The Structure of Support by Oncology Certified Nurse Specialists for Family Members as Surrogate Decision-Makers of Elderly Cancer Patient

Abstract

　The purpose of this study was to clarify the structure of support provided by Oncology Certified Nurse Specialists to families of elderly cancer patients who have difficulty making decisions, and to discuss the practical skills required of nurses. Data were collected through semi-structured interviews with eight Oncology Certified Nurse Specialists who had experience in providing surrogate decision-making support to families of elderly cancer patients. The method of analysis was qualitative inductive analysis. Support for family members who make surrogate decisions was summarized into four core categories: “lighten the burden borne of the family as much as possible,” “aim for decisions that reflect the elderly cancer patient’s wills,” “clarify family members who can carry out surrogate decision-making,” and “have family members be prepared to make proxy decision-making.” It was considered that support is continued from before the proxy decision is assumed to be made until after the proxy decision is made, interrelating, and aiming two goals that “lighten the burden borne of the family as much as possible,” “aim for decisions that reflect the elderly cancer patient’s wills.” The practical skills required of nurses include the ability to nestle the family, the ability to assess, the ability to build relationships with multiple professions, and the ability to respect the wishes of elderly cancer patients and to be aware of reducing the burden on the family.