Abstract

This study purposed to verify the causal model of the relationships among the three variables of difficulties, coping, and adaptation of cancer patients who were undergoing treatment in outpatient settings or repeating short-term hospital stays.

The questionnaire was developed based on a previous baseline qualitative study （Katagiri et al., 2001）, to examine difficulties, coping, and adaptation of cancer patients receiving continual treatments. The convenience sample consisted of cancer patients receiving treatment in outpatient settings or in short-term hospital stays in a total of 14 cancer hospitals and general hospitals from across the country. The questionnaire was sent to 350 patients and returned from 275（78.5%）patients.

An exploratory factor analysis was conducted for all items of difficulties, copings, and adaptations. A total of five factors were extracted : two factors of difficulties ‘difficulties associated with illness and treatment’ and ‘inadequate environment for treatment’, two factors of coping ‘adjusting to specific life-style go along with continuing treatment’ and ‘positive attitude towards the illness’, and one factor of adaptation ‘enhanced meaning of life through the cancer experience’.

Then the relationship among the five factors was examined using structural equation modeling. ‘Inadequate environment for treatment’ had a negative impact on ‘coping process to continued treatment’, which was set as a latent variable of the coping and adaptation factors, as its direct effect ; while it had a positive impact on the coping process regard the indirect effect through a mediator, ‘difficulties associated with illness and treatment’. All of the values were statistically significant（p＜0.05）and this causal model was well accepted according to the goodness-of-fit indices.

The results suggest that inadequate human resources and treatment facilities had a negative impact, causing greater anxiety in cancer patients, and which led to lowering patients’ coping for the continuation of treatment.

Abstract

This research is intended to clarify the process of events that long-term cancer survivors face and how they find meaning to live. Data was collected through semi-structured interviews and participant observation. Data was analyzed by the revised grounded theory approach. The subjects were seven patients who were informed of their diagnosis.

The results showed that the process of the patients finding meaning for their lives changed “awareness of the time remaining” and accordingly this process brought forth to “seeking value in one’s existence” continually. There were three steps involved in “seeking value in one’s existence.” The steps were “seeking motivation to find value in one’s existence”, “testing the value of one’s existence” and “confirming the value of one’s existence.”

The cancer survivors felt that the value of their existence was shaken due to their disease and the uncertain time left for them. They sought meaning for their lives by establishing relationships with people who have found new value for their existence as well as facing their inner selves.

It can be predicted that the chronic period of cancer survivors will be prolonged more than ever due to the increase in the survival rate. Therefore it is important to provide nursing services and a social system that supports and enables chronic cancer survivors living in the community to cope with difficulties or problems on their own.

Abstract

The purpose of this study was to examine the index efficacy of the peripheral skin blood flow volume by determining whether it could be used to predict the severity of lymphedema. The subjects of this study were 61 female breast cancer patients and 35 healthy females. The peripheral skin blood flow volume was measured by using the rheometer. The measurements were examined along with the existence of lymphedema and its severity. The results showed that the blood flow volume of the patients was significantly less than that of the healthy females. Among the right breast cancer patients, the blood flow volume of those with lymphedema was less than that of those without. Among the left breast cancer patients, the blood flow volume of those with lymphedema was more than that of those without. It was also shown that as the severity of lymphedema increased, so did the difference of the volumes between the left and right sides. Among the patients with the middle level severity, the flow volume of the left breast cancer patients was double that of the right-breast cancer patients. The results indicated a possibility of using the difference of blood flow volumes between the left and right sides, as an index for judging the severity of lymphatic anasacrca. It was also implied that the formation of the observational criterion and the intervention method which take into consideration the differences of blood flow volume, need be modified between left and right breast cancer patients.

Abstract

In the present study, a narrative approach was made between a WOC-certified nurse and 7 patients with recurrent, metastatic cancer and permanent stoma, and how this approach was useful in helping the patients form a new way of thinking was evaluated. Following learning they have cancer, the patients were anxious and distressed. The study was designed as a qualitative study based on patients' narrative and a self-reflection diary kept by the nurse in response to patients' narratives. It is a practical nursing study that links research and practical nursing activities.

Patients started their narratives with the nurse with the impact they received upon being informed of their illness. Thereafter, they found a meaning for the creation of stoma and ended by discovering a meaning in their cancer experience in new aspects of their life. Through the narrative approach, the nurse was able to discover new aspects in each patient, and her understanding of the meaning of stoma for patients expanded. She was able to understand the possibility of human beings who grow and develop themselves through cancer experience. Findings obtained in the present study suggested that the narrative approach can be introduced into practice as a nursing intervention that promotes the growth and development of both patients and nurses through their interactions.