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Cross Sectional Assessment of Health Related Quality of Life (HRQoL) among Patients with Cancer in Malaysia

  • Farooqui, Maryam;Hassali, Mohamed Azmi;Knight, Aishah;Shafie, Asrul Akmal;Farooqui, Muhammad Aslam;Saleem, Fahad;ul Haq, Noman;Othman, Che Noriah;Aljadhey, Hisham
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3017-3021
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    • 2013
  • Background: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients. Materials and Methods: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0. Results: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 ($SD{\pm}13$) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 494%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p-0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001). Conclusions: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.

Fatigue and Its Related Factors in Korean Patients on Hemodialysis

  • Kim Hye-Ryoung;Son Gwi-Ryung
    • Journal of Korean Academy of Nursing
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    • v.35 no.4
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    • pp.701-708
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    • 2005
  • Purpose. This study examined the characteristics of fatigue and the relationship between fatigue and its related factors in Korean patients on hemodialysis. Methods. A cross-sectional correlational study was conducted with 104 patients on hemodialysis in Seoul, Korea. Finding. Of a total of 104 subjects, eighty-one ($77.9\%$) complained of fatigue. Fatigue severity was measured by the self-rating Visual Analogue Scale-Fatigue (VAS-F) with a mean score of 36.5 (SD = 17.49, range 2 - 81). The mean duration of fatigue was 3.8 hours (SD = 5.3, range 0 - 24). Depression was most significantly correlated with fatigue (beta = .43, p<.00), with interdialytic weight gain (beta = .25, p<.05) being the second most significant correlate. Conclusion. This study shows that nursing interventions for patients who experience fatigue while on hemodialysis should be focused on both psychological problems, such as depression, as well as on physiological problems, such as interdialytic weight gain.

The Effect of Care Burden of Elderly Spouses Caring for Dementia Elderly on Life Satisfaction: The Moderating Effect of Social Support (치매 노인을 돌보는 노년기 배우자의 돌봄 부담감이 생활만족도에 미치는 영향: 사회적지지의 조절효과)

  • Park, Ju-Hee
    • Journal of Family Resource Management and Policy Review
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    • v.25 no.4
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    • pp.43-54
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    • 2021
  • The purpose of this study was to explore the effects of perceived care-related burden and social support on life satisfaction and the moderating effect of social support from elderly spouses caring for their elderly partners with dementia. The subjects were 165 spouses aged over 60 years, caring for their elderly partners afflicted with dementia, and living in Seoul and Gyeonggi Province. The analysis results are as follows: First, the quantified total care-related burden shouldered by the participant spouses was 3.76 points (SD = .57), which was slightly higher than the median value. In the case of social support, informal support was scored 2.65 (SD = .78), and formal support was scored 2.60 (SD = .77), which was lower than the median value. Life satisfaction earned a score of 3.11 points (SD = .78), which somewhat exceeded the median. Second, subjective health status, income level, burden from social activity, and informal support influenced life satisfaction. Put differently, the higher the subjective health status of a caring spouse, the higher the income level, the lower the social activity burden, the stronger the informal support, and the greater the life satisfaction. Third, the interaction terms of social activity burden and informal support were significant. Therefore, informal support had a moderating effect on the relationship between social activity burden and life satisfaction among the elderly with dementia. In other words, even though the caring spouses experienced a burden from social activities, the higher the frequency with which they accessed informal support, the lower the decrease in life satisfaction.

Development and Application of Simulation-based Nursing Education Program for Post-myomectomy Care in Nursing Students (간호 대학생의 시뮬레이션 기반 자궁근종절제술 후 간호교육 프로그램 개발과 적용)

  • Kim, Hee Sook;Noh, Gie Ok
    • Journal of East-West Nursing Research
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    • v.22 no.1
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    • pp.60-67
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    • 2016
  • Purpose: This study was conducted to develop and apply simulation-based nursing education program for post-myomectomy care in nursing students. Methods: One group pre-post design was utilized. One hundred and thirty two participants consisting of 66 nursing students 132 participants consisting of 66 nursing students team were recruited. The data were collected from March 2 to June 12, 2015. Eight hours of simulation-based education program for post-myomectomy care was operated. Forty five items of Clinical Competence Assessment Scale was developed and content validity was tested using the content validity index. Results: The total score of Clinical Competence Assessment Scale was 90 and mean score of it was 82 (SD 4.2). The item showing the lowest mean score was 'education for Foley catheter management'. Mean score of performance was 92.7%, education 90.2% and assessment 89.9% respectively. Conclusion: The findings suggest that it would be useful to use the simulation-based education program for post-myomectomy care for evaluating clinical performance in nursing students.

Factors influencing Symptom Experience in Patients with Liver Cirrhosis (간경변 환자의 증상경험에 영향을 미치는 요인)

  • Kim, Soo Hyun
    • Korean Journal of Adult Nursing
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    • v.17 no.2
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    • pp.248-258
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    • 2005
  • Purpose: The purpose of this study is to examine the factors influencing symptom experience in patients with liver cirrhosis(LC). Method: A descriptive correlational study design was used. A convenience sample of 129 subjects was recruited from the gastroenterology department at two university hospitals in Seoul, Korea. Symptom experience in LC was measured with the instrument developed by the researcher based on Theory of Unpleasant Symptoms(Lenz et al, 1995) and the Child-Pugh Score, the Korean version of Profile of Mood States, and the Family Support Questionnaire were used to identify the factors influencing symptom experience. Results: The mean score of symptom experience was relatively low(M=41.67, SD= 24.71). Among individual symptoms, fatigue had the highest score in all dimensions. Fatigue, abdominal distension and/or peripheral edema, muscle cramps, dry mouth, and change in appearance were explored as symptoms needing management. In the regression analysis, symptom experience was found to be influenced significantly by anxiety/depression($R^2=.418$, p=.000) and the severity of LC(Child-Pugh Score)($R^2=.125$, p=.000). These variables explained 54.3% of the variance in symptom experience(F=63.607. p=.000). Conclusion: It suggests that nurses need to take into consideration psychological factor as well as physiological factor in symptom management for patients with LC.

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Temperament and Character Profiles of Sasang Constitution in Middle School Students (중학생에서 기질 및 성격검사를 이용한 사상체질 특성 연구)

  • Sung, Won-Young;Kim, Ji-Young;Kim, Lak-Hyung
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.3
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    • pp.55-64
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    • 2011
  • Objectives : The purpose of this study was to compare the profiles of Junior Temperament and Character Inventory (JTCI) and Sasang constitution in middle school students. Methods : In this study, healthy 89 students(13 to 15 years old) except for 3 Taeyangin were analyzed; 37 Soyangin, 30 Taeeumin, 22 Soeumin. The Sasang Constitutional types were determined by the results of TS-QSCD(Two Step Questionnaire for Sasang Constitution Diagnosis) and the seven dimensions JTCI 12-18(The Junior Temperament and Character Inventory) were compared among the different Sasang types using analysis of variance(ANOVA). Results : In the temperament dimensions, Soyangin showed significantly higher score than Taeeumin and Soeumin in Novelty Seeking(NS). Soeumin showed significantly higher score than Soyangin in Harm Avoidance(HA). Soyangin showed significantly higher score than the others in RD(Reward Dependence) (Soyangin>Soeumin>Taeeumin). In the character dimensions, Soyangin showed significantly higher score than Soeumin in SD(Self-Directness). There were no significant differences in P(Persistence), and C(cooperativeness) and ST(self-transcendence). Conclusions : These results demonstrate that there are some differences of the temperaments and characters among Sasang types and could help adolescents to understand and develope themselves.

Osteoporosis in Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서의 골다공증에 관한 연구)

  • Kim, Seong-Ja;Lee, Young-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.90-96
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    • 1999
  • Background : Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. Method: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar. USA). Results: Mean bone mineral density(BMD) of spine in COPD group was $0.683{\pm}0.154 g/cm^2$ and $0.971{\pm}0.212g/cm^2$ in controls(p<0.01). But there was no significant difference in femoral neck BMD. There were seventeen cases of osteoporosis and six cases of osteopenia in COPD group and three patients of osteoporosis and one case of osteopenia in controls. But, there was no significant correlation between disease duration of COPD and spinal T score(r=-0.395, p>0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were $-3.82{\pm}0.94(SD)$ and $-2.82{\pm}0.97(SD)$ in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T score(r=-0.457. p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls($0.71{\pm}0.13 g/cm^2$ and $0.97{\pm}0.21 g/cm^2$, p<0.01). Conclusion : Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

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Treatment of Extremely High Risk and Resistant Gestational Trophoblastic Neoplasia Patients in King Chulalongkorn Memorial Hospital

  • Oranratanaphan, Shina;Lertkhachonsuk, Ruangsak
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.925-928
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    • 2014
  • Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.

The effectiveness of Cardiopulmonary Resuscitation training in elementary students (일부 초등학생의 심폐소생술교육의 효과)

  • Kim, Hee-Jung;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.2
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    • pp.51-66
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    • 2007
  • Purpose: With a view to providing basic data to develop cardiopulmonary resuscitation education suitable for elementary students, the cardiopulmonary resuscitation education was conducted to grasp students' knowledge, skills accuracy and the attitude change before and after the education. Methods: Convenience sampling was made on fourth and fifth graders(total-35 students) of S elementary school located in K city, Chungcheongnam-do, and this was a pre-experiment research designed before and after choosing a single group. In terms of methods, specifically we, researchers ; 1) Handed out questionnaires to students directly to make them fill in firsthand and collected the questionnaires. 2) Utilized PPT materials based on 2005 AHA guideline and DVD materials of AHA, to give students theoretical education of cardiopulmonary resuscitation. We used Anne/SkillReporter$^{(R)}$ torso produced by Leardal Inc, and Little Anne to conduct practical education individually. 3) Asked students to give Anne/SkillReporter$^{(R)}$ torso cardiopulmonary resuscitation five times with the ratio of 30 : 2, and then one of researchers filled in the evaluation sheet individually. 4) Evaluated the accuracy of students' ability to perform the resuscitation based on the record of Anne/SkillReporter$^{(R)}$ integrated printer(which was the objective tool to grasp students' skills accuracy). 5) Gave out questionnaires to make students fill them in and then collected them. after completing the practical evaluation. Results: 1) In case of the attitude about cardiopulmonary resuscitation, Students' confidency rose from 19.28%(before the education) to 93.57(after the education)- which is a positive change. 2) As the result of the education, some elementary students scored 11 points (full score-16 points), up from 5 points before the education, in terms of the knowledge about cardiopulmonary resuscitation. The average point also reached 13.14 points(after the education), jump from 8.37(before the education), which was the rise of 29.8%. 3) When it comes to the practical performance, the skills accuracy was 80.93% on average, and the calculation method was as follows: total items were 16, and each item was marked form 0 to 2 points, meaning the full score was 32 points. The minimum score was 19 points and the maximum was 32($M{\pm}SD=25.90{\pm}2.88$), which was calculated based on percentage. 4) Regarding skills accuracy, respiration accuracy(%)($M{\pm}SD=30.20{\pm}27.16$) was higher than pressure accuracy(%) ($M{\pm}SD=15.34{\pm}25.27$). Conclusion: The result showed that students' attitude on cardiopulmonary resuscitation changed positively. and meaningful difference(p = .00) existed in the change of students' knowledge. In terms of skills accuracy. chest compression and airway control showed high accuracy, but the result of Anne/SkillReporter$^{(R)}$ performance showed that the accuracy of chest compression was lower than that of mouth-to-mouth resuscitation.

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Case Series of Patients with Parkinson Syndrome visited in Oriental Medicine Hospital (한방병원에 내원한 파킨슨 증후군 환자 증례군 보고)

  • Lee, Seung-yeop;Kim, Mi-young;Kim, Young-jee;Choi, Won-woo;Min, In-kyu;Sun, Jong-joo;Hong, Jin-woo;Na, Byong-jo;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Kim, Young-suk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.8 no.1
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    • pp.34-39
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    • 2007
  • Objective : To report cases of patients with Parkinson's syndrome. Design : Case-series Patients and methods : 35 of patients with Parkinson's syndrome who visited Department of Cardiovascular and Neurologic Diseases of Kyunghee Oriental Medical Center were treated by acupuncture and herbal medicine from May until December 2007. 35 patients were participated in this study. 21 patients were dropped out during the trial, and we evaluated symptom progress of 14 patients by using several questionnaires such as Unified Parkinson's Disease Rating Scale(UPDRS), modified Hoehn & Yahr stage (H&Y stage) and Schwab & England ADL scale(S&E ADL scale). Results : The whole group consists of 14 male patients and 21 female patients. Mean±SD age range is 64.5±8.4. There were no significant differences of the demographic and clinical characteristics between the case group and drop-out group. The mean±SD medical treatment period of the Case group were 8.4±6.3weeks, the mean±SD of the total score in first medical treatment UPDRS section 1~3 were 29.6±11.0, the mean±SD of the final score were 27.1±12.6, all of which showed significant improvement(p=0.007). There were no significant changes on the H&Y stage and S&E ADL scale. Conclusion : Patients with Parkinson's syndrome who visited Department of Cardiovascular and Neurologic diseases of Kyunghee Oriental Medical Center had a tendency of showing improvement in clinical symptoms.

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