• 제목/요약/키워드: Cancer care

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Nausea/Vomiting and Self-care in Patients with Cancer on Chemotherapy (항암화학요법환자의 오심.구토 및 자가간호 실태)

  • Kim Hye-Jin;Kim Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • 제12권2호
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    • pp.180-185
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    • 2005
  • Purpose: The purpose of this study was to investigate the incidence and self care practice for nausea/vomiting in patients with cancer during chemotherapy. Method: The participants were 100 patients with cancer over 20 years of age who visited the outpatient department or were hospitalized for chemotherapy Self care in the case of nausea and vomiting was measured by the Dodd's scale. Data were analyzed using the SAS program and the following statistics were used frequency, percentage, unpaired t test, and Pearson correlation coefficient. Results: The ratio of the occurrence of nausea/ vomiting in the participants was 70.0%. The incidence of nausea/ vomiting was significantly higher for women than for men. The incidence of nausea/ vomiting was also higher for patients with cancer not in the gastro-intestinal system (GIS) compared to that for patients with GIS cancer. The incidence of nausea/ vomiting positively correlated with anorexia, skin injury, and fatigue. Conclusion: The ratio of occurrence of nausea/ vomiting for the participants was 70.0%. The incidence of nausea/ vomiting was higher fur women and patients with cancer not in the GIS. The incidence of nausea/ vomiting positively correlated with anorexia, skin injury, and fatigue. The results indicate that nausea/vomiting is a frequent symptom, particularly in women and there is a need to provide interventions to decrease the effects of this symptom.

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Knowledge and Attitude toward Cancer Pain Management: Clinical Nurses Versus Doctors (간호사와 의사의 암성 통증관리에 대한 지식과 태도)

  • Jun, Myung-Hee;Gong, Sung-Hwa;Lee, Seon-Hee;Kim, Yeon-Hee;Choi, Jin-Sun;Park, Kyeong-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • 제12권1호
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    • pp.115-123
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    • 2006
  • Purpose: This study is purposed to provide basic data needed in constructing the educational contents about cancer pain management for the health care professionals. Methods: This study surveyed the degree of knowledge in cancer pain management of clinical nurses and doctors. Subjects were clinical 143 nurses and 88 doctors in 3 cities. The tool used are 32-item scale for evaluation of health care professionals' knowledge modified by Kim(1997), which was originally developed by McCaffery and Ferrel(1995). Results: The level of the health care professionals' knowledge about and attitude toward pain management were insufficient. The level of the doctors' knowledge and attitude showed higher score than those of the nurses'. The knowledge of health professional who were not hesitated to administrate analgesia was showed more higher than who were hesitated to do. Conclusion: Nurses need more knowledge and effective attitude toward cancer pain management. Various and sufficient educational program about cancer pain management can be contribute to improve the nursing quality of cancer pain.

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Palliative Care for Patients with Gynecologic Cancer in Japan: A Japan Society of Gynecologic Palliative Medicine (JSGPM) Survey

  • Futagami, Masayuki;Yokoyama, Yoshihito;Sato, Tetsumi;Hirota, Kazuyoshi;Shimada, Muneaki;Miyagi, Etsuko;Suzuki, Nao;Fujimura, Masaki
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권10호
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    • pp.4637-4642
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    • 2016
  • Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.

Psychosomatic Integrative Care for Psychosocial Distress of Patients With Breast Cancer (유방암 환자의 정신사회적 디스트레스에 대한 정신신체의학적 통합치료)

  • Yang, Chan-Mo;Jang, Seung-Ho;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • 제29권2호
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    • pp.77-85
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    • 2021
  • Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

The Effect of Expanding Health Insurance Benefits for Cancer Patients on the Equity in Health Care Utilization (건강보험 암 중증질환 급여확대가 의료이용 형평성에 미친 영향)

  • Kim, Su-jin;Ko, Young;Oh, Ju-Hwan;Kwon, Soon-Man
    • Health Policy and Management
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    • 제18권3호
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    • pp.90-109
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    • 2008
  • Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.

The Need for Hospice Care in Families of Patients with Cancer (암 환자 가족의 호스피스 요구도)

  • Kim, Shin-Jeong;Kim, Young-Soon;Kang, Kyung-Ah
    • Research in Community and Public Health Nursing
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    • 제15권4호
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    • pp.639-647
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    • 2004
  • Purpose: The purpose of this study was to analyze the need for hospice care programs in families of patients with cancer. Method: The study surveyed 98 families who were taking care of patients with cancer. This survey was conducted from August 2004 to October 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 .93 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 $3.26({\pm}3.7$). The need for 'emotional care of patients showed the highest mean' (M=3.47), 'management of terminal physical symptoms' (M=3.34), 'control of secondary physical problems' (M =3.26), 'acceptance of the family's difficulty' (M=3.12), 'spiritual care for preparing for death' (M=2.96), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the onset of diagnosis (F=3.110, p=.030). Conclusion: Hospice care must be provided considering the needs of families of patients with cancer. In this sense, this country's needs as well as hospice nurses' higher concern and support for hospice care of patients require further education and program development to meet the current demands.

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Erlotinib-Related Spontaneous Pneumothorax in Patient with Primary Lung Cancer

  • Nam, Hae-Seong;Lee, Hyeon-Jeong;Kim, Min-Su;Park, Sung-Wook;Jeon, Sang-Hoon;Cho, Jae-Hwa;Kwak, Seung-Min;Lee, Hong-Lyeol;Ryu, Jeong-Seon
    • Tuberculosis and Respiratory Diseases
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    • 제69권6호
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    • pp.465-468
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    • 2010
  • Spontaneous pneumothorax (SPTx) associated with primary lung cancer is quite rare, but has been reported as the initial presentation or a complication of disease progression. Moreover, chemotherapy-related SPTx in primary lung cancer occurs at a very low frequency, accounting for less than 0.05% of all cases. Here, we report the first case of erlotinib-related SPTx in a patient with advanced lung adenocarcinoma in Korea. After 3 cycles of cisplatin-based chemotherapy as first-line therapy, erlotinib was administered as second-line treatment. Asymptomatic SPTx accompanied by a significant decrease in tumor size was observed in the left lung 7 weeks later. The patient received continuous administration of erlotinib, without additional treatment. This case showed that SPTx can occur in patients with primary lung cancer receiving erlotinib, and asymptomatic chemotherapy-related SPTx in primary lung cancer may not require therapeutic intervention.

Prescription, Transcription and Administration Errors in Out-Patient Day Care Unit of a Regional Cancer Centre in South India

  • Mathaiyan, Jayanthi;Jain, Tanvi;Dubashi, Biswajit;Batmanabane, Gitanjali
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권5호
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    • pp.2611-2617
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    • 2016
  • Background: Medication errors are common but most often preventable events in any health care setup. Studies on medication errors involving chemotherapeutic drugs are limited. Objective: We studied three aspects of medication errors - prescription, transcription and administration errors in 500 cancer patients who received ambulatory cancer chemotherapy at a resource limited setting government hospital attached cancer centre in South India. The frequency of medication errors, their types and the possible reasons for their occurrence were analysed. Design and Methods: Cross-sectional study using direct observation and chart review in anmbulatory day care unit of a Regional Cancer Centre in South India. Prescription charts of 500 patients during a three month time period were studied and errors analysed. Transcription errors were estimated from the nurses records for these 500 patients who were prescribed anticancer medications or premedication to be administered in the day care centre, direct observations were made during drug administration and administration errors analysed. Medical oncologists prescribing anticancer medications and nurses administering medications also participated. Results: A total of 500 patient observations were made and 41.6% medication errors were detected. Among the total observed errors, 114 (54.8%) were prescription errors, 51(24.5%) were transcribing errors and 43 (20.7%) were administration errors. The majority of the prescription errors were due to missing information (45.5%) and administration errors were mainly due to errors in drug reconstitution (55.8%). There were no life threatening events during the observation period since most of the errors were either intercepted before reaching the patient or were trivial. Conclusions: A high rate of potentially harmful medication errors were intercepted at the ambulatory day care unit of our regional cancer centre. Suggestions have been made to reduce errors in the future by adoption of computerised prescriptions and periodic sensitisation of the responsible health personnel.

Development and Effect of the Integrated Health Promotion Program for Cancer Survivors Living at Home (재가암 환자 통합건강증진 프로그램 개발 및 효과)

  • Yoon, Hee Sang;Hwang, Eun A
    • Research in Community and Public Health Nursing
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    • 제32권1호
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    • pp.51-63
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    • 2021
  • Purpose: This study aimed to develop an integrated health promotion program for cancer survivors residing in the community based on the shared care model, and evaluate its effectiveness. Methods: A quasi-experimental trial was conducted. The participants consisted of 35 cancer survivors with completed intensive cancer therapy at the cancer hospital. The intervention group (n=20) and the control group (n=15) were recruited from among a district home cancer patient registrations. The intervention group participated in an integrated health promotion program based on the MAPP (Mobilizing for Action through Planning and Partnership) development process. The program consisted of physical, psycho-social and body image units. The participants were assessed before the program, and immediately after the program. Data were collected between July 1 and September 2, 2018 using FACT-G quality of life (QOL), distress thermometer (DT), and resilience. The data were analyzed by performing a χ2 test, Fisher's exact test, Mann-Whitney test, and ranked ANCOVA using SPSS. Results: The intervention group reported a higher QOL overall and significantly higher social/family well-being than the control group. Distress was significantly lower in intervention group than in the control group. Resilience had no significant difference between the two groups. Conclusion: These findings indicate that the integrated health promotion program base on the shared care model and MAPP development process could be effective intervention for improving social/family well-being and the QOL, and reducing distress of cancer survivors at home. Community health center nurses need to provide intervention to support self-care competency for cancer survivors' comprehensive care with physical, psycho-social, and body image to help them adjust their life to a moderate risk group in the community.

A Comprehensive Analysis of 5-Year Outcomes in Patients with Cancer Admitted to Intensive Care Units

  • Hong, Yoonki;Kim, Woo Jin;Hong, Ji Young;Jeong, Yun-jeong;Park, Jinkyeong
    • Tuberculosis and Respiratory Diseases
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    • 제85권2호
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    • pp.195-201
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    • 2022
  • Background: The aim of this study was to evaluate the long-term (5-year) clinical outcomes of patients who received intensive care unit (ICU) treatment using Korean nationwide data. Methods: All patients aged >18 years with ICU admission according to Korean claims data from January 2008 to December 2010 were enrolled. These enrolled patients were followed up until December 2015. The primary outcome was ICU mortality. Results: Among all critically ill patients admitted to the ICU (n=323,765), patients with cancer showed higher ICU mortality (18.6%) than those without cancer (13.2%, p<0.001). However, there was no significant difference in ICU mortality at day 28 among patients without cancer (14.5%) and those with cancer (lung cancer or hematologic malignancies) (14.3%). Compared to patients without cancer, hazard ratios of those with cancer for ICU mortality at 5 years were: 1.90 (1.87-1.94) for lung cancer; 1.44 (1.43-1.46) for other solid cancers; and 3.05 (2.95-3.16) for hematologic malignancies. Conclusion: This study showed that the long-term survival rate of patients with cancer was significantly worse than that of general critically ill patients. However, short term outcomes of critically ill patients with cancer were not significantly different from those of general patients, except for those with lung cancer or hematologic malignancies.