The impact of income and education level on the clinical and pathologic characteristics, implementation of clinical breast examination (CBE), and treatment patterns of a small population of Chinese female breast cancer patients was studeied in order to provide a theoretical basis and statistical reference for further nationwide research. We included 484 pathologically confirmed female primary breast cancer inpatients of the First Affiliated Hospital of Medical College of Xi'an Jiaotong University from February 2003 to January 2004. All cases were reviewed and relevant information was collected using a designed case report form (CRF). Chisquare tests, rank-sum tests, and Fisher's exact tests were used in the analysis. Our analysis showed that: (1) women in different occupation groups had significant differences in tumor size, pre-operative mammography, surgical options, post-operative estrogen receptor (ER), progestin receptor (PR) and human epidermal growth factor receptor 2 (Her2) status, and post-operative radiotherapy and chemotherapy (P < 0.05); and (2) women with different education levels had statistically significant differences in tumor size, post-operative ER, PR and Her2 status, and post-operative chemotherapy, radiotherapy, and endocrine therapy (P < 0.05). In Xi'an, China, women in low-income occupations or with low education levels are more likely to have advanced tumor stages at presentation, lower implementation rate of clinical breast examination, and less treatment.
Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.
Background: With effective early treatments, many breast cancer patients suffer from psychological distress due to adverse effects and lifelong physical disfigurement. Our study aimed to evaluate the psychopathological profile of breast cancer patients in comparison with healthy women and explored demographic correlates. Method: We consecutively enrolled breast cancer patients who came to the hospital for follow-up or rehabilitation care after primary treatment, and healthy female relatives or friends of inpatients in the Cancer Institute of Chinese Academy of Medical Sciences between August 30, 2010 and January 1, 2012. Psychopathological profile was assessed based on the Symptom Checklist-90-R (SCL-90-R) for patients and controls. We compared demographics such as age, ethnicity, education, marriage, and occupation, and incorporated these data plus cancer status for the association with the general SCL-90-R index and scores for 9 major symptom dimensions in multiple regression analysis. Results: We surveyed a total of 291 female breast cancer patients and 531 healthy women. The average age was $55.1{\pm}6.40$ years for breast cancer patients and $43.1{\pm}12.8$ for healthy controls (P<0.01). The mean survival was 5.20 years for cancer patients (range, 0.60-9.90 years). There were statistically significant differences in education, marriage, and occupation between the two groups (P<0.01). General index ($1.45{\pm}0.45$ versus $1.32{\pm}0.37$) and 8 dimension scores (excluding anxiety) on SCL-90-R were significantly higher in patients (P<0.05). Multiple regression analysis showed that the breast cancer status was positively correlated with general SCL-90-R index and 6 dimension scores (excluding the anxiety, phobic anxiety and paranoid ideation dimensions) (P<0.05). Regression coefficients ranged from 0.10 (depression) to 0.19 (somatization). Higher interpersonal sensitivity was noticed in single women compared to married women. Conclusions: Chinese patients with breast cancer demonstrate greater psychopathology compared to healthy controls. The breast cancer status is an independent contributing factor to the general psychopathological profile. Breast cancer patients should be given particular counseling and care to alleviate their psychological distress.
Park, Jong-Min;You, So-Jung;Choi, Sung-Youl;Moon, Goo;Lyu, Yeoung-Su
Journal of Oriental Neuropsychiatry
/
v.26
no.1
/
pp.23-38
/
2015
Objectives: This study aimed to understand the motives for visiting oriental medical hospital and the satisfaction degree of cancer patients, in order to increase the satisfaction rate of oriental medicine among cancer patients. Methods: The data were collected from inpatients who responded to a self-report questionnaire. Independent t-test, analysis of variance (ANOVA), and correlation analysis were used for data analysis. Results: The most prominent motive for visiting oriental medical hospital was recurrence prevention and energy recovery. In oriental medical care, positive responses appeared in the order of 'Acupuncture', 'Pharmacopuncture', 'Enzyme therapy', 'Foot bath therapy', and 'Moxibustion'. According to the research on medical satisfaction degree, the overall satisfaction degree was 4.56. On each field, satisfaction degree related to the doctor service was 4.64, and satisfaction degree of using the procedure was 4.47. Conclusions: Cancer patients mostly visited oriental medical hospital for recurrence prevention and regaining energy, and the service distribution of oriental medical hospital was almost equal without being concentrated on the specified social classes.
Kim, Han-Kyoul;Lee, Kyoung-Sook;Kim, Yong-Ha;Kim, Kwang-Hwan
Journal of the Korea Convergence Society
/
v.2
no.4
/
pp.53-58
/
2011
This Study is to propose the resonable management for cancer patients by identifying correlation among the treatment, their length of hospital stay and medical charges. Research subjbject is 144 patient that breast cancer, uterine cancer and Family Medical patients of inpatients in K University Hospital in Korea during six month, from January 1, 2010 to June 30, 2010. The analysis shows that the emergecy is superior range thag outpatient because each of them has 97.9%, 2.1% by looking at the path to admission. And the age of 40-49 is the higest group by age. When matrix components of breast cancer patients, principal component is composed of two axes. Factors associated with the first component appeared correlations between all variables without the age. Following results, this study is considered similar types of disease or treatments are need to introduce the DRG.
Purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. Methods: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. Results: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (${\beta}=1.57$, p=.023) and did not use physical measures (${\beta}=-1.23$, p=.041) as coping methods were under the high risk of nutritional disorders. Conclusion: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.
Journal of Physiology & Pathology in Korean Medicine
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v.21
no.6
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pp.1590-1596
/
2007
Complementary and alternative medicine (CAM) has gained in popularity among cancer patients in recent years. The use of CAM in cancer patients is common with about one third of patients using some form of CAM in Western countries. The purpose of this study was to analyze the use of CAM and determine what factors affect to use CAM among cancer patients to provide CAM therapy information and assist therapy selection among various CAM therapies to cancer patients. The design of the study was descriptive cross-sectional, and data were collected using a 16-item questionnaire. This study was conducted in subjects with confirmed diagnosis of stomach, colon, liver, or pancreas cancer, in both out-patients clinics and inpatients setting in a tertiary hospital in Seoul Korea. As a result, among the participants, past or current CAM use was reported by 75%, which shows a statistically significant difference in income groups(P<0.05), but no difference in age and religion groups. The most common therapies use by cancer patients included traditional Korean medicine (32.1%), folk remedies (26.6%), exercise (14%), dietary supplements (11.6%), physical therapy (9.9%), diet therapy (5%), and meditation (4%). 77.8% of patients show satisfaction and 64.4% shows perceived effectiveness of CAM. Male patients with higher income, and previous treatment were more likely to use CAM. The main benefits from CAM reported by cancer patients were psychological improvement and symptom improvement. Of the cancer patients used CAM, 30.9% were dissatisfied, 25.8% did not have benefits from the use, and 7.6% experience side effects. Cancer patients who prefer CAM (more than 3 kinds) used it to cure cancer, on the contrary, the one who do not prefer CAM used to improve symptoms and psychological stability. The main sources of information about CAM were family and friends(54.4%), and media(24.5%), doctor and nurse(18.3%), and religion group(2.6%). Findings suggest that due to the relatively high use of CAM among cancer patients in Korea, this topic should be taken into account in the development of a holistic approach to cancer patients and efficient cancer patients management system and proactive and consistent management of CAM is necessary in the health care system in Korea.
Despite the advances in cancer therapy in the last 20 years, cancer continues to be a life-threatening illness, and the newly diagnosed individual faces a crisis that emphasized his or her mortality. Patients who suffer from cancer may have psychological problems, especially depression. Most tend to seek the meaning of suffering when continuing pain was experienced. Then the search for meaning, which is one of the primary needs of humans, begins. This meaning is "unique and specific" to the individual, and it must be fulfilled by the individual alone. This study was conducted to provide a basis of data for a nursing intervention program to minimize a cancer patient's suffering and to understand the relationship between life satisfaction, depression, and the meaning of suffering in cancer patients. The sample was composed of 160 cancer patients who were inpatients or outpatients of three general hospitals in Seoul. Data collections were carried out from February 25th to April 20th of 2000. The data was analyzed using a SAS program for descriptive statistics, Pearson Correlations, ANOVA, and Duncan tests. The results were as follows: 1. The scores on the depression scale ranged from 20 to 65 with a mean of 40.76 (SD 9.6) The mean score on the suffering scale was 97.72 (SD 12.7), and the score of the life satisfaction ranged from 15 to 37 with a mean of 25.51 (SD 5.2). 2. There were significant correlations between the amount of life satisfaction and depression (r=-.61, P=.00), the life satisfaction and the meaning of suffering (r=.30, p=.00), and the depression and the meaning of suffering (r=-.24, p=.00). 3. The factors influencing the depression in patients with cancer are age (F=2.52, p=.04) and education level (F=3.98, p=.00). The level of the meaning of suffering in cancer patients differed by education level (F=4.13, p=.00). Also, the level of the life satisfaction in cancer patients differed by education level (F=2.72, p=.04). In conclusion, the correlation between the depression, the meaning of suffering, and life satisfaction can be used as a concrete and practical datum for the development of nursing intervention. This may assist patients with cancer, overcome their suffering and lead to a hopeful life by understanding the meaning of suffering.
Background: The aim of this study was to examine the association of serum isoflavones, adiponectin, and insulin levels with ovarian cancer risk. Materials and Methods: We gathered cases with histologically confirmed epithelial ovarian cancer at Sapporo Medical University Hospital from October 2010 to September 2012. Potential controls were recruited from female inpatients without any history of cancer or diabetes mellitus in different wards of the same hospital over the same period of time. Serum isoflavones, adiponectin, and insulin levels were measured in order to estimate associations with ovarian cancer risk in a case-control study. Data from 71 cases and 80 controls were analyzed with a logistic regression model adjusting for known risk factors. Results: A significant reduction in ovarian cancer risk was observed for the high tertile of serum daidzein level versus the low ($P_{trend}<0.001$). A significant reduction in ovarian cancer risk was also observed for the high tertile of serum glycitein level versus the low ($P_{trend}=0.005$). Furthermore, a significant reduction in ovarian cancer risk was observed for the high tertile of serum adiponectin level versus the low ($P_{trend}=0.004$). Conversely, serum insulin level showed significantly elevated risk for ovarian cancer with the high tertile versus the low $P_{trend}<0.001$). Conclusions: Decreased serum isoflavones levels, such as those for daidzein and glycitein, decreased serum adiponectin levels, and increased serum insulin levels could be shown to be associated with elevated risk of ovarian cancer.
Background: Non-Hodgkin's lymphoma (NHL) patients demonstrate multiple symptoms in diagnosis and treatment processes. This cross-sectional descriptive study aimed to determine the symptoms and symptom clusters in such patients receiving chemotherapy. Materials and Methods: The study was carried out on a total of 110 inpatients and outpatients receiving treatment in 7 hospitals in Ankara, Turkey. A questionnaire form and the Memorial Symptom Assessment Scale (MSAS) were applied. Percentages, means, t test, one way analysis of variance (ANOVA) and cluster analysis were used for statistical analyses. Results: The most prevalent symptoms in this study were lack of energy, hair loss and change in the way food tastes. The most severe symptoms were hair loss, change in the way food tastes and constipation. The top three most distressing symptoms were taste change, constipation and mouth sores. Seven symptom clusters were determined in this study. Conclusions: Findings of the study will provide an understanding of symptom experiences of Non-Hodgkin's lymphoma patients receiving chemotherapy and will guide determining appropriate nursing interventions. Receiving care of desired quality will contribute to increasing quality of life of affected individuals.
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