Abstract

The purpose of this research was to clarify the relationship constituting the caring provided by caregivers to terminally cancer patients.

Participatory observations and interviews among eight subjects were used to study caregiver-patient relationship which imparted a perception that caregivers provided support or assistance and which produced a sense of security of mind. The data was analyzed according to inductive procedures based on the phenomenological approach.

The study defined 16 caregiver-patient relationship, including “Concern” “Recognition of worth” and “Respect for will”. These 16 caregiver-patient relationship constituting caring were also classified into five categories of : 1) caring intensifying trust in the caregiver, 2) caring providing perceptible support, 3) caring sustaining hopes, 4) caring confronting suffering while recognizing self-limits, and 5) caring sustaining patient stability. Caregivers included both professionals and non-professionals.

Caring allowed terminally cancer patients to acknowledge their own limitations and pain frankly and to live according to their true nature. Caring assisted self-actualization of terminally cancer patient. The results showed that in order to assist self-actualization of patient needs, the nurse should provide caring for them. The results also suggest the need for care allowing families to serve as caregivers.

Abstract

The purpose of this study was to clarify the essential support for ostomates living in their home after discharge by asking self-care ability, the evaluation on the care actually received and the care actually demanded. Subjects were consisted of 61 ostomates with 50 effective responses. The data were collected by the questionnaire included three domains in terms of the stoma care and the medical records.

In self-care ability, the responese rate was lower in a observational skill for stoma sites than in other skills of self-care. The observational skill was more accurately used by ostomates who had learnt it from health care professionals than those who had not it. It was shown that the response rate on the care actually received differed from that on the care demand after discharge, especially, in the area of activities to meet basic needs and care needs associated with physiological changes. It was also identified that ostomates tended to choose health related persons by themselves based on their needs for help. The research findings may suggest that skills and knowledge to evaluate a progress of stoma sites, to meet basic needs and the long-term care needs and specific care to solve the stoma related problems are needs to be supported ostomates in home.

Abstract

With the aim of predicting changes in perception related to subjective attitude toward life after construction of colostomy and to assist patients after such operation, we compared patients who underwent artificial construction of colostomy, and patients who were operated for rectal cancer but did not undergo construction of stoma. Thus, we identified longitudinal changes.

One of the changes in the perception characteristic to patients after construction of colostomy was that subjective attitude toward life declined before discharge from the hospital, and then gradually improved after discharge. We believe it necessary to preoperatively educate the patients about predicted postoperative changes in perception, as well as countermeasures for coping with such changes, in order to minimize decline in the subjective attitude toward life after construction of colostomy.

Changes in perception commonly observed among patients who underwent surgery for rectal cancer were those in positive attitude toward life, personal assessment of health, problem with evacuation, and satisfaction with diet. Positive attitude toward life and problem with evacuation increased after discharge from the hospital. Personal assessment of health declined before discharge, and did not improve after discharge from the hospital. Satisfaction with diet declined during hospitalization, and improved after discharge from the hospital. Patients who underwent surgery for rectal cancer were attempting to have positive attitude toward life, but a certain period of time appeared to be necessary in order for them to feel that they were leading healthy life. With respect to problems with evacuation, continual assistance seemed nacessary even after discharge from the hospital. As to diet, improvement should be made so that patients would be able to have satisfaction with diet during hospitalization.

Abstract

The purpose of this study was to explore the meaning of social support among women with breast cancer, focused on their preoperative states. A descriptive study with interview methods was designed. Sixteen Japanese women who were diagnosed with breast cancer and hospitalized to have their breast surgeries participated in the study. The women were interviewed by semi-structured questions ; then, thematic interpretive analysis was performed. The results indicated that the participants explained support as “kizukai”, “shinpai”, and “kokoro no sasae”. Positive and negative sides of social support were described. Regarding the positive side of social support, there were two directions : 1) from others to the participants and 2) from the participants to others. Also, They informed the negative side of social support, such as the lack of help. They identified family members, friends, relatives, and co-workers as their network. As the best support providers, married women stated their spouses, and single women expressed their parents. These results were discussed with the studies of social support among women with breast cancer that conducted in Western cultures. It was suggested that medical professionals should provide care for not only women with breast cancer but also their network persons.

Abstract

This research was conducted using the Grounded Theory approach with the aim of exploring the process whereby patients with stomach cancer being repeatedly hospitalized for chemotherapy encounter and overcome problems as they continue treatment. By interviewing how the patients with stomach cancer experienced the process of chemotherapy as they made repeated extended stays at the A University Hospital, we found the following three phases. Phase 1 : With a succession of experiences the like of which they had never encountered before, the patients become unhappy and despondent because they feel they have lost control over their lives. Phase 2 : In confronting this unhappiness and despondency, the patients revaluate the situation they have been placed in and come to realize that they themselves have been possessed by obsession of being ill and change their emotional state. Phase 3 : The patients obtain a new sense of controlling their own lives, thereby gaining comfort. In phase 1, what drove the patients into unhappiness and despondence was their sense of being restricted as a result of their diet and their relationships with others. Phase 2 proved to be an important turning point for the patients to continue chemotherapy during their repeated stays in the hospital. Finally, we found the following to be important factors for letting the patients move on to Phase 3, with the Phase 2 as turning point : (1) Whether the patients knew they had cancer or not ; (2) Whether the patients had experienced severe restrictions in lifestyle after being diagnosed with cancer or not ; and (3) Whether the patients were able to feel that the family members and other persons around them were supportive or not.

The results of this research show that the process whereby the research subject, i. e. the patients, overcome their problems and continue treatment includes not only the alleviation of the pain caused by the cancer itself and the treatment, but also the patients' own release from their feeling of being obsessed by their illness and that the latter is an important point in preventing the patients from driving themselves into a corner. They also show that, to achieve this release, the patients need to become aware that they have been obsessed by the illness and accept their unhappy and despondent situation as their own experience. The research results suggest the need for nurses to give the patient assistance in this respect.