PURPOSE
This study was done to identify the influencing factors of spiritual health in patients suffering from women cancers.
METHODS
The subjects were 130 in woman patients who were diagnosed with women cancer(breast Ca & uterine Ca) at three university hospitals and one general hospital. Data collection was conducted by using 4 questionnaires. The collected data were analyzed using frequency, percentage, t-test, ANOVA, Pearson's correlation coefficients, stepwise multiple regression.
RESULTS
Spiritual health score was middle. There were a significant correlation between spiritual health and depression, pain, fatigue and effects of religion. There were significant differences in spiritual health according to the education level, monthly income, meaning of religion or god, Frequency of attendance at worship. The most powerful predictor of spiritual health was depression(27.2%). Altogether depression, effects of religion, pain, and education level explained 46.1% of spiritual health of women cancer patients.
CONCLUSION
It suggested that concepts of depression, effects of religion, pain, and education level should be considered in developing spiritual health promoting program for women cancer patients.

PURPOSE
This study was to identify the level of quality of life in patients with woman cancer across treatment phases.
METHODS
The research method was a cross-sectional descriptive study. Data was collected by questionnaires from 226 female, who were in- and out-patients. They were diagnosed with breast and uterine cancer from three university hospitals and two general hospitals. The instruments used for this study included, "the Quality Of Life Scale(QOL)". The collected data were analyzed using Frequency, Percentage, ANOVA, Two-Way ANOVA.
RESULTS
Quality of life of women cancer patients was significantly different according to three treatment phases. Quality of life of women cancer patients was not significantly different according to areas of disease in the three treatment phases. Quality of life of women cancer patients was significantly different according to level of fatigue in the three treatment phases. Quality of life of women cancer patients was significantly different according to level of perceived health status in the three treatment phases(F=60.14, p=.000). Quality of life of women cancer patients was significantly different according to education level(F=3.70, p=.027) & occupation(F=5.67, p=.018) in three treatment phases.
CONCLUSION
Strategies for intervention are needed to improve the quality of life in women cancer patients across the treatment phases. The significant several characteristics of affecting on quality of life across treatment phases should be considered in sociopsychological nursing intervention.

PURPOSE
The purpose of this study were to investigate the self-reported quality of life and family burden and to examine the factors associated with the quality of life in patients with cancer.
METHODS
216 patients participated in the cross-sectional study. The European Group of Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Family Burden Scale were sent by mail to 2,000 cancer patients. Two hundred and sixteen patients answered the questionnaire. The stepwise multiple regression was conducted to analyze predictors of overall quality of life.
RESULTS
All subscales of EORTC QLQ-C30 were significantly correlated with family burden. The regression analysis of patients with cancer revealed some variables as significant predictors; performance, perceived severity, family burden, time since diagnosis, and sex.
CONCLUSION
The results offer a number of recommendations for future research and nursing practice focused on primary care for patients with cancer and their family for improving quality of life.

PURPOSE
The purpose of this study was to propose a theoretical model of hope commonly held by the cancer patients just after surgery, under the assumptions that hope of those patients is not only realistic and disease oriented but in dialectical circulation.
METHOD
A theoretical model was generated through 4 steps: exploring a hope structure by synthesizing the relevant hope structures expressed in Kim and Tae's studies, in-depth literature review, examining the meanings of the concepts consisted of the structure in use and their causal relations in logical adequacy, proposing a theoretical structure through synthesizing the causal relations, and diagramming the structure.
RESULTS
The proposed theoretical model involves concepts such as Cancer Related Uncertainty (CRU), Efforts to Find out the Possibility of Cure or Recovery (EFPCR), and Hopefulness or Hopelessness. The 'EFPCR' is stipulated as 'Behaviors Related to Looking for Evidences or Cues (BRLEC)' and 'Formation of Cognitive Schema (FCS)'. In the model, Hopefulness is directly influenced by 'CRU in low', which is affected by 'FCS in good' from the result of EFPCR started with 'CRU in increase' while 'CRU with increase' from the result from EFPCR has direct effect on Hopelessness.
CONCLUSION
The theoretical model would be used to enhancing hope of the cancer patients in post-operation.

PURPOSE
The study was to identify the relationship between the spiritual well-being, family support and depression in cancer patients. METHOD: Data were collected by questionnaires from 116 inpatients with cancer at one university hospital in J area using Spiritual Well-being Scale, Family Support Scale, and BDI. The collected data were analyzed by SPSS WIN 12.0 program. RESULT: 1) The mean scores of well-being, family support, and depression were 107.28, 41.14, and 16.79 respectively. 2) There were significant differences in the spiritual well-being by age, education, religion, and social group. There were significant differences in the family support by age, education, and number of admission. There were significant differences in the depression by occupation and social group. 3) Depression was significantly correlated with spiritual well-being, and family support. 4) The most signifiant predictor which influenced depression in cancer patients was spiritual well-being, followed by occupation, age, family support. CONCLUSION: These results suggested that providing spiritual nursing intervention and enhancing family support will effectively decrease depression in cancer patients.

This study was conducted to develop and evaluate guidelines for cancer patients' symptoms management such as nausea/vomiting, fatigue, constipation, diarrhea, and oral mucositis. Based on the literature review, assessment path to identify each stage of five symptoms were also developed. Guidelines for symptom management of each stage of the symptoms were developed. Guidelines then were evaluated by a panel of experts. Finally, 95 cancer patients were recruited and asked to use the guidelines for their symptom management Levels of understanding of and satisfaction with assessment path and management guidelines were surveyed. Prevalence rate of five symptoms varied ranging from 20% (diarrhea) to 47% (nausea/vomiting). Regarding the level of understanding of each symptom most of the cancer patients indicated that they were easy and sufficient. Regarding the easiness of use of the symptom management guidelines, most of cancer patients indicated that they were easy to use. Regarding the nursing intervention on each symptom, most of cancer patients indicated that they were easy and helpful. More information was added with feedback from the patients. The result of this study has implications on development of customized patient education materials based on assessment path and symptom management guidelines.

PURPOSE
The purpose of this study is to investigate fatigue and its related factors in cancer patients receiving radiotherapy. METHOD: The subjects of this study consisted of 98 patients receiving radiotherapy. Subjects were recruited from C University Hospital radiation oncology unit located in Gwangju from March to May, 2001. Questionnaire and medical records were used for data collection. The obtained data was analyzed using SAS program that included descriptive statistics, t-test, ANOVA, Post-hoc test(Fisher's LSD) and Pearson's correlation coefficients. RESULT: The fatigue perceived by the subjects was middle level (5.59 +/- 1.59) and 72.4% of them reported greater than 5 points. The subjects in no religion, low income, and spouse caregiver groups experienced the higher fatigue than another groups, respectively. The subjects in nasopharyngeal cancer, head & neck radiation site, and analgesics medication groups did, experience fatigue as well. The fatigue not only positively correlated with symptom distress, disruption of usual activity, sleep dissatisfaction, and mood state, but also negatively with less family support. CONCLUSION: Cancer patients receiving radiotherapy experience the middle level of fatigue and it correlates with the multi-dimensional factors. However, further research is needed to identify the changes in fatigue over the radiotherapy period through longitudinal design and to develop nursing intervention for fatigue decrease.

PURPOSE
All nurses should provide spiritual care for their clients. It is especially important to care spiritually for cancer patients facing the crisis of life. Therefore, the purpose of this study is to analyze the concept of spirituality which is one of the basic concepts for spiritual care in cancer patients. METHOD: The subjects of this study were 8 cancer patients; 2 Christians,3 Buddhists, and 3 persons who did not have any religion. The data was collected and analyzed by Hybrid Model. RESULT: The results of this study were as follows: Dimensions of spirituality(vertical dimension connected with the absolute being, horizontal dimension related to others, existential dimension related to seeking of meaning), attributes of spirituality(dynamic process strengthened in suffering due to struggle with cancer, connectedness with the absolute being or will and belief in oneself, transcendence of reality, meaning and purpose of life, future oriented), outcomes of spirituality(intrinsic, behavioral). CONCLUSION: The spirituality of cancer patients is manifested differently by his(her) religion, age, past experiences and burden of family, and is able to be strengthened with cancer. Therefore, nurses should recognize that diagnosis and deterioration of cancer is not only a spiritual crisis but can be a good chance for spiritual growth, as well.

PURPOSE
The purpose of this study was to identify the relationship of fatigue and quality of sleep in patients with cancer.
METHOD
The data was collected from January to February 2001. Study objects were recruited K university hospital in Busan, Korea. Their fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al(1998), and quality of sleep was measured using Quality of Sleep Questionare by Oh et. al(1998).
RESULT
1) The fatigue score was mean 114.80+/-34.88(range: 22-220). The sub dimension that showed behavior/severity score at 33.70+/-13.89, affective score at 24.23+/-3.33, sensory score at 27.74+/-12.51, and cognitive/mood score at 29.11+/-3.71. And sleep quality score was mean 37.32+/-8.18. 2) There was a significant difference in religion(F=4.157, P= .008), present therapy(F=2.536, P= .043), past therapy(F= 6.625, P= .000), major caregiver(F=3.133, P= .028), and change of weight(F=7.965, P= .006), according to general characteristics in the fatigue in patients with cancer. 3) There was a significant difference in present pain(t=-2.103, P= .037) and change of weight(F=5.484, P= .005), according to general characteristics in the sleep quality in patients with cancer. 4) There was a significant negative correlation between fatigue and quality of sleep(r=- .340, P= .000).
CONCLUSION
Patients with cancer experience in fatigue. Increase in fatigue are associated with decreases in quality of sleep. Nurses must provide patients with nursing care about the occurrence of fatigue and interventions to deal with sleep disturbance.

PURPOSE
Fatigue is one of the most common complaints of cancer patients. In this study, we analyzed the change of fatigue level and general symptoms as time go by, so that, we could explain more on the mechanism and change of fatigue in relation with treatment, and explore the influencing factors.
METHOD
The subjects of this study were 50 GI cancer patients who have visited the cancer center of A hospital in Suwon. We measured fatigue by using the Revised Piper Fatigue Scale(RPFS) at the time of starting and finishing induction chemotherapy, and starting the 2nd cycle of chemotherapy.
RESULTS
1) The fatigue score was 2.81, 3.73, and 3.82 in a 10 point scale at the time of starting and finishing induction chemotherapy, and starting the 2nd chemotherapy, respectively. This means fatigue persisted until after the treatment. 2) Fifty two percent of participants complained of some kinds of symptoms when starting the treatment, and the proportion increased up to 92% when finishing the treatment. 3) Fatigue scores were significantly high in patients with fatigue-related symptoms than for patients without those symptoms. 4) Fatigue scores showed significant differences according to patients' general characteristics such as age, educational level, economic status, occupation, diagnosis, hematocrit, weight, and amount of sleepy.
CONCLUSION
We have to develop intervention strategies to reduce fatigue in cancer patients in the consideration of influencing factors.

It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was 185.55+/-23.39 points(96 min. and 234 max.) 2.Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were 38.32+/-7.21(13 min, and 50 max.) and 52.97+/-8.49points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found 35.95+/-6.05(18 min, and 40 max) and 27.02+/-4.99 points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4.The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

The purpose of this study was to define the degree of the resourcefulness and the health-promoting behavior of cancer patients, to identify the relationship between the resourcefulness and the health promoting behaviors and to provide the basis for strategic nursing intervention. This study was conducted by an exploratory survey. Data were collected by self-reported questionnaires from 97 cancer patients in a university hospital in Tae-Gu from September to December of 1998. The sample data were collected by using a convenient sampling method. The following instruments were used in the study after some adaptation: Park Chai Soon's Health Promoting Lifestyle Profile, Oh Pok Ja's instrument for health promotion behavior and the Rosenbaum self-control schedule(SCS). The reliability of instruments was tested with Chronbach'alph(.79-.89). Data was analyzed by using the SAS program. T-test, ANOVA, and Pearson's coefficients of correlation. The results of this study were as follows: First, the average score of the resourcefulness variable was 22.20; the range of the score was from -30 to +81 The average score of the performance in the health promoting behavior variable was 96.13; the range of the score was from 39 to 137 Second, the resourcefulness variable was significantly different from such demographic factors as gender and perceived health status, but there was no statistically significant difference between the demographic factors and the health promoting behavior variable, except that of perceived health status. Third, the performance in health promoting behavior of cancer patients was significantly correlated with the resourcefulness of cancer patients(r= .50) In conclusion, resourcefulness was identified to be an important variable that could contribute to promote health-promoting behavior.

Cancer has been the leading cause of death in this country and produces high levels of stress not only in the patients themselves but also in their families. Caregiving during serious illness is a new experience for many family caregivers and social support and coping strategies have been found to reduce unfavorable health outcomes to stressful events such as cancer. The purpose of this investigation was to identify the relationship of caregiving stress, coping methods, social support, and health in caregivers of patients with cancer according to the phases of cancer illness. The subjects were 92 primary cargivers of cancer patients based on their phases of illness that consisted of 1st (initial) stage, 2nd (metastatic or recurring) stage, 3rd (terminal) stage recruited from two general hospitals in Seoul and Choongnam. The mean age of subjects was 39.1 years and 64.1% of subjects were female and 72.8% were married. The relationships to the patient were children(50%) or spouses (45.7%). According as the phase of illness progressed, caregiver's stress rose higher and their health got worse but coping methods and social support did not show a significant change. In the 1st stage the major predictors for the health of caregivers were family network support(R2=0.261, p=0.003) and the stress of the caregivers (R2=0.168, P=0.007). In the 2nd stage the most important predictor for the health of the caregivers was the stress of the caregivers (R2=0.483, P=0.000). Also in the 3rd stage the main predictor for health was the stress of the caregivers (R2=0.381, p=0.006). A better understanding of the stress process in family caregivers is needed so that nurses can provide family-centered care, taking into account caregiver, as well as patient, well-being.