| Miran Jung | 2 Articles |
PURPOSE
This systematic review and meta-analysis was performed to confirm the effects of exercise on Breast Cancer-Related Lymphedema (BCRL) in breast cancer survivors. METHODS Totally, 1,614 articles were retrieved from databases including PubMed, Ovid MEDLINE, Embase, Cochrane CENTRAL, CINAHL, Korea Med, Kmbase, KISS, NDSL, KiSTi, and academic journals related to nursing in Korea between June 17 and 18, 2019. Fifteen Randomized Controlled Trials (RCTs) were selected for the analysis from June 19 to July 12, 2019. Cochrane's Risk of Bias assessed the quality and risk of bias of selected articles. Review Manager version 5.3 was used for the meta-analysis. RESULTS Studies were published since 2006 including a total of 1,109 participants who were diagnosed with or at risk of BCRL or had undergone surgery for breast cancer treatment. Although exercises were found ineffective for reducing upper extremity edema (Z=0.37, 95% Confidence Interval [CI]=−0.06~0.04, p=.710), they significantly improved shoulder Range of Motion (ROM), especially flexion (Z=5.88, 95% CI=3.06~6.12, p<.001) and abduction (Z=3.41, 95% CI=2.71~10.06, p<.001), upper extremity function (Z=4.02, 95% CI=−12.09~−4.17, p<.001), and Quality of Life (QoL) (Z=3.00, 95% CI=0.13~0.61, p=.003). Egger's regression test assessed publication bias (Intercept=3.75, t=1.79, df=8, p=.111). CONCLUSION Results suggest that exercise is beneficial to BCRL management, especially improvement of shoulder ROM, upper extremity function, and QoL. However, exercise must be performed carefully to prevent side effects. Therefore, nurses should continuously observe signs and symptoms related to BCRL and educate breast cancer survivors on safely performing exercise. Citations Citations to this article as recorded by
PURPOSE
The purpose of this study was to compare the content of the falls prevention guideline developed by Korean Hospital Nurses' Association (KHNA) in 2008 with the seven guidelines recommended by The Joint Commission. METHODS The contents of the eight guidelines were categorized into eight assessment, eight intervention, and two outcome elements that were considered core concepts of individual nursing activities. Concept-level comparisons were conducted using the International Classification for Nursing Practice, and the Logical Observation Identifiers, Names, and Codes. Two researchers independently examined the content coverage of each guideline and assigned 1 point to included content, 0 to excluded content, and 0.5 to similar content that was ambiguous in terms of a broader expression. The scores were compared, with discordance among raters resolved through consensus-based discussions. RESULTS The communication element in the assessment area was missing from the KHNA guideline, while five elements of pathophysiologic, mental/cognitive, therapeutic, and post-fall assessments showed lack of content. Although there were no missing elements in the intervention area, the three elements of staff communication, risk-targeted, and post-fall interventions showed considerable lack of content compared to the other guidelines. In terms of outcomes, the severity of fall-related injury was omitted, and the facility's policy on falls prevention was not addressed. CONCLUSION Many nursing elements and key concepts were missing from the KHNA guideline, and its content was not comprehensive. This suggests that the current guideline needs to be revised urgently, and the points identified in this study should be considered a high priority. Citations Citations to this article as recorded by
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