• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.34-44
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• 2017

Purpose: The purpose of this study was to identify post-operative discomfort, sense of loss, family support, and resilience in breast cancer surgery patients, and to investigate factors that affect resilience. Method: The sample of this study consisted of 108 patients who underwent surgery for breast cancer in two university hospitals located in B city. The collected data was analyzed with descriptive statistics, t-test, ANOVA, and Scheffé test, Pearson's correlation coefficients, and hierarchical multiple regression. Results: The factors that significantly affected resilience were as follows: having a religion (${\beta}=-.20$, p=.006), having an occupation (${\beta}=.14$, p=.049), having a high school diploma (${\beta}=.31$ p=.001), making less than 2-3 million won (${\beta}=-.19$, p=.036) per month, experiencing a sense of loss (${\beta}=-.22$, p=.003) and family support (${\beta}=.44$, p<.001). The total explanatory power amounted to 53.8% (F=14.83, p<.001, $AdjR^2=.54$). Conclusion: Educational intervention programs for breast cancer surgery patients that improve resilience by reducing the sense of loss and increasing family support must be developed.

• Journal of Korean Academy of Nursing
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• v.48 no.5
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• pp.578-587
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• 2018

Purpose: This study aimed to understand the mechanisms of decision regret and stress of family surrogates' end-of-life decision making using an exploratory path model. In particular, the research identified the direct effects of perceptions of uncertainty and effective decisions on decision regret and stress, and examined the indirect effects of being informed, having clear values, and being supported for decision regret and the stress of end-of-life decision making through the mediating variables of perceptions of uncertainty and effective decisions. Methods: Data were collected from 102 family surrogates who had participated in end-of-life decision making for patients with terminal cancer in a tertiary hospital. Results: Perception of effective decisions was a significant direct predictor of decision regret, and uncertainty was a significant predictor of stress among the participants. Being informed, having clear values, and being supported had a significant indirect influence on decision regret through the perception of effective decisions among family surrogates. However, only having clear values had a significant indirect influence on stress through the perception of uncertainty. The model explained 63.0% of decision regret and 20.0% of stress among the participants and showed a good fit with the data, ${\chi}^2=12.40$ (df=8, p=.134), TLI=.97, and RMSEA=.07. Conclusion: Nurses can support family surrogates in end-of-life decision-making processes to decrease their decision regret by providing information about end-of-life care choices, clarifying personal values, and supporting the decision-making process, and to relieve their stress by facilitating the clarification of personal values.

• Journal of Korean Academy of Nursing
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• v.43 no.6
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• pp.812-820
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• 2013

Purpose: The purpose of this study was to construct a structural equational model to explain and predict burnout in family caregivers of patients with cancer. The study was based on the Stress-Appraisal-Coping Model of Lazarus and Folkman (1984) and Family Stress Theory (Hill, 1958). Methods: Data were collected from July 10 to September 30, 2012 through direct interviews and a self -report questionnaire survey. Participants in this study were 206 family caregivers providing care for patients with cancer in In-patient or Out-patient departments of three different general hospitals located in Busan. Measured variables were exogenous variables (social support and perceived health status) and endogenous variables (perceived stress, hope and burnout). Results: Goodness of fit in the hypothetical model was ${\chi}^2=174.07$, TLI=.95, CFI=.97, RMSEA=.08. Perceived health status, perceived stress, and hope showed statistically significant direct effects on burnout of family caregivers. Social support affected burnout of family caregivers indirectly. These variables explained 68.5% of total variance in burnout. Conclusion: The results from this study suggest that perceived stress, perceived health status, and hope should be considered as major influential factors when developing nursing interventions to control burnout of family caregivers (of patients with cancer).

• Asian Oncology Nursing
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• v.6 no.1
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• pp.15-26
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• 2006

Purpose: This study was to assess relationships among the uncertainty, medical staff's support, and anxiety perceived by family members with cancer patients while the family members were waiting for their patients undergoing surgery. Method: The data were collected from the family members of cancer patients who were undergoing surgery in D University Hospital at B city from February 1 to April 12, 2005. The used instruments were the State Anxiety Scale of Spielberger's(1975) STAI, Mishel's Uncertainty in Illness Scale (MUIS)(1981), and Relationship Questionnaires (Lee, 1978). The collected data was analyzed by using t-test, ANOVA, Pearson's coefficients, and stepwise multiple regression. Results: As the result, the most influential variable explaining anxiety of family members was uncertainty $({\ss}=0.37)$, followed by perceived illness state $({\ss}=-0.27)$. These two variables simultaneously explained 29.3% of the variance in anxiety. Conclusion: We suggest to develop a nursing intervention program to reduce the uncertainty through the medical staff's support and o test its effects.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.30-36
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• 2005

Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.163-171
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• 2002

Purpose : The purpose of this study was to analyze activities and satisfaction of volunteers for hospice care. Methods : We used 271 reports of hospice care and 20 questionnaire of activities and satisfaction of volunteers for hospice care from volunteers of in a community. Window SPSS-PC was used for the data analysis and the statistical method used were the descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient. Results : 1) The highest score of activity was emotional area and the next activities was physical area. 2) The degree of emotional area (t=4.94, P<.05) and spiritual area (t=3.80, P<.05) was influence by religion of volunteers. 3) The mean score of satisfaction was 3.61. 4) There was correlation between duration of activity and death experience (r=.558, P<.05), emotional care (r=.698, P<.01), spiritual care (r=.474, P<.05), satisfaction (r=.651, P<.01), and the between physical care and family care (r=.559, P<.05), and the between spiritual cue and family care (r=.512, P<.05), and between emotional care and satisfaction (r=.536, P<.05). Conclution : The above result indicated that we must develope the management and education of volunteer of hospice care for various hospice care. Also, We should to encouraged the continuous education and efficient management.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.449-458
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• 2015

Purpose: The aims of this study were to identify the reported attitudes of older patients with cancer toward advance directives (ADs) and the factors associated with their attitudes toward ADs. Methods: The design was a cross-sectional survey. The age mean of the 130 participants were 70.8, and 66.2% of the participants were male. The data were collected at one university hospital in Seoul, South Korea during the period from October $1^{st}$ to December $5^{th}$ in 2013. The data collecting instruments were the Advance Directives Attitude Survey (ADAS) and questionnaires including socio-demographic and disease-related characteristics, family function. Results: 30.0% of the participants were aware of ADs, only 9% of them had been informed by healthcare providers. Most participants (93.1%) intended to complete ADs. The mean score of ADAS was 48.29. The stepwise linear regression analysis indicated that family function, perceived health status, period of education, and age accounted for a significant percentage (52.0%, p<.001) of the variance in participants' ADAS. The variable with the greatest effect was family function. Conclusion: The findings suggest that family function and attitude of older cancer patients need to be considered for adapting ADs to Korean health care systems. Healthcare providers should include family members in advanced care planning discussions.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.93-99
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• 2017

Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.5
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• pp.327-336
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• 2020

This study was undertaken to identify ways that enable a successful comeback to everyday life and improvement in the quality of life, by understanding the experiences of cancer survivors in returning to everyday life. Totally, 19 people diagnosed with complete cure after 5 years of cancer treatment, were recruited for the study. Data was collected through in-depth interviews from January 18 to February 25, 2017. One-time interviews took 90 to 120 minutes, and data analysis was achieved by applying the grounded theory. The central phenomenon of 'reality that cannot be escaped' and 'uncertain reality that cannot know tomorrow' was attributed to the causal conditions 'hard reality', 'physical exhaustion', 'psychological exhaustion' and 'economic exhaustion'. Depending on context conditions such as 'lack of family support', 'shift to a vulnerable working class', 'insufficient support system', 'hope for the societal support system', 'daunted gender', 'prejudice against cancer/cancer patients', 'information on life after rare full healing'. The strategy for a successful return was influenced by intervention conditions such as 'robust family fence' and 'effective cancer insurance', which resulted in 'building a new life' or 'enduring'. We conclude that for a successful return to daily lives, cancer survivors require comprehensive information, health and social-welfare interventions.

• Proceedings of the Korea Information Processing Society Conference
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• 2010.04a
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• pp.902-904
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• 2010

본 논문에서는 개인 특화된 의료를 위한 진단, 치료선택, 예후 추정을 지원하기 위한 정보를 전문 의료인에게 효과적으로 제공하기 위한 데이터베이스 설계와 구축을 제시한다. 내원 환자들의 유전자 수준의 미시 데이터, 임상학적 거시 데이터, 가족력, 유사 질환군 등의 연관정보 데이터를 통합 연계하여 이력으로 관리하고, 데이터의 점진적 누적이 가능한 통합의료시스템을 위한 데이터베이스 설계의 프레임워크를 구축하였다.