매개모델을 이용한 유방암 환자의 증상클러스터 검증
A Symptom Cluster Analysis of Breast Cancer Patients Using a Mediation Model
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: This study was conducted to test whether sleep disturbance mediates the effect of pain on fatigue, whether fatigue mediates the effect of pain on depression, and whether fatigue mediates the effect of sleep disturbance on depression. Methods: This study was conducted from September 12th to December 20th, 2011. One hundred eighty-eight breast cancer patients were recruited from D city and S city in Korea. The instruments used in this study were the pain, sleep disturbance, fatigue, and depression scales. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and mediation pathway with the SPSS 12.0 and AMOS 20.0 programs. Results: There was correlation among pain, fatigue, sleep disturbance, and depression. Mediation analyses indicated that pain influences fatigue. sleep disturbance, and depression directly as well as indirectly. Sleep disturbance influences fatigue and depression directly, also fatigue influences depression directly. But sleep disturbance had no direct effect on depression. Conclusion: Significant correlations among the four symptoms supported the existence of the symptom cluster. Effects of pain on fatigue was partially mediated by sleep disturbance, also effects of pain on depression was partially mediated by fatigue. However, the effects of sleep disturbance on depression was fully mediated by fatigue.
Abstract
Purpose: This study was conducted to test whether sleep disturbance mediates the effect of pain on fatigue, whether fatigue mediates the effect of pain on depression, and whether fatigue mediates the effect of sleep disturbance on depression. Methods: This study was conducted from September 12th to December 20th, 2011. One hundred eighty-eight breast cancer patients were recruited from D city and S city in Korea. The instruments used in this study were the pain, sleep disturbance, fatigue, and depression scales. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and mediation pathway with the SPSS 12.0 and AMOS 20.0 programs. Results: There was correlation among pain, fatigue, sleep disturbance, and depression. Mediation analyses indicated that pain influences fatigue. sleep disturbance, and depression directly as well as indirectly. Sleep disturbance influences fatigue and depression directly, also fatigue influences depression directly. But sleep disturbance had no direct effect on depression. Conclusion: Significant correlations among the four symptoms supported the existence of the symptom cluster. Effects of pain on fatigue was partially mediated by sleep disturbance, also effects of pain on depression was partially mediated by fatigue. However, the effects of sleep disturbance on depression was fully mediated by fatigue.
참고문헌 (28)
- 김희주, "Symptom clusters - Concept analysis and clinical implications for cancer nursing", CANCER NURSING, 28(4), pp.270~282 (2005), LIPPINCOTT WILLIAMS WILKINS
- Byar KL, "Impact of adjuvant breast cancer chemotherapy on fatigue, other symptoms, and quality of life", Oncol Nurs Forum, 33, pp.E18~E26 (2006)
- Barsevick AM, "The elusive concept of the symptom cluster", Oncol Nurs Forum, 35, pp.971~980 (2007)
- Fan G, "Symptom cluster in cancer patients : A review of the literature", Curr Oncol, 14, pp.173~179 (2007)
- Beck SL, "Pain, sleep disturbance, and fatigue in patients with cancer: Using a mediation model to test a symptom cluster", Oncol Nurs Forum, 32, pp.E48~E55 (2005)
- Kirkova J, "Cancer symptom cluster: Old concept but new data", Am J Hosp Palliat Care, 27, pp.282~288 (2010)
- 김경덕, "항암화학요법을 받고 있는 유방암 환자의 증상 클러스터와 삶의 질", 성인간호학회지, 23(5), pp.434~445 (2011), 성인간호학회
- Stevens PE, "Prevalence, characteristics, and impact of postmastectomy pain syndrome: an investigation of women experience", Pain, 61, pp.61~68 (1995)
- Jung BF, "Neuropathic pain associated with non-surgical treatment of breast cancer", Pain, 118, pp.10~14 (2005)
- 김희주, "Treatment-Related Symptom Clusters in Breast Cancer: A Secondary Analysis", Journal of Pain and Symptom Management, 36(5), pp.468~479, Elsevier BV
- Fiorentino L, "The symptom cluster of sleep, fatigue and depressive symptoms in breast cancer patients : severity of the problem and treatment options", Sleep, 8, pp.167~173 (2011)
- , Kyunghee Univ, 2005
- Lis CG, "The relationship between insomnia and patient satisfaction with quality of life in cancer", Support Care Cancer, 16, pp.261~266 (2008)
- 박주현, "외래 항암화학요법 중인 유방암 환자의 수면의 질", Korean Journal of Family Medicine, 31(10), pp.778~785 (2010), 대한가정의학회
- Berger A, "Treating fatigue in cancer patients", Oncologist, 8, pp.10~14 (2003)
- Miaskowski C, "Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: A cluster analysis", Oncol Nurs Forum, 33, pp.E79~E89 (2006)
- Fann JR, "Major depression after breast cancer: a review of epidemiology and treatment", Gen Hosp Psychiatry, 30, pp.112~126 (2008)
- Pud D, "The symptom experience of oncology outpatients has a different impact on quality-of life outcomes", J Pain Symptom Manage, 35, pp.162~170 (2008)
- Dodd MJ, "The effect of symptom cluster on functional status and quality of life in women with breast cancer", Eur J Oncol Nurs, 14, pp.101~110 (2010)
- Bower JE, "Perception of positive meaning and vulnerability following breast cancer: Predictor and outcomes among long-term breast cancer survivors", Ann Behav Med, 29, pp.236~245 (2005)
- Daut RL, "Developmant of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases", Pain, 17, pp.197~210 (1983)
- , Seoul National Univ, 1992
- Yeun EJ, "Verification of the profile of mood states-brief: Cross-cultural analysis", J Clin Psychol, 62, pp.1173~1180 (2006)
- Hair JFJ, "Multivariate data analysis 5th ed" (1998), Prentice-Hall International
- Cheng KKF, "Effects of pain, fatigue, insomnia, and mood disturbance on functional status and quality of life of elderly patients with cancer", Crit Rev Oncol Hematol, 78, pp.127~137 (2011)
- So Winnie KW, "The symptom cluster of fatigue, pain, anxiety, and depression and the effect on the quality of life of women receiving treatment for breast cancer: A multicenter study", Oncol Nurs Forum, 36, pp.E205~E214 (2009)
- Reuter K, "Association of coping style, pain, age, and depression with fatigue in women with primary breast cancer", Psychooncology, 15, pp.772~779 (2006)
- , Hanyang Univ, 2010