Purpose: This paper used the Delphi technique to establish an expert consensus on the nursing competencies required for general nurses caring for patients with breast cancer and to evaluate their appropriateness. Methods: This descriptive study employed the Delphi technique. Breast cancer nursing clinical competency items were derived through three Delphi rounds with 21 experts, followed by an appropriateness evaluation in the fourth round with 100 general nurses. Results: A total of 133 items were derived from the Delphi survey and classified into three categories across eight subject areas and 20 subthemes: knowledge (42 items), skills (39 items), and attitudes (52 items). The evaluation in the fourth round showed high knowledge scores for general breast cancer characteristics, early detection, and imaging, whereas scores for pregnancy and fertility preservation were low. In the skills category, high scores were observed for privacy and information protection, as well as the six rights of chemotherapy administration, whereas scores for pregnancy and fertility preservation were low. All attitude items showed high mean scores (>= 3.30), and significant differences between skills and attitudes were identified in 34 of the 39 items (p<.05). Conclusion: The 133 items derived from this research provide a basis for developing a tool to objectively assess the clinical competence of nurses caring for patients with breast cancer.
Purpose: This study aimed to investigate nurses' knowledge regarding cancer pain management, empathy, and communication skills, as well as to examine factors influencing their competence regarding cancer pain management. Methods: A total of 166 nurses participated in this study, and all participants had more than three months' clinical experience working in wards and intensive care units where cancer patients were admitted. Data were collected using structured questionnaires and analyzed by an independent t-test, a one-way ANOVA, a Mann-Whitney U test, a Kruskal-Wallis test, a Pearson correlation coefficient, and hierarchical regression analysis using SPSS/WIN 27.0. Results: Significant differences were found in competence for cancer pain management among the participants based on gender (z=-5.36, p<.001) and education level (F=3.87, p=.023). The results of the regression analysis revealed that the factors affecting nurses' competence in cancer pain management included knowledge of cancer pain management (beta=.29, p<.001) and empathy (beta=.20, p=.031). Communication skills (beta=-.03, p=.773) had no significant effect on competence in cancer patient management. The total explanatory power was 31%. Conclusion: Nurses' competence in cancer pain management was significantly influenced by knowledge and empathy. Programs focusing on education regarding cancer pain and empathy enhancement are needed to improve nursing competence for cancer pain management.
Purpose: The purpose of this study was to identify the levels of professional autonomy, role conflict, nursing work environment, and clinical decision-making ability among nurses working in hematologic cancer wards, as well as to examine factors associated with nurses' clinical decision-making ability. Methods: Data were collected from 141 hematologic cancer ward nurses at a general hospital and a general cancer-specialized hospital in City B from May 14 to September 4, 2025. The collected data were analyzed using SPSS/WIN 29 with Pearson's correlations and multiple regression analyses. Results: Clinical decision-making ability in hematologic cancer ward nurses was found to be positively correlated with nursing work environment (r=.32, p<.001) and professional autonomy (r=.31, p<.001). According to the regression analysis of this research, nursing education level (beta=.25, p=.015), nursing work environment (beta=.21, p=.017), and professional autonomy (beta=.18, p=.040) were the factors that influenced clinical decision-making ability, with an explanatory power of 17% (F=5.70, p<.001). Conclusion: To develop clinical decision-making ability, it is essential to strengthen educational preparation, improve the nursing work environment, and enhance professional autonomy. Given the complexity of care in hematologic cancer wards, high level of clinical decision-making ability is required among nurses. Identifying factors associated with clinical decision-making ability can provide a foundation for developing targeted educational and organizational strategies.
Purpose: This study aimed to identify the incidence and related factors of delirium among cancer patients admitted to the general wards of a tertiary hospital. Methods: A retrospective analysis was performed on 9,749 adult cancer patients. Patients who screened positive for delirium were assessed using the Korean version of the Nursing Delirium Screening Scale (NuDESC). Data were analyzed using chi 2 tests, t-tests, and multiple logistic regression. Results: The incidence of delirium was 2.5% (n=243) based on screening results. Significant predictors included older age, longer hospital stays, emergency room admission, 90-day readmission, completion of life-sustaining treatment decisions, surgical department admission, altered consciousness (the strongest predictor), elevated white blood cell and blood urea nitrogen levels, and low albumin levels (p<.050). These 10 factors showed high discriminatory power for delirium (AUC=.91, 95% CI: 0.90 similar to 0.93). Conclusion: The Nu-DESC should be actively utilized in clinical practice for early delirium detection. Nursing interventions must prioritize managing modifiable factors such as nutritional status, infection, and dehydration. Furthermore, case-sharing systems and regular education are essential to enhance nursing expertise and ensure patient safety.
Purpose: This study aimed to examine the relationships between fatigue, self-care behavior, and quality of life (QoL) among patients receiving home-based chemotherapy with a disposable elastomeric infusion pump and to identify general and disease-related factors associated with QoL. Methods: Data were collected from 145 patients with various cancer types receiving home-based chemotherapy using a disposable elastomeric infusion pump. Fatigue was measured using the Korean version of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale. Self-care behavior was assessed with a validated self-report tool, and QoL was evaluated using the Functional Assessment of Cancer Therapy-General (FACT-G). Results: Fatigue was negatively correlated with QoL, whereas self-care behavior was positively correlated. Among general characteristics, occupation, meal frequency, meal portion size, and the self-reported Eastern Cooperative Oncology Group Performance Status (ECOG-PS) were significantly associated with QoL. Multiple regression analysis revealed that fatigue, self-care behavior, and self-reported ECOG-PS were significant predictors of overall QoL, with fatigue being the most influential factor. While most QoL domains were associated with fatigue and self-care behavior, the social/family well-being domain showed no significant correlation. Conclusion: Fatigue and self-care behavior are key factors influencing QoL in patients receiving home-based chemotherapy with a disposable elastomeric infusion pump. Targeted interventions, such as individualized fatigue management, nutritional support, and self-care education tailored to the home environment, are essential for improving patient outcomes. This study underscores the need for structured nursing models that support self-management in home-based chemotherapy with a disposable elastomeric infusion pump, particularly during public health crises such as the COVID-19 pandemic.
Purpose: The purpose of this study was to comprehensively understand and explore the experiences of young adult thyroid cancer patients who received radioactive iodine therapy and to interpret the meaning of the results. Methods: Data were collected from July to September 2024 through individual in-depth interviews with eight thyroid cancer patients who received radioactive iodine treatment. The data were analyzed using Giorgi's phenomenological analysis. Results: The nine components identified in this study consisted of the following: "Discovering the neglected self amid the shock of a cancer diagnosis," "The heavy burden of cancer that is not a 'good' cancer for me," "Revealing rather than hiding-living together with cancer," "The unrelenting pain caused by ever-fluctuating symptoms," "A brief respite found amid the pain of radioactive iodine therapy," "Regret over a life diverged from that of healthy peers," "Empathetic online peers bound by shared illness, with bonds stronger than family," "A new healthy routine that has taken root in my life," "A blessing in disguise-the cancer encountered in young adulthood." Conclusion: This research provides an in-depth understanding of the various challenges faced by young adult thyroid cancer patients undergoing radioactive iodine therapy. Based on these findings, this study is expected to serve as foundational data for developing comprehensive nursing intervention programs for young adult thyroid cancer patients, as well as for establishing policies related to financial support and job reentry.
Purpose: This study aimed to assess patient activation and quality of life levels in colorectal cancer patients receiving chemotherapy through a chemoport, as well as to investigate the factors influencing their quality of life. Methods: Research was conducted on 133 colorectal cancer patients receiving chemotherapy through a chemoport at the outpatient oncology clinic of a tertiary general hospital in Seoul. Patient activation and quality of life were evaluated using structured questionnaires. Data collection was conducted from March 14 to April 3, 2025, and the collected data were analyzed using IBM SPSS Statistics, version 27.0. Results: The results showed a mean patient activation of 57.00 +/- 13.90 out of 100 and a mean quality of life of 82.99 +/- 18.17 out of 136. In addition, there was a positive correlation between patient activation and quality of life (r=.18, p= .035). Multiple regression analysis revealed that previous chemoport insertion (beta=-.32, p<.001) and patient activation (beta=.17, p=.035) were significant predictors of quality of life in colorectal cancer patients undergoing chemotherapy. The model explained 12% of the variance (F=10.13, p<.001). Conclusion: Previous chemoport insertion history and patient activation were identified as significant factors influencing the quality of life of colorectal cancer patients receiving chemotherapy. Therefore, careful management is required for patients with a history of chemoport insertion, and practical, targeted interventions should be developed to enhance patient activation and improve quality of life throughout the treatment process.
Purpose: This paper aimed to investigate the levels and predictors of moral distress, compassion fatigue, and compassion satisfaction among nurses caring for patients with cancer and to identify predictors for the variables. Methods: A cross-sectional, descriptive correlational study was conducted on 245 nurses from hospitals in South Korea. Data was collected through online surveys from May to June 2025. Variables were measured using the Korean version of the Moral Distress Scale-Revised and the Professional Quality of Life Scale-5. Data were analyzed using a t-test, ANOVA, Pearson's correlation, and multiple regression analysis. Results: Nurses reported moderate-to-high levels of moral distress, compassion fatigue, and compassion satisfaction, with religious affiliation predicting lower moral distress. Nurses with 3 similar to 5 years of experience caring for cancer patients exhibited lower moral distress than those with less than 3 years of experience. Employment in tertiary hospitals and the availability of support programs were predictors of lower moral distress, while caring for cancer patients throughout one's career predicted higher moral distress. Advanced practice nurses, nurses providing advanced clinical support, and nurses who had completed self-care education were predictors of greater compassion fatigue. In contrast, religious affiliation, having more than five years of nursing experience, and possession of additional oncology nursing certifications significantly explained the variance in compassion satisfaction among nurses. Conclusion: Moral distress, compassion fatigue, and compassion satisfaction varied by nurses' personal and professional characteristics. Multilevel interventions, including structured self-care education and institutional support systems, are needed to alleviate emotional burden and promote professional well-being among oncology nurses.
Purpose: This study aimed to identify factors influencing self-care behaviors in patients with gastrointestinal cancer undergoing chemotherapy. Methods: Data were collected from 112 gastrointestinal cancer patients receiving chemotherapy at a general hospital in Daegu between December 2024 and February 2025. The data were analyzed using descriptive statistics, an independent t-test, one-way ANOVA, a Pearson correlation coefficient, and multiple regression using SPSS 29.0. Results: The mean score for self-care behaviors was 3.64 +/- 0.73. Multiple regression analysis revealed that significant predictors of self-care behaviors were family support (beta=.33, p=.001), gender (beta=.28, p<.001), monthly income (beta=.24, p=.003), and friend support (beta=.21, p=.018). This regression model explained 42% of the variance in self-care behaviors. Conclusion: The findings suggest that strengthening social support, particularly from family and friends, and tailoring nursing interventions to gender and economic status may enhance self-care behaviors among gastrointestinal cancer patients receiving chemotherapy.
Purpose: This study aimed to compare the factors associated with functional limitations between older adults with and without cancer. By identifying both shared and distinct associated factors, this research sought to provide evidence for tailored geriatric nursing interventions. Methods: A cross-sectional secondary analysis was conducted using data from the 2023 Korean National Survey of Older Adults, including 10,078 adults aged >= 65 years. Functional limitation is defined as any need for assistance in activities of daily living (ADL) or instrumental activities of daily living (IADL). Participants were grouped by physician-diagnosed cancer status, and hierarchical logistic regression was performed. Model 1 included age and depression; Model 2 added gender; and Model 3 incorporated self-rated health, urinary incontinence, and hospitalization experience. Results: Depression scores and functional limitations were found to increase with age. Functional limitations were more prominent in older adults with cancer except for those aged >= 85 years, and depression scores were higher in the cancer group across all ages. Across models, age and depression were significantly associated with functional limitation in both groups. Among non-cancer participants, being female, poor self-rated health, urinary incontinence, and hospitalization experience were also related factors, whereas in the cancer group, only age and depression remained significant. Conclusion: Age and depression were key factors associated with functional limitations across groups. Nursing interventions should take a comprehensive approach for the general older population, addressing both physical and psychological health, while prioritizing depression screening and management for older adults with cancer to prevent functional decline.
Purpose: Despite the importance of improving the quality of life of lung cancer patients, there is a lack of comprehensive understanding of the subject. Therefore, this study aimed to identify factors affecting the health-related quality of life (HRQoL) of lung cancer patients in South Korea. Methods: A systematic search of studies published between 1990 and 2024 was conducted using the keywords "lung cancer" and "quality of life" across the databases. A total of 37 articles were selected and analyzed through an integrated review method for this study. Results: Regarding biological and physiological factors, disease stage, treatment duration, and tissue type were found to affect HRQoL, although most studies did not consistently specify tissue type or stage. Symptom-related factors, including fatigue, anxiety, and depression, were found to have a significant impact, along with functional status. In addition, positive health perception, family support, higher educational attainment, and financial well-being were identified as factors to improve HRQoL. Conclusion: To develop and implement effective interventions aimed at improving HRQoL in Korean lung cancer patients, future research should adopt more biologically and physiologically detailed approaches. Furthermore, diversification of research methodologies and the implementation of multicenter studies are strongly recommended.
Purpose: The purpose of this study was to identify effects of symptom burden, self-efficacy, and stigma on cancer coping in patients with primary non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods: Data were collected from 140 patients receiving chemotherapy for NSCLC at the outpatient clinic of the respiratory department of a tertiary hospital in City B between February 3 and April 30, 2025. The data were analyzed using SPSS/WIN 28.0, and independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression analysis were applied. Results: Intrapersonal coping was found to be significantly correlated with symptom severity, symptom interference with daily life, stigma, and self-efficacy. Meanwhile, interpersonal coping was significantly correlated with symptom interference, stigma, and self-efficacy. Hierarchical regression analysis revealed that self-efficacy, symptom interference, and age were significant predictors of intrapersonal coping. In addition, marital status, selfefficacy, and stigma were identified as significant predictors of interpersonal coping. Conclusion: The findings highlight the importance of psychosocial and symptom-related factors, particularly self-efficacy, in supporting effective coping strategies among NSCLC patients undergoing chemotherapy. Tailored interventions that enhance self-efficacy and address stigma and symptom management may contribute to improved coping outcomes.
Purpose: Breast cancer survivors are likely to experience psychological distress during the cancer diagnosis and treatment process. In particular, psychological difficulties such as loss of purpose, anxiety, and depression may persist even after treatment. However, numerous breast cancer survivors often lack the internal resources and strategies to effectively manage this psychological distress. Therefore, it is necessary to develop a program that promotes self-transcendence to alleviate psychological distress and improve the quality of life of breast cancer survivors. Methods: This methodological study was designed to develop a self-transcendence promotion program to alleviate psychological distress in breast cancer survivors. Based on the ADDIE model, the program development process proceeded as follows: Phase A (Analysis) included a literature review and an educational needs survey; Phase D (Design) included learning module composition; and Phase D (Development) included expert validation. Results: An online self-transcendence promotion program for breast cancer survivors was developed, consisting of eight weekly sessions totaling 480 minutes. Conclusion: An online self-transcendence promotion program that considered the characteristics and circumstances of breast cancer survivors was found to be appropriate. This program is expected to contribute to alleviating psychological distress in breast cancer survivors.
Purpose: This study aimed to develop an online oncology nursing simulation module focused on septic shock care for cancer patients. Additionally, it sought to evaluate the module's effectiveness in improving nursing students' clinical performance, clinical confidence, learning satisfaction, and learning flow. Methods: A mixed-methods experimental design was employed. The simulation module was developed using the ADDIE model and delivered via a web-based platform. Fifty nursing students were randomly assigned to an experimental group (n=25) or a control group (n=25). As normality assumptions were not met, the Mann-Whitney U test was used for group comparisons, and Spearman's rank correlation was employed to examine relationships among dependent variables. Additionally, three focus group interviews were conducted with the experimental group, and qualitative data were analyzed using a thematic analysis approach. Results: The experimental group showed significantly higher scores in clinical confidence, learning satisfaction, and learning flow compared with the control group (all variables p<.001). Clinical performance also improved, but the difference was not significant (p=.070). Exploratory correlation analysis indicated strong interrelationships among clinical confidence, learning satisfaction, and learning flow (rho=.53-.76, p<.001), whereas clinical performance was only weakly related to learning flow (rho=.28, p=.047). Qualitative findings supported these results, highlighting immersive learning and enhanced clinical reasoning. Conclusion: The online oncology nursing simulation module effectively enhanced core competencies, particularly clinical confidence, while also supporting interrelated experiences of learning satisfaction and learning flow, as indicated by exploratory correlation analysis. These findings suggest that web-based simulation is a practical and scalable strategy for nursing education in the digital era.
Purpose: This study aimed to reach an in-depth understanding of the nursing behavior in hematologic cancer care from nurses' perspectives, within the sociocultural context of a hematology ward. Methods: Participants consisted of 15 hematology nurses in a tertiary hospital in a metropolitan city in South Korea. Data were collected through participant observation and in-depth interviews. The researcher acted as a complete participant observer in fieldwork. Data were analyzed using Spradley's ethnographic method, which includes four iterative stages: domain analysis, taxonomic analysis, componential analysis, and thematic analysis. Results: The main tailored nursing practices included emergency response, interaction coping, end-of-life nursing coping, and successful practice-oriented coping patterns. These nursing behaviors constituted the professional competencies and care strategies of hematology nurses. Conclusion: This study illustrates the characteristics of nursing behaviors in a hematology ward. The findings revealed that nurses experienced difficulties in responding to patients' needs due to complex nursing tasks and end-of-life care. Beneficial behaviors among hematology nurses included peer support and ongoing self-development. These findings highlight the need for supporting hematology nurses through peer collaboration and continuous professional development to enhance their capacity to manage complex tasks and end-of-life care.
Purpose: This study investigated the impact of physical discomfort and anxiety on the spiritual well-being and quality of life of families with terminally ill patients with cancer, focusing on meaning in life as a mediating factor. Methods: Out of the 230 questionnaires distributed, 186 were selected for analysis. Data collection included physical discomfort, anxiety, meaning in life, spiritual well-being, and quality of life. Data analysis was performed using structural equation modeling with SPSS/WIN 26.0 and AMOS 26.0. Results: Out of the total 186 participants, 73.1% were female, and the average age was 54.25 +/- 12.63 years. Physical discomfort and anxiety were found to significantly influence participants' meaning in life, with a total explanatory power of 28%. In addition, anxiety and meaning in life significantly affected spiritual well-being, explaining 67% of the variance. Meaning in life influenced quality of life with a 66% explanatory power and mediated the relationship between anxiety and spiritual well-being among family caregivers of terminal cancer patients, enhancing both spiritual well-being and quality of life. Conclusion: The findings suggest that meaning-centered interventions centered on meaning in life for family caregivers of patients with life-threatening illness are crucial.
Purpose: This study aimed to determine the influences of fatigue, uncertainty, and resilience on self-care behaviors in cancer patients undergoing chemotherapy. Methods: Data were collected using a self-reported survey method at a single university hospital over a three-month period from September 15 to December 15, 2024. The data were analyzed using an independent samples t-test, one-way ANOVA, LSD post hoc test, Pearson's correlation coefficient, and stepwise multiple regression analysis using the IBM/WIN 25.0 program. Participants consisted of 130 patients undergoing chemotherapy. Results: Self-care behaviors in cancer patients undergoing chemotherapy were found to be positively correlated with resilience (r=.54, p<.001), and resilience was found to be negatively correlated with fatigue (r=-.19, p=.023) and uncertainty (r=-.25, p=.004). According to the results of this research, resilience (beta=.53, p<.001) and gender (beta=.25, p=.001) were the factors that influenced self-care behaviors, with an explanatory power of 33.9%. Conclusion: It is necessary to develop nursing interventions that enhance resilience, resulting in improved self-care behaviors in cancer patients undergoing chemotherapy. Furthermore, active interventions should be particularly targeted at male cancer patients.
Purpose: This study aimed to identify the relationship between distress, uncertainty, and supportive care needs of preoperative gynecological cancer patients in the early stages of diagnosis and to identify the influencing factors on supportive care needs. Methods: This paper employed a cross-sectional study design. Data were collected from 154 preoperative gynecological cancer patients at a tertiary hospital in Seoul, South Korea. A self-report questionnaire was used that included a distress thermometer, a problem list, the Mishel Uncertainty in Illness Scale, and the Supportive Care Needs Survey-Short Form 34. In addition, descriptive statistics, a Pearson correlation coefficient, and multiple regression analyses were conducted using SPSSWIN 27.0. Results: The results showed a mean distress of 6.16 +/- 2.06 out of 10, a mean uncertainty of 92.49 +/- 11.41 out of 165, and mean supportive care needs of 46.50 +/- 14.48 out of 100. Supportive care needs were found to have significant positive correlations with distress (r=.39, p<.001) and uncertainty (r=.39, p<.001). Multiple regression analysis revealed that ambiguity of uncertainty (beta=.34, p<.001), distress (beta=.29, p<.001), and marital status (beta=-.26, p=.006) were significant predictors of supportive care needs, with an overall explanatory power of 29%. Conclusion: This study identified ambiguity of uncertainty, distress, and marital status as significant predictors of supportive care needs of preoperative gynecological cancer patients in the early stages of diagnosis. The findings of this study highlight the need to develop an intervention that addresses distress and uncertainty to meet the supportive care needs of patients with gynecological cancer at the early stage of diagnosis.
Purpose: This descriptive study aimed to identify symptoms, unmet needs, and length of hospital stay in older patients with hepatocellular carcinoma (HCC) who underwent transarterial chemoembolization (TACE), as well as to examine factors influencing prolonged hospitalization. Methods: This research included 102 patients aged 65 years or older who received TACE at two university hospitals in South Korea. Data were collected from December 2023 to September 2024 using structured questionnaires and reviews of medical records. Statistical analysis was performed using SPSS/WIN 24.0, including independent t-tests, one-way ANOVA, Pearson correlation coefficients, and logistic regression analysis. Results: Unmet needs significantly varied according to the severity of postembolization syndrome, particularly nausea (F=4.38, p=.006) and vomiting (F=6.13, p=.003). In addition, nausea (r=0.34, p=.001) and vomiting (r=0.32, p=.001) demonstrated a positive correlation with unmet needs. All components of the syndrome were associated with prolonged hospital stay. Logistic regression analysis identified post-procedural pain (OR=30.51, CI=2.56364.11, p=.007) and fever (OR=13.52, CI=2.51-72.79, p=.002) as significant predictors of prolonged hospitalization, defined as a length of stay of three days or more. Conclusion: These findings suggest that establishing proactive management strategies for postembolization syndrome in patients undergoing TACE may help reduce unmet needs, shorten hospital stays, and ultimately contribute to improved treatment outcomes.
