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Total Delay for Treatment among Cancer Patients: a Theory-guided Survey in China

  • Feng, Rui;Wang, De-Bin;Chai, Jing;Cheng, Jing;Li, Hui-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4339-4347
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    • 2014
  • Purpose: This study aimed at exploring treatment delay (TD) among cancer patients in China with an attempt to develop a practical methodology facilitating frontline Chinese clinicians in promoting earlier cancer diagnosis and treatment. Materials and Methods: The study comprised framework development, qualitative interviews and paired factor rating. Framework development utilized systematic literature review, soft systems thinking and consensus groups. Qualitative interviews employed a checklist of open questions soliciting information about all the domains included the framework from cancer patients drawn via stratified randomized sampling of inpatients at 10 hospitals in Hefei, China. Paired factor rating used a self-developed computer aid and the interviewed patients as referring cases to weigh the relative importance of the factors listed in the framework in terms of their contributions to specific components of total delay (TD). Results: a) A conceptual framework was proposed consisting of a 6-step path to TD and 36 category determinants. b) A total of 227 patients were interviewed; their TD was 267.3 mean or 108 median days ranging from 0 to 2475 days; average appraisal, illness, behavioral, preparation and treatment delay accounted for 52.1%, 9.4%, 0.30%, 8.8% and 29.4% of the TD respectively. Individual side factors were rated substantially more important than environmental side factors (60% vs. 40%); most influential TD factors included cancer symptoms, overall health, family relations and knowledge about cancer and health. Conclusions: The framework proposed together with the interviewing and rating approaches used provide a potential new methodology for understanding cancer patients' TD and promoting earlier cancer treatment.

Improving Safety-Related Knowledge, Attitude and Practices of Nurses Handling Cytotoxic Anticancer Drug: Pharmacists' Experience in a General Hospital, Malaysia

  • Keat, Chan Huan;Sooaid, Nor Suhada;Yun, Cheng Yi;Sriraman, Malathi
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.69-73
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    • 2013
  • Background: An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions. Materials and Methods: This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates. Results: The mean age of nurses was $32.2{\pm}6.19$ years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from $45.5{\pm}10.52$ to $73.4{\pm}8.88$ out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from $7.6{\pm}5.51$ to $15.3{\pm}2.55$ out of 20 (p<0.001). Conclusions: The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.

수원시내 일부 초등학생의 식행동과 주의력결핍 과잉행동장애 수준과의 관계 연구 (Relationship between Food Behavior and Level of Attention Deficit Hyperactivity Disorder in Elementary School Students in Suwon-si, Korea)

  • 이혜련;김형숙
    • 대한영양사협회학술지
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    • 제21권2호
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    • pp.110-122
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    • 2015
  • The purpose of this study was to investigate the correlation between food behavior and Attention Deficit Hyperactivity Disorder (ADHD) score in elementary students in Suwon-si, Gyeonggi-do. Two hundreds and thirty two students (113 male and 119 female) in grades 4~6 participated. We assessed food behavior by using Nutrition Quotient (NQ). NQ was examined by an NQ questionnaire, which consisted of 19 food behavior checklist items. Their items were grouped into five categories: balance, diversity, moderation, regularity, and practice. All data were statistically analyzed by SPSS 18.0. Among the five factors, NQ for food behavior and balance factor showed the lowest score, whereas that of diversity factor showed the highest score. The final Nutrition Quotient (NQ) score weighted on such five factors was 62.59 points. The average level of ADHD by Conners-Wells Adolescent Self-Report Scale (Short Form) [CASS(S)] was 17.02 points out of a total of 81 points. Six students (2.2%) who scored more than 41 points were classified as ADHD risk. By gender, male students (19.76 points) showed a higher CASS(S) score than female students (14.41 points) did. There was a significant negative correlation between NQ and CASS(S) score (r=-0.445, P<0.001). Multiple regression determined the effects of moderation ($Exp({\beta})=-0.193$, P<0.01) and practice ($Exp({\beta})=-0.345$, P<0.001) on CASS(S) score. In conclusion, distinctive nutritional education is needed for students with a high level of ADHD to help their understanding considering their different levels of attention.

0-8세 아동의 사회정서 발달과 어머니의 심리적 특성 : 보령 베이비패널 자료를 중심으로 (0-8 Children's Socio-Emotional Development and Mothers' Psychological States : Based on Boryung Baby Panel Data)

  • 박혜준;한경혜;박새롬;장미나;전을정
    • 가정과삶의질연구
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    • 제31권1호
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    • pp.11-27
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    • 2013
  • The purpose of this study was to investigate the overall developmental characteristics of Korean children ages 0 to 8, and then explore specifically how children's social and emotional developmental levels are related to mothers' psychological states. This study was part of newly launched Boryung Baby Panel Study using web-based survey in 2011. The subjects were all mothers of 940 infants(0-2 years), 654 toddlers(3-5 years), and 484 school-age children(6-8 years) The mothers were asked to administer the web-based standardized developmental checklist for their child and fill out the questionnaires of psychological variables(life satisfaction, depression, parenting attitude, parenting efficacy, and parenting stress). The data was analyzed using descriptive analysis, t-test, and logistic regression for SPSS 20.0 windows. Major findings were as follows: 1. Infants(0 to 2) showed higher developmental level in cognition and fine motor skill domain compared to other domains. 2. Most toddlers(3 to 5) showed normal development in the most domain such as gross motor skill, fine motor skill, language, letter, number, self-help behavior. 3. In socio-emotional development domain, the ratio of risk or delay group were highest at both infant and toddler. 4. The 6-8 years old children that belong to risk group by the result of SDQ(emotion and behavior assessment) were also relatively high. 5. The relation of the children's socio-emotional developmental level and the mother's psychological variables were reciprocal. Based on these findings, the implications and the limitations of current study were discussed.

류마티스 건강학회지 창간호부터 10년간의 실험연구 분석을 통한 연구 경향 분석 (An Analysis of Trends in Nursing Research Utilizing Experimental Designs)

  • 박경숙;최은희;황윤영;안양희;정혜경;백훈정;류언나;이은옥
    • 근관절건강학회지
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    • 제11권2호
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    • pp.136-152
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    • 2004
  • Purpose: The purpose of this study was to summarize trends and status of nursing research utilizing experimental designs in the Journal of Rheumatology Health over the past 10 years. Method: The Journal of Rheumatology Health published 37 experimental research articles between 1994 and 2004. These articles were included in a retrospective descriptive analysis. A checklist was utilized for data collection. Results: Qoasi-experimental researches were more frequent than pre-experimental research, but there were 8 research studies which had no hypothesis. The most frequently used nursing interventions were exercise/movement, and cognitive, followed by sensitive, and social interventions. There were very few research studies that used random assignment for internal validity. The rate of effectiveness of self-help interventions was lower than socio-psychological, cognitive, or motor-physical interventions. There was no research regarding families of patients with rheumatoid disease. Conclusion: Rigorous experimental research design is needed for internal and external validity in future research. Generalizing the effects of nursing interventions that are the results of rigorous experimental designs will contribute to promote the quality of life of patients with rheumatism and their families.

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직무 관련 스트레스, 문제해결양식이 소방대원의 심리적 디스트레스에 미치는 영향 (Effects of Job-related Stress and Problem Solving Styles on Psychological Distress of Firefighters)

  • 고진경;박재성
    • 한국화재소방학회논문지
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    • 제24권6호
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    • pp.133-138
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    • 2010
  • 본 연구는 소방대원의 직무 관련 스트레스, 문제해결양식과 심리적 디스트레스의 관계를 검증하고 직무관련 스트레스, 문제해결양식이 심리적 디스트레스에 미치는 영향을 살펴보고자 하였다. 이를 위해 소방대원의 스트레스의 심각도를 측정하는 스트레스 척도, 문제해결양식 척도 그리고 정신진단척도를 사용하여 스트레스의 양상, 문제해결양식과 심리적 디스트레스 간의 상관분석 및 회귀분석을 시행하였다. 상관분석 결과, 두 가지 직무 관련 스트레스와 심리적 디스트레스가 정적인 상관을 보이며, 문제해결양식의 무기력감과 문제에 대한 통제감이 심리적 디스트레스와 정적인 상관관계를 나타내고, 문제해결에 대한 자신감과 접근적 문제해결양식은 심리적 디스트레스와 부적인 상관관계를 보였다. 직무관련 스트레스와 문제해결양식이 심리적 디스트레스를 예측하는 정도를 파악하기 위해 시행한 중다회귀 분석결과, 직무 관련 스트레스 중에 부정적 인지와 정서, 문제해결양식 중에는 무기력감과 접근적 문제해결양식이 심리적 디스트레스에 유의한 영향을 끼치는 것으로 나타났다. 문제해결양식 중 무기력감이 심리적 디스트레스를 가장 크게 예측하였는데, 이는 직면한 문제를 효율적으로 해결하지 못한 것에 대한 자책과 함께 직업적 자존감(selfesteem)까지 저하시켜, 효율적인 직무수행에 부정적인 영향을 줄 수 있다.

자연유산을 경험한 여성의 신체적 증상 및 심리적 증상 관련요인 (Factors of Physical and Psychological Symptoms in Women after Miscarriage)

  • 정재원;정혜선;윤순녕;신종철;박현주;한미연
    • 여성건강간호학회지
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    • 제15권4호
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    • pp.303-311
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    • 2009
  • Purpose: The study aimed to explore the health consequences that women experienced after miscarriage and the factors related to them. Methods: A convenience sample consisting of 102 women who had miscarried within 2 years was used. Women were recruited from hospitals and enterprises in Seoul and Gyeong-Gi Province. Participants completed a self-administered questionnaire containing a physical and psychological symptoms checklist developed for this study. Results: More than 40% of the miscarriages occurred after 9 weeks of pregnancy and 35% of women were found to have had a previous miscarriage prior to this study. Psychological symptoms were more prevalent and prolonged than the physical symptoms, furthermore, the frequencies of the symptoms experienced were not consistent with the duration of symptoms. Employed women and women with early miscarriages complained of more physical symptoms; however, psychological symptoms were not different according to women's characteristics. Employment was a significant factor affecting physical symptoms. Conclusion: Health care professionals need to inform and educate women and the family of the potential health changes during the recovery after the miscarriage. Health consequences due to miscarriages also need to be incorporated in women's reproductive health care. Nursing care should consider factors of maternal age, employment status, and obstetrical conditions upon the apparent social changes.

Relationships of Fear of Breast Cancer and Fatalism with Screening Behavior in Women Referred to Health Centers of Tabriz in Iran

  • Ghahramanian, Akram;Rahmani, Azad;Aghazadeh, Ahmad Mirza;Mehr, Lida Emami
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권9호
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    • pp.4427-4432
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    • 2016
  • Background: Fear and fatalism have been proposed as factors affecting breast cancer screening, but the evidence is not strong. This study aimed to determine relationships of fear and fatalism with breast cancer screening behavior among Tabriz women in Iran. Materials and Methods: In a cross- sectional study, 370 women referred to 12 health centers in Tabriz were selected with two-stage cluster sampling and data regarding breast cancer screening, fatalism and fear of breast cancer were collected respectively with a checklist for screening performance, Champions Fear and Pow Fatalism Questionnaires. Data were analyzed by logistic regression with SPSS software version 16. Results: Only 43% and 23% of participants had undergone breast self- examination and clinical breast examination. Among women older than 40 years, 38.2% had mammography history and only 2.7% of them had done it annually. Although fatalism and fear had a stimulating effects on breast cancer screening performance th relationships were not significant (P>0.05). There was a negative significant correlation between fear and fatalism (r= -0.24, p=0.000). On logistic regression analysis, age (OR=1.037, p<0.01) and income status (OR= 0.411, p<0.05) significantly explained BSE and age (OR=1.051, p<0.01) and body mass index (OR= 0.879, p<0.01) explained CBE. Also BMI (OR= 0.074, p<0.05) and income status (OR=0.155, p<0.01) was significantly effective for mammography following. Conclusions: Breast cancer screening behavior is inappropriate and affected by family livelihood status and lifestyle leads to weight gain, so that for promoting of screening behaviors, economic support to families, lifestyle modification and public education are suggested.

한국판 상태-특성 분노표현척도를 이용한 한국 청소년의 분노 평가 및 우울과의 관계 (Anger Assessment Using State-Trait Anger Expression Inventory in Middle-School Students in Korea and Association with Depression)

  • 김희연;이명훈;배재남;김철응;유희정;이정섭
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제26권4호
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    • pp.288-294
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    • 2015
  • Objectives : The purpose of this study was to assess anger of middle school adolescents in an urban community using State-Trait Anger Expression Inventory (STAXI)-Korean and Korean Child Behavior Checklist (K-CBCL), and to determine whether specific anger expression of adolescents is associated with certain psychopathology including depression. Methods : Data were collected from 395 middle school students and their parents in Incheon city. The students completed the STAXI, Children's Depression Inventory, Korean version of Mood disorder Questionnaire, and Conners-Wells' Adolescent Self-Report Scale (Short Form), and their parents completed the K-CBCL. Results : No significant correlation was observed between aggression subscale K-CBCL and each scale of the STAXI, except anger out (r=0.704). The scores for STAXI total and respective scales were significantly higher for female students than male students. A stepwise logistic regression model was used to explore the possible predictors for depression in adolescents and lower anger control and higher anger suppression were found to be predictors for depression in adolescence. Conclusion : There is a possibility of a large discrepancy between anger that the adolescents actually feel and parents' judgment of their children's anger. It must be considered in assessment of adolescent anger and use of further structured interviews is necessary. In addition, it may be useful to consider the anger expression style in adolescents who report depressive symptoms.

남자소방공무원의 외상 후 스트레스와 대처방식이 문제음주에 미치는 영향 (Effect of Post-traumatic Stress and Ways of Stress Coping on Problem Drinking in Firefighters)

  • 전경선;강경아
    • 한국직업건강간호학회지
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    • 제26권4호
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    • pp.218-226
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    • 2017
  • Purpose: The study aimed to determine the impact of post-traumatic stress and ways of stress coping on problem drinking in firefighters. Methods: Data were collected from May 11 to June 11, 2015, in fire brigades across South Korea. Participants were 183 male firefighters who used self-report questionnaires containing questions from the Impact of Event Scale-Revised (IES-R), Ways of Coping Checklist (WCC), and Alcohol Use Disorders Identification Test (AUDIT). Data were analyzed using $x^2$ test, t-test, and logistic regression with the SPSS/WIN 21.0 program. Results: The prevalence of PTSD among firefighters was 36.7% and that of problem drinking was 39.3%. Firefighters with single (OR=0.23, 95% CI=0.038~1.321) and married status (OR=0.46, 95% CI=0.069~3.040) were less likely to have problem drinking than those who were divorced or bereavement. Those with invasion symptoms (OR=1.17, 95% CI=1.031~1.327) and hyperarousal symptoms (OR=0.85, 95% CI=0.722~0.989) were more likely to have problem drinking than those with avoidance symptoms. Conclusion: Post-traumatic stress symptom was a major risk factor that increased problem drinking, and married status reduced problem drinking. There is a need to develop post-traumatic stress symptom management program and early education content for symptom management.