2018 Volume 32 Article ID: 32_kogure_20180118
Abstract
In this study, we sought to demonstrate the process that family members of terminally-ill cancer patients go through when patients transition from the Palliative Care Unit （PCU） to home care in order to gain insights into how nurses can support these family members. We conducted semi-structured interviews of 15 bereaved family members of terminal cancer patients transitioning from the PCU to home care, and analyzed their responses using the Modified Grounded Theory Approach （M―GTA）. The results of our M―GTA analysis indicated that the family members experienced various feelings when the patient was admitted to the PCU, such as “not knowing whether they would be able to take them home again.”How ever, all respondents contemplated the transition amidst an impending time limit while realizing that the patient’s life expectancy was limited, and developed a “strong inclination towards caring for the patient at home after comparing continued hospitalization with home care,” before eventually “deciding on the transition to home care based on a ‘now or never’ attitude.” In the brief period of transition from hospital to home care, family members had “peace of mind that continued support from healthcare professionals can be obtained even at home” amidst the “hectic efforts to prepare the home care environment led by medical professionals,” and made the transition while “gradually becoming more positive about home care.” Although family members admitted to feeling “anxious about caring for the terminal cancer patient at home” from the time they started considering the transition, their underlying “desire to grant the terminal cancer patient’s wish to ‘return home’” formed the basis for proceeding with the transition while feeling a “sense of security about being able to return to this place at any time.” The study findings suggest that nurses should support preparations led by medical professionals to transition the terminally-ill cancer patient to home care by attempting to address the anxiety of family members early on, and by ensuring that the patient has the opportunity to be readmitted to the PCU if necessary.
