Abstract

The present study was conducted to longitudinally verify the factors associated with psychological stability in patients undergoing hematopoietic cell transplantation, from before transplantation until discharge from the laminar air flow (LAF) room. As the first stage of continuing research, we investigated psychological transplantation acceptance before entering the LAF room and identified related factors.

Data were collected using the existing scales, medical charts, and questionnaires, which were developed based on the results of a pilot study analyzing such factors as, transplantation acceptance (defined as recognition of the reality of undergoing transplantation and psychological stability), threatening recognition level (recognition of threatening associated with undergoing transplantation), optimistic level, coping, and individual factors (psychological traits, social support, medical condition and demographic data). A multiple regression analysis was performed to evaluate these data.

Subjects were 43 patients with hematological malignancies who underwent hematopoietic cell transplantation for the first time in one of the seven participating institutions.

The results indicated that : the stronger the threatening recognition, the lower the transplantation acceptance ; there was a negative correlation between threatening recognition and optimistic level ; and there was no correlation between transplantation acceptance and optimistic level. Moreover, optimistic thinking, a psychological trait, reduced threatening recognition, but did not affect transplantation acceptance. While optimistic thinking reduced threatening recognition, it did not lead to psychological stability and reality recognition. Furthermore, the results suggest that emotional support provided by medical personnel before transplantation, rather than informational support, is effective in reducing threatening level. The above findings provide important suggestion for establishing nursing intervention to achieve psychological stability in patients undergoing hematopoietic cell transplantation.

Abstract

The purpose of this study was to clarify the effect of emotional support on the QOL of cancer survivors who participated in self-help groups. Based on the conceptual models of Katz (1998) and Ferrell (1995), two instruments, Emotional Support of Self-Help Group (ES-SHG) and Quality of Life-Cancer Survivor translated version (QOL-CS) were developed by the researchers, and were examined the reliability and validity of both instruments.

A questionnaire, which addressed ES-SHG and QOL-CS, was administered to 234 cancer survivors who participated in self-help groups. One hundred and forty six (62.4%) survivors responded to the questionnaire. Then, one hundred and twenty one respondents were analyzed in this study.

The cancer survivors who participated in the self-help groups had completed medical treatments but still experienced some difficulties such as disturbance of daily life, side effect/aftereffect discomfort, and fear or distress about metastasis or recurrence. However, about 85% of cancer survivors indicated that they had positive changes after participating self-help groups, and about 49% mentioned that their emotional status and self-evaluation had been improved.

The self-help group emotional support factors were classified by factor analysis (principal factor method-promax rotation) as “the supportive effects on self-esteem/-acceptance,” and “the supportive effects on changing self-recognition and self-determination.” In addition, by multiple regression analysis, “the supportive effects on self-esteem/-acceptance” was shown to be a factor influencing cancer survivors' QOL.

Abstract

The purpose of this study was to identify valid means of coping with the stress of patients before and during first chemotherapy for lung cancer. Nine patients with lung cancer, who were 20 years old or over and were scheduled to receive chemotherapy for the first time, were interviewed and observed. The stress-coping means used before treatment were six problem-focused methods (e.g., “obtaining information on chemotherapy”, “reviewing information on chemotherapy” and “keeping a good physical condition”) and five emotion-focused methods (e.g., “diverting oneself”, “escaping from chemotherapy” and “remaining optimistic”). During treatment, eight problem-focused methods (e.g., “dealing with adverse reactions to anti-cancer agents”, “keeping a good physical condition” and “paying attention to the fatigue and feelings of family members”) and five emotion-focused methods (e.g., “diverting oneself”, “escaping from chemotherapy” and “accepting adverse reactions”) were used. When the stress-coping methods used before treatment were compared with those used during treatment, it was found that the methods “reviewing information on chemotherapy” and “remaining optimistic” were only used before treatment, while the methods “receiving drip infusion of anti-cancer agents”, “paying attention to the fatigue and feelings of family members”, “adjusting the ward environments” and “accepting adverse reactions” were used only during treatment.

These results suggest that nursing interventions required to encourage the patient to continue receiving treatment include : (1) supplying appropriate information to the patient before and during treatment, (2) dealing with the anxiety of the patient to help him/her become willing to receive treatment, (3) providing support to the patient and his/her family and (4) dealing with adverse reactions to chemotherapy.