The purpose of this study was to develop the basis of scientific nursing intervention by examining the changes of stress level with elapse of post chemotherapy in breast cancer patients. The design of this study was a longitudinal descriptive study. The subjects of this study was patients receiving chemotherapy from March 1, 1998 to June 30, 1998 at K university hospital in Taegu. The number of subjects was 14 and they were given treatment every 21 days, a cycle of chemotherapy. The changes of their stress with the elapse of chemotherapy were examined every other day. The changes of stress reaction were measured by fatigue and salivary cortisol level. The instrument used to measure fatigue was the revised Pipe Fatigue Scale which was developed by Piper(1984). The reliability of this instrument was Cronbach's alpha .997. The Salivary cortisol was meausured to examine the stress physiological reaction, analyzed using radioimmunoassay. Data was analyzed by computer using the SPSS WIN 7.0 program. Frequency, and Wilcoxon Singned Ranks test were used to examine the changes in degree of fatigue and salivary cortisol with the elapse of chemotherapy. The relationship between fatigue and salivary cortisol was examined using Spearman's rho. The results of this study were as follows: 1) The degree of fatigue was increased a little on the third day 5.64( +/- 1.86)(z=-1.85, p=.06) compared with that of fatigue on the basic day. After that, the degree of fatigue was continuously decreased. it had tendancy to increase a little as patients visited the clinic for next chemotherapy. 2) The mean of salivary cortisol concentration was the higest shortly before chemotherapy. 3) The relationship of fatigue and salivary cortisol was r= .4(p=.098). To sum up, the degree of fatigue was the highest on the third day and salvary cortisol was the highest shortly before chemotherapy. Because the stress reaction of cancer patient receiving chemotherapy was the higest within 3 days in one cycle, it will be effective to provide specified nursing interventions to reduce stress within 3 days after chemotherapy.
Breast Neoplasms* ; Breast* ; Daegu ; Drug Therapy* ; Fatigue* ; Humans ; Hydrocortisone* ; Nursing ; Radioimmunoassay

The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows: 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7~12 months(1 yr.) post operation period had higher than the one below 6months, 25~36 months(3 yrs.), 37~60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7~12 months(1 yr.) post operation period, but there was no significant difference by general characteristics. 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25~36 months of post operation period showed significantly lower level of coping than those below 6 months or 37~60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.
Anxiety* ; Breast Neoplasms* ; Breast* ; Christianity ; Compliance ; Surveys and Questionnaires ; Drug Therapy ; Humans ; Mastectomy* ; Nursing ; Uncertainty*

This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al. (1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percent-age for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows : In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5 FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a significant difference by job and religion, the degree of hopelessness a significant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.
Anxiety* ; Breast Neoplasms* ; Breast* ; Buddhism ; Daegu ; Diagnosis ; Drug Therapy* ; Humans ; Mastectomy ; Middle Aged ; Nursing ; Surveys and Questionnaires ; Spouses

PURPOSE: This study was done to identify the changes of cognitive function and depression following Chemotherapy in women with breast cancer. METHODS: Fifty patients participated in the study and completed the questionnaire at three-time points: pre-chemotherapy, post-chemotherapy, and six months after the completion of chemotherapy. The assessment tools were: everyday cognition, the Montreal Cognitive Assessment, and the Hospital Anxiety and Depression Scale. Data were analyzed using descriptive statistics and repeated measures analysis of variance. RESULTS: Immediately after chemotherapy, 52.0% of patients complained of subjective cognitive decline and reported greater difficulty in the cognitive domains of attention, memory, and visuospatial abilities. At six-month follow-up, 24.0% of patients exhibited mild cognitive decline. Repeated measures ANOVA showed a significant decline in cognitive function after chemotherapy. However, improvement was observed 6 months after the completion of chemotherapy. Depression showed similar patterns to cognitive function. Higher cognitive decline scores were significantly correlated with higher depression (r=.33, p=.020). CONCLUSION: These results suggest that chemotherapy is highly associated with cognitive decline and depression in women with breast cancer. Nursing intervention is needed to relieve depression as well as cognitive decline in patients undergoing chemotherapy.
Anxiety ; Breast Neoplasms* ; Breast* ; Cognition* ; Depression* ; Drug Therapy* ; Female ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Memory ; Nursing ; Prospective Studies*

PURPOSE: This study aimed to evaluate weight changes in women during the period of TAC (docetaxel-doxorubicin-cyclophosphamide) chemotherapy after breast surgery and the differences in weight changes by disease characteristics among Korean women with breast cancer. METHODS: The design of this study was retrospective survey research. The subjects of this study were 130 patients with fully completed TAC chemotherapy between January 2012 and April 2015. Body weight before their operation, and at 3 weeks, 6 weeks, 9 weeks, 12 weeks, 15 weeks, and 18 weeks after surgery, as well as general and disease characteristics, were reviewed via their medical charts. RESULTS: The mean age of the patients was 51.2 years. The preoperative (baseline) mean weight was 59.4±8.44. Significant weight losses were observed in the initial (1st 3 week) period of TAC chemotherapy compared to the baseline and significant weight losses were observed with the exception of the period 6 weeks after breast surgery. There were significant differences in mean weight changes according to the stage of breast cancer, radiotherapy, and hormone therapy among disease characteristics. CONCLUSION: It is necessary to study weight changes after breast surgery for the long periods of TAC chemotherapy. Through the accumulated results of studies, nursing programs for breast cancer patients must be developed for the prevention of weight gain in the periods of TAC chemotherapy.
Body Weight ; Breast Neoplasms* ; Breast* ; Drug Therapy* ; Female ; Humans ; Nursing ; Radiotherapy ; Retrospective Studies ; Weight Gain ; Weight Loss

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 χ2=423.18 (p<.001), χ2/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.
Anxiety ; Breast Neoplasms ; Breast ; Cognition ; Cognition Disorders ; Depression ; Drug Therapy ; Female ; Humans ; Menopause ; Models, Structural ; Nursing ; Psychology ; Quality of Life

PURPOSE: Cardiotoxicity following cancer chemotherapy or radiotherapy is an emerging issue for breast cancer patients. The purpose of this study was to analyze the current domestic research trends for exercise intervention for Korean breast cancer patients under chemotherapy or radiotherapy, focused on cardiovascular indices as study outcome measures and to make suggestions for future nursing studies. METHODS: A literature search was done using PubMed, CINAHL and two Korean databases to identify experimental studies reported in Korean or English between 2,000 and 2015. We identified five studies independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed by RoBANS criteria. RESULTS: Tai-chi exercise was used in three studies and aerobic exercise programs or yoga and walking exercise in the remaining studies. Two studies evaluated cardiovascular outcomes and showed positive findings for breast cancer patients. For cardiovascular indices, heart rate and blood pressure were used. CONCLUSION: This study showed the need for conducting well-designed experimental studies including clinical cardiovascular outcomes to generate evidence on exercise intervention for cancer therapy-induced cardiotoxicity prevention. Additional studies are warranted to accelerate the potential use of exercise as a nursing intervention for cancer patients under chemotherapy or radiotherapy.
Bias (Epidemiology) ; Blood Pressure ; Breast Neoplasms* ; Breast* ; Cardiovascular System ; Drug Therapy* ; Exercise ; Heart Rate ; Humans ; Nursing ; Outcome Assessment (Health Care) ; Radiotherapy* ; Walking ; Yoga

PURPOSE: The purpose of this study was to identify the degree of menopause symptoms and associated factors in patients with breast cancer who were receiving hormone therapy. METHODS: Data were collected with questionnaires from 150 patients with breast cancer who had been on hormone therapy at a hospital in Seoul. Data were analyzed with the t-test, ANOVA, and Pearson correlation coefficient to compare the degree of menopause symptoms by demographic, clinical and psychological factors. RESULTS: The mean menopause symptoms score was 13.39±7.97. Most participants reported having hot flushes and sweating (75.3%), physical and mental exhaustion (82.7%) and sexual problems (64.7%). Menopause symptoms and depression were correlated with each other (p < .01). Somato-vegetative symptoms were different significantly by age, menopausal status at time of operation, occupation and tumor. Psychological symptoms were different significantly by marital status, operation type and chemotherapy. Urogenital symptoms were different significantly by prior history of cancer, occupation, operation type and radiation therapy. CONCLUSION: These findings can be used to provide tailored nursing interventions by identifying high risk groups for menopausal symptom among breast cancer patients receiving hormone therapy.
Antineoplastic Agents, Hormonal ; Breast Neoplasms ; Breast ; Depression ; Drug Therapy ; Female ; Humans ; Marital Status ; Medication Adherence ; Menopause ; Nursing ; Occupations ; Psychology ; Seoul ; Sweat ; Sweating

The purposes of this study were to describe systematically 18 years of oncology nursing research in Korea and suggest it's direction in future. 149 nursing studies published from 1980 to 1998 were selected for the present study. There were examined the source and the design of study, type of subjects, measurement variables, the intervention outcome of experimental research, and theme of qualitative research. The results were as follows : 1. 121 of 149 studies were composed of master thesis and dissertation of graduate school. There were 55 correlations, 30 descriptions, 19 comparisons, 19 qualitative studies and 2 Q-methods as the type of research design. 2. Cancer patients without describing specified diagnose as subjects' characteristic were 44 of total studies. The others had various diagnoses such as gastric cancer, uterine cancer, breast cancer, leukemia, Iymphoma, colorectal cancer, and lung cancer. According to treatment type. patients receiving chemotherapy were the highest number distribution as 53 of all researches. 3. Most measurement instruments used for research were translated it into Korean that developed by foreigners, such as Zung's depression. Spielberg's anxiety, and Wallston's locus of control. 4. Quality of life was shown the most frequently among correlational researches. the next one was depression the third was hope, and so on. 5. There was the most frequent comparison between cancer and non-cancer patients in comparative researches. It was surveyed those variables as diet habits, risk factors, stressful life events, anxiety and depression and self-care capacity between two groups. 6. The subjects were mostly chemotherapy Patients as 15 of 24 experimental studies. Oral care and education were respectively the highest experimental interventions. 7. Qualitative researches about cancer were reported since 1991. Their themes were illness experience, adaptation process, dying experience, family experience, hope. caring, experience of health behavior, meaning of chemotherapy and experience of cancer survivor. Phenomenologic methodology was designed above 50% of qualitative researches. According to the above findings, cancer research had increased since 1990 and done mostly by descriptive design but a few experimental studies. As recommendations for the future, It is necessary to study the comparison of oncology nursing research internationally. the replication to establish the effect of nursing intervention and the family care of cancer patient.
Anxiety ; Breast Neoplasms ; Colorectal Neoplasms ; Depression ; Diagnosis ; Drug Therapy ; Education ; Emigrants and Immigrants ; Food Habits ; Health Behavior ; Hope ; Humans ; Internal-External Control ; Korea ; Leukemia ; Lung Neoplasms ; Nursing ; Oncology Nursing* ; Qualitative Research ; Quality of Life ; Research Design ; Risk Factors ; Self Care ; Stomach Neoplasms ; Survivors ; Uterine Neoplasms

PURPOSE: The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy. METHOD: The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program. RESULTS: There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times. CONCLUSION: Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy.
Vomiting/chemically induced/*prevention & control ; Nausea/chemically induced/*prevention & control ; Middle Aged ; *Massage ; Humans ; *Foot ; Female ; Fatigue/chemically induced/*prevention & control ; Breast Neoplasms/*drug therapy/nursing ; Antineoplastic Agents/*adverse effects/therapeutic use ; Adult