Abstract

The meaning and structure of hope were inductively examined in patients with hematological cancer who were under long-term care. Using an ethnographic approach, 7 patients were interviewed 41 times over a period of 3 months. The results were expressed in the following 6 categories : (1) the will to live ; (2) simply wishing to get better ; (3) motivation for living ; (4) inconvenience and irritation ; (5) no hope for the future until treatment is completed ; and (6) coming to terms with the disease. The hope of patients with hematological cancer who are under long-term care was expressed by the theme of “living”.

Their hope for “living” was expressed in the category that described the will to live. The category that consisted of reasons why they simply wish to get better explained how they perceive living under these circumstances. The category consisting of things that motivate one to live involved 5 aspects : 1) interpersonal relationship, 2) the fruits of their past experiences, 3) long-term care environment, 4) fear of death and dying, and 5) uncertainty. The category that consisted of inconvenience and irritation also confirmed the aspects corresponding to these findings. Cancer patients' inconvenience and irritation were caused by a situation in which they could not make their way to the future until their treatment was completed. They coped with that situation by coming to terms with their disease.

This study described the structure in which hematological cancer patients perceived their experiences while undergoing long-term care in their own way, maintained a positive attitude toward living in spite of inconvenient and irritating situations and continued to hope for the future.

Abstract

The manner and process, through which patients with hematological cancer under long-term care were able to hold on to hope, were inductively examined. Seven patients who were in a university hospital were interviewed 41 times over a period of 3 months, and the data obtained were analyzed, using an ethnographic approach.

In this process, there were 4 stages : (1) feeling that there is no future ; (2) hoping to resume their lives after discharge ; (3) getting accustomed to current conditions ; and (4) simply wishing to get better. Each stage was characterized by a difference set of attributes, rather than the progress of time. Specifically, the patients expressed the following thought processes at each stage : ① details of a substantial goal, ② interpretation of death and dying, ③ interpretation of effectiveness of cure, and ④ the manner by which they come to terms with their disease. The difference in the attributes at each stage influenced hope held by the patient. The shift to each stage was affected by an acknowledgment of the fact that without treatment there would be no prospects for continued life. They have learned to come to terms with their own diseases during the protracted treatment period. This was exemplified by a process in which they relied solely on the treatment, even though they chose not to set a specific goal upon recovery and even when they instinctively felt an impending doom. This study suggested that it is necessary for a nurse to support a patient's own strategy so as not to weaken his or her coping ability.

Abstract

This study aimed to identify behaviors in families supporting adult cancer patients in their rehabilitation following surgery, and nursing care for family members. We examined 8 family members of adult cancer patients who had been diagnosed with cancer and underwent surgery. Data was collected longitudinally using the participant-observation method and semi-structured interviews, and was analyzed qualitatively and inductively.

Supporting behaviors comprised 7 categories : (1) building a new life with the cancer survivor ; (2) facing the cancer together with the patient ; (3) supporting the patient's independence while maintaining concern about his/her condition ; (4) finding ways to coexist with cancer ; (5) allowing family members to maintain separate lifestyles ; (6) keeping the patient at some distance, and ; (7) leaving it to a patient's independence while concerning their condition. These categories and sub-categories were classified every subjects. As a result, subjects were divided into 2 groups. One group A was accounted for the majority of Categories 1-4, whereas another one B was accounted for the majority of categories 5-7.

Although family members displayed fears regarding cancer, they independently brought patient care. Supporting behaviors are with the intention of protecting a patient' life from the cancer illness, based on recognizing the role as a caregiver, and with the intention of sticking to her/his own life. We conclude that behaviors of group A focused more on patient care, while behaviors of group B focused more on lifestyle maintenance. Both types of behavior are present in the provision of support. This study indicates that nurses must choose methods matching family behaviors to allow family members to assist patient rehabilitation.