Purpose: The purpose of this qualitative study was to explore the experiences of post-traumatic growth in breast cancer survivors by applying grounded theory methods. Methods: Participants were seven breast cancer survivors who had been diagnosed with stage I or higher breast cancer, had completed acute treatment, and were members of an internet self-help group for breast cancer survivors. Data were collected through individual in-depth interviews from July 11, 2022 to May 4, 2023. The interview contents were transcribed and analyzed using Corbin and Strauss’s grounded theory method. A total of 18 sub-categories and 9 categories were identified through the open coding process. Results: As a result of axial coding based on the paradigm model, the central phenomenon of post-traumatic growth experiences of breast cancer survivors was revealed as ‘Finding true life after the pain of death’. The core category was identified as ‘Promise a life without regrets’, which consisted of a four-step process: reflection period, recovery period, transition period, achievement period. Breast cancer survivors experienced restoration of their inner selves, strengthening of positive thinking through the process of resetting their life values and goals, and pursuit a stable and satisfying life. Conclusion: To help breast cancer survivors grow after trauma, the importance of accepting changes in their bodies and maintaining a positive perspective was highlighted.

Background: In general, measurement qualities of cross-culturally adapted quality of life (QOL) measures are altered in many aspects, although versions of them are well-validated measures. The latent trait and measurement qualities of the QOL measures for cancer-related samples should be considered when developing cross-culturally adapted measures. Objects: To investigate the latent trait of the translated into Korean World Health Organization Quality of Life-BREF (WHOQOL-BREF) administered to different cancer survivors who had palliative rehabilitation care service (PRCS). Methods: A cross-sectional study with 139 cancer survivors who had an experience of cancer survivorship with PRCS were conducted with a two-step analytic procedure including exploratory factor analysis (EFA) to confirm the latent trait and Rasch rating scale modeling to investigate the measurement qualities of the cross-culturally adapted WHOQOL-BREF measure. Results: While the original WHOQOL-BREF measure constitutes a 4-latent trait, the EFA reveals that 24 items constitute six substantial factors. The item loadings are predominantly spread over factors 1 through 4 in a mixed manner of the latent traits, while the loadings of ‘physical health’ and ‘environmental health’ latent traits show similarity to what the original measure intended to assess. The latent trait of the cross-culturally adapted WHOQOL-BREF measure administered to different cancer survivors is likely to reveal more dimensions than the original WHOQOL-BREF measure. Person reliability (i.e., analogous to Cronbach’s alpha) and separation are measured with 0.92 and 3.48, respectively. All items except the one item (medical treatment item) fit the Rasch rating model. Conclusion: Findings suggest that the latent trait and the measurement qualities of the cross-culturally adapted WHOQOL-BREF measure should be taken into consideration when applying versions of it to various populations.

Background: Equating is a statistical procedure used to create a common measurement scale across two instruments. Item-level information should be taken into consideration so that scores can communicate interchangeably across the instruments. Objects: To investigate a common measurement scale across two health-related quality of life questionnaires (HRQOL) applied to various cancer survivors who underwent palliative care in healthcare institutions. Methods: A total of 139 cancer survivors who underwent palliative care were recruited from two rehabilitation hospitals and an oriental medicine hospital. Participants consisted of various cancer survivors who presented to the sites for palliative care. They were asked to fill out Korean versions of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires following the palliative care. For the item level comparison, the Rasch rating scale model was used to investigate how participants regarded individual test items of two instruments in relation to item difficulty calibrations. Results: All items except the three items fit the Rasch model. One item (anxiety/depression) of the EQ-5D and two items (dependence on medical aids and negative feelings) of the WHOQOL- BREF are misfit. The WHOQOL-BREF targets the survivors well, while the EQ-5D is able to target the survivors with lower HRQOL levels with some ceiling effects. By inspecting the item difficulty calibrations of the two instruments, five items of the WHOQOL-BREF are selected as common items in relation to the EQ-5D. These five items are considered compatible with each other. Differential item functioning (DIF) analysis reveals that the healthcare item of the WHOQOL-BREF vs the self-care item of the EQ-5D exhibits significant DIF. Conclusion: Findings suggest that one paired item should be taken into consideration when equating the WHOQOL-BREF and the EQ-5D applied to cancer survivors who underwent palliative care.

Background: Cross-culturally adapted questionnaires may not be comparable to their original version. Objects: To examine concurrent validity of two health-related quality of life (HRQOL) instruments for the Korean versions of EuroQOL-5 Dimension (EQ-5D) and the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Methods: A total of 139 cancer survivors from two rehabilitation institutes was recruited. All participants were registered for palliative rehabilitation care. Both instruments were concurrently administered by health care providers following the second bout of the rehabilitation cares. Rasch partial credit model and Spearman’s correlation analysis were used to investigate: 1) dimensionality, 2) hierarchical item difficulty, and 3) concurrent validity using correlations between two instruments. Results: For the WHOQOL-BREF, all items except negative feeling, pain, dependence of medical aid, were found to be acceptable, while all items of EQ-5D were acceptable. There was an evidence of negative correlations between EQ-5D and 4 domains of WHOQOL-BREF. Two correlations were strong (EQ-5D vs. physical health domain, ρ = –0.610, 95% CI = –0.716 to –0.475) and moderate (EQ-5D vs. psychosocial domain, ρ = –0.402, 95% CI = –0.546 to –0.236). Other two correlations were weak (EQ-5D vs. social relationship and environmental domains, ρ = –0.242, 95% CI = –0.401 to –0.075 and ρ = –0.364, 95% CI = –0.514 to –0.207, respectively). Item difficulty calibrations of the two measurements were ranged from –0.84 to 0.86 for the EQ-5D and –1.07 to 1.06 for the WHOQOL-BREF. Conclusion: The study provides some supports for the concurrent validity of the two Korean versions of HRQOL instrument, with evidences of weak to strong correlations between the EQ- 5D and four domains of the WHOQOL-BREF applied to various cancer survivors. Additionally, the cancer survivors appeared to have more of a tendency to view the EQ-5D items as being slightly more challenging than the WHOQOL-BREF items.

Background: Although the original version of the health-related quality of life (HRQOL) questionnaires are found to be acceptable, the cross-culturally adapted versions may not be comparable to their original version. Objects: To examine dimensionality and construct validity of two Korean versions of the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires. Methods: A total of 77 cancer survivors undergoing palliative rehabilitation programs from two rehabilitation institutes was recruited from April 16, 2018 to June 26, 2019. The WHOQOL- BREF and the EQ-5D were filled out by the various cancer survivors following a particular session of rehabilitation programs. The scores were analyzed with Winsteps Rasch analysis computer program using the rating scale model. Rasch fit statistics were used to determine the dimensionality and the item difficulty calibrations of WHOQOL-BREF and EQ-5D. Results: All items except two, negative feeling, need treatment function and pain prevent activity (mean square [MnSq] = 2.42, 1.82 and 2.51, respectively), were found to be acceptable, while two items of the EQ-5D, anxiety/depression and self-care, were misfit (infit MnSq = 1.65 and 0.38, respectively). Item difficulty calibrations of WHOQOL-BREF match person ability measures (i.e., HRQOL) fairly well. However, the person ability distribution showed obvious ceiling effects for EQ-5D. All items of EQ-5D were appeared to be less challenged in comparison with those of WHOQOL-BREF. Conclusion: Item-level analysis using the Rasch model supports the quality of culturally adapted items used to measure the HRQOL one exception; that is, whether or not to include misfit items as part of the HRQOL measurements. Additionally, cancer survivors undergoing palliative rehabilitation programs appear to have more of a tendency to view the EQ-5D items as being more challenging than the WHOQOL-BREF.

목적 : 유방암 환자의 자기효능감과 사회적 지지 및 지역사회참여 정도를 알아보고 작업치료중재 프로그램 개발의 기초선을 제공하고자 한다. 연구방법 : 본 연구는 H군에 위치한 병원에 외래로 방문하는 유방암 환자 40명을 대상으로 자가보고형 설문지를 배부하였고, 유방암 환자의 자가관리에 대한 자기효능감(Self-Efficacy Scale for Self-Management of Breast Cancer; SESSM-B), 사회적 지지(Multidimensional Scale of Perceived Social Support; MSPSS) 그리고 한국판 지역사회 참여 지표(Korean-Community Participation Indicator; K-CPI)를 측정하였다. 결과 : 자기효능감은 3.70±.38점, 사회적 지지는 3.49±.66점이었다. 지역사회 참여 정도는 주관적 특성 을 반영한 참여권 문항은 3.27±.65점이었다. 객관적 특성을 반영한 20개 활동들에 대하여 참여 빈도와 중요성을 알아본 결과 가장 중요하게 생각하는 활동은 가족과 시간을 보내기, 요리나 집안일을 하기 그 리고 취미나 여가활동에 참여하는 것이었다. 하지만 낮은 참여 빈도를 보였다. 각 변수간의 상관성을 알아본 결과 사회적 지지는 자기효능감(p<.01)와 지역사회 참여에서 양의 상관관계를 나타냈다(p<.001). 결론 : 유방암 환자의 사회적 역할, 관계 등을 고려한 작업치료 중재 프로그램의 개발과 추가적인 연구가 필요하다.

Purpose: Breast cancer survivors(BCS) have memory, attention, processing speed, and/or executive function impairment affecting their quality of life(QOL) and function. Study aims were: (1) compare computer-assisted cognitive training with visual exercises to one with audio+ visual exercises, and (2) gain insight into the relationship between engagement in meaningful activities, cognitive deficits and QOL. Methods: This pilot study used an experimental design with 24 women. Pre and post measures assessed working memory, perceived cognition, QOL and engagement in meaningful activities. Results: Treatment effects were not significant for working memory or engagement in meaningful activities. Visual group participants scored significantly better on perceived cognitive function posttest test(M = 91.62, SD = 21.75) than pretest(M = 74.48, SD = 29.00), p = .010 and significantly higher on QOL posttest(M = 6.42, SD = 1.27) than pretest(M = 5.60, SD = 1.76), p = .004. Pretest perceived cognitive function was significantly associated with pretest(ρ = .617, p < .001) and posttest(ρ = .436, p < .05) QOL. Conclusion: Computer-assisted cognitive training with visual exercises appears to improve perceived cognitive function and QOL for BCS. A positive relationship exists between perceived cognitive function and QOL.

Purpose: The purpose of this study was to understand and describe the experiences of stomach cancer patients in South Korea. Methods: Secondary analysis of qualitative data was designed. The data were analyzed via the Phenomenological Method, using the data of 12 stomach cancer patients, from the original data collected by narrative interviews in 2013. Results: Seven theme clusters emerged from the analysis. Beginning with: ‘Facing Life Threats from Cancer,’ this describes how the participants experience between cancer diagnosis and treatments. ‘Crossing the Boundary between Life and Death’ deals with desperate struggle to overcome medical treatments, such as gastrectomy and chemotherapy, while ‘Adjusting to Weakened Body’ illustrates the continuous daily struggle to follow dietary treatments after operation. ‘Dilemmas in Interpersonal Relationships’ illustrates the sensitivity of relationships from the cancer stigma, with predicaments rising in collective dining situations. ‘Encountering: Hidden Me, Inside Me’ describes changes in values of life and a matured self. ‘Supporters for Hope’ illustrates driving forces to keep hope alive in everyday lives. Lastly, ‘Happiness of Everyday Life Rescued from Misery’ describes how life turned into blessings from cancer after all. Conclusion: The results of this study would help oncology professionals to develop patient-centered cancer survivorship interventions, by understanding and gaining insights about the lived experience of stomach cancer patients.

This study investigated multidimensional body image, self-esteem, clothing benefits sought, and Body Image After Breast Cancer (BIABC) within surgical subgroups among breast cancer survivors. The study applied the questionnaire survey method and the main research was conducted through an online survey. The respondents included 207 breast cancer survivors between the ages of 30 and 59, each of whom received the Multidimensional Body-Self Relations Questionnaire (MBSRQ). Self-esteem, clothing benefits sought, examination, and demographic variables were measured using a 5-point Likert scale. The main results of this study are outlined below. For clothing benefit sought, six factors were formulated—pursuit of self-expression/social approval, function/health, compensation, femininity, fashion, and camouflage—and BIABC was defined by the four factors of body stigma/vulnerability, transparency, limitation and cancer concern. While MBSRQ and self-esteem did not show a statistically significant difference between groups differentiated by the surgical methods experienced, those who underwent mastectomies scored slightly lower than members of the other groups. Moreover, the reconstruction after mastectomy group showed the highest mean on self-expression/social approval, compensation, femininity and entire clothing benefits sought, followed by the lumpectomy group and mastectomy group. The lumpectomy group was found to have more positive BIABC than the mastectomy group. In particular, the mastectomy group showed a lower body stigma/vulnerability mean than the other groups. This study is meaningful in that it improves our understanding of the body image of breast cancer survivors and provides basic knowledge for developing products and marketing strategies for breast cancer survivors as consumers.

The objective of this study was to take a closer look at the clothing benefits sought by breast cancer survivors in Korea. A qualitative descriptive study was conducted, using the focus group interview. Data was collected from members of online breast cancer forum. 18 participants were breast cancer survivors who had mastectomy or lumpectomy in their 30s~50s. The data was analyzed using content analysis in order to identify significant themes. The analysis indicated that benefits were sought after functional/comfort, health, feminity, and compensation were found. First, breast cancer survivors considered functional/comfort to be most important benefit so as to keep the body comfortable from the weather. Second, participants put the healthy body as the first priority and chose a well-being lifestyle and were likely to wear clothes made in healthy fabric, such as organic, bamboo or charcoal. Also, they preferred to look active by wearing sport brands or outdoorwear brands. Third, after the surgery, they experienced the sense of femininity loss and the sense of crisis as a woman. Single women and married women in early 30s recognized more seriously, and they tried to recover feminity by wearing clothes with feminine details. Forth, breast cancer survivor consumers tended to shop for the psychological compensation. In summary, consumers with breast cancer surgery, unlike general healthy women, did not sought to be economic, fashion, self-expression benefits, rather they sought health, femininity, and compensation benefits. Therefore, it seems necessary to develop proper products and marketing strategy to meet the said consumer's special needs.

Breast cancer is the most frequently diagnosed cancer primarily affecting women and negatively impacting the individuals, families, and the health care system. Despite the well-known benefits of exercise for breast cancer survivors, rate of physical activity declines during adjuvant therapy and may not return to pre-diagnosis levels. In addition, low levels of adherence to exercise have been observed in this cohort. The challenge is to identify strategies that are effective in promoting exercise adherence. Several of the studies use social cognitive theory as a theoretical framework to design exercise interventions that encourage adherence. Within and without this framework, they have implemented interventions within the home and gym-based environments. Strategies used to encourage adherence to exercise programs and which are readily implemented in most situations have included distribution of print materials and pedometers, as well as recommendation from the oncologist. Other strategies that may be less feasible have included provision of trainers, gym memberships, regular phone-calls, and psychologist-lead stress management sessions.

Purpose: The purpose of the present study was to examine the physical and psychological benefits afforded by a 6-week yoga program for breast cancer survivors. Methods: Eligible participants (per-screened) were to the intervention group 17. All participants completed pre- and post-testing assessments immediately before and after the Mindfulness yoga program. Statistical analyses were paired samples t-test by SPSS 19.0. Results: The Mindfulness yoga program participants(female) included primarily breast cancer survivors, on average 46.5 months post-diagnosis. Significant differences between pre and post at post-intervention were seen only in psychosocial(i.e. QOL; Role function, Appetite loss, Constipation and PSQI) Finally, there were also significant improvements in the program participants from pre- to post-intervention on physical variables(Weight, BMI). Conclusion: The mindfulness yoga program has a positive effect on Quality of life in Breast cancer survivors. Future research might attempt to include control group and a longer program duration.