Community-Based Oncology Nursing: Status and Prospects

Purpose@#It is difficult to determine whether a comprehensive and systematic community-based cancer care project is properly carried out. The purpose of this article is to present the current status and prospects of community-based oncology nursing by reviewing related literature. @*Methods@#A new cancer care model is established through the analysis of existing cancer care models and literature review of community-based cancer prevention, cancer screening, cancer survivor care, cancer patient hospice care. @*Results@#The Comprehensive Cancer Care Model (CCCM) was presented. The CCCM arranges the periods of cancer treatment and the cancer journey on the horizontal axis, and public health centers, oncology hospitals, cancer convalescent hospitals, primary care physicians, and prayer centers on the vertical axis, and describes levels of care participation of human resources in institutions and the degree of interconnection. @*Conclusion@#It is expected that CCCM will be used for holistic, sustainable, and cost-effective cancer management. In community-based oncology nursing, health promotion team nurses of public health centers are in charge of population-based cancer prevention and early detection programs, and visiting health management team nurses of public health centers are in charge of individual-based cancer survivor and hospice programs.

The Effect of Self-Acupressure on Peripheral Neuropathy, Disturbance in Daily Activity, and Quality of Life in Breast Cancer Patients undergoing Chemotherapy

Purpose@#This study was done to investigate the effects of self-acupressure on chemotherapy-induced peripheral neuropathy (CIPN), the degree of disturbance in daily activity, and the quality of life in breast cancer patients undergoing chemotherapy @*Methods@#A randomized controlled pre-post experimental design was employed. The mean difference of study variables between pre- and post-test was evaluated to test the effects of self-acupressure on LI11, LI10, LI4, ST36, Ex-UE9, and Ex-LE10. The study participants were breast cancer patients treated with taxane-based chemotherapy (experimental group 28 and control group 30). Participants were instructed on the method of self-acupressure and performed self-acupressure three times a day for three weeks. Peripheral neuropathy symptoms, the degree of disturbance in daily activity caused by peripheral neuropathy, and the quality of life were measured before and after self-acupressure. Data were collected from July 2020 to January 2021. @*Results@#The experimental group that performed self-acupressure showed a significant decrease in the degree of peripheral neuropathy symptoms and the degree of disturbance in daily activity caused by peripheral neuropathy compared with the control group. The experimental group also showed a significant improvement in the quality of life compared with the control group. @*Conclusion@#The self-acupressure program adopted in this study was found to be an effective method to reduce peripheral neuropathy and the degree of disturbance in daily activity, and to improve the quality of life. Therefore, self-acupressure is recommended to reduce CIPN among breast cancer patients undergoing chemotherapy.

The Effect of Self-Acupressure on Peripheral Neuropathy, Disturbance in Daily Activity, and Quality of Life in Breast Cancer Patients undergoing Chemotherapy

Purpose@#This study was done to investigate the effects of self-acupressure on chemotherapy-induced peripheral neuropathy (CIPN), the degree of disturbance in daily activity, and the quality of life in breast cancer patients undergoing chemotherapy @*Methods@#A randomized controlled pre-post experimental design was employed. The mean difference of study variables between pre- and post-test was evaluated to test the effects of self-acupressure on LI11, LI10, LI4, ST36, Ex-UE9, and Ex-LE10. The study participants were breast cancer patients treated with taxane-based chemotherapy (experimental group 28 and control group 30). Participants were instructed on the method of self-acupressure and performed self-acupressure three times a day for three weeks. Peripheral neuropathy symptoms, the degree of disturbance in daily activity caused by peripheral neuropathy, and the quality of life were measured before and after self-acupressure. Data were collected from July 2020 to January 2021. @*Results@#The experimental group that performed self-acupressure showed a significant decrease in the degree of peripheral neuropathy symptoms and the degree of disturbance in daily activity caused by peripheral neuropathy compared with the control group. The experimental group also showed a significant improvement in the quality of life compared with the control group. @*Conclusion@#The self-acupressure program adopted in this study was found to be an effective method to reduce peripheral neuropathy and the degree of disturbance in daily activity, and to improve the quality of life. Therefore, self-acupressure is recommended to reduce CIPN among breast cancer patients undergoing chemotherapy.

Alleviation of ascorbic acid-induced gastric high acidity by calcium ascorbate in vitro and in vivo

Ascorbic acid is one of the most well-known nutritional supplement and antioxidant found in fruits and vegetables. Calcium ascorbate has been developed to mitigate the gastric irritation caused by the acidity of ascorbic acid. The aim of this study was to compare calcium ascorbate and ascorbic acid, focusing on their antioxidant activity and effects on gastric juice pH, total acid output, and pepsin secretion in an in vivo rat model, as well as pharmacokinetic parameters. Calcium ascorbate and ascorbic acid had similar antioxidant activity. However, the gastric fluid pH was increased by calcium ascorbate, whereas total acid output was increased by ascorbic acid. In the rat pylorus ligation-induced ulcer model, calcium ascorbate increased the gastric fluid pH without changing the total acid output. Administration of calcium ascorbate to rats given a single oral dose of 100 mg/kg as ascorbic acid resulted in higher plasma concentrations than that from ascorbic acid alone. The area under the curve (AUC) values of calcium ascorbate were 1.5-fold higher than those of ascorbic acid, and the C(max) value of calcium ascorbate (91.0 ng/ml) was higher than that of ascorbic acid (74.8 ng/ml). However, their T(max) values were similar. Thus, although calcium ascorbate showed equivalent antioxidant activity to ascorbic acid, it could attenuate the gastric high acidity caused by ascorbic acid, making it suitable for consideration of use to improve the side effects of ascorbic acid. Furthermore, calcium ascorbate could be an appropriate antioxidant substrate, with increased oral bioavailability, for patients with gastrointestinal disorders.

Development and Evaluation of a Joint Health Self-management Program for the Elderly with Knee Osteoarthritis in Communities: Applying the IMB Model

PURPOSE: The purpose of this study is to develop and evaluate a joint health self-management program for knee osteoarthritis elders in communities. METHODS: This program was developed based on the IMB (information-motivationbehavioral skills) model. The program methods include education, setting and achieving goals, sharing experiences, telephone counseling, and self-monitoring. The topics of the program include joint assessment, exercise, massage, joint protection, medication, depression management, diet, and healthcare approach. The research was conducted following the principles of the nonequivalent control group pretest-posttest design. Participants were 26 subjects in the experimental group, and 27 subjects in the control group. The experimental group participated in the self-management program, and the control group received general education. RESULTS: Both post-test scores of personal motivation, social motivation, behavior skill, self-management behavior, joint pain, joint stiffness, physical function disability, right knee extension, left knee extension, and depression were significantly different between the experimental group and the control group. CONCLUSION: The results of the study can be used to develop and standardize a systematic joint health self-management program. Further research is highly recommended to develop a strategy to continuously facilitate self-management of osteoarthritis patients' procedures.

Predictors and Frailty Level in the Frail Elderly Receiving Home Visiting Health Care Services / 農村醫學 地域保健

OBJECTIVE: The purpose of this study was to identify the predictors and frailty level in the frail elderly receiving home visiting health care services. METHODS: The subjects were 177 frail elders aged over 65 registered in the home visiting health care services of three public health centers in Daegu. The data collection was performed from June 9 to June 24, 2015. This study used descriptive statistics, t-test, ANOVA, scheffe test and stepwise multiple regression by SPSS Win 18.0 program. RESULTS: The mean of the frailty score was 10.05 (±4.52). Age and life satisfaction were the significant factors related to the frailty score in frail elderly. Health promotion behavior, empowerment, social participation and perceived health status had a negative correlation with the frailty score. Thirty seven point four percent of the variance in the frailty score can be explained by perceived health status (β=-0.398, p<0.001), health promotion behavior (β=-0.251, p<0.001) and age (β=0.232, p<0.001)(Cum R2=0.374, F=25.744, p<0.001). Perceived health status was the most important factor related to the frailty score in our study. CONCLUSIONS: An integrative care program which includes these significant variables of subjects is essential to prevent the deterioration of frailty in frail elderly.

A Meta-Analysis of Intervention Research for Posttraumatic Growth in Cancer Patients

PURPOSE: The objective of this study was to analyze effect size of the intervention studies for posttraumatic growth in patients with cancer. METHODS: A total of 871 studies published between 2000 and 2014 were identified by searching Ovid-Medline, CINAHL, PubMed, Scopus, PsycARTICLES, Cochrane library, RISS, and KISS. 15 studies were selected for inclusion in the meta-analysis. Data were analyzed using the Comprehensive Meta-Analysis (CMA) Ver. 3 program and the effect sizes were shown using Hedges's g score. RESULTS: Intervention studies included 5 studies on Cognitive Behavioral Stress Management (CBSM), 4 studies for Mindfulness-Based Stress Reduction (MBSR), 2 studies for couple-based intervention, and 1 study each for health coaching, building resilience, yoga and painting intervention. The overall controlled effect size was 0.335 (95% CI=0.231, 0.438), using a fixed effects model. The most effective intervention was the couple-based intervention (0.368, 95% CI=-0.146, 0.883), followed by MBSR (0.340, 95% CI=0.172, 0.508) and CBSM (0.314, 95% CI=0.139, 0.490). CONCLUSION: Cancer is one of the most significant traumatic events that affect patients' lives, a few cancer patients have been known to have posttraumatic growth. Therefore it is necessary to consider nursing interventions to increase posttraumatic growth for cancer patients such as couple-based intervention, MBSR and CBSM.

The Effect of A Salivation Stimulation Method on Xerostomia in Colon Cancer Patients after Surgery

PURPOSE: The aim of this study is to develop a salivation stimulation method and to verify the effect of a salivation stimulation method on xerostomia in colon cancer patients after surgery. METHODS: This study targeted 21 in the experimental group and 22 in the control group, who were diagnosed with colon cancer and underwent surgery at A university hospital. The salivation stimulation method consists of tongue movement for stimulating minor salivary glands in mouth and a parotid gland and submandibular gland massage with hands. The method was applied four times a day for 2 days the next day after surgery. RESULTS: On the first postoperative day, the experimental group showed a significantly larger amount of salivation than the control group (p=.010). On the second postoperative day, the experimental group showed a significantly larger amount of salivation than the control group (p<.001). On the first postoperative day, the subjective xerostomia scores in the experimental group and control group were not statistically significant (p=.165). On the second postoperative day, the experimental group showed a significantly lower subjective xerostomia score than the control group (p=.001). CONCLUSION: It is considered that providing cancer patients with this salivation stimulation method after surgery would reduce discomfort caused by xerostomia.

Development and Application of an Overcoming Compassion Fatigue Program for Emergency Nurses

PURPOSE: This study was conducted to develop a program to help emergency nurses overcome compassion fatigue, and to analyze the effects of the program. METHODS: A nonequivalent control group pretest-posttest design was used. There were 14 participants in the experimental group and 18 subjects in the control group. The program was comprised of five, weekly 80-minute sessions including understanding and assessment of compassion fatigue, enhancing positive affect, balancing work-life, planning self care, training in relaxation techniques and cognitive restructuring, and getting social support. Research variables were ego-resiliency, compassion satisfaction and compassion fatigue of the ProQOL 5, and salivary cortisol. Data were analyzed using Chi-square test, independent t-test, and paired t-test. RESULTS: The first hypothesis, "There will be a difference in scores for ego resiliency between the experimental group and the control group". was not supported. The second hypothesis, "There will be a difference in scores for compassion satisfaction between the experimental group and the control group" was supported (t=2.15, p=.046). The third hypothesis, "There will be a difference in scores for compassion fatigue between the experimental group and the control group" was not supported. CONCLUSION: The first program for emergency nurses to overcome compassion fatigue in Korea was effective in increasing emergency nurses' compassion satisfaction and decreasing salivary cortisol level in the experimental group. Therefore, this program for overcoming compassion fatigue is useful to increase emergency nurses' compassion satisfaction. However replication studies of short-term intensive program reflecting emergency nurses' opinion are needed.

The Meta-Analysis of the Effect of Acupressure for Nausea and Vomiting in Cancer Patients Receiving Chemotherapy / 종양간호학회지

PURPOSE: This study was to analyze the characteristics and effect size of intervention studies that used acupressure for the control of chemotherapy-induced nausea and vomiting (CINV). METHODS: Nine electronic databases including Korea Education Research and Information, the National Assembly Library, KISS, Korea Med, NDSL, PubMed, EBSCO, Cochrane library, and OVID (to December, 2009) were searched. Thirteen studies of randomized controlled trials (RCTs) or controlled clinical trials (CCTs) were selected. Data were analyzed by SPSS/WIN 18.0. RESULTS: Overall effect size of acupressure was moderate (0.684). Nausea had a moderate effect size (0.770) and nausea and vomiting had a high effect size (0.899). Acupressure using sticker needles had a high effect size (1.368) among finger acupressure, si-acupuncture, and wrist band treatment. CONCLUSION: This study suggests that acupressure using sticker needles on the spots of nei-guan, chok-samni and hap-kok can reduce the levels of nausea and vomiting in cancer patients receiving chemotherapy. For improving the reliability of the meta-analysis results, further randomized controlled trials with better study methodology are needed.

Analysis of Experimental Researches in Korea on the Effects of Aromatherapy to Relieve Pain / 한국호스피스완화의료학회지

PURPOSE: This study identifies research trends and provides fundamental data related to curative power of aromatherapy to relieve pain in Korea. METHODS: The study analyzed 44 experimental studies on humans that were published in Korea before the end of December, 2009. The key words used for searching were: aroma, aromatherapy, hyang-yobeob, hyanggi-yobeob, hyanggichilyo, aromatherapy and pain, headache, scapulodynia, omodynia, feeling uncomfortable in the perineal region, sense of pain, labor pains, arm pain, menstrual pain, aches, and dysmenorrheal. Those words were found on websites, including those for Korea Education & Research Information Service, the National Assembly Library, KISS, KoreaMed, and NDSL. Collected data were analyzed using descriptive statistics. RESULTS: The results showed that most of essential oils to relieve pain is composed of three to four kinds of oils, including Lavender, Roman chamomile, Rosemary, and Clarysage. Aromatherapy is applied usually by means of massage (50%), inhalation (13.6%), or a combination of the above two (13.6%). Measuring instruments as a dependent variable include VAS, questionnaire, GRS, blood pressure, pulse, and Algometer. Aromatherapy plays an important role in soothing headaches and arthralgia. However, when it comes to labor and menstrual pain, it doesn't seem to be effective. CONCLUSION: The study found that different kinds of oil, frequencies, and periods of time are used for the same symptoms. Further research should employ standardized oil blending, application, duration, and measuring instruments, and more systematically analyze the effects of aromatherapy to establish the effects on relieving pain.

The Effect of Transcutaneous Electrical Nerve Stimulation on Pain and Pulmonary Function with Post-Lobectomy Patient with Lung Cancer / 성인간호학회지

PURPOSE: This study was designed to evaluate the effect of TENS on pain and pulmonary function of post-lobectomy patients with lung cancer. METHODS: The study data collection was done from February 4, 2008 to February 7, 2009. The subjects were assigned at random to the experimental group and control group with 20 subjects in each group. The experimental group was measured for pain and pulmonary function after surgery and then again after applying TENS 100 Hz frequency and 40 mA output for 20 minutes. The control group was measured the same as the experimental group except applying sham TENS. RESULTS: The pain score of the experimental group which had TENS applied revealed that there were more significant reductions than the control group which had sham TENS applied. There was no significant difference with the number of times of receiving analgesics between the experimental and control group. The effect of TENS on pulmonary function was significantly different between the experimental group and the control group on VC 2 hours after surgery. There was no significant difference between FVC and FEV1. CONCLUSION: The findings of the study indicate that the TENS is effective in easing the pain of patients after a lobectomy.

Symptom Distress and Spiritual Well-Being in Patients with Cancer according to Illness and Treatment / 기본간호학회지

PURPOSE: This study was done to analyze symptom distress and spiritual well-being in patients with cancer according cancer diagnosis, metastasis, treatment stage, number of hospitalizations and treatment modality. METHOD: The participants, 285 patients being treated in one of ten general hospitals either as in- or out-patients, completed the McCorkle and Young (1978) Symptom Distress Scale translated and adapted by Uhm (1986) and the Spiritual Well-Being Scale by Paloutzian and Ellison (1982) translated by Choi (1990). Data collection was done from June 19 to September 30, 2006. RESULTS: For symptom distress, there were significant differences for cancer diagnosis (p=.018), metastasis (p=.000), treatment stage (p=.000), number of hospitalizations (p=.000), and treatment modality (p=.002). For spiritual well-being, the only significant difference was for cancer diagnosis (p=.002). Patients with ovarian/uterine cancer had the lowest spiritual well-being. CONCLUSION: For patients with cancer, symptom distress was significantly different for illness and treatment factors, in particular, stage of illness, while for spiritual well-being, patients with uterine ovarian cancer had the lowest spiritual level. These results indicate a need to develop nursing interventions to decrease symptom distress in patients according to treatment stage and to promote spiritual well-being, particularly in women with ovarian/uterine cancer.

The Effects of Dogbi(ST35) & Sulan Moxibustion on Knee Joint Pain, Range of Motion and Discomfort during ADL in the Aged / 간호학회지

PURPOSE: The purpose of this research was to test the effects of ST35 & Sulan moxibustion on knee joint pain, range of motion, and discomfort during Activies of Daily Living (ADL) in elderly with knee joint pain. METHOD: A nonequivalent control group pre-post test research design was used. Thirty four elderly who had knee joint pain were studied. Of them, sixteen were in the experimental group and eighteen the control group. The instruments used for this study were NRS, goniometer, and a modified ADL questionnaire developed by Lee. RESULT: The pain scores of right & left knee joint after moxibustion were significantly different between the experimental group and the control group (Right: F=26.27, p=0.000, Left: F=20.77, p=0.000). Right and left knee ROM scores were significantly different between the experimental group and the control group after moxibustion (Right: F=10.74, p=0.003, Left: F=9.239, p=0.005). Discomfort during ADL scores were significantly different between the experimental group and the control group after moxibustion (F= 32.31, p=0.000). CONCLUSION: It is necessary that nurses provide the elderly with knee joint pain with moxibustion to reduce joint pain and to increase knee ROM as an alternative therapy.

The Type and Importance of Oriental Health Promotion Services and Nursing: By Delphi Method / 성인간호학회지

PURPOSE: To identify the agreed opinion of experts on oriental health promotion services and nursing in Korea. METHOD: The study is based on the 3-round Delphi method. As a Delphi panel, a total of 28 people with at least three years of experience in the area of oriental medicine consisted of this. RESULTS: The experts suggested that Yangsaeng, lectures on prevention of CVA, correct understanding of the misuse/abuse of oriental medicine, daily health care, meridian/acupoints massage, and Kigong therapy should be included in the promoting oriental health nursing servies. CONCLUSION: The agreed opinions by the experts on the oriental health promotion services and nursing, can help enhance the understanding of oriental health promotion. The curriculum should be developed further and tested with the development of the Korean oriental nursing intervention methods which is appropriate to Korean culture.

The Effect of Music Therapy on Postoperative Pain in Patients with Total Hip Replacement / 성인간호학회지

PURPOSE: The purpose of the study was to test the effects of music therapy on postoperative pain in patients with total hip replacement. METHOD: The research design was a nonequivalent control group pretest-posttest design. The subjects were composed of thirty patients with total hip replacement. Fifteen of them were assigned to the experimental group and fifteen to the control group. Fifteen minutes tailored music therapy was given to the experimental group during five consecutive days. The instruments used for this study were pain NRS(numerical rating scale). The data were analyzed using percent, mean, standard deviation, chi-square-test and repeated measure ANOVA using SPSS WIN 11.0. RESULTS: Hypothesis 1 "The score of pain NRS of experimental group will be lower than those of control group" was accepted(F=15.945, p<.001). Hypothesis 2 "The frequency of PCA analgesics of experimental group will be fewer than those of control group" was accepted (t=-2.312, p=.028). Hypothesis 3 "The vital signs(pulse, systolic BP and diastolic BP) of experimental group will be different from those of control group" was rejected. CONCLUSION: This music therapy can be recommended as an efficient nursing intervention to reduce postoperative pain in patients with total hip replacement.

Development and Application of an Online Alternative Therapy and Health Promotion Class / 간호학회지

PURPOSE: This study was to develop an online 'alternative therapy and health promotion' class for university students and to evaluate its changes. METHOD: The online class was developed based on the Instructional Systems Development (ISD) model and model of Web-Based Instruction (WBI) developmental process. This was a quasi- experimental, one group pretest-posttest design. The subjects of this study were 130 students in 3 universities, and they were provided the cyber class for 16 weeks. Data was analyzed by descriptive and plural answer statistics, and paired t-test. RESULTS: The cyber class was developed in five steps : analysis, design, data collection and reconstruction, programing and publishing, and evaluation. The results of program evaluation were positive, which included learning 3.47, system 3.57, and learning satisfaction 3.64 on the scale of 5. The posttest scores of cognition and reliability of alternative therapy were higher than pretest scores. The posttest score of health promoting lifestyle (t=-5.051, p=.000) and perceived health status (t=2.979, p=.003) were significantly higher than those of the pretest. CONCLUSION: These results suggest that the cyber class is a positive method in increasing a cognition, reliability of alternative therapy, and is effective to improve a health promotion lifestyle and perceived health status for the university students.

Effects of Hand Massage and Hand Holding on the Anxiety in Patients with Local Infiltration Anesthesia / 간호학회지

PURPOSE: This study was to examine the effects of hand massage and hand holding as nursing interventions on the anxiety in patients with local infiltration anesthesia. METHOD: The design of this study was a nonequivalent, control group, non- synchronized design. The subjects of this study consisted of 15 patients for the hand group, 15 patients for the hand holding group and 17 patients for the control group awaiting surgery in the operation room of a general hospitalin Daegu. As an experimental treatment, hand massage was carried out by the Hand Massage Protocol developed by Snyder(1995) and interpreted by Cho(1998) and hand holding developed by Cho(1998). The data were analyzed by SPSS/WIN, T-test, ANOVA, Cronbach's alpha, and the Scheffe test. RESULTS: The hand massage group and hand holding group were more effective than the control group in reducing anxiety, VAS score, systolic blood pressure and pulse rate. CONCLUSION: Hand massage and hand holding are effective nursing interventions that alleviates the psychological and physiological anxiety of patients with local infiltration anesthesia. In particular, the simple contact of hand holding is regarded as an effective and easily accessible nursing intervention in the operating room.

A Comparative Study on Spiritual Well-Being and Perceived Health Status between Above Average and Low Income for Elderly People / 기본간호학회지

PURPOSE: This study was to provide basic data for comprehensive nursing care for elderly people and to compare the spiritual well-being and perceived health status between elderly people who have above average income and those who have low income. METHODS: The data were collected from 80 elders with above average income and 81 with low income through face-to-face interviews. An elder was defined as a person over 60 years of age. The data were analyzed using t-test, ANOVA, ANCOVA, Pearson correlation coefficients and Scheffe test. RESULTS: The mean score for spiritual well being for elders with above average income was 2.90 of a total possible score of 4 and for elders with low income, 2.49 and the difference was significant. The mean score for perceived health status for elders with above average income was 8.93 of a total possible score of 14 and for elders with low income, 7.47 and the difference was also significant. There was a statistically positive correlation between existential well-being and perceived health status for the total sample of elderly people and for the elders with low income. CONCLUSION: Spiritual nursing care should be included in comprehensive health care programs for elderly people in Korea. Especially, it is important to develop nursing interventions for elders with low income that will increase their spiritual well-being and help them to develop positive thinking towards perceived health status.

The Effect of Hand Moxibustion Therapy on Knee Joint Pain, Joint Range of Motion and Discomfort during ADL in Elderly People / 기본간호학회지

PURPOSE: This study was done for the purpose of testing the effects of hand moxibustion on pain in the knee joint, range of motion of the knee, and discomfort during ADL in elderly persons with knee joint pain. METHOD: Nonequivalent control group pre-post test research design was used. The participants were 35 elders who had knee joint pain. Sixteen were assigned to the experimental group and 19 to the control group. The instruments used for this study were the GRS (Graphic rating scale) for knee joint pain, goniometer for knee joint ROM, and modified ADL questionnaire developed by Lee. Analysis of data was done by percents, means and standard deviation, x2test, t-test, and ANCOVA using SPSS WIN 10.0. RESULT: The pain score for the right knee joint after hand moxibustion was significantly different between the experimental group and the control group after hand moxibustion (p=.035). The pain score for the left knee joint was not significantly different between the experimental group and the control group after hand moxibustion (p=.075). Right and left knee ROM scores were significantly different between the experimental group and the control group after hand moxibustion (Right p=.000, Left p=.034). Discomfort of ADL score was not significantly different between the experimental group and the control group after hand moxibustion (p=.053). CONCLUSION: In summary, knee joint pain in elders after hand moxibustion decreased and knee ROM in elders after hand moxibustion increased. So it would be useful for nurses to provide hand moxibustion as an alternative therapy to elders with knee joint pain in the community and thus reduce joint pain and increase knee ROM