PURPOSE: The purpose of this study was to investigate relationships among menopausal symptoms, functional status, and distress and to identify factors influencing distress in premenopausal breast cancer patients who had been on endocrine therapy. METHODS: A descriptive correlational study was conducted. Data were collected using questionnaires from 140 patients with breast cancer undergoing endocrine therapy at a general hospital. Data were analyzed using descriptive statistics, t-test, ANOVA, Tukey HSD test, Pearson's correlation analysis and hierarchical regression analysis. RESULTS: The mean scores for menopausal symptom, functional status, and distress were 19.65±7.86, 2.67±0.33 and 3.69±2.19, respectively. The menopausal symptoms and distress were positively correlated (r=.76, p<.001). The menopausal symptoms and functional status (r=−.43, p<.001) and functional status and distress (r=−.31, p<.001) were negatively correlated. The most influential factor for distress was menopausal symptoms (β=.79, p<.001). CONCLUSION: Based on the findings of this study, developing nursing intervention programs focusing on decreasing menopausal symptoms and distress are recommended.
Activities of Daily Living ; Antineoplastic Agents, Hormonal ; Breast Neoplasms ; Breast ; Female ; Hospitals, General ; Humans ; Menopause ; Nursing ; Stress, Psychological

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: The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients. METHODS: This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis. RESULTS: Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (β=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (β=.17, p=.026), social well-being (SWB) (β=.49, p=.010), and functional well-being (FWB) (β=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (β=-.07, p=.024), SWB (β=-.19, p=.008), and FWB (β=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB. CONCLUSION: Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.
Breast Neoplasms ; Breast ; Early Diagnosis ; Humans ; Korea ; Marriage ; Negotiating ; Nursing ; Quality of Life ; Spouses ; Uncertainty

PURPOSE: The purpose of this study was to investigate relationships among uncertainty, meaning of life, and anxiety in preoperative cancer patients. METHODS: Study participants were 90 adult patients with thyroid, breast, gastric, or colorectal cancer who were admitted to the general surgery ward and daily operation center in a university-affiliated hospital. Data were collected using Mishel's Uncertainty in Illness Scale, Meaning in Life Questionnaire, and State-Trait Anxiety Inventory. Data were analyzed using t-tests, one-way ANOVAs, Pearson's correlation coefficient, and a multivariate linear regression analysis (backward stepwise) with SPSS version 24. RESULTS: Anxiety showed a positive correlation with uncertainty in illness (r=.59, p < .001) and a negative correlation with meaning of life (r=−.49, p < .001), and uncertainty had a negative correlation with meaning of life (r=−53, p < .001). The regression model explained 40.0% variance of preoperative cancer patients' anxiety (F=20.55, p < .001). Significant factors were uncertainty (β=.43, p < .001), meaning of life (β=−.20, p < .001), and low income level (β=.18, p < .001). CONCLUSION: Our study's findings show that cancer patients' anxiety can be reduced within 24 hours before surgery through psychological nursing interventions aimed at reducing uncertainty and improving the meaning of life.
Adult ; Anxiety ; Breast ; Colorectal Neoplasms ; Humans ; Linear Models ; Nursing ; Preoperative Period ; Thyroid Gland ; Uncertainty

PURPOSE: To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor. METHODS: With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. RESULTS: The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were 1.57±0.51, 0.37±0.64, 3.62±0.67, and 4.00±0.45, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment. CONCLUSION: In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.
Body Image ; Breast Neoplasms* ; Breast* ; Humans ; Insurance Coverage ; Nursing

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: The purpose of this study was to identify the influence of spiritual well-being, self-esteem, and perceived social support on post-traumatic growth in breast cancer survivors in Korea. METHODS: Data were collected from March 2 to October 31, 2016 using self-reporting questionnaires from 126 breast cancer survivors who had visited out-patient clinics for follow-up in B city. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression. RESULTS: Post-traumatic growth was significantly correlated with spiritual well-being (r=.52, p < .001), self-esteem (r=.54, p < .001), and perceived social support (r=.47, p < .001). In a stepwise multiple regression, spiritual well-being (β=.26, p < .001), self-esteem (β=.23, p < .001), perceived social support (β=.21, p < .001), and presence of spouse (β=.20, p < .001) were associated with posttraumatic growth. These factors attributed to 37.0% of the total variance in post-traumatic growth in breast cancer survivors. CONCLUSION: Considering the results of this study, it is necessary to develop and implement effective nursing strategies that can improve spiritual well-being, and to develop a holistic nursing intervention that takes into account self-esteem, perceived social support, and spousal help, when applicable, in order to promote post-traumatic growth in breast cancer survivors in Korea.
Breast Neoplasms* ; Breast* ; Follow-Up Studies ; Holistic Nursing ; Humans ; Korea ; Nursing ; Outpatients ; Self Concept ; Spirituality ; Spouses ; Stress Disorders, Post-Traumatic ; Survivors*

To investigate the effect of the aroma therapy and music intervention on anxious and pain for the breast cancer patients in the perioperative period and the potential mechanisms.
 Methods: A total of 100 breast cancer patients who received surgical treatment in the comprehensive hospitals of Hunan province were recruited for this study. Patients were assigned randomly into a control group, an aroma therapy group, a music intervention group, and a joint-therapy group (n=25 per group). The patients in the control group received regular post-surgical nursery, while the patients from other groups received aroma therapy, music intervention, or both in addition to the regular nursery. The scale of anxiety and pain were measured. The measurements were carried at three time points, namely 30 min before the surgery (T1), 30 min after the recovery period of anesthesia (T2), and 4 hours after the removal of anesthesia tubing (T3). Repeated ANOVA was used to perform statistic analysis.
 Results: The scale of pain was significantly increased at the post-operation (T2, T3) compared to pre-surgery (T1). The therapeutic group showed significant decrease in pain at post-operation (T3) comparing with the control group (P<0.05). The scale of anxiety was the highest at pre-surgery (T1). During anaesthesia recovery, the anxiety of patients at post-operation T2 and T3 in the therapeutic groups significantly decreased compared with the control group (P<0.05).
 Conclusion: Both the aroma therapy and the music therapy can decrease the stress-responsive anxiety and pain for the breast cancer patients in the perioperative period.
Analysis of Variance ; Anxiety ; therapy ; Aromatherapy ; Breast Neoplasms ; nursing ; psychology ; surgery ; Female ; Humans ; Music Therapy ; Pain, Postoperative ; therapy ; Perioperative Period ; Preoperative Care ; Time Factors

PURPOSE: This is the methodological study to develop the cognitive function scale for breast cancer patients. METHODS: Study was consisted with 1st and 2nd items developing and testify for reliability and validity of them. 94 breast cancer patients in 2 university hospitals and 1 general hospitals responded to a questionnaire that assessed cognitive function scale. Collected data were analysed using the program SPSS/PC Win 21.0. Structural validity was determined factor analysis and convergent validity. This method yielded Cronbach's α value as an internal consistency for the reliability. RESULTS: Factor analysis resulted in six factors and 24 items accounted for 76.31% of the variance. Cronbach's α of scale developed was high as a .95. CONCLUSION: The developed cognitive function scale in breast cancer patients scale has reliability and validity as linear analogue scale witch quantitatively measure the subjectivity. Over these results, providing the way on an assessment in cognitive function in effect for breast cancer patients, it is supposed to contribute the development of nursing knowledge about the cognitive function in breast cancer patients.
Breast Neoplasms* ; Breast* ; Cognition* ; Hospitals, General ; Hospitals, University ; Humans ; Methods ; Nursing ; Reproducibility of Results

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