Nurses’ Value Judgments on Support Provided for Decision-making by Terminal Cancer Patients

─A Study Focusing on Experienced Nurses─

Abstract

Abstract

The purpose of this research was to understand the value judgments of nurses with practical experience of nursing patients with terminal cancer, regarding support provided for decision making by these patients. Semi-structured interviews were carried out with 16 nurses having at least 4 years’ practical experience of nursing adult patients with terminal cancer, and qualitative functional analysis of the interview content was performed. Analysis of the research results identified seven value judgments held by these nurses：‘a patient should make his own decisions until the end,’ ‘a patient should be able to approach and appeal to the medical team so that his decision is realized at all costs,’ ‘a patient should be given support to enable him to spend the remainder of his life at home if he wishes,’ ‘the family should respect the decisions of the patient and should be supported so that they can make treatment and other related decisions on the patient’s behalf more easily during the final stages,’ ‘when a patient changes his decision, the information should be shared and supported so that he may change his decision as many times as required,’ ‘considering the amount of time the patient has left, care should be taken to respect the patient’s decision,’ and ‘care should be taken to minimize the burden on the patient in realizing the content of his decision.’ The suggestions given regarding the support provided for decision-making included emphasizing the ability of patients to make their own decisions until the end based on correct recognition of their condition and respecting their decisions in a variety of ways, including approaching and appealing to the substitute decision maker and/or medical team；providing sufficient information regarding social resources and medical staff support systems to the patients’ families to allow for home care if the patients wish to receive treatment at home；taking into account the burden on the patients in realizing the content of their decision；and supporting the realization of their decision while providing care to ensure their safety.