Abstract

Patients with hematological malignancies, such as leukemia and malignant lymphoma must undergo treatment for long periods of time even after complete remission has been achieved. Thus, it is important to improve their psychosocial adjustment. The present study examined the psychosocial adjustment of adult outpatients with hematological malignancies from a multi-dimension viewpoint (i. e. vocational, social, domestic, and emotional). We also investigated the various factors related to adjustment.

Of 112 patients (age range, 20 to 60 years) attending the hematology ambulatory services of five different hospitals, 102 participated in the present study. Each patient filled out a questionnaire regarding their work status, living arrangements, appraisal of illness, coping strategy, and multi-dimensional psychosocial adjustment. Information regarding their disease, including the stage of illness and duration of hospitalization was taken from the patient's medical records.

Many of the variables showed the same relationship with the various dimensions of adjustment. In particular, better adjustment was related to a more positive appraisal of illness, less change in work, fewer subjective symptoms, a longer duration of suffering, and a positive coping strategy. On the other hand, certain variables were related to the subscales differently. For example, a shorter duration of hospitalization was related to a better vocational adjustment but a worse social adjustment. The same pattern was seen with age and living arrangements.

The present study confirmed the importance of helping adult outpatients with hematological malignancies with their psychosocial adjustment from a multi-dimension viewpoint. We need to understand each patient's risk of maladjustment early and deal with any specific problems from various viewpoints. The results also suggested the benefits of intervention in achieving symptom control and a positive appraisal of the illness.

Abstract

The purpose of this study was...to describe the stress-coping and make clear the different and the same point in stress-coping before and after the patients who have or had an operation on mastectomy or breast conserving.

The subjects were 24 patients (8 patients who need or needed an operation on mastectomy and 16 patients who need or needed an operation on breast conserving) who were informed that they had gotten breast cancer. Interview and participant observation methods were used to collect the deat. In consequence, I got the following results.

1. After I compared the stress which mastectomy have and breast conserving have I found that both patients experienced “The difficulty or anxiety getting out of the confusion” after they were informed. Most of the patients who had mastectomy went through “anxiety how do relatives and neighbors think about it” and “grief or anxiety about the loss of the breast.” Most of the patients who had breast conserving went through the anxiety for the treatment like X-ray, “anxiety about the treatment after they left hospital” and “discontent with doctors and nurses.” This means they couldn't consult doctors or nurses on the operation.

2. After I compared the coping which mastectomy have and breast conserving have I found that most of the patients who had mastectomy experienced coping-method about lossing their breast like “rethinking from a different point of view”, “abandoning” and “escaping from reality.” And most of the patients who had breast conserving experienced coping-method like “looking for information”, “thinking of solution concretely” and “bracing themselves.”