Purpose: The purpose of this study was to investigate the degree of fatigue and its related factors in cancer patients during chemotherapy. Methods: The subjects of this study consisted of 90 patients over 20 years old who were receiving chemotherapy at the injection room of the o.p.d. and ward admission care unit in a University hospital located in Gwang-ju city and data were collected from August 8th to October 2nd, 2002. Collected data were analysed using SPSS v 10.0. to obtain summary statistics for the descriptive analysis, t-test, ANOVA, pearson correlation, and multiple regression. Results: 1. Fatigue of the subjects was significantly correlated with physical distress score. and 6 items of subscale those were nausea, vomiting, anorexia, pain, and immobility, showed statistically significant correlation. 2. Fatigue of the subjects showed statistically significant differences according to a nap satisfaction. Fatigue of the subjects was significantly correlated with mood state, Also, all 5 items of subscale, which are those were anxiety, confusion, depression, energy, and anger showed statistically significant correlations. 3. Fatigue of the subjects showed statistically significant differences according to metastasis, chemotherapy cycle, post operation existence, post radiation therapy existence. There were significant negative correlation between fatigue and hematocrit and fatigue and weight change. There was no significant correlation between fatigue and spiritual well-being state. With the result to multiple regression, Immobility, Anorexia, Anger explained fatigue by, pain, and immobility showed statistically significant correlation.
Advanced cancer patients tend to present multiple concurrent symptoms which are often moderate or severe in intensity. To date, the majority of studies have focused on either a single symptom, such as pain, fatigue, or depression or associated symptoms. While this approach has advanced understanding of some symptoms, it has offered clinicians not much guidance for treating several multiple concurrent symptoms in cancer patients. So in recent years, a few symptom management studies attempted a new approach of focusing on symptom clusters instead of individual symptoms. A symptom cluster is defined as two or more concurrent symptoms that are related to each other. If we better understand symptom clusters, interrelations of symptoms, and their common mechanisms in advanced cancer patients, clinicians can more effectively control multiple, concurrent symptoms and reduce drug side effects. And clinicians can also predict any other symptoms, functional performance, and the relationship between symptom clusters and survival in advanced cancer patients. At present, there is inconsistency in symptom clusters due to many unexplained mechanisms and various means to assess and analyze symptoms. Still, with further study, the approach to symptom clusters rather than individual symptoms could more effectively control symptoms and improve patients' quality of life.
Jeong Hyeon Ju;Shin Young Ju;Mo Yang Kwang;Suh Hyun Suk;Chun Hachung;Lee Myung Za
Radiation Oncology Journal
/
v.17
no.1
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pp.36-41
/
1999
Purpose : We reviewed the treatment results for the patients with locally recurrent rectal carcinoma. The object was to evaluate the treatment outcome and to identify the prognostic factors influencing the survival. Methods and Materials: Twenty-eight patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1982 to 1996 in the Department of Radiation Oncology at Paik and Hanyang Hospital were reviewed retrospectively Of these, 17 patients had initially abdominoperineal resection, 9 had low anterior resection, and 2 had local excision. No patients had received adjuvant radiation therapy for the primary disease. There were 14 men and 14 women whose ages ranged from 31 to 72 years (median age:54.5). Median time from initial surgery to the start of radiation therapy for local recurrence was 11 months (4~47 months). Radiation therapy was given with total doses ranging from 27 to 64.8 Gy (median=51.2 Gy). Results : The median survival was 16.7 months. The 2-year and 5-year survival rates were 20.1%, 4.1% respectively. Upon multivariate analysis, overall survival was positively correlated with duration of intervals from initial surgery to local recurrence (P=0.039). Relief of pelvic symptoms was achieved in 17 of 28 patients (60.7%). Pain and bleeding responded in 40% and 100% of patients, respectively Conclusions : Patients with locally recurrent rectal carcinoma treated with radiotherapy have benefited symptomatically, and might have increased survivals with a small chance of cure. But, patient were rarely cured (median survival : 10 months, 5-year survival : less than 5%). Overall survival was positively correlated with long intervals from initial surgery to local recurrence. Future efforts should be directed to the use of effective therapy for patients with locally recurrent rectal carcinoma and adjuvant therapy for patients with rectal cancer to reduce the incidence of pelvic recurrence.
Intramedullary spinal cord metastases (ISCM) account for only $3.4\%$ of symptomatic metastases to the spinal cord. The survival of patients with ISCM is characteristically short, often no longer than 2 months, due to a rapid neurologic deterioration and the presence of widespread metastases, Including metastases to the brain. We report two cases of ISCM arising from primary sphenoid sinus carcinoma and primary lung cancer along with a review of the literature. The case of ISCM from the primary sphenoid sinus is the third case of secondary syringomyelia due to ISCM In the world literature, and ISCM from the primary lung cancer is the first case reported in Korea. One case showed a slow progression of symptoms and a longer survival (26 months after the radiotherapy to the spine), and the other showed a rapid deterioration of symptoms with a shorter survival. More effective palliation can be achieved if the disease is diagnosed at an early stage when the neurologic deficits are still reversible.
Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients. Methods: We enrolled the terminal cancer patients from Kangnam St. Mary's Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use. Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death. Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.5
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pp.660-670
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2016
This cross-sectional descriptive investigation attempted to identify the relationship among the symptoms, spiritual well-being, and depression experienced by patients undergoing hemodialysis. Data were collected from 146 patients at 6 hemodialysis clinics from October 15th, 2014 to January 15th, 2015. The Dialysis Symptom Index (DSI) was used to measure symptom experience, spiritual well-being was measured using the Spiritual Well-being Scale, and depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The data were analyzed using ANOVA, the t-test, Scheffe's test, Pearson correlation, and hierarchical regression analysis. The mean score of the symptom experience was 26.43 (range: 0~85), the mean spiritual well-being score was 47.79 (range: 20~80), and the mean depression score was 10.56 (range: 0~35). It was found that greater existential well-being leads to lower depression (r=-.23, p=.004) and symptom experience (r=-.17, p=.045). Greater physical (B=.09) and emotional (B=.64) symptom experience leads to higher depression and the explanatory power of these factors was 52.1% (F=18.54, p<.001). Therefore, a comprehensive nursing intervention that can help reduce the symptom experience and increase the existential well-being in hemodialysis patients is needed to reduce their depression.
This study aimed to investigate factors influencing depressive symptoms among middle-aged women based on walking and nonwalking. The participants of the study were 56,007 women aged 40-64 years. A complex sample statistical analysis was conducted. Notably, 48.9% of middle-aged women were in the walking group and 51.1% were in the nonwalking. In the nonwalking group, relative to the walking group, more people had high school diploma as their highest level of education, and were 40-49 years old, unemployed, and public assistance recipients than in the walking group. In addition, in the nonwalking group, more people had sleeping durations of less than 7 hours, perceived stress, and depressive symptoms than in the walking group. Factors influencing depressive symptoms were identified as less than 7 hours of sleeping duration and high perceived stress in both the walking and nonwalking groups, and the degree of influence was higher in the walking group than in the non-walking group, suggesting than further studies are needed to identify the cause. The results confirmed that perceived stress and depressive symptoms in middle-aged women could be reduced by walking. Therefore, if middle-aged women continue to engage in walking practices appropriate for them, it will enhance their walking rate, reduce stress, and improve their depressive symptoms.
This is a case report of a patient with Tourett's disorder treated by Ukgan-san. We evaluated the patient Tourett's disorder by behavior and sound. His tic behaviors like eye blinking, shoulder shrugging, head jerking, facial frimace have been shown frequently, and His phonic tic symptoms like coughing, throat clearing, sniffing have been presented frequently, too. We diagnosed his condition as Wind-syndrome Caused by Hyperactivity of Liver-yang by patient's redish face, taut pulse, Left umbilical throb. So we treated the patient with Ukgan-san. and the score of Yale Global Tic Severity Scale(YGTSS) was 30 at the start of treatment. and the score of YGTSS was 3 at the end. We found that Ukgan-san was effective for the patient with Tourett's disorder.
$\underline{Purpose}$: To evaluate the treatment results and prognostic factors of palliative radiation therapy in the patients with unresectable advanced pancreatic cancer. $\underline{Materials\;&\;Methods$: Thirty-seven evaluable patients with unresectable advanced pancreatic cancer who were treated by palliative radiation therapy for pain relief at the Department of Radiation Oncology, Kangnam St. Mary's hospital, the Catholic University of Korea between March 1984 and February 2005 were analysed retrospectively. There were 22 men and 15 women. Age at diagnosis ranged from 30 to 80 (median 57) years. Twelve patients (32.4%) had liver metastases and 22 patients (59.5%) had lymph node metastases. Radiation therapy was delivered to primary tumor and regional lymph nodes with $1{\sim}2\;cm$ margin, and total dose was $3,240{\sim}5,580\;cGy$ (median 5,040 cGy). Chemotherapy with radiotherapy was delivered in 30 patients (81%) with 5-FU alone (21 patients) or gemcitabine (9 patients). The follow-up period ranged from 1 to 44 months. Survival and prognostic factors were analysed using Kaplan-Meier method and log-rank test respectively. $\underline{Results}$: Overall mean and median survival were 11 and 8 months and 1-year survival rate was 20%. Among 33 patients who were amenable for response evaluation, 7 patients had good response and 22 patients had fair response with overall response rate of 87.9%. Mild to moderate toxicity were observed in 14 patients with nausea, vomiting, and indigestion, but severe toxicity requiring interruption of treatment were not observed. Chemotherapy didn't influence the survival and symptomatic palliation, but the group containing gemcitabine showed a tendency of longer survival (median 12 months) than 5-FU alone group (median 5.5 months) without statistical significance (p>0.05). The significant prognostic factors were Karnofsky performance status and liver metastasis (p<0.05). Age, sex, tumor location, lymph node metastasis, and CA 19-9 level did not show any prognostic significance (p>0.05). $\underline{Conclusion}$: Radiation therapy was effective for symptomatic palliation in the patients with unresectable advanced pancreatic cancer and would play an important part in the survival benefit with gemcitabine or other targeted agents.
Purpose: To identify perimenstrual discomforts, coping and relief of symptoms in female workers. Methods: A convenience sample of 203 women who had worked were obtained from two hospitals in Busan. Data were collected through questionnaires from November 8 to 16, 2004. Three instruments were used in this study: the Perimenstrual Discomfort Questionnaire by Park(1988) and the Menstrual Coping Questionnaire and the Relief of Symptoms by Billings & Moos(1981) modified for this study. The data were analyzed by descriptive statistics, t-test, and ANOVA with SPSS 10.0 program. Results: The prevalence rate of dysmenorrhea was 81.3%. The total mean score for perimenstrual discomforts was 2.83 out of a possible total of 5 and the mean score for each category was, 3.08 for water retention, 2.95 for pain, 2.88 for negative affect, 2.83 for behavioral change, 2.73 for autonomic reactions, and 2.51 for concentration. According to these study results, statistical differences were found for age(F=2.76, p=0.04), feeling to menstruation(F=3.94, p=0.00), dysmenorrhea(t=4.26, p=0.00), and taking medication(t=2.09, p=0.00). The coping modes with the highest scores were 'take a hot bath'(99.0%)', 'rest and go to bed'(83.7%), 'regard menstruation as a physiological and temporary phenomenon'(76.8%), 'take a warm shower'(65.0%). The most frequently used methods to relieve symptoms were 'rest and go to bed'(70.0%), 'take a warm shower'(57.6%), 'take pain killers'(49.8%), 'apply hot water bag on painful parts of the body'(46.8%). Conclusion: Further research is needed to understand perimenstrual discomforts and the variables associated with them. Nursing intervention has to be considered in any program aiming to reduce perimenstrual discomforts.
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