Effects of Uncertainty, Appraisal of Uncertainty, and Self-Efficacy on the Quality of Life of Elderly Patients with Lung Cancer Receiving Chemotherapy: Based on Mishel's Theory of Uncertainty

Background and Objectives: The purpose of this study is to enhance the quality of life in elderly patients with lung cancer by understanding relations of uncertainty, appraisal of uncertainty, self-efficacy, and quality of life targeting elderly patients with lung cancer receiving anticancer therapy, and also analyzing the factors affecting the quality of life based on Mishel's theory. Materials and Methods: The subjects were a total of 112 lung cancer patients aged 65 or older receiving anticancer therapy. The data was collected by using self-report questionnaires targeting patients in hemato-oncology at Chungbuk National University Hospital. The data were analyzed using descriptive statistics, a t-test, an analysis of variance, Pearson's correlational coefficients, and hierarchical regression analysis. Results: In stage 1, anticancer therapy (chemotherapy) (β = -0.34, p < 0.001), economic condition (low) (β = -0.30, p < 0.001), the number of anticancer therapies (three times or more) (β = -0.29, p < 0.001), and education (graduation from high school or higher) (β = 0.18, p = 0.033) were influencing factors (F = 0.52, p < 0.001). In stage 2, self-efficacy (β = 0.41, p < 0.001), appraisal of uncertainty: danger (β = -0.29, p < 0.001), appraisal of uncertainty: opportunity (β = 0.18, p = 0.018), the number of anticancer therapies (three times or more) (β = -0.17, p = 0.006), and anticancer therapy (chemotherapy) (β = -0.14, p = 0.031) were influencing factors, which showed 74.2% explanatory power (F = 26.17, p < 0.001). Conclusions: In order to improve the quality of life of subjects, it would be necessary to develop interventions for raising their self-efficacy by considering their degree of education, economic condition, the types and numbers of anticancer therapies, and understanding of the appraisal of uncertainty about the disease is assessed as an opportunity factor or a danger factor.

The impact of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life among gynecological cancer patients undergoing chemotherapy: a cross-sectional survey

PURPOSE

This study investigated the effects of peripheral neuropathy symptoms, self-care ability,and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy.

METHODS

The participants included 144 patients with gynecological cancer undergoing anticancerchemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28,2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed.

RESULTS

Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), andthe most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89)was greater than the midpoint. The regression model analyzing the patients' QoL was statisticallysignificant (F=15.38, p<.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p<.001),disturbances to daily life (β=-.38, p<.001), the duration of peripheral neuropathy symptoms(β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL.

CONCLUSION

Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their dailylife can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients' daily lives. Improving the self-care abilityof patients and alleviating their limitations in daily life may improve QoL.

Do spouse burden of care, family resilience, and coping affect family function in gynecologic cancer in Korea?: a cross-sectional study

PURPOSE

This study aimed to investigate family functioning among spouses of gynecologic cancer patients in Korea. McCubbin and McCubbin's Family Resilience Model (1993) guided the study focus on burden of care, family resilience, coping, and family functioning.

METHODS

An online survey collected data from 123 spouses of gynecologic cancer patients through convenience sampling from online communities for gynecologic cancer patients in Korea. Burden of care, family resilience (social support, family hardiness, and family problem-solving communication), coping, and family functioning were measured by self-report.

RESULTS

The patients (44.7%) and their spouses (47.2%) were mostly in the 41 to 50-year age group. Stage 1 cancer was 44.7%, and cervical cancer was the most common (37.4%) followed by ovarian cancer (30.9%) and uterine cancer (27.6%) regarding the cancer characteristics of the wife. Family function, burden of care, family resilience, and coping were all at greater than midpoint levels. Family functioning was positively related with social support (r=.44, p<.001), family hardiness (r=.49, p<.001), problem-solving communication (r=.73, p<.001), and coping (r=.56, p<.001). Multiple regression identified significant factors for family functioning (F=25.58, p<.001), with an overall explanatory power of 61.7%. Problem-solving communication (β=.56, p<.001) had the greatest influence on family function of gynecologic cancer families, followed by coping (β=.24, p<. 001) and total treatment period of the wife (β=.17, p=.006).

CONCLUSION

Nurses need to assess levels of family communication and spousal coping to help improve gynecologic cancer patients' family function, especially for patients in longer treatment.

Factors associated with distress among female cancer survivors at the workplace: A cross-sectional study

OBJECTIVES

This study aimed to investigate the levels of fatigue, social support, spiritual well-being, and distress of female cancer survivors at the workplace, and identify factors associated with distress.

METHODS

One hundred and eighty-two working female cancer survivors participated from the outpatient ward in two medical institutions in South Korea and they completed questionnaires assessing their general characteristics, fatigue, social support (colleagues and superiors), and spiritual well-being distress (existential and religious well-being). The data were analyzed using descriptive statistics, T-test, one-way ANOVA, correlation, and multiple linear regression with SPSS /WIN18 version.

RESULTS

Most of the participants were breast and thyroid cancer (78.5%), married (46.2%), working periods below 10 years (62.7%) and the average age was 49.7 years. Distress positively correlated with fatigue and significant predictors of distress were "type of work" and "main source of household income" among general characteristics, fatigue, religious well-being, and existential well-being.

CONCLUSIONS

Our findings suggest that integrated program including educational and practical factors to reduce fatigue and increase spiritual well-being (i.e., peace, faith, meaning, et al.) can decrease distress. Whereas, the "ambivalence" of God accompanied by high religious well-being (i.e., punishment, abandon, blame, and so on) can rather increase distress. The development of an integrated management system of distress at work can be applied as a practical factor to improve job satisfaction, organizational performance, and quality of life.

Factors associated with the quality of work life among working breast cancer survivors

Objective

In South Korea, the incidence and survival rate of breast cancer are high, and the return-to-work rate of breast cancer survivors continues to increase. However, there are various obstacles after returning to work, which can negatively affect long-term quality of life management. Therefore, the purpose of this study is to identify factors associated with the quality of work life, which is a priority factor in managing the quality of life.

Methods

Data were collected from 169 female breast cancer survivors and participants were selected from three different hospitals in the metropolitan city and snowball sampling was used in conjunction. The participants filled out questionnaires about a variety of factors that may associated with quality of work life (QWL); the data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple linear regression.

Results

All participants were women with an average age of 48.9 years after diagnosis of cancer, with 65.7% married. 46.2% of them were in Cancer stage 1, 65.7% had work experience over six years, and most of them were educated managerial workers, fixed duty. Multiple regression analysis indicated perceived health status, social support of superior and colleagues and spiritual well-being were positive predictors and cancer fatigue and distress were negative predictors of QWL, explaining 49.5% (adjusted R²) (F_10,158 ​= ​17,486, P ​< ​0.001).

Conclusions

For increasing the QWL of working breast cancer survivors, decreasing cancer fatigue and distress and increasing perceived health status, social support, and spiritual wellbeing can be considered. The findings can contribute for developing effective and systematic interventions that consider the identified predictors to enhance the QWL and successful returning to work and job retaining.

A serial multiple mediator model of sense of coherence, coping strategies, depression, and quality of life among gynecologic cancer patients undergoing chemotherapy

PURPOSE

This study evaluated whether coping strategies (positive reframing, planning, and active coping) and depression mediate the relationship between sense of coherence (SOC) and quality of life (QoL) using a serial multiple mediator model in patients with gynecologic cancer who are undergoing chemotherapy.

METHODS

A sample of 148 participants, with a mean age of 52.17 years (range 20-75) and diagnosed with gynecological cancer (e.g., cervix, ovary and endometrium) was surveyed in a cross-sectional study. Data were collected using a structured self-reporting questionnaire. A serial multiple mediator model was analyzed to explain sequential causality among two mediators (coping strategy and depression) and to investigate the direct and indirect effects of the mediator model in SPSSWIN 26.0 and PROCESS macro program.

RESULTS

The conceptual serial mediation model of SOC, positive reframing, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through single mediation of positive reframing (Effect = 0.925) and depression (Effect = 5.942) and that through both mediators (Effect = 1.161) were statistically significant. The total indirect effect was also statistically significant (Effect = 8.028). Moreover, the conceptual serial mediation model on SOC, planning, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through both mediation of planning and depression (Effect = 1.162) and the total indirect effect were statistically significant (Effect = 8.172).

CONCLUSIONS

Helping patients with gynecologic cancer undergoing chemotherapy to strengthen SOC may improve QoL by equipping them with efficient positive reframing or planning strategies to reduce depression.

Impacts of Psychological Distress, Gender Role Attitude, and Housekeeping Sharing on Quality of Life of Gynecologic Cancer Survivors

PURPOSE

To determine impacts of psychological distress, gender role attitude, and housekeeping sharing on quality of life of gynecologic cancer survivors.

METHODS

Subjects completed questionnaires consisting of four measurements: FACT-G (ver. 4) for quality of life, anxiety and depression from SCL-90-R for psychological distress, gender role attitude, and housekeeping sharing. A total of 158 completed data sets were analyzed by descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using SPSS 21.0 program.

RESULTS

Quality of life was significantly and negatively correlated with psychological distress (r=-0.64, p < .001), but not with gender role attitude (r=-0.14, p=.820) or housekeeping sharing (r=0.08, p=.350). Psychological distress was significantly and positively correlated with gender role attitude (r=0.25, p < .010). Factors that significantly impacted quality of life were type of cancer (t=2.27, p=.025), number of treatment methods (t=2.58, p=.011), education level (t=3.33, p < .001), and psychological distress (t=-9.96, p < .001).

CONCLUSION

Nursing interventions that can relieve psychological distress need to be developed for gynecologic cancer survivors. Nurses need to put priority on ovarian cancer survivors who have low education level with multiple treatment methods when performing nursing interventions to improve the quality of life of gynecologic cancer survivors.

The Exploration of Health-Related Quality of Life

The purpose of this study was to explore quality of life (QoL) and the factors influencing QoL in gynecological cancer patients. One hundred sixty-seven patients with gynecologic cancers were recruited from a district hospital in Southern Taiwan. The instruments used included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 Version 3.0 in Chinese (EORTC QLQ-C30), the Symptom Distress Scale, and demographic characteristics and disease-related variables. The results showed that the mean score for the QLQ-C30 was 61.13 ( SD = 22.71). In the stepwise regression model, two factors predicted overall global QoL: symptom distress (33.8%) and current occupation (2.2%). These predictors accounted for 36.0% of the total variance. These results showed that symptom distress was a predictor of QoL. This study provides a reference for use when designing improved educational care programs that reduce patient symptom distress and enhance gynecologic cancer patients' QoL.