Purpose The incidence of diabetes mellitus (DM) rises significantly in the post-middle-age population, and stress along with depressive symptoms hinders effective DM management. This study examined the mediating effect of social capital (trust in the physical environment, reciprocity, social participation, and social networks) on the relationship between perceived stress and depression among middle-aged adults with DM in Korea. It also aimed to provide data for developing targeted interventions to enhance blood glucose management in this population.
Methods A descriptive correlational study using data from the 2019 Community Health Survey by the Korea Disease Control and Prevention Agency (KDCA) was conducted. Complex sample regression analysis and the Sobel test were employed for mediation analysis. The study included 9,394 middle-aged adults (aged 45-64 years) diagnosed with DM. The analysis assessed the effects of perceived stress on social capital and depression, as well as the mediating role of social capital.
Results Perceived stress negatively impacted social capital (β=-0.16, p<.001) and positively influenced depression (β=0.37, p<.001). Both perceived stress and social capital significantly affected depression (F=998.83, p<.001), with social capital showing a partial mediating effect (z=2.65, p<.001).
Conclusion Social capital partially mediated the relationship between stress and depression, suggesting its potential as a strategy for reducing stress and lowering depression among middle-aged adults with DM. These findings lay the groundwork for targeted interventions to improve blood glucose management in this population. Future research should explore the relationships among specific components of social capital, stress, and depression.
Purpose This study aimed to assess the level of depression among older adults experiencing tinnitus and to identify predictive factors of depression through an analysis of secondary data.
Methods Data from the ninth Korea National Health and Nutrition Examination Survey conducted in 2022 were utilized for this analysis. We examined individuals aged 60 years or older who had experienced tinnitus for more than 6 months. Complex sample analysis techniques were conducted, and multiple regression analysis was performed to identify predictors of depression.
Results The study included 231 participants. Significant differences in depression levels were observed across several demographics and health factors, including gender, education level, self-rated health status, living alone, and stress level. Depression levels were significantly correlated with self-rated health status, stress levels, and average sleep duration. Additionally, significant correlations were found between self-rated health and stress levels, self-rated health and the number of chronic diseases, as well as between stress levels and the number of chronic diseases. Multiple regression analysis indicated that self-rated health status (p<.001), stress level (p<.001), and average sleep duration (p=.042) were significantly associated with depression. Specifically, poorer self-rated health, higher stress levels, and shorter sleep duration were associated with higher levels of depression.
Conclusion In older patients with tinnitus, self-rated health status, stress level, and average sleep duration significantly impact depression levels. These findings provide an important foundation for developing interventions to reduce depression in individuals with tinnitus.
Purpose This study investigated the mediating effect of sleep discomfort in the relationship between tinnitus distress and depression. Methods This cross-sectional study used the Tinnitus Handicap Inventory, the Korean Screening Tool for Depressive Disorders, and the Korean version of the Pittsburgh Sleep Quality Index to examine a convenience sample of 139 individuals with tinnitus who were selected from an online patient community in January 2023. Data were analyzed using the independent t-test, Pearson's correlation coefficients, and the PROCESS macro with 95% bootstrap confidence intervals. All statistical analyses were performed using IBM SPSS/WIN 25.0. Results Tinnitus distress exhibited a positive correlation with depression (r=.70, p<.001) and sleep discomfort (r=.33, p<.001), and depression showed a positive correlation with sleep discomfort (r=.52, p<.001). Further, sleep discomfort had a statistically significant partial mediating effect in the relationship between tinnitus distress and depression (β=.11; 95% CI, 0.05~0.18). Conclusion The findings of this study indicate that sleep discomfort plays a partial mediatory role in the relationship between tinnitus distress and depression.
Intervention programs for improving sleep discomfort among individuals with tinnitus are recommended to reduce depression in this population. In addition, screenings for sleep discomfort and depression should be routinely carried out as part of the treatment strategy for individuals with tinnitus.
Purpose This study was conducted to investigate the moderating effect of physical activity on the relationship between perceived stress and depression in patients newly diagnosed with ischemic heart disease.
Methods: This study had a cross-sectional design. Data were collected using a structured self-report questionnaire, which covered demographic characteristics, perceived stress, depression, and physical activity. Multiple linear regression was used to determine whether perceived stress and physical activity influenced depression, after controlling for demographic characteristics. The moderating effect of physical activity on the relationship between perceived stress and depression was analyzed using model 1 of the PROCESS macro (bootstrap sample size=5,000).
Results: The findings revealed that the level of depression was higher in women (p=.003), individuals without a spouse (p=.004), and those with an average monthly income of less than 3 million won (p=.045). The regression results showed that perceived stress was associated with a significant increase in the level of depression (β=.53, p<.001), and low physical activity was also a significant predictor of depression (β=.16, p=.013). The moderating effect of physical activity on the relationship between perceived stress and depression was confirmed, indicating that when physical activity was high, the impact of perceived stress on depression was weaker than when physical activity was low (B=-0.37, p=.038).
Conclusion: The findings suggest the need to implement a nursing program that can enhance physical activity and early screening for stress and depression in patients with ischemic heart disease.
Purpose This study investigated the effects of spiritual well-being on the cognitive function of elderly people, focusing on the mediating effects of health-promoting behaviors and depression. Methods Using convenience sampling, 136 elderly people were recruited from October 2018 through February 2019 for a cross-sectional survey. Data were collected through the Spiritual Well-Being Scale, Health-Promoting Lifestyle Profile, Geriatric Depression Scale, Everyday Cognition, and Montreal Cognitive Assessment and analyzed using descriptive statistics and correlation. Mediation analysis was also conducted using Hayes’ PROCESS macro (Model 4). Results The mean scores for spiritual well-being, health-promoting behaviors, depression, objective cognitive function, and subjective cognitive function were 60.96, 108.09, 18.58, 19.49, and 63.35. The mediation effects in step 1 indicated that spiritual well-being had a statistically significant positive effect on health-promoting behaviors (B=0.32, p<.001) (R2 =32.0%) and a significant negative effect on depression (B=-0.09, p=.001) (R2 =31.0%). In step 2, spiritual well-being had a significant negative effect on subjective cognitive function (B=-0.12, p=.007) (R2 =23.0%). In step 3, the direct effect of spiritual well-being on subjective cognitive function was not significant when the mediating variables (healthpromoting behaviors and depression) were introduced. Health-promoting behaviors (B=-0.18, p=.047) and depression (B=0.41, p=.008) had complete mediating effects on the relationship between spiritual well-being and subjective cognitive function. Conclusion These findings suggest that there is a need to develop and implement nursing strategies that can improve spiritual well-being, and to develop a holistic nursing intervention that considers depression and health-promoting behaviors, when applicable, to improve cognitive function in elderly people.
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Purpose This study investigated the factors affecting depression in nursing students during the COVID-19 pandemic.
Methods The participants of this descriptive study were 183 nursing students at four nursing colleges. Data were collected from August 27 to September 10, 2021 through an online questionnaire comprising 101 questions, and analyzed using SPSS/Win 25.0 program by frequency and percentage, mean and standard deviation, independent t-test, one-way ANOVA, pearson’s correlation coefficient, and hierarchical multiple regression analysis.
Results The results revealed that the average score for depression in the participants was 9.19±9.23 out of 63 points. The factors affecting depression in the participants during the COVID-19 pandemic were satisfaction with major (moderate) (β=-.38, p=.009), satisfaction with major (satisfied) (β=-.35, p=.018), job-seeking anxiety (β=.33, p<.001), health status (good) (β=-.28, p=.016), and self-efficacy (β=-.26, p=.001), and the explanatory power of these variables for depression in the participants was 43.0%.
Conclusion The results of this study suggest that for early prevention and management of depression in nursing students, to increase their satisfaction with the nursing major, it is necessary to implement learning enhancement programs and adopt strategies to improve their understanding of nursing. It is also necessary to develop and implement various extracurricular programs for reducing job-seeking anxiety and enhancing self-efficacy.
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Purpose The purpose of this study was to determine the levels of medication adherence in patients with heart failure and explore the factors related to it. Methods Cross-sectional and descriptive surveys were conducted in 107 patients with heart failure who visited C Hospital in D City. Data were collected from patients using self-report questionnaires between May 2015 and November 2016, and their medical records were identified. Data were analyzed using independent t-test, one-way ANOVA, and correlation and hierarchical multiple regression analyses using SPSS. Results The mean score of medication adherence was 10.23±2.70. Patients with long-term adverse effects showed worse medication adherence than those without long-term adverse effects (t=2.55, p=.012). Medication adherence positively correlated with depression (r=.34, p=.001) and barriers (r=.48, p=.001) but negatively correlated with attitude (r=-.39, p=.001). The hierarchical multiple regression analysis showed that the model with two independent variables of long-term adverse effects (β=-.23, p=.008) and barriers (β=.37, p<.001) explained the 29.6% in medication adherence (F=11.93, p<.001). Conclusion To improve medication adherence, a nursing strategy to reduce long-term adverse effects and barriers accompanied by continuous monitoring is required.
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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 is to explore the benefits of and barriers to disclosing one’s depressive feelings to others. In particular, this study contrasts the barriers to face-to-face communication of depressive feelings with the benefits of using Mobile Instant Messaging (MIM).
Methods: A total of 300 South Koreans participated in an online survey about their perceptions of disclosing depressive feelings. Paired t-tests, one-way ANOVA, and linear regression were used to examine the effect of demographic characteristics on the tendency to disclose depressive feelings. A semantic network analysis was conducted with open-ended responses to explore the proposed barriers and benefits.
Results: Barriers to expressing depressive feelings in face-to-face communication were observed, while benefits of using MIM were revealed. More importantly, while the perception of social norms was a major barrier to disclosing depressive feelings in face-to-face communication, it was a benefit of disclosing depressive feelings via MIM.
Conclusion: The results highlight the benefits of utilizing MIM as a channel for the disclosure of depressive feelings, which may, in turn, enhance emotional well-being.
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Purpose This study investigated factors affecting Quality of Life (QoL) of patients with Meniere disease. Methods A descriptive study design was used. Data were collected from March to April 2020 through an online survey of 130 participants diagnosed with probable or definite Meniere disease from a community of online-based patients.
The data were analyzed using the independent t-test, Pearson’s correlation coefficient, and multiple linear regression analysis. Results Perceived health, anxiety, depression, family support, and health care provider support significantly correlated with QoL. As a result of the multiple regression analysis, family support, perceived health, anxiety, and ear fullness were identified as factors influencing QoL, and these factors accounted for 65.0% of the variance in QoL. Of these variables, family support was the factor affecting the participants’ QoL the most (β=.45). Conclusion These results indicate a need for continuous efforts and strategies to increase family support to enhance the QoL of this population. In addition, to increase perceived health (which was the second most influencing factor on the QoL of this population), improved health care provider support (which showed a positive correlation with perceived health) is also warranted. Therefore, nursing interventions aiming to increase social support should be developed and implemented.
Purpose This study evaluated the impact of Chronic Kidney Disease (CKD) on depression, perceived health, and Health-Related Quality of Life (HRQOL) in community-dwelling adults. Methods Data from 9,778 adults who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2014 and 2016 were analyzed. The estimated glomerular filtration rate was calculated using the CKD Epidemiology Collaboration (CKD EPI) equation. Depression was defined as a score of at least 10 points on Patient Health Questionnaire-9 (PHQ-9).
The HRQOL was measured using the EuroQol-5D (EQ-5D). The effects of CKD on depression were analyzed using multivariate logistic regression, and the effects on perceived health and HRQOL were analyzed using multivariate ordered logistic regression. Results The prevalence of CKD was 3.7%. Among the adults with CKD, 13.1% had depression, 42.9% perceived their health to be bad, and their HRQOL was significantly lower than that of their non-CKD counterparts. The odds ratio for depression in patients with CKD was 1.66 (95% Confidence Interval [CI]=1.10~2.52, p=.017) and that of perceived bad or fair health was 1.80 (95% CI=1.35~2.40, p<.001). The likelihood of lower HRQOL in CKD patients was 1.44 times higher than in the non-CKD patients (95% CI=1.09~1.90, p=.010). Conclusion The prevalence of psychological problems in CKD patients was higher than in non-CKD patients. The results suggest the importance of comprehensive intervention for patients with CKD. Policies are needed to help assess and manage patients with CKD who are experiencing emotional problems.
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Purpose The purpose of this study was to identify the risk factors for suicidal ideation according to gender of old-old adults in South Korea. Methods Data were collected from the 2017 Living Profiles of Older People Survey, and participants were 4214 older adults (aged 75 years and above). Data were analyzed using SPSS Statistics 21.0 for Windows. Differences in suicidal ideation by gender were identified using the x2 test or independent t-test, with multi-variate logistic regression analyses conducted to determine the factors associated with suicidal ideation by gender. Results Among old-old adult participant, the prevalence of suicidal ideation in men and women were 5.4% and 6.7%, respectively. The significant predictive factors for suicidal ideation in men were the following: living alone, frequency of contact with children and friends etc., experience of discrimination, conflict with children, self-blame, anxiety, perceived health, number of chronic diseases, and diagnosed depression. The significant predictive factors for suicidal ideation in women were the following: frequency of contact with children, experience of discrimination, experience of abuse, conflict with children, anxiety, number of chronic diseases, perceived economic status, and diagnosed depression. Conclusion The study revealed differences in factors associated with suicidal ideation according to gender among old-old adults. These findings suggested that different approaches and strategies for suicidal prevention programs should therefore be considered according to gender in this population age group.
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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 This study aimed to investigate suicide ideation and attempts in older women living alone and to identify the factors affecting suicide ideation. METHODS This is a cross-sectional correlational study using secondary data analysis. Original data (n=1,023) were collected using face-to-face interviews from August to October 2018 in Siheung city to investigate the need for health care and daily life support services. Study participants were 297 older women (age=74.67±5.35), with inclusion criteria being women≥65 years old and living alone, those without cognitive impairment(Mini-Mental State Examination-2 Standard Version (MMSE-2 SV)≥24), and those who could evaluate instrumental activities of daily living. Data were analyzed using descriptive analysis, independent t-test, Pearson's correlation coefficient, and multiple linear regression analysis. RESULTS Data analysis showed 26.9% of participants reported suicide ideation with a frequency of 4.14 out of 10 points. Among study participants, 8.8% had attempted suicide with an average of 2.65 attempts. Participants who had children thought about suicide more than those who did not. Living children, personal income, participation in economic activity, social support, depression, chronic diseases, frailty, and suicide attempts were significantly correlated with suicide ideation. Therefore, depression, frailty and suicide attempts were factors affecting suicide ideation for older women living alone. CONCLUSION Our findings provide evidence that evaluating depression, frailty, and history of suicide attempts is important for suicide prevention in older women living alone.
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PURPOSE The purpose of this study was to explore influence of Type D personality of hemodialysis patients on quality of life and to elucidate mediation effects of depression and social supports between Type D personality and quality of life. METHODS The subjects were 126 patients who were receiving hemodialysis treatments at four dialysis clinics in Pusan and Daegu metropolitans. Data were collected from January 22th to February 28th, 2018 and analyzed with descriptive statistics, χ2 test, independent t-test, Pearson's correlation coefficient and three-step mediated regression analysis using SPSS/WIN 22.0. Significances of mediation effects were examined using bootstrapping method based on SPSS Process Macro program. RESULTS The prevalence of Type D personality in hemodialysis patients were 42.9%. Type D personality in hemodialysis patients had significant effects on quality of life, showing explanatory power of 12%. Depression showed complete mediating effects and also showed 42% of substantiating probability, and social supports showed partial mediating effects and showed 19% of substantiating probability. CONCLUSION Summing up the result of research until now, in order to improve the quality of life for Type D personality hemodialysis patient, it is necessary to develop strategies not only to relieve depression using early evaluation on depression status, consulting therapy, cognition behavior mediation and so on, but also to enhance social supports like participating in voluntary meetings and building up social network to expand relationship with close people.
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PURPOSE The purpose of this study was to identify factors associated with family caregivers' self-management of acute stroke survivors. METHODS The study participants were 130 stroke survivors and their caregivers. Data on participant characteristics, depression, task difficulty, survivor memory and behavioral problem, and self-management were collected from July 1 to September 30, 2017 using a structured questionnaire. Data were analyzed with the SPSS/WIN 23.0 program for descriptive statistics, using independent t-test, one-way analysis of variance, Pearson's correlation coefficient and enter multiple regression analysis. RESULTS Significant factors associated with self-management for family caregivers were survivors' age, the presence of comorbidities, the relationship between caregivers and survivors, and the presence of an alternative caregiver. Self-management has negative correlations with depression, task difficulty, and the occurrence of survivor memory and behavioral problems. The determining factors affecting caregiver self-management were caregiver depression (β=−.46, p < .001) and survivor age (β=.32, p=.004), and their explanation power was about 37%. CONCLUSION The results suggest that caregiver depression and survivor age should be considered in developing the nursing interventions to improve family caregiver self-management. Furthermore, findings underscore the importance of early screening and ongoing psychological assessments for depression in family caregivers of stroke survivors.
PURPOSE Geriatric depression is often closely connected with physical symptoms among older adults. This study aimed to determine the factors related to depressive symptoms among older adults with multiple chronic diseases. METHODS We assessed 6,672 older adults using data extracted from the 2014 National Survey on the Elderly in Korea. The short form of the Geriatric Depression Scale and the Korean versions of the Mini-Mental State Examination for dementia screening and the DETERMINE Your Nutrition Health Checklist were used. Statistical analyses included independent t-test, χ2 test, and logistic regression analysis. RESULTS We found that 36.7% of the older adults exhibited depressive symptoms, and the average score on the short form of the Geriatric Depression Scale was 5.90±4.53. The factors significantly related to depressive symptoms were unemployment (Odds Ratio [OR]=1.85, 95% Confidence Interval [CI]=1.59~2.15), “high risk†nutritional management status (OR=1.19, 95% CI=1.16~1.22), slight visual dysfunction (OR=1.21, 95% CI=1.05~1.38), high visual dysfunction (OR=1.41, 95% CI=1.04~1.91), slight hearing dysfunction (OR=1.22, 95% CI=1.05~1.43), slight chewing dysfunction (OR=1.37, 95% CI=1.19~1.59), high chewing dysfunction (OR=1.59, 95% CI=1.30~1.95), low cellphone utilization (OR=1.60, 95% CI=1.04~2.46), older age (OR=0.99, 95% CI=0.98~1.00), and higher educational level (OR=0.96, 95% CI=0.95~0.98). CONCLUSION Preventive interventions for depressive symptoms should include nutritional education programs, functional assistive devices, and the use of information technology.
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PURPOSE The purposes of this study were to examine the relationships between resilience, depression, and self-care competence and identify factors associated with self-care competence in patients with type 1 and type 2 diabetes mellitus. METHODS This study was a descriptive research. Structured questionnaire on patients' sociodemographic and clinical characteristics, resilience, depression, and self-care competence was used for survey with a convenience sample of 152 patients with diabetes mellitus. Data were collected from July to December 2016. Data were analyzed using descriptive statistics, independent t-test, one way ANOVA, Pearson's correlation coefficient, and multiple regression with SPSS/WIN 21.0 program. RESULTS The mean scores on resilience, depression, and self-care competence were 2.86±0.42, 18.11±10.05, and 4.27±0.78, respectively. Self-care competence showed a statistically significant positive correlation with resilience (r=.47, p < .001), and negative correlation with depression (r=−.29, p < .001). Resilience showed a negative correlation with depression (r=−.53, p < .001). Resilience (β=.38, p < .001) was significantly associated with factors of self-care competence in patients with diabetes mellitus. CONCLUSION The results of the study indicate that factor influencing self-care competence was resilience in patients with diabetes mellitus. Therefore, nursing intervention programs for increasing the self-care competence should include regular assessments and strategies for improving resilience in patients with diabetes mellitus. It is recommended that the studies should be performed to confirm the relationship between resilience and self-care competence by using resilience instrument developed for adults.
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PURPOSE Fatigue is common in older adults and may decrease the quality of life. The purpose of this study was to investigate the level and characteristics of fatigue of older adults, and identify the factors associated with fatigue. METHODS This study used a secondary data analysis (n=200). Data collection was conducted from July to September 2015. Fatigue Severity Scale, Geriatric Depression Scale Short Form Korea Version, Korean Version of Physical Activity Scale for Elderly, and Verran & Synder-Halpern Sleep Scale were used. RESULTS We used the data from 200 older adults in a local senior welfare center. Their average age was 74.5 years. We found that 35.5% of them had fatigue (≥4). The reported factors alleviating fatigue were taking rest, warm bath, and sleeping. Engaging in light sports was also reported to alleviate fatigue. The level of fatigue was higher in subjects with older age (p=.009), lower income (p=.003), higher number of diseases (p < .001), more medications (p < .001), and lower perceived health status (p < .001). In multiple linear regression analysis, the factors predicting fatigue were older age (p < .001), depression (p < .001), pain (p=.001), irregular exercise (p=.013), and lower perceived health status (p < .001). The explanatory power of the model was 47.5%. CONCLUSION Our study suggests that depression and pain were risk factors although engaging in light sports was a factor alleviating fatigue in older adults. The fatigue management strategies tailored to alleviate fatigue in older individuals by reducing these manageable risk factors are needed.
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PURPOSE The purpose of this study was to identify the factors influencing resilience of patients with stroke. METHODS A cross-sectional descriptive research design was used. The subjects of this study were 136 hospitalized patients with stroke in Dankook university hospital in Cheonan, Korea. Data were collected from August 2016 to March 2017 using a structured questionnaire including patient's characteristics, depression, uncertainty, social support, self-efficacy, and resilience. Data were analyzed using the SPSS/WIN 21.0 program for descriptive statistics, using independent t-test, one way analysis of variance, Pearson's correlation coefficient, and multiple regression. RESULTS Resilience had a statistically significant relationship with education (t=−2.17, p=.032), duration of diagnosis (F=4.09, p=.019), and mobility (F=4.44, p=.014). Further, depression (r=−.30, p < .001), self-efficacy (r=.44, p < .001), and social support (r=.37, p < .001) were significantly correlated with resilience. In the multiple regression analysis, self-efficacy and social support were statistically significant factors that explained 30.3% of variance of resilience in hospitalized patients with stroke. Depression and uncertainty were not found to be significant. CONCLUSION The results of the study indicate that factors influencing resilience are self-efficacy and social support. Therefore, nursing intervention programs for increasing the resilience should include strategies for improving self-efficacy and social support for hospitalized patients with stroke.
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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.
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