AbstractThe purpose of this study was to understand the attitudes of nurses regarding supporting changing gears in hematopoietic tumor patients, and to obtain insights into this aspect of nursing. The participants were nine nurs es with five or more years of cancer nursing experience and three or more years of clinical experience in caring for hematopoietic tumor patients. Semi-structured interviews were conducted, and interview contents were qual itatively and inductively analyzed. The following seven main categories were recognized as points of awareness in nursesʼ attitudes toward changing gears in hematopoietic tumor patients: “ the state of patients and their families who face life and death,” “the existence of sorrow among patients and families,” “palliative treatment being confusing to patients,” “the sig nificance of the existence of family,” “the importance of the patient-nurse relationship,” “determination toward the realization of a desirable end,” and “irritation from not being able to support changing gears.” With respect to be havior, the following seven main categories were recognized: “solidifying determination to get involved at the end of a patientʼs life,” “encouraging decision-making processes and making good use of time,” “summoning the strength to face changing gears,” “supporting the patientʼs way of life,” “healthcare professionals finding a way for the patient to live life their own way,” “developing partnerships,” and “enhancing the readiness to support chang ing gears.” Nurses were able to understand the state of hematopoietic tumor patients who were in the midst of changing gears, and used the optimism and negative emotions gained from their understanding as a driving force to become more involved in the patientsʼ crossroads of life. Along with these efforts aimed at allowing patients to decide their own way of life, nurses provided an encouraging enviroment where patients could exert their power . These efforts led to the support of changing gears.

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AbstractThe purpose of this study was to evaluate changes in discomfort over 6 postoperative months in patients with lung cancer and determine the influence of this discomfort on their daily life. Data was collected from 41 patients who underwent surgery for non-small cell lung cancer (mean age 67.0 years) through a self-administered ques tionnaire and medical records. The results indicated that approximately 60% of patients experienced two or more symptoms of discomfort, even at 6 months after surgery. The most common wound-related discomfort was at the wound surface at the time of hospital discharge and inside the wound 1 month after surgery. In addition, choking was a common com plaint in > 50% of patients 1 month after surgery and its incidence did not change over time, although the influ ence on the patientsʼ daily life varied depending on the type of surgical procedure and smoking history. Further more, acute shoulder discomfort on the operated side remained in approximately 17% of patients 1 month after surgery, while coughing was experienced by approximately 50% patients at 6 months after surgery. These results suggest that surgeons should educate patients with lung cancer about the recovery process and possible postoperative discomfort and encourage self-monitoring to gain a better understanding of symptoms and promote self-care. Perioperative nursing programs should be established for these patients in the future.

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AbstractThe purpose of this study was to clarify yuragi as experienced by middle-aged patients who are undergoing ini tial treatment for Malignant Glioma. The subjects included five patients aged 40-50 years undergoing initial treat ment. Semi-structured interviews were performed, and the data was analysed using a Modified Grounded Theory Approach. Results revealed that while subjects were “surprised and frightened by the presence of a brain tumor”, they began treatment with the determination “to take a chance with treatment”. However, they eventually faced a crit ical live-threatening situation as serious as “collapse due to brain tumor”. Furthermore, they had “doubt regarding the value of their existence” came about when interacting with family and friends. They were agitated by “unrest due to changes in their appearance” and “difficulties identifying with other patients suffering from the same dis ease”- or “the bright and dark side of interacting with fellow patients”. Therefore, they were experiencing an identity crisis. Meanwhile, they were encouraged by the notion that “people suffering from the same disease are a ray of light and salvation”, having a positive effect on the “the bright and dark side of interacting with fellow pa tients”. They then found themselves feeling “positive about a future lifestyle” and revaluating their existence. Due to the fact that the danger of living with a brain tumor is negative, confusing and difficult, it brought about more complex and chaotic aspects to the patientsʼ experiences as they fought to maintain a healthy balance in the way they identify with themselves. There is an opportunity here for nurses to provide support to the families and also to the patients having mid dle-aged identity crises to help them live their lives properly, and to help meet their requests and desires.

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AbstractThe purpose of this study was to identify process of how breast cancer survivors undertake home^―based exer cise in daily life in Japan. This study was the prospective exploratory study for a 6 -month home-based walking program with 24 breast cancer survivors who have not exercised before. We instructed the breast cancer survi vors to try to find their own way of home-based walking exercise in their daily life with 8 weekly phone calls, and providing a pedometer. Data was collected by semi-structured interviews. Furthermore, we conducted semi structured interviews about exercise with 15 breast cancer survivors who have exercised already. Data was ana lyzed by a quantitative inductive approach. As a result, three patterns of process were found in a home-based walking exercise. The first pattern was that breast cancer survivors easily found their own walking style in their daily life immediately learning the benefits of walking. The second pattern was that it took time to find their own confident walking style. The third pattern was that they could not find their walking style because of concerns about symptoms or anxiety of cancer recurrence, and other problems. The key was for paterns to find their own walking style with confidence and walking belief in a daily life. It is very important that nurses know the process how breast cancer survivors can find out their own walking style in their daily life.

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AbstractThe purpose of this study was to clarify the changes in feeling associated with treatment in married men who undergo radical prostatectomy. Data from eight subjects were analyzed in line with a modified grounded theory approach. It was found that their initial reaction to the diagnosis was shock, thinking I don’t know what to do. Upon learn ing the characteristics of the disease and other factors, however, their feeling changed to one of relief: This dis ease is not such a big thing, followed by I’d like to carefully select the treatment or I’d like to have a radical prostatec tomy. Selection of treatment was affected by feelings of As a man, I’d like to avoid urinary incontinence and I do not want to give up my sexual function, later arriving at I would like to consider other treatments. I do not want to give up my sexual function changed to Sexual dysfunction may be unavoidable, which had an effect in a change of feeling to I am not the only one together with I’d like to have a radical prostatectomy. The preoperative feeling of As a man, I’d like to avoid urinary incontinence changed postoperatively from I want to do something about urinary incontinence to Urinary incontinence is not that troubling. This also included feelings of seeking help from oneʼs wife. In contrast, the subjects continued to have feelings of I won’t purposely bring up the topic of sexual dysfunction, indicating a desire to avoid talking about it with oneʼs wife. Preoperatively, there were feelings of I do not want to give up my sexual function, Sexual dysfunction may be unavoidable, and I will not be so preoccupied by sexual dysfunction. The preoperative feeling of I do not want to give up my sexual function and Sexual dysfunction may be unavoidable changed postoperatively to I am sorry to have lost my sexual function. The changes in feelings shown here suggest that nurses should provide support that promotes understanding of characteristics of this disease in patients and that helps them to understand urinary incontinence and take mea sures to deal with it.

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