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Yu-Chi Li,Yin-Hsun Feng,Hui-Ying Chiang,Shu-Ching Ma,Hsiu-Hung Wang 한국간호과학회 2020 Asian Nursing Research Vol.14 No.4
Purpose: The aim of the study was to determine the effectiveness of dignity therapy for end-of-lifepatients with cancer. Methods: This study used a quasi-experimental study design with a nonrandomized controlled trial. Dignity therapy was used as an intervention in the experimental group, and general visit was used in thecontrol group. Thirty end-of-life patients with cancer were recruited, with 16 in the experimental groupand 14 in the control group. Outcome variables were the participants' dignity, demoralization, anddepression. Measurements were taken at the following time points: pre-test (before intervention), posttest1 (the 7th day), and post-test 2 (the 14th day). The effectiveness of the intervention in the twogroups was analyzed using the generalized estimating equation, with the p value set to be less than .05. Results: After dignity therapy, the end-of-life patients with cancer reflected increased dignity significantly[b ¼ 37.08, standard error (SE) ¼ 7.43, Wald c2 ¼ 24.94, p < .001], whereas demoralization(b¼ 39.55, SE ¼ 6.42,Wald c2 ¼ 37.95, p < .001) and depression (b¼ 12.01, SE ¼ 2.17,Wald c2 ¼ 30.71,p < .001) were both reduced significantly. Conclusion: Clinical nurses could be adopting dignity therapy to relieve psychological distress andimprove spiritual need in end-of-life patients with cancer. Future studies might be expanded tolooking at patients vis- a-vis end-of-life patients without cancer to improve their psychologicaldistress. These results provide reference data for the care of end-of-life patients with cancer fornursing professionals.
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Dignity and Related Factors in Patients with Cancer: A Cross-Sectional Study
Li Yu-Chi,Feng Yin-Hsun,Ma Shu-Ching,Wang Hsiu-Hung 한국간호과학회 2023 Asian Nursing Research Vol.17 No.1
Purpose: Dignity is a basic human right that is related to psychological distress factors in patients with cancer such as depression and demoralization. Hence, the dignity issue is of great importance to healthcare professionals. The present study aimed to advise healthcare professionals regarding the related distress factors of dignity in patients with cancer by investigating its relationship with patients’ demographics, disease characteristics, and psychological distress. Methods: This was a cross-sectional study design. A convenience sample of 267 patients with cancer from a medical center was recruited into this study. Each patient completed demographics and disease characteristics questionnaires, the Patient Dignity Inventory Mandarin Version, the Demoralization Scale Mandarin Version (DS-MV), and the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed with SPSS 22.0 software. Results: Dignity was significantly correlated with age, demoralization, and depression. Cancer patients aged 65 or above were more likely to have a lower sense of dignity. In the present study, the sensitivity and specificity of the Patient Dignity Inventory Mandarin Version for demoralization (DS-MVꠑ30) were 84.8% and 79.1% and for depression (PHQ-9ꠑ10) were 73.8% and 70.9% in patients with cancer with an aggregate score of 35 or above. Conclusions: Dignity is significantly correlated with personal demographic characteristics and psychoꠓlogical distress in patients with cancer. The results provide reference data for healthcare professionals to understand and enable dignity in patients with cancer and aid in the development of methods that promote their dignity
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Impact of Adjuvant Chemotherapy in Elderly Breast Patients in Taiwan, A Hospital-Based Study
Lee, Hsiu Chuan,Chen, Wei Yu,Huang, Wen Tsung,Cheng, Kuo Chen,Tian, Yu Feng,Ho, Chung Han,Tsao, Chao Jung,Feng, Yin Hsun Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10
Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age ($mean=74.0{\pm}5.3$ vs $77.5{\pm}5.3$, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted.
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