• Korean Journal of Digital Imaging in Medicine
• /
• v.17 no.1
• /
• pp.19-31
• /
• 2015

최근 우리나라의 암 발생률은 꾸준히 증가추세에 있고 그 중에서도 전립선암은 갑상선암을 제외했을 때 남성에서 가장 높은 증가 추세를 보이고 있는 암이다. 전립선암은 그 동안 선진국에서 주로 발병하는 것으로 알려진 암 종이지만 서구화된 식습관과 생활 행태 변화로 인하여 국내에서도 발생률이 증가하는 것으로 추정하고 있다. 따라서 국내 환경에 맞는 내장 지방 분포와 같은 정확한 비만도 측정을 통해 우리나라에서 증가율 1위를 보이고 있는 전립선암 발생의 원인 관계를 찾고자 한다. 본 연구는 환자와 정상군 비교를 하는 환자-대조군 연구이고 본 연구를 위하여 임상시험 윤리위원회 (IRB) 승인을 받았다 (NCC2014-0124). 환자군은 2014년 8월 1일부터 2015년 1월 6일 까지 국립암센터를 방문하여 전립선암을 진단받고 수술과 항암치료 그리고 방사선 치료를 시작하지 않은 초진을 대상으로 하였고, 정상군은 2009년 11월부터 2014년 9월 30일까지 공단검진을 목적으로 국립암센터를 방문한 정상인을 대상으로 하였다. 전립선암 연구는 환자 총 52명에 평균 66세 (51 - 82세)이고 정상군은 총 50명에 평균 64세 (59 - 75세) 이다. 모든 연구 대상자들의 생활 요인 평가를 위하여 암 가족력, 흡연, 음주 상태, 운동, 등을 추가적으로 설문 조사하였다. MRI 영상의 배꼽 주위에서의 내장 지방과 피하지방을 전용 분석 컴퓨터를 활용하여 측정 하였다. 복부비만율은 환자군과 정상군에서뿐만 아니라 (p = 0.03), 전립선암 악성도와 (Gleasonscore; p = 0.001)도 통계적 차이를 나타냈다. 하지만 BMI 결과와는 전립선암 발생과 악성도에서 무관함을 보인 것에 반해 허리둘레는 전립선암의 발생에 영향을 미치는 결과를 나타났다. 한편 전립선암의 또 다른 악성도 지표인 PSA는 비만 측정치와의 상관성이 Gleason score와 보다 대체적으로 낮게 나타났다. 학력, 운동량, 흡연, 음주 상태와 같은 생활 특성에 따른 전립선암 발생의 영향 관계는 뚜렷하지 않았다. 결론적으로 본 연구를 통해서 전립선암의 발생 위험도와 악성도 지표로 복부 비만도가 유용함을 나타냈고 간단한 신체 계측 지표 활용으로는 BMI보다 허리둘레 측정치가 더 암 발생의 연관성이 높음을 보였다.

• Journal of Hospice and Palliative Care
• /
• v.10 no.4
• /
• pp.190-194
• /
• 2007

Purpose: Individual cancer patients often experience many symptoms that impair their quality of life at the end of life. Identifying symptoms at the terminal stage of cancer patients and possible imminent death prediction by using that assessment can assist physicians and patients in preparing the 'peaceful death'. This study examines symptom experience during the last 48 hours of life of terminal cancer patients, and determines whether symptom experience change with proximal to death. Methods: The medical records of 89 patients who died with terminal cancer at a hospital between July 1, 2003 and March 31, 2006 were reviewed. Symptom prevalence at the last 48 hours was analyzed along with the change of symptom experience at the admission, $48{\sim}24$ hours, and $24{\sim}0$ hours before death. Results: Median age of all patients was 62 years old (range $16{\sim}97$). During the last 48 hours, symptom prevalence was described as follows; unclear consciousness (57%), pain (30%), fever (22%), and dyspnea (19%). According to the primary site, unclear consciousness was notified the most frequent symptom, but fever was relatively high prevalence in patients of biliary origin cancer rather than other site cancer (P=0.012). As death was Impending, the prevalence of poor appetite and general weakness were decreased, while that of unclear consciousness was increased, which were all statistically significant (P < 0.05). Conclusion: The presence of unclear consciousness could be regarded as the symptom indicator as imminent death of terminal canter patients.

• Korean Journal of Social Welfare
• /
• v.61 no.2
• /
• pp.325-348
• /
• 2009

This study intends to investigate the main and mediating effects which caregiving appraisal and positive reappraisal exert on quality of life (QOL) of primary family caregivers of cancer patient considering the relationship with social support. The processes of this study areas follows. First, the variables which research model were chosen on the basis of stress-appraisal-coping theory through reviews of the previous studies. Second, a survey was conducted upon 295 primary caregiver of patient with cancer at National Cancer Center. Collected data were analyzed by SPSS 12.0 and SEM (Structural Equation Modeling) method using AMOS 5.0. The summary of the result is as follows. First, the entire model including measurement and structural model shows sufficient fit index of CFI(.951), TLI(.940) and RMSEA(.062). Second, the results of analysis of direct effects among variables are as follows. The 'Social support' has statistically significant direct effect on the 'feeling of burden' and 'growth'. The 'feeling of burden' has statistically significant direct effect on the 'growth' and 'QOL-mental and physical'. The 'growth' has statistically significant direct effect on the 'QOL-mental'. Third, the results of analysis of mediating effects of the 'social support and QOL' and 'feeling of burden and QOL' are as follows. The effects of 'social support' on 'QOL-mental' are significantly mediated by the 'feeling of burden' and 'growth'. The effects of 'social support' on 'QOL-physical' are significantly mediated by the 'feeling of burden'. The effects of 'feeling of burden' on 'QOL-mental' are significantly mediated by 'growth'. Through this research, these implications in social work study and practice are found: (1) this study extended the scope of study in the caregiver's health area from negative sides into positive ones by using growth variables as positive reappraisalof caregiving in research model, which has not been tried on the Korean family caregivers of the cancer patient. (2) The effects of positive reappraisal on QOL-mental can provide a foundational necessity for social workers to help family caregivers find positive meaning in their caregiving experience. This approach of social work practice will improve QOL of family caregivers. (3) This study present a framework including social support, negative appraisal, positive reappraisal, and QOL variables available to social work practice and explaining affective relationships among these variables in various aspects.

• The Korean Journal of Rehabilitation Nursing
• /
• v.2 no.2
• /
• pp.215-224
• /
• 1999

This study was designed to compare care needs of patients with cancer and family members in inpatient and outpatient settings. The questionnaire was a Likert type 5 point scale with 57 items on four need categories; informational, physical care emotional care and socioeconomic care. There were significant differences between inpatient and outpatient settings. Also, there were significant differences in degree of care need according to gender, religion, marital status, economic status, public insurance status, and the past regimen. In conclusion, emotional needs perceived by patients with cancer and family members were higher than the others. Based upon the result, it is recommended that the research to compare needs between cancer patients who have a same illness and family member are necessary.

• Asian Oncology Nursing
• /
• v.12 no.1
• /
• pp.92-99
• /
• 2012

Purpose: The study was to examine the relationships between stress, ways of coping and burnout among family caregivers of cancer patients. Methods: Data were collected by self-reported questionnaires from 207 family caregivers of cancer patients at one university hospital and one general hospital in Busan, Korea. The instruments included a Stress Scale, a Ways of Coping Scale and a Burnout Scale. The collected data were analyzed using frequency, percentage, t-test, ANOVA, Scheffe's test, and Pearson's correlation coefficients with the SPSS WIN 19.0 program. Results: Stress was found to have significant relationships with age, relation to the patient, education, monthly income, degree of care-giving, financial burden and activities of daily living of patient. In active coping, there were significant differences according to education and religion. Passive coping was significantly related to gender. In burnout, there were significant differences according to age, relation to the patient, education, occupational status, monthly income, degree of care-giving, financial burden and activities of daily living of patient. Stress and burnout showed a positive correlation, while there was a negative correlation between burnout and active coping. Conclusion: These results suggest that promoting active coping would better support family caregivers of cancer patients in managing burnout effectively.

• Journal of Hospice and Palliative Care
• /
• v.7 no.2
• /
• pp.221-231
• /
• 2004

Purpose: The purpose of this study was to analyze the need for child hospice care programs in families of children with cancer. Methods: The survey of 104 families who were taking care of children with cancer was conducted. This survey was conducted from February 2004 to July 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .94 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of 3.40 (${\pm}3.8$). The need for 'emotional care of children' showed the highest mean (M=3.55), 'management of terminal physical symptoms'(M=3.49), 'control of secondary physical problems' (M=3.41), 'acceptance of the family's difficulty' (M=3.20), 'spiritual care for preparing for death'(M=3.17), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the child's mother's age (F==4.980, P=.009), whether or not there were cancer patients among their siblings or relatives (t=2.423, P=.017). Conclusion: The family of children with cancer have a heavy burden of ambivalence, especially in relieving the anxiety and fear of their children, communicating about death, and managing physical symptoms. Child hospice care must be provided considering the needs of families of children with cancer. Thus popular needs as well as hospice nurses' higher concern and support for hospice care of children require further education and program development to meet the current demands.

• Proceedings of the KSCN Conference
• /
• 2003.11a
• /
• pp.1089-1090
• /
• 2003

본 연구는 대구ㆍ경북지역 대장직장암 환자의 일반 생활 상황과 식행동 특성을 분석 평가하여 지역민의 대장직장암 예방을 위한 영양교육에 활용할 수 있는 식생활 관련 기초 자료를 얻고자 수행되었다. 최근 경북대학교 병원에서 대장직장암 진단을 받고 입원한 수술 전후 환자 123명 (남 79명, 여 44명)을 환자군 대상으로 하였고 대장질환이 없는 정형외과 환자 등 182명(남 117명, 여 65명)을 비교군 대상으로 하였다. 대상자의 일반 특성, 식습관, 식행동 특성, 식품섭취 빈도 등의 내용을 포함한 설문지를 이용하여 개인 면담을 통하여 조사하였다. 현재 BMI와 과거 가장 높았던 체중의 BMI는 남녀 모두 환자군에서 유의하게 높게 나타났다. 환자군의 교육 수준은 비교군에 비해 낮았고 주 거주지역 분포는 농촌이 가장 많았으며 가계 소득은 환자군에서 비교군에 비하여 높은 것으로 나타났다. 주요 일상활동 강도는 비교군에 비해 환자군에서 유의적으로 가벼운 것으로 나타났다. 발병 전 일상생활에서 느끼는 스트레스의 정도가 환자군에서 비교군에 비해 유의적으로 높았던 것으로 나타났다. 자신의 성격 유형을 비관적인 것으로 생각하는 비율과 가족의 암 병력이 환자군에서 유의적으로 높게 나타났다 식사의 규칙성에서도 환자군에서 끼니를 거르는 비율이 유의적으로 높았다. 환자군은 비교군에 비해 육식을 유의적으로 높게 선호하였으며 외식시 고기류를 선호하는 비율이 높았다. 평소 물 섭취량은 환자군에서 비교군에 비해 적었다. 환자군이 비교군에 비해 짠맛에 대한 선호도가 유의적으로 높았고 단 맛과 매운 맛은 비교군에 비해 싫어하는 경향을 보였으며 기름진 맛을 선호하는 경향이 환자군에서 유의하게 높았다. 환자군에서 굽기, 튀기기를 좋아하는 경향이 유의적으로 높았다. 환자군에서 음주 빈도, 음주량 그리고 커피 섭취량이 높게 나타났으며, 1일 흡연량이 많았고, 흡연 시작 연령은 빨랐으며, 금연 연령은 늦어 흡연 기간이 유의적으로 긴 것으로 나타났다. 환자군의 영양지식 정도와 영양태도는 비교군에 비해 유의적으로 낮았고 환자군의 영양지식 수준이 높을수록 좋은 영양태도를 가지는 것으로 나타났다. 과거 10년간 식품 섭취 빈도 조사 결과 환자군은 등푸른 생선류와 콩류 및 된장, 두부를 비교군에 비해 유의적으로 더 많이 섭취하였고 해조류, 생 녹황색채소류, 익힌 녹황색 및 담색채소류와 녹차를 더 적게 섭취한 것으로 나타났다. 본 연구의 결과는 일상생활의 스트레스와 가족의 암 병력 및 비관적 성격 유형이 대장직장암 발병의 위험인자가 될 수 있음을 제시하며 육식 선호, 적은 양의 물 섭취, 짜고 기름진 맛에 대한 높은 기호도, 음주, 흡연, 커피의 섭취 그리고 나쁜 식습관이 대장직장암 발생과 관련된 식생활 위험인자가 될 수 있음을 제시한다. 해조류, 녹황색채소, 담색채소, 녹차가 대장직장암 발생의 보호인자의 가능성도 제시되었다. 따라서 향후 지역적 식문화 특성을 고려한 보다 광범위하고 체계적인 조사 연구를 통해 이 지역의 대장직장암 발생의 위험인자와 보호인자를 재확인할 필요가 있다고 보며 본 연구의 결과는 지역민의 대장직장암 예방을 위한 영양교육 자료로서 활용될 수 있다고 본다.

• Journal of Korean Academy of Nursing
• /
• v.28 no.4
• /
• pp.970-979
• /
• 1998

Cancer has been considered a life-threatening disease and coping patterns could have a strong impact the physical and psychological health of patients and their family. The purpose of this study was to identify the change of coping patterns according to the phases of illness in the patients with cancer and their family caregivers and to compare the coping patterns of patients with those of their caregivers. The phases of illness consisted of 1st(initial) stage, 2nd(metastatic or recurred) stage and 3rd (terminal) stage based on literature. The coping methods were measured using the modified Ways of Coping Questionnaire by Lazarus & Folkman(1984). Seventy-nine patients(35 in stage 1, 31 in stage 2, and 13 in stage 3) and ninety-two caregivers (38 in stage 1, 30 in stage 2 and 24) agreed to participate from two general hospitals in Seoul and Choongnam. No significant changes were found in the coping patterns according to the phases of illness in both groups. Patients in stage 2 and caregivers in stages 2 and 3 problem-focused coping methods were significantly used more than emotion-focused coping methods. Patients in stage 1 significantly used two coping strategies that were cognitive reconstruction and emotion expression more than caregivers. Patients in stage 2 significantly used emotion-focused coping methods including minimizing threat, blame, and emotion expression excepting wishful thinking more than caregivers. We need more research to identify the relationship between the coping methods and their efficiencies through longterm observation and attempt to develope the nursing interventions that could have an improvement on positive coping methods and provide guidance on the problems the patients experience.

• Korean Journal of Adult Nursing
• /
• v.13 no.2
• /
• pp.317-326
• /
• 2001

The purpose of this study was to identify correlation of stress, coping patterns and physical symptoms in cancer patient's caregiver. The stress was measured by VAS(Visual Analogue Scale). The coping methods were measured using the modified Ways of Coping Questionnaire by Yang (1998) and the actual physical symptoms were investigated. The phases of patient illness consisted of 1st (initial) stage, and 2nd (recurred) stage and 3rd (terminal) stage based on literature (Lewandowski & Jones, 1988). The data were collected by a survey conducted from March to July, 2000 and which included 196 cancer patients' caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test, ANOVA, Scheffe test and Pearson correlation coefficient. The results were as follows: 1. The average of caregivers' stress scores was 62.5. Problem-focused coping methods were significantly used more than emotion-focused coping methods by the cancer patients' caregiver. The mean number of caregivers' physical symptom was 1.03. 2. There were significantly high level of stress in women, those who were more than 60 years old, those who had a low education level, those who had no job, those who are patients' wives' and those who are terminal patients' caregiver. There were significantly low levels of coping in women, those who were more than 60 years old, those who had low education levels, those who had no job and those who are patients' wives. There were significantly higher number of physical symptoms in women, and those who have no job. 3. Caregivers' stress was significantly correlated to problem-focused coping methods (r=-.21, p=.006), and physical symptom (r=-.28, p=.0001). In conclusion, attempts to develop nursing interventions for cancer patients' caregiver in women, those who are more than 60 years old, with a low education level, have no job, and are cancer patients' wives could have an improvement on positive coping methods and provide relaxation from stress in the patients' experience.

• Journal of Hospice and Palliative Care
• /
• v.2 no.2
• /
• pp.91-100
• /
• 1999

Purpose : This study was performed to investigate the satisfaction in the hospice services provided for inpatient families and bereaved families whose members had been admitted to the hospice unit at Kangnam St. Mary's Hospital to improve the quality of care for the terminally ill patients and their families. Methods : This sample consisted of 33 families of hospice patients during the period of April to lune, 1998 and 30 bereaved families whose patients had died from March, 1993 to March, 1998. The data were collected through a self-report questionnaire and analyzed using t-test and ANOVA. Results : 1) The satisfaction level of inpatient families and bereaved families showed the mean value of 3.5 where the highest value is 5.0. 2) According to age, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management(P=0.0001). The level of satisfaction of bereaved families showed significant differences in the field of support for the family, medical management, nursing management, and facilities of the hospice unit(P=0.0001). 3) By family relationship, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management (P=0.0001). 4) According to religion, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family and nursing management (P=0.0001), but there was no significant difference for the bereaved families. Conclusions : The findings of this study showed that hospice services had positive influence on families with terminal disease such as cancer. To improve the level of satisfaction in the hospice services for families with hospice patients, we need to provide care by an interdisciplinary hospice team approach, and to assess needs of the families according to their socio-psychological characteristics. Further studies need to be conducted with large samples.