• Journal of Korean Academy of Nursing
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• v.39 no.5
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• pp.613-621
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• 2009

The purposes of this study were to evaluate symptom experience and quality of life (QOL) and to identify the predictors of QOL among breast cancer survivors. Methods: A cross-sectional study was conducted on 200 disease-free breast cancer survivors at two hospitals between December 2007 and July 2008. Functional Assessment of Cancer Therapy Scale-B, Memorial Symptom Assessment Scale-short Form and The Linear Analogue Self Assessment Scale were used to assess symptom experience and QOL in these patients. Data were analyzed using the Pearson correlation, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. Results: The mean score of QOL for breast cancer survivors was 95.81 (${\pm}18.02$). The highest scores among physical and psychological symptoms were sexual interest and anxiety. Year since treatment completion was significantly associated with QOL in sociodemographic variables. Physical and psychological symptoms have a significant negative association with QOL. The results of the regression analyses showed that physical and psychological symptoms were statistically significant in predicting patients' QOL. Conclusion: Symptom experience and QOL are essential variables that should be acknowledged when delivering health care to breast cancer survivors. More attention to the reduction and management of psychological distress could improve QOL among breast cancer survivors.

• Journal of Korean Academy of Nursing
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• v.49 no.3
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• pp.298-306
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• 2019

Purpose: This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL. Methods: This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors' Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation. Results: The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (${\beta}=.55$, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001). Conclusion: The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.

• Journal of East-West Nursing Research
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• v.27 no.1
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• pp.43-50
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• 2021

Purpose: The purpose of this study was to identify the influence of depression, optimism and posttraumatic growth on health-related quality of life in female breast cancer survivors received adjuvant chemotherapy. Methods: In total, 115 female breast cancer survivors participated in this descriptive correlational study. The participants answered self-report questionnaires. Data were collected from 1 June 2020 to 10 June 2020, and were analyzed using descriptive statistics, the t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression with SPSS for Windows ver. 24.0. Results: The mean age of the breast cancer survivors was 45.83 years. The mean score for the degree of health-related quality of life was 81.85 out of 148 points. Participants' scores for health-related quality of life differed significantly based on economic status (F=5.36 p=.006) and hobbies (t=-3.37, p=.001). Health-related quality of life was negatively correlated with depression (r=-.73, p<.001), and positively correlated with optimism (r=.65, p<.001) and posttraumatic growth (r=.28, p=.002). Depression (𝛽=-.55, p<.001) was the most significant factor that affects health-related quality of life, followed by optimism (𝛽=.29, p<.001), and post-traumatic growth (𝛽=.12, p=.048), which together accounted for 62.2% (F=63.61, p<.001) of the variance. Conclusion: It is necessary to develop educational programs for breast cancer survivors to reduce depression, increase optimism and post-traumatic growth, and improve the health-related quality of life. By adapting these programs, positiveness may increase and this may lead to improvement of health-related quality of life for breast cancer survivors.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7749-7755
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• 2013

Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.

• The Research Journal of the Costume Culture
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• v.24 no.6
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• pp.886-902
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• 2016

This study investigated multidimensional body image, self-esteem, clothing benefits sought, and Body Image After Breast Cancer (BIABC) within surgical subgroups among breast cancer survivors. The study applied the questionnaire survey method and the main research was conducted through an online survey. The respondents included 207 breast cancer survivors between the ages of 30 and 59, each of whom received the Multidimensional Body-Self Relations Questionnaire (MBSRQ). Self-esteem, clothing benefits sought, examination, and demographic variables were measured using a 5-point Likert scale. The main results of this study are outlined below. For clothing benefit sought, six factors were formulated-pursuit of self-expression/social approval, function/health, compensation, femininity, fashion, and camouflage-and BIABC was defined by the four factors of body stigma/vulnerability, transparency, limitation and cancer concern. While MBSRQ and self-esteem did not show a statistically significant difference between groups differentiated by the surgical methods experienced, those who underwent mastectomies scored slightly lower than members of the other groups. Moreover, the reconstruction after mastectomy group showed the highest mean on self-expression/social approval, compensation, femininity and entire clothing benefits sought, followed by the lumpectomy group and mastectomy group. The lumpectomy group was found to have more positive BIABC than the mastectomy group. In particular, the mastectomy group showed a lower body stigma/vulnerability mean than the other groups. This study is meaningful in that it improves our understanding of the body image of breast cancer survivors and provides basic knowledge for developing products and marketing strategies for breast cancer survivors as consumers.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2949-2954
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• 2013

Background: This study was conducted to determine the relationship between lifestyle behavior and quality of life (QoL) among cancer survivors in Korea. Materials and Methods: Data for a total of 471 (173 men, 298 women) cancer survivors (CS) over 40 years old were obtained from the database of the $4^{th}$ Korean National Health and Nutrition Examination Survey (KNHANES IV). An identical number of subjects of the same age, sex, and education who had no restrictions in physical activity were randomly selected from the database and represented the control group (CG). Drinking, smoking, and exercise behavior were assessed. Results: The number of heavy drinkers was lower in CS (9.4%) than in CG (15.8%) (p<0.01); similarly, there were fewer smokers in CS (9.1%) than in CG (14.0%) (p<0.05). The percentage of individuals engaging in vigorous, moderate, and low-intensity exercise did not differ between CS (13.6%, 14.7%, and 50.0%) and CG (14.3%, 13.4%, and 49.7%, respectively). No differences in Euro QoL Questionnaire 5-Dimensional Classification (EQ-5D) scores on both drinking and smoking behaviors were noted. Compared to the non-exercisers, the low-intensity exercisers in CG ($0.91{\pm}0.10$ vs. $0.94{\pm}0.09$), vigorous-intensity exercisers in CS ($0.84{\pm}0.62$ vs. $0.91{\pm}0.11$), and low-intensity exercisers in CS ($0.82{\pm}0.22$ vs. $0.88{\pm}0.13$) scored higher on the EQ-5D. Conclusions: Although cancer survivors practiced more conscious health behavior in drinking and smoking, their engagement in exercise did not differ from that of non-cancer survivors. Since exercise engagement increases QoL in general, implementation of an educational program that promotes exercise engagement in cancer survivors may be required.

• Research in Community and Public Health Nursing
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• v.32 no.1
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.507-512
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• 2015

Background: This pilot study looked into the physical, social, psychological and economic issues of Indian adult cancer survivors. Materials and Methods: Assumed cancer free patients, after cancer directed therapy (CDT), were assessed on the basis of a questionnaire developed by the investigators. The mental status of the survivors was elicited by modified MINI international neuro-psychiatric interview. This cross sectional assessment was conducted as a direct interaction with each patient for 30 to 45 minutes at a cancer hospital in 2012. Results: Thirty one adult cancer survivors participated in this study. Median age was 53 years with a median follow up duration of 21.8 months (Range 2.3-194.1 months). The majority (68%) did not receive financial support for treatment. Median interval after CDT to start of activity of daily living was 1.5 months (range: 0-24 months). Fatigue and loss of appetite were reported by 52% and 29% respectively. The cancer diagnosis and its treatment adversely impacted the financial condition in 42% of patients. Nineteen percent each showed social anxiety and post-traumatic stress disorder and another 13% patients reported depression. Conclusions: This prospective assessment highlights survivorship issues and the need to address those issues particularly in the context of developing countries where resources and manpower are limited.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3091-3096
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• 2015

Worldwide, breast cancer is the most common malignant neoplasm and the second most common cause of cancer death in women. This malignancy is recognized to be estrogen-dependent and due to this feature, hormone replacement therapy is regarded as potentially dangerous in breast cancer survivors who seek relief of their menopausal symptoms. Whereas hot flashes are detected in nearly half of postmenopausal women with a relatively high frequency and severity, botanic sources of estrogens have been proposed as an alternative treatment. Nevertheless, estrogenic properties of these compounds suggest possibility of stimulating cancer recurrence or worsening prognosis in survivors. As well, effects in improving vasomotor climacteric changes is controversial. Many studies have considered the subject, some focusing on efficacy of phytoestrogens for control of menopausal symptoms, and others discussing effects of these compounds on breast cancer outcome in terms of survival or recurrence. The present article is a concise review of the effects of consumption of phytoestrogens on menopausal symptoms, namely hot flashes, and breast cancer recurrence and mortality in survivors of the disease. Overall, the major part of the current existing literature is in favor of positive effects of phytoestrogens on breast cancer prognosis, but the efficacy on menopausal symptoms is probably minimal at the best.

• Journal of Korean Academy of Nursing
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• v.41 no.3
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• pp.285-293
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• 2011

Purpose: In this study, the effects of laughter therapy on levels of depression, quality of life, resilience and immune responses in breast cancer survivors were examined. Methods: A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=37) included breast cancer survivors who finished chemotheraphy and radiation therapy: 16 in the experiment group and 21 in the control group. Data were collected from August to November 2009. The experimental group participated in laughter therapy eight times, twice a week for 60 min per session. Questionnaires were used to me-asure pretest and posttest levels of depression, quality of life and resilience. A blood test was used to analyze changes in Total T cell, T helper, T suppressor, Th/Ts ratio, Total B cell, T cell/B cell ratio and NK cell for immune responses. Results: The results showed that laughter therapy was effective in increasing the quality of life and resilience in breast cancer survivors. but depression and immune responses did not differ significantly between the groups. Conclusion: The results of the study indicate that laughter therapy may be an effective nursing intervention to improve quality of life and resilience in breast cancer survivors.