Abstract
"Quality of life(QOL)" of terminal cancer patients are closely related with the way they recognize and cope with the situations where they are confronted with death. This study examined cognitive process of terminal cancer patients through analysis of verbal behaviors obtained by interview on a single case. Five interviews were carried out once a week for 1 month, until 8 days before the patient have passed away. Interview transcripts were segmented by themantic units (TU) and judges scored each units for 13 topic categories and Elaboration-Dyselaboration measures, which assessed emotional and defensive discourse. Duration of TU were timed by seconds. The results were obtained from these procedures. First, TU duration changed significantly (p<0.001) with physical condition of the patient. This indicates that the way of expression of the subject has changed from the one with rich modifiers to the direct one. It implies that physical situation has great affects on verbal behavior of the subject. Second, personal maning structure (person schemas) was estimated through Elaboration-Dyselaboration relationships of each category, that it consists of 2 selves ; the positive expected self which could control any situation, and actual self which had disability in bad physical condition.These results indicate that the change of physical condition have great effect upon relation between expected self from past experiences and perceived actual self that have less control over the situations. That is, congnition of physical condition plays an important role in cognitive process of terminal cancer patients. These discussion suggests, from the cognitive view, that symptom control is important. In addition to the symptom controls, psychological support such as structured intervention and enduring psychological supports in daily care is needed for patients' QOL.
