젊은 유방암 생존자를 위한 전환간호 프로그램 개발 및 평가

Abstract

This study used the Transition theory of Meleis et al.(2000) to develop the transitional care program for young breast cancer survivors and verified the effect of the developed program. To develop the transitional care program based on the Transition theory, intervention content and activities were gathered through a literature review of prior studies on the Transition theory and intervention. The preliminary transitional care program was developed through process of ADDIE (Analysis, Design, Development, Intervention, Evaluation) and the verification by experts and the final transitional care program was developed. Nonequivalent control group pre-post test design was used to investigate the effects of the transitional care program based on the Transition theory on transition condition and patterns of response (process indicators - therapeutic alliance, body image, knowledge of menopause, attitude of menopause, coping of cancer and outcome indicators - emotional status, subjective health status, quality of life). The participants were 36 female breast cancer survivors during transitional cancer survivorship recruited from C hospital. The transactional care program was provided once per week for 4 weeks and data were collected three times (prior to the intervention, after the intervention, and 4 weeks after the intervention) The study period was from July to October, 2012. Data were analyzed using χ2-test, repeated measure ANOVA and t-test with SPSS 18.0. The results of this study are summarized as follow; (1) the transitional care program based on the Transition theory was developed by reviewing the prior literature, developing a draft program, testing the content by experts, simulating the draft program and revising the program. (2) results on hypothesis testing showed that transition condition (t=4.14, p=<0.001) were significantly increased in the intervention group compared to the control group. Process indicators was significantly increased in the intervention group compared to the control group (therapeutic alliance F=4.55, p=.014, knowledge of menopause F=46.25 p=<0.001, attitude of menopause F=18.89 p=<0.001, coping of cancer F=3.88 p=.025) but not the body image (F=1.45, p=.242). Outcome indicators was significantly increased in the intervention group compared to the control group (emotional status F=9.43 p=<0.001, quality of life F=13.13 p=<0.001) but not subjective health status (F=0.88, p=.421). In conclusion, the transitional care program developed in this study for young breast cancer survivors increased the awareness and engagement for transition and facilitate transition conditions to induced positive patterns of response and contribute to healthy transition experience and continuously enhances transition.