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수술 후 방사선 치료를 받는 원발성 뇌종양 환자의 미 충족 간호요구와 영향요인

Other Titles
 Unmet supportive care needs and their influencing factors in primary brain tumor patients receiving postoperative radiation therapy 
 College of Nursing (간호대학) 
 Dept. of Nursing (간호학과) 
Issue Date
Usually, patients diagnosed with primary brain tumors undergo surgical treatment in neurosurgery, after which an adjuvant radiation therapy is considered if residual tumors still remain or according to the patient’s histologic grade. Most radiation therapies are performed in outpatient treatment because they preserve the body’s structure and functions without toxicity and due to the trend of the health care environment emphasizing efficiency. However, patients who have less contact with health-care staff will find it difficult to manage and cope with the symptoms caused by radiation. Therefore, understanding the unmet supportive care needs of primary brain tumor patients receiving postoperative radiation therapy is very important because doing so can help with patients to successfully and safely return to the community. The purposes of this study were to identify the unmet supportive care needs of brain tumor patients who have received postoperative radiation therapy and to identify the factors that influence those unmet needs. This study applied a cross-sectional descriptive design. The M.D. Anderson Symptom Inventory Brain Tumor Module (MDASI-BT), Karnofsky Performance Status (KPS), and Comprehensive Needs Assessment Tool for Cancer (CNAT) were used for measurement. After IRB approval from a university-affiliated hospital in Seoul, South Korea, data were collected from 53 outpatients with primary brain tumors receiving postoperative radiation therapy after tumor removal surgery. To analyze the data, statistical analyses such as descriptive statistics, t-tests, ANOVAs, Pearson correlation analyses, and multiple regression were carried out using the program SPSS 24.0. The major results are as follows: 1. The average score of unmet supportive care needs among postoperative patients who underwent postoperative radiation therapy was 1.37 (±0.67), which was between a mild and moderate degree. Information- and education-related needs had the highest unmet supportive care needs score of 1.81 (±0.69). Next, needs related to health-care staff (physicians and nurses) was 1.68 (±1.05), and hospital facilities– and services-related needs was 1.57 (±0.88). 2. Regarding the participants’ sociodemographic characteristics, the unmet need for nursing care was statistically higher in women than men (p=.045), higher among college graduates than middle school graduates (p=.048), and higher among those living in lodgings than those living at home. (p=.019). 3. The unmet supportive care needs was positively correlated with symptom score (r=.613, p<.001) and negatively correlated with Karnofsky Performance Status (KPS)(r=­.547, p<.001). 4. The variables with the highest impacts on unmet supportive care needs were symptoms (β=.454, p<.001), followed by education level (β=.283, p=.007) and body performance status (β=.257, p=.033). The explanatory power of the whole model was 50.4% (adjusted R2=.504). In sum, based on these research findings, this study suggests various changes to nursing practice, research, and education. In nursing practice, health-care staff should develop intervention programs with multidimensional information and education content. In nursing research, even after discharge, it is necessary to discuss the development of and application timing for effective intervention programs by comparing and analyzing the degree of unmet supportive care needs. In nursing education, nurses should be aware about the unmet supportive care needs among patients with primary brain cancer, so that nurses can respond sensitively to patients’ appeals about symptoms and assess them. Furthermore, nurses should actively provide nursing interventions that support patients by alleviating patients' problems.
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