Abstract

The purpose of this study was to obtain suggestions for improved nursing care by clarifying the decision-making process to undergo surgery in young women with cervical cancer. We conducted semi-structural interviews with a convenience sample of nine women between the ages of 21-29 with primary cervical cancer. Interviews occurred during their hospital follow-up visit about six weeks after surgery. Data were analyzed qualitatively by inductively forming themes.

We found that the decision-making process to have surgery among young women with cervical cancer began with the “shock of the moment”, followed by their “resolute decision to have surgery” due to the “presence of a doctor whom they could trust” and the “encouragement of friends and relatives”. Thereafter, leading up to their hospitalization, they would “block out information other than that from their doctor” and “prepare for hospitalization”. What made their shock a momentary situation was “their desire to have children” and the “doctor’s guarantee of being able to still have children after the removal of the cancer”. However, in some cases, “post-decision doubts appeared”. When this happened, they “tried to dispel their doubts”, and once the doubts were resolved, they “refrained from making inquiries”. Some women “protected themselves by refraining from making inquiries”, despite “being uncertain”, and “decided that they must comply with the doctor and have surgery”. Others worried that this process would cause them to be “perceived as frivolous”. Moreover, it was exceedingly rare for a nurse to be part of their decision-making process to have surgery. This suggests that it is important that nurses become a resource in the decision-making process and conduct telephone or e-mail discussions with patients when they have questions and are in doubt.

Abstract

Objective: To clarify the relationship between QOL and coping behaviors for prostatic cancer patients’ voiding and sexual dysfunction during their first postoperative year.

Methods: Subjects were a convenience sample 76 men who underwent total prostatectomy. Data was generated from self-administered questionnaires.

Results: Among the subjects (mean age: 65.9 years), 78.9% had voiding dysfunction, 90.8% had sexual dysfunction and 69.7% had both voiding and sexual dysfunction. Significant positive correlations were observed between: (1) “addressing problems” (coping behavior) and two QOL subscales [(family social aspect (rs=0.44, p<0.01) and functional aspect (rs=0.35, p<0.01)]; (2) “use of external resources” and family social aspect (rs=0.26, p<0.05) and psychological aspect (rs=0.25, p<0.05) and (3) “active change of pace” and family social aspect (rs=0.34, p<0.01) and functional aspect (rs=0.25, p<0.05). Furthermore, significant inverse correlations were observed between: “addressing problems” and physical aspect (rs=-0.29, p<0.01); “self control” and physical aspect (rs=-0.31, p<0.01) and “manifest negative feelings” and functional aspect (rs=-0.40, p<0.01).

Conclusions: The relationship between QOL and coping behaviors in patients who underwent total prostatectomy and experienced postoperative dysfunction suggests the necessity of providing support for strengthening the coping behaviors of patients facing postoperative dysfunction in order to improve their QOL. More explicitly, it is important to provide support for the following: improving skills for interacting with various types of people in order to solve problems; improving skills for selecting various solutions that are available externally and encouraging a change of pace and managing complications that impact postoperative dysfunction.