Abstract

Our research aims at defining yuragi of patients who have been diagnosed with cancer for the first time and have undergone surgery. We conducted semi-structured interviews with 20 cancer survivors who had undergone a gastrectomy in order to obtain data regarding their feelings and experiences after the cancer diagnosis. The Modified Grounded Theory Approach is used for analysis, and the results are as follows. Yuragi of cancer survivors started from severe mental turmoil, “being overwhelmed by getting cancer diagnosis and treatment.” However, this was temporary. In order to stabilise their yuragi, they reclaimed their inner strength by first “trying their best to be treated and to recover from cancer,” then by “preparing themselves to face cancer,” and eventually by “finding hope in cancer treatments.” At the same time, they started “becoming envious of themselves before developing cancer,” when they thought about the past before yuragi had developed. While yuragi involving missing oneʼs previous health conditions presented a risk of reverting the patients back to violent mental agitation, yuragi involving ʻa hope to recover to the previous healthy stateʼ encouraged them to pacify such perturbation. Thus, yuragi as a whole is a spiral change which includes regressions and new indications. The process of going through various stages of yuragi also let the cancer survivors “realise the value of their remaining time.” This helped the patients to live “in the now.” After “being overwhelmed by getting a cancer diagnosis and treatment,” they experienced the stages of yuragi mentioned above, which were “trying their best to be treated and to recover from cancer,” “preparing themselves to face cancer,” “finding hope in cancer treatments,” and “becoming envious of themselves before developing cancer.” Therefore we conclude that each stage of yuragi accentuates every emotional shift patients have to go through.

Abstract

The objective of this study was to identify elements of how older patients with metastatic cancer become “nattoku” with treatment. In this study, nattoku was defined as “a state of cognitive and emotional acceptance of treatment” by older cancer patients. A qualitative descriptive study was employed, and semi-structured interviews were carried out with 20 metastatic cancer patients aged 65 years or older who were currently undergoing cancer treatment on their own volition. We extracted six elements that involve becoming nattoku with treatment: a strong intention to save oneself, certainty that the treatment was required in order to live, expectations of the potential of treatment, trusting that they chose the optimum treatment, the desire to give something back to those around them, and accepting to live life to the fullest, even while undergoing treatment. Our results suggested that the values of patients themselves were affected by their treatment status. Also, patients were not solely concerned with their own interests, but sensed the feelings of those around them and took them into consideration. A third characteristic suggested by our findings was their acceptance of treatment, and their attitude towards life and the way in which they have lived. This was characteristic of older patients with advanced illness who were in the final stage of life. These elements were fostered during the lives of older patients with metastatic cancer, and our study suggested that support that encourages patients to commit to a lifestyle and their current circumstances may help them become nattoku with treatment.

Abstract

The purpose of this study was to clarify the process through which female patients with breast cancer who had obtained a second opinion made an initial treatment choice, and to obtain suggestions for nursing practice. Data was collected from twenty-four subjects using a semi-structured interview and analyzed using the modified grounded theory approach. As a result, the process of initial treatment among the patients could be divided into two core categories: “doubts arising,” and “doubts being clarified.” At first, subjects experienced a crisis that “breast cancer will take their life,” then some underwent the stages of “questioning the value of life and the nature of womanhood,” “searching for information about a treatment to enable maintaining everyday life,” and “being overloaded with information and losing control.” At other times, subjects went through the stages of “not trusting this doctor” and “not being able to ask questions, understand anything, nor solve any problems.” Due to subjects experiencing “finding no decisive factors in making a treatment choice”, they reached the conclusion that “a second opinion is the only means” and through “being encouraged by surrounding people”, every patient decided to seek a second opinion. After receiving a second opinion, subjects experienced “being fully prepared because they understood clearly.” Although they sometimes went back to the stage of “questioning the value of life and the nature of womanhood,” and “not being able to ask questions, understand anything, nor solve any problems,” they eventually made a treatment choice by feeling “confusion removal through consultation with healthcare professionals” and “finding a satisfactory treatment.” Results suggest that nurses need to understand the reasons why female patients with breast cancer seek a second opinion, and the process by which they receive it. Helping patients find a treatment that allows them to maintain their everyday routines is especially important. Due to their involvement in the patientsʼ care on a day-to-day basis, nurses are in the best position to do so.