Purpose
This study's purpose was to identify the relationship between daily vitamin intake and blood glucose in cancer patients undergoing chemotherapy and identify factors affecting blood glucose.
Methods
This descriptive study included 134 cancer patients undergoing chemotherapy at a university hospital. Data were analyzed with descriptive statistics, independent T-test, one-way analysis of variance, Pearson's correlation coefficients, and stepwise multiple regression analysis using SPSS/WIN 27.0 version.
Results
The average blood glucose of the subjects was 128.13±37.34 mg/dL and 30.6% of the subjects had readings of over 140 mg/dL. Blood glucose varied significantly by sex, age, education level, exercise frequency, and comorbidity. Vitamins A, E, and C, thiamin, riboflavin, niacin, vitamin B6, folate, and biotin were negatively correlated with blood glucose. Factors affecting blood glucose were exercising 7 times a week (β=-.61, p<.001), 4 to 6 times a week (β=-.41, p<.001), 1 to 3 times a week (β=-.38, p<.001), age (β=.18, p=.016), and vitamin A intake (β=-.16, p<.043), with a total explanatory power of approximately 31.5%.
Conclusion
Nurses should provide patients undergoing chemotherapy with lifestyle interventions including exercise at least 3 days a week and appropriate vitamin A intake, especially for older patients, to prevent hyperglycemia.

Purpose
Since anticancer medication nursing is an evaluation area for accreditation by medical institutions in Korea, all clinical nurses are required to attend an annual classroom lecture. However, it is necessary to reconsider the methods and effects of this requirement. This study was conducted to develop a web-based anticancer chemotherapy nursing course for clinical nurses and to examine its effectiveness in terms of job knowledge, self-efficacy, and nursing performance.
Methods
A randomized controlled design using random selection was utilized. The content was developed into 5 modules featuring basic and advanced learning, and the total learning time was 80 minutes. To test the effect of the multimedia contents, a randomized control group pretest-posttest study design was adopted. Clinical nurses with less than five years of experience were recruited from a university-affiliated hospital and randomly assigned to an experimental (n=28) or control (n=28) group. The experimental group autonomously learned web-based anticancer chemotherapy nursing for two weeks through a website.
Results
There was a statistically significant increase in the job knowledge of the experimental group receiving the classroom lecture (p=.001). However, there were no statistically significant differences between the two groups in self-efficacy (p=.055) and nursing performance (p=.359).
Conclusion
This study found that web-based self-learning could be a useful learning strategy for the anticancer chemotherapy and nursing education that clinical nurses must complete annually. However, it is necessary to verify the effect on self-efficacy and nursing performance through repeated studies.

Citations

• Effectiveness of a blended learning program on chemotherapy nursing education led by oncology clinical nurse specialists: A single-group pretest–posttest study
  Hyuna Kim, Laehee Kim, Suyeon Kim, Shin Kim, Eunhye Park, Kyounmin Lee, Suyeoun Lee, Jeounghee Kim
  Asia-Pacific Journal of Oncology Nursing.2025; : 100695.     CrossRef
• Redesigning Competency Assessment
  Sharon R. Kauffman, Brittni Prosdocimo
  Journal for Nurses in Professional Development.2024; 40(6): 322.     CrossRef
• Asynchronous e-learning with technology-enabled and enhanced training for continuing education of nurses: a scoping review
  Rika Kimura, Mayumi Matsunaga, Edward Barroga, Naoko Hayashi
  BMC Medical Education.2023;[Epub]     CrossRef
• Self‐efficacy in the context of nursing education and transition to practice as a registered practitioner: A systematic review
  Mousa Abusubhiah, Nuala Walshe, Rena Creedon, Brendan Noonan, Josephine Hegarty
  Nursing Open.2023; 10(10): 6650.     CrossRef
• Effect of Website-based Learning on Improved Monitoring of Adverse Drug Reactions by Clinical Nurses
  Hyun jin Kim, Seon Young Hwang
  Asian Nursing Research.2022; 16(1): 45.     CrossRef
• Development of a Web-Based Korean Triage and Acuity Scale Learning Program for Emergency Department Nurses
  Hyo-Jin Kim, Hee-Young Kang, Hae-Ran Kim
  CIN: Computers, Informatics, Nursing.2021; 39(11): 821.     CrossRef

PURPOSE
This study was conducted to identify factors associated with oncology nurses' adherence to Chemotherapy-Induced Neutropenia (CIN) guidelines based on Pender's Health Promotion Model (HPM).
METHODS
For this cross-sectional descriptive study, 187 nurses who worked at the oncology department of Channam National University Hawsun Hospital responded to self-administered questionnaires. A tool for CIN guideline adherence was developed through systematic search, synthesis, translation, and content validation. Data collection was conducted by a trained research assistant from September 18 to September 26, 2017. Data were analyzed using independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression.
RESULTS
Stepwise multiple regression showed that guideline adherence was associated with CIN education (β=.26, p<.001), self-efficacy (β=.17, p=.018), perceived benefits (β=.16, p=.026), interpersonal factors (β=.16, p=.043), and educational level (β=.14, p=.030).
CONCLUSION
The findings of this study could be used to develop interventions focusing on CIN education and for the strengthening oncology nurses' self-efficacy and beliefs to promote adherence to CIN guidelines. In addition, repeated studies would be needed to verify application of Pender's HPM to explain nurses' adherence.

PURPOSE
The purpose of this study was to identify over time the changes of cancer symptom, depression and quality of life (QOL) among people who had stomach or colorectal cancer.
METHODS
Of the 74 participants recruited, 67 participated in the study. Participants were asked to complete three instruments at three different time. The instruments were the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, Hospital Anxiety Depression Scale, and the Functional Assessment of Cancer Therapy-General. The questionnaires were administered before chemotherapy, toward the end of chemotherapy, and six months after the completion of adjuvant therapy. Data were analyzed using descriptive statistics and repeated measure ANOVA.
RESULTS
At the immediately after chemotherapy point, the most frequent symptom was lack of appetite, followed by fatigue and problem with remembering things. The mean score for depression was 8.27 with a prevalence of 31.3%. The mean score for quality of life was 61.88 out of 135. Repeated measures ANOVA showed a significant increase in cancer symptom (F=23.22, p < .001) and depression (F=35.29, p < .001) after chemotherapy. However, improvement was observed 6 months after the completion of chemotherapy. QOL (F=33.73, p < .001) also showed similar patterns as observed with cancer symptom and depression. Cancer symptom was the strongest predictor of QoL at pre-chemotherapy point. but depression was the strongest predictor at immediately after chemotherapy point.
CONCLUSION
Chemotherapy is highly associated with cancer symptom, depression and QOL in patients with cancer. The nursing intervention is needed to relieve depression as well as cancer symptoms to improve QOL in patients undergoing chemotherapy from baseline to follow-up.

Citations

• Mediating Effect of Resilience between Supportive Care Needs and Quality of Life of Female Genital Cancer Patients
  Yu-Jung Son, Keum-Hee Nam
  Korean Journal of Adult Nursing.2022; 34(3): 269.     CrossRef
• Impact of Posttraumatic Growth and Health Promoting Behavior on Quality of Life in Patients with Gastrointestinal Cancer
  Mi-Ae Kim, Hyun-Ju Lee
  Journal of Korean Academy of Fundamentals of Nursing.2021; 28(1): 32.     CrossRef
• Changes in chemotherapy-induced peripheral neuropathy, disturbance in activities of daily living, and depression following chemotherapy in patients with colorectal cancer: A prospective study
  Pok-Ja Oh, Jung Ran Lee, Sook-Kyoung Kim, Jeong-Hye Kim
  European Journal of Oncology Nursing.2020; 44: 101676.     CrossRef
• Qualitative Study of Compliance with Nutritional Management in Colorectal Cancer Patient Undergoing Chemotherapy
  Heejung Park, Hyonson Kil, Wookyoun Cho
  Korean Journal of Community Nutrition.2020; 25(4): 303.     CrossRef
• Health-related Quality of Life and Its Related Factors among Cancer Survivors and General Adults: Focusing on Lifestyle Behaviors and Mental Health
  Eun A Song, Youngran Kweon, Yoon Young Hwang, Minjeong An
  Korean Journal of Adult Nursing.2020; 32(4): 385.     CrossRef
• Changes in Chemotherapy-induced Peripheral Neuropathy, Sleep Quality, and Quality of Life following Chemotherapy in Stomach Cancer Patients: a Prospective Study
  Pok Ja Oh, Jin Lee, Jeong Hye Kim
  Asian Oncology Nursing.2020; 20(2): 72.     CrossRef
• Symptom Distress and Depression in Patients with Recurrent Gynecologic Cancer Undergoing Chemotherapy: Mediating Effect of Resilience
  Eun Jung Yang, Ho Sihn Ryu
  Korean Journal of Adult Nursing.2019; 31(1): 28.     CrossRef
• Predictors of Quality of Life and Social Support as a Mediator between Defecation Function and Quality of Life among Rectal Cancer Patients
  Jung Rang Kim, Seon Young Hwang
  Korean Journal of Adult Nursing.2019; 31(5): 487.     CrossRef
• Changes of Cognitive Function and Fatigue following Chemotherapy in Patients with Gastrointestinal Cancer: A Prospective Controlled Study
  Pok-Ja Oh, Sun Mi Moon
  Asian Oncology Nursing.2019; 19(3): 126.     CrossRef
• Oxaliplatin-induced Peripheral Neuropathy, Symptoms, Distress and Quality of Life among Korean Patients with Gastrointestinal Cancer
  Hye Jeong Jung, Soo jung Ahn, Yoo Ri Yang, Kyoung A Kim, Sang Joon Shin, Min Kyu Jung, Sang Hui Chu
  Asian Oncology Nursing.2019; 19(4): 204.     CrossRef
• Health care Utilization of Cancer patient Women at Nursing Hospital
  Hye-Sun Park, Kyung-Sook Park
  Journal of Digital Contents Society.2018; 19(11): 2139.     CrossRef

PURPOSE
This study aimed to identify the levels of oxaliplatin-induced peripheral neuropathy (OXLIPN) and the quality of life (QOL) related to OXLIPN in patients with digestive system cancer.
METHODS
A total of 83 patients with chemotherapy-induced peripheral neuropathy (CIPN)-related symptoms participated in this study. Data were collected through self-reported questionnaire which were constructed to include general and clinical characteristics, EORTC QLQ-C30, Patient Neurotoxicity Questionnaire (PNQ), and EORTC QLQ-CIPN20.
RESULTS
The average scores of OXLIPN upper and lower extremity scale were 30.01 and 29.16, respectively. The average scores of PNQ sensory and motor scale were 2.11 and 1.70, respectively. The mean score of the QLQ-C30 global health status was 54.85, and the range of mean score of the functional and symptom subdomains was 34.85~73.29 and 17.67~53.54, respectively. The CIPN-related symptoms positively correlated with the global health status scale and all subdomains of functional scale, respectively and negatively correlated with fatigue, pain, dyspnea, insomnia, and financial problem subdomains of the symptom scale, respectively.
CONCLUSION
Oncology nurses should pay attention and provide remedies for CIPN symptoms reported by their patients. Nursing interventions should be developed for patients with digestive system cancer to alleviate CIPN and enhance their QOL.

PURPOSE
This study was aimed to identify the incidence and severity of chemotherapy-induced peripheral neuropathy (CIPN) among patients with hematologic malignancies and to examine the relationship between the quality of life (QOL) and CIPN.
METHODS
A total of 66 patients with CIPN-related symptoms participated in this study. Data were collected through self-reported questionnaires consisted of the European Organization for Research and Treatment of Cancer QLQ-C30 version 3.0 and the 16-item QLQ-CIPN20. Data were analyzed with SPSS/WIN20 for descriptive statistics using the Mann-Whitney and Kruskal-Wallis tests, and Spearman's rho.
RESULTS
The mean lower and upper extremity scale scores were 31.95 and 23.16 respectively for the 16-item QLQ-CIPN20. The mean QLQ-C30 subcategory scores were 46.84 for global health status, 58.72 for functional scales, and 34.85 for symptom scales. The CIPN-related lower extremity scale symptoms correlated negatively with the QOL subscales. There was no correlation between CIPN-related upper extremity symptoms and health-related QOL.
CONCLUSION
Patients with hematologic malignancies treated with neurotoxic chemotherapeutic agents had CIPN-related symptoms in the lower extremities mainly, and their QOL functional subscale scores were relatively lower than those of other cancer patients. Interventions need to be developed for patients with hematologic malignancies to alleviate CIPN and enhance their QOL.

Citations

• Taxane-induced peripheral neuropathy and quality of life in breast cancer patients
  Ebrahim Salehifar, Ghasem Janbabaei, Abbas Alipour, Nasim Tabrizi, Razieh Avan
  Journal of Oncology Pharmacy Practice.2020; 26(6): 1421.     CrossRef
• Oxaliplatin-Induced Peripheral Neuropathy and Quality of Life in Patients with Digestive System Cancer
  Hye Young Kim
  Korean Journal of Adult Nursing.2016; 28(3): 343.     CrossRef

PURPOSE
This study was aimed to identify NANDA-NOC-NIC linkage in cancer patients receiving chemotherapy.
METHODS
This study was a descriptive study conducted in three steps. First, nursing diagnoses were identified from the electronic nursing records. Second, content validity of nursing diagnoses and outcomes were evaluated. Third, major nursing interventions associated with expected nursing outcomes were collected from 97 nurses who worked in the oncology unit. Data were analyzed using descriptive statistics.
RESULTS
Four major nursing diagnoses were identified: acute pain, knowledge deficit, health seeking behaviors, and ineffective protection. Associated with each respective diagnosis, 3 major outcomes (pain level, pain control, and comfort state) for acute pain, 8 major nursing outcomes (diet, disease process, treatment regimen, illness, ostomy care, prescribed activity, health behavior, and infection management) for knowledge deficit, 4 major outcomes (health promoting behavior, health promotion, health belief, and knowledge: health resource) for health seeking behaviors, and 3 major outcomes (fatigue level, immune status, and nutritional status) for ineffective protection were identified. In addition, nursing interventions frequently used in clinical practice for each major nursing outcome were identified.
CONCLUSION
The identified NANDA-NOC-NIC linkage can contribute to improving the applications of nursing process and care plans.

Citations

• Identification of North American Nursing Diagnosis Association—Nursing Interventions Classification—Nursing Outcomes Classification of nursing home residents using on‐time data by android smartphone application by registered nurses
  Juh Hyun Shin, Sun Ok Jung, Jee Sun Lee
  International Journal of Nursing Knowledge.2024; 35(1): 46.     CrossRef
• Effectiveness of Nursing Interventions using Standardized Nursing Terminologies: An Integrative Review
  Sena Chae, Hyunkyoung Oh, Sue Moorhead
  Western Journal of Nursing Research.2020; 42(11): 963.     CrossRef
• Identification of Nursing Diagnosis–Outcome–Intervention Linkages for Inpatients in the Obstetrics Department Nursing Unit in South Korea
  Min Ji Yang, Hye Young Kim, Eun Ko, Hyun Kyung Kim
  International Journal of Nursing Knowledge.2019; 30(1): 12.     CrossRef
• The Network Analysis of Nursing Diagnoses for Children Admitted in Pediatric Units Determined by Nursing Students
  Mikyung Moon
  Journal of Health Informatics and Statistics.2017; 42(3): 223.     CrossRef
• Identification of Nursing Diagnosis-Outcome-Intervention Linkages for Inpatients in Gynecology Department Nursing Units
  Min Ji Yang, Hye Young Kim
  Korean Journal of Women Health Nursing.2016; 22(3): 170.     CrossRef

PURPOSE
This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence.
METHODS
The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool.
RESULTS
1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience.
CONCLUSION
The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

PURPOSE
The present study is a quasi?experimental research for examining the effects of imagery on stress, anxiety and immune cells in acute leukemia patients receiving chemotherapy and utilizing the therapy for their self control and stress management.
METHODS
The subjects were 60 patients who were diagnosed with acute leukemia and scheduled to receive chemotherapy at A hospital in Seoul during the period from November 2006 to March 2007. After the start of chemotherapy, the experimental group received imagery for 4 weeks, three sessions a week, so a total of 12 sessions and 156 minutes.
RESULTS
The decrease of stress was larger in the experimental group than in the control group. Systolic blood pressure decreased significantly more in the experimental group than in the control group. In the experimental group, state anxiety decreased significantly in the 2nd week of the experiment and after the final stage of the experiment. The total number of white blood cells, and the absolute number of neutrophils and lymphocytes were showing significant differences between the time points.
CONCLUSION
Imagery is an effective intervention for reducing stress and state anxiety and stabilizing blood pressure in acute leukemia patients receiving chemotherapy.

PURPOSE
The study is to investigate the effects of tea tree oil gargling on oral cavity micro-organism growth and on the perceived discomfort of patients receiving chemotherapy. METHODS: A nonequivalent control group non-synchronized design was used to determine the effects of tea tree oil gargling on oral cavity for 20 second after using it for one week, twice a day. The sample consisted of two groups of patients receiving chemotherapy : 19 patients in experimental and 20 patients in control group. The instruments used in the study were Oral Assessment Guide(OAG), a measure of perceived symptoms on oral cavity, and a test of oral mucosal micro-organism culture. The data were analyzed using chi-square test, repeated measure of ANOVA, and Pearson correlation coefficient. RESULTS: There was no significant difference between the two groups in micro-organism culture test of oral mucosa. The experimental group showed a lower number and fewer kinds of micro-organisms than the control group. CONCLUSION: It is considered that use of tea tree oil is effective in infection control of the oral cavity.

PURPOSE
The purpose of this study was to describe the pattern of changes on the score of nausea/vomiting and anxiety during one cycle of chemotherapy. METHOD: A total of 53 subjects who were admitted to C University Hospital for a period of 3 days and 2 nights for chemotherapy were selected from February to April, 2003. Total scores of nausea/vomiting were measured twice a day 3 days for a total of 6 measurements. Anxiety, anorexia, and fatigue were also measured at the first and last measurement points. Data were analyzed by one-way repeated measures, ANOVA, t-test, paired t-test, & Pearson's correlation. RESULT: The score of nausea/vomiting increased over time except for the 4th measurement point but no changes were significant over time. There were the significant differences between 1st and 2nd, and 2nd and 3rd nausea/vomiting score at p < 0.05. The scores of anxiety, anorexia, and fatigue between the first and 6th points were significantly different(t=-5.69, p=.001; t=6.25, p=.0001; t=3.65, p=.0007). CONCLUSION: Further studies are needed to identify the relationship between anxiety, and anticipatory and acute nausea/vomiting respectively.

PURPOSE
The purpose of this study was to examine the effects of aroma oil inhalation using peppermint and bergamot on nausea vomiting and anorexia in cancer patients receiving chemotherapy. METHOD: Study subjects were 30 patients who had experienced nausea and vomiting when they had been hospitalized in K university hospital located in D city after receiving more than two Cisplatin combination chemotherapy treatments. Among them 15 patients were in the experimental group doing aroma oil inhalation and the other 15 patients were in the control group without aroma oil inhalation. The data were collected from February 1, 2002 to May 17, 2002. The data were analyzed with SPSS WIN 10.0 program using frequency, percentage, chi-square-test, t-test, Repeated Measures ANOVA. RESULTS: 1) The degree of nausea and vomiting in the experimental group with aroma oil inhalation using peppermint and bergamot were significantly lower than that of the control group. 2) The degree of anorexia in the experimental group with aroma oil inhalation using peppermint and bergamot were significantly lower than that of the control group. CONCLUSION: aroma oil inhalation was effective for relieving patients' nausea vomiting and anorexia receiving chemotherapy. Therefore, it is proposed that aroma oil inhalation should be applied as a supportive nursing arbitration method to relieve patients' nausea vomiting and anorexia who are receiving chemotherapy.

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.

PURPOSE
This study was conducted to investigate the level of nausea & vomiting, anorexia and food intake during the periods of chemotherapy and 14 days after discharge. METHOD: The subjects were 40 cancer patients(cervix cancer : 20 patients, stomach cancer: 20 patients) who had chemotherapy with Cisplatin & 5-Fu. Data were analyzed by mean & standard deviation, ANCOVA. RESULT: 1. The severity of nausea & vomiting with anorexia in cancer patients receiving chemotherapy was the highest at the 3rd day and then it gradually decreased. At the 14th day after discharge, nausea & vomiting with anorexia still remained with very low levels. 2. The amount of food intake was the lowest on the 3rd day and then gradually increased. However, it was 53.3-72.5% of the ordinary food intake on the 14th day after discharge. Calorie intake was 625.31 Kcal on the 3rd day and 1130.92 Kcal on the 7th day after discharge. 3. There were no significant differences in nausea & vomiting, anorexia, food intake, calory intake between those with cervix cancer and stomach cancer. CONCLUSION: In cancer patients nausea & vomiting and anorexia were severe and food intake was very poor during chemotherapy but afterwards they were gradually improved, but were not completely recovered on the 14th day after discharge. Therefore the nursing intervention regarding the increase of food intake was necessary during chemotherapy and after discharge.

PURPOSE
Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction.
METHOD
Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods.
RESULT
Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group; 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting.
CONCLUSION
Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.

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.

The current patient management system has several limitations. To develop the critical pathway (CP) as a cost-effective method via continuous patient management, we investigated the medical records of 77 patients who underwent FP chemotherapy in Seoul National University Hospital from Feb, 1 to 28, 1999. And the pilot study was done to 12 patients admitted to undergo the FP chemotherapy. 1. The vertical contents in the CP consisted of 7 items; assessment, activity, diet, IV therapy, medication, education and evaluation. The duration of the horizontal axis was 6 days from admission to discharge. 2. The medical performance according to the vertical axis in the preliminary CP, consisted of 72 , and modified to 74 items in the final form of CP. 3. The nursing record consisted of a vertical axis of 4 items; assessment, IV therapy, medication and education. The duration of the horizontal axis was 6 days from admission to discharge of hospital days.

Fatigue is a very distressing symptom experienced by many individuals with cancer, especially those who are receiving active chemotherapy. The effects of fatigue are multiple. If not managed, impaired functional status with a decreased quality of life may result. Therefore, this study was designed to identify the relation between fatigue and quality of life in cancer patients undergoing chemotherapy. The subjects for this study were 180 cancer patients receiving chemotherapy who were hospitalized or who visited the outpatient clinics of two university hospitals in Seoul. The following instruments were used in the study: Piper's fatigue scale, Symptom checklist, Mood state scale, Disruption of usual activity scale. The result of this study can be summarized as follows: 1. The relationship between fatigue and quality of life revealed a significantly negative correlation(r=-.513, p<.001). Therefore, the hypothesis "the lower the level of fatigue, the higher the quality of life" was accepted. The relationship between fatigue and physical well-being revealed a significantly negative correlation(r=-.319, p<.001). The relationship between fatigue and emotional well-being revealed a significantly negative correlation(r=-.417, p<.001). The relationship between fatigue and social well-being revealed a significantly negative correlation(r=-.409, p<.001).

The effects of the mouth care using cool normal saline on oral discomfort were investigated in 40 patients on chemotherapy. The subjects were divided into two groups, one was experimental group(N=20) in which the subjects were provided mouth care with cool normal saline, the other was the control group(N=20). The data was collected from June. 20 to Oct. 30 in 1998. Oral discomfort was measured by Self Reported Oral Discomfort Assessment Instrument developed by Jung(1995) and Oral Assessment Guide (OAG) Instrument developed by UNMC. Collected data were analyzed by means of frequency, percentage, standard deviation, chi-squre test, t-test. The results were summarized as follows: 1. 'The experimental group which recieved oral care with cool normal saline shoud be lower self reported oral discomfort on 3, 5, 7, 14 days after chemotherapy was supported (p=.025-.000). 2. 'The experimental group which recieved oral care with cool normal saline shoud be lower observational symptom oral discomfort on 3, 5 days after chemotherapy was not supported, but on 7, 14 days after chemotherapy was supported(p=.0011, 0.001). In conclusion, the patient who recieved oral care with cool normal saline showed the decrease in degree of oral discomfort of cancer patient undergoing chemotherapy. So oral care with cool normal saline had been judged the nursing intervention to improve oral discomfort of cancer patients undergoing chemotherapy.

The purpose of this study was to develop the basis of scientific nursing intervention by examining the changes of stress level with elapse of post chemotherapy in breast cancer patients. The design of this study was a longitudinal descriptive study. The subjects of this study was patients receiving chemotherapy from March 1, 1998 to June 30, 1998 at K university hospital in Taegu. The number of subjects was 14 and they were given treatment every 21 days, a cycle of chemotherapy. The changes of their stress with the elapse of chemotherapy were examined every other day. The changes of stress reaction were measured by fatigue and salivary cortisol level. The instrument used to measure fatigue was the revised Pipe Fatigue Scale which was developed by Piper(1984). The reliability of this instrument was Cronbach's alpha .997. The Salivary cortisol was meausured to examine the stress physiological reaction, analyzed using radioimmunoassay. Data was analyzed by computer using the SPSS WIN 7.0 program. Frequency, and Wilcoxon Singned Ranks test were used to examine the changes in degree of fatigue and salivary cortisol with the elapse of chemotherapy. The relationship between fatigue and salivary cortisol was examined using Spearman's rho. The results of this study were as follows: 1) The degree of fatigue was increased a little on the third day 5.64( +/- 1.86)(z=-1.85, p=.06) compared with that of fatigue on the basic day. After that, the degree of fatigue was continuously decreased. it had tendancy to increase a little as patients visited the clinic for next chemotherapy. 2) The mean of salivary cortisol concentration was the higest shortly before chemotherapy. 3) The relationship of fatigue and salivary cortisol was r= .4(p=.098). To sum up, the degree of fatigue was the highest on the third day and salvary cortisol was the highest shortly before chemotherapy. Because the stress reaction of cancer patient receiving chemotherapy was the higest within 3 days in one cycle, it will be effective to provide specified nursing interventions to reduce stress within 3 days after chemotherapy.