Abstract

【Purpose】Secondary lower limb lymphedema （SLLL） is a serious complication caused by lymphadenectomies occurring with gynecological cancer. SLLL preventive education has garnered attention in recent years. The present study fills a gap through a qualitative analysis of the impressions of women who were educated about the importance of continued lifelong self-care.

【Method】Semi-structured interviews were conducted following a lymphedema prevention class at a gynecological ward. Interview data was qualitatively analyzed using an inductive approach. This study was approved by our own Ethical Committee.

【Finding】Fifteen patients aged from their thirties to sixties participated in the study. Four primary categories emerged from the analysis. The four primary categories are as follows, “The burden of continuing lifelong self-care,” “Uncertainty about one’s ability to sustain self-care behaviors and whether it was even possible to do so,” “Persuading oneself to engage in continued self-care,” and “Thinking about practicable self-care in SLLL prevention.”

【Discussion & Conclusions】The category “The burden of continuing lifelong self-care”, means “ prognosis uncertainty.” The other category, “Uncertainty about one’s ability to sustain self-care behaviors and whether it was even possible to do so,” means “medical uncertainty.” The patients evaluated two uncertainties and began thinking of engaging in self-care to prevent SLLL. These results suggest the necessity for healthcare professionals to acknowledge the uncertainty gynecological cancer survivors face and to support them in taking the lead with regard to thinking about and incorporating self-care into their daily lives.

Abstract

The purpose of this study is to illustrate the value of moisturizing cream in preventing the acute skin side effects induced by radiotherapy and helps nursing care. Thirty three patients with radiotherapy for head and neck cancer from January 2011 to September 2013 were enrolled with their consent. Patients were ineligible if they had undergone tracheotomy or they had not had whole neck field radiotherapy excluding larynx cancer patients. Using the envelope method, we divided patients into those using moisturizing cream (n=16) those not using cream (n=17).

The moisturizing cream was applied gently twice a day, after the radiotherapy treatment and before going to bed. During treatment patients underwent daily subjective and objective assessments. We classified these assessments from 0 to 6 step by step and totaled these scores.

We analyzed these scores using a statistical method (Mann‒Whitney U test).

As a result, the patients using moisturizing cream displayed a delay in appearance symptoms and significant lower scores subjective and objective assessment than the patients not using moisturizing cream (60Gy: 67.7 vs. 88.4 p＜0.01, 66Gy: 83.9 vs. 112.3 p＜0.01, 70Gy: 94.5 vs. 127.3 p＜0.05).

Using moisturizing cream prevents the worsening of radiation dermatitis and relieves the symptoms induced by radiation dermatitis.

Abstract

【Object】The purpose of this study is to explore what changes appear about the patients’ own way to live, if advanced lung cancer patients of middle age and nurse were able to follow together pattern recognition based on the M. Newman theory．

【Method】Subject is lung cancer patient that physicians predict difficult to continue the curative treatment or he have distant metastases．The researcher conducted nursing intervention with reference to previous studies based on the M. Newman theory．

【Result】Patients revealed five aspects and followed a rapid process of change．

【Conclusion】This study was able to suggest that advanced lung cancer patients of middle age in the process of pattern recognition found meaning and self-insight through living with lung cancer and they can express how their hopes for the future.

Abstract

The purpose of this study is to clarify the needs and related factors of outpatient colorectal cancer patients using portable disposable injection pumps for chemotherapy. The authors implemented a postal questionnaire survey of 668 patients with colon cancer who were undergoing outpatient chemotherapy. Responses were received from 298 subjects, all of which were suitable for analysis. Analysis was comprised of simple calculations, chisquare testing and logistic regression analysis. The written questions were subjected to categorization of the details provided.

Such chemotherapy treatment interferes with the activities of daily life, particularly in the areas of hygiene and work, with side effects and the physical impact of the pump being contributing factors. In all, 60% of respondents were concerned about living with their pump attached, and the factors related to the concerns included “young age” and “Not the person doing most of the housework.” In many cases, respondents were concerned about protecting the tubes and needles from damage, etc. A total of 70% completed their injections at home, with approximately 30% of these finding difficulties such as the tape being difficult to remove, that they were afraid of handling the needles, etc. Altogether, 40% of respondents had experienced some sort of problem during injection, with more than half of these reporting skin symptoms in the area where the tape was fixed. Factors involved in experiencing problems included “Female,” “Having the disease for a long time,” and “port location : chest.” The needs ascertained from the free responses included “Would like needle insertion that hurts less and improved tape fixing,” “Would like an improved method of attaching pump,” and “Problems with and concerns about the port,” etc.

It is important to ensure the provision of information and guidance regarding treatment and lifestyles prior to the initiation of treatment. Even patients used to treatment may have skin trouble or other problems, or experience lifestyle issues. For these reasons, it appears that ongoing support and access to advice are required.

Abstract

Purpose : The purpose of this study was to clarify visiting nurses’ awareness of obstacles to continued home care for terminal cancer patients.

Method : Questionnaires on the 90 potential obstacles grouped into 12 domains were conducted for full-time visiting nurses who worked for 24-hour home nursing stations in the Kanto region, and the percentage of nurses who recognized each of the potential obstacles to be an actual obstacle was calculated.

Result : Obstacles identified as actual obstacles by high percentages of the nurses included a lack of understanding of home care for terminal cancer patients by physicians and care managers, problems in the home nursing systems, and the financial burden on patients and their families. The results of the study indicated that the following were important for continued home care for terminal cancer patients.

Discussion : Physicians, care managers, and visiting nurses must understand the characteristics of home care for terminal cancer patients and improve knowledge and skills in alleviating symptoms. Moreover,visiting nurses must coordinate closely with physicians and care managers. The financial burden on patients and their families must be eased.

Abstract

Purpose : In the course of lung cancer treatment, the doctor at some point must disclose “bad news” to the spouse of a married patient. In this research the stress reaction of the spouse was analyzed at three points in time: When cancer was diagnosed and announced; When recurrence of the cancer was found; and when positive medical treatment was to end. To offer the best possible nursing assistance, how badly the spouse was affected by the news was determined. Factors that may have affected the mental reaction that he/she displayed were also examined.

Methods : Data was collected after disclosures of “bad news” and from the self-account questionnaires which the spouse had filled in. The items therein contained his/her mental stress reaction and the degree of satisfaction in their marital relationship.

Results : Of a total of 44 spouses who took part in the study, about two-thirds of them had their own health problems. Although their mental stress reaction showed a more negative tendency at the initial diagnosis of cancer than the subsequent disclosures, there was no significant difference between the timing of bad news. “Degree of marital satisfaction”, “state of spouse’s own health”, “financial uncertainty” and “family make-up” were the main factors that influenced a spouse’s mental stress reaction. As to how these factors affected his/her mental status changed somewhat depending on the phase of the cancer.

Conclusion: Nurse is lung cancer patient’s spouse will help alleviate for the mental stress. It is to nursing in consideration of the factors varies depending on the stage is important.

Abstract

The aim of this study was to clarify the process, from acceptance to the building of new relationships, undertaken by cancer patients in a university hospital informed that they were being transferred to a regional medical support hospital for continuation of active treatment. We also sought to obtain insight into nursing practices that would support this process.

Subjects comprised 13 gastrointestinal cancer patients who transferred from University Hospital A to Regional Medical Support Hospital B. Semi-structured interviews were conducted after the transfers, and were analyzed using a modified grounded theory approach. Results showed that the process went from “the experience of overcoming mental conflict and preparing for the new environment” before transfer to “the experience of living in a new environment while being mindful of interactions with others” after transfer. Experiences before transfer started with “bewilderment at the transfer notice, which came like a bolt from the blue”. After transfer, patients experienced “confusion in entering a new, unknown environment” accompanied by anxiety about medical professionals they were meeting for the first time; however, the welcoming attitude of nurses allowed them to begin making steps forward in creating bonds with creating bonds with others. As a result, from the turning point of recovery in terms of both physical and social states, they experienced “deepening connections with others,” which were subsequently reinforced.

In both processes, “trusting the treatment based on the desire to survive” was the apparent method of battling cancer. One characteristic of cancer patients told they were being transferred was that they “thought this meant the cancer could no longer be cured” and descended into a negative spiral. It is thus important that nurses recognize such thought processes in patients to ensure psychological stability and help prevent patients from falling into a negative downward spiral. An environment that facilitates acceptance of and adaptation to transfer must also be created, as this was thought to help promote a system of complete community medical care.