The Process of Accepting Transfer to Another Hospital and Building Human Relations with Others in a New Environment among Cancer Patients in a University Hospital

Abstract

Abstract

The aim of this study was to clarify the process, from acceptance to the building of new relationships, undertaken by cancer patients in a university hospital informed that they were being transferred to a regional medical support hospital for continuation of active treatment. We also sought to obtain insight into nursing practices that would support this process.

Subjects comprised 13 gastrointestinal cancer patients who transferred from University Hospital A to Regional Medical Support Hospital B. Semi-structured interviews were conducted after the transfers, and were analyzed using a modified grounded theory approach. Results showed that the process went from “the experience of overcoming mental conflict and preparing for the new environment” before transfer to “the experience of living in a new environment while being mindful of interactions with others” after transfer. Experiences before transfer started with “bewilderment at the transfer notice, which came like a bolt from the blue”. After transfer, patients experienced “confusion in entering a new, unknown environment” accompanied by anxiety about medical professionals they were meeting for the first time; however, the welcoming attitude of nurses allowed them to begin making steps forward in creating bonds with creating bonds with others. As a result, from the turning point of recovery in terms of both physical and social states, they experienced “deepening connections with others,” which were subsequently reinforced.

In both processes, “trusting the treatment based on the desire to survive” was the apparent method of battling cancer. One characteristic of cancer patients told they were being transferred was that they “thought this meant the cancer could no longer be cured” and descended into a negative spiral. It is thus important that nurses recognize such thought processes in patients to ensure psychological stability and help prevent patients from falling into a negative downward spiral. An environment that facilitates acceptance of and adaptation to transfer must also be created, as this was thought to help promote a system of complete community medical care.