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This systematic review aimed to scrutinize the progression of symptom cluster research in adult cancer patients who received primary or adjuvant chemotherapy between 2001 and 2023, providing a comprehensive understanding of clinical practice and future research.
PubMed, Ovid MEDLINE, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and Web of Science databases were searched for theme words and free words related to symptom clusters, cancer, and chemotherapy. Eligible studies were published between January 1, 2001, and May 30, 2023; adults who were diagnosed with cancer and received primary or adjuvant chemotherapy were evaluated.
Twenty-eight studies were included in this review. The Memorial Symptom Assessment Scale emerged as the predominant instrument and exploratory factor analysis was the most frequently employed statistical method to identify symptom clusters. Psychological, gastrointestinal, and physical image symptom clusters were the most commonly delineated. Furthermore, the temporal stability of the symptom clusters showed varying dynamics, with psychological symptom clusters displaying relative consistency over time.
Interventions are needed for the most common and stable symptoms in patients with cancer undergoing chemotherapy. Future endeavors may necessitate more longitudinal studies to delve deeper into the temporal stability and dynamic variations of symptom clusters. Such investigations hold promise for advancing symptom cluster research, elucidating the underlying mechanisms, and fostering the development of targeted interventions, thereby enriching the symptom management paradigm in oncological care.
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The purpose of this study was to investigate the effects of aromatherapy on sleep quality.
This is a systematic review of randomized controlled trial studies (PROSPERO registration number CRD42017064519). In this study, the PICO were adults and the elderly, aromatherapy intervention, a comparative intervention with the control and placebo oil groups, and sleep. The selected articles were in English, Korean, and Chinese.
The results of the meta-analysis showed that the effect sizes of the experimental group were 1.03 (n=763, SMD=1.03, 95% CI 0.66 to 1.39) (Z=5.47,
A total of 23 literature analyses showed that aromatherapy is effective in improving quality of sleep, and the massage method is more effective in improving quality of sleep than the inhalation method. A meta-ANOVA showed that the aromatherapy intervention affected the high heterogeneity of the effect size. Thus, future research with stricter control in methods and experimental procedures is necessary.
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The purpose of this study was to examine the effects of oral cryotherapy on oral mucositis, reactive oxygen series, inflammatory cytokines, and oral comfort in patients undergoing chemotherapy for gynecologic cancers.
Participants were randomly assigned to the experimental group (n=25, receiving oral cryotherapy during chemotherapy) and the control group (n=25, receiving the usual care consisting of 0.9% normal saline gargles three times before meals). Oral mucositis was assessed using the oral assessment guide, while oral comfort was assessed using the oral perception guide. Reactive oxygen series was measured as total oxidant stress, and the level of two inflammatory markers, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), were examined. The data were analyzed using t-test, chi-square test, Fisher's exact test, Mann-Whitney U-test, and repeated measures analysis of variance.
There was a significant difference in the oral mucositis score, reactive oxygen series score, TNF-α level, and oral comfort score between the two groups, and there were significant changes over time and in the group-by-time interactions. There was a significant difference in the IL-6 score between the two groups, but there were no significant changes over time or in the group-by-time interactions.
The study results revealed that oral cryotherapy was more effective than the usual care regime of normal saline gargles for reducing oral mucositis, reactive oxygen series, and inflammatory cytokines and for improving oral comfort in gynecologic cancer patients undergoing chemotherapy.
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This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy.
The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants’ health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0.
Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group.
The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.
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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 construct an acceptance-commitment therapy (ACT)-based stress management program for inpatients with schizophrenia and to examine its effects on hospitalization stress, self-efficacy, and psychological well-being.
A non-equivalent control group pretest-posttest design was used. Participants were 44 inpatients with a diagnosis of schizophrenia. The experimental group (n=22) received the ACT-based stress management program twice a week for a total of four weeks. The control group (n=22) received the usual care from their primary health care providers. The study was carried out from August 7 to September 1, 2017, and data were analyzed using IBM SPSS/WIN 22.0 with a Chi-square test, Fisher's exact test, and an independent t-test.
The experimental group showed a significant decrease in hospitalization stress (t=5.09,
The results of this study suggest that the ACT-based stress management program can be used as an effective mental health nursing intervention for hospitalization stress and self-efficacy for inpatients with schizophrenia.
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This study aimed to develop a Group REBT program with group counseling for nurses and test the effect of group counseling on their job stress, burnout, job satisfaction, organizational commitment, and turnover intention.
A quasi-experimental study with nonequivalent control group design was employed to identify the effect of the Group REBT program on nurses’ job stress, burnout, job satisfaction, organizational commitment, and turnover intention. Data were collected from 47 participants from two hospitals. The data from the experimental (n=23) and control (n=24) groups were analyzed from January 5 to April 3, 2015. The Group REBT program was conducted eight tmes in all, once a week, with each session lasting 180 minutes. The effect of experimental intervention was measured for each group using a series of structured questionnaires at each of the phases: Pre-intervention, post-intervention (immediately after intervention), and post-intervention (four weeks after intervention). Following this, the significance of the changes in the scores was tested.
The scores of the experimental group, which received the Group REBT program, were compared with those of the control group; the hypotheses were supported in terms of job stress (F=8.85,
The Group REBT program was shown to be an effective intervention that could reduce nurses’ job stress and burnout and increase job satisfaction and organizational commitment. Therefore, the Group REBT program can be adopted by nursing organizations to strategically decrease nurses’ turnover intention.
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The purpose of this study was to examine the effects of the laughter therapy program on perceived stress and psycho-neuro-endocrine-immune responses in obese women.
A nonequivalent control group with a pretest-posttest design was used. The participants (n=60), whose age ranged from 30 to 50 years (pre-menopausal and body mass index of over 25 kg/m2), were assigned to the experimental group (n=24) or control group (n=26). The experimental group was provided with the laughter therapy program (12 sessions) for 6 weeks.
There were significant differences in perceived stress, psychological stress response, fasting blood sugar, interleukin-6, and tumor necrosis factor alpha between the two groups after the program. However, there were no significant differences in normalized low frequency (norm LF), normalized high frequency (norm HF), LF/HF ratio, and cortisol between the two groups after the program.
It was found that the laughter therapy program had positive effects on some variables in terms of perceived stress and psycho-neuro-endocrine-immuno responses. It is suggested that the laughter therapy in this study can provide the direction for developing a program for obese women.
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This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN).
PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses.
Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (
Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.
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The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG).
A non-equivalent control group with a pretest-posttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney
Significant interactions in the high frequency of ANS (F=5.58,
The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.
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This study aimed to examine the effects of cognitive behavior therapy for insomnia (CBT-I) based on the mobile social networking service (SNS) on dysfunctional beliefs and attitudes about sleep, sleep quality, daytime sleepiness, depression, and quality of life among rotating-shift nurses in a hospital in Korea.
A nonequivalent control group pre-post test design was used. The participants included 55 nurses with rotating three-shift work (25 in the experimental group and 30 in the control group). For the experimental group, CBT-I using mobile SNS was provided once a week for 60 minutes over six weeks. Data were analyzed using descriptive statistics, χ2-test, independent samples t-test, and Mann-whitney U test with the SPSS 21.0 program.
In the homogeneity test of the general characteristics and study variables, there were no significant differences between the two groups. Nurses in the experimental group had significantly lower scores on dysfunctional beliefs and attitudes regarding sleep and sleepiness than nurses in the control group. Nurses in the experimental group had significantly higher scores on sleep quality and quality of life than nurses in the control group.
These findings indicate that using the mobile SNS-based CBT-I is feasible and has significant and positive treatment-related effects on rotating-shift nurses' irrational thoughts and beliefs in association with sleep, sleep quality, daytime sleepiness, and quality of life. These contribute to expanding our knowledge of rotating-shift nurses' sleep issues and their preferences for intervention.
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This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors.
Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs.
Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress.
Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.
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This study was done to analyze the effects of prompted voiding therapy on urinary incontinence in elderly patients in an elderly care hospital. Specifically, this study looks to evaluate the effects of prompted voiding as an intervention for improving independent voiding and also identified the relationship of urinary continence to cognitive, emotional, and physical factors. The study was based on a pre-experimental design used to evaluate the effects of prompted voiding therapy on an experimental group without a control group. An experimental group of 143 patients was selected through convenience sampling from patients in an elderly care hospital. The data was collected from November 4 to December 14, 1996. Prompted voiding therapy is a behavioral therapy for managing incontinence and it is applied to patients who are cognitively impaired and dependent. In this study, the patients were asked at each designated time whether or not they had to urinate. If they answered yes, they were either given a bedpan or were assisted to the bathroom, and if the patient answered no, their diaper was checked to determine whether or not it was wet. The results were then recorded on the patients urinary voiding record. The urinary voiding score based on the model presented by Burton(1984), Burke and Walsh(1992), Chenitz, Stone and Salisbury(1991 was modified and used as a tool in this study. After forty six out of the total of 143 patients were selected for interviews through random sampling the levels of cognitive functions, mental depression and ADL(activities of daily life) within the given time frame were measured. In this study, the cognitive function was measured using the scale developed by Kabhn, Goldfarb, Pollack and Peck(1960), elderly mental depression, using the tool developed by Sheikh and Yesavage(1986), and the ADL(activities of daily living, through the Barthel Index. The data was analyzed through SPSS windows for descriptive statistics, repeated measured ANOVA and Pearson's correlation. According to the results of the study, the application of the prompted voiding therapy can improve the voiding pattern of patients. It was shown especially that incontinence could be controlled by the intervention developed according to the individual voiding pattern. In terms of the relationship between cognitive function, mental depression and ADL and the voiding function score, a close correlation was not found. It was shown that urinary incontinence can be improved through therapy even though patients have problems with their cognitive, mental and physical functions.

The purpose of this study was to present an effective nursing intervention for helping the patients of mental illness by determining the effect of nursing-logotherapy on purpose in life and finding meaning, and hope of the patients of mental illness by developing and applicating program of nursing-logotherapy. The data was collected from March to September in 1995, and its subjects were the patients of mental illness who was appropriate to the standard of this study among the patients of mental illness who hospitalized into Neuro-Psychiatric ward of M. and B. hospital located in Pusan area. They were all 60 subjects, thirty of them for an experimental group and the rest for a control group. The research design was an equivalent control group pre-test and post-test design as an quasiexpe-rimental research and the conceptual framework was an interpersonal model. The data analysis was computerized by using SP-SS/PC+ and hypothesis testing was done with 2-way ANCOVA and simple correlation. Results were summarized as follows : 1. There were significant changes of purpose in life and finding meaning in an experimental group before and after treatment and a control group before and after. 2. There were significant changes of hope in an experimental group before and after treatment and a control group before and after. 3. The positive correlation between purpose in life and finding meaning and hope of the patients of mental illness were observed. Consequently, nursing-logotherapy could significantly increase the purpose in life and finding meaning, and of hope, so it could be said an effective nursing intervention for helping the healing of the patients of mental illness.
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The purpose of this study was to identify how internal and external coping resources influenced active coping in the process of stress-coping. The model was established theoretically by comparing and integrating the following theories : Stress-Coping, Self-Care, and Resourcefulness. The subjects consisted of sixty eight patients undergoing chemotherapy(experimental group 34, control group 34) at two general hospitals from January to July, 1995, The results were as follows : After self-care education, the active coping score of the experimental group was significantly higher than that of the control group. The active coping score of the high resourcefulness group was significantly higher than that of the low resourcefulness group. The interaction effect between self-care education and resourcfulness was not significant statistically. Specifically as to such scores of seeking social support, problem-oriented strategy and self care behavior, there were significantly higher in the experimental group and high resourcefulness group than in each of the other groups. Considering them both, self-care education and resourcefulness are effective nursing strategies to promote active coping including self-care. Consequently, the synthesis and testing of theories of stress-coping, self-care, and resoucefulness in this study are mostly proven to enhance the explanation and prediction of the change of active coping including self-care. Therefore the result of this study will contribute in the development of practice theory of nursing. A further study is necessary to reevaluate the interaction effect between self-care education and resourcefulness and to identify the difference between resourcefulness and self-efficacy.
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Quality of life(QOL) and fatigue in cancer patients receiving the radiotherapy was assessed. The subjects were 46 cancer patients who daily attended the radiotherapy department. Assessment was done on four occasions ; the first assessment was done on the treatment simulation visit, the second one was four week after treatment started, the third one at the completion of treatment and the last assessment was done between six and eight week following treatment. The results are as follows : The fatigue scores of the patients at each stage of assessment ranged from 5.49 points to 7.67 points and highest score was recorded at the third assessment hat is, at the completion of treatment. The fatigue points showed an increase from the 1st. to 3rd. stage. However, at the 4th. stage, fatigue points decreased to the level at the first stage, fatigue points decreased to the level at the first stage of assessment. QOL were assessed in three areas namely, physical, emotional and social/functional. The QOL scores in the physical area showed the highest score, followed by social/functional and emotional areas. The QOL scores decreased gradually to the third. stage of assessment thereafter recovered to the level of the first. stage. Correlation between QOL and fatigue scores during the treatment indicated that the level of QOL decreased as the level of fatigue increased. In particular, fatigue persisted after completion of the treatment and showed a significantly negative correlation with QOL. The present study strongly suggests that a strategy to restore the emotional well being level of the patient should be devised in order to improve QOL and reduce fatigue of patients receiving radiotherapy.

The purpose of this study was to identify the effects of music therapy on anxiety in neurotic patients. The subjects of the study were 41 patients that had been diagnosed as having anxiety disorder, neurotic depression, or somatization disorder and were admitted to one general hospital in Seoul. The 41 research subjects were assigned to an experimental (22 clients) and a control (19clients) group. Data were gathered from September. 25, 1995 to December. 15, 1995 using a questionnaire and physiological measurement tool. Data were analyzed with the SAS package using frequency, t-test, paired t-test and Pearson correlation coefficients. The results of this study are as follows; 1. There were significant differences between two groups on systolic and diastolic blood pressure, and pulse rate after treatment. In the experimental group, Systolic and diastolic blood pressure, and pulse rate decreased significantly after Music Therapy. 2. There were no significant differences between the two groups on the pre and post psychological anxiety score. But, after music therapy, experimental group had a lower psychological anxiety score than the control group. From these results, it is concluded that the music therapy can be effective in decreasing anxiety in neurotic patients.
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Stomatitis is a common toxicity associated with the administration of certain cancer chemoth-erapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to estabilish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subject were devided into three groups; control group: not gargling experimental group A: normal saline gargling (4 times a day) experimental group B: nystatine solution gar-gling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times (once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X2 test. The results are as follows; 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B. (X2=0.002 P=0.001) 2. The grade of stomatitis (mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A (F=1.96 P=0.0024). 3. In incidence of tougue change, control group, experimental group B were significantly higher than experimental group B(F=6.84 P=0.0039). 4. In control group and experimental group A, oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.
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PURPOSE: The purpose of this study wsa to necessitate auricular acupressure therapy as an independent nursing intervention on cancer paitents by confirming its effectiveness. METHOD: The experimental study was unequivalently controlled pre-post measure study. The subjects were 40 cancer patients who were hospitalized in K medical center in Seoul. The experimental group (20) and the control group (20) were randomly assigned. As measured tools, Spielberger's State-trait Anxiety (1976) measured tool by Kim's transplation (1978). The auricular acupressure therapy was applied to experimental group, and the pre-post measure was performed to both group. The data was analyzed by using SPSS computer program that included descriptive statistics, x2-test, and t-test. RESULT: 1) The experimental group with the auricular acupressure therapy showed lower trait anxiety scores in comparison with the control group (t= 8.036, p=.000). 2) The experimental group which applied the auricular acupressure therapy showed lower state anxiety scores in comparison with the control group (t= 19.616, p=.000). This result showed that cancer patients with the auricular acupressure therapy applied cancer patients decreased state anxiety and trait anxiety. Therefore , effectiveness of the auricular acupressure therapy was confirmed through this study. CONCLUSION: According to the result, anxiety of cancer pateint should be decreased and controlled by the auricular acupressure therapy as independent nursung intervension. In addition, the auricular acupressure therapy will provide effective independent nursing intervention that will decrease anxiety on patient with other disease and will improve quality of their lives.
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PURPOSE: To examine the effect of the exercise therapy, and exercise-behavior modifi- cation therapy on obesity, blood lipids and self-esteem of the obese middle-aged women. METHOD: A total of 35 middle-aged women (BMI: over 30) were selected for this research. Walking at a 50% intensity was administered 4 days a week for 12 weeks, while the behavior modification therapy performed for 60~90 minutes per week for 12 weeks. RESULT: Body weight and BMI has significantly reduced in the case of EG and E.BG. The result of comparing body weight between groups showed significant difference between EG and CG, and E.BG and CG whereas BMI showed significant difference between EG and CG only. TC, TG, LDL-C, %TC/HDL-C have shown significant decrease in EG and E-BG, while HDL-C displayed significant increase in EG and E.BG. And HDL-C showed significant decrease in CG. As for comparison between groups, significant difference was noted in EG and CG, and E.BG and CG at TC, HDL-C, LDL-C, and in EG and CG at %TC/HDL-C. Self-esteem displayed significant increase in EG and E.BG; however, there was no significant different in CG. As for comparison between groups, there was significant difference noted in E.BG and CG only. CONCLUSION: The results showed that the exercise therapy and the exercise-behavior modification therapy were effective in changing obesity, blood lipids and self-esteem of the obese middle-aged women.
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PURPOSE: The purpose of the study was to determine the effects of the 8-week, 16-session group art therapy program on body image and self-esteem in college women. METHOD: Data collected by self-reported questionnaires from 58 college women in Inchon who were selected by criteria of this study, from the 6 of March to 10 of May, 2002. The 11 experimental group participated in a 8-week group art therapy program. Descriptive statistics, homogeneity test, hypothesis, and reliability test were performed statistically by utilizing SPSS PC+ 8.0 program. RESULT: 1. 'The experimental group showed significantly higher scores in body image than the comparison group. 2. No significant differences were found between two groups in self-esteem. CONCLUSION: The findings showed the possibility of applying group art therapy as an effective intervention for clients with negative body image to improve their body image.

PURPOSE: This study aimed to identify the change patterns of fatigue and quality of life during consecutive chemotherapies and to determine the relationship of these two variables. METHOD: Stomach cancer patients receiving chemotherapy were recruited from a university hospital in Seoul. Each chemotherapy, subjects were asked to respond to the questionnaires regarding their fatigue and quality of life. The number of subjects who completed 4 cycles and over was 11. Fatigue was measured with Lee's tool(1999). Quality of life was measured with a tool revised by the author based on Padilla et al(1983). RESULT: Most patients were in 1st stage(5 patients) or 3rd stage(5 patients). Fatigue was revealed at its highest level in the 3rd or 4th chemotherapy and at its lowest level in the 1st or 6th chemotherapy. A quality of life appeared at its highest level in the 5th or 6th chemotherapy and the lowest level in 3rd or 4th chemotherapy. CONCLUSION: Among 6 cycles of chemotherapy, in 3-4th chemotherapy the fatigue was the highest and the quality of life were the lowest. Many patients decided to stop treatment at the same period. Therefore we can recognize cancer patients receiving chemo- therapy are in the highest risk at the time of the 3-4 th chemotherapy.
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PURPOSE: The purpose of this study was to verify the effect of aromatherapy on the stress response in menstrual period. METHODS: A randomized, single-blind, pretest- posttest design was used. The study subjects were 60 college women with dysmenorrhea and they were randomized into 3 groups, experimental, 1st control(placebo) and 2nd control group. The researchers massaged treatment oil(3% dilution essential oil of Lavender, Clary sage and Rose) into the abdomen of experimental group. The placebo group used almond oil(carrier oil) instead, and the 2nd control group did not give any treatment. Baseline data including pre- treatment stress response score were obtained on the first day of usual period. Aromatherapy provided for about 7 days until the next cycle began. Post-treatment stress responses were measured by 94 item SOS(symptom of stress) scale on the first day of the cycle. RESULTS: As a results, the stress response score of experimental group was significantly lower than two control groups. And there was no significant difference in stress responses of two control groups. CONCLUSION: The results show aromatherapy using selected essential oils to be an effective intervention for stress response during menstruation.
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PURPOSE: The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy.
METHOD
To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy.
RESULT
93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake.
CONCLUSION
The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.
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The purpose of this study is to identify and classify the different types of cancer patients who use alternative therapies, to understand their subjective frameworks in using such alternative therapies. The results of this study provided the subjective information on five types of attitudes towards alternative therapies and described characteristics of five types from 30 cancer patients. The "Dependent to Others" (the first type) decided to use alternative therapy because they were influenced by the experiences of others and invocations of the family (especially spouse) or close relatives. In general, they did not believe that it will cure the diseases but generally thought it was not harmful and it may be better than doing nothing. There were a group of patients who chose to use alternative therapy with vague hope and belief. These patients decided to try alternative methods with their own convictions and confidences because they have personally seen or heard about some people who had been cured miraculously. This group of patients was grouped as "Belief in Effects (second type)." Although, there is a very little chance for miracles, "Expecting for Effects (third type)" believed alternative therapy will strengthen immune systems, help with feces and urine, change physical constitutions, slow down the progression of cancerous cell, have no side-effects, and expects to have practical effects and uses. The fourth group of patients thought foods in alternative therapies were same as general foods, therefore, it was easy to take, did not expect miracles to happen but considered the alternative therapy as supplementary treatments. This "Supplementary for Effects (fourth type)" patients thought it was their duty to do everything possible. The last type was "Expecting for Miraculous Effects (fifth type)." The patients in this group were devastated and thought of alternative treatments as the last hope for miracles. They thought it would relieve their physical pains, reduce the chance of side effects from chemical treatments, help them for comfortable and painless death, and considered it as the last possible option with expecting for miracles. The result of this study has implications to provide practical and concrete guidelines for caring and nursing cancer patients using alternative therapies. It will be used as a tool to work on independent for nursing intervention. Furthermore, the result of study will provide practical guidelines to help develop better tools and nursing intervention strategies to nurse cancer patients.

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 this study is to evaluate the effects of Chu-ma therapy and to suggest that the therapy is an effective nursing intervention tool to reduce blood pressure. The research design employed was the non-synchronized research method with non- equivalent control group. A total of 30 people with essential hypertension, who were from forty to sixty five years old, participated in the study. The Chu-ma therapy was administered by every day for ten or fifteen minutes for eight weeks from 19, April to 13, June in 1999. In order to evaluate the effects of Chu-ma therapy, blood pressure of the two groups were measured once a week, and physiological parameters (epinephrine, norepinephrine, total cholesterol, HDL-cholesterol, triglycerides) were measured before and after the treatment. Collected data was analyzed by SAS package. The results of this study can be summarized as follows: 1) There were significant decrease in systolic blood pressure and diastolic blood pressure in the experimental group. 2) There were no significant changes in epinephrine, norepinephrine of the two groups. 3) There were significant decrease in total cholesterol and triglycerides, and HDL- cholesterol increased significantly in the experimental group. 4) The effect of Chu-ma therapy on the measured time on the blood pressure in experimental group was as follows: Both of systolic and diastolic blood pressures were significantly decreased after 5weeks. The result proved that Chu-ma therapy is an effective nursing intervention tool for clients with essential hypertenion. However further research is still necessary to compare the effect with the different periods and number of times for Chu-ma therapy.
Citations

The hemodialysis patients with chronic renal disease have experienced negative emotions, especially
depression among with physical, social, and psychological changes. Based upon a stress-coping theory, group
imago psychotherapy which can induce effective coping through self awareness and positive emotional
responses is implemented to the hemodialysis patients. The effects of the imago psychotherapy in regards to
comfort and depression are studied here.
Group imago psychotherapy was performed on forty-three subjects(twenty subjects in the experimental
group and twenty-three subjects in the control group).
The results of the study were as follows.
After being given group imago psychotherapy, the comfort scores of the experimental group were
significantly higher than those of the control group (F=15.33, p= .003).
Moreover, after being given treatment, the depression scores of the experimental group were significantly
lower than those of the control group (F=9.14. p=.0044).
Specifically, the scores on comfort in the experimental group under emotion-focused coping style were
significantly higher than those of the control group (F=18.59, p= .0002).
The mean difference on comfort scores in the experimental group under problem - focused coping style was
higher than that of the control group. But their scores were not significant (F=0.19, p= .6729).
The scores on depression in the experimental group under emotion-focused coping style were significantly
lower than those of the control group (F=14.62, p= .0006).
The mean difference on depression scores in the experimental group under problem - focused coping style
was much lower than that of the control group. But their scores were not significant (F=0.31, p=.5947).
There was a significant positive correlation between comfort and depression variables.
After group imago psychotherapy the hemodialysis patients recognized positive changes in emotional reponses,
self awareness, self control, ease of mind, and felt overall more relaxed.
Imago psychotherapy is a nursing intervention which as this study has shown can improve to comfort. The
results
of this study can be applied to general nursing practices. In the view of holistic nursing, the
development of the nursing practice combined with imago psychotherapy will contribute to the enlargement of
the nursing field with conventional nursing practices.
Citations

Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.
Citations

This study was performed to evaluate the effectiveness of music therapy as one of the psychiatric nursing intervention tools, with addtional information in relieving anxiety during the procedure. Data were collected through nonequivalent pre-and post tests from July 1, 1998 to September 30 1998 in 90 patients (test group A: 28 patients, test group B: 27 patients, control group: 33 patients) who were hospitalized in DongSan Medical Center in order to have cardiac catheterization. The Subjects were informed by educational videos, which were modified according to the sensory information of the 10 study patients. They were based on the informative booklet by Kim keum-soon (1989). The procedural information was also modified according to the hospital`s customs. Provided the music for patients suitable to their tastes, and measured their blood pressure, heart rate, the degree of anxiety using the Spielberger`s measurement device of anxiety, and behavioral response of Finesilver`s. The statistical significance was analyzed using chi-square test and ANOVA. The results of this study were as follows : Hypothesis 1 : There are significant differences in the degree of anxiety among test group A, Test group A was provided only information, Test group B was provided information and the control group was provided neither. Hypothesis 2 : There are significant differences in systolic blood pressure among test group A, test group B, and control group.: non-significant. Hypothesis 3 : There are significant differences in diastolic blood pressure among test group A, test group B, and control group.: significant(F=1.31, p=.27, interaction; F=3.80, p=.00). Hypothesis 4 : There are significant differences in heart rate among test group A, test group B, and control group.: non-significant. Hypothesis 5 : There are significant differences in behavioral responses among test group A, test group B, and control group.: significant(F=10.05, p=.00). Further validation study is required with other subjects and other settings.
Citations

This study is aimed at analyzing the trend of research on the use of exercise in nursing research, through suggesting directions for future research and implementation of the various exercise therapies. Research studies were taken from dissertations and theses selected from the Academic Society Journals of nursing science, Journals from universities, medical and nursing schools, research institutes in various universities, the Central Journal of Medicine, and the New Medical Journal. The research published between 1970 and 1997 in Korea were analyzed, 51 research were selected. The research are analyzed according to: published time, source of the research, research design, subjects, sample size, dependant variables, exercise therapy, and effect of exercise therapy. The results were as follows: 1. Research on exercise therapy increased rapidly in the 1990's. At this time, 88.2% of research was published. 2. Research areas included: 54.9% non- degree research, 27.5% Doctoral theses, and 17.6% Master's theses. 3. The experimental design included: 66.7% non- equivalent control group pre-test/ post-test design and 29.4% one group pre-test/post- test design. 4. Out of the Subjects: 52.9% were patients with various health problems, and 47.1% were healthy individuals. 5. Sample size included: 52.9% with above 31 subjects, 11.8% with 11~15 and 26~30. 6. Exercise therapy was analyzed by type, intensity, frequency, duration, and period. 1) The Types: Aerobic exercise at 60.8% was the most common, active exercise for muscle strengthening and building made up 21.6%. 2) Exercise with 40~65% intensity comprised 25.5%, 70~85% with 7.8%, and no description of the intensity was 66.7%. 3) Frequency of 3~5 per week was the most common at 78.4%. 4) Duration: 15~60 minutes was the most common length of time at 76.5%. 5) Periods: More than 5 weeks at 82.3% were the most common in their categories. 7. Dependant variables: Psychological response was measured as a dependant variable in 92.2%, Cardio-pulmonary function 88.2%, Body Composition was 86.3%, Physical Response was 60.8%, Lipid Metabolism was 58.8%, Physical Strength was 49.0%, Glucose Metabolism was 25.5%, Activities of Daily Living was 17.6% and others added to be 3.9%. 8. The effect of Exercise Therapy was categorized into 'positive', 'partially positive', and 'no effect' according to dependant variables: Having a positive effect - Glucose Metabolism (93.3%), Physical Response (85.0%), Activities of Daily Living (81.8%), Psychological Response (71.6%), Lipid Metabolism (67.6%), Cardio- pulmonary Function (63.6%), Physical Strength (68.1%), and Body Composition (56.4%). The following suggestions can be made on the above findings: 1. Research findings on Exercise Therapy as a Nursing Intervention need to be described by their elements of type, intensity, frequency, duration and period. 2. Toproperly study the positive effects of Exercise Therapy, there needs to be (1) appropriate research design, (2) selection criteria for the subjects (3) contents of exercise prescription to individuals or groups (4) measurement criterion for the dependent variables. 3. Meta-analysis on exercise therapy also needs to be done to analyze and integrate the various results.
Citations

A meta-analysis of 14 quasi-experimental studies was conducted to compare the effect of size on various relaxation therapies applied to patients and health volunteer students. These studies were selected from theses, dissertations and papers that have been done between 1982 to 1993. Also They have a randomized or nonequivalent control group in a pre test-post test design. The studies were evaluated in different ways; 1) types of relaxation therapy, 2) total amount of time of relaxation therapy, and 3) types of outcome variables. For a group of homogenious studies, the weighted mean effect size and standard error were estimated. Some findings are summarized as follows : 1. Jacobson relaxation therapy had a larger effect on systolic and diastolic blood pressures than on state anxiety. 2. For the total time of relaxation therapy, (longer than 60 minutes) had a much larger effect in decreasing systolic and diastolic blood pressures than in the case of a time period shorter than 60 minutes. 3. Relaxation therapy applied to surgery patients also had a larger effect in decreasing state anxiety than when applied to other patients.
Citations

The purpose of the study was to determine the effects of the 8-week, 15-session group art therapy program on self-esteem and mental health status in chronic schizophrenic inpatients. The sample consisted of two groups of chronic schizophrenic inpatients: 10 patients with an average of total disease duration of 8.90 years who participated in a 8-week group art therapy program, and 8 comparison subjects with an average of total disease duration of 8.25 years who did not participate in the program. A pretest-posttest quasiexperimental design was used to assess self-esteem and mental health status at the beginning and at the end of the 8-week, 15-session group art therapy program. The time points for obtaining data were matched for both groups. The effectiveness of the 8-week group art therapy program was assessed by Rosenberg's Self-esteem Scale(Rosenberg, 1965) and SCL-90- R(Derogatis et al., 1973). SPSSWIN 8.0 was utilized for data entry and analysis employing Mann-Whitney U test. The findings of the study indicated the followings: (a) No significant differences were found between two groups in self-esteem and (b) The experimental group showed significantly lower scores in obsessive-compulsive symptom dimension and interpersonal sensitivity symptom dimension on the SCL-90-R than the comparison group after participating in the group art therapy program. In conclusion, the findings showed the possibility of applying group art therapy as an effective nursing intervention for patients with lack of verbal communication skills and social interaction to improve their interpersonal relationship.
Citations

Breathing is essential for life and at the same time takes a role as a antidote for stress. In the Orient, it was recognized early that respiration, mind, and body have a relation that is inseparable and therefore proper breathing is so important. However, since the mechanism of therapeutic effect by breathing have not been verified, the treatment has been continued till recent years. From that which originated in the Orient, several techniques in the west have been developed to regulate breathing, and have been applying to the clinical situation and to studies, however scientific studies are still lacking. Recently, relaxed breathing has been used as an efficient strategy for breathing therapy as it has an effect on reducing physiological tension and arousal, and, therefore can be used as a basic technique to control or manage stress. In this study, in order to provide basic information and guidelines for clinical application, which will aid in the application of the theoretical basics of breathing therapy and its technique, a review of the literative was conducted. The findings are as follows: 1. Since proper breathing not only has, physically, the important function in supplying oxygen to the body but also gives a good emotional, or pleasant state of mind, it is the first step in controlling physical and mental health. 2. The basic types of breathing can be classified into two types; 'diaphragmatic breathing(relaxed breathing)' and 'chest breathing(stress breathing)'. In yoga type breathing, there are four kinds of breathing, 'upper breathing', 'mid breathing', 'down breathing', and 'complete breathing'. 3. The theoretical explanation of the positive thera peutic effect of breathing therapy techniques exemplifies good brain function, sufficient air flow through the nasal passages, diaphragmatic movement, light vagal stimulation, CO2 changes and cognitive diversion but in most studies, the hypothesis of CO2 is supported. 4. The technique of breathing is designated with many names according to the muscles and techniques used for breathing, and for control of stress, diaphragmatic breathing(relaxed breathing) is explained as a basic technique best used to manage of stress. 5. The relaxed-breathing includes slow diaphragmatic breathing, breath meditation, nasal breathing, yogic abdominal breathing, Benson's relaxed response, and quiet response.
Citations

This study was designed to investigate the effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. Twenty one subjects of this study were selected from St. Paul's Hosipital in Seoul. All the subjects were received the mineral oil massage at the arm without fistular three timesper week for 4 weeks. After 2 weeks period of wash-out, the subjects were received the aromatherapy of lavender and tea tree essence oil in the same way. This study was carried out from March 20 to June 13, 1998. Pruritus score, skin pH and stratum corneum hydration were measured before and after each treatment. But, biochemical parameters were measured before the treatment of the mineral oil massage, after the treatment of the mineral oil massage and the aromatherapy. Data of this study were analyzed by paired t-test, repeated measures ANOVA, Bonferroni multiple comparisons and Pearson correlation coefficient. The results were as follows: 1. Pruritus score was significantly decreased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the priritus score between the two treatments. 2. Stratum corneum hydration was significantly increased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the stratum corneum hydration between the two treatments. 3. Skin pH was significantly increased after the treatment of the mineral oil massage, while no significant change after the aromatherapy. Therefore, there was no significant difference in the skin pH between the two treatments. 4. After the aromatherapy, the serum calcium was significantly increased. Whereas the serum parathyroid hormone intact was significantly decreased compared with the treatment of the mineral oil massage. But the level of the serum Ca and PTH-intact were within the normal range. 5. Stratum corneum hydration was decreased corresponding to the duration of hemodialysis, while pruritus score and skin pH showed no change corresponding to the duration of hemodialysis and the age of the subjects. The correlation of pruritus score on skin pH, stratum corneum hydration and biochemical parameters was not significant. In conclusion, this findings indicate that aromatherapy may be effective in decreasing skin xerosis and pruritus score in uremic pruritus patients undergoing maintenance hemodialysis.
Citations

This study was done to explore the effects of dance therapy on pulmonary and cognitive functions in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Kyoungi-Do. Fifty eight subjects had normal cognition, sensory function and resting blood pressure. They underwent tests of pulmonary and cognitive function as baseline data before dance therapy, and at 6th week and at the end of 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consisted of 50 minutes session, 3 times a week for 12 weeks. One session consisted of warming-up, expression, catharsis, sharing and closing stage. the intensity of the dance therapy was at the 40% of age-adjusted maximum heart rates. Data were analyzed with mean, standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. The results were as follows: 1. Pulmonary function(forced expiratory volumn at one second and forced vital capacity) of the experimental subjects significantly increased over time more than that of the control subjects. 2. The experimental group had significantly higher score for pulmonary function than the control group at the 12nd week after dance therapy. 3. Cognitive function of the experimental subjects significantly increased over time more than that of the control subjects. 4. The experimental group had significantly higher score for cognitive function than the control group at the 6th week and 12nd week after dance therapy. The findings showed the dance therapy could be effective in improving the pulmonary and cognitive function of the elderly.
Citations

This study was conducted to identify appetite and nutritional status of 48 cancer patients who have been irradiated over 150 cm2 on chest or pelvic area over the three-month period. The data were gathered 3 phases, Each from initiation to completion of radiotherapy through the questionnaires of anorexia, the anthropometric and biochemical measures were used such as weight, TSF, MAC, MAMC, serum albumin and hemoglobin, TLC. Using SAS program, data were analyzed by percentage, Mean+/-SD, and two-way repeated measures ANOVA. The results were summarized as follows: 1. Eighty five percent(85%) of the subjects were aged from fifties to sixties. Cancers in the chest area occurred in 100% of men, 56% of the all subjects. The other 44% were pelvic cancer and 71% of the pelvic cancer occurred in women. 2. There were no significant differences in the appetite scores by all groups(characteristics). Changes of the appetite score over time were statistically significant by age, sex, cancer areas staging, treatment modality, and radiation dosage (F=4.0, p=.022; t=6.09, p=.003; t=4.90, p=.009; F=3.28, p=.042; t=5.04, p=.0084; t=4.76, p=.011). The appetite score on the 2nd phase (4 weeks after initiating radiotherapy) decreased from the 1st phase (initiating irradiation), and then increased on the 3rd phase (completing irradiation). 3. There were no significant differences in the body weight and MAMC by all characteristics, and no changes in the body weight and MAMC over time. However there were significant differences of TSF, MAC, level of hemoglobin, level of albumin, and TLC by all characteristics during the three phases. TSF of the men and the chest cancer were lower than those of the women and the pelvic cancer (t=73.20, p=.0001; t=22.91, p=.0001). And there was significant difference by cancer staging(F=3.19, p=.050). But there was no change in TSF over time. MAC of the men and the chest cancer were lower than those of the women and the pelvic cancer each(t=9.23, p=.004; t=17.85, p=.0001). But no change in MAC over time. Levels of hemoglobin had significant differences by age, sex and cancer areas; levels of hemoglobin of older than the fifties, men, and chest area were higher than those on the others(F=3.82, p=.029; t=21.75, p=.0001; t=8.71, p=.005). Levels of albumin were significant differences by sex and cancer areas; levels of albumin on women, and pelvic area were higher than those on the others(t=6.34, p=.015; t=15.23, p=.0003). While the levels of hemoglobin were changed over time, levels of albumin were not changed and within normal limit. TLC of the men was higher than women(t=5.05, p=.029). Changes in the level of hemoglobin over time were statistically significant according to sex, cancer areas, and radiation dosage(t=3.49, p=.035; t=3.36, p=.039; t=4.04, p=.021).
Citations

This study was performed to explore the effects of a dance therapy on physical and psychological characteristics in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Suweon and Bucheon. Fifty eight subjects, aged between 65 and 93 years who had normal cognition, sensory function, balance, and resting blood pressure. They underwent tests of balance, flexibility, muscle strength, depression, and anxiety as baseline data before dance therapy, and at 6 th week and at the end of the 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy between April and July, 1998. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consists of 50 minutes session, 3 times a week for 12 weeks. One session was consisted of warming-up, expression, catharsis, sharing, and closing stage. The intensity of the dance therapy was at the 40% of age-adjusted maximum heart rates. Data were analyzed with mean, standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. 1. The results related to the physical characteristics were as follows : 1) The balance (standing on one leg, walking on the balancing bar), flexibility and muscle strength (knee extensor, knee flexor, ankle plantarflexor and dorsiflexor) of the experimental subjects significantly increased over time more than that of the control subjects. 2) The experimental group had significantly higher score for balance, flexibility, muscle strength of knee extensor, and knee flexor than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly higher score for muscle strength of ankle dorsiflexor and plantarflexor than the control group at the 6th week and the 12nd week after dance therapy. 2. The results related to psychological characteristics were as follows : 1) Scores of Geriatric Depression Scale, Hamilton Depression Rating Scale, and Zung's Self-rating Anxiety Scale of the experimental group were significantly decreased over time more than that of the control group. 2) The experimental group had significantly lower score for depression than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly lower score for anxiety than the control group at eh 6th week and the 12nd week after dance therapy. The findings showed that the dance therapy could be effective in improving the balances, flexibility, and muscle strength of lower limb, and effective in decreasing the depression and anxiety of the elderly. Additional merits of the dance therapy would be inexpensiveness, easy accessibility, and increasing interpersonal relationship. It can be suggested that the dance therapy is effective in the health promotion of the elderly.
Citations

This study looks at the various alternative therapy methods used in day to day life by elderly, over 60 years of age. The elderly have come to know and practice these methods for the following reasons : it is good for the health ; it is the method used in the olden days when there wesn't modern medicine ; it has been passed down from generations ; it can be done at home without having the need to go to the hospital ; acupuncture or poulticing can be used ; it can be done at home, which was an important factor in rural areas where hospitals are few and far between ; and [herbal] medicine could be prepared at home at no cast ; it derives from experience ; it is impossible to ignore tradition passed down through the generations. Diet control and plants(herbs) are methods most often used, as they are easy to find and can be readily used in critical situations. Other methods include oriental medicine practices of moxibustion with moxa cone, negative therapy, hand and finger acupunture, finger press method, ordinary acupunture, finger press method, ordinary acupunture, manual healing methods of massage, diaphoretic therapy and meditation to reach a state of calm, and qigong dirigation. The reasons for its use are as follows : it has been used before ; it is effective ; there is some improvement after the treatment ; it is not harmful to the body ; medicine cannot be obtained and it is the only thing available ; it is not good for an old person to go to the hospital everyday, the symptoms are not serious enough to go to a hospital ; and acupuncture is for these things. The means that the elderly have come to practice these methods are ; it has been used since the past ; it has been told by the elders ; they have been told by friends ; it was part of their knowledge ; and they have come to know by watching their mother. Further, to regain vitality lost through old age, the elderly have relied on hot soup, a hearty meal, brewed honey water, pumpkin, or ginseng. Humans, by instinct, would rub or massage the areas that caused pain. These actions, combined with a breathing technique have been recognized in Tong-Eui-Bo-Gam(the essential of eastern medicine), the complete work of early modern medicine, are a useful means to revive chi. This knowledge is thought to have greatly affected our healthy lifestyle. Furthermore, though the demand for medical services would increase with age, the elderly have not always been able to tend to their needs at the hospital for reasons economic or other. Hence, these alternative therapy methods seem to have been practiced as a temporary means of relief. The excellence of our traditional therapeutic custom has not received full recognition due to the argument relating to its scientific merits. As a result, it has become vital to prove their effectiveness through scientific and other experimental means. The potency of moxibustion with moxa cone and hand and finger acupunture have been proven scientifically, but diet and herbal methods appear to be practiced as a result of customs passed down from generations. In addition, it is submitted that the effectiveness of the traditional methods of disease control and our heathy lifestyle that are easily found in the nursing field must be verified.
Citations

This study was designed to investigate the effects of exercise therapy on joint mobility, daily activity, pain and depression of patients with ankylosing spondylitis. 25 persons with the experimental group and 25 persons with the control group were conveniently sampled among out-patients diagnosed with ankylosing spondylitis at the rheumatism center of H University Medical Center. The control patients were matched to the experimental group and they were selected considering sex and age. The exercise therapy was developed by the author with the assistance of exercise specialists. The program includes muscle relaxation, flexibility, muscle strengths, breathing strengths and straight posture exercises. The 20-minute exercise therapy was carried out to the experimental group once a day for eight weeks from October, 1997 to February, 1998. Before and after the experiments, joint mobility, daily activity, pain and depression were measured respectively. Data were analyzed by x2-test, t-test, paired t-test and unpaired t-test. The results were as follows : Joint mobility(cervical flexion, extension, shoulder flexion, abduction, hip abduction, knee flexion and fingertip to floor distance) and daily activity in the experimental group after the exercise were significantly increased than that in the control group. The pain and depression score in the experimental group after the exercise were significantly decreased than that in the control group. These findings may indicate that the exercise therapy is effective in increasing the joint mobility and daily activity, and also effective in decreasing pain and depression in patients with ankylosing spondylitis. Accordingly, the exercise therapy can be adopted as an effective nursing intervention for ankylosing spondylitis.

The purpose of this study is to analyze the effects of exercise therapy on serum lipid levels and antioxidants of obese and normal college female students. The subject group composed of ten normal-weight students(below 30% body fat ratio) and ten obese students(above 30% body fat ratio). After a pilot test, the subjects were given an eight-weeks exercise program. Before and after the exercise program, the subjects were given test for serum lipid and antioxidants were analyzed. The SAS program was used in the data analysis. The statistical measurements employed here were T-test, Wilcoxon signed rank test, and Wilcoxon rank sum test. The results of this research are as follows. 1) The effects of exercise therapy on serum lipid levels; Before the exercise therapy, the levels of Total-cholesterol, Triglyceride and LDL-cholesterol of the obese group were higher than those of the normal-weight group. However, the HDL-cholesterol levels were higher in the normal-weight group than in the obese group, but these differences were not significant. With the exercise therapy, the levels of Total-cholesterol increased gradually. The HDL-cholesterol increased gradually, the LDL-cholesterol level decreased in both groups, However, the Triglyceride level decreased in the obese group and increased in normal group, but the difference was not significant. 2) The effects of the exercise therapy on serum antioxidants; Before exercise therapy, the serum FR and GSSG levels of the obese group were significantly higher than those if the normal-weight group(p=0.00, p=0.04). The serum GSH level of the normal-weight group was higher than that of the obese group, and the serum MDA level of the obese group was higher than that of the normal-weight group. Again these differences were not significant. With exercise therapy, serum FR level was reduced and serum GSSG level significantly increased in both group(obese group p=0.01, normal-weight group p=0.01), The serum GSH level of the obese group significantly increased(p=0.01), and serum MDA level significantly increase in the obese group(p=0.01), but the difference in the normal-weight group was not significant. These results show that regular exercise therapy reduces serum FR levels and activation of antioxidant systems, and suppress oxidative stress. These effects were slightly higher in the obese group than in the normal-weight group. The regular exercise therapy decrease the serum Triglyceride levels more in the obese group than in the normal-weight group. However the improvement of the serum lipid profile may require a longer exercise period than eight weeks. The results show that the exercise therapy was overall more effective in the obese group than the normal-weight group.

This study was conducted to investigate whether exercise therapy applied in an efficacy expectation promoting program based on the self-efficacy theory of Bandura(1977) would increase self-efficacy and metabolism in NIDDM patients. The study design was a nonequivalent control group pre-test post-test quasi-experimental design. The exercise therapy applied in the efficacy expectation promoting program was composed of a staged exercise program, a small booklet relating personal experience with diabetes mellitus and a telephone coaching program on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. The subjects of the study were twenty eight NIDDM patients who received follow-up care regularly through the out-patient department of endocrine medicine in one general hospital which had a diabetic clinic. Fourteen were assigned to the experimental group and fourteen to the control group. The experimental group participated in the exercise therapy applied in the efficacy expectation promoting program from three to five times per week for four weeks and the control group did not have the program. The collected data were analyzed using the x2-test, t-test, paired t-test, and Cronbach's Alpha using SPSS/PC+. The results are summarized as follows : 1. Experimental group had higher efficacy score than control group(t=5.98, p=.00). And, There was a significant different in the efficacy score before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(t=-6.42, p=.00). 2. Experimental group did not have lower level of glucose metabolism than control group(FBS : t=.32, p=.75, HbA1C : t=.60, p=.55, pc 2hrs. glucose : t=-.29, p=.78). But, There was a significant different in the amount of glucose metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(FBS : t=3.63, p=.003, HbA1C : t=4.20, p=.00 2hrs . glucose : t=1.93, p=.001). 3. Levels of lipid metabolism were partly a significant different between Experimental group and control group(triglyceride : t=-1.87, p=.07, HDL cholesterol : t=-.29, p=.77, body weight : t=1.78, p=.09, Total cholesterol : t=-2.17, p=.04). And, There was partly a significant different in the amount of lipid metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(triglyceride : t=2.50, p=.03, HDL cholesterol : t=-.43, p=.67, body weight : t=5.34, p=.00, Total cholesterol : t=2.26, p=.04). In conclusion, it was found that exercise therapy applied in an efficacy expectation promoting program was an effective nursing intervention for increasing self-efficacy and metabolism.
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PURPOSE: The purpose of this study was to identify the effects of hand acupuncture therapy on sleep quality by means of a sleep questionnaire, polysomnography and a cerebral blood flow test in 30~59 year old adults. METHODS: The study was a sham controlled design. Twenty-two adults were assigned to the pellet stimulating group (11) or sham group (11). The pellet stimulating group received hand acupuncture therapy using New Seoam Press Pellets number 1 for 4 weeks. On the other hand, the sham group used the same Adhesive tape in terms of shape, size and quality as New Seoam Press Pellets number 1 for 4 weeks. A Transcranial Doppler Ultrasonography and Carotid Duplex Ultrasonography examination were used for evaluating cerebral blood flow. Data was analyzed using the SPSS 12.0 version program with Chi2-test, Fisher's exact test and Mann Whitney U-test. RESULTS: In the pellet stimulating group, subjective sleep quality significantly improved more than that of the sham group. Among the sleep indices of the polysomnography, total sleep time and sleep latency of the sham group significantly improved. The cerebral blood flow test didn't show any differences. CONCLUSION: These results suggest that hand acupuncture therapy is effective for subjective sleep improvement only, not polysomnographical sleep indices and cerebral blood flow.
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The effects of telephone intervention on self-care practices and quality of life for gynecological cancer patients under chemotherapy was investigated.
A non-equivalent control group pre-test post-test quasi-experimental design was used. The subjects were women cancer patients who had received less than two chemotherapy sessions at C university hospital of Chonnam province(26 in the experimental group: 25 in the control group). The patient's self-care practices(Na & Lee, 1999; Jang, 2004) and quality of life(Lee & Jo, 1997) were measured three times. using a questionnaire. The data was analyzed by Repeated Measures ANOVA, the Friedman test, and the Mann-Whitney test using the SPSS window version 12.0 program.
This study showed that the score of self-care practices and quality of life for the experimental group under telephone counseling were higher than those of the control group.
This study revealed that a telephone intervention as supportive nursing care for women cancer patients under going chemotherapy was effective for self-care practices and qualify of life during the recovery period. Futhermore, this study also suggests that telephone counseling can serve as a continuing nursing supportive intervention for women cancer patients for the upcoming stages of further chemotherapy.
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This research was conducted to compare the effects of drug therapy, physical therapy, and exercise on pain, disability, and depression in patients with chronic low back pain.
The research design of this study was a nonequivalent control group pretest-posttest design. The subjects of this study were 28 patients for the drug therapy & physical therapy, 24 patients for the drug therapy & exercise, and 22 patients for the physical therapy & exercise. Data was collected by MVAS, Oswestry disability questionnaires, and questionnaires of depression. It was analyzed by paired t-test for effectiveness, ANOVA, and Scheffe for comparison of the effects of the 3 experimental treatments, using SPSS/WIN 12.0.
There were no effects of drug therapy & physical therapy on pain, disability, and depression. However, there were effects of drug therapy & exercise and the physical therapy & exercise on pain, disability, and depression. The effects of physical therapy & exercise on pain, disability, and depression were the greatest, but there was no statistically significant differences between the drug therapy & exercise and the physical therapy & exercise.
Exercise is regarded as a more effective and easily accessible nursing intervention to apply alone than drug therapy or physical therapy simultaneously in reducing pain, disability and depression.
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The purpose of this study was to verify the effect of aromatherapy massage on abdominal fat and body image in post-menopausal women.
A Non-equivalent control group pre-post test Quasi-experimental design of random assignment was applied. All subjects received one hour of whole body massage as treatment by the same researcher every week for 6 weeks. Participants also massaged their own abdomen two times everyday for 5 days each week for 6 weeks. The two groups used different kinds of oil. The experimental group used 3% grapefruit oil, cypress and three other kinds of oil. The control group used grapeseed oil. Data was collected before and after the treatment using Siemens Somatom Sensation 4, a tape measure and MBSRQ. Data was analyzed by ANCOVA using the SPSS/PC+Win 12 Version.
Abdominal subcutaneous fat and waist circumference in the experimental group significantly decreased after aromathetapy massage compared to the control group. Body image in the experimental group was significantly better after aromathetapy massage than in the control group.
These results suggest that Aromatheapy massage could be utilized as an effective intervention to reduce abdominal subcutaneous fat, waist circumference, and to improve body image in post-menopausal women.
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