PURPOSE: The purpose of this study was to evaluate the cognitive effects of chemotherapy in patients with breast cancer. METHODS: Using several databases, prospective studies were collected up to August 2011. Of 2,106 publications identified, 12 met the inclusion criteria, and 8 studies were used to estimate the effect size of chemotherapy on cognitive impairment. RESULTS: Twelve studies were done since 2005 and most of the research was performed in Europe or North America. Eight studies were used to generate effect size across the cognitive domains of attention/concentration, verbal and visual memory, executive function, visuospatial skill, language, and subjective cognitive function. Each of the cognitive domains showed small effect sizes (-0.02 ~ -0.26), indicating diminished cognitive function for the chemotherapy group compared with non-chemotherapy groups. CONCLUSION: Finding suggests that breast cancer patients who undergo chemotherapy may experience mild cognitive decline. Further study is needed to generate knowledge and guideline for interventions to address chemotherapy related cognitive impairment in these patients.
Antineoplastic Agents/adverse effects/*therapeutic use ; Breast Neoplasms/*drug therapy ; Cognition Disorders/*physiopathology ; Databases, Factual ; Female ; Humans ; Language Tests ; Memory, Short-Term ; Neuropsychological Tests

PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.
Delivery of Health Care ; Education ; Human Rights ; Mortality ; Occupations ; Quality of Life ; Social Discrimination ; Socioeconomic Factors*

PURPOSE: This study was conducted to identify relations among health behaviors, health symptoms and physical fitness of people in the same community. METHOD: The study was designed as a descriptive survey and the participants were 1,621 healthy people. Data were collected from March to December, 2003 using a structured questionnaire on health behaviors, health symptoms and physical fitness. Data were analyzed by descriptive statistics, chi2-test, t-test, two-way ANOVA, Pearson correlation coefficients and multiple regression using SPSS/PC. RESULTS: The result of multiple regression showed that sex, age, and BMI were related to physical fitness. In health-related physical fitness, regular exercise was related to cardiorespiratory endurance and flexibility, and daily caffeine intake was related to muscular endurance. In performance-related physical fitness, having breakfast regularly was related to power, daily caffeine intake was related to agility, and regular lifestyle and health symptoms were related to balance. CONCLUSION: In conclusion, this study suggests that for better physical fitness, nursing strategies and intervention programs should include physical fitness-related factors, and education programs should be developed based on the above parameters to promote positive perception of physical fitness.
Breakfast ; Caffeine ; Education ; Health Behavior* ; Life Style ; Nursing ; Physical Fitness* ; Pliability ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to examine the impact of type D personality on health status and health promoting behaviors in middle-aged women. METHODS: A cross-sectional study design was used with 220 middle aged women. All participants completed 3 measuring tools: a 14-item Type D Personality Scale, a 12-item Short Form Health Survey Questionnaire version 2, and Health Promoting Lifestyle Profile-version II. All were completed in November 2010. RESULTS: The prevalence of type D personality was 34.5%. Type D women had significantly lower physical (p=.020) and mental health status (p<.001) compared with non-type D women. In addition Type D women reported significantly poorer performance of health responsibility (p=.015), physical activity (p=.001), nutrition (p=.027), spiritual growth (p<.001), interpersonal relations (p<.001) and stress management (p<.001) techniques in health behaviors than non-type D women. CONCLUSION: Type D personality is a vulnerability factor that affects health status and is associated with poor health promoting behaviors in middle aged women. Therefore, screening for Type D personality is important to detect women at risk for health status and quality of life in community settings in Korea.
Cross-Sectional Studies ; Female ; Health Behavior ; Health Surveys ; Humans ; Interpersonal Relations ; Korea ; Life Style ; Mass Screening ; Mental Health ; Middle Aged ; Motor Activity ; Prevalence ; Quality of Life ; Surveys and Questionnaires

PURPOSE: This study was done to identify self-directed learning readiness, achievement goal orientations, learning satisfaction and learning achievement, and to evaluate the factors affecting learning achievement for nursing students using a web-based Health Assessment e-Book. METHODS: The research design was a cross-sectional study with a structured questionnaire and data were collected before using the web-based Health Assessment e-Book and 1 week after finishing. The participants were 80 nursing students who were taking the Health Assessment class from March to June 2009. RESULTS: Mean score for subjective learning achievement was 31.26 and for objective learning achievement, 69.25. Subjective and objective learning achievement were positively correlated with self-directed learning readiness, mastery goal, attitude toward distance education, and learning satisfaction. In subjective learning achievement, learning satisfaction and mastery goal were significant predictive factors and explained 64% of the variance. Objective learning achievement was significantly predicted by learning satisfaction and self-directed learning readiness, which explained 24% of the variance. CONCLUSION: Learning satisfaction, mastery goal and self-directed learning readiness were found to be very important factors associated with learning achievement for nursing students using a web-based Health Assessment e-Book. To provide high quality and effective web-based courses and to improve nursing students' learning achievement and learning satisfaction, educators should consider the learner's characteristics from the initial stages of lecture planning.
Adult ; *Computer-Assisted Instruction ; Cross-Sectional Studies ; *Education, Nursing, Baccalaureate ; Educational Status ; Female ; Humans ; Internet ; *Learning ; Male ; Personal Satisfaction ; Questionnaires ; Students, Nursing/*psychology

PURPOSE: The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD). METHODS: A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events. RESULTS: Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events. CONCLUSION: Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.
Aged ; Aged, 80 and over ; Anger ; Anxiety ; Cohort Studies ; Coronary Artery Disease/*psychology ; Databases, Factual ; Depression ; Female ; Hostility ; Humans ; Male ; Prospective Studies ; Recurrence ; Risk Factors ; *Stress, Psychological

PURPOSE: Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy. METHODS: Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses. RESULTS: At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function. CONCLUSION: These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.
Adult ; Analysis of Variance ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use ; Attention/drug effects ; Breast Neoplasms/*drug therapy ; Chemotherapy, Adjuvant ; Cognitive Dysfunction/epidemiology/*etiology ; Female ; Humans ; Longitudinal Studies ; Memory/drug effects ; Middle Aged

PURPOSE: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. METHODS: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. RESULTS: The mean score for RSS was 17.80+/-9.16. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). CONCLUSION: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.
Adaptation, Psychological ; Adult ; Aged ; Critical Illness/*psychology ; Cross-Sectional Studies ; Female ; Humans ; *Intensive Care Units ; Male ; Middle Aged ; Patient Transfer ; Questionnaires ; Stress, Psychological/*etiology ; Syndrome

PURPOSE: The purpose of this study was to identify changes of symptom distress and quality of life (QOL) in breast cancer patients receiving adjuvant therapy. METHODS: 113 patients with breast cancer were administered the Memorial Symptom Assessment Scale-Short Form and the Functional Assessment of Cancer Therapy-Breast before adjuvant therapy, both a week and 6 months after completing adjuvant therapy. 71 patients (CTx group) were treated with adjuvant chemotherapy and radiotherapy. 42 patients (RTx group) received only adjuvant radiotherapy. Data were analysed using the SPSS/Win 21.0 program. RESULTS: Compared with the RTx group, patients in the CTx group reported higher overall symptom distress and physical symptom distress. The CTx group reported lower scores in overall QOL, physical well-being and the breast cancer specific domain than the RTx group. CONCLUSION: Findings from this study support that chemotherapy results in higher risk for more severe symptoms and leads to impaired QOL for breast cancer patients. Comprehensive symptom management should be implemented for breast cancer patients receiving chemotherapy.
Breast Neoplasms* ; Chemotherapy, Adjuvant ; Drug Therapy ; Humans ; Quality of Life* ; Radiotherapy ; Radiotherapy, Adjuvant ; Symptom Assessment ; Surveys and Questionnaires

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.
Anxiety ; Behavior Therapy ; Bias (Epidemiology) ; Counseling ; Depression ; Education ; Humans ; Publication Bias ; Quality of Life ; Survivors*