapy massage. 2) Score of milk ejection reflex increased significantly after the use of aromatherapy massage. 3) Level of IgA of breast milk did not change significantly after the use of aromatherapy massage. 4) After the use of aromatherapy massage, there wasn't any correlation among mood, milk ejection reflex, and level of IgA of breast milk. In conclusion, the results suggest that aromatherapy massage is an effective nursing intervention to enhance the mood and the milk ejection reflex and to increase the rate of breastfeeding in the breastfeeding mothers under stresses like a Cesarean section.

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The Effects of Chu-ma Therapy on Decreasing Blood Pressure in Essential Hypertension: Nam Sun Kim; Journal of Korean Academy of Nursing 2000;30(4):967-981. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.4.967

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The purpose of this study is to evaluate the effects of Chu-ma therapy and to suggest that the therapy is an effective nursing intervention tool to reduce blood pressure. The research design employed was the non-synchronized research method with non- equivalent control group. A total of 30 people with essential hypertension, who were from forty to sixty five years old, participated in the study. The Chu-ma therapy was administered by every day for ten or fifteen minutes for eight weeks from 19, April to 13, June in 1999. In order to evaluate the effects of Chu-ma therapy, blood pressure of the two groups were measured once a week, and physiological parameters (epinephrine, norepinephrine, total cholesterol, HDL-cholesterol, triglycerides) were measured before and after the treatment. Collected data was analyzed by SAS package. The results of this study can be summarized as follows: 1) There were significant decrease in systolic blood pressure and diastolic blood pressure in the experimental group. 2) There were no significant changes in epinephrine, norepinephrine of the two groups. 3) There were significant decrease in total cholesterol and triglycerides, and HDL- cholesterol increased significantly in the experimental group. 4) The effect of Chu-ma therapy on the measured time on the blood pressure in experimental group was as follows: Both of systolic and diastolic blood pressures were significantly decreased after 5weeks. The result proved that Chu-ma therapy is an effective nursing intervention tool for clients with essential hypertenion. However further research is still necessary to compare the effect with the different periods and number of times for Chu-ma therapy.

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Effects of a Qi Massage Program on the Physio-psychological State of Industrial Employees with Hypertension
Yoon Ju Han, Kyung Sook Kang
Journal of East-West Nursing Research.2014; 20(2): 73. CrossRef
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Mi-Young Gi, Young-Hae Park
Korean Journal of Occupational Health Nursing.2012; 21(1): 1. CrossRef

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