Role performance and factors affecting quality of life in bladder cancer survivors with ileal orthotopic neobladder.

Objective: Bladder cancer survivors with neobladder experience changes in role performance and quality of life (QoL) due to various symptoms and problems, but related studies are limited. Therefore, this study attempted to explore the QoL and factors influencing it in bladder cancer survivors with neobladder. Methods: A cross-sectional descriptive design was used. Data were collected from 100 bladder cancer survivors with a neobladder using the European Organisation for Research and Treatment of Cancer QLQ-C30 and Muscle-Invasive Bladder Cancer Module, the Patient Activation Measure 13, the Enforced Social Dependency Scale, and the Multidimensional Scale of Perceived Social Support. Factors affecting the QoL were identified using multiple regression analysis. Results: QoL significantly differed by daily pad usage, need for clean intermittent catheterization, and role performance. QoL was correlated with urinary symptoms and problems, future perspective, abdominal bloating and flatulence, body image, role performance, and social support. Role performance, body image, and the need for clean intermittent catheterization were identified as the factors affecting QoL. Conclusions: The study highlights the importance of bladder cancer survivors continuing their roles at home, at work, and in society after neobladder reconstruction. Specifically, continuing recreational and social activity positively affects QoL, even if the activity range is modified. To help with their role performance, institutional support and changes in social perception are needed. Additionally, education and interventions, including body image enhancement, symptom management, and self-care, should be developed and applied to improve their QoL.

Perceived New Normal and Inner Strength on Quality of Life in Breast Cancer Patients Receiving Adjuvant Endocrine Therapy.

OBJECTIVE: This study aimed to investigate the differences in symptom experience, inner strength, adherence, and quality of life (QOL) according to the perception of the new normal, and identify the factors related to the QOL of breast cancer patients undergoing adjuvant hormonal therapy based on the theory of inner strength in women. METHODS: This cross-sectional study recruited patients with breast cancer receiving adjuvant hormonal therapy in the National Cancer Center. Demographic and clinical characteristics were recorded, and patients were assessed using the M. D. Anderson Symptom Inventory, Connor-Davidson Resilience Scale 2, Morisky Medication Adherence Scale 8, and Functional Assessment of Cancer Therapy-General Scale. RESULTS: After the breast cancer diagnosis, the perception of the new normal showed a significant dependence on pill count and emotional and functional well-being. The hierarchical regression analysis indicated that the new normal, symptom interference, and inner strength after adjusting for age, time since diagnosis, and receiving chemotherapy were significant predictors of QOL in breast cancer patients receiving adjuvant endocrine therapy. The model accounted for 47.8% of the variance in QOL. CONCLUSIONS: The theory of inner strength might be a potential pathway in health care to improve patients' QOL during long-term medication. The results of this study have both theoretical and applied implications. The findings can be utilized as evidence for developing an effective intervention that improves the QOL and adherence to adjuvant hormonal therapy of breast cancer patients.

The mediating effect of resilience on happiness of advanced lung cancer patients.

PURPOSE: To identify the perceived level of lung cancer stigma, resilience, and happiness among advanced lung cancer patients during treatment, and to analyze the mediating effect of resilience in the relationship between stigma and happiness. METHODS: A cross-sectional study design was used. A total of 184 patients diagnosed with advanced lung cancer were recruited from the National Cancer Center in Korea. Lung cancer stigma, resilience, and happiness were measured using questionnaires. RESULTS: Findings indicate that whereas lung cancer stigma had a negative correlation with resilience and happiness, resilience had a positive correlation with happiness. There was a significant indirect effect of stigma on happiness through resilience, indicating a mediating effect of resilience. CONCLUSIONS: The results make significant contributions, like the importance of encouraging patients with non-judgmental approach, to clinical practices related to happiness of individuals with advanced cancer. It suggests that the stigma of advanced lung cancer patient can be overcome with enough resilience, and patients may experience happiness during treatment.

A Narrative Inquiry into the Adjustment Experiences of Male Bladder Cancer Survivors with a Neobladder.

This study aimed to explore three male bladder cancer survivors' adjustment experiences after neobladder reconstruction. A narrative inquiry method was adopted to closely investigate the individual experiences of bladder cancer survivors and the meaning of their experiences. Three themes emerged regarding physical and mental changes resulting from neobladder reconstruction: difficulty urinating or holding urine, sexual dysfunction and sexlessness, and stress resulting from urinary incontinence. Life changes following surgery varied across each participant and included 'unwanted retirement', 'quitting drinking and leaving work', and 'beginning of a restrained life'. The theme of adjustment experience emerged, comprising 'active exploration of resolutions', 'accepting change and partial return to daily life', and 'living in line with the health condition and family wishes'. Bladder cancer survivors with a neobladder, in this study, continue to adjust to changes in the voiding mechanism, various symptoms including incontinence, and life changes even after surgical cancer resection. The findings suggest that not only therapeutic interventions, but additional interventions are also needed to assist bladder cancer survivors with adjustment, rehabilitation, and return to society. These findings are also expected to be used both to educate bladder cancer survivors with a neobladder and to develop policies to help them.

Breast and cervical cancer screening for risk assessment in Cambodian women.

The estimated mortality rates for breast and cervical cancer in Cambodia are high, perhaps because the Cambodian population lacks information about their detection and prevention. This cross-sectional study assessed the distribution of cervical cancers among and the behavioural and clinical characteristics of Cambodian women. It comprised 1039 Cambodian women who were interviewed between August 2013 and January 2016; the interviews were conducted in person using structured questionnaires. Among the participants, 801 (77.2%) and 709 (68.3%) had heard of cervical cancer and cervical cancer detection tests, respectively. However, 830 (80.2%) had never undergone a Pap smear, and 633 (60.9%) had never heard of breast self-examination. Despite the high mortality rates for breast and cervical cancer in Cambodia, only a small percentage of the participants had risk factors (e.g. smoking, alcohol consumption) for female cancers. A nationwide survey of the knowledge, attitudes and practices related to female cancers is recommended.Impact StatementWhat is already known on this subject? The estimated incidence and mortality rates of breast and cervical cancers in Cambodia are high. How much Cambodian women know about these cancers and whether they are receptive to cancer screening are questions requiring further study.What do the results of this study add? To our knowledge, this is the first study to describe the female cancer-related behavioural and clinical characteristics of Cambodian women. We show that rural Cambodian women are mostly unaware of breast and cervical cancer screening and that only a small percentage had risk factors for these cancers, despite the high incidence of these cancers in Cambodia.What are the implications of these findings for clinical practice and/or further research? Our findings potentially aid the design of programmes that increase awareness of breast and cervical cancers in Cambodia. Such programmes would be expected to reduce the incidence and mortality rates of these cancers in this country. Nationwide screening programmes for female cancers should be implemented in Cambodia.

Does Holding Back Cancer-Related Concern Affect Couples' Marital Relationship and Quality of Life of Patients with Lung Cancer? An Actor-Partner Interdependence Mediation Modeling Approach.

PURPOSE: This study was designed to examine both actor and partner effects of perceived marital relationship on quality of life, as well as the mediating effect of holding back cancer-related concerns. METHODS: This was a cross-sectional study in an outpatient setting. Participants were 150 couples consisting of patients with lung cancer and their spouses. Perceived marital relationship, holding back cancer-related concerns, and quality of life were measured with self-report scales. Actor and partner effects on quality of life were analyzed using the actor-partner interdependence mediation model by using structural equation modeling. RESULTS: A couple's quality of life had a significant direct actor effect on the perceived marital relationship. However, the partner effect and the indirect effect of holding back cancer-related concerns on quality of life was not significant. CONCLUSION: When patients with lung cancer and their spouses perceived their marital relationship positively, they assessed their quality of life positively. They were also found to be less hesitant when talking about cancer-related concerns. However, holding back on talking concerns did not have a significant impact on the quality of life (of either oneself or the spouse). Therefore, nurses should first check how they perceive their marital relationship before encouraging communication between patients with lung cancer and their spouses. Nurses can assess these risk factors and intervene if needed, along their cancer trajectory.

Depression and health-related quality of life among Cambodian patients with cancer.

BACKGROUND: Symptom assessment and quality of life (QoL) are considered two of the most important factors in the overall care of cancer patients. Although cancer is one of the leading causes of death after communicable disease in Cambodia, the QoL of Cambodian cancer patients has not been examined previously. This study aimed to describe the QoL of cancer patients in Cambodia. METHODS: A cross-sectional study was conducted with cancer patients who visited Khmer-Soviet Friendship Hospital in Phnom Penh. Two hundred patients participated in this study. The inventory comprised two previously validated scales: the Center for Epidemiological Studies Depression Scale-10 (CESD-10) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. Descriptive analyses, independent samples t-tests, and Pearson's correlation analysis were performed to examine the differences and relationship between study variables. RESULTS: The mean global health score was 51.62, and 58.5% of the participants had depressive symptom. The global health score was statistically significantly lower in depressive patients. The QoL was negatively correlated with depression, but positively and significant correlated with physical function, role function, emotional function, cognitive function, and social function. CONCLUSION: This study is the first to describe the QoL of Cambodian cancer patients. Our findings suggest that more attention should be paid to psychological concerns and symptom management in Cambodian cancer patients. Appropriate management could be effective in improving the QoL of cancer patients.

Parental Occupational Status and Suicidal Ideation in Adolescent: Cross-Sectional Secondary Data Analysis.

PURPOSE: This study aimed to identify the effect of parental occupational status on adolescents' suicidal ideation from a representative sample of the Korean population. DESIGN AND METHODS: A cross-sectional analysis was performed. Participants were 3201 adolescents aged 12-18 years from the Korean National Health and Nutrition Examination Survey. RESULTS: Adolescents experiencing suicidal ideation were found to be more likely to be female, have a history of smoking or alcohol use, a shorter sleep duration, greater perception of stress, and greater experience of depression when compared to those who did not report suicidal ideation. There was a statistically significant difference in perception of stress, experience of depression, and experience of suicidal ideation according to parental occupational status. Adolescents' suicidal ideation was associated with parents' employment status, work status, work schedule patterns, and working hours per week. CONCLUSIONS: Parental occupational status was associated with adolescents' suicidal ideation, but fathers' and mothers' occupational status affected children's suicidal ideation in different ways. Adolescents' suicidal ideation seems to have been affected by economic difficulty and stress, resulting from the father's occupational status, amount of time spent interacting with the mother, and the mother's employment status. Policies are needed to improve the quality of employment to reduce the financial difficulties and stresses of the father. A strategy for work-family compatibility is needed so that the mother can have enough time with her children while she has a job. PRACTICE IMPLICATIONS: It is necessary to consider parents' occupational status when assessing adolescents' suicidal ideation and providing interventions.

Assessment of the awareness and knowledge of cancer survivors regarding the components of metabolic syndrome.

This study aimed to assess the prevalence of metabolic syndrome and the level of knowledge and awareness of its related conditions in a sample of cancer survivor patients. In this cross-sectional survey, a self-reported questionnaire was administered to outpatients aged >20 years with a diagnosis of cancer. This self-reported questionnaire on patient demographic characteristics, disease characteristics, and knowledge and awareness of metabolic syndrome was used as an instrument to assess patient's knowledge of metabolic syndrome. A total of 88 participants were included; of these 34.1% had metabolic syndrome, although only 6.8% of participants were diagnosed with metabolic syndrome. Over half of the participants had heard about metabolic syndrome; however, 70% of the participants did not know about the blood tests for the diagnosis of metabolic syndrome although they were aware of the physical measurements, such as weight, blood pressure, and waist circumference. The highest proportion of correct answers for questions about metabolic syndrome was related to stroke, while the lowest was about cholesterol levels. The proportions of correct answers for selected parameters were as follows: diabetes, 39.1%; adiposity, 47.2%; hypertension, 46.8%; cholesterol levels, 36.7%; arteriosclerosis, 45.5%; myocardial infarction, 37.8%; and stroke, 62.8%. The results suggest that the level of knowledge of metabolic syndrome among the cancer survivors in our sample was poor, although more than one-third of them had metabolic syndrome. Thus, it is essential to educate cancer survivors about metabolic syndrome and its related conditions to improve their overall health and quality of life.

Association between Awareness of Nutrition Labels and Menstrual Cycle Irregularity in Korean Women: The Fifth Korea National Health and Nutrition Examination Survey (2010~2012).

PURPOSE: The aim of this study was to identify the relationship between awareness of nutrition labeling and menstrual cycle irregularity in women from a nationally representative sample of the Korean population. METHODS: A cross-sectional analysis was performed using hierarchical multivariable logistic regression analysis models. A total of 4,324 women aged 19~54 years from the 2010~2012 Korean National Health and Nutrition Examination Survey participated in the study. The participants were classified into three groups based on self-report responses to a questionnaire about their awareness of nutrition labels: Reading, Not-Reading, and Not-Knowing Groups. RESULTS: The Reading, Not-Reading, and Not-Knowing Groups comprised 46.4%, 44.9%, and 8.7% of the participants, respectively, and 53.6% of the participants had never used nutrition labels. In the Not-Knowing Group, irregular menstrual cycles for more than 3 months were significantly more common than women with irregular menstrual cycles for up to 3 months and women with regular menstrual cycles. Women in the Not-Knowing Group were more likely to exhibit menstrual cycle irregularity (adjusted odds ratio: 1.63, 95% confidence interval: 1.10~2.41) compared to women in the Reading Group after adjusting for age, body mass index, smoking status, alcohol intake, exercise regularity, stress, depression, suicidal ideation, metabolic syndrome, age at menarche, parity, and use of oral contraceptives. CONCLUSION: No awareness of nutrition labeling appears to be associated with a higher prevalence of menstrual cycle irregularity in a nationally representative group of Korean women.

Risk of secondary lymphedema in breast cancer survivors is related to serum phospholipid fatty acid desaturation.

PURPOSE: Secondary lymphedema is a common irreversible side effect of breast cancer surgery. We investigated if risk of secondary lymphedema in breast cancer survivors was related to changes in serum phospholipid fatty acid composition. METHODS: Study subjects were voluntarily recruited into the following three groups: breast cancer survivors who had sentinel lymph node biopsy without lymphedema (SLNB), those who had auxillary lymph node dissection without lymphedema (ALND), and those who had ALND with lymphedema (ALND + LE). Body mass index (BMI), serum lipid profiles, bioimpedance data with single-frequency bioimpedance analysis (SFBIA), and serum phospholipid compositions were analyzed and compared among the groups. RESULTS: BMI, serum total cholesterol (total-C), and low-density lipoprotein cholesterol (LDL-C) and SFBIA ratios increased only in the ALND + LE. High polyunsaturated fatty acids (PUFAs) and high C20:4 to C18:2 n-6 PUFAs (arachidonic acid [AA]/linoleic acid [LA]) was detected in the ALND and ALND + LE groups compared to SLNB. The ALND + LE group showed increased activity indices for delta 6 desaturase (D6D) and D5D and increased ratio of AA to eicosapentaenoic acid (AA/EPA) compared to the ALND and SLNB groups. Correlation and regression analysis indicated that D6D, D5D, and AA/EPA were associated with SFBIA ratios. CONCLUSION: We demonstrated that breast cancer survivors with lymphedema had elevated total PUFAs, fatty acid desaturase activity indices, and AA/EPA in serum phospholipids. Our findings suggested that desaturation extent of fatty acid composition might be related to the risk of secondary lymphedema in breast cancer survivors.

Serum fibronectin 1 and ApoE levels increase with risk of lymphedema in Korean breast cancer survivors.

PURPOSE: Lymphedema is an irreversible disorder often seen as a postoperative side effect in breast cancer survivors. We aimed to identify serum factors that are associated with lymphedema risk in breast cancer survivors. METHODS: This study recruited 60 volunteer breast cancer survivors. Participants were classified into either a CTRL group who underwent sentinel lymph node biopsy (SLNB), a RISK group who underwent axillary lymph node dissection (ALND) with removal of fewer than five lymph nodes, or an LE group who underwent ALND with removal of more than five lymph nodes. Bioimpedance was measured to determine the ratio of extracellular water (ECW) to total cellular water (TCW) and single-frequency bioimpedance analysis (SFBIA) ratios. Serum lipid profiles were compared among the groups using label-free quantitative proteomics with the nano-liquid chromatography (LC)-tandem mass spectrometer (MS/MS) and emPAI method. RESULTS: The CTRL, RISK, and LE groups had similar body weights and body mass indexes (BMIs) (<25 kg/m(2)). The LE group showed a higher grade of lymphedema severity compared to the RISK and CTRL groups. Lymphedema indices such as the ECW/TCW ratio and SFBIA ratio at 1 and 5 kHz were greatly increased in the LE group. Serum total cholesterol (total-C) level was higher in the LE group without affecting atherogenic index. Serum proteomics revealed that fibronectin 1 (FN1), apolipoprotein E (ApoE), antithrombin (ANT3), and complement C4 had different abundance values among the groups. ELISA confirmed that FN1 and ApoE were significantly elevated in both the RISK and LE groups compared to the CTRL group. CONCLUSIONS: Changes in serum FN1 and ApoE levels were detected prior to changes in serum total-C level and lymphedema indices such as SFBIA ratio. Therefore, elevation in serum FN1 and ApoE concentrations could likely be used to monitor the risk of lymphedema in breast cancer survivors.

[Posttraumatic growth, dyadic adjustment, and quality of life in breast cancer survivors and their husbands].

PURPOSE: The purpose of this study was to identify whether the couple perceived breast cancer as a traumatic event, to evaluate the association among posttraumatic growth, dyadic adjustment, and quality of life and to explore the predictors affecting quality of life of the couple. METHODS: A cross-sectional comparative survey design was utilized. Participants were 57 couples recruited from a national cancer center in Korea. Data were analyzed using paired t-test, McNemar test and independent t-test. On the basis of variables found to be significantly associated with quality of life, multiple regression was used to examine the simultaneous influence of multiple predictors. RESULTS: Breast cancers survivors and spouses perceived breast cancer as a traumatic event (43.9% and 24.6%, respectively). The global quality of life was explained by perception as trauma (ß=-19.79) and posttraumatic growth (ß=0.46) in survivors, and perception as trauma (ß=-18.81) and dyadic adjustment (ß=0.53) in spouses. CONCLUSION: Results suggest that future research should use qualitative methods to evaluate why contemplating reasons for cancer contributed to posttraumatic growth, examine other potential predictors of quality of life such as dyadic adjustment and intimacy, and identify links between posttraumatic growth and other psychological outcomes such as distress and well-being, using prospective analyses.

The Korean version of the Symptom Experience Index: a psychometric study.

BACKGROUND: Symptom assessment and management are vital aspects of patient care through the entire illness trajectory. Patients often experience two or more symptoms concurrently. Building global assessment capacity on symptoms holds significant promise for advancing the science of nursing. The Symptom Experience Index is a reliable and valid patient-centered health outcome measure developed in the United States to assess multiple symptoms and distress. No Korean version is available for Korean healthcare professionals and patients to promote an accurate assessment of multiple symptoms. OBJECTIVE: To translate the Symptom Experience Index into Korean language and assess its psychometric properties in Korean patients and healthy adults. DESIGN: A psychometric study with a cross-sectional design. SETTING: Two hospitals and a large university in Seoul, Korea in 2009. PARTICIPANTS: A purposive sample of 230 adult participants, including medical-surgical and oncology patients, as well as healthy university students. METHODS: The English Symptom Experience Index was translated to Korean language using an integrative translation method to ensure its semantic equivalence and content validity. The Korean version was then pretested and tested using a contrast-group and test-retest method. RESULTS: Semantically, no modifications to items were needed in terms of comparability of language and similarity of interpretability. Feedback on the pretest of the Korean version by 15 Korean adult patients resulted in one item deletion and one item modification. The Korean version demonstrated high internal consistency with the Cronbach's alpha coefficient: total symptom experience of 0.92, occurrence of 0.91 and distress of 0.90. Intra-class correlation coefficients demonstrated strong stability over time: total symptom experience (ICC=0.82; 95% CI=0.73-0.88), occurrence (ICC=0.77; 95% CI=0.66-0.84), and distress (ICC=0.85; 95% CI=0.77-0.89). Construct validity was supported by (1) factor analysis; (2) differences in symptom experience scores between healthy university students and patient groups; and (3) positive correlations between symptom experience scores and functional impairment. CONCLUSIONS: Our study provided evidence to support psychometric properties of the Korean Symptom Experience Index. The use of the instrument can help patients who speak Korean language systematically report symptoms and assist healthcare professionals in assessing multiple symptom experience.

Health-related quality of life in cancer patients between baseline and a three-year follow-up.

PURPOSE: The aim of the study was to identify health-related quality of life (QOL) in persons diagnosed with cancer and to determine differences between the QOL over a 3-year period. METHODS: We investigated the QOL in cancer patients at baseline and 3 years later using the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) and the ECOG (Eastern Cooperative Oncology Group) Performance Status. Initially 216 participants (85 women, 131 men) were enrolled, and at the 3-year follow-up there were 126 (52 women, 74 men). RESULTS: Scores on the function and symptom scales changed significantly between the baseline and the 3-year follow-up. Physical, role, and social functions improved, whereas problems with constipation worsened. The global QOL of the participants at the 3-year follow-up was lower than that of baseline, but it was not statistically significant. The QOL in cancer patients improved from the baseline to the 3-year follow-up. CONCLUSION: The results could serve as a guideline for nurses interpreting the perspective of QOL in their own groups of patients, and improve the understanding of the significance of mean QOL scores and develop nursing interventions in the future.

Symptom clusters and quality of life in Korean patients with hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide, causing about 1 million deaths annually. Patients with HCC usually reported multiple concurrent symptoms. The purpose of this multivariate study was to explore whether multiple concurrent symptoms are clustered into groups of symptoms and to explore the effect of symptom clusters on the quality of life (QOL) in patients with HCC. A sample of 180 patients with HCC at a medical center in Korea was recruited. Patients completed a demographic questionnaire, a Symptom Checklist, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy-Hepatobiliary. Factor analysis was used to identify symptom clusters based on the severity of patients' symptom experiences. Four symptom clusters were identified: pain-appetite, fatigue related, gastrointestinal, and itching-constipation. Two patient subgroups were identified through cluster analysis: high- and low-symptom group. Patients in the high-symptom group had significantly poorer functional status and poorer QOL in all the domains, with the exception of social well-being. The differences between the 2 patient subgroups were not only statistically but also clinically significant. Patients in the high-symptom group were also statistically and clinically anxious and depressed. Further research is needed to explore whether compositions of symptom cluster phenotypes vary over time and whether the associations of symptom clusters with QOL and mood are changing along the disease and treatment trajectory as well as symptom status.

[Identification and validation of symptom clusters in patients with hepatocellular carcinoma].

PURPOSE: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. METHODS: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. RESULTS: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. CONCLUSION: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea.

This study examined the effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. A nonequivalent, control group, pre-posttest design was used. A convenience sample of 41 nursing students were randomly assigned to experimental (n=21) and control groups (n=20). Stress was measured with the PWI-SF (5-point) developed by Chang. Anxiety was measured with Spieberger's state anxiety inventory. Depression was measured with the Beck depression inventory. The experimental group attended 90-min sessions for eight weeks. No intervention was administered to the control group. Nine participants were excluded from the analysis because they did not complete the study due to personal circumstances, resulting in 16 participants in each group for the final analysis. Results for the two groups showed (1) a significant difference in stress scores (F=6.145, p=0.020), (2) a significant difference in anxiety scores (F=6.985, p=0.013), and (3) no significant difference in depression scores (t=1.986, p=0.056). A stress coping program based on mindfulness meditation was an effective intervention for nursing students to decrease their stress and anxiety, and could be used to manage stress in student nurses. In the future, long-term studies should be pursued to standardize and detail the program, with particular emphasis on studies to confirm the effects of the program in patients with diseases, such as cancer.

Predictors of mammography uptake in Korean women aged 40 years and over.

AIM: This paper is a report of a study performed to identify the predictors of mammography uptake for Korean women according to the stage of change, as determined by the transtheoretical model. BACKGROUND: Although breast cancer is the most common female cancer in South Korea, its early detection rate here is low when compared with other developed countries. The transtheoretical model can be used to facilitate health promotion based on individual health behaviour and to devise stage-tailored interventions. METHOD: The participants were a convenience sample of 920 women aged > or =40 years between December 2005 and February 2006. A cross-sectional design was used in which participants completed a questionnaire that consisted of measures of the transtheoretical model. To provide a standard of measure, the variables were converted from raw scores to standard scores and then to T scores (mean = 50, sd = 10). Logistic regression analysis was then used to estimate predictors of the stage of maintenance of mammography uptake. FINDINGS: The most frequent stage of mammography uptake was 'contemplation'. Predictors of mammography uptake included decisional balance, commitment to regular screening and avoiding contact with the healthcare system. Commitment to regular screening and breast self-examination were strongly related to mammography maintenance. CONCLUSION: The results of this study can be used for the development of theory-based and empirically supported mammography uptake intervention strategies and programmes directed towards women aged > or =40 years.

[Predictive factors of aspects of the transtheoretical model on smoking cessation in a rural community].

PURPOSE: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. METHOD: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. RESULT: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with 42.1% in Precontemplation, 24.1% in Contemplation, 9.7% in Preparation, 6.2% in Active, and 17.9% in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained 33.2% of the smoking cessation. CONCLUSION: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.