Abstract

The purpose of this study was to determine the structure of the life redesigning experience of patients with neuropsychological disorder after glioma surgery. We conducted individual interviews with ten outpatients whose progress we were observing after surgery of the first glioma. We used A. Giorgi’s descriptive phenomenological method to structurally analyze their life redesigning experiences. Analysis revealed 16 components of life redesigning.

From the analysis four themes emerged from the viewpoint of “accepting and coping with the disability.” The overall structure of life redesigning was as follows. Patients first became conscious of “a sense of incongruity in their daily life due to their neuropsychological disorder.” They then “became aware of their disorder, felt bewildered, and were shaken with emotion.” They “searched for a way to live with the disorder” and found a new way of life. They finally “became able to think of the future realistically.”

Patients with glioma characteristically feel a sense of incongruity, when interacting with others in their community, after discharge. This neuropsychological disorder makes it difficult to correctly analyze their sense of incongruity. Thus, redesigning their life, within the context of their condition, after discharge is difficult.

Thus it becomes necessary for nurses to seek support and understanding about this neuropsychological disorder directly from family members and others in society key to the patient, so they can facilitate patients’ living within their communities.

Abstract

The purpose of this study was to clarify ways in which older people, in the course of cancer treatment, accept and coped with “living with cancer”. Data were collected, using semi-structured interviews, from 24 hospitalized older patients undergoing surgery, chemotherapy or radiotherapy. Collected data were analyzed with reference to Krippendorff’s content analysis method. The results showed that acceptance of “living with cancer” among older patients in the process of treatment could be divided into four main categories：‘letting cancer take its course without resistance’, ‘still wanting to complete one’s life’, ‘realizing one’s own fragility’ and ‘being overwhelmed with anxiety and bitterness’. Older people could draw on their long life experience to accept the threat of cancer without being overwhelmed by it, reinterpreting their sense of being at the limit of life to a sense of realizing the importance of life, as they “lived with cancer”. At the same time, older patients in the course of treatment “lived with cancer”, by receiving a double blow with the combination of decline due to cancer and decline due to ageing. The past experiences of older patients with cancer were thus important resources for reflecting on life and it seems that this may be linked to an opportunity for overcoming the threat of cancer. For nurses, focusing on the life history of older cancer patients may be an important way of obtaining information that can help older cancer patients “live with cancer”.

Abstract

Context：In Japan the incidence of many types of cancer is increasing and due to earlier discharges from the hospital, homecare needs are also increasing. End-of-life homecare is a recent trend；cancer patients may feel very burdened knowing their families are exhausted and anxious attempting to provide their homecare. However, there is no research about what types of difficulties the family caregivers have in managing patients at home.

Objective：The purpose of this study was to identify the difficulties encountering family caregivers in providing home-based terminal care for cancer patients.

Methods：Semi-structured interviews were conducted with seven family caregivers and five homecare providers（N=12）to identify the difficulties providing home care. Data were analyzed quantitatively using content analysis.

Results：The difficulties for caregivers consisted of two aspects and 15 categories. The first aspect regarded the relationship between patients and family；seven categories were identified：（1）difficulty managing symptoms and pain；（2）experiencing family's spiritual pain；（3）increasing caregiver burden；（4）caregiver’s psychological burden；（5）caregiver’s physical burden；（6）disruption of balance between caregiving and work and（7）relationship disharmony between caregiver and relatives. The second aspect regarded homecare providers and services；eight categories were identified as difficulties with：（1）beginning homecare in a way that the patient feels relief；；（2）creating a committed relationship with hospital-based doctor：（3）creating a good relationship with home-based doctor；（4）receiving sufficient support by home-based doctor；（5）creating a good relationship with home-visiting nurse；（6）complaints and confusion by home-helper：（7）receiving good home services and（8）anxiety about patient's funeral.

Conclusion：This study identified the difficulties facing family caregivers while providing home-based terminal care of cancer patients. The findings are useful for home-care providers to assess care needs for family caregivers who care for the cancer patient at the end of life.

Abstract

This aim of this study was to elucidate the process of changes in empowerment by conducting interviews for promoting empowerment with lung cancer survivors receiving chemotherapy. Three male patients in their 50s or 60s undergoing first time chemotherapy for lung cancer agreed to participate. We used a partially modified version of Chang et al.’s interview model, which was based on Freire’s theory of empowerment. Verbatim records of all recorded respondent interviews and researcher’s journal were collected as descriptive data, which was individually coded and categorized. Subsequently, aspects of the empowerment process that were common to all three participants were identified from the perspective of mutual changes among participants and the researcher. Participants were supervised by the qualitative researcher throughout the entire process.

The results showed five stages of change common to all participants：Stage 1）initiation of partnership with the researcher, Stage 2）helplessness associated with diagnosis of cancer, Stage 3）critical consciousness, Stage 4）recovery of self-efficacy and Stage 5）recovery of the power to undergo lung cancer treatment.

The results also suggested as with previous studies, critical consciousness was identified as an essential stage. In addition, the present findings suggest that mutual changes among cancer survivors and nurses that promote “new confidence” among cancer survivors are important even during the short period between diagnosis and acceptance of treatment.