Purpose
Colorectal cancer (CRC) survivors face significant challenges after completing treatment, including returning to work, concerns about the future, and financial difficulties. Understanding how inner strength developed after treatment affects survivors’ lives is crucial for informing patient-centered care. This study explored the unique inner strength exhibited by CRC survivors during their transition to a “new normal.” Methods: We recruited 16 patients from Korea who had completed treatment, to explore their experiences of managing their health. We conducted a qualitative study from July 4, 2022 to July 25, 2022 using individual interviews and directed content analysis. Transcribed interview data were analyzed to interpret meaning from the data, consistent with the naturalistic paradigm. Results: Participants described their transition to a new normal by reframing the cancer experience, struggling to return to normal life, experiencing growth promoted by supportive relationships, and encountering both positive and negative life changes. Throughout these experiences as survivors, inner strength played a critical role in adapting to a new normal. Conclusion: Our findings suggest that inner strength serves as a dynamic psychological resource, enabling CRC survivors to reframe their illness, regain disrupted roles, and reconstruct a meaningful life despite ongoing physical and emotional challenges. In doing so, inner strength facilitates their adaptation to a new normal.

Purpose
This study investigated differences in inner strength, multiple identities, and quality of life among colorectal cancer survivors, considering gender and the presence of an ostomy. It also focused on identifying factors that influenced their quality of life.
Methods
In this cross-sectional study, 170 colorectal cancer survivors were recruited. Inner strength, multiple identities, and quality of life were assessed through an online survey. Within each subgroup, comparisons were made in two ways: (a) between women and men; and (b) between ostomy and non-ostomy groups.
Results
The quality of life for colorectal cancer survivors was higher among men than women. For inner strength, men reported higher levels of anguish and searching, whereas women showed higher levels of connectedness. The quality of life was higher in the non-ostomy group than the ostomy group. However, the non-ostomy group had a higher level of anguish and searching than the ostomy group. Inner strength emerged as the most powerful factor influencing quality of life after adjusting for age and gender.
Conclusion
This study emphasizes the significance of inner strength in colorectal cancer survivors. It provides a deeper understanding of quality of life in colorectal cancer survivors by examining factors that influence it and considering how these effects differ based on gender and the presence of an ostomy. To improve the quality of life of colorectal cancer survivors, it is essential to comprehend the roles of factors such as gender and ostomy and develop individualized interventions tailored to their specific characteristics.

Citations

• The Role of Inner Strength in Korean Colorectal Cancer Survivors on the Journey from Treatment to New Normal: A Qualitative Study
  Hannah Yu, Eunjung Ryu
  Korean Journal of Adult Nursing.2025; 37(3): 332.     CrossRef
• Cultural Adaptation of a Web-Based Ostomy Care Intervention for Hispanic Cancer Patients and Caregivers: A Mixed Methods Study (Preprint)
  Xiaomeng Wang, Lixin Song, Amy Vondenberger, Fei Yu, Jia Liu, Roxana Delgado, Robert Svatek,  Natalia Villegas Rodriguez, Lurheinna Rosado Rivera, Mark Bonnen
  JMIR Cancer.2024;[Epub]     CrossRef

Purpose
The purpose of this study was to investigate family support and medical staff support and their mediating effects in the relationship between self-efficacy and resilience in patients with colorectal cancer with stoma. Methods: The participants were 170 patients with colorectal cancer who were hospitalized or receiving treatment for colorectal anus surgery in general hospitals located in B, D, and I cities. Data were collected from July 1 to October 25, 2019 through a structured questionnaire. Data analysis was conducted using descriptive statistics, Pearson's correlation coefficient, multiple linear regression analysis, and the bootstrapping method with SPSS/WIN 25.0 and the PROCESS macro program. Results: The mean score for resilience was 2.70±0.62 (range 0~4). Resilience was significantly associated with self-efficacy (r=.59, p<.001), family support (r=.38, p<.001), and medical staff support (r=.37, p<.001). Using Baron and Kenny's approach and PROCESS macro model 4, resilience was found to be affected by self-efficacy (β=.53, p<.001). Further, family support (β=.25, p<.001) and medical staff support (β=.39, p<.001) were affected by self-efficacy. The partial mediating effects of family support (β=.25, p<.001, 95% confidence interval 0.01~0.12) and medical staff support(β=.15, p=.022, 95% confidence interval 0.01~0.16) in the impact of self-efficacy on resilience were confirmed. Conclusion: The impact of self-efficacy on resilience was mediated by family support and medical staff support in patients with colorectal cancer with stoma. The results suggest that family and medical staff support need to be considered in developing nursing interventions to improve self-efficacy and resilience in these patients.

Citations

• Influences of Fatigue, Uncertainty, and Resilience on Self-Care Behaviors in Cancer Patients Undergoing Chemotherapy
  Sa-Rang Kim, Gie-Ok Noh
  Asian Oncology Nursing.2025; 25(2): 110.     CrossRef

PURPOSE
This study aimed to investigate the improvement in lifestyle of patients with Colorectal Cancer (CRC) by examining their lifestyle before and after diagnosis, and to identify the factors influencing lifestyle improvement to prevent the recurrence of CRC.
METHODS
The participants were 125 patients with CRC who visited the outpatient clinic of Kyungpook National University Chilgok Hospital in Daegu from December 2017 to March 2018. Questionnaires consisted of items on CRC-related lifestyle, knowledge of lifestyle risks for CRC, beliefs of lifestyle improvement (perceived benefits and barriers), self-efficacy, and fear of cancer recurrence. Lifestyle improvement referred to the score given to the improved lifestyle through the score difference in the measure of lifestyle related to CRC before and after diagnosis. The collected data were analyzed using SPSS/WIN 21.0 program.
RESULTS
The factors influencing lifestyle improvement were gender (β=.46, p<.001), age (β=.31, p<.001), knowledge of lifestyle risks for CRC (β=.20, p=.005), perceived benefits of lifestyle improvement (β=.19, p=.008), and number of discomforts(symptoms) that impede lifestyle improvement (β=.17, p=.016). These variables explained 38% of CRC patients' lifestyle improvement.
CONCLUSION
These findings suggest that we need to find ways to provide knowledge of the lifestyle risks for CRC to patients with CRC and improve their perceptions of the benefits of lifestyle improvement to promote lifestyle improvement and help prevent the recurrence of CRC after CRC diagnosis.

Citations

• Health-promoting lifestyle among Chinese patients with colorectal polyps: a cross-sectional study
  Jingru Zhou, Yanjun Liu, Fang Yang, Yanfen Wang, Yan Liu, Wenwen Ming, Sisi Guo, Dan Zhou, Lin He, Xiaoli Zhong
  Scientific Reports.2025;[Epub]     CrossRef
• The Proliferation Inhibitory Effect of Postbiotics Prepared from  Probiotics with Antioxidant Activity against HT-29 Cells
  Yeeun Kim, Hak Jun Kim, Keunho Ji
  Applied Sciences.2022; 12(24): 12519.     CrossRef
• What is the prevalence of fear of cancer recurrence in cancer survivors and patients? A systematic review and individual participant data meta‐analysis
  Yvonne L. Luigjes‐Huizer, Nina M. Tauber, Gerry Humphris, Nadine A. Kasparian, Wendy W. T. Lam, Sophie Lebel, Sébastien Simard, Allan Ben Smith, Robert Zachariae, Yati Afiyanti, Katy J. L. Bell, José A. E. Custers, Niek J. de Wit, Peter L. Fisher, Jacquel
  Psycho-Oncology.2022; 31(6): 879.     CrossRef
• Convalescent Hospital Use among Young and Older Female Cancer Survivors
  Hyesun Park, Kisook Kim
  International Journal of Environmental Research and Public Health.2021; 18(5): 2744.     CrossRef

PURPOSE
Sleep disturbances related to multiple conditions are common in patients with cancer while undergoing chemotherapy. The quality of life in these patients may be negatively affected due to sleep disturbances. Therefore, by analyzing nursing records, this study aimed to examine factors influencing sleep disturbances among hospitalized patients with colorectal cancer undergoing chemotherapy.
METHODS
This study was a retrospective review of nursing records of 231 patients with colorectal cancer who were hospitalized for chemotherapy in 2015. Data were collected from electronic medical records, and analyzed using the independent t-test, χ2 test, and logistic regression.
RESULTS
Thirty-five (15.2%) patients had sleep disturbances. Nursing records related to sleep (n=85) consisted of 32 (37.6%) assessments and 53 (62.4%) interventions. Pharmacological interventions for sleep disturbances (98.1%) were used more often as compared to non-pharmacological interventions (1.9%). In logistic regression analysis, sleep disturbances were related to the body mass index (Odds Ratio [OR]=0.86, 95% Confidence Interval [CI]=0.76~0.98), targeted therapy(OR=2.62, 95% CI=1.09~6.32), and length of hospital stay (OR=1.08, 95% CI=1.02~1.14).
CONCLUSION
Sleep disturbances were influenced by body mass index, targeted therapy, and length of hospital stay. Thus, nutritional and psycho-emotional status after metastasis or recurrence should be closely monitored in patients with colorectal cancer undergoing chemotherapy, especially during prolonged hospitalization. Further, in addition to the use of pharmacological interventions, various non-pharmacological nursing interventions to promote sleep health should be developed.

Citations

• Effect of Healing Beats Program on Stress, Heart Rate and Sleep Quality of Colorectal Cancer Patients Treated with Chemotherapy: A Randomized Controlled Trial
  Eun-Jeong Hong
  Asian Oncology Nursing.2024; 24(1): 32.     CrossRef
• The Effect of a Supportive Educational Intervention Through Virtual Social Networks on Sleep Quality and Insomnia of Patients with Cancer
  Elahe Sarlak, Jamshid Ansari, Rahmatollah Moradzadeh, Nazi Nejat
  Journal of Cancer Education.2023; 38(5): 1675.     CrossRef
• Systematic Review of the Pittsburgh Sleep Quality Index used for Measuring Sleep Quality among Adults with Trauma Experiences
  Go-Un Kim, Ju Hee Lee
  Korean Journal of Adult Nursing.2019; 31(4): 337.     CrossRef

PURPOSE
This study aimed to evaluate effects of heated-humidified anesthetic gas on body temperature, acid-base balance, blood cortisol, and lymphocyte in the elderly patients with colorectal cancer during laparoscopic surgery.
METHODS
This study utilized an experimental design with a randomized controlled trial. A total of 60 patients with colorectal cancer were randomly assigned to one of two groups: either to the heated-humidified anesthetic gas group or to the usual anesthetic gas group. The following variables were measured: body temperature, acid-base balance, blood cortisol, and lymphocyte. The data were analyzed with independent t-test, χ2 test, ANCOVA, and repeated ANOVA using SPSS/WIN 20.0.
RESULTS
There was a significant difference in body temperature between the experimental group and the control group during laparoscopic surgery (F=41.18, p < .001). However, no statistically significant differences were found in acid-base balance, blood cortisol, and lymphocyte between two groups.
CONCLUSION
In this study, the body temperature during laparoscopic surgery was more effectively maintained with the heated-humidified anesthetic gas compared with the regular anesthetic gas. Therefore, the heated-humidified anesthetic gas might be considered to maintain the body temperature during laparoscopic surgery especially in the elderly population.

Citations

• Living experiences of older patients with cancer amid the COVID-19 pandemic: A phenomenological study
  Yong Hwan Hyeon, Kyoung Ja Moon
  Journal of Korean Gerontological Nursing.2024; 26(1): 54.     CrossRef

PURPOSE
This study was to explore and describe their experience of living with a colostomy.
METHODS
The data were collected by in-depth interviews with eight patients with colorectal cancer. The individual interviews lasted from 45 minutes to one hour each time, up to two times. The main questions were “How do you cope with the distress related to your colostomy?” The interview data were analyzed using Colaizzi's phenomenological method.
RESULTS
Of the eight participants, five were men and three were women. Mean age was 60.6 years. Three theme clusters were identified; ‘overcoming adversity of ostomy’, and ‘adjustment to ostomy’ and ‘new life through self-transcendence’.
CONCLUSION
These results showed that participants try to overcome their negative images and distress of having an ostomy by themselves, or with support from neighbors, families, religious persons or health professionals. The results from this study can help nurses to develop effective colostomy-caring interventions for patients living with a colostomy.

Citations

• Hopelessness and suicide ideation in ostomy patients: a mixed method study
  Nasrin Sarabi
  Journal of Coloproctology.2020; 40(03): 214.     CrossRef
• Effects of social support and self‐efficacy on the psychosocial adjustment of Korean ostomy patients
  Keum Hee Nam, Heui Yeoung Kim, Jung Ho Kim, Ki‐Noh Kang, Soo Yang Na, Bok Hee Han
  International Wound Journal.2019; 16(S1): 13.     CrossRef

PURPOSE
Korean elderly women residing in rural areas still appear to be marginalized from health services for cancer prevention. The purposes of this study were to measure the degrees of colorectal cancer (CRC) knowledge, health literacy, and self-management behaviors among the elderly women in rural areas and to identify the influences of their CRC knowledge and health literacy on self-management behaviors.
METHODS
Total 121 elderly women aged 65 or older living in rural areas were recruited for this descriptive study and answered survey questionnaires.
RESULTS
The participants' mean age was 78.2±7.51 years old. Of participants, 49.6% completed CRC screening and age of non-screening group was significantly older than that of screening group (χ²=35.31, p < .001). The screening group showed higher levels of CRC knowledge (t=3.76, p < .001) and cancer preventive behaviors (t=2.68, p=.008) than non-screening group. Age (B=0.15) and CRC knowledge (B=-0.36) were identified as influencing factors on the CRC screening. Health literacy (β=.37) and CRC knowledge (β=.30) were found as the most influencing factors on the cancer preventive behaviors.
CONCLUSION
The results of this study could be used as a basis for developing educational interventions and effective strategies specifically for the elderly women residing rural areas in Korea.

Citations

• Structural Equation Modeling Analysis on Health Literacy and Cancer Prevention Behaviors among Medically-Underserved, Low-Income Populations
  Eun Jin Kim, Su Hyun Kim
  Journal of Korean Academy of Fundamentals of Nursing.2021; 28(1): 83.     CrossRef
• Factors Influencing the Self-management Behaviors of the Elderly with Hypertension in the Local Community
  Jeongju Hong
  Journal of Korean Academy of Community Health Nursing.2021; 32(3): 303.     CrossRef
• Associations among Health Literacy, Psychosocial Factors, and Cancer-related Health Actions: A Systematic Literature Review
  Eun Jin Kim, Su Hyun Kim
  Korean Journal of Adult Nursing.2018; 30(6): 565.     CrossRef