• PNF and Movement
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• 제18권1호
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• pp.1-10
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• 2020

Purpose: This study was conducted to examine the effects of a PNF intervention using elastic bands on edema, range of motion (ROM), and pain in post-mastectomy patients with upper limb lymphedema, according to their hand grip type. Methods: The subjects were 14 female patients who were at Stage II lymphedema after undergoing mastectomy for Stage II breast cancer. They were randomly divided into an experimental group (n =7) and a control group (n = 7). Both groups participated in a treatment program four times (one time under the therapist's instructions and three times as self-exercise) a week for 4 weeks. Both groups repeated an upper limb PNF pattern exercise for 30 min using elastic bands after receiving a manual lymph drainage treatment for 1 hour. Here, subjects in the experimental group performed the PNF exercise with an open-hand grip by putting their hands into the loops of elastic bands and keeping their fingers spread out. Subjects in the control group performed the PNF exercise with a closed-hand grip by holding the loops of elastic bands with their fingers. In both groups, the subjects' edema, ROM, and pain levels were measured before the intervention and 2, 3 and 4 weeks after the intervention. Results: As a result of the experiment, both groups demonstrated edema reductions, ROM increases, and pain reductions in four areas of the upper limbs. Notably, the experimental group exhibited larger ROM increases in flexion, extension, and abduction as well as greater edema and pain reductions than the control group. In particular, the most significant effects were found in the elbow of the four upper limb areas for edema reductions and in extension for ROM increases. Conclusion: The present study indicates that exercise therapy-based approaches using elastic bands in post-mastectomy patients with upper limb lymphedema can have different effects depending on the type of hand grip (open or closed), which is the body's most distal part. Therefore, these approaches should be based on the conditions of the distal parts of the patient's body for their effective applications in clinical practice.

• 한국보건간호학회지
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• 제15권1호
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• pp.148-156
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• 2001

Data were collected using questionnare to 102 post-mastectomy patients visiting the out-patient department at Catholic University St. Mary Hospital and Kang Nam St. Mary Hospital from October, 1998 to January, 1999 in order to provide the basic data for development of nursing intervention which can help patients' emotional and sexual adaptation to treatment outcome as well as increase quality of life by studying spouse support, sexual satisfaction and marital intimacy of patients. Spouse support and sexual satisfaction were measured with the tool developed by Soon-bok Jang (1989). Marital intimacy was measured with the tool developed by Waring (1984) and improved by Sook-nam Kim (1998). Data were analyzed using t-test, ANOVA, multiple comparison by Duncan. Pearson correlation coefficients, and stepwise multiple regression. The results were as follows ; 1. Spouse support in the group of 6 month or less post-operative period was higher than that of 13 to 36 month period. 2. Sexual satisfaction in the group college graduation or above was higher than that of high school and middle school graduation. 3. Marital intimacy in the group of 61 month or above post-operative period was higher than that of 6 month or less and 13 to 36 month period. 4. The higher spouse support results in the higher sexual satisfaction and the higher marital intimacy according to a positive correlation. 5. The main effective variable on marital intimacy was spouse support. and the effectiveness showed $31.09\%$, while it was $43.06\%$ including sexual satisfaction and post-operative period.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2241-2247
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• 2012

Objective: This qualitative study retrospectively examined the experience and psychological impact of contralateral prophylactic mastectomy (CPM) among Southern Chinese females with unilateral breast cancer history who underwent BRCA1/2 genetic testing. Limited knowledge is available on this topic especially among Asians; therefore, the aim of this study was to acquire insight from Chinese females' subjective perspectives. Methods: A total of 12 semi-structured in-depth interviews, with 11 female BRCA1/BRCA 2 mutated gene carriers and 1 non-carrier with a history of one-sided breast cancer and genetic testing performed by the Hong Kong Hereditary Breast Cancer Family Registry, who subsequently underwent CPM, were assessed using thematic analysis and a Stage Conceptual Model. Breast cancer history, procedures conducted, cosmetic satisfaction, pain, body image and sexuality issues, and cancer risk perception were discussed. Retrieval of medical records using a prospective database was also performed. Results: All participants opted for prophylaxis due to their reservations concerning the efficacy of surveillance and worries of recurrent breast cancer risk. Most participants were satisfied with the overall results and their decision. One-fourth expressed different extents of regrets. Psychological relief and decreased breast cancer risk were stated as major benefits. Spouses' reactions and support were crucial for post-surgery sexual satisfaction and long-term adjustment. Conclusions: Our findings indicate that thorough education on cancer risk and realistic expectations of surgery outcomes are crucial for positive adjustment after CPM. Appropriate genetic counseling and pre-and post-surgery psychological counseling were necessary. This study adds valuable contextual insights into the experiences of living with breast cancer fear and the importance of involving spouses when counseling these patients.

• 재활간호학회지
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• 제2권1호
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• pp.61-71
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• 1999

This quasi-experimental study was intended to test the effect of self-help group program, which is one of the way to enhance adaptation and quality of life to mastectomy patients. Data was collected from July 14, 1998 to Oct. 31, 1998 at two Medical Center in Seoul. The subjects for this study were the patients who had undergone mastectomy and were follow-up ; 14 in experimental group and 14 in control group matched with age and treatment. The instruments for this study were adaptation in Lee(1994)'s physical symptom questionnaire, Zung's Self-rating Depression Scale(SDS, 1965), and Self-rating Anxiety Scale(SAS, 1970), quality of life in Spranger(1996)'s and No(1988)'s Quality of Life Questionnaire. The self-help group program for mastectomy patients was developed based on literature review and pilot study by the investigator. The subjects of experimental group were participated in 6 weeks self-help group program and were received arm and shoulder exercise, informational support, and interpersonal support by group members. The control group were received no intervention, Both group answered questionnaires prior to intervention and 6 weeks later. The data analyzed by frequency, $X^2$-test, Mann-Whitney U test. Wilcoxon Signed Rank test, Pearson's Correlation Coefficient and Stepwise Multiple Regression using SPSS WIN. The results are as follows ; Hypothesis 1. "The experimental group with the self-help group program will have a higher score on adaptation state than control group." was not supported. But the post test score of anxiety and depression in experimental group were declined and the depression score was reduced relatively. Hypothesis 2. "The experimental group with the self-help group program will have a higher score on quality of life than control group." was not supported. But the posttest score of quality of life in experimental group was reduced relatively. Hypothesis 3. "The higher adaptation state of mastectomy patients, the higher quality, of life." was supported(r=,80, p<.001). Additionally, the lower physical symptom, depression and anxiety, the higher quality of life And depression, which was the main predictor of quality of life, accounted for 59.5%, depression and anxiety accounted for 65.5% of the variance in quality of life. In conclusion, when the self-help group program was intervened to mastectomy patients, it was tended to increase quality of life and to reduce depression and anxiety. So self-help group program can be considered useful nursing inter vention effect on adaptation and quality of life of mastectomy patients. With discussion, I suggest repeated further re search on self-help group with appropriate sample size and longitudinal study. Also during adjuvant therapy, it is needed to develop convenient method to be supported from peer group and family, such as computer mediated support group.

• 대한간호학회지
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• 제36권7호
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• pp.1111-1122
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• 2006

Purpose: This study examined the effects of aerobic exercise using a flex band on the improvement of physical functions & body image in breast cancer women undergoing radiation therapy after a mastectomy. Method: Women with breast cancer(n =26) were assigned to an experimental group(EG, n = 15) and control group(CG, n = 11). The E.G participated in an aerobic exercise program with a 60% to 80% intensity of maximal heart rate for 25 minutes during the main exercise, 3 times per week, for 6 weeks. The EG did not exercise regularly for 3 months before participating in this program. The CG received no exercise treatment during the research period. Data were analyzed using the $x^2-test$ and Mann-Whitney U test by the SPSS version 11.0 program at a 5% significant level. Results: Group analysis revealed that the EGwomen had significantly more improved cardio-pulmonary functions, ROM of the affected shoulder joint, and body image compared to the CG, Conclusion: Aerobic exercise using a flex band may be an effective rehabilitative measure for mastectomy women with respect to cardio-pulmonary functions, ROM, & body image. Further studies are recommended to study early rehabilitation programs within 10 days post-operatively.

• 종양간호연구
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• 제2권1호
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• pp.17-26
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• 2002

Purpose: This study was conducted to evaluate the effects of aerobic dance on physical functionnings of women with mastectomy. The study was single group pre- & post-test time series design. The aerobic dance program was performed three times a week for eight weeks, 45${\sim}$60 minutes per session. Method: The research variables used in the study were the period(seconds) of exercise that was taken for target heart rate, activity systolic pressure, range of motion of shoulder joint in affected side, and flexibility for physical functionnings. The data were analyzed with repeated measure ANOVA and Bonferroni multiple comparisons. Results: Over the period of aerobic dance, the degree of all the research variables were changed significantly, and also differed significantly every 2 to 4 weeks. The period(seconds) of exercise that was taken for target heart rate (p <.000), systolic pressure in exercise(p =.019), range of motions of shoulder joint on the affected side(flexion, abduction, over-adduction, over-extension, external & internal rotation), and flexibility(sit & reach, back & reach) (p= .003; p=.001; p(.001; p<.001; p= .014; p<.001; p=.036; p<.001) were differed significantly respectively. Conclusion: The results suggest that the aerobic dance program for women with mastectomy can improve and recover cardiopulmonary endurance and ROM of shoulder joint and that the period of exercise had to be performed over six to eight weeks and three times a week at least.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.483-493
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• 2021

Background Direct-to-implant (DTI) breast reconstruction after nipple-sparing mastectomy (NSM) with the use of acellular dermal matrix (ADM) provides reliable outcomes; however, the use of ADM is associated with a higher risk of complications. We analyzed our experiences of post-NSM DTI without ADM and identified the predictive factors of adverse surgical outcomes. Methods Patients who underwent NSM and immediate DTI or two-stage tissue expander (TE) breast reconstruction from 2009 to 2020 were enrolled. Predictors of adverse endpoints were analyzed. Results There were 100 DTI and 29 TE reconstructions. The TE group had a higher rate of postmastectomy radiotherapy (31% vs. 11%; P=0.009), larger specimens (317.37±176.42 g vs. 272.08±126.33 g; P=0.047), larger implants (360.84±85.19 g vs. 298.83±81.13 g; P=0.004) and a higher implant/TE exposure ratio (10.3% vs. 1%; P=0.035). In DTI reconstruction, age over 50 years (odds ratio [OR], 5.43; 95% confidence interval [CI], 1.50-19.74; P=0.010) and a larger mastectomy weight (OR, 1.65; 95% CI, 1.08-2.51; P=0.021) were associated with a higher risk of acute complications. Intraoperative radiotherapy for the nipple-areolar complex increased the risk of acute complications (OR, 4.05; 95% CI, 1.07-15.27; P=0.039) and the likelihood of revision surgery (OR, 5.57; 95% CI, 1.25-24.93; P=0.025). Conclusions Immediate DTI breast reconstruction following NSM is feasible in Asian patients with smaller breasts.

• 종양간호연구
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• 제7권1호
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• pp.36-46
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• 2007

Purpose: This study was designed to fine out the relationships among body image, self-esteem and health promotion behavior in mastectomy patients. Method: Data were obtained by self -reported questionnaires from 218 patients undergone mastectomy from September 1 to October 15, 2005. And data were analyzed using SPSS/PC WIN 12.0 program. For the statistical analysis of the date, frequency and percentage, mean and standard deviation, t-test, ANOVA and Scheffe test and Pearson's correlation coefficients were used. Result: The mean scores of the body image, self-esteem, and health promotion of the subjects were $41{\pm}7.40$ (range of scale : 17 to 68), $22.22{\pm}4.95$ range of scale : 10 to 40), and $130.45{\pm}23.99$ range of scale : 50 to 200), respectively. There were significant differences with the score of body image by the work type (F=4.018, p= .008), a number of child (F=3.069, p= .029), and participation with self help group program (t=68.177, p= .001). There were significant differences with the score of self-esteem by the type of religion (F=4.546, p= .002), work type (F=4.488, p= .004), post operation period (F=2.814, p= .026), and participation with self help group program (t=12.901, p= .001). There were significant differences with the score of the health promotion behavior by the type of religion (F=3.066, p= .018), economic state (F=11.765, p= .001), level of education (F=6.285, p= .001), operation site (F=.368, p=.027), family history (t=6.557, p= .011), and hope of breast reconstruction (t=7.025, p=.009). Relationship between body image and self-esteem showed moderate positive correlation (r=0.631, p= .001). The relationship between body image and health promotion behavior showed slightly positive correlation (r=0.257, p= .001). The relationship between self-esteem and health promotion behavior showed moderate positive correlation (r=0.431, p=.001). Conclusion: For the increasement of the health promotion behavior, it is needed to improve body image and self-esteem in mastectomy patients. And, It is needed to encourage to participate with self help group program in mastectomy patients.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.222-228
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• 2007

Purpose: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post-operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. Methods: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. Results: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. Conclusion: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.

• 한국산학기술학회논문지
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• 제19권10호
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• pp.313-323
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• 2018

본 연구의 목적은 유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램을 개발하여 적용하고 그 효과를 검증하기 위한 것이다. 연구설계는 유사실험설계이며, 연구대상은 D지역의 2개 대학병원에서 유방절제술을 받은 3년 이내의 환자로 실험군 17명, 대조군 16명이 연구에 참여하였다. 본 연구에 참여하는 실험군에게는 2015년 6월부터 7월동안 총 주 3회의 운동프로그램을 7주간 실시하였고, 대조군에게는 운동프로그램을 제공하지 않았다. 본 연구 프로그램의 사전, 사후 어깨관절 유연성은 줄자를 이용한 등 뒤 손잡기와 관절 각도계를 이용한 어깨가동범위를 측정하였으며, 악력은 악력계를 이용하여 측정하였다. 자료 분석은 SPSS/Win 21.0 program을 이용하였고, 사전 동질성 검증은 카이제곱 검정과 Fisher's exact test, Mann-Whitney U-test를 이용하였으며, 가설 검증은 Mann-Whitney U-test, Wilcoxon Signed Rank test를 이용하였다. 연구결과, 맞춤형 상지 운동프로그램에 참여한 실험군은 대조군에 비해 등 뒤로 두 손 마주잡기(p=.001), 굽힘(p<.001), 벌림(p=.032), 바깥돌림(p=.024), 안쪽돌림(p=.041) 등에서 모두 유의한 변화를 나타내 유연성과 관절가동범위가 증가한 것으로 나타났다. 또한 실험군은 대조군에 비해 악력(p<.001)도 유의하게 증가한 것으로 나타났다. 본 연구에서 개발된 개별 유방암 환자의 특성과 신체적 상태를 고려하여 과부하의 원리와 점증적 원리로 구성된 유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램은 수술 후 환자들의 어깨관절 유연성과 악력 향상에 효과적이었으며 수술 후 많은 환자들이 호소하는 어깨관절 기능 및 악력 저하를 예방하고 신체기능을 향상시켜 일상생활로의 복귀를 도와줄 수 있을 것으로 기대된다.