PURPOSE: The purpose of this study was to develop a Japanese version of the Oncology Patients’ Perceptions of the Quality of Nursing Care Scale Short Form (OPPQNCS-SF) to allow patients with cancer to evaluate the quality of nursing care.

METHODS: The original English version of the OPPQNCS-SF was translated into Japanese by two translators. After pre-testing on four patients with cancer, the Japanese version of OPPQNCS-SF was administered to 93 inpatients who received hospital care in the Gastrointestinal Surgery Unit, Oncology Center. The reliability and validity of the questionnaire was assessed using Cronbach’s alpha test and retesting; convergent validity was measured using the Hospital Patient Satisfaction Questionnaire-13 (HPSQ-13), which evaluates inpatient satisfaction and exploratory factorial analyses.

RESULTS: A total of 89 inpatients answered the Japanese version of OPPQNCS-SF. Cronbach’s αvalue was 0.94 for the Japanese version. The test–retest reliability was ≥0.6 in 14 items, except for 3 items. Also, correlation coefficients were ≥0.7 between the Japanese version and HPSQ-13. Unlike the original, the Japanese version possessed a one-factor structure.

CONCLUSIONS: The Japanese version of OPPQNCS-SF is a valid and reliable questionnaire for patients with cancer to evaluate the quality of their nursing care.

The purpose of this study was to clarify the process through which fluctuating feelings lead to self-determination in patients with advanced/recurrent cancer who received the last standard treatment and to investigate effective nursing support.

Semi-structured interviews were conducted with 14 patients receiving outpatient chemotherapy and were analyzed qualitatively and descriptively using a modified grounded theory approach (M-GTA).

In the process through which fluctuating feelings lead to self-determination in patients with advanced/recurrent cancer who received the last standard treatment, the affected patients first are informed by a physician of the progression of their cancer and an explanation is given as to why their treatment is to be changed and then experience confusion and conflict due to the difference between physical sensation and explanation content. While continuing to receive the same treatment, they ‘wander in the dark’ while turning everything over in their minds. And then becomes a turning point. The patients take this opportunity to escape from their fluctuating feelings and follow the process of self-determination beginning with facing reality, i.e., the last stage of treatment.

Nursing support begins with recognizing that the patient's fluctuating feelings is the first step towards making an internal compromise. Furthermore, nurses should listen to the patient's narratives, encourage patient introspection while accepting them seriously, and prepare the environment so that feelings can be expressed adequately. In addition, it is important to support the strengthening of the relationship between patients and loved ones such as their families, and to construct social support systems such as peer supporters.

Understanding the hope-related experiences of lung cancer patients during postoperative recovery is expected to help support patients with maintaining enhancing their mental energy at the initial stage of treatment and to clarify valuable perspectives of support that influence quality of life.

The present study aimed to promote a better understanding of lung cancer patients and to identify requirements for physical and psychological recovery by examining their hope-related experiences during postoperative recovery.

A qualitative and descriptive study including a semi-structured interview　was conducted three to six months after surgery involving lung cancer patients during postoperative recovery. The hope-related experiences of 23 patients during postoperative recovery were classified into the following seven categories: even if the patients had lung cancer, they were able to undergo surgery, the patients live with their remaining lung, the patients hope to overcome cancer and live positively, the patients can return to their old lifestyle even if operated on, current symptoms will be cured, the patients hope their loved ones recognize that they are trying their best, and the patients live in a reality where their joy is restrained. For cancer patients, being able to undergo surgery means a cure for cancer and the possibility of continuing to live. As “surgical” treatment is associated with definitive therapy for most patients, the fact that they were able to undergo it helped them recognize the possibility of continuing to live and recover, as well as motivated them to put forth the effort for self-help, which increased their sense of hope.

Objectives: To clarify factors that affect differences in the information needed by patients with gynaecological cancer during different phases of treatment in order to obtain suggestions regarding information support for patients who have been diagnosed with a gynaecological cancer and are receiving treatment.

Methods: An anonymous postal questionnaire survey was carried out among patients with gynaecological cancer who belonged to the A association of cancer patients. The questionnaire covered 21 items based on previous research. Differences in the information needed by patients with gynaecological cancer at the time of diagnosis and during and after treatment, and the influencing factors, were statistically analysed.

Results and Discussion: The questionnaire was sent to 209 women; 115 replied (55.0%), of which 111 replies (96.5%) were usable. Among the 21 items of information needed by patients with gynaecological cancer, 20 differed in need depending on the phase of treatment, with the exception being ‘psychological support’. At the time of diagnosis, patients with gynaecological cancer especially need information relating to treatment of the disease and economic aspects; during treatment, they especially need information relating to complications and adverse reactions due to treatment; and after treatment, they especially need information relating to self-care and recurrence. Ninety percent need ‘psychological support’ through the entire treatment period, indicating that support is needed continuously from the time of diagnosis onward. In addition, young patients need sexual information during all phases of treatment, moreover, young patients who desire to have children especially need it at the time of diagnosis. Therefore, it is necessary to provide information considering the age of patients with gynaecological cancer and whether they desire to have children.

Conclusions: 1. The information needed by patients with gynaecological cancer differs depending on the phase of treatment.

2. The need for sexual information differs depending on the age of patients with gynaecological cancer at diagnosis.

Aim: To elucidate sexuality-related experiences among women who received radiation therapy to the pelvic area, and their coping behaviors.

Methods: Among nine women, six with cervical cancer and three with anal canal cancer, who received radiation therapy to the pelvic area, we conducted semi-structured interviews on issues regarding sexuality, including changes in their sex life post treatment and coping behaviors. The data were analyzed using a qualitative and inductive approach.

Results: Sexuality-related experiences of the female cancer patients were classified into six categories: suffering from mucous membrane disorder of the vagina, intestine and bladder for several years after treatment not wanting to be seen naked due to changes in the lower body caused by the treatment having no desire for sexual activity due to vaginal pain or bleeding, and awareness of inability to get pregnant, and other two categories. Their coping behaviors to deal with these experiences were classified into five categories: seeking guidance on taking care of the treated area even during treatment to minimize damage from radiation, trying to think that pubic hair removal and darkened skin around the buttocks and abdomen should be accepted, and prioritizing one’s family over one’s physical condition to fulfil one’s role, and other two categories.

Discussion: Pain and suffering caused by adverse events of radiation to the pelvic area influenced the patients’ body image and relationships with surrounding people. Our findings suggested that it is important for nurses to understand patients’ experiences that may not be apparent and establish supportive relationships that encourage patients to express themselves before providing them with appropriate information and self-care assistance according to the onset of adverse events.

The purpose of this study is to clarify how cancer patients’ anxieties shift along with nursing supports, which start being provided when the “Cancer Patient Personal Counseling 2” fees are determined and their diagnoses and therapeutic plans as outpatients are decided. The research objects are cancer patients who started receiving nursing supports when their diagnoses and therapeutic plans were decided. Their STAS-J scores were assessed when the supports started, while they were being provided, and when they ended. The patients’ data, the status and the situation of them and their families, their STAS-J scores and the scores reflecting their “anxiety shifts” with the influencing factors were gained retrospectively from their medical records. Their overall STAS-J scores were tallied first, and the score changes showing their “anxiety shifts” from when their nursing supports started to when they ended were evaluated based on the Wilcoxon signed-rank test and the Fisher’s exact test (with the significance level 5%). Also, the STAS-J score changes were visualized in a line chart for the quality assessment of the influencing factors. Sixty-two patients participated, including 11 men and 51 women with an average age of 55.9 (31–76). Lowering of the anxieties was identified among 85.5% of them, with significant differences in their STAS-J scores between when the nursing supports started and ended (p<0.001). There were no significant differences per attributions of the patients. Four types were identified among the changes, including the lowering-only type identified in 64.5%, which confirmed the assumption that being able to decide on their own treatments and starting taking them could be the lowering factors. During the periods when diagnoses and therapeutic plans were decided, many patients and families showed anxieties. It proved the needs for supporting them especially at the time of their decision-making, for identifying their anxieties, and for arranging early inter-professional supports.

Aspiration pneumonia is a common complication during the management of head and neck cancer, especially with chemoradiotherapy. Once aspiration pneumonia develops, it can lead to forced interruption of therapy. The purpose of this study was to determine the process of patients undergoing chemoradiotherapy for head and neck cancer until they developed aspiration pneumonia. This was a retrospective study of 37 patients who underwent chemoradiotherapy for head and neck cancer. We collected data on treatment, physical symptoms and nursing care from medical and nursing records. The collected data were analyzed by qualitative description, and a category relation diagram was created for the aspiration pneumonia and control groups to clarify the features in the aspiration pneumonia group. There were six patients in the aspiration pneumonia group and 31 patients in the control group. We found that the processes from the category relation diagram for both groups were: “oral mucosal adverse event in the soft palate and tongue border” to “use of painkillers because of progression of pain symptoms” and “use of medical narcotics because of progression of pain symptoms.” The processes for the aspiration pneumonia group were: “repeated increase in medical narcotics dose due to pain relief,” “dealing with lowering of consciousness level because of onset of delirium’’ and “use of muscle relaxant agonists.” Patients who had “repeated increase in medical narcotics dose due to pain relief” against pain caused by progression of oral mucosal adverse events required “dealing with lowering of consciousness level because of onset of delirium” and psychotropic drugs used for delirium treatment. “Use of muscle relaxant” caused relaxation of the esophageal sphincter. It was thought that aspiration pneumonia developed. To prevent the occurrence of aspiration pneumonia, it is important to focus on pain control before shifting to the use of medical narcotics to prevent the occurrence of delirium.

Objective: This study aims to clarify the relationships among perceived uncertainty, adaptation and QOL of newly diagnosed breast cancer patients using covariance structure analysis.

Methods: A questionnaire survey was conducted among 147 breast cancer patients. Patients' perceived uncertainty was assessed using the Universal Uncertainty in Illness Scale (UUIS), and their adaptation and QOL were evaluated using POMS-TMD and QLI-CV respectively. A model was made with reference to Mishel's model of perceived uncertainty in illness.

In this model, the uncertainty perceived by a patient under the influence of antecedent factors affects her adaptation and QOL. The model was analyzed using covariance structure analysis.

Results: All respondents were female, and their average age was 52.6 years (SD=9.9). The model selected in this study indicated that uncertainty affected by certain antecedent factors (e.g., pain, number of years of schooling, availability of consultation with a doctor or a nurse) directly influenced adaptation and QOL. In addition, uncertainty affected by antecedent factors affected QOL via adaptation. (GFI= .967, AGFI= .924, CFI= .968, RMSEA= .066).

Implications for practice: Discussion: Because the risks of recurrence and metastasis cannot be eliminated for breast cancer patients, their uncertainty is said to persist for life. The model showed that patients’ perceived uncertainty prevented them from adapting to their circumstances, resulting in a decline in QOL.

It was also suggested that nurses' support helped to reduce perceived uncertainty. Continual support by nurses is essential for breast cancer patients to control their perceived uncertainty and to maintain their QOL.

We aimed to investigate the experiences of family members of outpatients with end-stage cancer who are receiving anticancer medication therapy. In addition, we aimed to obtain suggestions for improving nursing support, which is necessary to assist family members of patients with cancer.

Eight family members of patients who underwent outpatient medication therapy participated in semi-structured interviews. A qualitative content analysis approach was used to analyze the data.

Based on the interviews, six categories of family experiences were recognized, which are as follows: (1) having great expectations of the efficacy of anticancer medication therapy, (2) prioritizing the patient’s mental and physical well-being to improve the patient’s condition, (3) having concerns regarding the progression of cancer and uncertainty about the choice of treatment and location, (4) adjusting their lifestyle to support the patient, (5) having conflicts between expectations of a prolonged life and the reality of death occurring in the near future, and (6) gaining positive thoughts and experiences during times when the patient and their family supported each other.

Four types of nursing support were identified, which are as follows: (1) understanding the emotional state of families who want the outpatient receiving anticancer medication therapy to live for as long as possible and encouraging the families to believe they have done what they could despite the time constraints, (2) effectively utilizing the waiting time of families during outpatient medication therapy and creating an environment where families can conveniently consult the medical personnel, (3) maintaining the mental and physical well-being of the family, and (4) ensuring the patient’s view of death is realistic and encouraging the family members’ desire to provide emotional support while continuing anticancer medication therapy.

The purpose of this study is to explore the experience of breast cancer patient’s distress of telling the disease to their children through dialogues based on Margaret Newman theory. The participants were breast cancer patients rearing children.The researchers interviewed the patients based on hermeneutical dialectical approach. As a result, this study showed five phases through which participants recognized their own patterns and identified found out a new direction. First, the participants entered the phase of “expressed distress caused by the morbidity of breast cancer about how to tell their children about their disease”, and then, the phase of “recognition of their patterns.” Subsequently, the participants went through the phase of “perception of existence of person suffer together and search for new coping methods” and into the phase of “asking themselves whether or not to tell their breast cancer from their child’s perspective and expressing their will.”Finally, the participants entered the phase of “their transformed perception of their life as a cancer survivor.” Through dialogues based on Margaret Newman theory, this study shed new light on the experiences of patients who overcome distress concerning telling the disease to their child under their own power, and find the meaning in their way of life as a cancer survivor.

This study aims to elucidate the challenges facing spouses of patients with gynecologic cancer who repeatedly receive chemotherapy, as well as their coping process. We conducted semi-structured interviews with 10 spouses of patients with uterine or ovarian cancer who received 2 or more courses of chemotherapy.

Through an analysis employing the Modified Grounded Theory Approach, we identified 24 concepts classified under 6 categories as below. Although spouses were willing to offer emotional support to their wives, this proved challenging due to gender differences. Thus, spouses “repressed their feelings as they witnessed their wives suffer” while they continued supporting their wives. During first-line chemotherapy, spouses “sought ways to anticipate the future” and strived to “care for their wives on their own”. Eventually, however, they began “seeking ways to avoid mutual exhaustion”. During second-line chemotherapy, although spouses “supported their wives’ continuation of treatment”, they also acknowledged that the treatment may become ineffective in the near future and “lived on as couple while being conscious of the limits of therapy”. These results illustrate the need for nurses to understand the difficulties that arise because of treatment timing and gender differences, as well as to demonstrate the willingness to work together for a solution. In addition, these results highlight the importance of emotional support such as affirming the spouse’s efforts.

To clarify cancer survivors’ process of playing to their strengths to fulfill their lives after experiencing recurrence/metastasis, semi-structured interviews were conducted with 14 cancer survivors who had been told that the disease recurred/metastasized and were receiving treatment at the time of the study. The obtained data were analyzed using the modified grounded theory approach.

Such a process in these cancer survivors was summarized into “overcoming distress due to uncertainty” and “living a limited life with mindfulness”.

While facing “distress due to cancer”, the cancer survivors relied on “their belief in life”, and made “effort to survive”, which provided them with a basis for maintaining self-confidencein doing their best. Maintaining such self-confidence and using their “resistance to deal with the menace of cancer” and “strength to step forward” were their measures for “taking their mind off cancer” and “overcoming distress due to uncertainty”.

Even in the midst of “distress due to cancer”, the cancer survivors used mindfulness to develop by “estimating their remaining lives”. Using their “ability to protect their daily lives”, in addition to “thoughts to live a life without regrets”, they developed “insight into feasible activities”, which led to “self-recognition”. Supported by such recognition, they established, consequently “living a limited life with mindfulness”.

The purpose of this study was to explore the nursing care in delirium care by clarifying the factors that impede communication with delirium patients. Taking nursing records of dealing with delirium patients as descriptions of the experiences of the nurses and patients, we performed a qualitative analysis through descriptive phenomenology to clarify the meaning of their experiences. Since the consciousness of nurses struggling with delirium care is mediated by their responsibility for safety management, their attention is directed toward the symptoms and treatment of delirium. Hence, they unknowingly look upon delirium patients as “things” that cannot communicate verbally, making the patients’ complaints appear meaningless. These factors impeded communication with delirium patients. On the other hand, when nurses practiced care by paying attention to the suffering of delirium patients and encouraging them to talk, they became calm and composed, and consequently were able to sleep without drugs. Since the experience of a delirium patient involves suffering in which the patient is confused about time, place, and the presence of oneself or others, the nurses’ awareness of the patients’ suffering and their encouragement by listening to their stories reassured and calmed the patients. In the field of cancer medical care, delirium care involving “the potential of nursing” that does not include prediction, prevention, medication, or physical restraint is strongly suggested.

The purpose of this study is to reveal what kind of influence skin care instructions given by nurses has on skin symptoms, water content of stratum corneum ,QOL ,self care of patient who are receiving chemotherapy by Cetuximab which is an anti EGFR antibody preparation.

The subjects were 10 patients with colorectal or the head and neck cancer (four patients in the control group, six in the intervention group) using the anti EGFR antibody preparation and receiving outpatient chemotherapy. we considered the patient selection shouldn’t be unbalanced in their disease and gender, The control and intervention groups were then selected in order. Skin care instructions was given based on the skin care day book the researcher made for the intervention group and evaluated them by using EQ-5D, moisture checker, and CTCAE. As a result, we could see increasing water content of stratum corneum and reduction Grade of CTCAE of a steroid user. Additionally, the improvement of the self-care ability could be seen from the interview for patients. It is suggested that the skin care intructions for patient giving anti EGFR antibody preparation is effective for their water content of stratum corneum ,skin symptom, and improvement of the self-care ability.

Patients undergoing chemotherapy as outpatients have reported painful side-effects at every session of chemotherapy. However, while they experience distress, they keep trying to return to their normal lives or lives before the treatment. In this study, we aimed to clarify such life adjustments and thoughts of outpatients undergoing chemotherapy to prepare them for the next treatment cycle. We conducted a semi-structured interview for 11 outpatients who did not have a recurrence and metastasis and underwent more than 2 cycles and less than 6 months of chemotherapy, with a performance status of 0–1, and then conducted a qualitative and inductive analysis. With regards to life adjustments, the following 5 categories were extracted ; <have a unique feeling at the beginning and end of experiencing side-effects> ; <investigate strategies to alleviate distress from side-effects> ; <prospects based on past treatment experiences> ; <prioritize the physical condition of patients> ; <reduce worry among family members>. With regards to the patients, the following 6 categories were extracted : <I do not know how to deal with the side-effects> ; <I feel sorry for my family> ; <I will complete the treatment to keep myself alive> ; <I am supported by my family, friends and colleagues> ; <I am satisfied even though there are things I can do fewer than when I was healthy> and <anxiety about recurrence>.