Abstract

The aim of this study was to evaluate the efficacy of a care model that assists patients with aphonia resulting from total laryngectomy to master the esophageal speech method. A study using a pretest-posttest design with a nonequivalent control group was performed to compare two groups：a group of 10 patients who were treated under an applicable care model following approximately one week of esophageal speech therapy（application group）, and another group of 12 patients who were not treated under the same care model（non-application group）. In the application group, a survey about “therapy-related stress and coping”, “self-practice situation”, “number of vocalizations”, “psychological factors”, and “psychological adaptation state” were conducted after approximately one week of speech therapy and again after one month of care model application. Data were also collected in the same way from the non-application group without the application of the care model. Statistical analysis using the t test, the paired t test, and repeated measures analysis of variance found an interaction effect between “number of vocalizations” and the intervention as well as the timing of the survey. This is likely because patients in the application group performed an imagery technique and a muscle relaxation method to relax the neck and shoulders, making it easier to inject air into the esophagus and to generate voice. Patients also practiced speech at home after mastering an individualized self-practice technique through conversations with a researcher about the therapy. This likely also improved the “number of vocalizations”. The survey timing had a main effect on “practice frequency”, “self-practice duration”, and “mutually supportive coping”, suggesting that continuation of therapy at the esophageal speech training center contributed to the results.

Abstract

Objective：To investigate the actual status of and factors related to the quality of life（QOL）of patients in the recovery phase after surgical procedures for gynecological cancer.

Method：We conducted a survey among a group of 112 outpatients with gynecological cancer. The survey comprised questions related to postoperative complications, the satisfaction level in the patient’s marital relationship, and social support received. The Functional Assessment of Cancer Therapy-General（FACT‒G）, the short depression inventory, and the simplified menopausal index were also a part of the survey for assessing QOL levels. Descriptive statistics were obtained from the analysis and a comparison and correlation analysis was performed for FACT‒G results. Subsequently, a multiple regression analysis was performed for the items that were correlated.

Results：Of the 112 patients, 110 responded to the survey（98.2％）. The average FACT‒G score was 86.4±11.6. The FACT‒G score was significantly related to the relationship of the patients with their husband or partner（p＜0.05）, fecal excretion disorders（p＜0.05）, urination trouble（p＜0.05）, economic stability（p＜0.001）, and the change in social role（p＜0.05）. Multiple regression analysis revealed that social support（β＝0.42, p＜0.001）had a positive effect on QOL while depression（β＝0.51, p＜0.001）had a negative effect on QOL.

Conclusion：To improve QOL of patients in the recovery phase after surgical procedures for gynecological cancer, we suggest that a detailed analysis of the social support received by these patients and their depression levels is essential in addition to provision of nursing care support.

Abstract

The aim of this study was to clarify attitudes of cancer patients toward pain management, and examine nursing support that may promote patients’ subjective approaches. We performed a qualitative and inductive analysis of data collected through interviews and participant observation of 7 patients experiencing cancer pain. Patients faced difficulties such as “problems caused by pain”, “problems with sedative use”, and “problems with pain management support”. Some problems were solved by the patients’ approaches, which revealed the following：cancer patients experiencing pain conducted self‒directed approaches based on their own will through examining the causes of pain, the effects of pain treatment and management support, and these approaches require understanding of their pain and knowledge of treatment, as well as the presence of health care workers to support and ensure their approaches. The results indicate the need to provide pain management‒related information, educational support to enhance patients’ understanding of pain, and communication and continuous support which can motivate their self‒directed behavior.

Abstract

This study aimed to identify the recognition and coping behavior of spouses of breast cancer patients, from the time of cancer diagnosis to the completion of initial treatment. We conducted semi─structured interviews with 6 husbands whose wives had received a diagnosis of breast cancer and undergone initial treatment. The interviews were transcribed verbatim and analyzed using a content analysis approach to examine the husbands’ recognition and coping behavior. The study was conducted with the approval of the research ethics committees at our affiliations. As a result, 8 categories were extracted in relation to the husbands’ recognition during the period from diagnosis to the completion of initial treatment. These categories included：‘being shocked at the wife’s breast cancer diagnosis, which was unexpected’, ‘not taking the diagnosis too seriously if the wife’s breast cancer is in an early, treatable stage’, ‘being aware of the possibility that breast cancer could recur or metastasize, thereby requiring professional treatment’, ‘realizing that their emotions are affected by the wife’s condition’, and ‘finding it difficult to talk about breast cancer and associated health issues specific to women’. As for coping behavior, 4 categories were extracted. Among them were：‘collecting information on breast cancer and related topics’ and ‘making efforts to ease the wife’s mind’. The findings showed that the husbands of breast cancer patients watched over their wife and were careful not to disturb or provoke her, while feeling confused when faced not only with changes in their wife because of cancer and its treatment, but also with difficulties in understanding the wife’s feelings and situation. Husbands considered it their role to be there for their wife, and looked at possible ways to support her. This suggests the need to provide nursing assistance to help husbands enhance their ability to support their wife with breast cancer.

Abstract

The purposes of this study were to compare the difference between nurses’ cognition including impressions and psychological distance from patients with end-stage cancer（ESC）and those with non-end-stage cancer（N-ESC）, and to elucidate feelings and emotional labor involving these patients.

The sample was a convenience sample of nurses who provided nursing care to patients with both ESC and N-ECS cancer. A self-oriented questionnaire was delivered to 567 nurses who had 13 months or more of clinical experience. Each nurse was asked to choose two patients in the past or present, one with ESC and the other with N-ESC, and then asked to respond to questions about nurses’ cognition, feelings, and emotional labor involving these patients.

A total of 372 agreed to participate in this study. The nurses’ cognition about “friendliness toward their patients” and “feeling of psychological distance” was negatively correlated for the patient with ESC, and was positively correlated for the patient with N-ESC. The nurses showed emotional conflict between having an intimate relationship with the patients and feeling grief. In addition, the nurses responded that they did more “expression of caring”, and “suppressed expression” of emotional labor tasks for the ESC patients than for the N-ESC patients （p＜0.001）. These results suggested that the nurses provided pain relief care with sympathy. In addition, the nurses tended to hide their feelings and tried to show a smile on their face when they provide care to the ESC patients.

Abstract

The objective of the study was to clarify the issues related to the care of end-of-life cancer patients at home from the perspective of visiting nurses, as well as to clarify the measures implemented in response to the identified issues. The subjects of this study were 25 visiting nurses working full time at visiting nurse stations in the Kanto region of Japan and who have worked with at least 3 patients with cancer in the last year. About one-half of these nurses have 10 or more years of experience as a visiting nurse, and 19 nurses have been involved with 10 or more cancer patients. The issues related to the care of end-of-life cancer patients at home were identified by a semi-structured interview, and these issues were classified into the following 11 categories：doctors, family, care environment, nurses, feeling of burden experienced by the visiting nurse, workers of other occupations, patient, cooperation, operation of the visiting nurse station, adjustments of opinions between the parties involved, and economic burden of use. Furthermore, measures that can be implemented by the visiting nurses in response were clarified for each of the identified issues. The clarification of issues and the investigation of possible countermeasures will lead to high-quality care of end-of-life cancer patients at home, which then, as a result, will lead to the satisfaction of patients and their families.

Abstract

Aim：The aim of this study was to investigate the correlation between the quality of life of cancer patients and their partnership with their primary family caregiver, as well as the effects on their partnership.

Method：The subjects were 28 pairs（56 people）of both in- and outpatients and their families who received a “structured interview.”

The assessment was carried out using character, WHOQOL26 and the Family Communication Scale for both the patients and their families；Mental Adjustment to Cancer Scale for the patients；and Caregiver Quality of Life Index-Cancer for the families.

The criterion was the sum of the positive communication points, and the analysis was based on the Pearson product-moment correlation coefficient, and multiple regression analysis（p＜0.05）.

Result：The data analysis was done on 25 pairs of patient and primary caregiver（50 people）, and all of the patients had been receiving chemotherapy. The analysis revealed that partnership has a positive correlation with the patient’s QOL（r＝0.504, p＜0.05）and the family’s QOL（r＝0.615, p＜0.01）, which indicates there is a correlation between patient’s QOL and family’s QOL.

The impact factors on partnership were “the patient is pessimistic”, “the primary family caregiver’s burden”, “the patient’s negative communication”, “the primary family caregiver’s negative communication” and “the primary family caregiver’s support”.

Discussion：This study on the correlation between QOL for cancer patients and their primary family caregiver shows a great need for practical nursing, in which the patient and their family are considered as a system. The result also revealed that in order to encourage and build patient partnership with the primary caregiver, it is important for nurses to thoroughly understand the character of the patient’s family, which can influence partnership.

It is also important to give a helping hand to alleviate “patient’s pessimism” and “family’s burden”.

Nursing assistance plays an important role to mediate and establish communication between patients and their family and a support system for primary family caregivers should be established.

Abstract

The purpose of this study was to clarify how spouses of cancer patients experience social support, including positive and negative aspects, so as to identify how nurses can better promote their mental health. Data collected from 13 spouses of cancer patients through semi-structured interviews were analyzed by a quantitative inductive approach.

As a result, the following seven categories were extracted：‘awareness of the necessity of support’, ‘hesitation in receiving support’, ‘careful evaluation of support providers’, ‘deciding whether to accept support’, ‘understanding the usefulness of received support’, ‘emotions aroused by receiving support’, and ‘tailoring support based on the relationship with support providers’.

The results showed that some spouses are hesitant to accept support, some do not receive support, and some receive non-beneficial support. Through discussions, suggestions for nursing practice were extracted, including：（1）to suggest and provide appropriate support by understanding their hesitation in mentioning their needs, and to ask their resources to provide support on their behalf（2）to help increase the ability of family members to support each other and adjust their relationship,（3）to find potential support providers and explain what social resources are available for spouses not receiving enough support,（4）to understand that providing appropriate care to patients is actually useful for spouses, and（5）to mediate between spouses and non-beneficial support, as well as to increase spouses’ responsiveness when dealing with non-beneficial support.

Abstract

Recently, “cancer salons” have been established in Japan where cancer patients or their families can seek support. The purpose of this study was to examine the process of change experienced by cancer patients or their families who volunteered to participate as peer supporters in one such salon for a year or more．Data were collected using semi-structured interviews of seven volunteers and analyzed qualitatively.

The results showed that the experiences of volunteers can be divided into three main categories：anxiety about the work and role as a counselor, mental distress and experiences with cancer, and spiritual healing.

The volunteers faced difficulty in attending to visitors because of anxiety about their work and role as a counselor and their position, stress in interacting with others, etc. The volunteers were distressed because of their own experiences with cancer. At the salon, they got the opportunity to feel calmed by interacting with others. This led them to comfortably interact with the visitors and listen to their experiences, because they knew from experience that the visitors could feel comforted by being heard. Hence, they listened to the visitors’ experiences and kept a practical outlook that they couldn’t do everything to help them, which made them confident that they could comfort any visitor. Moreover, the number of visitors and repeat visitors increased, which proved that the salon met its aim. Through this process, the volunteers gained confidence as peer supporters and felt a sense of self-respect, which led to spiritual healing. However, the present conditions presented challenges, so they continued to explore ways to progress. In order to develop the salon, it appears necessary that medical workers continue to explore ways to progress with the volunteers and to exist as a partner.