PURPOSE: The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer. METHODS: A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation. RESULTS: The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R2=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R2=43%). Psychological distress had a partial mediating effect (beta= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.
Adult ; Aged ; Antineoplastic Agents/therapeutic use ; Anxiety/epidemiology/etiology ; Cognitive Dysfunction/epidemiology/*etiology ; Colonic Neoplasms/drug therapy/*psychology ; Cross-Sectional Studies ; Depression/epidemiology/etiology ; Female ; Humans ; Middle Aged ; *Quality of Life ; *Stress, Psychological ; Surveys and Questionnaires

PURPOSE: This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors. METHODS: Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon). CONCLUSION: It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.
Age Factors ; Aged ; Breast Neoplasms/*psychology ; Colonic Neoplasms/*psychology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Neoplasms, Second Primary/*psychology ; Perception ; Sex Factors ; Socioeconomic Factors ; Stomach Neoplasms/*psychology ; Survivors/*psychology ; Time Factors

Constipation is a common gastrointestinal disease affecting approximately 16.5% of the population in Korea. Systemic diseases such as hypothyroidism or colon cancer and drugs can cause constipation in some patients with constipation, there is no obstructive mucosal or structural cause in the vast majority of patients with constipation. Evaluation for secondary causes of constipation is needed to provide appropriate management. Once secondary causes have been excluded, constipation may be classified into normal or slow transit constipation, evacuation disorder of the spastic or flaccid varieties, or both. Treatment of chronic constipation based on the underlying pathophysiology is generally successful. The aims of this review are to discuss the management of functional constipation based on guidelines for the treatment of constipation published in Korean Journal of Gastroenterology in 2011: lifestyle changes; bulking agents and stool softeners; osmotic agents; stimulant laxatives; prokinetics; biofeedback and surgical treatments. Exercise and dietary fiber are helpful in some patients with constipation. Laxatives including bulking agents, stool softeners, osmotic agents, stimulant laxatives have been found to be more effective than placebo at relieving symptoms of constipation. New enterokinetic agents such as 5-hydroxytryptamine-4 receptor agonists, intestinal secretagogues, and peripheral opioid antagonists could be effective in patients with constipation who cannot get adequate relief from current laxatives. Biofeedback could relieve symptoms in selected patients with constipation due to pelvic floor dyssynergia. Surgical treatments can be helpful in some patients with refractory constipation.
Ataxia ; Biofeedback, Psychology ; Colonic Neoplasms ; Constipation ; Dietary Fiber ; Gastroenterology ; Gastrointestinal Diseases ; Humans ; Hypothyroidism ; Korea ; Laxatives ; Life Style ; Muscle Spasticity ; Narcotic Antagonists ; Pelvic Floor ; Receptors, Serotonin, 5-HT4

PURPOSE: This study was a descriptive survey of nursing needs for post surgical colon cancer patients at discharge. METHOD: A survey was done utilizing questionnaires about the nursing needs a target sample of 61 patients who had colon cancer surgery during April May 2006 in a general hospital in Seoul. RESULTS: Levels for treatment & prognosis were the highest in all domain, high in order of psychological support & stability, complications & discomfort, diet, daily life style, recovery & health promotion, and support system. Patient factors affecting nursing needs were age, job, duration of colon cancer and handling of stoma. CONCLUSION: Using discharge education for colon cancer patients based on the results of this study, nurses should focus on the domains of treatment & prognosis, psychological support & stability and complication & discomfort, and should tailor teaching content to be specified for age, job, duration of colon cancer, and handling of stoma.
Colon ; Colonic Neoplasms ; Diet ; Handling (Psychology) ; Health Promotion ; Hospitals, General ; Humans ; Life Style ; Prognosis ; Surveys and Questionnaires

PURPOSE: The aim of this prospective study was to analyze anorectal physiologic and clinical outcomes of the colonic J-pouch-anal anastomosis compared with the traditional straight colorectal anastomosis after ultra-low anterior resection in patients with rectal cancer, thus to define if this method of modified reconstruction has a functional superiority. METHODS: After total mesorectal excision for mid or low rectal cancers, patients were randomized to either a straight (n=23) or a colonic J-pouch anastomosis (n=24) to the lowermost rectum or anal canal. Functional outcomes were compared between two groups using an anorectal manometry performed before and 1 year after surgery and a bowel function questionnaire administered 6 months and 1 year postoperatively. RESULTS: Except the arithmetic level of anastomosis which was significantly higher in straight group than in pouch group (5.1 +/- 1.2 cm vs. 3.8 +/- 0.9 cm; P=0.0001), the two groups were well matched for demographic distribution, pathologic stage, colonic segment used for neorectum and use of adjuvant therapies. Patients with colonic J-pouch anastomosis showed functional superiority in terms of frequency of bowel movements, degree of urgency at 6 months (P<0.0001 and =0.03, respectively) and 1 year postoperatively (P<0.0001 and <0.05, respectively). Functional parameters, including incontinence to liquid stool and impaired discrimination between gas and stool were more pronounced in straight group after 6 months (P=0.04, and <0.05, respectively), but the differences were not statistically significant after 1 year. Sensation of incomplete evacuation was not different statistically between groups at 6 months, but more common in J-pouch group at 1 year (39.1% vs. 8.3%; P=0.04). As well as the length of high pressure zone and presence of rectoanal inhibitory reflex, there was no difference in sphincter pressure parameters between groups either before or 1 year after surgery. Maximal tolerable volume of the neorectum in J-pouch group was 110.2 +/- 16.7 ml, which was significantly larger than that of 74.1 +/- 14.9 ml in straight group (P<0.0001), and the neorectum in J-pouch group was significantly more compliant than that in straight group (6.1 +/- 1.9 vs. 3.3 +/- 2.1; P<0.0001) in 1 year after surgery. CONCLUSIONS: Construction of a colonic J-pouch as a substitute for the rectum restores neorectal volume and compliance. Clinically it offers patients superior anorectal function compared with straight anastomosis. To minimize evacuation difficulty associated with the pouch, optimal size of the pouch should be defined, thus to achieve an ideal balance between stool frequency/urgency and evacuation problems through larger prospective studies.
Anal Canal ; Colon* ; Colonic Pouches* ; Compliance ; Discrimination (Psychology) ; Humans ; Manometry ; Prospective Studies* ; Surveys and Questionnaires ; Rectal Neoplasms* ; Rectum ; Reflex ; Sensation