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오복자(Oh, Pok Ja),최은숙(Choi, Eun Sook),이진(Lee, Jin) 대한종양간호학회 2019 Asian Oncology Nursing Vol.19 No.2
Purpose: The purpose of this study was to explore the experiences of adult cancer patients living with chemotherapy induced peripheral neuropathy (CIPN). Methods: Data were collected from January 2018 to April 2018 through in-depth interviews with nine patients of colorectal and breast cancer. The main question was, ‘What is your experience living with CIPN such as tingling and/or numbness?’ . The data were analyzed using Colaizzi’s phenomenological method. Results: Three theme clusters and six themes emerged: (1) unusual body change; ‘experience of unusual distressing symptoms’ , ‘daily activities and functioning affected’ , (2) CIPN: a less important risk; ‘CIPN: a distressing and have to endure’ , ‘lack of concern and therapeutic communication’ , (3) struggle for distressing CIPN through trial and error; ‘try all the remedies that can do’ , ‘getting used to distressing CIPN’ . Conclusion: These results showed that patients did not consider CIPN important until symptoms affected daily activities and QOL. They then tried self-management strategies to deal with CIPN through trial and error. A two-way exchange of information between patients and health professionals could help patients understand CIPN and deal with symptoms if they occur.
존엄중재가 말기 환자의 심리적ㆍ실존적 디스트레스에 미친 효과
오복자(Oh, Pok Ja),신성례(Shin, Sung-Rae) 한국간호과학회 2014 Journal of Korean Academy of Nursing Vol.44 No.5
Purpose: This study was done to evaluate the effects of dignity interventions on depression, anxiety and meaning of life in terminally ill patients. Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms indicating dignity intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane’s Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.2.11 program of Cochrane Library. Results: Twelve clinical trials met the inclusion criteria with a total of 878 participants. Dignity intervention was conducted for a mean of 2.2 weeks, 2.8 sessions and an average of 48.7 minutes per session. Effect sizes were heterogeneous and subgroup analysis was done. Dignity interventions had a significant effect on depression (ES= -1.05, p<.001, I<SUP>2</SUP>=15%) and anxiety (ES= -1.01, p<.001, I<SUP>2</SUP>=0). For meaning of life, dignity interventions were effective (ES= -1.64, p=.005) and effect sizes were still heterogeneous. Conclusion: Results support findings that dignity interventions can assist terminal ill patients in reducing emotional distress and improving meaning of life. Further well-designed dignity studies will lead to better understanding of the effects of treatments on spiritual well-being.
암환자교육이 암환자의 심리적 디스트레스와 자가간호지식 및 자가간호행위에 미치는 효과
오복자(Oh, Pok-Ja),최형지(Choi, Hyeong-Ji) 대한종양간호학회 2012 Asian Oncology Nursing Vol.12 No.4
Purpose: The purpose of this study was to evaluate the effectiveness of patient education interventions on distress, self-care knowledge and self-care behavior in cancer patients. Methods: A total of 1,102 studies were retrieved from 6 electronic databases in Korea. From these studies, 18 studies met the inclusion criteria with a total of 850 participants. Two authors independently assessed the methodological quality by Cochrane’s Risk of Bias and Methodological Items for Non Randomized Studies. The data were analyzed by the RevMan 5.1 program of Cochrane library. Results: Overall effect size of education interventions on anxiety was -2.12 (95% CI: -3.90, -0.34) (p<.001). The effects on self-care knowledge and self care behavior were -1.08 (95% CI:-1.73, -0.43) (p=.001), and -1.41 (95% CI: -2.13, -0.68) (p<.001), respectively. Publication bias was detected as evaluated by funnel plot, but the fail-safe number was moderate. Conclusion: This study suggests that patient education interventions can relieve anxiety and self-care. Further randomized controlled trials studies are needed to evaluate the effects of patient education intervention on depression.
오복자(Oh, Pok Ja),김정혜(Kim, Jeong Hye) 한국간호과학회 2016 Journal of Korean Academy of Nursing Vol.46 No.1
Purpose: The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer. Methods: A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R<SUP>2</SUP>=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R<SUP>2</SUP>=43%). Psychological distress had a partial mediating effect (β= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.
암 환자에게 적용한 심리사회적 중재가 코티졸과 면역기능에 미친 효과: 메타분석
오복자(Oh, Pok Ja),장은수(Jang, Eun-su) 한국간호과학회 2014 Journal of Korean Academy of Nursing Vol.44 No.4
Purpose: This study was done to evaluate the effects of psychosocial interventions on cortisol and immune response in adult patients with cancer. Methods: MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and domestic electronic databases were searched. Twenty controlled trials (11 randomized and 9 non-randomized trials) met the inclusion criteria with a total of 862 participants. Methodological quality was assessed using the Cochrane’s Risk of Bias for randomized studies and the Risk of Bias Assessment tool for non randomized studies. Data were analyzed using the RevMan 5.2.11 program of Cochrane library. Results: Overall, study quality was moderate to high. The weighted average effect size across studies was -0.32 (95% CI [-0.56, -0.07], p=.010, I²=45%) for cortisol concentration, -0.62 (95%CI [-0.96,-0.29], p<.001, I²=0%) for T lymphocyte (CD3) and -0.45 (95%CI [-0.74, -0.16], p=.003, I²=0%) for Th lymphocyte (CD4) numbers. Psychosocial interventions were not effective for Tc lymphocyte (CD4), NK cell, monocyte, and cytokine response. Conclusion: Although these results provide only small evidence of successful immune modulation, they support the conclusion that psychosocial interventions can assist cancer patients in reducing emotional distress and improving immune response.