Cancer has been the leading cause of death in this country and produces high levels of stress not only in the patients themselves but also in their families. Caregiving during serious illness is a new experience for many family caregivers and social support and coping strategies have been found to reduce unfavorable health outcomes to stressful events such as cancer. The purpose of this investigation was to identify the relationship of caregiving stress, coping methods, social support, and health in caregivers of patients with cancer according to the phases of cancer illness. The subjects were 92 primary cargivers of cancer patients based on their phases of illness that consisted of 1st (initial) stage, 2nd (metastatic or recurring) stage, 3rd (terminal) stage recruited from two general hospitals in Seoul and Choongnam. The mean age of subjects was 39.1 years and 64.1% of subjects were female and 72.8% were married. The relationships to the patient were children(50%) or spouses (45.7%). According as the phase of illness progressed, caregiver's stress rose higher and their health got worse but coping methods and social support did not show a significant change. In the 1st stage the major predictors for the health of caregivers were family network support(R2=0.261, p=0.003) and the stress of the caregivers (R2=0.168, P=0.007). In the 2nd stage the most important predictor for the health of the caregivers was the stress of the caregivers (R2=0.483, P=0.000). Also in the 3rd stage the main predictor for health was the stress of the caregivers (R2=0.381, p=0.006). A better understanding of the stress process in family caregivers is needed so that nurses can provide family-centered care, taking into account caregiver, as well as patient, well-being.
Caregivers* ; Cause of Death ; Female ; Hospitals, General ; Humans ; Life Change Events ; Seoul ; Spouses

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported. METHODS: Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame. RESULTS: During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. CONCLUSIONS: This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.
Aged ; Clinical Coding ; Critical Care* ; Diffusion ; Disease Outbreaks ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Enterobacteriaceae ; Hand ; Humans ; Infection Control ; Intensive Care Units* ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Male ; Methods ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Sputum

PURPOSE: The purpose of this study was to investigate the level of nausea, vomiting, anorexia, fatigue and quality of life as well as to determine the relationship between those variables and identify the influencing factors on fatigue and quality of life in stomach cancer patients receiving adjuvant chemotherapy. METHOD: Subjects were 94 stomach cancer patients undergoing postoperational chemotherapy in a general hospital in Seoul. Nausea and vomiting were measured with Rhodes et al(1984) and anorexia with one 5-point item. Fatigue was measured using Lee's tool(1999) except open questions. The tool for quality of life was modified based on the Quality of Life Index by Padilla et al(1983). RESULT: Subjects reported low level of fatigue(mean=3.86, range=0-10) compared with the results of previous researches and moderate quality of life(mean=2.64, range=1-4). Fatigue was positively correlated with nausea, vomiting and anorexia(r=.21 ~ .55, p<.05). Quality of life was negatively correlated with nausea, vomiting, anorexia(r= -.24 ~ -.45, p<.05) and fatigue (r=-.61, p<.01). Multiple regression analysis revealed that activity level, vomiting before admission, anorexia during chemotherapy and age explained 52.8% of the variance in fatigue. Fatigue, anorexia before admission, age and sex explained 50.5% of the variance in quality of life. Fatigue and quality of life were not influenced by the stage of disease, nor weight change. CONCLUSION: These results may contribute to a better understanding of how much the side effects of anticancer drugs can affect fatigue and quality of life in cancer patients undergoing chemotherapy. Also it is the remarkable fact that symptoms remaining after discharge such as vomiting or anorexia continued until re-admission, contributing to patients fatigue and lowered their quality of life.
Anorexia ; Chemotherapy, Adjuvant ; Drug Therapy* ; Fatigue* ; Hospitals, General ; Humans ; Nausea ; Quality of Life* ; Seoul ; Stomach Neoplasms* ; Stomach* ; Vomiting

PURPOSE: The purpose of this longitudinal prospective study was to assess changes in fatigue and quality of life for a 6-week course of radiotherapy. METHOD: A descriptive and longitudinal design was used to this study. Twenty-three subjects receiving radiotherapy from a radiotherapy clinic of a general hospital completed the questionnaires. Fatigue was measured using Lee's scale(1999) and quality of life using Yang's scale(2002) weekly for 6 weeks. RESULT: Fatigue significantly increased(F=6.043, p=.000), and quality of life significantly decreased(F=3.938, p=.003) and physical symptoms also significantly increased(F=2.432, p=.039) during a 6-week radiotherapy. Multiple regression analysis revealed that fatigue at the first week and physical symptoms at the 6th week were the significant affecting variables(60.1% of the variance) on fatigue. And 63.2% of the variance in quality of life was explained by quality of life and fatigue at the first week and body weight change for 6 weeks radiotherapy. CONCLUSION: Based on these results, the fatigue and quality of life at the beginning time of radiotherapy have a lasting impact throughout the course of treatment. It suggests that nurses provide patients with information about the occurrence of fatigue during radiotherapy and the practical methods of intervening physical symptoms.

PURPOSE: The purpose of this study was to identify the relationship between fatigue and nutritional status in patients undergoing radiotherapy. DESIGN: A correlational and crossectional study design was used. METHOD: One-hundred-fifty-one subjects with cancer receiving radiotherapy were recruited from a university hospital in Chonan, Korea. Fatigue was measured using Piper's Fatigue Scale (PFS). The parameters for nutritional status included body weight, body mass index, hemoglobin, and lymphocyte counts. Cancer stage was controlled in analyzing the differences in fatigue, body weight and body mass index. RESULTS: The patients who experienced most fatigue were in their fifties, employed, had head and neck cancer, received radiotherapy on the head and neck, and had concomitant chemotherapy. Disease-related characteristics such as cancer type, and treatment type were frequently related to poorer nutritional status. Patients who showed poorer nutritional status, such as those with lower body weight, lower body mass index and lower hemoglobin levels were more fatigued than those who did not exhibit such characteristics. Lymphocyte counts did not correlate with fatigue. CONCLUSION: The findings can be used by nurses who are taking care of patients undergoing radiotherapy. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

This study was undertaken in order to examine the effect of hardiness on future stress-related physical symptoms in the female students in a longitudinal design. The subjects who participated in this study were 97 female nursing students (in the analysis of data after 1 year). The instruments used for this study were a survey of general characteristics, stress (43 items), hardiness(25 items), and physical symptoms(35 items). Analysis of data was done by use of mean and hierarchical multiple regression with the SAS program. The results of this study were as follows. 1) Main effects of hardiness on future stress-related physical symptoms was found. 2) The stress buffering effects of hardiness were not found.
Female ; Humans ; Longitudinal Studies* ; Nursing* ; Students, Nursing*

PURPOSE: Breast cancer is a common cancer in women in Korea. Early detection of breast cancer is very important for the protection of a woman's health. The purpose of this quasi-experimental study was to determine the effect of BSE education on knowledge, self efficacy and performance in middle-aged women. METHOD: The participants were 33 women who agreed to participate in the study. They responded to a questionnaire that included items on knowledge, self-efficacy and performance of BSE. The experimental group was given a 90 minute-session including a lecture and practice with a BSE practice model and their own body. Their knowledge of the BSE was measured using Choi's tool and self-efficacy was measured using the scale by Champion and Scott. RESULTS: Homogeneity for knowledge, self-efficacy and performance of BSE between the experimental and the control groups was confirmed. After 3 months of BSE education, knowledge, self-efficacy and frequency of BSE performance in the experimental group were significantly higher than for the women in the control group. CONCLUSION: A BSE education program would be helpful to enhance health behavior by early detection of breast cancer in middle-age women.
Breast Neoplasms ; Breast Self-Examination ; Education* ; Female ; Health Behavior ; Humans ; Korea ; Surveys and Questionnaires ; Self Efficacy ; Women's Health

PURPOSE: The purpose of this study was to identify the relationship between anorexia, nausea, and vomiting (ANV) and food intake patterns in patients with cancer on chemotherapy. METHOD: Ninety-one patients from a university hospital in Seoul were recruited and were asked to record food intake and ANV during one cycle of chemotherapy. RESULTS: Caloric and protein intake decreased significantly. The mean caloric intake was 808.75 Kcal (SD=177.54), 48.2% of the recommended intake and the mean of protein intake was 28.44 g (SD=16.44) only 34.7% of the recommended intake. The mean score for dietary diversity was 3.57 (SD=.73) indicating that the patients had taken 3 or more of the 5 food groups. ANV had a significant negative correlation with caloric and protein intake and dietary diversity (r=-.29~-.56, P<.05) and dietary diversity had a significant positive correlation with caloric and protein intake (r=.46 and .57, P=.000). CONCLUSION: Patients receiving chemotherapy had a very poor intake that could lead to malnutrition and a compromised immune system. These findings suggest the need to develop interventions that encourage for food intake.
Anorexia* ; Drug Therapy* ; Eating* ; Energy Intake ; Humans ; Immune System ; Malnutrition ; Nausea* ; Seoul ; Vomiting*

PURPOSE: The purpose of this study was to compare long-term hospital and general hospital for delirium prevalence and precipitating factors in elderly patients. METHOD: The participants were 184 patients aged 65 or older from one general hospital and 4 long-term facilities. Delirium was assessed using the Confusion Assessment Method and precipitating factors for delirium were classified as demographic, physical condition, disease and drug factors associated with delirium found in a literature analysis. RESULTS: Delirium prevalence was 5.4% and there was no significant difference according to hospital type. Most of the patients with delirium were male, dependent and dehydrated and had sleep disturbances, diseases and drugs associated with delirium and, had multi-drugs prescriptions. Non-delirious patients also had two or more delirious symptoms and several precipitating factors. Delirious patients were more dependent, urinary incontinent and had sleep-disturbances compared to the non-delirious group. The participants in the long-term hospitals were found to have frequently previous delirium history. CONCLUSION: Even though the prevalence rate of delirium was not high, most elderly patients, regardless of delirium, are a very high risk group and dependent ADL, sleep disturbances, and/or urinary incontinence could be used predictive factors for delirium.
Activities of Daily Living ; Aged ; Delirium ; Hospitals, General ; Humans ; Long-Term Care ; Male ; Precipitating Factors ; Prescriptions ; Prevalence ; Urinary Incontinence

To evaluate the establishment of Mungyong Saejae Natural Ecology Park located in the northwestern Gyongbuk Province, a scientific survey for the mushroom flora of the park was carried out from May to December of 1999. A checklist of the Aphyllophorales collected from the park was prepared. The list included 67 species of 44 genera belonging to nine families in the Aphyllophorales. Among them, seven species, Antrodia malicola, Ceriporia purpurea, Oligoporus leucospongia, Perenniporia tephropora, Phanerochaete xerophila, Sistotrema diademiferum and Vuilleminia comedens, were confirmed as new to Korea and are registered here as unrecorded species along with descriptions and microscopic drawings.
Agaricales ; Antrodia ; Checklist ; Ecology ; Humans ; Korea ; Phanerochaete ; Polyporales*