Purpose: This study aimed to evaluate the effects of a nursing education program for hyperglycemia patient care using standardized patients. Methods: This study used a nonequivalent control group pre-test and post-test non-synchronized design. A total of 50 senior university nursing students who had completed an adult nursing course participated in this study (experimental group, n=24; control group, n=26). This nursing education program was developed according to the stages of analysis, design, development, implementation, and evaluation. The collected data were analyzed using χ2-test, Fisher’s exact test, independent t-test, paired t-test, and repeated measure ANOVA. Results: Significant differences were shown between the experimental and control groups in clinical performance ability (F=277.41, p<.001), communication skills (F=47.18, p<.001), self-efficacy (F=3.81, p=.031), and learning satisfaction (t=2.25, p=.033). Problem-solving ability was not statistically significant between the groups. Conclusion The nursing education program for hyperglycemia patient care using standardized patients was effective in improving nursing students’ clinical performance ability, communication skills, and learning satisfaction. Therefore, it is proposed that the education program developed in this study be used as part of an education program to enhance nursing students’ abilities in caring for hyperglycemia patients.

Purpose: This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability. Methods: A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews.Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach’s alpha. Results: The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, main-taining comfort, professional insight and competence–accounted for 61.8% of the total variance. Cronbach’s ⍺ for total items was .96, andtest-retest reliability of intraclass correlation coefficient was .90. Conclusion Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients.

Purpose: This study aimed to develop a mobile web-based food allergy (FA) and anaphylaxis management educational program for parents of school-aged children with food allergies and evaluate its effectiveness. Methods: A mobile program was developed based on a web-based teaching-learning system model. Its effectiveness was subsequently evaluated using a parallel, randomized controlled pre- and post-test design. This study included 73 parents of school-aged children with food allergies. These parents were randomly assigned to either the experimental (n ¼ 37) or control (n ¼ 36) groups. The experimental group participated in a 2-week mobile web-based educational program that covered major topics in FA and anaphylaxis management. These topics included an understanding of food allergies and anaphylaxis, learning techniques for using an epinephrine auto-injector, and developing an emergency action plan. An educational booklet was provided to the control group. Participants completed a pre-test and two posttest questionnaires to evaluate the impact of the program. The assessment tools were the Food Allergy Knowledge Test, Food Allergy Self-Efficacy for Parents, and Food Management and Adaptation Scale. The data were analyzed using descriptive statistics, a test of homogeneity for the pre-test, an independent ttest, and repeated measures ANOVA. Results: The experimental group experienced greater improvement in the knowledge of FA (postintervention t ¼ 14.51, p < .001; 2 weeks post-intervention, t ¼ 16.15, p < .001), FA self-efficacy (postintervention t ¼ 77.99, p < .001; 2 weeks post-intervention, t ¼ 76.09, p < .001), and practice behavior in FA management (post-intervention t ¼ 28.10, p < .001; 2 weeks post-intervention, t ¼ 27.98, p < .001) after web-based FA education. Conclusion This study revealed improvements in the knowledge, self-efficacy, and practice behaviors of parents regarding FA and anaphylaxis management. Therefore, the mobile web-based educational program can contribute to the effective management of food allergies and anaphylaxis for parents of schoolaged children. CRIS registration: KCT0007491.

Purpose: This study was conducted to explore the experiences of adult cancer patients living with Chemotherapy-Related Cognitive Impairment (CRCI). Methods: Data were collected by using in-depth and audio-recorded interviews with seven patients of colorectal, stomach, and breast cancer. The participants were asked to describe their CRCI experience. The data were analyzed according to Colaizzi’s method for phenomenological analysis. Results: Three-theme clusters and six themes emerged: (1) Foggy daily life: brain health impairment; “I feel different from my usual self: cognitive impairment,” “Lost daily activities: work-related tasks affected,” (2) Struggle to retain memories; “Tried using all strategies I could to recall my memories,” “Need for concern and therapeutic communication,” (3) Expectation of a whole body: hope to live; “Expectations for cognitive rehabilitation,” “Reorganizing daily life.” Conclusion These results showed that patients did not consider CRCI important until symptoms affected daily activities and workrelated tasks and tried to use self-management strategies to manage CRCI. A two-way exchange of information between patients and health professionals can help patients understand and prepare for CRCI in dealing with symptoms.

Purpose: This study is a descriptive correlation research to test the mediating effect of spiritual well-being in the relationship between posttraumatic growth and health promotion behaviors of cancer patients. Methods: The data were collected from 145 cancer patients of three hospitals. The instruments were Posttraumatic Growth Inventory, Health-Promoting Lifestyle Profile, and Spiritual Well-Being Scale. Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny’s steps for mediation. Results: The mean score for posttraumatic growth was 3.57. The mean score was 2.98 for health promotion behaviors. The mean score for spiritual well-being was 2.96. There were significant correlations among the variables, posttraumatic growth, health promotion behaviors, and spiritual well-being. Spiritual well-being was directly affected by posttraumatic growth (Adj R2 =25). Health promotion behaviors were directly affected by posttraumatic growth (Adj R2=26). Posttraumatic growth and spiritual well-being affected health promotion behaviors (Adj R2 =31). Spiritual well-being had a partial mediating effect (β=.25, p<.001) on the relationship between posttraumatic growth and health promotion behaviors (Sobel test: Z=2.84, p<.001). Conclusion Based on the findings of this study, nursing intervention programs focusing on managing posttraumatic growth and increasing spiritual wellbeing are highly recommended to improve health promotion behaviors in cancer patients.

Purpose: This study is a descriptive correlation research to test the mediating effect of spiritual well-being in the relationship between posttraumatic growth and health promotion behaviors of cancer patients. Methods: The data were collected from 145 cancer patients of three hospitals. The instruments were Posttraumatic Growth Inventory, Health-Promoting Lifestyle Profile, and Spiritual Well-Being Scale. Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny’s steps for mediation. Results: The mean score for posttraumatic growth was 3.57. The mean score was 2.98 for health promotion behaviors. The mean score for spiritual well-being was 2.96. There were significant correlations among the variables, posttraumatic growth, health promotion behaviors, and spiritual well-being. Spiritual well-being was directly affected by posttraumatic growth (Adj R2 =25). Health promotion behaviors were directly affected by posttraumatic growth (Adj R2=26). Posttraumatic growth and spiritual well-being affected health promotion behaviors (Adj R2 =31). Spiritual well-being had a partial mediating effect (β=.25, p<.001) on the relationship between posttraumatic growth and health promotion behaviors (Sobel test: Z=2.84, p<.001). Conclusion Based on the findings of this study, nursing intervention programs focusing on managing posttraumatic growth and increasing spiritual wellbeing are highly recommended to improve health promotion behaviors in cancer patients.

Purpose: The purpose of this study was to identify the changes of chemotherapy induced peripheral neuropathy (CIPN), sleep quality, and quality of life and their interrelationships following chemotherapy. Methods: A sample of 52 patients who had been diagnosed with stomach cancer receiving oxaliplatin containing chemotherapy were included in a prospective longitudinal study. The assessment tools were Chemotherapy-induced Peripheral Neuropathy 20, Pittsburgh Sleep Quality Index, and EORTC Quality of Life- Cancer. The data were collected at three time points: pre-chemotherapy, post-chemotherapy, and three months after the completion of chemotherapy, using questionnaires given between June 2017 and March 2019. Data were analyzed using descriptive statistics, repeated measures analysis of variance, and multiple regression analysis. Results: Post-chemotherapy, 19.2% of patients complained of CIPN and 21.2% exhibited CIPN at three-month follow-up. Repeated measures ANOVA showed a significant increase in CIPN after chemotherapy and it remained high at three-month follow-up (F = 39.90, p< .001). Functional quality of life (F = 8.23, p< .001) and symptom quality of life (F = 7.88, p= .001) also showed significant decreases after chemotherapy, and symptom quality of life remained low at three-month follow-up. However, for sleep quality, no significant main effect of time point was shown. CIPN and sleep quality were a factor influencing quality of life with an explanatory power of 48.3% at post-chemotherapy and 65.3% at three-month follow up. Conclusion These results suggest that chemotherapy is highly associated with CIPN and symptoms affecting quality of life in cancer patients. Nursing intervention is needed to monitor and relieve these symptoms of patients during the cancer care trajectory.

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.

PURPOSE: The purpose of this study was to explore the experiences of adult cancer patients living with chemotherapy induced peripheral neuropathy (CIPN). METHODS: Data were collected from January 2018 to April 2018 through in-depth interviews with nine patients of colorectal and breast cancer. The main question was, ‘What is your experience living with CIPN such as tingling and/or numbness?’. The data were analyzed using Colaizzi's phenomenological method. RESULTS: Three theme clusters and six themes emerged: (1) unusual body change; ‘experience of unusual distressing symptoms’, ‘daily activities and functioning affected’, (2) CIPN: a less important risk; ‘CIPN: a distressing and have to endure’, ‘lack of concern and therapeutic communication’, (3) struggle for distressing CIPN through trial and error; ‘try all the remedies that can do’, ‘getting used to distressing CIPN’. CONCLUSION: These results showed that patients did not consider CIPN important until symptoms affected daily activities and QOL. They then tried self-management strategies to deal with CIPN through trial and error. A two-way exchange of information between patients and health professionals could help patients understand CIPN and deal with symptoms if they occur.

PURPOSE: This study was to identify changes in cognitive function and fatigue following chemotherapy in patients with stomach or colorectal cancer. METHODS: Of the participants, 67 underwent adjuvant chemotherapy, while 66 healthy participants made up the comparison group. Three assessment tools were used: 1) the Korean Mini-Mental State Examination; 2) Everyday Cognition; 3) Functional Assessment of Chronic Illness Therapy-Fatigue. The questionnaires were administered in three stages, before chemotherapy, towards the end of chemotherapy, and 6 months after the final chemotherapy session. Data were analyzed using descriptive statistics and repeated measures analysis of variance (RM ANOVA). RESULTS: At the post-chemotherapy stage, 38.8% of the patients who underwent adjuvant chemotherapy complained of subjective cognitive impairment and reported greater difficulty in the cognitive domains of attention and concentration, memory, and executive function. RM ANOVA revealed a significant decline in cognitive function after chemotherapy. However, improvement was observed six months after the completion of chemotherapy (F=42.68, p< .001). Cancer-related fatigue also showed similar patterns as observed in the case of cognitive function (F=44.76, p< .001). CONCLUSION: Chemotherapy was associated with increased cognitive decline and fatigue in cancer patients with cancer. Nursing intervention programs need to be developed to counteract cognitive decline and fatigue in patients undergoing chemotherapy.
Chemotherapy, Adjuvant ; Chronic Disease ; Cognition Disorders ; Cognition ; Colorectal Neoplasms ; Drug Therapy ; Executive Function ; Fatigue ; Gastrointestinal Neoplasms ; Healthy Volunteers ; Humans ; Longitudinal Studies ; Memory ; Nursing ; Prospective Studies ; Stomach