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

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: 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

PURPOSE: The purpose of this study was to identify the knowledge structure of cancer survivors. METHODS: For data, 1099 articles were collected, with 365 keywords as a Noun phrase extracted from the articles and standardized for analyzing. Co-occurrence matrix were generated via a cosine similarity measure, and then the network analysis and visualization using PFNet and NodeXL were applied to visualize intellectual interchanges among keywords. RESULTS: According to the result of the content analysis and the cluster analysis of author keywords from cancer survivors articles, keywords such as 'quality of life', 'breast neoplasms', 'cancer survivors', 'neoplasms', 'exercise' had a high degree centrality. The 9 most important research topics concerning cancer survivors were 'cancer-related symptoms and nursing', 'cancer treatment-related issues', 'late effects', 'psychosocial issues', 'healthy living managements', 'social supports', 'palliative cares', 'research methodology', and 'research participants'. CONCLUSION: Through this study, the knowledge structure of cancer survivors was identified. The 9 topics identified in this study can provide useful research direction for the development of nursing in cancer survivor research areas. The Network analysis used in this study will be useful for identifying the knowledge structure and identifying general views and current cancer survivor research trends.
Cluster Analysis ; Databases, Factual ; Humans ; *Models, Nursing ; Neoplasms/pathology/*psychology ; Palliative Care ; Qualitative Research ; Quality of Life ; Social Support ; Survivors/psychology

PURPOSE: The purpose of this study was to identify the factors affecting symptom experiences of breast cancer patients. METHODS: A cross-sectional descriptive study was conducted with based on the Unpleasant symptom Theory. Sixty breast cancer patients were recruited. We measured their symptom experiences, physiologic factors (immune system function and specific perceived symptoms), psychological factors (depression and anxiety), and situational factors (family support). After obtaining permission from the IRB, data were collected from self-report questionnaires and electronic medical records from a single cancer center. Descriptive statistics, t-test, one-way ANOVA, correlations and multiple regressions were used to analyze the data. RESULTS: The most frequent and severe symptoms were fatigue (4.47+/-2.99), numbness or tingling (3.67+/-3.08) and sadness (3.45+/-3.64). Symptom experiences were significantly positively correlated with psychological factors (r=.603, p<.01) and physical symptoms (r=.384, p<.01). Symptom experiences and situational factors (r=.302, p<.05) were had a significantly negative correlation. The factor that had the most impact on symptom experiences were psychological factors, followed by perceived physical symptoms. The regression model explained 44.8% of the variances. CONCLUSION: Based on the results of this study, the physiological, psychological and situational factors should be considered for caring breast cancer patients.
Breast Neoplasms* ; Electronic Health Records ; Ethics Committees, Research ; Fatigue ; Humans ; Hypesthesia ; Nursing Theory ; Oncology Nursing ; Psychology ; Surveys and Questionnaires

PURPOSE: This study was done to develop tool to evaluate the core competencies regarding nursing cancer patients on chemotherapy, and to verify the reliability and efficacy of the developed tool. METHODS: A tool to evaluate the core competencies was developed from a preliminary tool consisting of 112 items verified by expert groups. The adequacy of the preliminary tool was analyzed and refined to the final evaluation tool containing 76 items in 8 core competencies and 18 specific competencies. The evaluation tool is in the form of a self-report, and each item is evaluated according to a 3-point scale. From September 22 to October 14, 2011, 349 survey responses were analyzed using SPSS 20.0 and the WINSTEPS program that employs the Rasch model. RESULTS: Results indicated that there were no inappropriate items and the items had low levels of difficulty in comparison with the knowledge levels of the study participants. The results of factor analysis yielded 18 factors, and the reliability of the tools was very high with Cronbach's alpha=.97. CONCLUSION: The results of this study can be used for training and evaluation of core competencies for nursing cancer patients, and for standardizing nursing practices associated with chemotherapy.
Adult ; Antineoplastic Agents/*therapeutic use ; Female ; Focus Groups ; Humans ; Male ; Neoplasms/*drug therapy ; Nurse's Practice Patterns ; Nurse-Patient Relations ; *Nursing Evaluation Research ; Nursing Staff, Hospital/*psychology ; *Program Development ; Program Evaluation ; Questionnaires

PURPOSE: This study was done to develop and test a palliative care program based on home care nursing. METHODS: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. RESULTS: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. CONCLUSION: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.
Aged ; Demography ; Family/psychology ; Female ; Home Care Services, Hospital-Based ; Humans ; Male ; Middle Aged ; Neoplasms/*nursing/psychology/therapy ; Pain/therapy ; Palliative Care/*methods ; Patient Satisfaction ; Program Evaluation ; Quality of Life ; Terminal Care

PURPOSE: The purpose of this study was to understand the meanings and nature of living in the world among cancer patients. The present study adopted a hermeneutic phenomenological method which was developed by van Manen. METHOD: The participants for this study were 5 men and 6 women, who were over the age of 20 with admission or a follow up visit in the medical or surgical department. Data were collected by using in-depth interviews and observations from February to September, 2007. The contents of the interviews were tape-recorded with the consent of the subject. RESULT: The essential themes that fit into the context of the 4 existential grounds of body, time, space and other people were: a body that cannot be restored, a body that endures and lives, waiting in uncertainty, a valued calculation for the living day, being in a world of invisible power, reestablishing relationships, and reflection on his or her life. CONCLUSION: These findings revealed that living in the world is affected to varying degrees by the cancer. It is important for nurses to identify and take care of disabilities and to support the reorientation in the disintegrated life situation. The result of this study can give nurses some insight into these experiences and help promote empathetic care.
*Activities of Daily Living ; *Adaptation, Psychological ; Adult ; Aged ; Attitude to Death ; Female ; Humans ; Interpersonal Relations ; Interviews as Topic ; Male ; Middle Aged ; Neoplasms/nursing/*psychology ; Quality of Life ; Stress, Psychological ; Young Adult

PURPOSE: The purpose of this study was to develop and evaluate a quality of life scale for Korean patients with cancer (C-QOL). METHODS: The C-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. A total of 337 patients diagnosed with stomach, liver, lung, colon, breast, or cervix cancer were recruited. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, the SF-36, and the ECOG performance status. The obtained data was analyzed using descriptive statistics, factor analysis, multidimensional scaling (MDS), multitrait/multi-item matrix, ANOVA, t-test, and Cronbach's alpha. RESULTS: Preliminarily twenty-six items were generated through content validity and a pilot study. Factor analysis and MDS extracted a total of 21 items with a 5-point Likert-type scale (C-QOL). The C-QOL included five subscales: physical status (6 items), emotional status (6 items), social function (3 items), concern status (2 items), and coping function (4 items). The C-QOL established content validity, construct validity, item convergent and discriminant validity, known-groups validity, reliability, and sensitivity. CONCLUSION: The Newly developed C-QOL is an easily applicable instrument which established psychometric properties and reflected Korean culture. It is recommended for further study to examine the responsiveness of the C-QOL using a longitudinal research design.
Adult ; Aged ; Female ; Humans ; Korea ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasms/nursing/*psychology ; Program Evaluation ; Psychometrics ; *Quality of Life ; *Questionnaires ; Research Design

PURPOSE: The purpose of this study was to describe and to analyze real communication about a patient's discomfort between a patient with cancer and a nurse. METHOD: A dialogue analysis method was utilized. Fifteen patients and 4 nurses who participated in this research gave permission to be videotaped. The data was collected from January, 3 to February 28, 2006. RESULTS: The communication process consisted of 4 functional stages: 'introduction stage', 'assessment stage', 'intervention stage' and 'final stage'. After trying to analyze pattern reconstruction in the 'assessment stage' and 'intervention stage', sequential patterns were identified. In the assessment stage, if the nurse lead the communication, the sequential pattern was 'assessment question-answer' and if the patient lead the communication, it was 'complaint-response'. In the intervention stage, the sequential pattern was 'nursing intervention-acceptance'. CONCLUSION: This research suggests conversation patterns between patients with cancer and nurses. Therefore, this study will provide insight for nurses in cancer units by better understanding communication behaviors.
Adult ; Aged ; *Communication ; Female ; Humans ; Inpatients ; Male ; Middle Aged ; Neoplasms/nursing/*psychology ; Nurse's Role/psychology ; Nurse-Patient Relations ; Nursing Methodology Research ; Nursing Staff, Hospital/*psychology ; Tape Recording