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Original Articles
Experiences of Self-management Support among Breast Cancer Survivors
Seok Mo Heo, Narae Heo
Korean J Adult Nurs 2016;28(4):470-481.   Published online August 31, 2016
DOI: https://doi.org/10.7475/kjan.2016.28.4.470
PURPOSE
The purpose of this study was to explore self-management support experiences among breast cancer survivors.
METHODS
Individual in-depth interviews were performed for survivors who had treated breast cancer after completion of chemotherapy and radiation therapy. Data were collected from April 2014 to July 2014 and analyzed using phenomenological method by Colaizzi.
RESULTS
Five essential themes were found as follows: 1) Need for continuous help and support to maintain self-management, 2) Need for professional resources to carry out regular exercise, 3) Overcoming psychological difficulties through others rather than health care professionals, 4) Disappointment with time with and circumstances of health care consultation, 5) Dependence on means of media for health related information.
CONCLUSION
The results might contribute to an understanding of self-management support experienced by breast cancer survivors in Korea. It is suggested that evidence-based program for self-management support should be developed and applied to nursing intervention for breast cancer survivors.

Citations

Citations to this article as recorded by  
  • Development and Evaluation of an App-Based Self-Management Program for Exercise Practice of Breast Cancer Survivors: A Non-Randomized Controlled Trial
    Suyoun Maeng, Jungok Yu
    Journal of Korean Academy of Nursing.2024; 54(2): 250.     CrossRef
  • A systematic review of qualitative research on the self‐management experience of breast cancer patients
    Xi‐Bo Sun, He‐Peng Su, He Jiang, Bing Wang, Shuai Lu, Jin‐Xiu Qu, Xiang‐Qi Li, Ben‐Qiang Rao
    The International Journal of Health Planning and Management.2024; 39(4): 1131.     CrossRef
  • Verification of Usability of Medical Image Data Using Projective Photography for Designing Clothing for Breast Cancer Patients
    Youn Joo Kim
    Tomography.2022; 8(4): 1820.     CrossRef
  • Photovoice-Based Assessment of Weight Management Experiences of Breast Cancer Patients Treated with Tamoxifen
    Jung Suk Park, Jeong-Won Han, Jin Hyuk Choi, Kyoung Chun Lee
    International Journal of Environmental Research and Public Health.2020; 17(12): 4359.     CrossRef
  • Journey through the Fight against Ovarian Cancer: Finding the Existence Value with being Tied to the Bridle of Death
    Young-Suk Park, Jeong Sook Park
    Korean Journal of Adult Nursing.2018; 30(6): 656.     CrossRef
  • Experience of Chemotherapy in Ovarian Cancer Patients
    Nayeon Shin, Jiyoung Kim
    Asian Oncology Nursing.2017; 17(3): 158.     CrossRef
  • The phenomenological study of self-management intervention among breast cancer survivors: Non-pharmacological approaches
    Seok-Mo Heo, Narae Heo
    Journal of the Korea Academia-Industrial cooperation Society.2016; 17(12): 270.     CrossRef
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  • 5 Scopus
Symptom Clusters in Patients with Breast Cancer
Soo Hyun Kim, Ran Lee, Keon Suk Lee
J Korean Acad Adult Nurs 2009;21(6):705-717.   Published online December 31, 2009
PURPOSE
The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL).
METHODS
A convenient sample of 303 patients was recruited from an oncology-specialized hospital.
RESULTS
Two distinct clusters were identified: A gastrointestinal-fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL.
CONCLUSION
Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.
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Factors Influencing Family Functioning of Couples with Breast Cancer in the Middle Adaptation Stage: Trajectory of Chronic Illness
Jinsun Yong, Im sun Seo
J Korean Acad Adult Nurs 2009;21(6):666-677.   Published online December 31, 2009
PURPOSE
This study was to test a theoretical model examining the relationships among social support, illness demands, marital adjustment, family coping and family functioning in couples more than three years after breast cancer diagnosis.
METHODS
A causal modeling methodology was used to test the specified relationships in the recursive theoretical model. A total of 60 couples with breast cancer were recruited from January to April 2005. Five standardized questionnaires were used to measure the theoretical concepts: social support (ISSB), illness demands (DOII), marital adjustment (DAS), family coping (F-COPES), and family functioning (FACESII).
RESULTS
Path analysis results from the wives and the husbands revealed different patterns. Three hypotheses were supported in the wife model as predicted: social support and family coping, family coping and family functioning, and social support and marital adjustment (trend). Five hypotheses were supported in the husband model as predicted: social support and illness demands, also social support and marital adjustment, illness demands and marital adjustment, marital adjustment and family coping, and family coping and family functioning.
CONCLUSION
This study provides valuable information for developing various interventions with social support for improving family functioning of breast cancer couples in the middle adaption stage (more than three years after diagnosis).
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Factors Related to Breast Cancer Screening using Mammography and Clinical Breast Examination of Korean Women Over 40 Years of Age
Young Eun, Mee Ok Gu, Eunice L Lee, Kyung Sook Choi, Myung Hee Jun
J Korean Acad Adult Nurs 2009;21(6):580-592.   Published online December 31, 2009
PURPOSE
The purpose of this study was to investigate the factors related to Breast cancer Screening using Mammography and CBE of Korean women over 40 years of age.
METHODS
The participants for this study were 183 Korean women living in 3 urban cities and aged from 40 to 75. The data were collected using structured questionnaires which included sociodemographic factors (11 items), frequency and regularity of mammography and clinical breast examination (7 items), knowledge (16 items), health belief model scale (28 items), and family support (4 items) about breast cancer and breast cancer screening. Frequencies, Chronbach's alpha for reliability, Chi-square, t-test and logistic regression with the SPSS/WIN 12 program were used to analyze the data.
RESULTS
The percentages of Korean women who had a mammography and CBE for breast cancer screening were 60.1 and 31.1, respectively. Logistic regression analyses demonstrated that regular check ups and perceived barriers were significant predictors of mammography and CBE use for breast cancer screening.
CONCLUSION
In order to increase the frequency of breast cancer screening practices, educational support and a health care delivery system is needed to improve the chance of regular health check ups.
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The Relationship of Sexual Satisfaction and Daily Stress in the Breast Cancer Patients
Kyung Hee Kim, Hye Jin Kwon, Mi Hye Choi, Jung Ae Kim, Ki Sook Kim
J Korean Acad Adult Nurs 2009;21(5):529-537.   Published online October 31, 2009
PURPOSE
The purpose of this study was to investigate the correlation of sexual satisfaction and daily stress in breast cancer patients.
METHODS
Data was collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, ANOVA and Pearson's correlation. Data survey was conducted with 500 conveniently selected breast cancer patients who visited the out patient department in 5 university hospitals in Seoul, Gyung-gi and Gang-won province.
RESULTS
The sexual satisfaction of breast cancer patients score was 31.34 and there were significant sexual satisfaction differences by age, education level, menopause and sexual activity frequency. Sexual satisfaction was negatively related with daily stress (r = -.177) especially personal stress (r = -.155), economic stress (r = -.138), stress of self (r = -.181), family stress (r = -.154) and stress about leisure (r = -.139).
CONCLUSION
These findings are expected to make a contribution to creation of ideal sexual rehabilitation nursing interventions for breast cancer patients care nurse. Furthermore continuous and customized education and counseling programs can contribute to promote healthy sexual life for breast cancer patients.
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Development of a Program for Anger Management Based on Self-efficacy in Patients with Breast Cancer
Pok Ja Oh, Seung Yi Choi
J Korean Acad Adult Nurs 2009;21(2):199-211.   Published online April 30, 2009
PURPOSE
The purpose of this study was to develop a program for anger management based on self-efficacy.
METHODS
In this study, four types of approaches to enhance anger control were developed; 1) a role play for vicarious experiences; 2) an assertive training for anger expression; 3) a 30-minute long education program & a 20-minute long telephone call coaching for verbal persuasion; and 4) a booklet for anger management and self care behaviors. One group pretest-posttest design was used for evaluating the program. Study subjects were 6 cancer patients undergoing chemotherapy. The group were received a 4-week intervention, 60 ~ 90 minutes a day weekly, and measured the variables at baseline, 4 weeks later. Anger-in, anger-out, and anger-control were measured by STAXI-K. Data was analysed by Wilcoxon using SPSS/WIN 12.0 program. Anger situation was analysed according to primary anger-thoughts and secondary anger-thoughts based on cognitive theories of anger.
RESULTS
The program for anger management consisted of a role play, assertive training, education, telephone call coaching and a booklet. The program revealed significantly less Anger-in (Z = -1.997, p = .046), anger-out (Z = -2.207, p = .027). No difference, however, was found in anger control (Z=-1.826, p=.068).
CONCLUSION
This evaluation suggested that more assertive training and longer intervention may be needed to maximize anger control.
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Implementing and Evaluating a Nurse Led Hereditary Cancer Genetics Educational Program in a Korean Breast Cancer Surgery Clinic
Kyung Sook Choi, Myung Hee Jun, Sei Hyun Ahn, Gwen Anderson
J Korean Acad Adult Nurs 2008;20(6):815-828.   Published online December 31, 2008
PURPOSE
This study was to develop and evaluate the clinical utility of the breast and ovarian cancer genetic counselling program specific for 20 Korean women(KBOCGP).
METHODS
The KBOCGP was developed using three types of approaches: an ethnography among Korean women who underwent BRCA1/2 test, designing and implementing one week clinical genetic educational course for clinical cancer nurses, educational observation visits to three American cancer genetic counselling programs. And then pre-experimental design was implicated to evaluate the change of the women's knowledge about the hereditary breast and ovarian cancer and the level of the satisfaction with genetic counselling.
RESULTS
The mean score of the knowledge has significantly increased from 7.45 +/- 3.86 to 11.55 +/- 2.21(t = 5.63, p < .001). The level of the satisfaction with the counselling was very high (27.47 +/- 1.35). Because most of the subjects have young kids, they showed strong concerns about their kids' getting cancer.
CONCLUSION
This new KBOCGP is the satisfactory program for the education and communication of the genetic information to the Korean women with HBOC. But it is needed more to strengthen the cultural sensitivity especially to Korean family relationships. Authors recommend that this program be provided by other nurses who are counselling women at high risk of breast cancer.
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Use of Complementary and Alternative Medicine and its Affecting Factors in Women with Breast Cancer
Yeon Ok Suh
J Korean Acad Adult Nurs 2007;19(3):447-458.   Published online August 31, 2007
PURPOSE
This exploratory study was to identify the use of complementary and alternative medicine(CAM) in women with breast cancer and to analyze which factor influence CAM use.
METHODS
114 patients with breast cancer were identified and approached. The instrument used to gather data were the common types, main reasons and effects as well as stress, mood states and fatigue.
RESULTS
42.7% of all participants reported the use of CAM. The most common types of CAM used were Phellinus linteus, elm tree, and vitamin C. The main reasons for CAM use were to boost the immune system and to prevent recurrence. Prayer, massage, Shitake mushroom, and Ganoderma lucidum were, identified as being more effective than others. 93.6% of the respondents informed their physicians of their use of CAM. Logistic regression analysis determined that stress, mood states, and duration after diagnosis were factors significantly associated with CAM use.
CONCLUSION
CAM use is increasing among patients with breast cancer. Health care professionals are in the main position to identify what treatments patients are using and implement CAM therapies that can be helpful to relieve patient symptoms related to treatment and psychological distress.
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The Effects of a Follow-up Program on Physical, Emotional, and Social Function after Breast Cancer Surgery
Heeyoung So, Hyun Li Kim
J Korean Acad Adult Nurs 2006;18(3):416-425.   Published online August 31, 2006
PURPOSE
To evaluate the effects of a follow-up program for breast cancer patients after surgery.
METHOD
A quasi-experimental design was used. The subjects were 56 breast cancer patients (experimental group: 27, control group: 29). The subjects of the experimental group participated in the Follow-up program of 7 sessions once a week, during 4 weeks including one telephone visit. The program consisted of health education of breast cancer, exercise, lymph edema prevention, diet education, theraband rehabilitation exercise, laugh therapy, and breast self examination. The obtained data were analysed by using the ANCOVA of SPSS.
RESULTS
There was a significant difference in the scores of physical wellbeing, symptom distress and mood state between the two groups.
CONCLUSION
Considering these research results, short-term intervention could improve physical and emotional functioning abilities by helping better health. Nurses should establish and manage a proper program to provide multipurpose support and it must apply the program after surgery as soon as possible for breast cancer women.
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Comparisons of Physiological and Psychosocial Symptoms for Breast Cancer Patients with and without Lymphedema
Jin Hee Park
J Korean Acad Adult Nurs 2006;18(3):357-366.   Published online August 31, 2006
PURPOSE
The purpose of this study were to examine the incidence of lymphedema and to compare to physiological and psychosocial symptoms between breast cancer patients with lymphedema and without lymphedema.
METHOD
Four hundreds fifty women with breast cancer receiving mastectomy were recruited from two out-patient breast clinics of A and S university hospitals in Seoul, Korea from October, 2004 to May, 2005. Lymphedema was defined by circumferential measurement. Differences greater than 2cm between the affected arm and normal arm were considered to be lymphedema. A descriptive design was used for this study and data was collected using a structured questionnaire. The data were analyzed using descriptive statistics and independent t-test.
RESULTS
Lymphedema developed in 112(24.9%) of the 450 subjects. Subjects with lymphedema reported more severe sensation change of arm and more depression and confusion than subjects without lymphedema. Range of motion of shoulder as a physical indicator and social support, however, were not significantly different between the two groups.
CONCLUSION
Lymphedema is recognized as an unpleasant and uncomfortable consequence of breast cancer- related treatment. Therefore, more research is needed to evaluate the impact of lymphedema on quality of life in patients with lymphedema and the efficacy of nursing intervention.
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Relationships of Perceived Health Status, Depression and Quality of Life of Breast Cancer Survivors
Young Ran Chae
J Korean Acad Adult Nurs 2005;17(1):119-127.   Published online March 31, 2005
PURPOSE
The purpose of this study was to describe the degree of perceived health status, depression and quality of life(QOL) and to examine the relationships among these factors in breast cancer survivors. METHODS: The subjects were 105 women with mastectomy after breast cancer diagnosis who were in the out-patient department of surgery at SNUH in Seoul. Data was collected using self-report instruments. The instruments included 1-item for perceived health status, Chae and Choe's QOL scale for Korean breast cancer survivors, and Beck Depression Inventory(BDI) as well as socio-demographic and medical information. Data were analyzed with SPSS WIN 10.0 program. RESULTS: The levels of perceived health status and QOL were moderate. Mild depression was found on the BDI. QOL and depression showed a negative correlation(r= -.598), whereas QOL and perceived health status was correlated positively(r=.370). Depression, perceived health status, and time since diagnosis accounted for 47.4% of variance of the QOL. Depression was the most significant predictor of QOL in breast cancer survivors. CONCLUSION: Breast cancer survivors may experience depression and alteration in QOL. Future nursing research should be directed toward the implementation and evaluation of interventions that promote QOL and decrease depression in breast cancer survivors.
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A Study on Age-related Difference in Risk Perception of Breast Cancer and Influencing Predictors
Dong Suk Lee, Haeng Mi Son
J Korean Acad Adult Nurs 2004;16(2):327-336.   Published online June 30, 2004
PURPOSE
The aim of this study was to identify the age-related differences in risk perception of breast cancer and the age-related differences in predictors of risk perception. METHOD: The subjects were 553 women aged from 15 to 64 who lived in Seoul, Kwang-Ju, Jeon-nam province. Data was collected by self-reported questionnaire surveys using convenience sampling. The collected data was analyzed using descriptive statistics, F-test with Scheffe test, and stepwise multiple regression with SPSS-Win 10.0 version. RESULT: Risk perception of breast cancer was different by age group. Especially, risk perception in teenagers and the 50~64 years group was lower than the other groups. Additionally, general fear of breast cancer, information seeking style, experience, and knowledge were different between the age groups. The results of multiple regression analyses predicting risk perception indicated the following significant predictors: general fear and knowledge in all the subjects, general fear and experience in the 20~29 years group, and general fear in the other age groups. CONCLUSION: These results suggested that the construction of educational messages for breast cancer prevention and early detection should be designed differently for each age group.
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A Study on Quality of Life of those who have Breast Cancer Patients taking Chemotherapy
Ju Hyeon Shim, Kyung Sook Park
J Korean Acad Adult Nurs 2004;16(1):49-59.   Published online March 31, 2004
PURPOSE
This study is a descriptive research study to measure the quality of life of those who suffer from breast cancer and take the chemotherapy. METHOD: The Subjects were 70 breast cancer patients who took the chemotherapy from September 2 to October 31, 2003. Quality of life was measured by Ferrell's measurements. RESULTS: Quality of life indicators were spiritual domain=6.44, physical domain= 5.45, social domain=4.15, and mental domain= 3. 95. Whole quality of life was 4. 68 out of 10 points. The quality of life of those with a practicing religion was significantly higher than those without(F=3.88, P=0.026). Subjects who were less than 2 months post-operation had higher points in the physical domain than those who were more than 2 months post-operation (t= 2.76, p=0.007). Subjects who had less than 4 treatments of chemotherapy had higher points in the physical domain than those who had more than 4 treatments of chemotherapy (t=2.03, p=0.046). COLCLUSION: The results of this study serve as a meaningful source to promote quality of life of breast cancer patients who undergo chemotherapy. The results can also be applied to the development of education programs and counseling materials for chemotherapy patients. Health care strategy can also raise the quality of life of brest cancer patients.
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The Effects of Dynamic Imagery Therapy on "Anger-in" and Immune Function in Patients with Breast Cancer
Eun Sim Kim
J Korean Acad Adult Nurs 2003;15(4):639-649.   Published online December 31, 2003
PURPOSE
The purpose of this study was to identify the effect of dynamic imagery therapy on "anger-in" and immune function in patients with breast cancer. METHOD: Dynamic imagery therapy was given for 10 sessions with 2 times informative education. Data collection was from June, 24th to August, 12th 2002. The participants were experimental group 15, control group 15. This study was designed using a quasi-experimental approach with non-equivalent Pre test-Post test Design. The instruments used in this study include the anger scale developed by Spielberger(1972) and modified by Chon, Kyum Koo (1996), The data was analysed with chi(2)-test, t-test, ANOVA and ANCOVA. RESULT: 1) That the level of "Anger-in" in patients will be significantly lower than that of the control group was supported (p<.001). 2) That the level of T3 lymphocyte and NK Cells, IgG. Cortisol in patients will be significantly lower than that of the control group was supported (T3, IgG: p<.05, Cortisol p<.001). CONCLUSION: The dynamic imagery therapy is suggested as an effective nursing intervention to reduce anger level and increase immune function for patients with breast cancer.
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Predicting Factors of Breast Self-Examination Among Middle Aged Women
Young Whee Lee, Eun Hyun Lee
J Korean Acad Adult Nurs 2001;13(4):551-559.   Published online December 31, 2001
PURPOSE
The purpose of this study is to identify predicting factors of the performance of breast self-examination (BSE) among Korean middle-aged women based upon the Health Belief Model.
METHOD
A descriptive design was used for this study. A total of 309 convenience samples were recruited from Yonsu-Gu, Inchon. The Champion's Health Belief Model Scale was used to measure the health belief related variables of susceptibility, severity, benefits, barriers, confidence, and health motivation. The performance of BSE asked of it was as ever or never performed during the last year. The obtained data were analysed using descriptive statistics, x2-test, t-test, and logistic regression.
RESULT
Results showed that 32% had ever BSE last year. Age and BSE education among demographic characteristics were significantly associated with the performance of BSE. Thus, these demographic variables were added to the logistic regression analyses with the health belief variables. As a result, age, BSE education, health motivation, and confidence significantly explained the performance of BSE.
CONCLUSION
This study suggests that it is important that the development of BSE educational programs increase confidence and motivation, particularly for middle aged-Korean women.
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Development of a Quality of Life Scale for Patients with Breast Cancer in Korea
Young Ran Chae, Myoung Ae Choe
J Korean Acad Adult Nurs 2001;13(3):486-495.   Published online September 30, 2001
The purpose of this study was to develop a Quality of Life(QOL) scale for breast cancer patients in Korea and to test the validity and reliability of the instrument. To achieve the purpose of the study, a questionnaire was developed to interview 10 breast cancer patients and distributed to 155 patients with breast cancer in Korea. For data analysis, SPSS WIN 8.0/PC were used. Item analysis and factor analysis were carried out to test validity of the QOL scale. Cronbach's alpha and Guttman split half coefficient were used to test reliability of the scale. The results were as follows; As a result of the item analysis, 27 items were selected from the total of 34 items. 6 factors were selected by factor analysis. Six factors were labeled as 'response to cancer diagnosis and treatment', 'family well-being', 'physical concerns', 'psychological well-being', 'spiritual well-being', and 'economic concerns'. Six factors were explained by 72.236% out of the total variance. The first factor explained 20.738% and the second factor explained 16.593%, which were major factors for Korean breast cancer patients. Chronbach's alpha coefficient of the tool was .9120, and Guttman split-half coefficient was .8148. The scale was identified to be a tool with a high degree of reliability and validity. Therefore, this scale can be effectively utilized for assessment of Quality of Life of patients with breast cancer in Korea.
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Information Needs of Women with Breast Cancer
Hea Kung Hur
J Korean Acad Adult Nurs 2000;12(2):286-295.   Published online June 30, 2000
Nurses play an important role in patient education, including providing patients with useful and appropriate information. The purpose of this study was to explore what particular types of information were important to women diagnosed with breast cancer. Sixty seven women with breast cancer an outpatient clinic in W Christian Hospital responded to the structured questionnaires developed by the investigator. Interviews and mail surveys were used in this study. The findings in this study showed that six kinds of information needs arose, ranked as the signs and symptoms of recurrence, the possibility of recurrence, the possibility of metastasis, treatment, diet and physical activities in daily living. Marital status, level of education, and level of monthly income were not related to level of informational need. Younger women rather than older women had a greater need to seek information(r=-.471, p<.01). There was a significantly negative relationship between duration of disease and the score on information needs(r=-.32, p<.05). The findings have implications that the opportunity to ask questions and have accurate information on the recurrence should be provided to women with breast cancer.
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