Purpose: Many people with a cancer-induced limited life expectancy choose to spend the remainder of their lives at home. Despite this, home mortality only accounts for about 10% of deaths among cancer patients. One factor is the burden on caregivers who must balance childcare and work. Thus, this study seeks to clarify the process by which primary caregivers take care of end-of-life cancer patients at home while also balancing work or childcare, as well as to examine nursing support.

Methods: Semi-structured interviews were conducted with 15 consenting primary caregivers who took care of cancer patients at home while working or caring for children. Given the focus of the analysis, three people were excluded; the remaining 12 participants were eligible for data collection. The participants’ data were analyzed qualitatively and descriptively using a modified grounded theory approach.

Results: The process began when the subject decided to provide end-of-life care at home and nurse the patient while maintaining the same lifestyle as before. Although this decision faltered when the patient's condition deteriorated, the caregiver reaffirmed their decision and continued to care for the patient at home because of the appearance and the thoughts of the patient.

Discussion: In terms of nursing support, when the patient’s condition is stable (with little need for nursing care), it is necessary to prepare via an explanation of the prognosis and the condition of the patient, or by adjusting work or childcare after deterioration of the patient's condition. Furthermore, in response to the spiritual conflict—between distress due to balancing work/childcare and nursing care and a renewed commitment following the deterioration of the patient’s condition—there is a need to display an attitude that is accepting of the patient’s state of mind and to identify their underlying needs.

Purpose: To clarify how testicular cancer and its treatment affects the sexuality of testicular cancer survivors'

Method: Participants were survivors with a diagnosis of testicular cancer who were visiting an outpatient clinic post completion of treatment. Semi-structured interviews were conducted for the qualitative and descriptive study. The interviews were recorded, and the contents were analyzed.

Results: The study participants included 11 testicular cancer survivors (mean age: 39.8 years). The results of content analysis were classified into six main categories in terms of the impact of testicular cancer treatment on sexuality. The categories included “I think I will lose masculinity due to changes in body image and inability to work”, “As I go through the treatment , I found that my masculinity didn't change”, “Concerns about spermatogenic function and the growth of my child who was born after my treatment”, “There’s no life-change by status of libido”, “ Entire life goes wrong by libido and motivation”, and “Reframe one's masculinity”.

Discussion: Participants experienced unpredictable changes in sexuality after discharge from the hospital, such as a diminished libido and motivation. Changes in sexuality only became apparent post completion of the treatment, and patients experienced difficulty dealing with problems concerning their sexuality. Therefore, it is necessary to provide testicular cancer survivors with resources concerning potential sexuality issues and the potential means for coping with such issues. Furthermore, it was also suggested that nursing support should be provided for reframe one's masculinity.

Objective: To clarify the stress coping methods of older adult patients undergoing oral anticancer drug therapy.

Methods: Twelve older adult patients undergoing outpatient oral anticancer drug therapy were included in the study. Data were collected by a medical record survey and semi-structured interview and were analyzed qualitatively and inductively.

Results: The patients were “strongly conscious of having cancer”, saying that they could not get rid of it, and they were committed to treatment by “consistently taking oral anticancer drugs”, encouraging themselves to “continue with their lives”. Patients prioritized having “time to forget about their cancer status” in their daily lives. At the same time, patients were “having doubts about the meaning of continuing oral anticancer drug treatment” and continued treatment by “trusting the medical staff with their treatment”. Patients “accepted that they had to live with the side effects”, learned how to “incorporate them as a new habit” so that they could work with them in their daily lives without difficulty, and gained a sense of control that they could “live with this physical condition”. Patients also worried about the economic burden on their families, saying, “I don’t want to burden my children and siblings” and “I have to bear the burden of medical expenses while my income changes” and took measures to avoid burdening their family, saying, “I will work on the treatment myself”.

Conclusion: While consistently taking oral anticancer drugs, patients experienced doubts about the meaning of continuing oral anticancer drug therapy. It is important to provide nursing care with regard to concerns about oral anticancer drug therapy and the range of activities and social roles possible in patients’ daily lives. It is suggested that self-care support that helps with the continuation of enjoyment and social roles in daily life and utilizes information from patients’ past lifestyles should be provided.

Purpose: This study aims to clarify fall-prevention behaviors and the conditions that influence such behaviors among cancer patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT)after their discharge from the hospital.

Methods: Semi-structured interviews were conducted with five patients who underwent allo-HSCT for hematologic malignancy, and a qualitative descriptive analysis was conducted based on the seesaw model for health behavior.

Results: Patients undergoing allo-HSCT cited several motives for following fall-prevention behavior, which could be classified into seven categories: awareness of their physical vulnerability after treatment, wary of the dangers of falling, reference to past experience of falling, awareness about the secondary effects of falling, awareness of their responsibilities in society, and two other categories. On the contrary, not following or being unable to follow fall-prevention behaviors was classified into five categories: inability to do so due to the effects of treatment, lack of interest in fall-prevention behaviors, lack of social support, and two other categories. The subjects differed in their independence in decision-making and acceptance of support from others. As social support, support from medical personnel, family, friends, and acquaintances, and use of public systems were recognized. Influenced by these factors, fall-prevention actions to be taken by patients after discharge from the hospital were classified into four categories: coping with symptoms, being careful when moving, adjusting to daily life activities, and exercising to restore physical function.

Conclusions: This study suggests the importance of nurses providing timely support to patients, when they encounter situations in which patients feel vulnerable, by communicating to them the benefits of following fall-prevention behaviors, referring to their past experiences, proposing specific methods in accordance with patients' goals, and offering constant support toward fall prevention.

The purpose of this study was to clarify the process through which female breast cancer patients of reproductive age make decisions regarding fertility preservation, and to obtain suggestions for nursing practice.

Semi-structured interviews were conducted with 30 female outpatients with primary breast cancer who had no previous history of cancer, were of reproductive age at the time of decision-making, underwent surgery as their first treatment, had been on cancer-drug treatment for between 6 months and 10 years (if they have started it), and had no metastasis or recurrence at the time of the interviews. A modified grounded theory approach was used for the analysis. Decision-making was thus broken down into a process with two core categories: “Choose the option of give birth or not that you did not need to decide yet by a time limit” and “I am beginning to redraw the map of my life”. The progress of the whole process was supported by “getting help from others”. In addition, the process of “Choose the option of give birth or not that you did not need to decide yet by a time limit” consisted of four patterns.

The following approaches were suggested to support patient decision-making: understanding how patients perceived the information provided about fertility preservation; predicting the pattern of the process leading up to the decision on whether or not to preserve fertility; providing individualized support according to patients’ experiences in that process; encouraging patients to express their various emotions such as ambivalence and confusion; providing information at the time of diagnosis in collaboration with physicians; providing continuous support when fertility is not preserved; and providing support when patients change their mind and wish to have a child.

The purpose of this study was to clarify clarify the process of primary breast cancer survivors continuing to work after the completion of initial treatment as a basis for discussing nursing practice to help these people continue to work. Fourteen adult female breast cancer survivors who had continued to work in the same workplaces as during outpatient treatment, were examined using the modified grounded theory approach to address the theme , focusing on . The survivors’ process of continuing to work was summarized into 6 categories, two concepts with similar interpretability to categories, and two core categories that outline both the categories and concepts: “work as a foundation” and “maintaining an appropriate distance from the job”. “Work as a foundation” represents a fundamental characteristic of work being important as a foundation for self-actualization, as many cases of breast cancer develop in the working-age population. “Maintaining an appropriate distance from the job” explains that breast cancer survivors’ process of continuing to work is promoted by exploring how to continue to work as a breast cancer survivor and by accepting new working styles, such as maintaining distance.

The aim of this study was to clarify the care that visiting nurses determined to be important for home care patients with one month to live and their families. The participants were seven visiting nurses who focus on providing end-of-life care at home for cancer patients. The method is a qualitative inductive study design using semi-structured interview, and the content of the interviews covers care that has been determined to be important for cancer patients with a month to live and their families.

Analysis results extracted six categories from a month to a week before death: “capturing the changes of the patients and their families and striving to reduce their nursing care burden”, “supporting preparation for a common understanding between family members and nurses”, “providing and managing medical care that takes into account the medical condition and life background of the patient”, “strengthening cooperation among various professionals”, “supporting safe and comfortable daily life based on the situation at the time of the visit”, and “respecting the patient’s thoughts and approaching them empathetically so they can be true to themselves until the end”. Seven categories were extracted from less than one week before passing to immediately after passing, with “acknowledging dying at home as grief care and providing emotional support for family members” newly discovered.

Home-visit nurses help reduce the burden of long-term care and comforting of patients by observing small changes in facial expressions as well as listening to statements made by patients and their families. Also, they are sensitive to aspects of the living situation, medical conditions, and prognosis of the patient. Finally, our study concludes that it is crucial to coordinate multidisciplinary collaboration in preparation for family support while keeping in mind the likely need for grief care at the time of the patient’s passing.

This study assessed the experiences of patients with lymphedema who underwent ICG fluorescence lymphangiography (ICG test) and lymphatic mapping. A semi-structured interview survey was conducted involving 18 patients with secondary lymphedema who underwent the ICG test and lymphatic mapping at a lymphedema treatment facility to investigate their experiences. The content of the interview was analyzed by qualitative inductive analysis.

As a result, the following 6 categories were extracted: “having faced my lymphatic condition”, “having been shocked to find that the lymphatic flow was different from what I had previously learned”, “having felt a sense of fondness for my lymph that is trying to flow”, “having seen a ray of hope in the darkness”, “having felt motivated to do things about it on my own” and “having understood what I should do to improve my lymphatic condition”.

The patients were shocked to see their lymphatic condition and how it differed from their prior knowledge; however, they were convinced by the consistency between their lymphatic condition and subjective symptoms. Observing a lymph that is trying to flow was hypothesized to provide patients with a sense of hope and care, and their desire to maintain their current health status increased their motivation for self-care.

The visualization of lymphatic flow using the ICG test and lymphatic mapping enabled patients to confront their disease, providing hope to patients with lymphedema for which there is no cure. This study suggested that visualization of the lymphatic condition is key to supporting long-term self-care of lymphedema.

We aimed to examine the life experiences of breast cancer patients with malignant fungating wounds.

Four patients with fungating wounds who were receiving chemotherapy in the outpatient department of a cancer treatment core hospital were interviewed concerning their life life experiences before their first contact with the doctor and also from the time of diagnosis through their treatment period. Data was analyzed using qualitative induction.

Patient experiences before their initial consultation were grouped into five categories: “Experiencing physical and mental deterioration”, “Attempting to control physical changes to continue daily life”, “Building a wall and hiding feelings inside”, “Accepting one’s fate and cherishing beliefs”, “Beginning to suspect that this could be cancer”. Experiences from the time of diagnosis through the treatment period were grouped into four categories: “Feeling easier to live than before treatment”, “Learning to depend on others and social resources”, “Feeling uneasy and anxious about treatment and side effects” and “Appreciating life and wishing to live better than before”.

On the basis of these results, the importance of proactive wound care to control odor and exudate founded on a respect for patients’ own beliefs, an understanding of the complex, tough experience and also an assessment of patient-family relationships to enhance social support were indicated.

The aim of this study was to explore the self-management process for the prevention of severe oral mucositis of patients receiving radiation for head and neck cancer (HNC), and to obtain suggestions for nursing practices. Semi-structured interviews and reviews of patient records were conducted with ten head and neck cancer patients and data were analyzed using the Modified Grounded Theory Approach.

The results showed that HNC patients sensed the change in the state of the oral cavity and matched the symptoms with the knowledge and the judgment of medical professionals to acknowledge the changing oral hygiene. The patients, depending on the severity of their symptoms, may have attempted to overcome xerostomia and mucositis, and used conventional methods and ideas to expand their knowledge of the course of symptoms and how to alleviate them. The patients recognized the ongoing therapy status as a positive state, and they had retained the ability to associate the changes with radiotherapy. These results suggest that the patients came to deeply understand the side effects after experiencing them. To promote their self-management, nurses need to know when symptoms appear and need to deliberately ask patients about symptoms.