Abstract

The objective of this research is to clarify the concept of rehabilitation nursing of women with breast cancer from the standpoint of such women's determination to survive from the time they are diagnosed as having cancer. This research was designed so as to clarify aspects of nursing practices, taking into consideration the Walker and Avant method of concept analysis.

The data was collected through interviews with and observations of women with breast cancer and nurses who are engaged in the nursing of them. As a result, the following conclusions were reached regarding the concept attributes in terms of rehabilitation nursing of women with breast cancer : 1. Nurses assist women in facing the challenges arising as a result of their illness. 2. Nurses assist women in taking active part in new lifestyles. 3. Nurses assist women in reconstructing their lives. 4. Nurses assist women in finding meaning in their new lives. It could also be inferred that the fourth concept listed above was a central part of the other three. It could also be said that such women's experience with breast cancer is a transition : leaving behind their old lifestyles as lived up to the time of the diagnosis, and creating new lifestyles.

In listing the concepts of rehabilitation nursing of women with breast cancer based on these points, it could be said that nurses ameliorate the quality of women's experiences with breast cancer by helping them deal with their experiences, participate in new lifestyles, reconstruct their lives (transition), and find some kind of meanings within such new lives, as well as helping women grow throught their experience with cancer.

Such nursing practices are described in detail, based on the aforementioned four conceptual attributes.

Abstract

The purpose of this study was to identify the level of the caring self-evaluation of nurses concerned with cancer nursing and to verify the factors, which related to caring of nurses by the multiple regression analysis. This was questionnaire investigation and the subjects of this study were 500 nurses who worked in the cancer wards of 8 general hospitals in Osaka. The variables used for the multiple regression analysis were the caring scale of nurses as the subordinate variable and 17 variables (which include the attitude toward death, the care anxieties scale of nurses, general-self-efficacy〈GSES〉, etc), as the independent variable. The main results were as follows :

1) The levels of the caring self-evaluation and the GSES of nurses were relatively low. These levels became high when the experience years increased and significant differences were noted between the levels of the years by multiple comparison (Tukey).

2) Results of the multiple regression analysis demonstrated that there was a strong order of the relation of 4 in 17 factors. Care anxieties scale of nurses didn't originate in the caring evaluation, but a significant negative correlation (γ=－0.199, P＜0.001) was noted. The order from strongest factor to weaker factors were age (β＝0.256, P＜0.001), GSES (β＝0.255, P＜0.001), the feeling of the gap for a goal for cancer nursing (β＝－0.187, P＜0.001), unwillingly, facing a patient's death adopting an attitude to care for with a businesslike feeling (β＝－0.113, P＜0.01), respectively.

3) 3 factor except for the age was the related factor of the reverse (plus and minus) to the caring self-evaluation and the care anxieties scale of nurses.

The findings indicated the factors enhancing caring of nurses concerned with cancer nursing, and corelations between the factors. It was also suggested that the need of follow up research about the multiple experienced nurses' practical caring ability and ways of making use of it.

Abstract

The purpose of this study is to analyze the practical nursing care for the patients with cancer pain performed by the expert nurses, and to identify a relation between the intrinsic practical knowing and four patterns of Carper's knowing. Pain relieving care performed by six expert nurses was studied by perticipant observations and interviews to analyze their practice. It was known that 15 patterns of the practical knowing extracted from the pain relieving care performed by the expert nurses, were classified into four patterns of Carper's knowing, i.e. empirical-, aesthetic-, personal-, ethical knowing, respectively. Simultaneously, they were overlapping and integrated into the practical knowing.

The result of this study revealed that the superior practice of the experts in pain relieving care for the patients with cancer was deeply related to the intuition, knowing on an expert oneself, and sensibility to ethical topics ; it means so-called Carper's patterns of aesthetic-, personal-, and ethical knowing respectively. It was suggested that for excellent practice of the nursing care, not only the empirical knowing but also other patterns of knowing are important, and it is necessary to sense up all four knowing patterns.

Abstract

The purpose of this study is to describe the meaning of hope for the patients in the terminal stage of cancer and the factors related to the patients' hope. The design of this study is descriptive using a qualitative research method. The participants were twelve patients admitted in the hospice/palliative care unit or attending the hospice outpatient clinic. The data were collected through non-structured interviews and participant observation, and analyzed by inductive coding.

As a result, hope for the patients in the terminal stage of cancer was reflected as three themes of “living”, “representing oneself”, and “transcending one's own death”. “Living” included the two sub-themes of ‘recovering’ and ‘continuing to live (with cancer)’ ; “representing oneself” included the four sub-themes of ‘being free’, ‘being independent’, ‘having real feeling of present life’ and ‘completion of one's own life’ ; and “transcending one's own death” included the three sub-themes of ‘leaving a proof of one's own life’, ‘having faith in life after death’ and ‘praying for happiness of others’. The important factors related to hope were revealed as internal energy for maintaining hope, awareness of approaching one's death, and human environment for fostering hope.

When considered based on the above three themes revealed as phases of hope, the meaning of hope signified a way to exist for the patients in the terminal stage of cancer.