• Journal of Breast Cancer
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• v.21 no.4
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• pp.442-446
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• 2018

Purpose: The definition of nodal pathologic complete response (pCR) after a neoadjuvant chemotherapy (NAC) just included the evaluation of axillary lymph node (ALN) without internal mammary lymph node. This study aimed to evaluate the feasibility of internal mammary-sentinel lymph node biopsy (IM-SLNB) in patients with breast cancer who underwent NAC. Methods: From November 2011 to 2017, 179 patients with primary breast cancer who underwent operation after NAC were included in this study. All patients received radiotracer injection with modified injection technology. IM-SLNB would be performed on patients with internal mammary sentinel lymph node (IMSLN) visualization. Results: Among the 158 patients with cN+ disease, the rate of nodal pCR was 36.1% (57/158). Among the 179 patients, the visualization rate of IMSLN was 31.8% (57/179) and was 12.3% (7/57) and 87.7% (50/57) among those with $cN_0$ and cN+ disease, respectively. Furthermore, the detection rate of IMSLN was 31.3% (56/179). The success rate of IM-SLNB was 98.2% (56/57). The IMSLN metastasis rate was 7.1% (4/56), and all of them were accompanied by ALN metastasis. The number of positive ALNs in patients with IMSLN metastasis was 3, 6, 8, and 9. The pathology nodal stage had been changed from $pN_1/pN_2$ to $pN_{3b}$. The pathology stage had been changed from IIA/IIIA to IIIC. Conclusion: Patients with visualization of IMSLN should perform IM-SLNB after NAC, especially for patients with cN+ disease, in order to complete lymph nodal staging. IM-SLNB could further improve the definition of nodal pCR and guide the internal mammary node irradiation.

• Journal of Korean Academy of Nursing
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• v.45 no.4
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• pp.613-624
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• 2015

Purpose: The purpose of this study was to develop a scale to evaluate empowerment in woman with breast cancer and to examine the validity and reliability of the scale. Methods: The development process for the initial items included a literature review, interviews, and construction of a conceptual framework. The identified items were evaluated for content validity by experts, resulting in 3 factors and 48 preliminary items. Participants were 319 women with breast cancer recruited to test reliability and validity of the preliminary scale. Data were analyzed using item analysis, confirmatory factor analysis, criterion related validity, internal consistency and test-retest reliability. Results: The final scale consisted of 30 items and 3 factors. Factors, including 'intrapersonal factor' (14 items), 'interactional factor' (8 items), and 'behavioral factor' (8 items), were drawn up after confirmatory factor analysis. Goodness of fit of the final research model was very appropriate as shown by ${\chi}^2/df=1.86$, TLI=.90, CFI=.92, SRMR=.06, and RMSEA=.05. Criterion validity was evaluated by total correlation with the Cancer Empowerment Questionnaire .78. Cronbach's alpha for total items was .93 and test-retest reliability was .69. Conclusion: Findings from this study indicate that the scale can be used in the development of nursing interventions to promote the empowerment of women having breast cancer.

• Asian Oncology Nursing
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• v.11 no.1
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• pp.41-48
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• 2011

Purpose: The study was to identify relationships between the family support, perceived health status and self esteem in Korean women with breast cancer. Methods: Data were collected by questionnaires from 214 women with breast cancer in inpatient and outpatient settings at three different university hospitals and one cancer hospital in B city, Korea. The instruments included Family Support Scale, Perceived Health Status Scale, and Self Esteem Scale. The collected data were analyzed using frequency, percentage, t-test, ANOVA, Scheffe's test, and Pearson's correlation coefficients by SPSS WIN 15.0 program. Results: There were significant differences in the family support by age, education, and cost burden. There were significant differences in the perceived health status by education, occupation, economic status, pain, fatigue, and cancer insurance. There were significant differences in the self esteem by age, occupation, economic status, type of religion, pain, fatigue, and cancer insurance. Self-esteem was significantly correlated with family support and perceived health status. Conclusion: These results suggested that promoting perceived health status and enhancing family support would increase self-esteem effectively among Korean women with breast cancer.

• Korean Journal of Adult Nursing
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• v.27 no.2
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• pp.188-197
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• 2015

Purpose: The purpose of this study was to examine fatigue, sleep disturbances, and quality of life (QOL) among patients with breast cancer receiving radiotherapy. Methods: A cross-sectional, descriptive design was used. Data were collected through questionnaires distributed to 201 breast cancer patients in a hospital. The data were analyzed using SPSS 21.0. Results: The fatigue scores showed significant differences depending on exercise and duration since diagnosis. The sleep disturbance scores showed significant differences depending on duration since diagnosis. QOL scores showed significant differences depending on exercise, duration since diagnosis, and treatment site. Fatigue and sleep disturbances (r=.40, p<.001) showed statistically significant positive correlations, while fatigue and QOL (r=-.55, p<.001), and sleep disturbances and QOL (r=-.45, p<.001) showed statistically significant negative correlations. The multiple regression analysis, which was used to determine the variables influencing on QOL after radiotherapy, resulted in a significant regression model (F=23.88, p<.001), which accounted for approximately 45% of the explanatory power. Fatigue (${\beta}=-.39$, p<.001) and sleep disturbances (${\beta}=-.27$, p<.001) were revealed to adversely affect quality of life. Conclusion: The nursing intervention is necessary to reduce fatigue and sleep disturbance and to promote exercise in order to enhance QOL of patients with breast neoplasm while receiving radiotherapy.

• Korean Journal of Adult Nursing
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• v.23 no.5
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• pp.446-459
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• 2011

Purpose: The purpose of this study was to understand the reported experiences of sexuality among Korean women who are breast cancer survivors. Methods: Participants of this study were 12 women who had breast cancer surgery. Data were collected October, 2010 to January, 2011 through in-depth interviews by using tape-recordings. Data were analyzed with Colaizzi's (1978) phenomenological methodology. Results: From significant statements, four categories, ten theme clusters and 32 themes were extracted from the essential meaning of the sexuality experience as reported by the women participants. Within the four categories were 'Negatively changed in sexuality', 'Feeling of great loss as a woman', 'Changed martial relations with husband', and 'Turning to the happy life'. 'Overcoming sexuality caused by distress and feeling of loss' was united from four categories. Conclusion: The results of this study could help contribute to provide educational program on sexuality to improve sexual well-being and quality of life of women with breast cancer survivors and their spouses.

• Journal of Korean Academy of Nursing
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• v.42 no.2
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• pp.269-279
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• 2012

Purpose: To develop a expressive writing program for women with breast cancer and to identify its effects on stress physical symptom, cancer symptom, anxiety, depression, and QOL. Methods: A non-equivalent control pre-post design was used. Participants were recruited from self-help groups in six hospitals and were assigned to the experimental group (29) or control group (29). Data were collected before, after, and at four weeks after the intervention program. Changes in the variables were evaluated to test effects of the developed program, using $X^2$-test, Fisher's exact test, repeated measures ANOVA, and paired t-test. Results: The expressive writing program was developed for women with breast cancer based on Pennebaker's expressive writing. Significant differences were found between the two groups for stress related to physical symptoms ($p$<.00) and quality of life ($p$=.024). No significant differences were found in cancer symptoms, anxiety, or depression between the two groups. Conclusion: The results indicate that the expressive writing program designed to express cancer-related deep thoughts and emotions helps in decreasing physical symptoms and improving QOL. Further studies are needed to identify the effect on emotions such as anxiety and depression for women with breast cancer with above average levels of anxiety and depression.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.12-19
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• 2012

Purpose: To examine the levels of physical activity (PA) and diet quality, socio-demographic and clinical correlates, and identify associations with health-related quality of life (HRQOL) among breast cancer survivors. Methods: The study used a cross-sectional study design. A total of 74 breast cancer survivors who had completed their primary cancer therapy were recruited from a comprehensive cancer center in Korea. Measurements used included the International Physical Activity Questionnaire, the Diet Quality Index, and the EORTC QLQ-C30. Results: Only twenty-six women (35.1%) met the American Cancer Society criteria of weekly PA, while most participants (93.2%) displayed good or excellent diet quality. Those less likely to meet the PA criteria were older women, women who had a lower economic level, and women not receiving anti-hormone therapy. However, there was no significant factor associated with diet quality. Women who met the criteria for PA displayed significantly better global QOL than women who did not meet the criteria. No significant differences were found in HRQOL between women who did and did not meet the diet quality criteria. Conclusion: Nurses should be aware of breast cancer survivors who are older and who have a low economic status when assessing and screening the level of PA to improve HRQOL.

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.120-129
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• 2017

Purpose: The purpose of this study was to identify the degree of menopause symptoms and associated factors in patients with breast cancer who were receiving hormone therapy. Methods: Data were collected with questionnaires from 150 patients with breast cancer who had been on hormone therapy at a hospital in Seoul. Data were analyzed with the t-test, ANOVA, and Pearson correlation coefficient to compare the degree of menopause symptoms by demographic, clinical and psychological factors. Results: The mean menopause symptoms score was $13.39{\pm}7.97$. Most participants reported having hot flushes and sweating (75.3%), physical and mental exhaustion (82.7%) and sexual problems (64.7%). Menopause symptoms and depression were correlated with each other (p<.01). Somato-vegetative symptoms were different significantly by age, menopausal status at time of operation, occupation and tumor. Psychological symptoms were different significantly by marital status, operation type and chemotherapy. Urogenital symptoms were different significantly by prior history of cancer, occupation, operation type and radiation therapy. Conclusion: These findings can be used to provide tailored nursing interventions by identifying high risk groups for menopausal symptom among breast cancer patients receiving hormone therapy.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.2
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• pp.187-199
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• 2010

Purpose: The purpose of this study was to describe experiences of sexual life among Korean women with breast cancer. Methods: Data were collected by focus group and individual tape-recorded interviews. The data were analyzed using qualitative content analysis. Results: Participants were 13 women who had stage I, II, or III breast cancer. Four major categories were discovered. "Not interested in sexual life at all" in which participants described their struggle to live while avoiding sexual life during initial stages of disease. "Sexual life that could not go back to previous normal life" in which participants described how they began to recognize many problems related to their sexual life resulting from the loss of femininity and pain during intercourse. "Dangerous marriage due to no sexual life" in which participants illustrated how no or unsatisfactory sexual life threatened their entire marriage and family life. Finally, "rediscovery of sexual life as a vital element in life" in which participants described how, with support from their spouse, they came to realize that sexual life was an important and vital part of their life. Conclusions: The results of this study could help in developing-educational programs to improve sexual well-being of women with breast cancer and their spouses.

• Journal of Korean Academy of Nursing
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• v.48 no.2
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• pp.241-253
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• 2018

Purpose: The purpose of this study was to test the mediating effect of social support and resilience on the relationship between symptom distress and coping in young Korean breast cancer survivors. Methods: A purposive sample of 209 young breast-cancer survivors (mean age 39.9) was recruited for a cross-sectional survey, and the data were collected between June and October 2015. The instruments used in this study were the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, 10-item Connor-Davidson Resilience Scale, and Cancer Coping Questionnaire. The collected data were then analyzed using the SPSS 23.0 and AMOS 23.0 programs. Results: Symptom distress was found to have a significant indirect effect on coping (beta=-.32, p=.002), but not a significant direct effect (beta=.06, p=.577). Additionally, based on the values obtained for the squared multiple correlation, symptom distress, social support, and resilience were found to explain 46.4% of the total variance of coping. Conclusion: Based on the results of this study, it can be suggested that in order to enhance young breast cancer survivors' ability to cope with the distress they commonly feel, intervention methods that strengthen resilience and provide social support should be developed and made available to them.