암 생존력에 대한 개념분석

변혜선,박현주,김지연 대한종양간호학회 2012 Asian Oncology Nursing Vol.12 No.3

Purpose: The purpose of this study was to identify attributes of the concept of cancer survivorship. Methods: Walker & Avant’s concept analysis framework (2005) was used to review the medical & nursing text books, medical and nursing research articles related to cancer survivorship and published from 1985 to 2011. Results: There were nine aspects of the concept of cancer survivorship: A process, liminality, uncertainty, life-changing experience, complexity, unique experience, duality of positive and negative aspects, partnership, and need for support. Antecedents of cancer survivorship were cancer diagnosis and perception as a cancer survivor. Empirical referents of cancer survivorship were survival rate, quality of life, adaptation to the survivorship experience, and health-related hardiness, social support, spirituality, and health behavior. The consequences of cancer survivorship were effects on the physical, psychosocial, spiritual and socio-economic well-being of the patients. Conclusion: This concept analysis of cancer survivorship is expected to contribute to promotion of survivorship care in the clinical field by removing conceptual ambiguity and confirming the true meaning of survivorship care.

Cancer Survivorship에 대한 이해와 전망

김수현(Kim Soo Hyun) 대한종양간호학회 2010 Asian Oncology Nursing Vol.10 No.1

Purpose: The purpose of this article was to review and discuss the current status, issues, and nursing perspectives of cancer survivorship. Methods: A comprehensive literature review was conducted. Results: The major areas of concern for the survivors included recurrence, secondary malignancies, and long-term treatment sequalae which affect their quality of life. The four essential components of survivorship are prevention, surveillance, intervention, and coordination. Cancer survivorship care plan should address survivor’s long-term care, such as types of cancer, treatment modalities, potential side effects, and recommendations for follow-up. It also needs to include preventive practices, health maintenance and well-being, information on legal protections regarding employment and health insurance, as well as psychosocial services in the community. Survivorship care for cancer patients requires multidisciplinary efforts and team approach. Conclusion: Nurses are uniquely positioned to play a key role in ensuring quality services for cancer survivors and family members. Nurses should review the care plans for cancer survivorship with patients and families by instructing them when to seek medical treatment, promoting any recommended surveillance protocols, and encouraging healthy life styles for health promotion and quality of life.

Long-Term Outcomes of High-Flexion Design Total Knee Arthroplasty with a Short Posterior Flange

Chang-Rack Lee,Dae-Hyun Park,Ki Seong Heo,Se-Myoung Jo,Kyung-Jae Seo,Seung-Suk Seo 대한정형외과학회 2024 Clinics in Orthopedic Surgery Vol.16 No.2

Background: The purpose of this study was to evaluate the clinical and radiological outcomes of high-flexion total knee arthroplasty (TKA) using Vega Knee System (B. Braun, Aesculap) at a long-term follow-up and to analyze the implant survivorship. Methods: We enrolled 165 patients (232 knees) with a minimum 7-year follow-up after TKA (VEGA Knee System). For clinical assessment, range of motion (ROM), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used. For radiologic assessment, hip-knee-ankle angle, component position, and the existence of radiolucent lines and loosening were used. Survival analysis was conducted using the Kaplan-Meier method. Results: The mean follow-up period was 9.8 years. The mean ROM increased from 124.4° to 131.4° at the final follow-up. The WOMAC score decreased from 38.5 to 17.4 at the final follow-up (p < 0.001). All 5 subscales of the KOOS improved at the final follow-up (all subscales, p < 0.001). Revision TKA was performed in 10 cases (4.3%), which included 9 cases of aseptic loosing and 1 case of periprostatic joint infection. Of the 9 aseptic loosening cases (3.9%), 8 cases (3.4%) were loosening of the femoral component and 1 case (0.4%) was loosening of the tibial component. When revision for any reason was considered an endpoint, the 10-year survivorship was 96.2% (95% confidence interval [CI], 93.9%–98.5%). On the other hand, when revision for aseptic loosening was considered the endpoint, the 10-year survivorship was 96.6% (95% CI, 94.4%–98.8%). Conclusions: The Vega Knee System provided good clinical results in the long-term follow-up period. Although the VEGA Knee System showed acceptable implant survivorship, loosening of the femoral component occurred in about 3.4% of the patients. For more accurate evaluation of the survivorship of high-flexion design TKA with a short posterior flange, it is necessary to conduct more long-term follow-up studies targeting diverse races, especially Asians who frequently perform high-flexion activities.

Population dynamics of the red-eared slider (Trachemys scripta elegans) with changes in the population dependent carrying capacity in Republic of Korea

Wi Yunju,Oh Gyujin,Kang Hee-Jin,성하철,Cheon Seung-ju,홍성진 한국생태학회 2022 Journal of Ecology and Environment Vol.46 No.1

Background: In this study, we proposed that the population dynamics of non-native red-eared sliders (Trachemys scripta elegans) depends on the species’ habitat extension and survivorship. We used a logistic equation with time-dependent habitat carrying capacity. In detail, the present carrying capacity depends on the red-eared slider population of the previous year. Anthropogenic activities such as the abandonment of previously captive red-eared sliders or the release due to religion customs would supply new habitats to the species. Therefore we assumed that anthropogenic spread increases the habitat carrying capacity. Based on the urbanization increase rate of 3% in Korea from 1980 to 2000, we assumed an annual spread of 3% to simulate the population dynamics of the red-eared slider. In addition, the effect on the population of an increase of natural habitats due to migration was simulated. Results: The close relationship between the distributions of non-native red-eared sliders and of urbanized areas demonstrates that urbanization plays an important role in providing new habitats for released individuals. Depending on the survivorship, the population of the red-eared slider in Korea increased 1.826 to 3.577 times between 1980 and 2000. To control population growth, it is necessary to reduce carrying capacity by reducing habitat expansion through prohibition of release into the wild ecosystem and careful managements of the wetland or artificial ponds. Changes in the habitat carrying capacity showed that the population fluctuated every other year. However, after several years, it converged to a consistent value which depended on the survivorship. Further, our results showed that if red-eared sliders expand their habitat by natural migration, their population can increase to a greater number than when they have a 99% survivorship in a fixed habitat. Conclusions: Further introductions of red-eared sliders into wetlands or artificial ponds should be prohibited and managed to prevent future spread of the species. Moreover, it is important to reduce the species’ survivorship by restoring disturbed ecosystems and maintaining healthy ecosystems.

유방암 및 부인과 암 생존자의 삶의 질에 대한 생존단계별 비교 연구

임정원(Jung-won Lim),한인영(In-young Han) 한국사회복지학회 2008 한국사회복지학 Vol.60 No.1

본 연구는 유방암 및 부인과 암 생존자를 대상으로 암 생존 단계에 따른 삶의 질의 차이를 다각적인 측면에서 조사함으로써 그들의 삶의 질을 생존 단계별로 이해하는데 그 목적이 있다. 서울에 거주하는 110명의 유방암 및 부인과 암 생존자를 대상으로 세 개의 표준화된 삶의 질 척도를 사용하였고, 연구분석을 위해 급성, 확장, 영속적 생존단계에 따라 크게 세 집단으로 구분하였다. 연구 결과는 암 생존자의 생존 기간이 길어지면서 신체적 측면에서의 삶의 질이 전반적으로 향상됨을 증명하였다. 하지만, 심리 사회적 기능과 관련된 영역에서는 유의미한 차이를 보여주지 못했다. 본 연구는 향후 암 생존자의 삶의 질을 향상시키기 위해, 생존 단계를 고려한 차별화된 전략 개발 및 다각적 측면에서의 사회사업적 접근을 시사한다. Purpose: This study aims to better understand the quality of life (QOL) for Korean breast and gynecological cancer survivors by examining the differences in multi-dimensional QOL outcomes according to stage of cancer survivorship. Methods: To identify the multiple dimensions of health status and psychosocial outcomes, three standardized QOL and psychological distress measures were administered to 110 Korean breast and gynecological cancer survivors. These participants were divided into three groups based on the stage of cancer survivorship. Results: Analyses of covariance revealed that once important confounders were controlled for, QOL outcomes were partially different depending on the stage of cancer survivorship. Results for SF-36 measure showed significant differences between acute and long-term survival stages, indicating that QOL for cancer survivors had gradually improved in the physical domain. However, there were no significant group differences in the psychological domain of SF-36. Additionally, QOL-CS and BSI-18 measures did not show significant QOL differences according to the stage of cancer survivorship. Conclusions: Evidence that, for Korean survivors, QOL outcomes differ according to the stage of cancer survivorship serves as a rationale for developing discriminatory strategies and interventions that take into account survival stage.

유방암 및 부인과 암 생존자의 사회적 지지: 암 병기 및 생존단계별 비교분석

백옥미 ( Ok Mi Baik ),임정원 ( Jung Won Lim ) 한국가족사회복지학회 2011 한국가족복지학 Vol.32 No.-

본 연구는 유방암 및 부인과 암 생존자들의 병기별, 생존단계별 사회적 지지의 차이를 고찰, 생존자들의 특수성에 따른 사회적 지지 욕구를 이해함으로써 개별화된 사회사업적 개입방안을 제시하는데 목적이 있다. 이를 위해 본 연구는 사회적 지지의 다양한 측면을 확인하기 위해 사회적 지지의 구조적, 기능적 측면을 포괄하는 다양한 사회적 지지척도를 사용했다. 연구대상은 유방암 및 부인과 암으로 진단받은 110명의 성인 여성으로, 서울에 위치한 5개의 종합 병원에서 설문조사를 통해 수집되었다. 분석 결과, 가장 진행된 형태인 3기 진단자들이 사회적 지지를 가장 낮게 인지하고 있었으며 특히 2기 진단자들에 비해 유의미하게 차이가 났다. 또한 3기 진단의 응답자들이 암 치료 및 적응과 관련한 제반 서비스의 이용 횟수도 낮았으며, 향후 서비스 이용 욕구도 낮은 것으로 나타났다. 생존기간별 분석에서는 진단받은지 2년 이하의 급성 생존단계 응답자들이 진단 후 2-5년 경과된 확장 생존단계의 사람들이나 진단 후 5년 초과된 영속 생존단계 응답자들에 비해 유의미하게 높은 서비스 이용욕구를 보였다. 이와함께 서비스 이용 욕구 면에서도 생존단계별로 필요로 하는 서비스의 우선순위가 다르게 나타났다. 본 연구는 장기 유방암 및 부인과 암 생존자들이 지속적으로 증가하고 있는 현실을 감안할 때 병기별, 생존단계별로 차별화된 사회사업적 개입의 필요성을 시사한다는 점에서 의의가 있다. This study aims to understand the social support among Korean breast and gynecological cancer survivors by examining the differences according to cancer stage at diagnosis and the stage of cancer survivorship. Thus, this study tried to suggest the strategies for social work intervention based on the survivors` specific needs. The research subjects were 110 breast and gynecological cancer survivors in Korea. The participants were divided into four groups by the cancer stage at diagnosis from 0 to 3 stage and three groups such as acute, extended and long-term survival stages. Analyses of covariance revealed that the participants at stage 3 at diagnosis showed the statistically significant lower level of perceived social support compared to the participants at earlier stages. The participants at stage 3 also showed lower use of supportive care services and needs for services. The participants at acute survival stage showed significantly higher needs for supportive care services compared to the participants at the later survivorship stages. Overall, this study evidenced that the breast and gynecological cancer survivors have distinct recognition and needs related to social support according to their cancer stage and their stage of cancer survivorship. Therefore, this study suggests the specific intervention strategies based on the cancer stage and the stage of survivorship.

부인암 환자의 생존단계에 따른 디스트레스와 신체상 비교

박정숙(Park, Jeong Sook),이혜란(Lee, Hye Ran) 대한종양간호학회 2014 Asian Oncology Nursing Vol.14 No.1

Purpose: This study was to compare distress and body image according to the stages of cancer survivorship in patients with gynecological cancer. Methods: The subjects were 231 patients who visited for treatment or follow-up care at a university medical center in a city, Korea. These participants were divided into three groups based on the stages of cancer survivorship. The data were collected from November, 18, 2010 to January, 28, 2011 with the use of a structured questionnaire which measured the distress thermometer (DT) and problem list (PL), and body image. Results: Distress scores were not significantly different among three stages of cancer survivorship, but the patients of acute cancer survival experienced the distress of 4.50 point of moderate level (DT>4). The problem list of distress score was significantly higher in the acute cancer survival than long-term cancer survival (F=3.04, p=.048). The score of body image was significantly lower in the acute cancer survival stage than long-term cancer survival (F=3.69, p=.026). Conclusion: Gynecological cancer patients in the acute cancer survival among the three stages will to need to provide a nursing intervention to decrease distress and improve body image.

Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys

Yoon, Hyung-Suk,Yang, Jae Jeong,Song, Minkyo,Lee, Hwi-Won,Lee, Yunhee,Lee, Kyoung-Mu,Lee, Sang-Ah,Lee, Jong-koo,Kang, Daehee Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.11

Background: Though a large proportion of cancer survivors are assumed to be commonly affected by sleep disturbance, few studies have focused on short sleep problems and its correlates among Korean cancer survivors. The purpose of this study was to evaluate the prevalence of short sleep in adult cancer survivors from a nationwide population-based sample and to identify risk factors for short sleep duration. Materials and Methods: Based on the fourth and fifth Korea National Health and Nutrition Examination Surveys (2007-2012), 1,045 cancer survivors and 33,929 non-cancer controls were analyzed. The prevalence of short sleep was compared between these two groups. Associations between short sleep and its correlates were evaluated using multiple logistic regression among cancer survivors: odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated after adjusting for sociodemographic factors, lifestyle factors, psychological conditions, and cancer-related factors. Results: About 8.1% of cancer survivors slept for less than 5 hours per day (6.2% men and 9.3% women), whereas this was the case for only 3.7% of non-cancer controls. Cancer survivors who had the lowest household income level showed a significantly higher likelihood for short sleep (adjusted OR 2.82, 95%CI 1.06-7.54). Self-reported poor health and depressive symptoms were found to be associated with significantly increased likelihood for short sleep in cancer survivors (adjusted OR 3.60, 95%CI 1.40-9.26 and adjusted OR 2.00, 95%CI 1.17-3.42). Gastric cancer survivors had a 3.97-fold increased risk for short sleep (95%CI 1.60-9.90). Conclusions: The prevalence of short sleep occurs at a high rate among the Korean cancer survivors, which may indicate a poorer quality of life and a higher risk of future complications in survivorship. Targeted interventions that can assist cancer survivors to cope with sleep disturbances as well as ensuring psychological stability are warranted to reduce the latent disease burden.

Public attitudes toward cancer and cancer patients: a national survey in Korea

Cho, Juhee,Smith, Katherine,Choi, Eun‐,Kyung,Kim, Im‐,Ryung,Chang, Yoon‐,Jung,Park, Hyun‐,Young,Guallar, Eliseo,Shim, Young Mog John Wiley Sons, Ltd 2013 PSYCHOONCOLOGY Vol.22 No.3

<P><B>Abstract</B></P><P><B>Background</B></P><P>Regardless of improved survival rate, negative images and myths about cancer still abound. Cancer stigma may reduce patients' life opportunities resulting in social isolation, decreased level of emotional well‐being, and poor health outcomes. This study was aimed to evaluate public attitudes toward cancer and cancer patients and people's willingness to disclose cancer diagnosis in South Korea.</P><P><B>Methods</B></P><P>A cross‐sectional survey was conducted in August and September 2009. A nationally representative sample of 1011 men and women with no history of cancer was recruited. A set of 12 questions grouped into three domains (impossibility of recovery, cancer stereotypes, and discrimination) was used to assess public attitudes toward cancer.</P><P><B>Results</B></P><P>It was found 58.5% of study participants agreed that it is impossible to treat cancer regardless of highly developed medical science, 71.8% agreed that cancer patients would not be able to make contributions to society, and 23.5% agreed that they would avoid working with persons who have cancer. The proportions of people who said that that they would not disclose a cancer diagnosis to family, friends or neighbors, or coworkers were 30.2%, 47.0%, and 50.7%, respectively. Negative attitudes toward cancer were strongly associated with lower willingness to disclose a cancer diagnosis.</P><P><B>Conclusions</B></P><P>Negative attitudes, stereotypes, and discriminating attitudes toward cancer and people affected by the disease were very common in spite of clinical progress and improved survivorship.</P><P><B>Impact</B></P><P>Our findings emphasize the need for health policy and social changes to provide a more supportive environment for cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd.</P>

암 생존자를 위한 한국형 지역사회 건강돌봄체계 개발 연구

임정원 ( Lim¸ Jung-won ),김민정 ( Kim¸ Min Jung ) 경희대학교 사회과학연구원 2021 社會科學硏究 Vol.47 No.2

항암 치료 후 일상생활로의 복귀에 어려움을 경험하는 암 생존자를 위해, 지역사회 단위의 ‘암 생존자 건강돌봄체계(Cancer Survivorship Care Plan)’가 필요함에도 불구하고, 우리나라의 경우 이들을 위한 지역사회 건강돌봄체계가 아직 구축되어 있지 않다. 본 연구의 목적은 미국에서 운영하고 있는 암 생존자를 위한 지역사회 기반 건강돌봄체계에 대한 문헌고찰을 통해 한국형 지역사회 건강돌봄 운영 방안을 제안하는 데 있다. 지역사회 건강 돌봄체계에 대한 문헌 분석은 서비스 제공 주체, 욕구 및 서비스 내용, 효과성 평가의 세가지 항목으로 나누어 실시하였다. 욕구 및 서비스 내용은 행동적, 심리적, 사회적 요인을 중심으로 각 요소와 관련된 암 생존자의 문제와 이에 효과적으로 대응할 수 있는 서비스 제공자를 위한 권고사항을 제시하였다. 한국형 지역사회 기반 암 생존자 건강돌봄체계를 발전시키기 위한 방안으로 암 생존자 건강관리를 위한 전문 인력 양성, 암 생존자 건강돌봄체계 운영을 위한 지침서 개발, 종양학 전문의와 일차 진료의 간의 효과적인 의사소통 및 유기적인 연계, 암 생존자 건강돌봄체계에 대한 연구 확대를 제안하였다. An integrated cancer survivorship care plan designed for cancer survivors to promote their adjustment in the community has not been developed in Korea, despite a variety of difficulties they face after cancer treatment. The purpose of this study was to review articles regarding cancer survivorship care plans and programs which had been proposed in the United States, and to find applicability and practical implications for Korea in developing a cancer survivorship care planning model. Specifically, cancer survivorship care plans were analyzed based on 1) service providers, 2) service needs and contents, and 3) evaluation of the effectiveness. In terms of service needs and contents, cancer survivors' issues were categorized by behavioral, psychological, and social factors and recommendations were provided to effectively manage survivors' issues. Strategies to develop cancer survivorship care plans in Korea included raising professionals, retaining resources, developing tools to identify high-risk groups, promoting effective communications and networks between oncologist and primary care doctors, and developing cancer survivorship care plan manuals. Further studies need to develop an evidence-based Korean cancer survivorship care planning model, considering Korean health care system and culture.