Purpose Cancer diagnosis is associated with psychological distress, which often leads to a significant reduction in adaptation and quality of life. This study aimed to identify the prevalence and related factors of psychological distress in newly diagnosed breast cancer patients. Methods The study included 138 women scheduled for surgery or neoadjuvant chemotherapy following a recent breast cancer diagnosis at a university hospital in Korea.
Psychological distress was assessed using the National Comprehensive Cancer Network Distress Thermometer and problem lists. Data collection occurred from November 1, 2021, to November 30, 2022. Descriptive statistics and logistic regression analysis were utilized for data analysis. Results The average age of the participants was 51.72 years. Among the 138 participants, 67.4% (n=93) reported moderate to severe levels of psychological distress. Multivariate logistic regression analysis identified financial burden (Odds Ratio [OR]=4.32), fears (OR=5.35), and nervousness (OR=5.50) as predictors of moderate to severe psychological distress. Conclusion Approximately two-thirds of newly diagnosed breast cancer patients experienced significant psychological distress.
Nervousness, fears, and financial burden were significant factors influencing this distress. Therefore, management of psychological distress should be implemented for patients experiencing financial burdens or emotional problems, such as nervousness and fear, from the time of diagnosis.
Purpose This study aimed to compare the lifestyle, self-rated health, and mental health of breast cancer survivors with those of the healthy people through a propensity-matched comparison, and identify factors affecting the mental health of breast cancer survivors.
Methods This study was a secondary analysis that used data from the Korea National Health and Nutrition Examination Survey (KNHANES), from 2015 to 2020. It included 47,118 participants, of which 134 breast cancer survivors and 268 healthy people were separated and analysed by 1:2 Propensity Score Matching (PSM), and complex sample logistic regression analysis was performed using SPSS and R programs.
Results Statistically significant differences were found in smoking rate, walking exercise rate, cancer screening rate, daily energy intake, and self-rated health between breast cancer survivors and healthy groups. After PSM, there were significant differences in the ratio of perceived stress, suicide plan, suicide attempts, and mental health counseling experiences between the healthy group and breast cancer survivors. As compared to the healthy group, breast cancer survivors had a significantly higher risk of mental health issues by 2.19 times. Self-rated health, household income, and number of household members were significant influencing factors affecting the mental health of breast cancer survivors.
Conclusion This study provides evidence of an increased mental health risk in breast cancer survivors compared with healthy women with no cancer. Mental health outcomes, such as stress, sleep disturbance, and suicidal ideation, have been reported post cancer treatment. Counselling and management strategies would be helpful for breast cancer survivors.
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Purpose This study aimed to construct and test a hypothetical model which explains the psychosocial adjustment of breast cancer survivors using the family resilience model suggested by McCubbin and McCubbin. Methods The study participants were 242 breast cancer survivors who had finished active treatments within the past five years. Data were collected from September to October 2017 from an offline breast cancer self-help group survey and an online breast cancer support group. Data were analyzed using SPSS version 22.0 and AMOS version 23.0. Results The model fit indices for the modified hypothetical model were suitable for the recommended level: x2 =223.80 (df=88, p<.001), x2 /df=2.54, RMR=.04, GFI=.90, IFI=.93, CFI=.93, and RMSEA=.08. Symptoms and posttraumatic growth directly affected psychosocial adjustment. Symptoms were found to be the most influential factors in the psychosocial adjustment. All three family resilience factors-family hardiness, problem-solving communication, and problem-solving coping-directly affected posttraumatic growth and indirectly affected psychosocial adjustment through posttraumatic growth. These variables explained 81.2% of breast cancer survivors’ psychosocial adjustment. Conclusion Health care professionals need to continue to provide interventions for symptom relief and support to improve the psychosocial adjustment of breast cancer survivors. Additionally, practical nursing interventions should be prepared for individuals and families of breast cancer survivors to promote recovery and reinforce family resilience. This will ultimately improve the quality of life for breast cancer survivors and their families.
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Purpose This study was conducted so as to determine a hypothetical model concerning factors affecting breast cancer patients' resilience.
Methods: Data were collected via a self-administered questionnaire from 212 patients with breast cancer between July 25 and August 24, 2020. The data were analyzed using SPSS/WIN 20.0 and AMOS 21.0.
Results: The model supported 7 of the 11 presented hypotheses for all participants. Test results indicated that “hope”, “uncertainty”, and “symptom experience” all directly affected participants' resilience, and that “uncertainty” also affected participants', “depression” and “hope”. “Spiritual well-being” affected participants' sense of “hope” and “symptom experience”. Of these variables, “hope” had the strongest direct influence on resilience across all participants. “Uncertainty” was found to directly and indirectly affect participants, whereas “spiritual well-being” indirectly affected the resilience of all participants. “Uncertainty” and “spiritual well-being” indirectly affected the resilience of all participants.
Conclusion: These results suggest that management strategies to enhance breast cancer patients' resilience should address patients' uncertainty, spiritual well-being, hope, and symptom experience.
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Purpose The purpose of this study was to evaluate whether hand press pellet is effective for constipation in breast cancer patients receiving chemotherapy.
Methods: This was a quasi-experimental study that used non-equivalent control group pretest-posttest design. Participants were 52 breast cancer patients-26 each in the experimental and control groups. The intervention was conducted thrice a week for 6 weeks; for the experimental group, a hand press pellet was applied to the corresponding points (A1, A5, A8, A12, A16, N18, E22, K9, F6, D2, D6, H2, L4, B7, B19) of the left hand (palm and back) to alleviate constipation. Three and 6 weeks after the intervention, outcomes were measured by using the Constipation Assessment Scale, Bristol Stool Form Scale, and Patient Assessment of Constipation-Quality of Life questionnaire.
Results: A significant difference was observed between the two groups on the Constipation Assessment Scale (χ2=44.38, p<.001) and Bristol Stool Form Scale (χ2=33.24, p<.001). Patient assessment of constipation-quality of life of the experimental group were statistically significant compared with that of the control group (F=37.23, p<.001).
Conclusion: Hand press pellet can be used as an effective nursing intervention to alleviate constipation in breast cancer patients.
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Purpose The objective of this study was to assess effects of a medication adherence promotion program for breast cancer patients receiving adjuvant hormonal therapy. Methods This study used a randomized control group repeated measures design. A total of 79 participants were recruited from an outpatient clinic in the Chonbuk National University Hospital, Jeonju city. The program's effects on medication adherence, perceived stress, depression, and fatigue were assessed at three points: before, at the 9th week, and again at the 16th week of the program application. The data were collected from July 3 to November 9, 2017. Results Statistically significant differences in changes in medication adherence, perceived stress, and depression over the assessment points between experimental and control groups were revealed. Scores on medication adherence in the experimental group improved at the 9th week mark and lowered a little at the 16th week, but remained higher than before the program application, however. Scores on perceived stress and depression in the experimental group improved at the 9th week and stayed almost at the same level at the 16th week. Conclusion It is clear that consistent nursing interventions are needed to promote and maintain medication adherence and associated symptoms, particularly for breast cancer patients who require long-term hormonal therapy.
PURPOSE The purpose of this study was to identify the relationship between the supportive care needs and quality of life of back-to-work breast cancer survivors, and determine the factors that affect their quality of life. METHODS Data were collected from 146 patients who had undergone surgery and treatment for breast cancer at Konyang University Hospital in Daejeon city and were receiving outpatient care from December 21, 2017 to November 30, 2018. The collected data were analyzed using the SPSS/WIN 21.0 program with descriptive statistics, an independent t-test, a one-way ANOVA, the Duncan test, Pearson's correlation coefficient, and hierarchical multiple regression. RESULTS Back-to-work breast cancer survivors show higher physical and mental health indices, which reflect quality of life, when they have fewer physical supportive care needs. Additionally, their physical and mental health indices based on the characteristics of the illness differed according to the cancer stage. CONCLUSION It is necessary to develop and test the effectiveness of health education programs that meet the supportive care needs and improve the quality of life of breast cancer survivors returning to work.
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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.
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PURPOSE The objective of this study was to identify and evaluate the measures used for assessment of posttraumatic growth (PTG) for women survivors with breast cancer and to evaluate the psychometric properties of each instrument. METHODS A systematic review was conducted to identify measurement instruments used for assessment of PTG using electronic databases such as KoreaMed, DBpia, PubMed, Embase, PsycINFO, CINAHL, and Cochrane Library. Studied published both in Korean and/or English were included for the analysis. Studies were examined by two independent reviewers and eighty-nine studies met the inclusion criteria. The selection of the eighty-nine studies was evaluated on methodological and psychometric properties including validity and reliability of the instruments. RESULTS Three instruments were identified in the review of the eighty-nine studies. The three instruments were identified as 1) Posttraumatic Growth Inventory (PTGI), 2) Benefit Finding Scale, and 3) Positive Meaning Scale. The PTGI was the most frequently reported instrument used in the review. The majority of the reported studies were used translation and back-translation, but some of the studies did not report translation methods. Most studies (71.9%) reported reliability, but only 29.2% studies reported validity of the instruments used in the study. CONCLUSION This study was conducted to provide an evidence for selection and development of measurement instruments of PTG for breast cancer survivors.
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PURPOSE The purpose of this study was to describe the impact of fatigue and distress on self-efficacy among breast cancer survivors and to provide a base for development of nursing intervention strategy to improve self-efficacy. METHODS A descriptive research design was used. The subjects were 158 patients who were either being treated or were receiving follow-up care at a university breast center in D City from May 30 to August 30, 2014. Structured questionnaires, Revised Piper Fatigue Scale, Distress Thermometer, and Self-Efficacy Scale for Self-Management of Breast Cancer were used to measure fatigue, distress, and self-efficacy. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regressions. RESULTS The mean scores of fatigue, distress, and self-efficacy were 3.83, 4.31, and 3.77, respectively. There were significant differences among participants in terms of educational background, current treatment methods, perceived health status, economic burden for fatigue and perceived health status for distress. Self-efficacy was impacted by age, educational background, marital status, average monthly income, perceived health status, and medical expenses. Fatigue, age, and the burden on medical expense had the most impact on self-efficacy, accounting for 17% of the variance. CONCLUSION Fatigue should be managed to improve self-efficacy of breast cancer survivors. Therefore, nursing programs designed to decrease fatigue may be helpful.
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PURPOSE The purpose of this study was to assess the relationship between cognitive function impairment and quality of life (QoL) among patients with breast cancer. Specifically, the intention was to verify the mediating effects for promoting behaviors leading to better health and QoL. METHODS A purposive sample of 152 patients undergoing chemotherapy was recruited. A cross-sectional survey design was used. Data were collected using four instruments: Everyday Cognition Scale, Korean Mini-Mental State Examination, Functional Assessment of Cancer Therapy-Breast Cancer Version 4, and Health Promoting Lifestyle Profile. RESULTS The mean score for subjective cognitive decline was 65.84; the health promotion behavior was 95.89, and 83.34 for QoL. Health promotion behavior was directly affected by cognitive decline (R2=6.0%) as was QoL (R2=43%). Subjective cognitive decline (β=-.57, p<.001) and health promotion behavior (β=.37, p<.001) were seen as predicting factors in QoL and explained 56% (R2=56%). Health promotion behavior had a partial mediating effect in the relationship between self-reported cognitive decline and QoL (Sobel test: Z=-3.37, p<.001). CONCLUSION Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline and promoting health promotion behavior are highly recommended to improve QoL in cancer patients.
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Do spouse burden of care, family resilience, and coping affect family function in gynecologic cancer in Korea?: a cross-sectional study Minkyung Kim, Sukhee Ahn Korean Journal of Women Health Nursing.2022; 28(3): 197. CrossRef
Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy Yeong Kyong Oh, Seon Young Hwang Journal of Korean Academy of Nursing.2018; 48(1): 50. CrossRef
PURPOSE The purpose is to explore the illness experience of Korean women with breast cancer using feminist phenomenology. METHODS Data were collected by individual in-depth interviews from ten women with total mastectomy. The data were analyzed using Colaizzi's method from feminist perspective to reveal implicit socio-cultural norms that oppress women with breast cancer. RESULTS Two categories and seven major themes emerged: cancer-related experience (1) unfairness of having breast cancer; (2) being confined to the gaze of the others; patriarchy-related experience (3) hardness of being daughter-in-law; (4) struggling to keep on being good mother; (5) continued housework as duty; (6) recognizing self as precious wife, and (7) awakening of true self. All participants felt it was very unfair to get breast cancer because they had done their best for roles of mother, wife, and daughter-in-law. They struggled to free themselves from the social disgrace like the roles imposed by the patriarchal society. By awakening their true selves, they could manage a balance between other-oriented life and self-oriented life. CONCLUSION Oncology nurses need to provide psychosocial support for women with breast cancer in finding their true selves in a traditional patriarchal society where women are oppressed and breast cancer is stigmatized.
PURPOSE 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. METHOD Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). RESULTS 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. CONCLUSION On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.
PURPOSE The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on grip strength, pinch strength, the shoulder joint function, flexibility, and fatigue in mastectomy patients. METHOD: The subjects were fifty-five women with breast cancer (27 in the control group and 28 in the experimental group). The subjects in the experimental group participated in a comprehensive rehabilitation program for 10 weeks, which was composed of education, stress management, exercise, and peer support group activity. RESULTS: The results revealed that the increase in grip strength, key pinch, the shoulder joint function, and flexibility (Back & Reach test, Standing & Bending reach test) of the operated extremity, and the decrease in fatigue were significantly higher in the experimental group than in the control group. However, the results revealed that tip strength and palmar pinch of the experimental group increased but there was no significant difference from that of the control group. CONCLUSIONS: The 10-week comprehensive rehabilitation program showed much affirmative effect on physical function, and fatigue of breast cancer patients after mastectomy.
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