Purpose Lung cancer (LC) is the leading cause of cancer-related death globally, and understanding symptom clusters (SCs) among LC patients could improve symptom management. This scoping review provides a comprehensive summary of the most common SCs and their compositions identified in studies specifically investigating SCs of LC patients. Methods A scoping review was conducted following the Joanna Briggs Institute methodology. The study included LC patients as participants, SCs as the concept, and studies with distinct aim to investigate LC SCs as the context. We searched studies from inception to September 2022 in PubMed, Embase, PsycINFO, CINAHL, and the Cochrane Library databases using the terms: "lung cancer," "cancer survivors, " and "symptom cluster." Results: Of 41 reviewed reports, 188 SCs were identified. Both a priori and de novo method were used to identify LC SCs, with exploratory factor analysis being the most commonly used statistical method in the de novo approach. The three most frequent SCs were respiratory, gastrointestinal (GI), and psychological SCs. The most common respiratory SC included cough + dyspnea. Nausea + vomiting was the most prevalent cluster membership among GI SCs. Sad + feeling irritable + feeling nervous + worrying was the most common cluster membership among psychological SCs. Conclusion Respiratory, GI, and psychological SCs were common among LC patients, and addressing these clusters could improve symptom management strategies. Further research on SCs across the lung cancer trajectory is essential to enhance our understanding about SCs and facilitate effective symptom management throughout the disease course.
Purpose This systematic review and meta-analysis aimed to investigate the effects of aromatherapy interventions on stroke symptoms in stroke patients. Methods This study adhered to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. Relevant studies published between 2004 and 2022 were searched in the PubMed, CINAHL, Cochrane Library, EMBASE, ERIC, and RISS databases. The review included randomized and non-randomized studies of stroke patients who received aromatherapy interventions targeting stroke symptoms. The extracted literature was evaluated via the ROB 2 and ROBINS-1 quality appraisal checklists and visualized using a risk-of-bias visualization tool. Results The review included five randomized controlled trials and five quasi-experimental studies. The results showed that aromatherapy, administered through massage, inhalation, acupressure, mouth care, and olfactory stimulation, was effective in alleviating pain, constipation, oral health, motor power, muscle strength, balance, fatigue, and sleep quality. Aromatherapy also demonstrated beneficial effects in reducing depression, stress, delirium, blood pressure, pulse rate, respiration rate, serum cortisol, and antioxidants, while enhancing happiness, body temperature, and quality of life. A meta-analysis of mean differences in post-test results revealed that three studies reported a significant effect on pain, with an effect size of 1.85 (95% CI, 0.18~3.51). Conclusion Aromatherapy had positive effects on physical, physiological, psychological, cognitive, and integrative health outcomes. We recommend the use of aromatherapy in stroke patients to improve pain relief and health outcomes.
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Purpose This study aimed to identify the characteristics and efficacy of Intermittent Pneumatic Compression (IPC) interventions for preventing Venous Thromboembolism (VTE) in critically ill patients.
Methods: The CENTRAL, Embase, OVID, CINAHL, KMbase, KoreaMed, and KoreaScience databases were searched from January 7 to 11, 2023. The search included all records from the inception of each database up to January 2023, with publication language restrictions to English and Korean. Three reviewers independently carried out the entire process, which included data search, quality assessment, and data extraction.
Results: Out of 1066 articles, six Randomized Controlled Trials (RCTs) were included. One of the four studies that reported on the incidence of DVT, and one of the six studies that measured the incidence of Pulmonary Embolism (PE), found that IPC alone was effective in reducing the incidence of DVT and PE. One of the four studies that reported on VTE incidence demonstrated a significant reduction in VTE incidence with a triple intervention of IPC, anticoagulants, and elastic compression stockings compared to a combined intervention of anticoagulants and graduated compression stockings. Four studies that reported data on the incidence of bleeding reported no effect on reducing bleeding.
Conclusion: Our findings suggest that IPC interventions may reduce the incidence of DVT as a preventive strategy in critically ill patients. Further RCTs are necessary to evaluate the effect of IPC interventions on DVT prevention in this patient population and to provide robust evidence for critical care nursing.
Purpose After Transarterial Chemoembolization (TACE), patients may experience Post-Embolization Syndrome (PES), which is characterized by abdominal pain, fever, and nausea/vomiting. Various risk factors, including demographic, clinical, laboratory, and radiological data, have been reported. This study aimed to identify sex-specific risk predictors of PES following TACE. Methods This retrospective study included 1,495 patients who underwent TACE and were discharged from January 1, 2014 to December 31, 2021. The demographic, clinical, laboratory, and radiological characteristics of the patients undergoing TACE were analyzed. Descriptive statistics, the χ2 test, the independent t-test (or Mann-Whitney U test), Spearman correlation analysis, and logistic regression were used. Results The incidence of PES was higher in female (43.9%) than in male (37.3%). Multivariate logistic regression analysis Alanine aminotransaminase (ALT) levels as the only independent predictor of PES in female patients (Exp [B]=1.01, 95% Confidence Interval [CI]=1.00~1.01). The risk factors of PES in male patients were a tumor >5 cm in diameter (Exp [B]=2.51, 95% CI=1.46~4.32), the amount of lipiodol (Exp [B]=1.27, 95% CI=1.01~1.60), C-Reactive Protein (CRP) levels (Exp [B]=1.11, 95% CI=1.02~1.21), ALT level (Exp [B]=1.00, 95% CI=1.00-1.01), lymphocyte levels (Exp [B]=0.98, 95% CI=0.96~0.99), and right posterior section (S6-S7) (Exp [B]=0.71, 95% CI=0.55-0.92). Conclusion Oncology nurses should be aware of sex-specific differences in PES risk and monitor clinical, laboratory, and radiological data to evaluate PES in female and male after TACE. The results of this study will serve as basic data for establishing a clinical decision-supporting system.
Purpose The purpose of this study was to investigate the impacts of digital literacy, attitudes towards internet health information, and e-health literacy on health promotion behavior among adults. Methods A cross-sectional survey design was used. Data were collected from 260 adults aged 19 and older from two provinces. Data were collected from September 1 to 22, 2020. The data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression analysis. Results Hierarchic multiple regression analysis was conducted to evaluate the impact of the analyzed variables on participants' health promotion progress older age, better self-perceived health status, frequency of exercise (≥3/week), frequency of exercise (1~2/week), higher digital literacy scores, and no smoking history were associated with a higher degree of health promotion behavior, with an explanatory power of 37.0%. Conclusion Based on these results, in order to improve health promotion behavior in adults, it is necessary to pay more attention to younger people, those who do not exercise regularly, and smokers. In particular, as digital literacy was found to be a factor influencing health promotion behavior in adults, it is necessary to consider strategies that are tailored towards improving digital literacy in adults from all age groups and to conduct systematic education on digital devices.
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Purpose This study identified and compared the pain and associated symptoms of stable coronary artery diseases and acute coronary syndrome. Methods The study participants comprised 180 patients with stable coronary artery diseases and acute coronary syndrome. The data were collected from August 25, 2020, to October 30, 2020. Results We found that 77.2% of participants had pain and associated symptoms, and 85.6% had one or more associated symptoms. In the associated symptoms, patients with acute coronary syndrome expressed squeezing, and patients with stable coronary artery diseases expressed expanding. Patients with stable coronary artery diseases reported increased pain during exercise. Moreover, although there was no statistically significant difference, drinking, eating, and cold weather often exacerbated pain in patients with acute coronary syndrome.
The average pain intensity of patients with stable coronary artery diseases was moderate (4.09±2.79). The average pain intensity of acute coronary syndrome patients was severe (5.68±3.34). Patients with acute coronary syndrome mainly reported cold sweat and loss of consciousness. Palpitations and dizziness were prevalent complaints in patients with stable coronary artery diseases. Conclusion Based on this study's results, a nursing assessment can be performed when managing patients with coronary artery disease. In addition, a nursing assessment protocol could be developed based on the analysis results regarding pain and associated symptoms in patients with stable coronary artery diseases and acute coronary syndrome.
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Purpose This study aimed to examine the effects of health-related behaviors on metabolically healthy non-obese or obese groups and to analyze gender differences. Methods This study was a secondary descriptive study. A total of 14,277 adults from the Korea National Health and Nutrition Examination Survey 2013~2015 were classified as: metabolically healthy non-obese; metabolically unhealthy non-obese; metabolically healthy obese; or metabolically unhealthy obese. Five health-related behaviors (amount of alcohol consumption, smoking status, physical activity, daily energy intake, and sleep duration) were included as independent variables. Results The health-related behaviors associated with metabolic status in non-obese participants were drinking and smoking, whereas those of obese individuals were associated with physical activity. Subgroup analysis showed that more metabolically healthy non-obese men were light drinkers and former smokers than metabolically unhealthy non-obese men.
Metabolically healthy non-obese women were more likely to engage in physical activity than metabolically unhealthy non-obese women. Among the obese men, light drinking and physical activity were associated with metabolic status. Conclusion Evidence-based interventions promoting health-related behaviors are needed to support metabolic health, considering the metabolic status and obesity phenotypes of the participants and their gender.
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Purpose The purpose of this study was to compare and verify the effects of aroma essential oil inhalation and music listening on stress response, vital signs, and bispectral index.
Methods In a randomized controlled trial design, the participants consisted of healthy adults aged 20~50 years who were randomly assigned to the Aroma essential oil inhalation Group (AG), Music Listening Group (MLG), or control group. The AG inhaled aroma essential oil for 10 minutes, the MLG listened to music for 10 minutes, and the control group took a break for 10 minutes. Stressors introduced to the participants included 70 dB of white noise and an arithmetic calculation.
Results The perceived stress was significantly different between three groups at 10 minutes and 30 minutes after the intervention. The stress responses of the AG and MLG were significantly lower than that of the control group. At 10 minutes and 30 minutes after the intervention, there were significant differences in the Bispectral index (BIS) between three groups, and the BIS of the AG and MLG were significantly lower than that of the control group. At 30 minutes after the intervention, the stress index, systolic blood pressure, and heart rate were significantly different between three groups.
Conclusion Aroma essential oil inhalation and music listening are effective nursing interventions as they reduce stress, stabilize vital signs, and have sedative effects in healthy adults who perceive stress.
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Purpose This study aimed to investigate the symptom clusters and quality of life among patients with type 2 diabetes mellitus and to identify the relationship between quality of life and symptoms by cluster. Methods Data were collected through questionnaires and medical records of 123 patients with type 2 diabetes between December 27, 2018 and May 8, 2019. Type 2 diabetes-related symptoms were investigated using the Diabetes Symptom Self-Care Inventory, and quality of life was evaluated using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L). The collected data were analyzed using mean, standard deviation, factor analysis, Pearson correlation coefficient, and hierarchical multiple regression analysis. Results Tiredness was a most frequently reported symptom; however, symptom with weight loss was the most critical symptom reported. Five symptom clusters were identified, four of which correlated with quality of life. Hierarchical multiple regression analysis showed that thirst-fatigue clusters affected quality of life (β=-.26, p=.019). Conclusion Active treatment and continuous lifestyle management are needed to maintain proper blood sugar levels to address type 2 diabetes mellitus-related symptoms within a thirst-fatigue cluster. Identifying the cause of fatigue and applying physical and psychosocial interventions is also required. Symptoms experienced by patients with type 2 diabetes are connected to clusters. Effective disease management and improvement in the quality of life can be achieved by identifying these symptoms through merging and managing the relevant symptoms simultaneously.
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Purpose Intradialytic exercise could be a cornerstone of management in hemodialysis patients. The aim of this study was to evaluate the effect of intradialytic stretching training on Restless Legs Syndrome (RLS) and sleep quality among patients undergoing hemodialysis.
Methods: This 8-week quasi-experimental design study involved adult patients undergoing chronic hemodialysis treatment for at least 3 months at the Drug Dependency Hospital Nephrology Unit in Jakarta. Nineteen participants were listed in each group, so a total of 38 participants were registered. Convenience sampling was used to select respondents. In addition, each respondent was asked to complete the International Restless Legs Syndrome Study Group (IRSSG) rating scale and the Pittsburgh Sleep Quality Index (PSQI).
Results: The majority of respondents were women (55.3%), unemployed (71.1%), with duration of hemodialysis>12 months (55.3%), and having hemoglobin levels less than 10 mg/dl (68.4%). The mean RLS before intervention was 1.74 (Standard Deviation [SD]=0.23) and after intervention, there was significant reduction in RLS score to a mean of 0.42 (SD=0.17) (p<.001). Similarly, mean sleep quality before intervention was 4.02 (SD=2.56) and after intervention, it reduced significantly to a mean of 6.16 (SD=3.18) (p<.001).
Conclusion: Intradialytic stretching training could play a significant role in decreasing RLS and improving quality of sleep. Further studies with larger sample sizes and longer periods of intervention are required to validate our results and contribute to better patient outcomes.
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PURPOSE This study aimed to identify the factors explaining the performance of health behaviors among adults with metabolic syndrome based on the theory of planned behavior. METHODS A total of 218 adults with metabolic syndrome were recruited for the study from September to December, 2017. Data were analyzed using SPSS/WIN 22.0 and AMOS 24.0. RESULTS The hypothetical model appeared to fit the data with χ²/df=2.65, SRMR (Standardized Root Mean Residual)=.07, PNFI (Parsimonious Normed Fit Index)=.67. Attitude toward health behavior, subjective norm and perceived behavioral control explained 32.3% of variance in intention toward health behavior. Perceived behavioral control showed significant direct effects and mediating effect through intention on health behavior (γ=.57, t=5.85). Family support also had significant direct effects on health behavior (γ=.38, t=4.75). Attitude toward health behavior, subjective norm, perceived behavioral control, and family support were the significant factors explaining 56.3% of variance in the performance of health behaviors among patients with metabolic syndrome. CONCLUSION Health promotion programs for behavioral modification in this population should focus on these factors to lead to better health outcomes. Further studies are warranted to test the health promotion strategies based on theory of planned behavior for long-term change toward a healthy lifestyle among individuals with metabolic syndrome.
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PURPOSE This study aimed to examine the relationship between illness perception, stress, and sleep, focusing on the influence of illness perception on the quality of sleep through the mediating effect of stress in patients with metabolic syndrome risk factors. METHODS A cross-sectional correlational study was conducted with 219 patients with two metabolic syndrome risk factors. Participants were recruited from outpatient clinics in Daegu and Gyeongbuk between June and July 2016. Data were collected using a self-administered structured questionnaire that included items from the Brief Illness Perception Scale, the Perceived Stress Inventory, and the Pittsburgh Sleep Quality Index. Pearson's correlation coefficient, independent t-test, one-way ANOVA, multiple linear regression analysis, and a SPSS macro bootstrap approach were performed. RESULTS There were significant correlations between illness perception and sleep (r=.42, p<.001) and between stress and sleep (r=.49, p<.001). Illness perception was a significant predictor of stress (t=7.99, p<.001) and sleep (t=5.83, p<.001) after adjusting for the influence of age, gender, job status, and body mass index. A mediating effect of stress on the relationship between illness perception and sleep was demonstrated by Baron and Kenny's approach (Z=4.57, p<.001) and the PROCESS macro for SPSS (95% confidence interval=0.04~0.13). CONCLUSION This study suggests that the negative impact of illness perception on sleep can be reduced by regulating stress. Further, it is necessary to develop intervention programs that can reduce stress linked to the illness perception among patients with metabolic syndrome risk factors.
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PURPOSE To provide basic data for the health management of adults with prolonged fatigue, demographic characteristics, stress, sleep quality, and metabolic syndrome were compared between groups with and without prolonged fatigue. METHODS Data of 370 adults (197 with Prolonged Fatigue [PF] and 173 without PF) from the 2014~2016 database of Korea Medicine Data Center were used. Fatigue, stress and sleep quality were measured with the revised Chalder Fatigue Scale, Psychosocial Well-being Index-Short Form, and Pittsburgh Sleep Quality Index, respectively. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS First, regarding demographic characteristics, there were significant differences in occupation, smoking, and Body Mass Index (BMI) between groups with and without PF. More of the participants with PF than those without PF were employed, and smokers. They were also more likely to be obese than the participants in the group without PF. Second, there were significant differences between the groups in terms of stress and sleep quality; the participants with PF showed higher stress and lower sleep quality than those without PF. Finally, the prevalence of metabolic syndrome was found to be higher in the participants with PF than those without PF. CONCLUSION Considering the characteristics of the participants with PF, it is necessary to develop nursing programs to improve stress, sleep quality, and metabolic syndrome to reduce fatigue. These kinds of nursing programs are particularly necessary for people who are smokers, obese and employed.
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PURPOSE This study aimed to compare the effects of hand massage with the preferred aroma oil to those of hand massage with lavender oil on stress and sleep in residents at a long-term care facility. METHODS A group randomized controlled design was used. Of the 37 participants, 19 were assigned to the experimental group(hand massage with the preferred aroma oil) and 18 to the control group(hand massage with lavender oil). Data collection was performed from Nov. 26 2016 to Jan. 27 2017. Hand massage was offered for 5 minutes each side 3 times a week for a total of 12 sessions over 4 weeks. Stress was measured using the Perceived Stress Questionnaire and sleep was measured using the Verran and Snyder-Halpern Sleep Scale. RESULTS Subjects in the experimental group showed significantly lower stress levels (physical stress, t=−2.10, p=.048; psychological stress, t=−4.41, p<.001) and sleep (t=3.37, p=.002) than those in the control group. CONCLUSION These results suggest that aromatherapy with hand massage should consider client aroma preference for elderly at long-term care facilities in the future.
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PURPOSE The purposes of this study were to investigate the moderating effect of lifestyle and Type-D personality on the relation between metabolic syndrome and severity of coronary artery disease and to provide practical knowledge and directions for nursing intervention. METHODS The participants were 111 adult outpatients with coronary artery disease in the cardiology department of a medical center in Korea. The study tools included diagnostic criteria for metabolic syndrome, lifestyle evaluation tool for patients with metabolic syndrome, the Korean Type-D scale-14, and measures of severity of coronary artery disease. The data were obtained by electronic medical record reviews and surveys using structured questionnaires and interviews. Data were analyzed using descriptive statistics, χ2 test, independent t-test, one-way ANOVA, Pearson's correlation coefficient, multiple linear regression analysis and two-way ANOVA. RESULTS The severity of coronary artery disease was positively correlated with the presence of metabolic syndrome (r=.26, p=.006) and type-D personality (r=.49, p < .001). There was a significant negative correlation (r=−.54, p < .001) between the severity of coronary artery disease and lifestyle. Lifestyle had the moderating effect on the relationship between metabolic syndrome and severity of coronary artery disease (β=−.22, p < .001), but type-D personality had no moderating effect (F=0.13, p=.719) on it. CONCLUSION Based on the results of this study, it is necessary to establish individualized intervention considering the condition of the patients according to the criteria of the metabolic syndrome diagnosis when establishing the lifestyle intervention plan. And also it is necessary to define influencing factors including the personality on lifestyle change.
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PURPOSE The purpose of this study was to assess the relationship between cognitive function impairment and quality of life (QoL) among patients with breast cancer. Specifically, the intention was to verify the mediating effects for promoting behaviors leading to better health and QoL. METHODS A purposive sample of 152 patients undergoing chemotherapy was recruited. A cross-sectional survey design was used. Data were collected using four instruments: Everyday Cognition Scale, Korean Mini-Mental State Examination, Functional Assessment of Cancer Therapy-Breast Cancer Version 4, and Health Promoting Lifestyle Profile. RESULTS The mean score for subjective cognitive decline was 65.84; the health promotion behavior was 95.89, and 83.34 for QoL. Health promotion behavior was directly affected by cognitive decline (R2=6.0%) as was QoL (R2=43%). Subjective cognitive decline (β=-.57, p<.001) and health promotion behavior (β=.37, p<.001) were seen as predicting factors in QoL and explained 56% (R2=56%). Health promotion behavior had a partial mediating effect in the relationship between self-reported cognitive decline and QoL (Sobel test: Z=-3.37, p<.001). CONCLUSION Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline and promoting health promotion behavior are highly recommended to improve QoL in cancer patients.
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PURPOSE The purpose of this study was to examine the effects of health promotion program on healthy aging preparation for late middle aged women. METHODS The research design was a non-equivalent control group quasi-experimental study. Participants were recruited from K and Y cities in Gyeong-nam Province from October, 2013 to January, 2014. They were 26 for the experimental group and 31 for the control group. The experimental group participated in a health promotion program for healthy aging preparation. The program consisted of education, exercise, and small group discussion over 8 weeks. Data were analyzed by Chi-square, t-test and ANCOVA, using the PASW 18.0 program. RESULTS There were significant improvements in aging anxiety and general self-efficacy, health promoting behaviors in the experimental group compared to those of the control group. However, there was no significant differences in attitude toward older adults between the two groups. CONCLUSION The health promotion program on healthy aging preparation for late middle aged women was found to be effective in enhancing aging anxiety and self-efficacy, and health promoting behavior. Thus, the developed program is recommended for use in clinical practice as an effective nursing intervention for late middle aged women in order to keep up with their health in later life.
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PURPOSE This study was to develop a health promotion program for marriage immigrant women and to evaluate its efficacy. METHODS The health promotion program was comprised of eight 100-minute weekly sessions. Each session included understanding of health responsibility, nutrition, physical activity, interpersonal relations, stress management, and self actualization. The research was conducted under the principles of nonequivalent control group pretest-post test design. The outcome variables were health promoting behavior, health status, acculturation, self efficacy, and perceived barrier. The participants were 15 immigrant women in the experimental group and 16 in the control group. Data was analyzed using chi2 test, Fisher's exact test, Mann Whitney U-test and Wilcoxon signed rank test. RESULTS There was a significant improvement in health promoting behaviors (U=-3.08, p=.002), left shoulder flexibility (U=-3.02, p=.003), right shoulder flexibility (U=-3.02, p=.003), low back flexibility (U=-3.37, p=.001), social health status (U=-3.38 p=.001) and subjective health status (U=-2.17 p=.030) in the experimental group compared to the control group. CONCLUSION The health promotion program for marriage immigrant women was an effective intervention for improving health promoting behavior, physical health status, social health, and subjective health status. Therefore, the developed health promotion program needs to be applied to married immigrant women in other kinds nursing care settings in future research.
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