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This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS).
A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA.
At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24,
The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.
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This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model.
The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs.
The modified model was a good fit for the data. The model fit indices were χ 2=423.18 (
These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.
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The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer.
A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast.
Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group.
These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.
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The purpose of this study was to test the mediating effect of social support and resilience on the relationship between symptom distress and coping in young Korean breast cancer survivors.
A purposive sample of 209 young breast-cancer survivors (mean age 39.9) was recruited for a cross-sectional survey, and the data were collected between June and October 2015. The instruments used in this study were the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, 10-item Connor-Davidson Resilience Scale, and Cancer Coping Questionnaire. The collected data were then analyzed using the SPSS 23.0 and AMOS 23.0 programs.
Symptom distress was found to have a significant indirect effect on coping (beta=-.32,
Based on the results of this study, it can be suggested that in order to enhance young breast cancer survivors’ ability to cope with the distress they commonly feel, intervention methods that strengthen resilience and provide social support should be developed and made available to them.
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The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients.
This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis.
Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (b=-.39,
Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.
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The purpose of this study was to examine the effect of supportive nursing one stress reaction of breast cancer patients undergoing chemotherapy. The nonequivalent control group pre-test/post-test design was used for this experimental study. The subjects were 32 patients who were receiving chemotherapy after mastectomies at K hospital in Taegu from June, 1994 to June 1995. Among 32 subjects, 16 were placed in the experimental group and 16 in the control group. The experimental and control groups were tested for general characteristics, trait anxiety, health locus of control, family support, state anxiety, hopelessness, physical stress, and anxiety behavior. Collected data was analyzed by means of a chisquare test and a t-test for the comparative analysis of the general characteristics and homogeneity of subjects. ANOVA, and MANOVA were used for testing the hypothesis. Reliability of the tools were analyzed using the Pearson Correlation coefficient. The results of this study were as follows : 1. The hypothesis ; The stress reaction of the experimental group which took supportive nursing was lower than the stress reaction of the control group ; this was supported statistically. The main variable influenced in stress reaction was hopelessness. Supportive nursing for breast cancer patients, who are receiving chemotherapy, was especially effective in the reduction of hopelessness compared to state anxiety, physical stress, and anxiety behavior. 2. An analysis of the difference on stress reaction, according to the frequency of supportive nursing between the control and experimental group showed the level of hopelessness of the experimental group was lower than the control group after four supportive meeting sessions. But there was no statistical difference in state anxiety, physical stress, and anxiety behavior. In conclusion, this study supported utilization of supportive care as well as demonstrating the effectiveness of the System-Developmental Stress Model developed by Chrisman and Riehl-Sisca.

The majority of studies on breastfeeding consists of descriptive correlational studies identifying the incidence and correlates of breastfeeding. The theory of planned behavior has been shown to yield great predictive power for behavioral goals over which individuals have only limited control such as improving school grades and weight loss. The purpose of this study was to test the "theory of planned behavior" in the prediction of breastfeeding of mothers who delivered vaginally. One hundred mothers who delivered vaginally in one general hospital in Seoul and one general hospital and three private hospitals in Taejeon participated in this study. The instruments used for data collection in this study were developed by the researchers following the guidelines suggested by Ajzen and Fishbein(1980) and Ajzen and Madden(1986). The instruments included measurement of attitude, subjective norm, perceived behavioral control and intention. The collected data were analyzed using descriptive statistics, Pearson product moment correlation, hierachical multiple regression and logistic regression. The results are as follows : 1. Intention to breastfeed correlated significantly with attitude, subjective norm and perceived behavioral control. Both attitude and subjective norm did not make a significant contribution to the prediction of intention, but the addition of perceived behavioral control to the regression equation greatly improved the model's predictive power, increasing the R(2) from .05 to .52. 2. Intention to breastfeed alone had a significant predictive effect on actual breastfeeding, resulting in a regression coefficient of .16(x2=8.60, p<.01), but when perceived behavioral control was added to the equation, intention was not a significant predictive variable and only perceived behavioral control showed significant predictive power on actual breastfeeding, resulting in a regression coefficient of .12(x2=4.68, p<.05). In sum, breastfeeding behavior lent only partial support to the second version of the theory of planned to the second version of the theory of planned behavior, and because perceived behavioral control had a strong effect on intention to breastfeed and actual breastfeeding, it would be desirable to develop nursing intervention programs which focus on strengthening the perceived behavioral control for the promotion of breastfeeding.
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The purpose of this study was to understand the subjective breastfeeding experience of primiparous women to identify how breastfeeding was started and to explore the process of breastfeeding. The Grounded theory methodology was used. Data was collected from 6 primiparous women who had breastfeed their infants for at least over 8 weeks, recently breastfeeding or having breatfeed their infants within the last 6 months. With the permission of the subjects, the interviews were recorded and transcribed. The data were analysed in the framework of grounded theory method as mapped out by Strauss and Corbin(1990). 105 concepts and 21 subcategories were of data analysis. In the process of data analysis, "Identity as a mother" was found to be the core phenomenon. The 21 sub-categories were as follows : natural food, neighbour inducement, self purpose, good feeling, tenderness, breast pain, change of breast shape, physical discomfort, loss of physical energy, confirmation of adhesion, one body through coupling, tie, capacity, role performance, mental comfort, healthy mother, healthy infant, confidence of breast milk, feeling of satisfaction. The sub-categories were again grouped into 14 categories including infant nutritious food, formation of breastfeeding opportunity, feeling of satisfaction, injury of the breast, physical suffering, awareness of mothering, formation of maternal affection, connecting, coupling, acceptance, effort, emotional stability, mother and child health and feeling of achievement.
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BACKGROUND: Pediatric societies throughout the world recommend breastfeeding as the optimal form of infant nutrition. This recommendation is based on extensive epidemiologic research that documents the health, developmental, psychological, social, economic, and environmental benefits to infants, mothers, families, and society. The purpose of this study was to examine breastfeeding information and emotional support received by mothers prenatally, hospital breastfeeding practices, and the relationship between information and support received and breastfeeding initiation and planned feeding method post discharge from the hospital.
METHODS
A 36-item questionnaire was distributed during the Spring 2000 to mothers who delivered babies at maternity centers in Seoul, South Korea. A sample of 52 mothers was surveyed at the time of hospital discharge. The questionnaire was developed based on the literature and reviewed by experts including internationally board certified lactation consultants, a nutritionist, and perinatal nurses. The survey instrument consists of five components: sociodemographic information, breastfeeding information received by mothers prenatally, emotional support regarding the mothers' infant feeding choice, breastfeeding initiation and supplementation, and hospital breastfeeding practices.
RESULTS
Fifty-two breastfeeding mothers at three hospitals completed the survey. The majority of the mothers were 26 to 35 years of age, college graduates, married, had uncomplicated vaginal or planned cesarean deliveries, and primiparas. Forty-nine mothers responded that they decided to breastfeed during their pregnancy. Mothers reported that the information they received during pregnancy was provided primarily by their mothers, or friends and other relatives. The majority of mothers reported that others influenced their infant-feeding decision. Forty mothers reported receiving emotional support for their infant feeding choice during their pregnancy with mothers or mothers-in-law and friends providing the greatest support.
DISCUSSION
Women obtain information prenatally about breastfeeding from many sources-family, friends, written materials, prenatal classes, and health care professionals. There are benefits and drawbacks to information received from multiple sources. Additionally, research has shown that a woman's infant-feeding decision is affected by the type of professional and social support the mother receives. Postpartum professional support for new breastfeeding mothers encompasses multiple dimensions ranging from a follow-up telephone call from the hospital nursing staff to referral to a community resource. Prenatal breastfeeding education on a community-wide basis can provide essential information for future mothers, families, and community support networks. Additional research needs to be done exploring the impact of prenatal, postpartum, and post-discharge support for women on breastfeeding initiation and duration rates.
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PURPOSE: The purpose of this study was to determine the effects of exercise program
on cardiopulmonary functions and shoulder joint functioning in breast cancer patients who
under- went radiation therapy after surgery. METHOD: Subjects in the experimental
group(N=12) participated in an exercise program for eight weeks. The Exercise program
consisted of shoulder stretching, arm weight training, and walking on treadmill. Maximal
oxygen uptake(o2max), maximal running time, shoulder joint range of motion, and
shoulder functional assessment were determined before and after the exercise program.
Baseline sociodemographic and medical data were compared between experimental group
and control group using the Fisher's exact test and Mann- Whitney U test. For effects
of the exercise program, repeated measures ANOVA were used. RESULT: 1) Following
the exercise program for eight weeks, both o2 max and maximal running time tended
to increase in experimental group comparing with the control group. 2) Shoulder
abduction, extension and flexion of the operated upper extremity in the experimental
group comparing with control significantly increased after the exercise program(p<0.05).
3) Shoulder flexion of the normal upper extremity in the experimental group comparing
with control significantly increased after the exercise program(p<0.05). CONCLUSION: The
results
suggest that the exercise program for breast cancer patients undergoing radiation
therapy after breast surgery can improve shoulder functions and increase
cardiopulmonary functions, which are maximal oxygen uptake and maximal running time.
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The purpose of this quasi-experimental study was to explore the effect of aromatherapy massage on the mood, the milk ejection reflex, and the immunoglobulin A of the breast milk of mothers who gave birth through a Cesarean section delivery. Twenty mothers who had Cesarean section were selected as an experimental group, and twenty-two were in the control group. Lavander and Rosemary oil mixed with Jojova carrier oil was used to massage the back, both axillar and breasts. Aromatherapy massage was done once a day for 20 minutes by the researcher. Each session consisted of 4 minutes for warm-up, 14 minutes for massage and 2 minutes for closure. The levels of IgA within the breast milk was analyzed by an immunoturbidimeter assay (Cobas INTEGRA, Roche, Swiss) before and after aromatherapy massage. Mood and milk ejection reflex were measured by self-reports at the same time. The data were analyzed using SPSS 7.5 and the hypotheses were tested by ANCOVA and the Pearson coefficient correlation. The results were as follows: 1) Score of mood increased significantly after the use of aromatherapy massage. 2) Score of milk ejection reflex increased significantly after the use of aromatherapy massage. 3) Level of IgA of breast milk did not change significantly after the use of aromatherapy massage. 4) After the use of aromatherapy massage, there wasn't any correlation among mood, milk ejection reflex, and level of IgA of breast milk. In conclusion, the results suggest that aromatherapy massage is an effective nursing intervention to enhance the mood and the milk ejection reflex and to increase the rate of breastfeeding in the breastfeeding mothers under stresses like a Cesarean section.

The purpose of the present study is to identify the mediation effect of hope between fatigue and psychosocial adjustment in women with breast cancer. The framework for this study was guided by concepts and propositions derived from the theoretical and empirical literature on fatigue, hope and adjustment. The design of this study is a descriptive correlation study using a cross-sectional design. One hundred and twenty two outpatients with early breast cancer, receiving post-surgical radiation therapy or chemotherapy, were selected from three major medical centers in Seoul, Korea. A packet including PABCF (Psychosoical Adjustment to Breast Cancer Factor), revised RPFS (Revised Piper Fatigue Scale), HHI (Herth Hope Index), and self-addressed return envelope was given to the participants at seven to eight weeks post surgery. The questionnaires were to be completed at home and returned to the researcher by mail. The obtained data were analyzed using three regression equations guided by Baron and Kenny (1986); first, hope was regressed on fatigue; second, psychosocial adjustment was regressed on fatigue; and third, psychosocial adjustment was regressed on fatigue and hope, simultaneously. In the first equation, fatigue explained 4% of the variance in hope. In the second equation, fatigue explained 47% of the variance in psychosocial adjustment. In the last equation, hope and fatigue significantly explained the variance in psychosocial adjustment. Therefore, all conditions for the test of mediation effect of hope were satisfied. For the test of the mediation effect, the beta coefficients of fatigue on psychosocial adjustment on the second and third regression equations were compared. The beta coefficients were decreased from .69 (p < .001) on the second regression equation to .63 (p < .001) on the third regression equation. Thus, the hypothesis of this study was supported. As a result of this study, the negative Influence of fatigue on psychosocial adjustment is dampened through the mediator effect of hope in women with breast cancer. Therefore, when planning care for the adverse effect of fatigue on psychosocial adjustment, oncology nurses should consider hope as a mediator between fatigue and psychosocial adjustment to breast cancer.
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To determine whether personal history of lactation in premenopausal women influence bone mineral density, a cross-sectional study was conducted. One hundred eighty-four premenopausal women were selected from women who had been checked for bone mineral density by dual energy x-ray absortiometry in lumbar spine, femoral neck, Ward's triangle, and trochanteric site at general hospitals in Seoul and Pusan. They completed a questionnaire including life style factors and reproductive history. In the data analysis, Pearson correlation coefficients were used to test any association between individual variables and bone mineral density and a statistical comparisons between long term lactation(>24 months) and short term lactation(<24 months) were made by one way analysis of covariance. The results were summarized as follows: 1) There was no significant difference in the bone mineral density of the lumbar vertebrae in premenopausal women between the long term lactation group(>24months) and the short term lactation group(<24months). 2) There was no significant difference in the bone mineral density of the femur neck, Ward's triangle, and trochanteric site in premenopausal women between the long term lactation group (>24months) and the short term lactation group (<24months). Considering these results, we suggest prospective studies that measure bone mineral density before and after, in addition to those during lactation. We also suggest the further study with premenopausal women less than 35 who have achieved peak adult bone mass.
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The Purpose of this study was to explore the meaning of breastfeeding using a phenomenological research methodology. The sample consisted of 9 primiparous mothers who had breastfed their babies at least for 3 consecutive months. Data were collected from January 10 to February 28, 1998 through interviewing. The research question was "What was the meaning of breastfeeding to breastfeeding mothers?" Responses to non-structured open-ended question was audio-recorded during the interview. Data were analyzed using the phenomenological method of Colazzi. From the protocols, significant statements about meaning of breastfeeding were clustered into 8 themes. Mothers perceived meaning of breastfeeding as feeling of unification through tie, expression of love, gift, nutritional supplement, duty as a mother, nurturing, mystery, and identity. From the results of this study, breastfeeding mothers perceived breastfeeding positively, so nurses need to encourage mothers to breastfeed her baby and develop program which can promote successful breastfeeding.

Breast self-examination is the most effective and easiest way for women to increase the responsible consciousness about their health. The purpose of this study was to test the variables impacted to promote breast self-examination practice. The research design used in this study was a nonequivalent control group of a non-synchronized design. The sample that was assembled consisted of 124 women. A purposive sample consisted of 124 omen. Each subject was given to assessed on the following the demographic data relate to the breast self-examination, knowledge of self-examination, accuracy, in performing self-examination, self-efficacy about breast cancer and breast self-examination, and the number of subjects who found a mass. The result of this study may be summarized as follows : 1. To examine the theoretical model fit to the data, chi square test statistics and goodness of fit index were identified(x2=2.30, df=2, GFI=0.99, AGFI=0.94 RMSR=0.02, NFI=0.99, NNFI=0.99, Critical Number=439). 2. The direct effects of education of breast self- examination were knowledge, self-efficacy, accuracy, number finding a mass. But the indirect effect of education in breast self-examination was frequency of breast self-examination. 3. Knowledge, as direct paths to the breast self-examination practices, was removed in the theoretical model. The parsimonious best fit model included self-efficacy, accuracy, the number finding mass, frequency of breast self-examination practices. 4. The final model produced a chi-square=5.58(p=0.35) with df=5, and GFI=0.99 AGFI=0.94, NFI=0.03, NFI=0.99, NNFI=0.99, CN=339 indicating very a good fit. Based on the result of this study, education of breast self-examination is very effective for increasing the competency of the breast self-examination through the knowledge and self-efficacy. Resources to promote self-examination may be helpful to increase the frequency of self-examination because self-efficacy is a direct effort on it. These findings suggest the need t develop nursing strategy to promote the self- efficacy of breast self-examination.
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By using Q-methodology, this study examines the attitudes of pregnant womens' husbands toward breastfeeding. Also, the research provides basic data necessary to develop a strategy for recommending breastfeeding. A total of 112 items for the Q-population were collected from related literature and interviews with the general public, specialists, pregnant women and the general public, specialists, pregnant women and their husbands. Finally, 38 statements were selected. Twenty one husbands of pregnant women classified these statements on each card on a 1 to 9 point scale(forced normal distribution) and wrote the reasons for both the most supported and the mos resisted statements. The materials collected were analyzed by using pc QUANL program. The analysis drew down following fact that even though the attitudes of the husbands of pregnant were very similar, they could be classified to three types according to the motivation and recognition the degree of choosing breastfeeding. Type 1 is the mother's duty supporter, who insists that breastfeeding is completely natural and the proper duty of the mother. Type 2 is the emotional value supporter, who thinks that breastfeeding emotionally affects both the baby and the mother in a positive way. Type 3 is the conditional choice supporter, who chooses the most proper suckling way of feeding according to given conditions.

This study examined what characteristics and variables predict participation in support groups for women with breast cancer.
282 women with breast cancer from 4 hospitals located in Busan were included in the study. Data was measured on each participant from September 2006 to February 2007. Data was collected using structured researcheradministered sheets and analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis.
The clients reported medium levels of illness perception, anxiety and depression, stress with coping, social support and self-efficacy. 48.9% of women with breast cancer participated in support groups. Significant influencing factors on the participation in support groups were 'operation time(+)', 'illness perception(+)', 'social support(-)', and 'self-efficacy(+)' Those variables explained 73.4%.
It is necessary to develop a strategy or promoting program for promotion of illness perception and self-efficacy of women with breast cancer. Thus, it is essential to provide participation to a support group to a women with breast cancer.
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This study was to identify predictors of quality of life in breast cancer patients. Physical and pscyhological factors like stress, mood, and fatigue with sociodemographic factors like education, income, job and stage of disease were used to predict quality of life.
One hundred eleven patients with breast cancer participated in this study? The functional Assessment of Cancer Therapy-Breast(FACT-B) was used to assess quality of life.
The mean age of the patients was 46.7 years. The FACT-B mean score was 89.89 (SD:17.31) Education, income, job and stage of disease were significantly associated with QOL. In a regression analysis, mood, income, and fatigue were significant predictors for QOL: where as, stress was not significant. Among the subscales of QOL, physical well-being, functional well-being, emotional well-being, and the breast cancer subscale were included as predictors of QOL
Physical and psychological factors were strong predictors of QOL. These results demonstrate the need for interventions to improve QOL in breast cancer survivors.
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Koreans are one of the fastest growing Asian populations in the U.S. since 1960s. In Korean immigrant women (KIW), breast cancer was reported as the most frequently diagnosed cancer. However, their screening rates for breast cancer are lower than national guidelines; it is assumed that underlying cultural schemas of breast, breast cancer, and its screening modalities exist and need to be studied. This study was aimed to investigate cultural meanings of breast, breast cancer, and breast cancer screenings in KIW.
Using cultural models theory from cognitive anthropology, naturalistic qualitative methodology was utilized. Three focus group interviews with fifteen KIW were conducted. Thematic analysis with constant comparison technique was performed eliciting units of meaning, categories, and themes.
The cultural schema of the meaning of breast is “mother who is breast-feeding her baby,” with two themes of “balance in size,” and “shyness.” Regarding breast cancer, three themes, i.e., “indifference,” “fear,” and “uncertainty” are emerged. “Lack of information about screening modalities” is the overarching schema with reference to breast cancer screenings.
The findings of this study demonstrate unique cultural models of KIW related to breast cancer and its screenings, which are critical to understand and penetrate their barriers to breast cancer screening.
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The purpose of this study was to investigate the effects of a rehabilitation program on physical health, physiological indicators and quality of life in breast cancer mastectomy patients.
The subjects included thirty-one patients with breast cancer (17 in the experimental group and 14 in the control group). The subjects in the experimental group participated in a rehabilitation program for 10 weeks, which was composed of an exercise program, teaching, counseling and support for 2 sessions per week.
There was a significant increase in flexion, internal rotation and external rotation but no significant increase in extension in the experimental group compared to the control group. The total cholesterol, triglyceride, HDL, LDL, and CD56 in the experimental group compared to the control group was not significantly decreased after the rehabilitation program. Compared to the control group, quality of life in the experimental group was significantly improved and fatigue in that group was significantly decreased after the rehabilitation program.
The 10-week rehabilitation program showed a large affirmative effect on physical health, physiological indicators and quality of life in breast cancer mastectomy patients.
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The purpose of this study was to determine the effect of EPMLM(educational program of manual lymph massage) on the arm functioning and QOL(quality of life) in breast cancer patients with lymphedema.
Subjects in the experimental group(n=20) participated in EPMLM for 6 weeks from June to July, 2005. The EPMLM consisted of training of lymph massage for 2 weeks and encourage and support of self-care using lymph massage for 4 weeks. The arm functioning assessed at pre-treatment, 2weeks, and 6weeks using Arm functioning questionnaire. The QOL assessed at pre-treatment and 6 weeks using SF-36. The outcome data of experimental group was compared with control group(n=20). The collected data was analyzed by using SPSS 10.0 statistical program.
The arm functioning of experimental group was increased from 2 weeks after(W=.224, p=.011) and statistically differenced with control group at 2 weeks(Z=-2.241, p=.024) and 6 weeks(Z=-2.453, p=.013). Physical function of QOL domain increased in experimental group(Z=-1.162, p=.050), also statistically differenced with control group(Z=-2.182, p= .030) at 6weeks.
The results suggest that the educational program of manual lymph massage can improve arm functioning and physical function of QOL domain in breast cancer patients with lymphedema.
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This study was to determine the effects of abdominal breathing training using biofeedback on stress, immune response, and quality of life.
The study design was a nonequivalent control group pretest-posttest, quasi-experimental design. Twenty-five breast cancer patients who had completed adjuvant chemotherapy were enrolled. The experimental group(n=12) was provided with abdominal breathing training using biofeedback once a week for 4 weeks. State anxiety, cancer physical symptoms, serum cortisol, T cell subsets(T3, T4, T8), NK cell and quality of life were measured both before and after the intervention.
Though state anxiety, cancer physical symptoms, and serum cortisol were reduced after 4 weeks of abdominal breathing training using biofeedback, there was no statistical significance. It showed, however, improvement in quality of life (p=.02), and T3(p=.04).
Abdominal breathing training using biofeedback improves quality of life in breast cancer patients after a mastectomy. However, the mechanism of this beneficial effect and stress response requires further investigation with special consideration in subject selection and frequency of measurement. Nurses should consider this strategy as a standard nursing intervention for people living with cancer.
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The purpose of this study was to identify direct, mediating, and moderating relationships of mood disturbance, symptom experience, and attentional function in Korean women with breast cancer based upon a middle-range theory of unpleasant symptoms.
This study used a cross-sectional, correlational design. A convenience sample of 125 women receiving chemotherapy for breast cancer was recruited from a university hospital in South Korea. The women completed questionnaires on mood disturbance, symptom experience, and attentional function using the Linear Analogue Self-Assessment Scale, the Symptom Experience Scale, and the Attentional Function Index, respectively.
Each mood disturbance and symptom experience showed a significant relationship with attentional function. Symptom experience did not act as a mediator between mood disturbance and attentional function, but it did act as a moderator: patients with a higher level of mood disturbance exhibited a lower level of attentional function when their symptoms were at the level of medium, but not when their symptoms were either high or low.
This suggests that clinical interventions for attenuating the influence of mood disturbance on attentional function may be effective only in women experiencing medium level of symptoms.
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This cross-sectional survey was conducted to described the compliance of Breast Self-Examination of middle-aged women using a convenient sample, and to examine relationships between the compliance of BSE and Health Beliefs, and the influencing factors on the compliance of BSE.
The subjects were 373 literate volunteers who were from 41 to 60 years of age who visited 6 public health centers. From June 7, 2004 to August 20, 2004, data were collected by 5 research assistants using a self-report questionnaire. The questionnaire was used to obtain information on the general characteristics, knowledge, health beliefs, and compliance of BSE.
The findings of this study suggested that there were significant differences in the scores of the perceived susceptibility and severity between compliers and non-compliers of the BSE. BSE compliance was significantly correlated with knowledge, perceived susceptibility, and perceived severity. The most powerful predictor of BSE compliance was the perceived susceptibility. The perceived susceptibility, the perceived severity, the knowledge and educational level accounted for 41.8% of the variance in middle aged women's BSE compliance.
Increase in knowledge about breast cancer, with a concomitant increase in both perceived susceptibility and perceived severity could produce a subtle cue or motivating force sufficient to affect a behavior change. Further research is needed to examine the qualitative difference between BSE and other early detection behaviors.
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The purpose of this study was to identify the effects of a workbook program on percieved stress levels, maternal role confidence and breastfeeding practices of mothers of premature infants.
This study employed a quasi-experimental non-equivalent pre-and-post test to compare the two groups. Data was collected from 32 subjects from March 10. to September 5, 2003 at an NICU located in S. city. In the sample, fifteen mothers were in the experimental group and seventeen were in the control group. A workbook program was provided twice during a period from two-three days after the baby's admission to one week after the first intervention. The instruments used were the PSS and self confidence scale. Data was analyzed by means of frequency, SD, χ2-test, Fisher's exact test, Mann-Whitney test, and the Wilcoxon signed rank test.
There was a significant difference in perceived stress levels between the experimental and control group (U=2.366, p=.018). There was not a significant difference in maternal role confidence between the two groups (U=1.002, p=.316). There was a significant difference in breastfeeding practice between the two groups (χ2= 4.910, p=.035).
It is concluded that a program using a workbook has a positive effect on decreasing the perceived stress level and increasing breastfeeding practice.
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The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy.
The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program.
There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times.
Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy.
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The purpose of this study was to explore the relationship of uncertainty, hope and quality of life in patients with breast cancer.
The subjects of the study were 113 breast cancer patients treated at 3 university hospitals in Daegu and Busan from June 1 to September 30, 2003. Uncertainty was measured by the Mishel Uncertainty in Illness Scale (MUIS), Hope was measured by Nowotny's Hope Scale, and quality of life by Ro's Korean Quality of Life(QOL). Data was analyzed with the SPSS program by t-test, ANOVA, Spearman's rank correlation and Multiple Regression Analysis.
The scores of uncertainty were negatively correlated with hope and QOL(all p's<0.05). Uncertainty revealed that there was a negative correlation among subitems of hope such as confidence, relationship with others, possibility of future, and inner motivation(r=-.333, p=.000; r=-.230, p=.015; r=-.260, p=.006; r=-.291, p=.003). Uncertainty also showed a negative correlation among subitems of QOL such as emotional status, self esteem, and relationship with family(r=-.29, p=.004; r=-.326, p=.000; r=-.197, p=.044), whereas hope revealed a positive correlation among subitems of QOL such as emotional status, self esteem, relationship with neighbor, and relationship with family(r=.243, p=.011; r=.487, p=.000; r=.29, p=.001; r=.29, p=.001). The score of uncertainty was low in graduate school students and subjects using problem solving as a coping method. However, the score of hope was high in college students and subjects using a problem solving method, and the score of QOL was high in professionals.
Based on the study results, breast cancer patients experienced living with uncertainty and maintaining hope. Thus the study's findings can be useful in directing a comprehensive nursing care plan to improve QOL of breast cancer patients.
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The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on physical function, immune response, fatigue and quality of life in mastectomy patients.
The subjects included fifty-five patients with breast cancer (27 in the control group and 28 in the experimental group). The subjects in the experimental group participated in a comprehensive rehabilitation program for10 weeks, which was composed of 1 session of education, 2 sessions of stress management, 2 sessions of exercise, and 1 session of peer support group activity per week.
The results revealed anincrease in shoulder extension, abduction, external rotation, and internal rotation of the affectedupper extremity, and in shoulder extension and abduction of the healthy upper extremity. Also an increase in quality of life and a decrease in fatigue were significantly higher in the experimental group than the control group. However, the results revealed that the natural killer cell ratio of the experimental group increased but there was no significant difference from that of the control group.
The 10-week comprehensive rehabilitation program showed a large affirmative effect on physical function, fatigue and quality of life of breast cancer patients after a mastectomy.
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This study was to investigate the characteristics and related factors of breast cancer screening and repeat screening, and to propose nursing interventions to increase the rate of breast cancer screening and repeat screening.
Study subjects was 236 women residing in the community, teachers and nurses who were older than 45 were recruited. Data was collected with self administered questionnaires from July 1st to August 31st, 2003 and analysed using SPSS/WIN 10.0 with X2test, t-test, and stepwise multiple logistic regression at a significant level of =.05.
The breast cancer screening rate was 57.2%, and repeat screening rate was 15.3%. With the multiple logistic regression analysis, factors associated with mammography screening were age and perceived barriers of action, and factors related to the repeat mammography screening were education level and other cancer screening experience.
Based on the results, we recommend the development of anintervention program to decrease the perceived barrier of action, to regard mammography as an essential test in regular check-up, and to give active advertisement and education to the public to improve the rates of breast cancer screening and repeat screening.
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This cross-sectional survey was undertaken to examine the differences of BSE (breast-self examination) performance and health beliefs between Korean and Korean-American women and to identify which factors influence the BSE based on the HBM variables.
The study subjects were recruited from both Korea(189 women) and Cleveland in Ohio, USA(146 women). The HBM variables were measured using a reliable and valid Health Belief Model Scale. The subjects were also asked whether or not they did a BSE in the last year.
The Korean-American women who performed the BSE was statistically higher than that of Korean women. Regarding to the BSE-related health belief, the scores of benefits, confidence, and health motivation was significantly higher in Korean-American. After controlling for living places, age, education, and job, barriers and confidence variables significantly explained the BSE performance of Korean and Korean-American women.
There was a differences in BSE-related health belief and performance between Korean and Korean-American women. Among health belief variables, barriers and confidence were core variables predicting the BSE performance of Korean and Korean-American women together.
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Breast cancer is the most common form of cancer among Korean women. Only 14% of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999).
The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea.
First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n= 494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection.
After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2% of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.
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The purpose of this study was to identify the influencing factors on the compliance of breast self-examination (BSE) among nurses who work at three general hospitals in Kyung-Nam areas.
258 hospital nurses were included in the study. Data were collected using structured self-administered questionnaires and analyzed by descriptive statistics, t-test, x2 test and logistic regression analysis.
Nurses reported medium levels of knowledge, self efficacy and health believes about breast cancer and BSE, and 26% of the nurses performed the BSE at least once during the last 6 months. Compliers of BSE perceived significantly higher levels of self-efficacy, susceptability and health motivation, and lower level of barrier compared to non-compliers. Significant influencing factors on BSE compliance were ‘experience of getting recommendation for breast self-examination’, ‘susceptibility’, ‘barrier’, and ‘self-efficacy’ and those variables explained 22.5% of variance in compliance of BSE.
Nurses, who must play as a role model for health promoting behaviors, did not have enough knowledge of breast cancer and BSE. Also, their performance rate of BSE was quite low. Thus, it is essential to provide an educational program for breast cancer and BSE to nurses in order to enhance nurses' performance rate of BSE.
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This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding intervention on breastfeeding rates.
Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using eight core electronic databases and other sources including gray literature from January 9 to 19, 2017. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.2 software.
A total of 16 studies were included in the review and 15 were included for meta-analysis. The most frequently used intervention topics were the importance of good latch-on and frequency of feeding and determining adequate intake followed. The pooled total effect of breastfeeding intervention was 1.08 (95% CI 1.03~1.13). In the subgroup analysis, neither pre-nor post-childbirth intervention was effective on the breastfeeding rates at 1, 3, and 6 months, and neither group nor individual interventions had an effect. Only the 1 month breastfeeding rate was found to be affected by the individual intervention with the persistent strategies 1.21 (95% CI 1.04~1.40).
Effective breastfeeding interventions are needed to help the mother to start breastfeeding after childbirth and continue for at least six months. It should be programmed such that individuals can acquire information and specific breastfeeding skills. After returning home, there should be continuous support strategies for breastfeeding as well as managing various difficulties related to childcare.
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The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy.
Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction.
Five theme clusters emerged. First, “expected loss of sexuality and discovery of autonomy” illustrates various aims of breast reconstruction. Second, “holding tight to the reputation of doctors amid uncertainty” specifies the importance of a trust relationship with their physician despite a lack of information. Third, “family members to step back in position” describes support or opposition from family members in the decision making process. Fourth, “bewilderment due to the paradox of appearance-oriented views” illustrates paradoxical environment, resulting in confusion and anger. Lastly, “decision to be made quickly with limited time to oneself” describes the crazy whirling process of decision making.
Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.
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Posttraumatic growth (PTG) is defined as 'positive psychological change experienced as a result of a struggle with highly challenging life circumstances'. The purpose of this study was to identify the level of PTG and its correlates in Korean patients with breast cancer.
A sample of 120 participants was recruited from outpatients, who had successfully completed primary treatment of breast cancer at a university hospital., Data were collected from June to December, 2014 using Posttraumatic Growth Inventory, lllness Intrusiveness Rating Scale, Cancer Coping Questionnaire, Revised Life Orientation Test and The Multidimensional Scale of Perceived Social Support.
Total score for the PTG was 79.18±17.54 in patients surviving breast cancer. Bivariate analyses indicated that PTG was positively associated with having a religion, perceived social support, greater optimism, cancer coping, and illness intrusiveness. Results of the regression analysis showed that cancer coping (β=.29,
The research findings show that the variables of cancer coping, optimism and illness intrusiveness significantly explain PTG and these psychological variables can be used to provide improvement in PTG for patients with breast cancer
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The purpose of this study was to develop a breastfeeding empowerment program and to investigate the effects of the breastfeeding empowerment program on self-efficacy, adaptation and continuation of breastfeeding for primiparous women.
The 5 session breastfeeding empowerment program was developed and a non-equivalent control group non-synchronized quasi-experiment design was used. Fifty-five participants were assigned to either the experimental group (n=27) or the control group (n=28). Effects were tested using repeated measures ANOVA and χ2-test.
Scores for self-efficacy, adaptation and continuation of breastfeeding of in the experimental group after program were significantly higher than 1week, 4weeks, 8weeks scores in control group.
The effects of the breastfeeding empowerment program for elevating self-efficacy, adaptation and continuation of breastfeeding in primiparous women were validated. Therefore, this program can be recommended for vigorous use in clinical practice.
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The purpose of this study was to construct and test a structural equation model on resilience of breast cancer patients receiving chemotherapy.
Participants were 204 patients with breast cancer who received chemotherapy treatment. They participated in a structured interview, which included social support, depression, symptom experience, self-efficacy, hope, resilience, and infection prevention behaviors. Data were analyzed using SPSS/WIN 20.0 and AMOS 18.0.
Lower depression (γ=-.33,
The findings of the study suggest that breast cancer patientsw ith greater resilience who are receiving chemotherapy participate in increased infection prevention behaviors. Further research should be conducted to seek intervention strategies that improve breast cancer patients' resilience.
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The purpose of this study was to develop a scale to evaluate empowerment in woman with breast cancer and to examine the validity and reliability of the scale.
The development process for the initial items included a literature review, interviews, and construction of a conceptual framework. The identified items were evaluated for content validity by experts, resulting in 3 factors and 48 preliminary items. Participants were 319 women with breast cancer recruited to test reliability and validity of the preliminary scale. Data were analyzed using item analysis, confirmatory factor analysis, criterion related validity, internal consistency and test-retest reliability.
The final scale consisted of 30 items and 3 factors. Factors, including 'intrapersonal factor' (14 items), 'interactional factor' (8 items), and 'behavioral factor' (8 items), were drawn up after confirmatory factor analysis. Goodness of fit of the final research model was very appropriate as shown by χ2/df=1.86, TLI=.90, CFI=.92, SRMR=.06, and RMSEA=.05. Criterion validity was evaluated by total correlation with the Cancer Empowerment Questionnaire .78. Cronbach's alpha for total items was .93 and test-retest reliability was .69.
Findings from this study indicate that the scale can be used in the development of nursing interventions to promote the empowerment of women having breast cancer.
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Maternal knowledge, positive attitudes and interest toward breastfeeding may improve the sustainability of breastfeeding. This study examined the associations of knowledge, attitudes, and interest toward breastfeeding with the duration of breastfeeding in Korean mothers who used the internet.
We conducted a cross-sectional study of 604 Korean mothers who breastfed their babies. Mothers were recruited through the internet and their knowledge, attitudes and interest toward breastfeeding were assessed using a web-based self-administered questionnaire. Geometric means and odds ratio (OR) with 95% confidence intervals were calculated.
Higher knowledge, attitudes, and interest toward breastfeeding were associated with longer duration of breastfeeding in Korean mothers. In particular, mothers who had optimal breastfeeding duration were more likely to be aware of the easiness of breast milk stimulation and breastfeeding, the development of attachment between mother and child, and pleasure from breastfeeding compared to those mothers with shorter duration. The association with optimal breastfeeding duration was more pronounced among mothers who graduated from high school for total attitude scores and total interest scores, compared to mothers who graduated from college or above.
The results of this study suggest that it is important to improve maternal knowledge, attitudes, and interest toward breastfeeding in Korean mothers who use the internet as a source of knowledge. Also, the study results imply that the development of strategies to target mothers with relatively low education levels may improve breastfeeding rates.
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The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status.
Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers’ employment status.
Breastfeeding initiation rates were similar regardless of mothers’ employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers.
These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.
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Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy.
Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses.
At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function.
These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.
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The purpose of this study was to identify whether the couple perceived breast cancer as a traumatic event, to evaluate the association among posttraumatic growth, dyadic adjustment, and quality of life and to explore the predictors affecting quality of life of the couple.
A cross-sectional comparative survey design was utilized. Participants were 57 couples recruited from a national cancer center in Korea. Data were analyzed using paired t-test, McNemar test and independent t-test. On the basis of variables found to be significantly associated with quality of life, multiple regression was used to examine the simultaneous influence of multiple predictors.
Breast cancers survivors and spouses perceived breast cancer as a traumatic event (43.9% and 24.6%, respectively). The global quality of life was explained by perception as trauma (β=-19.79) and posttraumatic growth (β=0.46) in survivors, and perception as trauma (β=-18.81) and dyadic adjustment (β=0.53) in spouses.
Results suggest that future research should use qualitative methods to evaluate why contemplating reasons for cancer contributed to posttraumatic growth, examine other potential predictors of quality of life such as dyadic adjustment and intimacy, and identify links between posttraumatic growth and other psychological outcomes such as distress and well-being, using prospective analyses.
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