Purpose This study aimed to construct and test a hypothetical model which explains the psychosocial adjustment of breast cancer survivors using the family resilience model suggested by McCubbin and McCubbin. Methods The study participants were 242 breast cancer survivors who had finished active treatments within the past five years. Data were collected from September to October 2017 from an offline breast cancer self-help group survey and an online breast cancer support group. Data were analyzed using SPSS version 22.0 and AMOS version 23.0. Results The model fit indices for the modified hypothetical model were suitable for the recommended level: x2 =223.80 (df=88, p<.001), x2 /df=2.54, RMR=.04, GFI=.90, IFI=.93, CFI=.93, and RMSEA=.08. Symptoms and posttraumatic growth directly affected psychosocial adjustment. Symptoms were found to be the most influential factors in the psychosocial adjustment. All three family resilience factors-family hardiness, problem-solving communication, and problem-solving coping-directly affected posttraumatic growth and indirectly affected psychosocial adjustment through posttraumatic growth. These variables explained 81.2% of breast cancer survivors’ psychosocial adjustment. Conclusion Health care professionals need to continue to provide interventions for symptom relief and support to improve the psychosocial adjustment of breast cancer survivors. Additionally, practical nursing interventions should be prepared for individuals and families of breast cancer survivors to promote recovery and reinforce family resilience. This will ultimately improve the quality of life for breast cancer survivors and their families.
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PURPOSE The purpose of the study was to provide deep understanding of the reported experiences of families with their loved one in the intensive care unit (ICU), focusing on interactions with healthcare providers. METHODS The data were collected by individual interviews of eleven participants. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of families. RESULTS Five themes and 13 sub-themes emerged. “Captive of patients' delayed death: Fear and anxiety†describes psychological problems arising when the family member became critically ill enough to warrant being admitted to the ICU. “Families as the weak: Suppression and resistance†describes interpersonal difficulties arisingdue to lack of information and trust with healthcare providers. “Deprivation of authority and duty as families: Helplessness†illustrate situational barriers in attempting to protect and support family member. “Re-establishment of trust relationship with healthcare providers: Gratitude and appreciation†describes how they satisfied with themselves by regaining trust relationship. Lastly, “Acceptance of reality through direct care participation: Relief and peace†illustrates peace of mind by gaining sense of reality through active direct care participation. CONCLUSION This study demonstrates the positive and negative experiences of families with ICU patients. The results will be useful in developing family-centered nursing interventions.
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PURPOSE The purpose of the study was to examine the relationships among pain belief, perceived social support, coping strategies, and quality of life of people with noncongenital spinal cord injury and to identify factors influencing quality of life. METHODS A correlational predictive design was used. The data were collected from 197 people with noncongenital spinal cord injury with questionnaires in 2012 in Korea. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using SPSS/WIN 18.0. RESULTS Pain belief, perceived social support, and coping strategies were correlated significantly with the quality of life. As a result of stepwise multiple regression analysis, pain belief, perceived social support, coping strategies, damaged area, and time since injury were discovered to account for 59.1% variance of the quality of life. The variable that most affected the quality of life was pain belief followed by perceived social support and coping strategies. CONCLUSION The results of the study clearly demonstrate the importance of pain control, social support, and coping skills in order to improve quality of life among people with noncongenital spinal cord injury.
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PURPOSE The purpose of this study was to examine the relationships among perceived health, parental stress, social support, and quality of life of grandparent caregivers and to identify the factors influencing quality of their life. METHODS A descriptive correlational design was used. The data were collected by questionnaires from a convenience sample of 130 participants taking care of their grandchildren from ten children's daycare centers in Seoul, Korea from August to September, 2013. Data were analyzed using t-test, ANOVA, Pearson's correlation efficients, and multiple regressions. RESULTS Perceived health, parental stress and social support were correlated significantly with quality of life. As a result of the multiple regression analysis, education level, age of grandchildren, perceived health, parental stress and social support accounted for 48% of the variance in quality of life. Perceived health, parental stress, and social support were identified as factors influencing quality of life and the variable that most affected quality of life was perceived health. CONCLUSION The results of the study indicate that health of people taking care of their grandchildren must be promoted while relieving their parental stress with appropriate social support in order to improve quality of life.
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PURPOSE Liver transplantation (LT) is the best treatment for patients with end-stage liver disease and most patients with LT return to their normal life. However, pregnancy and childbirth for women with LT are less common, mainly because it is considered to be dangerous for their health. The purpose of this study was to describe how Korean women after LT experience their pregnancy and childbirth. METHODS This study was designed to explore the experiences of pregnancy and childbirth of women with LT. Data were collected by individual in-depth interviews with four women who were pregnant and gave birth following LT in 2009. All interviews were audio-taped and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. RESULTS Four themes emerged as a result of analysis: recovery of lost feminity and marriage; fulfilling roles through pregnancy; life-risking pregnancy; and perfect family achieved by childbirth. These themes describe in detail about challenges and concerns the women with LT faced for their pregnancy and childbirth as well as many emotionally touching experiences. CONCLUSION The results of this study would support health professionals to be better prepared to help women with LT for pregnancy and childbirth by providing in-depth and insightful information.
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PURPOSE The purpose of the study was to examine the relationships between cognitive coping, hope, depression, and life satisfaction of hemodialysis patients based on the stress-coping model. METHODS For this cross-sectional survey, 142 participants were recruited from 10 local clinics in Seoul and Daegu during 2012-2013. The data collection instruments included the Cognitive Emotion Regulation Questionnaire, the Herth Hope Index, the Hospital Anxiety and Depression Scale, and the Satisfaction with Life Scale. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation analysis, and stepwise multiple regression. RESULTS The cognitive coping scores were significantly related to hope, depression, and life satisfaction. The coping strategies explained 80%, 37%, and 38% of the variances in hope, depression, and life satisfaction, respectively. The most powerful coping strategy was positive refocusing, explaining 73% in hope, 25% in depression, and 25% in life satisfaction. CONCLUSION The results of the study indicate that cognitive coping plays an essential role for psychological adaptation of hemodialysis patients. Thus, interventions integrating positive refocusing would help instilling hope of hemodialysis patients in Korea.
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PURPOSE The purpose of the study was to identify the levels of anxiety, depression and uncertainty of patients who participated in the clinical trials for anticancer drug, and to identify correlations among these variables. METHODS Cross-sectional survey used the Symptom Check List-90-Revision and the Mishel Uncertainty in Illness Scale from 106 subjects in 2011. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients. RESULTS The mean score of anxiety was 2.06, that of depression 2.35, and that of uncertainty 2.61. Anxiety and depression (r=.70), anxiety and uncertainty (r=.44), depression and uncertainty (r=.60) were significantly correlated each other. The levels of anxiety, depression and uncertainty were different in various characteristics of the subjects, such as education, recurrence, and economic burden. CONCLUSION The results of the study indicate that when implementing psychosocial interventions for cancer patients who participate in clinical trial, factors such as education, economic burden, and recurrence should be integrated into the intervention. Further studies applying theoretical model would be helpful to identify directional relationships among the variables that are important in psychosocial well-being of cancer patients undergoing clinical trial.
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PURPOSE The aim of this study was to compare the levels of anxiety, depression, and quality of life (QOL) among kidney or liver transplant candidates and recipients. METHODS A cross-sectional descriptive design was utilized. The 160 subjects were recruited and assigned to three different conditions: awaiting transplant group; post-transplantation (TPL) group within less than one year of surgery; and post-TPL group with one year and no more than two years post surgery. The levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. The level of quality of life was measured by the Medical Outcomes Study Short Form-36 version 2. RESULTS The anxiety score was significantly higher in the waiting group compared with the 1~2 years post TPL group. The depression score was significantly higher in the waiting group compared with the post TPL groups. The QOL was significantly lower in the waiting group compared with the post TPL groups. CONCLUSION Our results show a high prevalence of anxiety and depression and a marked reduction in the QOL in transplant candidates compared to the recipients. This study indicates that the group waiting for transplants may have unmet needs during that time period. Health professionals should be encouraged to attend to the psychological distress of the transplant candidates in order to improve their quality of life.
PURPOSE This study was designed to investigate the levels of anxiety, depression, physical symptoms, and supportive care needs in patients with hematologic malignancy and to identify predictive factors of supportive care needs. METHODS The data were collected from 100 subjects undergoing treatments during 2010 in Korea. The questionnaires included the Hospital Anxiety-Depression Scale, the M. D. Anderson Symptom Inventory, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. RESULTS Forty percent of the subjects had anxiety and 58% had depression. Thirty-eight percent of the subjects reported to have moderate-to-severe levels of physical symptoms. The most severe physical symptom was lack of appetite, followed by fatigue and pain. In terms of supportive care needs, the health system and information domain showed the highest among all domains. Supportive care needs had a significant positive correlation with anxiety, depression, and physical symptoms. And its predictive factors were identified as anxiety, physical symptoms and marital status, with the explanatory power of 48.9%. CONCLUSION These findings demonstrate that anxiety and physical symptoms should be assessed and treated to meet the supportive care needs of patients with hematologic malignancies.
PURPOSE The purpose of the study was to identify levels of hope, self-esteem, and quality of life, and to find correlations among these variables in people with spinal cord injury. METHODS This study was a cross-sectional descriptive survey. The data were collected by survey interview in 2010 from 120 people with spinal cord injury living in the community. To measure hope, self-esteem and quality of life, the Dispositional Hope Scale, Self-Esteem Scale, and World Health Organization's Quality of Life Instrument were utilized respectively. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation and stepwise multiple regression analysis using SPSS version 12.0. RESULTS Mean score of hope was 2.56 and that of self-esteem was 3.23. Mean score of quality of life was 3.01. Statistically significant relationships were found between quality of life and hope (r=.73, p<.001), and between quality of life and self-esteem (r=.67, p<.001). Multiple regression analyses showed that hope and self-esteem were statistically significant in predicting quality of life with the explanatory power of 59.1%. CONCLUSION The results of this study indicate that nursing interventions fostering hope and self-esteem should be integrated in developing rehabilitation programs to improve quality of life for people with spinal cord injury.
PURPOSE The purpose of the study was to understand and describe the experiences of young Korean women with attempted suicide. METHODS The data were collected by individual interviews from four women who attempted suicide during 2008-2009. A total of 25 hours interviews were audio-recorded and transcribed verbatim. The data were analyzed using feminist phenomenology to reflect and respect the participants' view and experience as much as possible. RESULTS Five theme clusters and ten themes emerged from the analysis. Five theme clusters include "anger resulting from others-oriented life," "guilt resulting from selfish life," "confusion resulting from unbalanced life between self and others," "attempted suicide resulting from the chaos of life as a whole," and "peace resulting from balanced life between self and others." While these theme clusters represent the phases of life experience, ten themes indicate specific problems or strategies raised during these phases in the context of male-oriented Korean patriarchal society. CONCLUSION The results of the study provide insights by deeply understanding of life of young women who attempted suicide in the Korean sociocultural context with the ideology of the subjection of women.
PURPOSE The purpose of the study was to describe psychosocial difficulties experienced by cancer patients. METHODS Three focus group interviews were conducted to collect the data from 19 outpatients with cancer undergoing treatments during 2009. All interviews were audio-recorded and transcribed verbatim. The data were analyzed using constant comparative analysis of grounded theory. RESULTS As a result of constant comparative analysis, 'psychosocial distress' was identified as a core category, and seven subcategories were identified. 'Plunged into negative emotions' and 'damaged self-identity' were identified as major categories in the individual dimension. 'Difficulty in dealing with diagnosis' and 'hasty expectations and concerns' were identified in the dimension of family. 'Inefficient communication' and 'lack of necessary information' were identified in the dimension of health care setting. 'Lonely journey into a strange territory' was identified in the dimension of society. CONCLUSION The results of the study indicate that cancer patients experience a wide range of psychosocial problems. Thus, in assessing and relieving psychosocial distress of cancer patients, it is necessary to focus not only on the level of the individual but also on the levels of family, health care setting, and society in general is necessary.
PURPOSE The purpose is to explore the illness experience of Korean women with breast cancer using feminist phenomenology. METHODS Data were collected by individual in-depth interviews from ten women with total mastectomy. The data were analyzed using Colaizzi's method from feminist perspective to reveal implicit socio-cultural norms that oppress women with breast cancer. RESULTS Two categories and seven major themes emerged: cancer-related experience (1) unfairness of having breast cancer; (2) being confined to the gaze of the others; patriarchy-related experience (3) hardness of being daughter-in-law; (4) struggling to keep on being good mother; (5) continued housework as duty; (6) recognizing self as precious wife, and (7) awakening of true self. All participants felt it was very unfair to get breast cancer because they had done their best for roles of mother, wife, and daughter-in-law. They struggled to free themselves from the social disgrace like the roles imposed by the patriarchal society. By awakening their true selves, they could manage a balance between other-oriented life and self-oriented life. CONCLUSION Oncology nurses need to provide psychosocial support for women with breast cancer in finding their true selves in a traditional patriarchal society where women are oppressed and breast cancer is stigmatized.
PURPOSE The purpose of the study was to understand and describe health-related experience of women with physical disabilities, using feminist qualitative approach. METHODS Eight women with physical disabilities participated to the study. Their mean age was 43, ranging from 39 to 67 years old. The data were collected by individual in-depth interviews and all interviews were audio-taped and transcribed verbatim. The transcribed data were analyzed using traditional qualitative content analysis from a feminist perspective. RESULTS Six major categories emerged from the data. Category 1: "Isolation and alienation from the world.", Category 2: "A distorted self-image of physically disabled body.", Category 3: "Difficulties due to a fixed gender role.", Category 4: "Constant suffering from chronic pain.", Category 5: "Health problems that they have to endure by themselves.", Category 6: "Sublimation through selfreliance." The results of the study show how Korean women with physical disabilities suffer from social stigma, indifferences, and discriminations and struggle to survive in these unfriendly surroundings. CONCLUSION The results of the study would help health professionals in designing effective intervention to improve health and to empower women with physical disabilities by providing deep understanding and critical insights of those women.
PURPOSE The purpose of this study was to understand the experiences of interpersonal relationships of head nurses in interacting with others in general hospital settings. METHODS The data were collected by individual in-depth interviews from seven head nurses and were analyzed using qualitative content analysis. RESULTS Five major categories emerged and they represent a major strategy according to five different groups of interacting people. 'Establishing trust' was identified as the key strategy in dealing with patients and family members. 'Embracing with sisterly love' and 'helping with self-defense' were major strategies for subordinate nurses and physicians, respectively. 'Respecting and recognizing' was the main approach for other professionals such as dietitians and 'emphasizing rules and educating' were a major one for non-professionals. Head nurses paid more attention and made efforts in dealing with their subordinate nurses than with other groups of people, because they felt the most difficulty in their relationship with subordinate nurses. CONCLUSION The results of the study showed that head nurses employ unique strategies in interacting with different groups of people to increase the efficiency of communication. This study would help nurse administrators establish an effective program for improving interpersonal relationships of head nurse.
PURPOSE The purpose of the study was to describe nonverbal behaviors of nurses in communication with patients with dementia in an elderly care institution in Korea. METHODS Conversation analysis was utilized to analyze the data which were collected using video camera to capture non-verbal as well as verbal behaviors. A total of 66 episodes of everyday conversations were analyzed using seven nonverbal categories: affirmative head nodding; illustrative gestures; patient-directed eye gaze; smiling and/or laughing; forward leaning; affective touch; and instrumental touch. RESULTS Among seven categories, patient-directed eye gaze(94%) was the most frequently utilized among nurses followed by affirmative head nodding(67%) and forward leaning(67%), while smiling was the least used(32%). Affective touch was identified in 39 episodes(59%). Among them, the most frequently touched area was hand or handshaking(59%) followed by shoulder or back, arm, and face. There were wide differences among nurses in terms of using affective touch, ranging from 0% to 98%. Nonverbal behaviors were more frequently identified in effective episodes than in ineffective episodes. CONCLUSION Actively utilizing effective nonverbal behaviors may help geriatric nurses in promoting communication and in establishing rapport with patients with dementia.
PURPOSE The purpose of this study was to explore the effectiveness of informational intervention delivered by electronic patient information board in the OR waiting room for reduction of anxiety of mothers with child having operation. METHOD: Nonequivalent control group non-synchronized design was used in this study. The subjects was 52 mothers whose children underwent elective surgery in one Pediatric Hospital. Informational intervention in this study consisted of four critical stages. State anxiety by Spielberger, mean arterial pressure, and heart rates at preoperative and postoperative period were measured. The data were analyzed by using Chi-Square test and t-test with SPSS/PC 10.0 program. RESULTS: 1) There was a significant difference in the state anxiety between the control and the experimental groups. 2) There was no significant difference in the mean arterial pressure between the two groups. 3) There was no significant difference in the heart rate between the two groups. CONCLUSION: The results of this study indicate that informational intervention delivered by electronic patient information board would be an effective intervention during the operation in reducing anxiety of mothers with child having operation.
PURPOSE The purpose of the study was to explore how hospital nurses decide to quit working as professional nurses using the grounded theory method. METHOD: The data was collected by individual in-depth interviews with 12 hospital nurses who recently resigned from work and it was analyzed using 'constant comparative analysis.' RESULT: The core category that emerged was "in search of new balance with self, work, and family". Three stages were identified: 1) "unconditionally accepting the working situation of itself," 2) "weighing advantages and disadvantages of working as a hospital nurse", and 3) "redesigning a future". Each stage contains three major strategies. The major strategies of the first stage are "maintaining a learning attitude", "enduring physical burnout," and "enduring unfair interpersonal relationships". The second stage contains "identifying advantages of working", "identifying disadvantages of working", and "comparing the advantages with the disadvantages". Lastly, the third stage includes "reassessing the aim of life", "beginning to construct an alternative life", and "deciding to quit working at a certain point". CONCLUSION: The results of the study will help nursing administrators in designing and implementing an effective turnover prevention program for nurses by understanding more deeply the process of turnover phenomenon among hospital nurses.
The purpose of this study was to understand and describe how people with kidney transplantation experience using grounded theory method. Purposeful sampling was employed. Total of 20 kidney recipients participated in the study. To collect the data 11 individual in-depth interviewes and two focus group interviews were utilized. Each interview took about one hour, ranging from one to three hours and were audio-taped under the permission of the participants. All interviewes were transcribed to analyze. The results of the study show three stages of life process after kidney transplantation; 1) honeymoon stage, 2) anxiety and depression stage: 3) recovery and stable stage. In the honeymoon stage, all kidney recipients were exhilerated after the operation. They were happy receiving healthy kidney from others, often from beloved families. In the anxiety and depression stage, however, they experienced numerous psychosocial problems mainly due to the health, interpersonal, financial, and physical appearance problems. In the recovery and stable stage, they came out from the psychosocial problems by viewing their situation more objectively and by using many effective coping strategies to imporve their quality of life. Nine strategies which were identified as significant are 1) complying therapeutic regimens, 2) seeking information, 3) keeping their own job, 4) restricting social activities, 5) lowering aimes in their life, 6) managing the fact about their own kidney transplantation, 7) comforting themselves by comparing with others, 8) living religious or altruistic life, and 9) accepting redialysis and retransplantation. In the end, most of them experienced changed value system of life. They were satisfied with their current life, and thanked for living so many years after the transplantation. However, some of them, especially younger ones, regreted of losing hope and ambition they had planned when they were young. And many of them also experienced restricted social life, financial difficulties, and continuous fear of rejection of kidney. The results of the study might help nurses who work with kidney recipients in establishing and implementing effective nursing interventions by understanding the stages of life after kidney transplantations as well as their problems and strategies.
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