Jong-Hyock Park

Impact of perceived social support on the mental health and health-related quality of life in cancer patients: results from a nationwide, multicenter survey in South Korea

We investigated whether and how perceived social support is associated with depression and quality of life among patients with various cancer diagnoses.

Effect of cancer diagnosis on patient employment status: a nationwide longitudinal study in Korea†

Background: Cancer diagnosis may adversely affect employment status. Our aim was to investigate whether cancer diagnosis effects employment status by comparing employment status changes in cancer patients withto that of cancer‐free workers over a 5–6‐year period.

The Association Between Perceived Social Support and Continued Smoking in Cancer Survivors

OBJECTIVE With the increased survival rate of cancer patients, positive changes in health behaviors, including smoking cessation, are becoming progressively more important. While studies in the general population have demonstrated the beneficial effects of high perceived support of smoking cessation and continuing abstinence, few studies have addressed such issues in cancer survivors. We examined the factors related to continued smoking among cancer survivors with specific attention given to the role of perceived social support. METHODS A nationwide, multicenter survey was conducted with 1956 cancer patients. Smoking status at the time of diagnosis and at the time of survey, and perceived social support, as measured by the Duke-UNC Functional Social Support Questionnaire, were collected by self-reported questionnaire. RESULTS Among 493 participants who were smoking at the time of cancer diagnosis, 131 (26.6%) were continued smokers at the time of survey. In a multivariate logistic regression analysis, current alcohol consumption (odds ratio, 3.29; 95% confidence interval, 1.91-5.65), early cancer stage (P(for trend)< 0.01), lung cancer diagnosis (odds ratio, 0.41; 95% confidence interval, 0.19-0.88), and high perceived social support (odds ratio, 0.59; 95% confidence interval, 0.37-0.96) showed significant associations with continued smoking. CONCLUSIONS Cancer survivors with low perceived social support were more likely to continue smoking. Our study suggests that perceived social support may be an important factor for smoking cessation and maintenance of smoking cessation in this population.

Disparities between persons with and without disabilities in their participation rates in mass screening

OBJECTIVES The purpose of this study was to determine the number of persons with and without disabilities who participated in the National Health Insurance (NHI) chronic disease mass screening programs in South Korea. METHODS The data were obtained from mass screening claims submitted to the NHI and National Disability Registry. Factors affecting the participation rate included demographic variables, socioeconomic status, residential region, and disability type and severity. A multiple logistic regression analysis was used to evaluate the relationship between participation rates and disability type and severity adjusted for confounding factors. RESULTS The analysis revealed that persons with a disability were less likely to participate in mass screening programs than those without a disability (35.8% vs. 40.2%). Multiple logistic regression analysis indicated that persons with severe disabilities had lower participation rates than those without disabilities [adjusted odds ratio (aOR): 0.64, 95% confidence interval (CI): 0.63-0.64]. In particular, persons with severe disabilities such as limb, brain, visual and internal organ impairment, were less likely to participate in the mass screening programs. However, persons with mild disability had higher participation rates than those without disabilities (1.03, 1.02-1.03). CONCLUSIONS Although the prevalence rates of chronic diseases are higher among persons with disabilities, various types of impairments such as limb, brain, visual and internal organ impairment, hinder participation in mass screening programs for chronic diseases. The reasons for this disparity must be investigated and health policies must be altered to make preventative treatments more accessible to persons with disabilities.

Comprehensive needs assessment tool in cancer (CNAT): the development and validation

PurposeNeeds assessment is an important step toward quality and patient-centered cancer care, as it identifies patient need, guiding evidence-based cancer care policy, and maximizing care outcome. This study reports on the development and validation of comprehensive needs assessment tool in cancer (CNAT).MethodsThe CNAT, 59-item needs assessment tool for cancer was developed and validated in a large scale multi-center survey involving 2,661 cancer patients in ten fairly distributed cancer centers throughout Korea.ResultsTo ensure content validity of the CNAT, items were derived from major needs assessment tools and input from experts and patients. Exploratory factor analysis confirmed its construct validity and identified seven factors: health care staff, psychological problems, physical symptoms, information, social and religious/spiritual support, practical support, and hospital facilities/services. Cronbach’s alpha for the scale was 0.97, and for subscales, it varied from 0.80 to 0.97. Convergent validity was demonstrated by its significant association with the EQ5D. Patients with elevated stress, depressive episodes, or suicidal ideation reported a significantly higher level of psychological and overall need. Known-group validity was also supported by its ability to detect significant differences according to age, gender, education, insurance status, months since diagnosis, and non-surgical anticancer treatment. Needs differed according to SEER stage and cancer type: advanced stage and breast and lung cancer were associated with a greater level of need.ConclusionsThe CNAT constitutes a meaningful and valid response to the challenges of cancer care, enabling assessment of need in cancer with a comprehensive yet concise and psychometrically sound tool.

Discordance among patient preferences, caregiver preferences, and caregiver predictions of patient preferences regarding disclosure of terminal status and end-of-life choices

The complexity of end‐of‐life (EOL) communication in cancer care is often increased by family caregivers, who frequently affect the information and decision‐making process. We assessed cancer patient preferences (PP), family caregiver preferences (FCP), and family caregiver predictions of patient preferences (FCPPP) regarding the disclosure of terminal status, family involvement in the disclosure process, and EOL choices, and we evaluated the concordances among them.

Changes in employment status and experience of discrimination among cancer patients: findings from a nationwide survey in Korea.

Background: As the number of working cancer patients increases, workplace discrimination and its relationship to changes in employment status among cancer patients is becoming an increasingly important social concern. The aim of this study is to provide a comprehensive overview of the relationship between changes in employment status and discrimination following a diagnosis of cancer.

Costs During the First Five Years Following Cancer Diagnosis in Korea

OBJECTIVES We estimated the total medical costs incurred during the 5 years following a cancer diagnosis and annual medical use status for the six most prevalent cancers in Korea. METHODS From January 1 to December 31, 2006, new patients registered with the six most prevalent cancers (stomach, liver, lung, breast, colon, and thyroid) were randomly selected from the Korea Central Cancer Registry, with 30% of patients being drawn from each cancer group. For the selected patients, cost data were generated using National Health Insurance claims data from the time of cancer diagnosis in 2006 to December 31, 2010. The total number of patients selected was 28,509. Five-year total medical costs by tumor site and Surveillance, Epidemiology, and End Results (SEER) stage at the time of diagnosis, and annual total medical costs from diagnosis, were estimated. All costs were calculated as per-patient net costs. RESULTS Mean 5-year net costs per patient varied widely, from

Comparison of Health-related Quality of Life Between Cancer Survivors Treated in Designated Cancer Centers and the General Public in Korea

5,647 for thyroid cancer to

Validity and reliability of the Korean version of the Caregiver Reaction Assessment Scale in family caregivers of cancer patients

20,217 for lung cancer. Advanced stage at diagnosis was associated with a 1.8-2.5-fold higher total cost, and the total medical cost was highest during the first year following diagnosis and decreased by the third or fourth year. CONCLUSIONS The costs of cancer care were substantial and varied by tumor site, annual phase, and stage at diagnosis. This indicates the need for increased prevention, earlier diagnosis, and new therapies that may assist in reducing medical costs.