Abstract

The purpose of this study was to identy cognition and decision making of 5 home care nurses of the terminally cancer patients in transition from hospital to home. Data were collected by semi―structured interviews and participant observation, and were analyzed qualitatively and inductively. Before discharging, home care nurses knew the patients’ and families’ mind, and accepted it. While the nurses were perceiving difficulty about collaborating with hospital physicians and nurses, they judged to make sure that patients and families knew about the truth, to prompt the hospital clinicians to tell it them, to predict and mitigate their suffering. They ascertained whether the patients returned home, based on their cognition, and prepared home care. After discharging, they perceived their meaning of being at home, predicted and mitigated their physical and psychological suffering. In order to assist sustainability of home care, nurses effort to build trust with the patients and their families. Their cognition and decision making after discharge lead to ascertain whether they were continually being at home, confirm their decision. These findings suggested the features tell the truth to them and relieve their psychological suffering, control cancer pain, support caregivers, establish relationships to them, ascertain they are at home, are difficult to cooperate with hospital medical staff in transition for terminal cancer patients.

Abstract

The present study investigated the effect of taste alteration, oral cavity response and food characteristics on the appetite of 13 oral cancer patients receiving radiation therapy. Each subject underwent a semi―structured interview at or within 7 days of completing therapy, and the resulting data were qualitatively and inductively analyzed. There are 5 main characteristics of food that affect appetite: ‘texture’, ‘seasoning’, ‘temperature’, ‘serving style’, and ‘flavor’. Patients reported significant effects of these when the radiation dose reached 40―50 Gy. With 30―40 Gy there were significant alterations in taste, and the food characteristics affecting appetite were ‘texture’, ‘seasoning’, ‘temperature’ , and ‘flavor’. ‘Personal preference’ was associated with food characteristics on 30―40Gy. With 50 Gy, there was significant oral cavity pain on day 7 after completion of therapy and a dry mouth. The food characteristics affecting appetite were ‘texture’, ‘temperature’ , and ‘serving style’. With 60 Gy, ‘flavor’ was highly associated with appetite on day 7; that is, intense flavor specific to the food decreased the subject’s appetite. The results also showed circadian changes in the relationship among taste alteration, pain, dry mouth and food. The diet for oral cancer patients should take into account the level of treatment, the characteristics of the food, ‘personal preference’ and circadian changes.

Abstract

The purpose of this research is to make evident the experience of the family accompanying a cancer patient undergoing surgery from the viewpoint of the family. I will examine how nursing support can supplement the growth of family’s accompanying cancer patients throughout the surgery including pre and post surgery.

I found nine target families, and having received their consent, I conducted semi-structured interviews that were about accompanying a cancer patient, and I observed the families as they spent time with the patient. In those ways, I collected date that I then analyzed qualitatively and inductively.

The results I found were that families accompanying cancer patients go through three stages. They are: a stage of reaction and preparation prior to the surgery, a stage of being at the mercy of the patient’s condition and having to face that reality, and a stage of the appearance of beneficial results from sticking together as a family. I also found that each family’s experience can be categorized into three patterns: being unable to escape a chaotic situation, the emergence of unshakable family bonds, and the surgery being a good opportunity to strengthen family bonds. Moreover, by combining these three stages and patterns, I was able to construct a diagram describing the experience of a family accompanying a cancer patient undergoing surgery.

Lastly, standing by a family member about to undergo surgery often brings about a sense of satisfaction and ease, and is one part of the growth as a family. However, there were also indications that there is a danger of latent problems and uncertainty within the family being brought to the surface. This is why nursing support which focuses on preoperative mental stress and helping the family to view their experiences in a positive light is necessary so that accompanying a family member with a cancer can contribute to the family’s growth.

Abstract

The purpose of this study is to explore the experience of fatigue in cancer patients receiving chemotherapy. Eleven patients participated in this study. Data were collected through unstructured interviews and were analyzed using a qualitative method. Categories and dimensions emerged from the data as follows; experiences of fatigue（feeling exhausted during daily activities, decreased desire to be active, less mobile, feeling out of control, unusual sleepiness, incomplete thought, no difficulty in limited activities, decreased endurance during activities when out of hospital, affected psycho―social aspects negatively）, self―care for coping with fatigue（limiting expenditure of energy by rest or adjusting activities, getting energy by uplifting themselves or common health―improving behavior, limiting and getting energy from distractions, preserving energy through exercises）, and factors influencing fatigue（physical, emotional）. Fatigue was demonstrated as an experience of process that these categories affected mutually and consecutively, and it was impossible to determine where these experiences of fatigue were processed. Fatigue was also illustrated by energy level changes. That is, a major aspect of experiencing fatigue involved a feeling of energy depletion, and such feeling initiated self―care behavior to control energy level. Findings in this research suggested that information about fatigue such as the anticipation of appearance, period and degree is needed by cancer patients receiving chemotherapy and should be given before the beginning of chemotherapy. It is also suggested that self―care education that does not excessively emphasize limiting expenditure of energy is needed. Furthermore, it was shown that controlling other symptoms such as nausea had an important impact on controlling fatigue. Further research on patints’ perspectives is needed to deepen understanding of fatigue in cancer patients receiving chemotherapy and to develop effective nursing interventions.