2020 Volume 34 Article ID: 34_imai_20200325
The purpose of this study was to clarify the process through which fluctuating feelings lead to self-determination in patients with advanced/recurrent cancer who received the last standard treatment and to investigate effective nursing support.
Semi-structured interviews were conducted with 14 patients receiving outpatient chemotherapy and were analyzed qualitatively and descriptively using a modified grounded theory approach (M-GTA).
In the process through which fluctuating feelings lead to self-determination in patients with advanced/recurrent cancer who received the last standard treatment, the affected patients first are informed by a physician of the progression of their cancer and an explanation is given as to why their treatment is to be changed and then experience confusion and conflict due to the difference between physical sensation and explanation content. While continuing to receive the same treatment, they ‘wander in the dark’ while turning everything over in their minds. And then becomes a turning point. The patients take this opportunity to escape from their fluctuating feelings and follow the process of self-determination beginning with facing reality, i.e., the last stage of treatment.
Nursing support begins with recognizing that the patient's fluctuating feelings is the first step towards making an internal compromise. Furthermore, nurses should listen to the patient's narratives, encourage patient introspection while accepting them seriously, and prepare the environment so that feelings can be expressed adequately. In addition, it is important to support the strengthening of the relationship between patients and loved ones such as their families, and to construct social support systems such as peer supporters.
