Impact of post-treatment symptoms on supportive care needs among breast cancer survivors in South Korea

Objective

The aim of this study is to investigate the factors influencing the supportive care needs of survivors of breast cancer who have completed major treatment.

Methods

A total of 121 survivors of breast cancer from an online community in South Korea participated in this study. The study variables were supportive care needs, physical symptoms, anxiety, and depression. Independent t-tests, one-way Analysis of Variance (ANOVA), Pearson's correlation, and hierarchical regression analyses were performed.

Results

The highest rankings of supportive care needs of survivors of breast cancer were medical system and information needs, patient care and support needs, psychological needs, sexual needs, and physical and daily life needs. Hierarchical regression analysis revealed that the participants' supportive care needs were explained by physical symptoms (P ​< ​0.001) and anxiety (P ​< ​0.001), accounting for 52.1% of the variance.

Conclusions

Supportive care needs of survivors of breast cancer have a high level of medical system and information needs, and posttreatment conditions are related to high physical symptoms and anxiety. In the future, it will be necessary to identify supportive care needs and apply interventions to reduce their physical symptoms and anxiety.

Effects of a web-based expert support self-management program (WEST) for women with breast cancer: A randomized controlled trial

INTRODUCTION

This study was a randomized controlled trial that examined the effects of a web-based expert support self-management program (WEST) on metabolic syndrome risk factors and self-efficacy among Korean women with breast cancer.

METHODS

Participants were 60 women with breast cancer (30 participants each in both the experimental and control groups) who also had metabolic risk factors. WEST is based on the self-efficacy theory and is a self-health management program consisting of a web-based program, DIETEX (which entails keeping a health diary, identifying a lifestyle type, inputting personal health information), and expert support. WEST was provided to the experimental group once a week for 24 weeks. Metabolic syndrome risk factors and self-efficacy of the experimental and control groups were examined pre-intervention and at 12 and 24 weeks after intervention.

RESULTS

The decreases in body fat, body fat percentage, and waist circumference were greater in the experimental group than in the control group at 24 weeks (p = 0.019, p = 0.025, and p = 0.038, respectively).

DISCUSSION

The present study can provide basic data for the development and application of interventions for women with breast cancer in the future. Additionally, we propose that WEST be included in the treatment process to complement the intervention of medical personnel for improving metabolic risk factors in women with breast cancer.

Aspects of Health-Related Factors and Nutritional Care Needs by Survival Stage among Female Cancer Patients in South Korea

PURPOSE

This study examined diet-related problems and needs associated with nutritional care according to survival stage in Korean female cancer survivors.

METHODS

186 outpatients (breast or gynecologic cancer survivors) recruited. Subjects were classified as (1) extended stage (ES, 2-5 years from diagnosis) and (2) long-term stage (LS, ≥5 years from diagnosis). Eating habits, changes in health related factors, nutritional needs, and quality of life were investigated.

RESULTS

43% of ES survivors had diet-related problems (p = .031); ES group reported dyspepsia and LS group reported anorexia/nausea as the major problem. Half of ES survivors had taste change, decreasing amount of intake, and reduced quality of life (p < .05). The LS group had a greater preference for sweet tastes than the ES group. According to their diagnosis, ES survivors with breast cancer gained weight (27.1%), whereas ES survivors with gynecologic cancer lost their body weight (34.5%) significantly. LS breast cancer patients showed great food preference for vegetables, whereas those with gynecologic cancer showed an increased preference for fish, meat and grain. Approximately 90% of survivors demanded nutritional care regarding restricted foods, preventing recurrence, particularly in ES survivors (p < .01). Moreover, main factors for nutritional care needs were body weight control for breast cancer and food environment for gynecologic cancer.

CONCLUSION

Survivors have different aspects of diet-related problems by survival stage as dyspepsia in ES and anorexia in LS. ES stage had changes in dietary patterns and their food consumption have decreased. Most of survivors have demanded nutritional care regardless of survival stage. These features of each stage should be considered to improve their health.

Weight Gain and its Correlates among Breast Cancer Survivors

PURPOSE

Weight gain after diagnosis of breast cancer is a profound issue that may negatively impact cancer prognosis. However, most existing research on weight change has been conducted in Western countries. In addition, several factors related to weight gain have been reported; however, the evidence is inconsistent. The purpose of this study was to examine weight gain and its correlates among Korean breast cancer survivors.

METHODS

A total of 132 female breast cancer survivors were recruited from one university hospital in South Korea. Participants completed anthropometric measurements (i.e., body weight, height) and a self-reported questionnaire, including the International Physical Activity Questionnaire Short Form and Mini Dietary Assessment.

RESULTS

The mean weight change was -0.09 kg (SD = 4.28). Only 27 women (19.7%) gained more than 5% of their weight at diagnosis, 59.1% maintained weight, and 21.2% lost weight. In multivariate logistic regression analysis, significant correlates of weight gain were younger age, obesity at diagnosis, duration of more than 36 months since diagnosis, and low diet quality.

CONCLUSION

Younger women, women who were obese at diagnosis, women with more than 36 months since diagnosis, or women who showed lower diet quality should be considered at high-risk for weight gain. Findings from our study suggest that optimal weight management strategies should be developed using ethnically- or culturally-appropriate approaches.

Randomized pilot test of a simultaneous stage-matched exercise and diet intervention for breast cancer survivors

PURPOSE/OBJECTIVES

To investigate the feasibility and preliminary effects of a simultaneous stage-matched exercise and diet (SSED) intervention in breast cancer survivors.

DESIGN

Randomized, controlled trial.

SETTING

Oncology outpatient treatment clinics at the National Cancer Center in South Korea.

SAMPLE

45 women with breast cancer who completed their cancer therapy.

METHODS

Participants were assigned to the SSED intervention group (n = 23) or a control group (n = 22). Participants in the SSED group received a 12-week individualized intervention promoting prescribed exercise and a balanced diet through stage-matched telephone counseling and a workbook.

MAIN RESEARCH VARIABLES

Program feasibility, behavioral outcomes (stage of motivational readiness for exercise and diet, physical activity, and diet quality), and quality-of-life (QOL) outcomes (functioning and global QOL, fatigue, anxiety, and depression).

FINDINGS

Participant evaluations of the SSED intervention indicated that it was feasible and acceptable. All women felt that the overall intervention contents were appropriate, and 95% believed that the intervention helped to promote healthy behaviors. Objective data also supported the SSED intervention's feasibility (i.e., 91% completed the trial and 100% of intervention calls were received). When compared to control, the SSED intervention group showed significantly greater improvement in motivational readiness for exercise and diet, emotional functioning, fatigue, and depression.

CONCLUSIONS

Preliminary results suggest that the SSED intervention delivered via telephone counseling and workbook is feasible and beneficial for positive behavioral and QOL outcomes.

IMPLICATIONS FOR NURSING

Nurse-led lifestyle interventions may improve QOL for cancer survivors.