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Madariaga A, Lau J, Ghoshal A, Dzierżanowski T, Larkin P, Sobocki J, Dickman A, Furness K, Fazelzad R, Crawford GB, Lheureux S. MASCC multidisciplinary evidence-based recommendations for the management of malignant bowel obstruction in advanced cancer. Support Care Cancer 2022; 30:4711-4728. [PMID: 35274188 PMCID: PMC9046338 DOI: 10.1007/s00520-022-06889-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/30/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To provide evidence-based recommendations on the management of malignant bowel obstruction (MBO) for patients with advanced cancer. METHODS The Multinational Association for Supportive Care in Cancer (MASCC) MBO study group conducted a systematic review of databases (inception to March 2021) to identify studies about patients with advanced cancer and MBO that reported on the following outcomes: symptom management, bowel obstruction resolution, prognosis, overall survival, and quality of life. The review was restricted to studies published in English, but no restrictions were placed on publication year, country, and study type. As per the MASCC Guidelines Policy, the findings were synthesized to determine the levels of evidence to support each MBO intervention and, ultimately, the graded recommendations and suggestions. RESULTS The systematic review identified 17,656 published studies and 397 selected for the guidelines. The MASCC study group developed a total of 25 evidence-based suggestions and recommendations about the management of MBO-related nausea and vomiting, bowel movements, pain, inflammation, bowel decompression, and nutrition. Expert consensus-based guidance about advanced care planning and psychosocial support is also provided. CONCLUSION This MASCC Guideline provides comprehensive, evidence-based recommendations about MBO management for patients with advanced cancer.
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Affiliation(s)
- Ainhoa Madariaga
- Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada.,Autonomous University of Barcelona, Barcelona, Spain.,12 Octubre University Hospital, Madrid, Spain
| | - Jenny Lau
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Arunangshu Ghoshal
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Tomasz Dzierżanowski
- Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Philip Larkin
- Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jacek Sobocki
- Department of General Surgery and Clinical Nutrition, Centre for Postgraduate Medical Education, Warsaw, Poland
| | - Andrew Dickman
- Academic Palliative and End of Life Care Department, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, England, UK
| | - Kate Furness
- Department of Dietetics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Rouhi Fazelzad
- Library and information services, University of Health Network, Toronto, Canada
| | - Gregory B Crawford
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Stephanie Lheureux
- Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada.
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Chang HK, Shim SH, Lee M, Lee WM, Eoh KJ, Yoo HJ, Kim MK, Kim MK, Lee KB, So KA, Kim YT, Lee DW, Hyun DY, Lee JM. Informed consent forms for gynecologic cancer surgery: recommendations from the Korean Society of Gynecologic Oncology. Obstet Gynecol Sci 2022; 65:105-12. [PMID: 35255543 DOI: 10.5468/ogs.22900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/12/2022] [Indexed: 11/16/2022] Open
Abstract
The sociomedical environment is changing. In the traditional physician-patient relationship, the physician was authoritative and the patient was obedient. The contractual relationship featured patient consent to the physician’s decision. Today, the physician must explain fully the planned medical treatment, and any alternative, to the patient, who has the right to choose her treatment after considering the benefits and side-effects. The Korean Society of Gynecologic Oncology thus decided to standardize the surgical consent forms to meet the legal requirements of modern medicine, improve patient understanding of the surgical details, and protect medical staff from legal disputes. To determine the format and content, subcommittees for each cancer type collected and reviewed all relevant articles and the current consent forms of domestic medical institutions. After several meetings, 16 basic items to be included for each type of gynecologic cancer were selected. Also, to help patients understand the surgical details, figures were included. The revised forms were legally reviewed in terms of the appropriateness of the format and content. We also developed English versions to provide adequate information for foreign patients. We hope that these efforts will promote trust between patients and physicians, and contribute to effective treatment by laying a foundation of mutual respect.
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Wei JJ. HMGA2: A Biomarker in Gynecologic Neoplasia. J Clin Transl Pathol 2022; 2:3-7. [PMID: 35340777 PMCID: PMC8950094 DOI: 10.14218/jctp.2021.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
High Mobility Group A2 gene (HMGA2), an oncofetal protein, is normally expressed in fetal development and completely shuts down in almost all organs and tissue types during adulthood. It is upregulated or overexpressed again in certain mesenchymal neoplasms due to chromosomal translocations and in malignant epithelial tumors through transcription regulation. HMGA2 overexpression can either drive tumor development or promote the aggressiveness of tumor growth. Many gynecologic neoplasms, including uterine smooth muscle tumors and ovarian cancer, are associated with HMGA2 overexpression. In this article, we review recent developments in the study of HMGA2 and its expression as a potential biomarker for gynecologic neoplasms and clinic application.
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Affiliation(s)
- Jian-Jun Wei
- Correspondence to: Jian-Jun Wei, Department of Pathology, Northwestern University, School of Medicine, Feinberg 7-334, 251 East Huron Street, Chicago, IL 60611, USA. Tel: +1-312-926-1815, Fax: +1-312-926-3127,
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Kim HS, Nho JH, Nam JH. A serial multiple mediator model of sense of coherence, coping strategies, depression, and quality of life among gynecologic cancer patients undergoing chemotherapy. Eur J Oncol Nurs 2021; 54:102014. [PMID: 34509089 DOI: 10.1016/j.ejon.2021.102014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/06/2021] [Accepted: 08/12/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study evaluated whether coping strategies (positive reframing, planning, and active coping) and depression mediate the relationship between sense of coherence (SOC) and quality of life (QoL) using a serial multiple mediator model in patients with gynecologic cancer who are undergoing chemotherapy. METHODS A sample of 148 participants, with a mean age of 52.17 years (range 20-75) and diagnosed with gynecological cancer (e.g., cervix, ovary and endometrium) was surveyed in a cross-sectional study. Data were collected using a structured self-reporting questionnaire. A serial multiple mediator model was analyzed to explain sequential causality among two mediators (coping strategy and depression) and to investigate the direct and indirect effects of the mediator model in SPSSWIN 26.0 and PROCESS macro program. RESULTS The conceptual serial mediation model of SOC, positive reframing, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through single mediation of positive reframing (Effect = 0.925) and depression (Effect = 5.942) and that through both mediators (Effect = 1.161) were statistically significant. The total indirect effect was also statistically significant (Effect = 8.028). Moreover, the conceptual serial mediation model on SOC, planning, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through both mediation of planning and depression (Effect = 1.162) and the total indirect effect were statistically significant (Effect = 8.172). CONCLUSIONS Helping patients with gynecologic cancer undergoing chemotherapy to strengthen SOC may improve QoL by equipping them with efficient positive reframing or planning strategies to reduce depression.
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Affiliation(s)
- Hee Sun Kim
- College of Nursing · Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54896, Republic of Korea.
| | - Ju-Hee Nho
- College of Nursing · Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54896, Republic of Korea.
| | - Joo-Hyun Nam
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Lee B, Kim K, Ahn S, Shin HJ, Suh DH, No JH, Kim YB. Continuous wound infiltration system for postoperative pain management in gynecologic oncology patients. Arch Gynecol Obstet 2017; 295:1219-26. [PMID: 28293723 DOI: 10.1007/s00404-017-4342-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 03/02/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE Major open surgery for gynecologic cancer usually involves a long midline skin incision and induces severe postoperative surgical site pain (POSP) that may not be effectively controlled with the conventional management. We investigated whether combining a continuous wound infiltration system (CWIS, ON-Q PainBuster®) and intravenous patient-controlled analgesia (IV PCA) effectively decreases POSP, compared with IV PCA alone, in gynecologic oncology patients. METHODS This retrospective study included 62 Korean patients who received a long midline skin incision during gynecologic cancer surgery. The combined therapy group (n = 31), which received CWIS (0.5% ropivacaine infused over 72 h) and IV PCA (fentanyl citrate), and the IV PCA only group (n = 31) were determined using 1:1 matching. POSP was assessed using resting numeric rating scale (NRS) scores measured for 96 h after surgery, which were analyzed using a linear mixed model. RESULTS The slopes of the predicted NRS values from the linear mixed model were significantly different between the groups. Compared with the control group, the combined therapy group had lower predicted NRS scores for the first 72 h, but higher predicted scores between 72 and 96 h. Moreover, the mean NRS scores over the first 48 h postoperation were significantly lower in the combined therapy group than in the control group; the scores were similar in both groups during the remaining period. With the exception of a higher body mass index in the CWIS group, the other variables, such as the dosage and usage time of fentanyl citrate, use of additional painkillers, and side effects, including wound complications, did not differ between groups. CONCLUSIONS Combined therapy using CWIS and IV PCA may be a useful strategy for POSP management in gynecologic oncology patients.
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Nho JH. Development of a Web-based Sexual Health Program for Women Undergoing Treatment for Gynecologic Cancer and Their Partners. Korean J Women Health Nurs 2016; 22:104-115. [PMID: 37684849 DOI: 10.4069/kjwhn.2016.22.2.104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/16/2016] [Accepted: 06/16/2016] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to develop a web-based sexual health program for women undergoing treatment for gynecologic cancer and their partners, and to evaluate the validity of the developed program. METHODS A web-based sexual health program was developed and evaluated: analysis (needs assessment on 23 patients and content analysis through literature review and web search), design, development, implementation, and evaluation. RESULTS The web-based sexual health program for women undergoing treatment for gynecologic cancer and their partners was structured with sexual life, sexual response cycle, change of sexual function, sexual dysfunction related to treatment, and useful method for sexual dysfunction. This program included a video to improve for understanding and a bulletin board to promote bi-directional interactions between program users and providers. Experts and users rated this program in terms of efficacy, convenience, design, relevance, and usefulness. This program contents were found appropriate and satisfactory to both experts and users. CONCLUSION This web-based sexual health program for women undergoing treatment for gynecologic cancer and their partners would contribute to sexual health promotion for gynecologic cancer women and their partners.
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Affiliation(s)
- Ju Hee Nho
- College of Nursing, Chonnam National University, Gwangju, Korea
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An H, Nho JH, Yoo S, Kim H, Nho M, Yoo H. [Effects of Lifestyle Intervention on Fatigue, Nutritional Status and Quality of Life in Patients with Gynecologic Cancer]. J Korean Acad Nurs 2016; 45:812-22. [PMID: 26805494 DOI: 10.4040/jkan.2015.45.6.812] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 06/24/2015] [Accepted: 08/04/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. METHODS A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. RESULTS Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. CONCLUSION Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.
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Affiliation(s)
- Hyunjin An
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Ju Hee Nho
- College of Nursing, Chonnam National University, Gwangju, Korea.
| | - Sunyoung Yoo
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Hyunmin Kim
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Minji Nho
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Hojeong Yoo
- Department of Nursing, Asan Medical Center, Seoul, Korea
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Nho JH, Kim SR, Kang GS, Kwon YS. Relationships among Malnutrition, Depression and Quality of Life in Patients with Gynecologic Cancer receiving Chemotherapy. Korean J Women Health Nurs 2014; 20:117-125. [PMID: 37684787 DOI: 10.4069/kjwhn.2014.20.2.117] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to identify nutritional status, and relationships among malnutrition, depression and quality of life in patients with gynecologic cancer who were receiving chemotherapy. METHODS For this study a descriptive cross-sectional design was used. Participants were 111 women who were enrolled and agreed to undergo a face-to-face interviews including administration of the structured questionnaires: Patient-Generated Subjective Global Assessment (PG-SGA), Beck Depression Inventory (BDI), Simplified Nutritional Appetite Questionnaire (SNAQ), and Functional Assessment of Cancer Therapy-General (FACT-G). RESULTS Mean body mass index was 23.3 and mean body weight was 56.5 kg. Sixty-three (57%) of the 111 patients were malnourished according to the PG-SGA. The malnourished patients showed higher levels of depression and lower quality of life compared to the non-malnourished patients. In addition, malnutrition was associated with BMI level, depression, appetite and quality of life. CONCLUSION The findings indicate that the prevalence of malnutrition is high and malnutrition in patients with gynecologic cancer influences depression and adversely affects the quality of life of these women. To improve the patient's quality of life, nutritional assessment and appropriate management is important to decrease malnutrition in patients with gynecologic cancer.
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Affiliation(s)
- Ju Hee Nho
- Department of Nursing, University of Ulsan, Ulsan, Korea
| | - Sung Reul Kim
- Department of Nursing, University of Ulsan, Ulsan, Korea
| | | | - Yong Soon Kwon
- Department of Nursing, University of Ulsan, Ulsan, Korea
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Jeong JH, Nho JH, Kim GS, Lee YE, Yu SY, Lee HJ, Sim YM, Lee YS. Characteristics and Quality of Life in Gynecologic Cancer Patients with Chemotherapy-induced Peripheral Neuropathy. Korean J Women Health Nurs 2013; 19:201-210. [PMID: 37684765 DOI: 10.4069/kjwhn.2013.19.4.201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to identify chemotherapy induced peripheral neuropathy, quality of life of patients with gynecologic cancer. METHODS This was a cross-sectional survey design. We collected 130 patients with gynecologic cancer. They complete a self reported questionnaire including items related neuropathy and quality of life (FACT-GOG/Ntx subscale, FACT-G scale). RESULTS The neuropathy score was 14.3+/-7.9. The quality of life score was 64.8+/-16.4. The neuropathy induced significant difference according to diabetic status, difficulties in performing household chores and willing to discontinuity of chemotherapy. And duration of cancer diagnosis, neuropathy, number of total chemo agent associated with quality of life. There was a negative correlation between number of total chemo agent and quality of life. Neuropathy independently affected quality of life. CONCLUSION Chemotherapy induced peripheral neuropathy of patients with gynecologic cancer adversely affected women's quality of life and activities of daily living. To improve patient's quality of life, it is important that accurate assess and appropriately manage neuropathy in patients with gynecologic cancer.
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Chung D, Lee YJ, Jo MH, Park HJ, Lim GW, Cho H, Nam EJ, Kim SW, Kim JH, Kim YT, Kim S. The ON-Q pain management system in elective gynecology oncologic surgery: Management of postoperative surgical site pain compared to intravenous patient-controlled analgesia. Obstet Gynecol Sci 2013; 56:93-101. [PMID: 24327987 DOI: 10.5468/OGS.2013.56.2.93] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 10/22/2012] [Accepted: 10/24/2012] [Indexed: 11/29/2022] Open
Abstract
Objective The goal of this study was to compare postoperative surgical site pain in gynecologic cancer patients who underwent elective extended lower midline laparotomy and managed their pain with either the ON-Q pain management system (surgical incision site pain relief system, ON-Q pump) or an intravenous patient-controlled analgesia pump (IV PCA). Methods Twenty gynecologic cancer patients who underwent elective extended lower midline laparotomy were divided into two groups. One group received a 72-hour continuous wound perfusion of the local anesthetic ropivacaine (0.5%, study group) into the supraperitoneal layer of the abdominal incision through the ON-Q pump. The other group received intravenous infusion pump of patient-controlled analgesia (fentanyl citrate 20 mg/mL · kg+ondansetron hydrochloride 16 mg/8 mL+normal saline). Postoperative pain was assessed immediately and at 6, 24, 48, 72, and 96 hours after surgery using the visual analogue scale. Results Postoperative surgical site pain scores at 24, 48, and 72 hours after surgery were lower in the ON-Q group than the IV PCA group. Pain scores at 24 hours and 48 hours after surgery were significantly different between the two groups (P=0.023, P<0.001). Overall painkiller administration was higher in the ON-Q group but this difference was not statistically significant (5.1 vs. 4.3, P=0.481). Conclusion This study revealed that the ON-Q pain management system is a more effective approach than IV PCA for acute postoperative surgical site pain relief after extended lower midline laparotomy in gynecologic cancer patients.
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Kim YH, Lee JH. Relationships between Side Effects, Depression and Quality of Sleep in Gynecological Cancer Patients Undergoing Chemotherapy. Korean J Women Health Nurs 2010; 16:276-287. [PMID: 37697595 DOI: 10.4069/kjwhn.2010.16.3.276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
PURPOSE This study was to identity the relationships between the side effects of depression and quality of sleep among gynecological cancer patients undergoing chemotherapy. METHODS The data was collected from 113 patients at two general hospitals within B metropolitan city. The instruments used to collect the data for the study was the 'Side Effect Scale' developed by Kwon, Young-eun; 'Depression scale' developed by Oh, Se-man, and the 'Quality of Sleep Scale' developed by Oh, Song & Kim. RESULTS Results showed that the mean of side effects was 39.75+/-9.99, mean of depression was 9.63+/-3.93 and mean of 'quality of sleep' was 36.99+/-6.66. The quality of sleep variable showed statistically significant differences for the variables: age (F=3.203, p=.026), cancer insurance (t=-2.278, p=.025), and perceived physical condition (F=3.152, p=.047) respectively. The relationship between side effects and quality of sleep showed a low negative, but significant correlation (r=-.327, p<.001). The relationship between depression and quality of sleep also showed a low negative correlation (r=-.365, p<.001). CONCLUSION This study shows that it is necessary to develop nursing intervention programs because it can successfully improve the quality of sleep of gynecological cancer patients undergoing chemotherapy.
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