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 developed a self-management program for patients undergoing lumbar spinal stenosis surgery utilizing the information-motivation-behavioral skills (IMB) model. Methods: This study employed a quasi-experimental design with a nonequivalent control group and pretest–posttest design. Data were collected from August 11, 2022, to March 31, 2023, at a general hospital in South Korea. A total of 58 patients participated in the study (30 experimental, 28 control group). The experimental group received a six-session self-management program based on the IBM model, whereas the control group received usual education and information. Data were analyzed with SPSS/WIN 23.0 using the independent t-test, chi-square test, Fisher’s exact test, Shapiro-Wilk test, and Mann-Whitney U test. Results: Significant differences were observed in self-management information (p<.001), personal motivation (p=.002), social motivation (p=.002), behavioral skills (p=.002), behaviors (p=.003), health-related quality of life (p<.001), and disc height (p=.006) in the experimental group following program implementation, compared to the control group. However, no significant differences were found in lower extremity muscular strength, lumbar lordotic angle, or the visual analog scores for low back pain and leg pain between the two groups. Conclusion: The self-management program developed in this study, based on the IMB model, was effective in improving self-management information, motivation, behavioral skills, behaviors, health-related quality of life, and self-management health outcomes in patients undergoing lumbar spinal stenosis surgery. Nevertheless, future research should aim to verify the long-term effects of such self-management programs by extending the intervention period.
Purpose The incidence of gynecological cancers is increasing, presenting significant challenges for patient care and outcomes. Perceived stress and negative affect can impede self-care behaviors and reduce health-related quality of life (HRQoL). This study examined the mediating effects of negative affect and cancer coping on the relationship between perceived hospital stress and HRQoL among patients with gynecological cancer. Methods: A cross-sectional mediation analysis was conducted with 118 gynecological cancer patients recruited from the outpatient clinic of a university hospital (October 2023 to February 2024). Participants completed validated instruments assessing perceived stress, negative affect, cancer coping, and HRQoL. Data were analyzed using Spearman’s correlations and the PROCESS macro (Model 4) with 95% bootstrap confidence intervals (CIs). Results: Perceived stress was significantly correlated with negative affect (r=.58, p<.001), cancer coping (r=.23, p=.012), and HRQoL (r=–.45, p<.001). Negative affect was correlated with HRQoL (r=–.59, p<.001). Furthermore, negative affect and cancer coping mediated the relationship between stress and HRQoL (B=–0.18, 95% CI=–0.27 to –0.11 and B=0.04, 95% CI=0.01 to 0.08, respectively). Conclusion: Negative affect and cancer coping significantly mediated the relationship between hospital stress and HRQoL. Targeted interventions aiming to reduce stress and strengthen emotional and coping strategies could enhance HRQoL among gynecological cancer patients.
Purpose This study identified the mediating effect of resilience on the relationship between job stress and the professional quality of life of hospice and palliative care nurses. Methods The participants included 136 hospice and palliative care nurses from 13 inpatient hospice and palliative care wards at a tertiary hospital in a metropolitan city in South Korea. Data were collected from February 2022 to March 2022. Hayes' PROCESS macro 3.5 was used to test the significance of the parameter's indirect effects. Professional quality of life was divided into three subdomains: compassion satisfaction, secondary traumatic stress, and burnout. Results As a mediator, resilience had both direct and indirect effects on the relationship between job stress and the compassion satisfaction of hospice and palliative care nurses. Furthermore, there were both direct and indirect effects on the relationship between job stress and secondary traumatic stress. Finally, although there was no direct effect on the relationship between job stress and burnout, there was an indirect mediating effect. Conclusion This study confirmed the direct effect of compassion satisfaction on job stress and the professional quality of life of hospice and palliative care nurses, as well as the mediating effect of resilience on job stress and burnout. To improve the professional quality of life of hospice and palliative care nurses, it is necessary to develop and apply programs that enhance resilience in order to promote its mediating effects on compassion satisfaction and burnout.
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.
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Purpose This study employed structural equation modeling to verify the suitability and causality of a hypothetical model constructed based on Wilson and Cleary's health-related quality of life model. The aim was to explain and identify the factors that influence quality of life in middle-aged men with prostatic hyperplasia. Methods The study included 217 middle-aged men diagnosed with prostatic hyperplasia between February and March 2022 at the urology department of a general hospital in UJB city. The measurement tools used included biological characteristics, International Prostate Symptom Scores, functional health, general health perceptions, social support, and quality of life. The data collected were analyzed using the SPSS 25.0 and AMOS 25.0 programs. Results The final model revealed that the variables with the highest explanatory power for quality of life in middle-aged men with prostatic hyperplasia were general health perceptions, followed by the International Prostate Symptom Score, functional health, and prostate size. The explanatory power of the variables for quality of life in middle-aged men with prostatic hyperplasia was 89.7%. Conclusion The model used in this study was found to be suitable for assessing quality of life in middle-aged men with prostatic hyperplasia. Based on the study's findings, it is deemed necessary to foster competencies for managing the disease through the development of educational programs, nursing interventions, and countermeasures. These should be based on general health perceptions, symptoms, and functional health, with an accurate knowledge of the characteristics of prostatic hyperplasia, as per Wilson and Cleary (1995)'s health-related quality of life theory.
Purpose The objective of this study was to ascertain the level of life satisfaction among baby boomers in South Korea, as well as the factors that influence it. Methods We conducted a secondary analysis and descriptive research using data from the 2020 Korea National Survey of Elderly. From a total of 10,097 individuals, we analyzed the responses of 605 who provided feedback on life satisfaction, applying sample weights for accuracy. Data analysis was performed using hierarchical multiple regression in the SPSS/WIN 23.0 program. Results The study's participants comprised 61.8% women, 80.2% individuals with a living spouse, and 54.8% high school graduates, and the participants had an average subjective health status score of 3.77 points. Hierarchical regression analysis revealed several significant factors impacting life satisfaction. These included the presence or absence of a spouse (p<.001), education level (p<.001), subjective health status (p<.001), experience of suicidal thoughts after the age of 60 (p=.004), and use of a smartphone or tablet (p=.037), degree of social respect (p<.001) and the degree of preparation for death (p=.001). The overall explanatory power for life satisfaction was 57.5%. Conclusion The life satisfaction of baby boomers did not differ greatly from that of previous generations of older adults. A future longitudinal study should observe changes in older adults' life satisfaction. Additionally, it is important to explore variations in life satisfaction across different age groups, especially given the increasing longevity of older adults.
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Purpose This study aims to identify factors affecting the Health-Related Quality of Life (HRQoL) in patients with atrial fibrillation. Methods The study subjects were 158 outpatients with atrial fibrillation at a university hospital in Metropolitan City B. Data were collected from March 18, 2022 to July 1, 2022 and were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and hierarchical multiple regression with SPSS 22. Results Self-management behaviors (β=.27, p<.001), self-efficacy (β=.30, p<.001), and grit (β=.33, p<.001) were found to have statistically significant effects on HRQoL. Hierarchical regression analysis showed that age, employment status, and monthly household income explained 23.6% of the variance in HRQoL, while subjective health status and perceived stress added 18.6% of the variance. Self-management behaviors, self-efficacy, and grit had an explanatory power of 32.4%, and the overall explanatory power was 74.6%. Conclusion Self-management behaviors, self-efficacy, and grit were identified as factors affecting HRQoL in patients with atrial fibrillation. These results will be used as important fundamental data to develop nursing interventions in order to improve the HRQoL of patients with atrial fibrillation.
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Purpose The purpose of this study was to develop and verify a Quality of Life Scale (QOLS) specifically for hypertensive patients.
Methods: In the development phase of the QOLS, initial items were derived based on literature review and content analysis through in-depth interviews. After verifying the content validity of the expert group, preliminary questions composed of 94 items were created and confirmed by conducting preliminary research on hypertensive patients. During the verification phase, the preliminary QOLS was administered to 392 hypertensive patients from general hospitals, medical clinics, and public health centers in Busan. Data were analyzed using item analysis, exploratory factor analysis, convergent validity, discriminant validity, criterion validity, and Cronbach’s ⍺.
Results: The final scale consisted of 30 items derived from 5 factors. Five factors (negative emotion, acceptance of disease, self-reinforcement, social support, self-regulation) were extracted from the factor analysis, which explained 68.0% of the total variance. The convergent validity showed a positive correlation (r=.51, p<.001), discriminant validity showed an inverse correlation (r=-.60, p<.001), and criterion validity showed a positive correlation (r=.35~.64, p<.001). The Cronbach’s ⍺ was .94 and reliability of the subscales was .78~.92.
Conclusion: The specific Quality of Life Scale for hypertensive patients (QOLS_HP) was composed of 30 items using a 5-point Likert scale. The scale demonstrated acceptable validity and reliability.
Purpose This study aimed to determine the impact of health literacy, self-efficacy, and social support on the Health-Related Quality of Life (HRQoL) of Korean patients with Acute Coronary Syndrome (ACS) after Percutaneous Coronary Intervention (PCI). Methods A cross-sectional design was used, and a total of 189 participants were enrolled. Data were collected using self-reported questionnaires and patient medical records between September and November of 2021. Health literacy, self-efficacy, social support, and HRQoL were measured. The HRQoL was measured using the 12-item Short Form Survey, which included Physical Component Summary (PCS) and Mental Component Summary (MCS). Data were analyzed using hierarchical multiple regression with SPSS/WIN 26.0 program. Results The findings revealed statistically significant differences in the PCS according to gender, presence of hypertension, exercise, and sleep state. Furthermore, there were statistically significant differences in the MCS according to disease period and stress management. Hierarchical multiple regression analysis showed that higher social support was a significant factor of better PCS (p<.005). Higher health literacy, self-efficacy, and social support were significant factors of better MCS (p<.005). Conclusion Nurses should play a key role in providing social support to ACS patients, particularly to female patients and patients with hypertension and poor sleep state and no regular exercise for better PCS. Also, nurses should think about how to promote health literacy, self-efficacy, and social support for better MCS, particularly in ACS patients who had undergone PCI, had longer diagnosis periods, and had no stress management.
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Purpose This study aimed to clarify the relationship between andropause syndrome and health-related quality of life, as well as the mediation effect of family bond among middle-aged males in South Korea.
Methods A total of 135 middle-aged males who live in B, K, and U City participated in the study, conducted from March 10 to May 31, 2021. Participants were invited to complete self-reported questionnaires measuring andropause syndrome, health-related Quality of Life (QoL), family bond, and demographic information. The data obtained were analyzed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval (5,000 bootstrap resampling).
Results The QoL of middle-aged males in South Korea showed a significant negative correlation with andropause syndrome (r=-.32, p<.001), and a significant positive correlation with family bond (r=.59, p<.001). Futher, family bond had a mediating effect between andropause syndrome and QoL (indirect effect=-4.07, 95% Boot confidence interval=-6.53~-1.97).
Conclusion Based on the results of this study, in order to improve the QoL of middle-aged males in South Korea, it is necessary to provide programs that can improve family bond along with physical and mental intervention programs to effectively alleviate andropause syndrome.
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Purpose This study aimed to confirm the relationship between supportive care needs and resilience of female genital cancer patients, and to investigate the mediating effect of resilience in the relationship between supportive care needs and quality of life. Methods This study was conducted with 105 outpatients and inpatients who were receiving treatment for female genital cancer at K University Hospital in B City. Data were collected from July 22, 2021 to August 17, 2021 and analyzed by using the SPSS/WIN 23.0 program. The correlation between the patients’ supportive care needs, resilience, and quality of life was analyzed by Pearson's correlation coefficients, and SPSS Process Macro was used for the significance of parameter indirect effects. Results The quality of life of female genital cancer patients showed a significant negative correlation with supportive care needs (r=-.68, p<.001), and a significant positive correlation with resilience (r=.53, p<.001). Moreover, resilience partially mediated the relationship between supportive care needs and quality of life (95% CI -0.009~-0.032). Conclusion Based on the results of this study, improving the resilience of female genital cancer patients may act as an additional coping strategy to reduce supportive care needs and establish an enhanced quality of life.
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Purpose This study aimed to evaluate distress, family resilience, and Quality of Life (QoL) among family caregivers of cancer patients undergoing chemotherapy and explore whether family resilience moderates the association between distress and QoL. Methods This is a cross-sectional study. One hundred seventeen family caregivers of cancer patients undergoing chemotherapy were recruited through the oncology outpatient clinic and two oncology wards at a tertiary university hospital. The participants completed self-reported questionnaires, including the Hospital Anxiety and Depression Scale, Family Resilience Scale-Cancer, and Caregivers’ Quality of Life Index-Cancer. Descriptive statistics, independent t-tests, one-way Analysis of Variance (ANOVA), and hierarchical regression analysis were used for statistical analysis. Results The mean distress score was 15.31±6.91, the mean family resilience score was 112.71±14.11, and the mean QoL score was 71.19±18.90. After controlling for potential covariates, distress was found to be negatively associated with QoL (β=-.45, p<.001), whereas family resilience was positively associated with QoL (β=.49, p<.001), explaining 62.8% of the variance. However, family resilience did not moderate the association between distress and QoL in this study. Conclusion Distress and family resilience are crucial factors associated with QoL in the caregivers of cancer patients undergoing chemotherapy. This finding indicates that oncology nurses should develop interventions to relieve distress and enhance family resilience to improve family caregivers’ QoL. Further studies are required to confirm the moderating role of family resilience.
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Purpose Patients with heart failure report low levels of physical activity and quality of life, both of which are important predictors of patient prognosis. This study aimed to investigate the effects of nurse-led motivational interviewing on self-efficacy for exercise, engagement in regular exercise, exercise capacity, and quality of life among patients with heart failure. Methods A randomized controlled trial design was used, and 66 Korean participants (i.e., 38 in a control group and 28 in an intervention group) aged 40~80 years who were diagnosed with heart failure were recruited between May 2012 and September 2013. The intervention group received telephone-based motivational interviews twice a week for one month. All participants were assessed for exercise regularity, levels of exercise, exercise capacity, and quality of life at baseline, one month, and three months. The data were analyzed using independent t-tests, repeated measures ANOVA, and nonparametric tests. Results At one month, there were significant group differences in exercise regularity (x2 =6.10, p=.013) and levels of exercise (Z=-2.56, p=.024). There was a significant group-by-time effect on the quality of life (F=3.76, p=.044). Conclusion Nurse-led motivational interviewing was effective in increasing exercise levels and quality of life in patients with heart failure. In the future, we propose a study with a larger number of participants and a long-term follow-up study with additional contact to maintain the intervention effect.
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Purpose This study aimed to investigate the symptom clusters and quality of life among patients with type 2 diabetes mellitus and to identify the relationship between quality of life and symptoms by cluster. Methods Data were collected through questionnaires and medical records of 123 patients with type 2 diabetes between December 27, 2018 and May 8, 2019. Type 2 diabetes-related symptoms were investigated using the Diabetes Symptom Self-Care Inventory, and quality of life was evaluated using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L). The collected data were analyzed using mean, standard deviation, factor analysis, Pearson correlation coefficient, and hierarchical multiple regression analysis. Results Tiredness was a most frequently reported symptom; however, symptom with weight loss was the most critical symptom reported. Five symptom clusters were identified, four of which correlated with quality of life. Hierarchical multiple regression analysis showed that thirst-fatigue clusters affected quality of life (β=-.26, p=.019). Conclusion Active treatment and continuous lifestyle management are needed to maintain proper blood sugar levels to address type 2 diabetes mellitus-related symptoms within a thirst-fatigue cluster. Identifying the cause of fatigue and applying physical and psychosocial interventions is also required. Symptoms experienced by patients with type 2 diabetes are connected to clusters. Effective disease management and improvement in the quality of life can be achieved by identifying these symptoms through merging and managing the relevant symptoms simultaneously.
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Purpose The purpose of this study was to evaluate whether hand press pellet is effective for constipation in breast cancer patients receiving chemotherapy.
Methods: This was a quasi-experimental study that used non-equivalent control group pretest-posttest design. Participants were 52 breast cancer patients-26 each in the experimental and control groups. The intervention was conducted thrice a week for 6 weeks; for the experimental group, a hand press pellet was applied to the corresponding points (A1, A5, A8, A12, A16, N18, E22, K9, F6, D2, D6, H2, L4, B7, B19) of the left hand (palm and back) to alleviate constipation. Three and 6 weeks after the intervention, outcomes were measured by using the Constipation Assessment Scale, Bristol Stool Form Scale, and Patient Assessment of Constipation-Quality of Life questionnaire.
Results: A significant difference was observed between the two groups on the Constipation Assessment Scale (χ2=44.38, p<.001) and Bristol Stool Form Scale (χ2=33.24, p<.001). Patient assessment of constipation-quality of life of the experimental group were statistically significant compared with that of the control group (F=37.23, p<.001).
Conclusion: Hand press pellet can be used as an effective nursing intervention to alleviate constipation in breast cancer patients.
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Purpose This study investigates the effects of oral care interventions on oral health and oral health-related quality of life in denture-wearing older adults.
Methods: A nonequivalent control group pretest-posttest design was utilized.
There were 26 participants in the experimental group and 30 in the control group. Participants were aged 65 or older, residing at long-term care facilities for more than six months, using dentures, able to brush their teeth, follow gymnastics without jaw joint problems, and cooperate in the measurement of bad breath. The oral care interventions consisted of brushing teeth, denture management, and mouth gymnastics and was performed three times/week, for 20 minutes/session, for a total of 4 weeks. The x 2 test, Fisher's exact test, repeated measures ANOVA, and independent t-test using SPSS/WIN 22.0 program were analyzed.
Results: The performance of brushing teeth (F=27.66, p<.001), denture management (F=38.23, p<.001), and mouth gymnastics (F=5.12, p=.016) significantly increased with time up to the fourth week. After the interventions, significant differences were found between groups in subjective oral health status (t=5.87, p<.001), dry mouth (t=-9.24, p<.001), bad breath (t=-3.37, p<.001), and oral health-related quality of life (t=-6.46, p<.001).
Conclusion: The oral care interventions, including a self-administered oral care checklist, can improve the motivation for oral care performance, oral health behaviors, oral health status, and oral health-related quality of life among older adults. Broader application of the intervention is warranted.
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Purpose This study investigates the mediating effects of self-care competence on the relationship between uncertainty and quality of life in stroke patients.
Methods: This study adopts a descriptive research approach using 158 patients diagnosed with ischemic or hemorrhagic stroke through brain Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). The data collection period was from May 20, 2020 to September 29, 2020. The data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and a three-step regression analysis using Baron and Kenny’s method for mediation.
Results: The mean scores for uncertainty, self-care competence, and quality of life were 3.07±0.49, 3.66±1.07, and 3.54±0.93, respectively. Self-care competence was found to completely mediate the relationship between uncertainty and quality of life (z=-5.31, p<.001), and its explanatory power was 77.2%.
Conclusion: To improve the quality of life among stoke patients in uncertain situations, it is necessary to improve their self-care competence and develop step-by-step and differentiated self-care competence enhancement programs through multidisciplinary collaboration.
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Purpose This study examined sociodemographic and health factors affecting Health-Related Quality of Life (HRQoL) among older adults with osteoarthritis based on the duration of osteoarthritis. Methods Data were obtained from the Seventh Korean National Health and Nutrition Examination Survey (Ⅶ-1, 2016; Ⅶ-2, 2017). The sample consisted of total 747 older adults with osteoarthritis. The complex sample analysis was performed using an independent t-test, ANOVA, x2 test, and multiple linear regression using the SPSS/WIN 24.0 program. Results The HRQoL of older adults who had experienced osteoarthritis for 10 years or more was lower than the group who had experienced osteoarthritis for less than 10 years. The most influential factors affecting HRQoL across both groups were subjective health, limit of daily activity, and sickbed experience. Current alcohol consumption and body weight control were factors affecting HRQoL in the group who had experienced osteoarthritis for less than 10 years, while gender, current smoking, and walking were factors affecting HRQoL in the group who had experienced osteoarthritis for 10 years or more. Conclusion Community nurses should consider the target population and customize interventions based on the duration of osteoarthritis in order to improve HRQoL in older adults with osteoarthritis.
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“Helplessness-hopelessness” and “anxious preoccupation” were negatively correlated with quality of life (r=-.61, p<.001; r=-.46, p<.001, respectively). “Fatalism”, “fighting spirit”, and “cognitive avoidance” showed positive correlations with quality of life (r=.37, p<.001; r=.42, p<.001; r=.19, p=.035, respectively). Factors influencing quality of life by multiple regression were identified as helpless-hopelessness, fatalism, performance status, and anxious preoccupation (F=35.76, p<.001, Adjusted R2 =54%). Conclusion Maximizing positive adjustment response and improving performance status were effective in improving quality of life of middle-aged male patients with lung cancer. The development of nursing interventions focusing on psychological adjustment and physical activity should be warranted for the given patient population.
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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 The purpose of this study was to examine lifestyle behaviors, mental health, and Health-Related Quality of Life (HRQoL) and identify the effects of lifestyle behaviors and mental health on the HRQoL of cancer survivors and general adults. Methods Secondary data analysis was conducted. The data used in the study were drawn from the Korea National Health and Nutrition Examination Survey VII-2 (January 1, 2017, to December 31, 2017).
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