Abstract

The purpose of this study was to identify what changes occur in the experience of illness, when a nurse and a client who has undergone bone marrow transplantation (BMT) and continues to visit hospital for a long time follow his pattern recognition process together. The theoretical framework is Newman’s theory of health. Newman’s hermeneutic, dialectic approach was chosen for praxis research design. The participants were 4 male outpatients in their 30’s. The data consisted of the content of dialogues in the participant–researcher partnership and of the researcher’s journals. The participants showed four transformational phases. These were: “Superficial reflection on one’s own life and expressions of the experiences of illness that one had not been able to confront”, “Groping for one’s true feelings and showing them”, “Recognition that one is in a hard situation at present”, “New awareness and self–revolution”. Their insights suggested an expanding human consciousness and supported Newman’s theory. The findings suggest that this nursing support helps long term male outpatients in early adulthood who are suffering from not being able to achieve their life tasks after BMT.

Abstract

The purpose of this study is to make clear the enrichment that family caregivers experience by sharing enriching events with terminally ill cancer patients at home, while gaining positive meaning and satisfaction through these events.

Enrichment has been defined by Archbold and Cartwright as the process of endowing caregiving with meaning or pleasure for both caregiver and care recipients. It enhances the positive qualities of the mutual relationship and is associated with reducing some dimensions of caregiver role strain.

Data was collected from 15 caregivers and 13 terminally ill cancer patients at home introduced by home care stations, and by semi-structured interviews in their homes or in a hospital. The data was analyzed qualitatively and inductively through three stages: antecedent factors, enriching events, and consequences.

The enriching events occur as a result of the long interpersonal history and relationship between patients and caregivers. The enriching events have 4 categories (events arising from continuation of customary routines, events where the routine is adapted, developing greater closeness in the terminal phase, and meaningful events even if only done once), and includes 9 reasons for significance attached (return to daily happiness, sharing pleasure and joy, making the most of remaining time together, mutual reassurance, confirming that the patient is in the best condition possible, mutual recognition of shared life, focusing on the patient’s life, sharing memories of their life, reconfirm the dignity and self respect of the patient). Family caregivers gained meaning and identity from caregiving (maintaining their normal life, strengthened relationship, putting their emotions in order, and reaffirming reasons for being) through the enriching events.

These results suggested that family caregivers to terminally ill cancer patients can overcome grief through gaining positive thinking and emotional enrichment. This is why nursing support is necessary to promote value and meaning in the lives of the terminally ill.

Abstract

This study examines the cognitive appraisal of patients who have decided to undergo total laryngectomy, conducted immediately before the operation. Data were collected from 5 patients who had been hospitalized for total laryngectomy, using the methods of participant-observer study and semi-structured interview. The collected data were analyzed in the following process: 1) The cognitive appraisal for each patient was summarized in concise sentences, 2) For each patient, sentences of similar context were grouped and each group was given a name, 3) The four groups common to all patients were selected: “realization that the surgery is unavoidable”, “sense that the surgery is unacceptable”, “hope that surgery is the best option” and “determination that life will be meaningful after the surgery”. The results show that patients tend to recognize that the operation is the best option and that they try to face it despite feeling unwilling to become aphonic because of laryngeal cancer. Regarding nursing, the results reveal the necessity of understanding ambivalence in patients, that they feel the surgery is unacceptable despite agreeing to it.

Abstract

In the present study, cancer patients receiving outpatient chemotherapy were interviewed in order to clarify the types of pain and suffering that they experience in daily living. More than half of the cancer patients receiving outpatient chemotherapy experienced physical symptoms (such as “constantly tired” and “hair loss”) and non-physical symptoms (“thinking about having to come for treatment”, “having to wait for treatment with other patients”, and “affects my work/home duties”). Six of the ten most common symptoms were non-physical symptoms. Cancer patients reported experiencing a total of 19 categories of worries and difficulties. These include six categories for treatment-related pain and anxiety including “pain associated with prolonged therapy” and “anxiety about the body’s tolerance of therapy”; six categories for family-related anxiety and discontent, such as “family is worried about the disease” and “family is uncooperative”; and other categories including “anxiety about work”, “anxiety about finance”, “always thinking about the disease”, “anxiety about mortality”, “responses by healthcare professionals”, “lack of people to talk with” and “social prejudice”. As family relations such as family-related anxiety and discontent affect the patient’s perception of chemotherapy side-effects, it is necessary to help family members understand the importance of family support and assist them in providing support so that the patient’s anxiety and chemotherapy side-effects can be minimized in order to maintain their QOL.

Abstract

The purpose of this study is to elucidate the interaction between terminally ill cancer patients and aroma therapist-nurses.

The participants in this study were ten aroma therapist-nurses who have a private qualification as an aroma therapist and had practiced aroma massage for terminally ill cancer patients. Data was collected by semi-structured interviews, and analyzed by qualitative and inductive methods. Each participant received an explanation of this study’s purpose and content verbally and in writing, and they agreed to participate in this study.

The interaction between the therapist-nurses and patients was classified into nine categories:“desire happiness and best care for the patient,” “concentrate consciousness and catch the wavelength of the patient”, ”practice care action that respects the patient”, “mixing massage oil according to assessment”, “a prominent skill that can help the body by touch”, “sense of energy received from the patient”, “a sense of fulfillment by good reaction from the patient”, “education about symptom management”. One category was common to the therapist-nurses and patients:“sharing an effect from the essential oil”.

The therapist-nurses desired the happiness of the patients during the massage and they tried to catch the wavelength of the patient while using sensitivity and skills to help the body by touch. They practiced care action that respects the patient. It is thought that aroma massage has potential to become one tool in “individual nursing care that sympathizes with the patient, and accepts the feelings of the patient and one’s own feelings”, and has high potential to spread as part of standard nursing care.

Abstract

The aim of this study is to identify autonomous activities to enrich life for cancer survivors in a hospice. Four cancer survivors agreed to participate. Data was collected by semi-structured interviews and treatment records, and analyzed qualitatively and inductively. Participants reflected on their richness of life within the context of six main themes: giving value to life, sense of connection, inner-integration, harmony with changes, self-advocacy, and minimization of suffering. Changes in the richness of life in the illness process were found for the following four elements: increased sensitivity toward actualization of richness of life, changing mental energy for direct internalization of richness, change in value standards to emphasize the richness of daily life, and changing to a more fluid foundation for appreciation of richness.

The results showed richness of life for cancer survivors in the hospice had similarities with elements for finding hope, and importance was attached to establishing a peaceful space to assist inner-integration.

The results also suggest that changes in the richness of life were actually increased richness of life, which was an outcome of the process of personal growth of the cancer survivors.

Abstract

Purpose: To clarify the characteristics of the sense of control in cancer survivors. Methods: We searched for articles, published between 1996 and August 2008, related to the sense of control in cancer survivors, using keywords such as ‘sense of control’ and ‘cancer survivors’ in Medline, CINAHL, CiNii, and other databases. We extracted attributes, antecedents, and consequences of the concept from the references and analyzed their characteristics using Rodgers’ concept analysis method. Results: Sense of control in cancer survivor comprises attributes such as ‘diverse’, ‘dynamic’, ‘conscious’, ‘acceptance of involvement’, and ‘well acquainted with life’, as well as cancer survivors’ uncertainty. Antecedents included ‘belief’, ‘relationship with others’, ‘self-confidence’, and ‘quantity and quality of cancer information’. ‘Quality of life’, ‘better adaptation’, and ‘coexistence with cancer’ were described as consequences. Discussion: ‘Sense of control in cancer survivors’ is an important concept, where survivors strive for a better quality of life and adaptation while maintaining a dynamic diversity. They continue to adapt for a future coexistence with cancer, considering it an innate human characteristic, and search for future prospects while dealing with a stressful event such as cancer.