Trajectories of Wok Adjustment and Influencing Factors Among Newly Registered Nurses.

PURPOSE: This study explored the work adjustment trajectory and its predictors and characteristics among newly registered nurses. METHODS: A total of 245 newly registered nurses working in a university hospital provided general baseline characteristics and completed a work adjustment questionnaire along with self-report measures of clinical competency, psychological capital, preceptor exchange, social support, and role conflict when they started working independently (baseline) and at 7 and 12 months after employment. Data were collected from July 2020 to August 2022. The collected data were subjected to a group-based trajectory model, χ2 test, F test, one-way ANOVA, and multiple logistic regression using SAS 9.4, and SPSS 25.0. RESULTS: Group-based trajectory modeling classified three newly registered nurse groups: nurses with a high work adjustment level in all subscales from the beginning of employment (early adjustment group, 16.1%), nurses with a moderate level of adjustment from beginning to end (standard adjustment group, 60.6%), and nurses with a low level of work adjustment from early to mid-term, rising later (delayed adjustment group, 23.3%). Higher hope, optimism, and emotional support predicted early and standard adjustments. CONCLUSIONS: Based on the trajectory characteristics, newly registered nurses need to improve their work adjustment. The early and standard adjustment groups should continuously monitor their levels of work adjustment while monitoring their hopes, optimism, and emotional support. In particular, the delayed adjustment group required customized educational programs and strengthened peer support.

Impact of nonpharmacological interventions on cognitive impairment in women with breast cancer: A systematic review and meta-analysis.

Objective: This study aimed to examine the characteristics of research conducted on nonpharmacological interventions for cognitive impairment in patients with breast cancer and identify the primary effects of nonpharmacological interventions through a systematic review and meta-analysis. Methods: Five electronic databases were searched to identify all randomized controlled trial studies until September 30, 2022, using the key terms "breast cancer," "cognitive disorders," and their possible variations. The Cochrane Risk of Bias tool was used to assess risk of bias. The effect sizes were calculated in Hedges' g. Potential moderators influencing the intervention effects were explored. Results: Twenty-three studies were included in the systematic review, and 17 studies were included in the meta-analysis. Among the nonpharmacological interventions for patients with breast cancer, cognitive rehabilitation and physical activity were the most common, followed by cognitive behavioral therapy. The meta-analysis indicated that nonpharmacological interventions had a significant effect on attention (g â€‹= â€‹0.83; 95% CI: 0.14 to 1.52; I 2 â€‹= â€‹76%), immediate recall (g â€‹= â€‹0.33; 95% CI: 0.18 to 0.49; I 2 â€‹= â€‹0%), executive function (g â€‹= â€‹0.25; 95% CI: 0.13 to 0.37; I 2 â€‹= â€‹0%), and processing speed (g â€‹= â€‹0.44; 95% CI: 0.14 to 0.73; I 2 â€‹= â€‹51%) among objective cognitive functions, as well as subjective cognitive function (g â€‹= â€‹0.68; 95% CI: 0.40 to 0.96; I 2 â€‹= â€‹78%). Intervention type and mode of delivery were potential moderators for the effects of nonpharmacological interventions on cognitive functions. Conclusions: Nonpharmacological interventions can improve subjective and objective cognitive functioning among patients with breast cancer undergoing cancer treatment. Therefore, it is necessary to provide nonpharmacological interventions by screening patients at high risk of cancer-related cognitive impairment. Systematic review registration: CRD42021251709.

Simulation-based training program on patient safety management: A quasi-experimental study among new intensive care unit nurses.

BACKGROUND: Patient safety is an essential responsibility of nurses. However, newly graduated nurses experience patient safety incidents due to a lack of patient safety competency. In particular, intensive care unit nurses provide care to critical patients, making it difficult for new nurses to maintain patient safety. Therefore, it is necessary to improve the patient safety competency of newly graduated nurses working in the intensive care unit. OBJECTIVES: To analyze the effects of a simulation-based training program on patient safety management on the patient safety competency, patient safety management activity, communication self-efficacy, and teamwork of newly graduated nurses working in an intensive care unit. DESIGN: A quasi-experimental study. SETTINGS: The study was conducted at a university in Korea. PARTICIPANTS: A total of 44 newly graduated nurses working in the intensive care unit of a university hospital. METHODS: A simulation-based training program on patient safety management was applied to the experimental group (n = 22), while only the usual hospital training program was used for the control group (n = 22). A structured questionnaire survey comprising Patient Safety Competency Self-Evaluation, Patient Safety Management Activities, the Korean version of the self-efficacy questionnaire, and K-self assessment of teamwork was conducted at baseline test (T1), post test (T2), and follow-up test (T3). Data were analyzed using a repeated measures ANOVA. RESULTS: The experimental group showed significantly higher patient safety competency, patient safety knowledge, and patient safety skills, along with higher communication self-efficacy scores than the control group (p < .05) after the intervention and at four weeks after the intervention. CONCLUSIONS: The simulation-based training program on patient safety management effectively improved the patient safety competency, patient safety knowledge, and patient safety skills as well as communication self-efficacy of newly graduated nurses working in an intensive care unit.

A Cross-Sectional Analysis of Health Literacy and Compliance to Treatment in Organ Transplant Recipients.

This study was conducted to determine the correlations between health literacy, transplant effects, and compliance to treatment in organ transplant recipients and to identify the factors influencing compliance to treatment. The participants (n = 130; males = 66.9%; mean age = 56.4 years) were organ transplant recipients visiting an organ transplantation center in Seoul, South Korea. The regression model explained 32% of the variance in participants' compliance to treatment. Among the health literacy variables, "Scale 3: Actively managing my health" (ß = 0.38, p = 0.001) and "Scale 4: Social support for health" (ß = 0.25, p = 0.019) had a significant effect on compliance to treatment. In this study, health literacy was identified as a key factor influencing compliance to treatment. Therefore, patients' health literacy should be assessed prior to transplantation to identify potential high-risk patients for treatment nonadherence. In addition, after transplantation surgery, patient-tailored interventions should be developed and provided for self-management that reflects the patient's health literacy level to ultimately enhance patient outcomes.

Trajectories of quality of life in breast cancer survivors during the first year after treatment: a longitudinal study.

BACKGROUND: Although quality of life (QOL) improves over time for most breast cancer patients after their treatment, some patients may show different patterns of QOL. Beyond determining distinct QOL trajectories, identifying characteristics of patients who have different trajectories can help identify breast cancer patients who may benefit from intervention. We aimed to identify trajectories of QOL in breast cancer patients for one year after the end of primary treatment, to determine the factors influencing these changes. METHODS: This longitudinal study recruited 140 breast cancer patients. Patients' QOL, symptom experience, self-efficacy, and social support were assessed using the Functional Assessment of Cancer Therapy Scale-G, Memorial Symptom Assessment Scale-Short Form, Self-Efficacy Scale for Self-Management of Breast Cancer, and Interpersonal Support Evaluation List-12. Data were collected immediately after the end of primary treatment (T1) and at three (T2), six (T3), and 12 months (T4) after primary treatment. Group-based trajectory modeling was used to identify distinct subgroups of patients with similar patterns of QOL change after treatment. A one-way analysis of variance was used to determine which variables were associated with trajectory membership. A multinomial logistic regression was performed to identify factors associated with trajectory group membership. RESULTS: We analyzed 124 patients (mean age: 48.75 years). Latent class analysis of the QOL identified three trajectory groups: the low QOL group (n = 27; 21.1%), moderate QOL group (n = 57; 45.3%), and high QOL group (n = 40; 33.6%). The low QOL group showed consistently low QOL after the end of primary treatment, and the moderate QOL group showed a slight decrease in QOL from T1 to T3, which returned to the T1 level at T4. The high QOL group maintained a consistently high QOL. By multinomial logistic regression, psychological symptoms (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.22-0.99) predicted a moderate QOL, and both psychological symptoms (OR 0.19, 95% CI 0.07-0.51) and belonging support (OR 1.60, 95% CI 1.06-2.39) predicted a high QOL. CONCLUSION: Identifying high-risk groups for reduced QOL after the end of primary treatment is necessary. Moreover, psychosocial interventions should be provided to alleviate psychological symptoms and increase belonging support to enhance patients' QOL. Trial registration Not registered.

Predictors of health-related quality of life after coronary artery bypass graft surgery.

Health-related quality of life (HRQOL) is a multifactorial concept in assessing physical and mental health. This study was performed to evaluate the HRQOL of patients undergoing coronary artery bypass graft (CABG) surgery and the predictors of HRQOL in patients until 1 year after surgery. This cross-sectional study included 110 consecutive patients who underwent elective CABG in a medical center in South Korea. The Short-Form Health Survey, cardiac symptom survey, cardiac self-efficacy, and the Interpersonal Support Evaluation List-12 were used to measure the HRQOL, symptom experience, self-efficacy, and social support, respectively. The regression model explained 42% of the variance in the participants' physical HRQOL. The predictors of the physical HRQOL include the presence of a spouse, post-CABG duration, symptom experience, and self-efficacy. The regression model explained 36% of the variance in the participants' mental HRQOL. The predictors of the mental HRQOL included perceived health status, self-efficacy, and social support. The predictive factors for HRQOL after CABG were the presence of a spouse, post-CABG duration, symptom experience, self-efficacy, and social support. Furthermore, a suitable program and nursing interventions could be implemented to improve the HRQOL of post-CABG patients.

Cultural and linguistic adaption and testing of the Health Literacy Questionnaire (HLQ) among healthy people in Korea.

BACKGROUNDS: This study administered the Health Literacy Questionnaire (HLQ) among Korean adults to examine its factor structure, reliability, and validity. METHODS: The HLQ items were translated and culturally adapted to the Korean context. The convenience sampling method was used, and data were collected. The difficulty level, confirmatory factor analysis (CFA) using diagonal weighted least squares (DWLS) estimator in R, discriminant validity, and composite reliability were performed. RESULTS: The easiest scale to obtain a high score was "Scale 4. Social support for health" and the hardest was "Scale 7. Navigating the healthcare system." Nine one-factor models fitted well. The nine-factor structural equation model fitted the data well. All HLQ scales were homogenous, with composite reliability. CONCLUSIONS: The Korean version of the HLQ has a strong construct and high composite reliability when applied to Korean adults.

Pandemic Fatigue and Anxiety Sensitivity as Associated Factors With Posttraumatic Stress Symptoms Among University Students in South Korea During the Prolonged COVID-19 Pandemic.

Objectives: The global impact of COVID-19 driven by new variants may add to the negative mental health consequences of the prolonged pandemic, including posttraumatic stress symptoms (PTSS). University students may be prone to develop a series of PTSS due to life plan disruptions as well as increased uncertainty caused by the pandemic. The purpose of this study was to assess the associations between pandemic fatigue, anxiety sensitivity (AS), and PTSS among university students in South Korea. Methods: Using convenience sampling, 400 students participated in this cross-sectional online survey. Descriptive statistics and linear mixed models were used to examine factors associated with PTSS. Results: About one-third (32.3%) of the participants reported clinically significant levels of PTSS. Multivariate analyses revealed that pandemic fatigue (ß = 0.124, p < 0.001) and AS (ß = 0.212, p < 0.001) were significantly associated with PTSS while controlling for other study variables. Conclusion: Young adults who feel more fatigue related to the COVID-19 pandemic and with high AS should be given access to mental health resources to better manage their mental health and reduce PTSS.

Mobile web-based self-management program for breast cancer patients with chemotherapy-induced amenorrhoea: A quasi-experimental study.

AIM: The aim of this study was to examine the effects of a mobile web-based self-management program on menopausal symptoms, self-efficacy and quality of life in breast cancer patients with chemotherapy-induced amenorrhoea. DESIGN: A quasi-experimental pretest-posttest design with repeated measures. METHODS: The study was carried out at a university medical centre between October 2017 and September 2018. The intervention group received a 12-week mobile web-based self-management program including education and coaching/support. Multiple instruments were used to measure menopausal symptoms, self-efficacy, and quality of life at pre-test, after the intervention (post-test), and 3 months post-intervention (follow-up test). Repeated measure ANOVA was used to analyse the data. RESULTS: In the intervention group, menopausal symptoms were significantly improved compared to the control group at the follow-up test. In the follow-up test, the intervention group's self-efficacy and quality of life were significantly improved, whereas that of the control group was decreased.

Determinants of quality of life in women immediately following the completion of primary treatment of breast cancer: A cross-sectional study.

BACKGROUNDS: Many breast cancer patients experience significant distress immediately following the completion of primary treatment. Women who report low levels of quality of life (QOL) early in this phase of transitional survivorship tend to experience diminished long-term adjustment. However, since most of the prior studies on survivors were conducted on patients at various times, studies on QOL of women during the end of primary treatment have been insufficient. This study aimed to identify determinants of QOL in women with breast cancer immediately following the completion of treatment. METHODS: A cross-sectional study was conducted on 140 disease-free breast cancer patients who had completed therapy in the past 1 month at university hospitals. Functional Assessment of Cancer Therapy-Breast (FACT-B), Memorial Symptom Assessment Scale-Short Form (MSAS-SF), Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B), and Interpersonal Support Evaluation List-12 (ISEL-12) scales were used to assess predictors and QOL. The data were analyzed using the Pearson correlation, t-test, ANOVA, and hierarchical multiple regression. RESULTS: The mean score of QOL for breast cancer survivors was 97.23 (±20.01). Chemotherapy and perceived economic status were significantly associated with QOL in terms of sociodemographic and disease/treatment-related characteristics. Physical and psychological symptoms and social support had a significant association with QOL. The regression analyses showed that physical and psychological symptoms and belonging support were statistically significant in predicting the QOL of breast cancer survivors. CONCLUSIONS: The variables of symptom experience and social support must be acknowledged when improving women's QOL immediately after their completion of primary breast cancer treatment. Greater focus on the reduction of symptom distress and increasing a sense of belonging could improve QOL among breast cancer survivors.

Incidence and Risk Factors of Cardio-Cerebrovascular Disease in Korean Menopausal Women: A Retrospective Observational Study using the Korean Genome and Epidemiology Study data.

PURPOSE: Cardio-cerebrovascular diseases constitute the most common and fatal disease among menopausal women. However, the risk of cardio-cerebrovascular diseases in menopausal women compared to men has been underestimated, with insufficient related studies. Therefore, we examined the incidence and risk factors of cardio-cerebrovascular diseases among Korean menopausal women. METHODS: A retrospective observational study design with secondary analysis was conducted using data from the Korean Genome and Epidemiology Study survey. We used the study's data of 1,197 menopausal women, aged 40-64 years, who did not have cardio-cerebrovascular diseases at baseline and their related data from the biennial follow-ups over 14 years. Cardio-cerebrovascular diseases were defined as hypertension, coronary artery disease, or stroke. The incidence of cardio-cerebrovascular diseases was calculated per person-years, and multivariate Cox proportional hazards models were used to determine the predictors of cardio-cerebrovascular diseases during the follow-up period. RESULTS: Of the 1,197 cases, 264 were early or surgical menopausal women. The overall incidence of cardio-cerebrovascular diseases was 18.75 per 1,000 person-years. Early or surgical menopause (HR = 4.32, p < .001), along with family history of cardiovascular disease (HR = 1.87, p = .024), elevated blood pressure (HR = 1.79, p < .001), abdominal obesity (HR = 1.37, p = .046), or duration of menopause at the same age (HR = 1.01, p = .001), were strong predictors of cardio-cerebrovascular diseases. CONCLUSION: Based on the results of this study, it is necessary to identify and closely monitor women with early or surgical menopause for cardiovascular and cerebrovascular diseases prevention. Also, prevention of cardio-cerebrovascular diseases through blood pressure and abdominal obesity management is vital for menopausal women.

Reliability and validity of the Korean version of the MacNew heart disease Health-related Quality of Life questionnaire.

BACKGROUND: Myocardial infarction and unstable angina are prevalent in Korea. The MacNew Heart Disease health-related quality of life questionnaire is a widely used patient-reported outcome measure for patients with heart disease in several countries. In this study, we tested the validity and reliability of the Korean version of the MacNew (K-MacNew). METHODS: Participants were 200 patients who had experienced unstable angina or myocardial infarction, and were recruited from a tertiary hospital in Korea. The K-MacNew was developed using forward-backward translation techniques. Construct validity (including discriminative validity), concurrent validity, and internal consistency reliability of the K-MacNew were assessed. Discriminative validity was assessed by examining the between-group differences in the K-MacNew scores according to functional capacity, anxiety, and depression levels. Concurrent validity was examined by correlating the K-MacNew dimensions with the physical and mental health domains of the 36-item Short Form Health Survey Instrument (SF-36). RESULTS: Factor analysis results of the K-MacNew demonstrated a three-factor structure (emotional, physical, and social) that explained 57.92% of the variance. Significant differences in the K-MacNew scores were observed according to patients' functional capacity, anxiety, and depression levels. The SF-36 physical health domain score showed a moderate positive correlation with the physical dimension score of the K-MacNew (r = 0.517, P < 0.001), and the SF-36 mental health domain score showed a strong positive correlation with the emotional dimension of K-MacNew (r = 0.745, P < 0.001). The K-MacNew showed good internal consistency, with a Cronbach's α of 0.947 for the global scale. CONCLUSION: The K-MacNew demonstrated good reliability and validity for use as a patient-reported outcome measure and is ready for the assessment of the health-related quality of life of patients with coronary artery disease in Korea. To establish the clinical validity of the K-MacNew, additional studies should be conducted to verify the validity and reliability of the K-MacNew in a number of participants, including those with various types of coronary artery disease.

[Validity and Reliability of the Korean Version of the Menopause-Specific Quality of Life].

PURPOSE: This study aimed to evaluate the validity and reliability of the Korean version of Menopause-Specific Quality of Life (MENQOL). METHODS: The MENQOL was translated into Korean according to algorithm of linguistic validation process. A total of 308 menopausal women were recruited and assessed using the Korean version of MENQOL (MENQOL-K), the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), and Center for Epidemiological Studies Depression Scale (CES-D-K). In estimating reliability, internal consistency reliability coefficients were calculated. Validity was evaluated through criterion validity and construct validity with confirmatory factor analyses using SPSS 23.0 and AMOS 25.0 software. RESULTS: In item analyses, the "increased facial hair" symptom was excluded because of the low contribution of MENQOL-K. The confirmatory factor analysis supported good fit and reliable scores for MENQOL-K model, and the four-factor structure was validated (χ²=553.28, p<.001, NC=1.84, RMSEA=.05, AGIF=.85, AIC=765.28). The MENQOL-K consists of 28 items in 4 domains, including vasomotor (3 items), psychosocial (7 items), physical (15 items), and sexual subscales (3 items). There was an acceptable criterion validity with moderately significant correlation between MENQOL-K and WHOQOL-BREF. The Cronbach's α for the 4 subsacles ranged from .80 to .93. CONCLUSION: The MENQOL-K is a valid and reliable scale to measure condition-specific quality of life for perimenopausal and postmenopausal women. It can be used to assess the impact of menopausal symptoms on the quality of life of Korean women in clinical trials.

Systematic review and meta-analyses of randomized control trials of the effectiveness of psychosocial interventions for homeless adults.

AIMS: To evaluate the effect of psychosocial interventions for homeless adults on their psychosocial outcomes. DESIGN: A systematic review and meta-analyses were performed for critical appraisal and synthesis of the included studies. DATA SOURCES: A systematic search of studies published before 10 September 2018 was performed using PubMed, Cochrane Library, EMBASE, PsycINFO, and CINAHL. REVIEW METHODS: The review included randomized controlled trials conducting psychosocial interventions and assessing psychosocial outcomes for homeless adults. After systematically describing study and intervention characteristics, we conducted meta-analyses by the type of outcome and subgroup meta-analyses by the type of intervention and outcome. Fourteen studies were included in this review and 11 were included in the meta-analyses. RESULTS: A significant effect of psychosocial interventions in reducing anxiety and enhancing mental health status among homeless adults was noted. CONCLUSION: The meta-analyses showed that psychosocial interventions may reduce anxiety and enhance the mental health status of homeless people. Specifically, we suggest that relaxation response training may be effective in improving anxiety and mental health status and cognitive behavioural therapy may reduce anxiety. IMPACT: Although psychosocial interventions for homeless persons have been implemented for a decade, their impact for psychosocial outcomes among homeless adults has not been evaluated. This review suggest that psychosocial interventions may improve anxiety and mental health status among homeless adults. The findings of the present study may provide directions for developing psychosocial interventions to help vulnerable homeless adults in managing psychological outcomes.

Trajectories of health-related quality of life in breast cancer patients.

PURPOSE: The purpose of this study was to explore the trajectory of health-related quality of life (HRQoL) and its predictors in breast cancer patients. METHODS: A total of 126 women with newly diagnosed breast cancer provided baseline sociodemographic and medical characteristics and then completed an HRQoL questionnaire along with self-report measures of anxiety, depression, and cancer-related fatigue prior to their first cycle of chemotherapy (baseline), after chemotherapy completion, and at 6, and 12 months after chemotherapy completion. Group-based trajectory models were constructed to identify HRQoL trajectories over time. Logistic regression analysis was used to evaluate predictors of HRQoL in distinct patient groups. RESULTS: Group-based trajectory modeling classified two patient groups: participants with consistently medium overall HRQoL trajectories (41.1%) and participants with consistently low overall HRQoL trajectories (58.9%). Older age, perceived severe economic burden, and higher depression predicted consistently low overall HRQoL through 12 months after chemotherapy. CONCLUSIONS: Less than half of the total number of patients maintained a medium level of overall HRQoL after diagnosis and treatment of breast cancer, and nearly 60% continued to have lower overall HRQoL even after the treatment was complete. Older participants with more severe economic burden and higher depression experienced lower and more persistent overall HRQoL; thus, these patients should be monitored and provided supportive care as a part of survivorship care.

The role of depression in the relationship between cognitive decline and quality of life among breast cancer patients.

PURPOSE: Cancer patients who underwent chemotherapy experience cognitive decline, which, in turn, negatively impacts quality of life (QoL). Depression is considered a psychological factor that is negatively associated with the QoL of cancer patients. However, the relationships among cognitive functioning, depression, and QoL in breast cancer patients are under-researched in the literature. The aim of this cross-sectional study was to identify the role of depression in the relationship between cognitive functioning and QoL among breast cancer patients. METHODS: One hundred thirty breast cancer patients who underwent primary treatment participated. Participants completed the Functional Assessment of Cancer Therapy-Cognitive Function version 3, the Montreal Cognitive Assessment, the Beck Depression Inventory-II, and the Functional Assessment of Cancer Therapy-Breast Scale. The data were analyzed using multiple regression according to Baron and Kenny's strategies and the Sobel test. RESULTS: Subjective and objective cognitive functioning and depression were statistically significant predictors of QoL in breast cancer patients. Depression played a partial mediating role in the relationship between objective cognitive functioning and QoL and between subjective cognitive functioning and QoL. Additionally, the Sobel test demonstrated that depression had a significant partial mediating effect between subjective cognitive functioning and QoL (Z = 4.91, p < 0.001) and between objective cognitive functioning and QoL (Z = 2.62, p = 0.009). CONCLUSIONS: The findings indicated that depression could influence the association between cognitive functioning and QoL in breast cancer patients. Healthcare providers should develop an intervention focused on decreasing depression to evaluate the effectiveness of improving quality of life for breast cancer patients with cognitive dysfunction.

[Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer].

PURPOSE: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. METHODS: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. RESULTS: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. CONCLUSION: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

[Effects of Psychoeducational Intervention for Cancer Survivors: A Systematic Review and Meta-Analysis].

PURPOSE: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. METHODS: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. RESULTS: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. CONCLUSION: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

Effects of compensatory cognitive training intervention for breast cancer patients undergoing chemotherapy: a pilot study.

PURPOSE: Numerous breast cancer patients experience cognitive changes during and after chemotherapy. Chemotherapy-related cognitive impairment can significantly affect quality of life. This pilot study attempted to determine the effects of a compensatory cognitive training on the objective and subjective cognitive functioning of breast cancer patients receiving adjuvant chemotherapy. METHODS: Fifty-four patients were assigned to either a compensatory cognitive training or waitlist condition. They were assessed at baseline (T1), the completion of the 12-week intervention (T2), and 6 months after intervention completion (T3). Outcomes were assessed using the standardized neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), version 3. Raw data were converted to T-scores based on baseline scores, and a repeated-measures ANCOVA, adjusting for age, intelligence, depression, and treatment, was used for analysis. The effect sizes for differences in means were calculated. RESULTS: The intervention group improved significantly over time compared to the waitlist group on objective cognitive function. Among ten individual neuropsychological measures, immediate memory, delayed memory, verbal fluency in category, and verbal fluency in letter showed significant group × time interaction. In subjective cognitive function, scores of the waitlist group significantly decrease over time on perceived cognitive impairments, in contrast to those of the intervention group. CONCLUSION: The 12-week compensatory cognitive training significantly improved the objective and subjective cognitive functioning of breast cancer patients. Because this was a pilot study, further research using a larger sample and longer follow-up durations is necessary.

Predictors of Psychological Distress Trajectories in the First Year After a Breast Cancer Diagnosis.

PURPOSE: Psychological distress is a significant and ongoing problem for breast cancer. These mental health problems are often neglected as they are not always properly understood. This study was performed to explore the trajectory of psychological distress over 1 year since breast cancer surgery and to identify the associated factors for the trajectory. METHODS: One hundred seventeen women who underwent surgery for breast cancer completed the psychological distress thermometer and problem lists from after surgery to 12 months after surgery. Information on their sociodemographic and clinical characteristics was also obtained. Group-based trajectory modeling was performed to identify the distinct trajectories of psychological distress. Chi-square test and logistic regression analysis were performed to determine predictors of psychological distress trajectories. RESULTS: A two-group linear trajectory model was optimal for modeling psychological distress (Bayesian information criterion = -777.41). Group-based trajectory modeling identified consistently high-distress (19.4%) and low-decreasing distress (80.6%) trajectories. Old age, depression, nervousness, and pain were significant predictors of consistently high-distress trajectory. CONCLUSION: Our results indicate that distinct trajectory groups can be used as a screening tool to identify patients who may be at an increased risk of psychological distress over time. Screening for psychological distress during disease diagnosis is important and necessary to identify patients who are at an increased risk of elevated distress or at risk of experiencing psychological distress over time.