Purpose: To identify the professionalism of certified nurses in breast cancer nursing, which is formed by their clinical nursing practice.

Methods: The study participants were certified nurses in breast cancer nursing who had been certified by the Japanese Nursing Association’s certification system. Data were collected by semi-structured interviews and inductive content analysis was conducted.

Result: There were 17 participants. The professionalism of certified nurses in breast cancer nursing was summarized as: recognition of the essence of breast cancer nursing, excellent breast cancer nursing practice, contribution to the cultivation of breast cancer nursing, contribution to organizational development, maintenance of an attitude appropriate for professional nursing, efforts to improve and self-improvement, and recognition of the value of breast cancer nursing.

Discussion: The professionalism of certified nurses in breast cancer nursing is formed, fostered, and renewed through their accumulated experience as breast cancer nursing professionals, based on the professionalism of the nursing profession as a whole. In order for these nurses to form and maintain their professionalism as breast cancer care develops, the support of the work environment and nursing management, coupled with their own efforts, will contribute to their professionalism. In order to deepen awareness of the professionalism of these nurses among health care providers and those who are the target of nursing care, it is important to visualize and communicate the significance and usefulness of these nurses to society.

Purpose: To clarify how wives prepare for their husbands’ loss of voice after they undergo a total laryngectomy.

Methods: A qualitative-descriptive research design was adopted to conduct semi-structured interviews with five wives of men who had undergone a total laryngectomy at least three months prior to the interviews. The study analyzed how these women prepared for the husbands’ loss of voice prior to surgery and classified their responses.

Results: The results indicate that, prior to surgery, these wives first went through the stages of “understanding and recognizing their husbands’ impending loss of voice” and “preparation for surgery.” They then experienced the conflicting emotions of “unperturbed acceptance of their husbands as they were headed for surgery” and “acceptance of themselves despite anxiety” which are deep feelings of trying to accept the reality of the situation. Thus, the study depicted changes in how the wives, as they experienced these two emotions, prepared themselves for their husbands’ loss of voice.

Conclusion: A total of nine categories extracted with respect to how wives prepare themselves suggest the importance of observing the couples’ situations by focusing on their bond as husband and wife and providing support so that they can look ahead.

Purpose: The purpose of this study is to clarify the significance of “eating” for terminal cancer patients.

Research Method: Semi-structured interviews were conducted with terminal cancer patients admitted to the palliative care unit in prefecture A. Patients were analyzed using the Krippendorff content analysis method from Krippendorff.

Result: The subjects were 10 people between 40 and 80 years old. Their scale of performance statuses were PS1 to PS3. All subjects had food intolerance symptoms. Seven core categories were formed to support the significance of “eating”: “Eating is a natural activity for all humans”, “Eating brings happiness”, “Eating deepens family ties”, “I want to eat whatever delicious food I want”, “I want to continue eating to survive”, “I feel distressed that I cannot eat” and “I know that my life is limited and accept that I can no longer eat”.

Discussion: It is thought that terminal-stage cancer patients reinterpret “eating” as a natural activity from the standpoint of people and consumers, and that while they struggle with the meaning of “eating” as “living” and “enjoying” and with their inability to eat, they accept their inability to eat, which allows them to prepare for death.

Conclusion: It was suggested that support for eating according to their significance of “eating” may lead to the improvement of the patient’s spiritual care.

Background: Patients with pancreatic cancer show moderate to severe weight loss in 66-84% of cases. This suggests that, pancreatic cancer patients experience eating-related distress, which is presumed to affect their quality of life (QOL). Therefore, the purpose of this study was to characterize the health-related QOL in patients undergoing pancreatic cancer chemotherapy and to examine its relationship with nutritional indices and eating-related distress.

Methods: A self-administered questionnaire and medical record survey were conducted with 33 pancreatic cancer patients undergoing chemotherapy after obtaining their informed consent. The survey items included basic information, medical-related information, Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep), a disease-specific QOL Assessment Scale for Patients with Hepatobiliary and Pancreatic Cancer, and nutritional indices. Analysis was based on the mean value of FACT-Hep, which was classified into high and low groups, and statistical group comparisons were made with respect to the association with other variables.

Results: The mean FACT-Hep was 117.1±23.7, and 72.7-78.9% of subjects had more than mild nutritional disorders. Comparison of the low and high FACT-Hep groups showed no significant differences in nutritional indices. The low FACT-Hep group showed significantly higher rates of feeling “Although I know that I have to eat enough, I cannot do it.” (p=0.033) and “I am burdened by the meals that my family serves me” (p=0.009) in the eating-related distress items.

Conclusions: Our results suggest that symptom management based on FACT-Hep assessment and efforts to alleviate eating-related distress are necessary to improve the quality of life of pancreatic cancer patients.

The purpose of this study was to identify facilitators and inhibitors of continued employment among gastric cancer patients who are working while receiving adjuvant chemotherapy. Semi-structured interviews were conducted with eight gastric cancer patients who were working while receiving postoperative chemotherapy, and were analyzed qualitatively and inductively. Five categories of disincentives to continue working were identified: “changes in life due to gastrectomy”, “distress due to side effects of adjuvant chemotherapy”, “difficulty adjusting to social life due to treatment”, “concerns about continuing to work due to treatment”, and “lack of information necessary to continue working”. Four categories were identified as factors that promote continuation of employment: “self-care behavior aimed at balancing treatment and employment”, “systems and structures that enable balancing treatment and employment”, “surroundings that support motivation to work”, and “motivation to work”.

As disincentives to continue working, side effects from gastrectomy and postoperative adjuvant chemotherapy directly affected daily eating and defecation, resulting in physical weakness and anxiety. Due to symptoms that were difficult to predict or control, such as loss of appetite without a clear timeline for improvement, the patient’s willingness to work may have decreased and affected QWL. As a factor promoting continued employment, even though postoperative adjuvant chemotherapy was new to the patient, they had developed their coordination and coping skills through their own coping and adjustment process. The understanding and cooperation of coworkers and the work environment were conducive to increased motivation to work.

Purpose: This study aimed to examine the role of Certified Nurse Specialists (CNSs) in Cancer Nursing in providing support to adult patients undergoing emergency surgery following their initial cancer diagnosis, from the time of admission.

Methods: Semi-structured interviews were conducted to collect data from experienced CNSs who provided support to cancer patients undergoing emergency surgery. The collected data were analyzed using qualitative and inductive methods.

Results: A total of seven CNSs were included in this study. The data analysis resulted in the identification of eight categories: “capturing the overlooked emotions of patients and their families”, “predicting future developments based on medical conditions and ensuring timely support”, “unraveling the complicated situations between patients, their families, and healthcare providers to ascertain the team strength”, “advocating for patients and their families to help them overcome challenging circumstances”, “helping patients adjust to a new normal after experiencing sudden changes to their body and undergoing cancer treatments”, “supporting hesitant ward nurses and doctors in engaging with patients and their families”, “utilizing their expertise to care for cancer patients in complex situations and collaborating with other medical professionals”, and “promoting the presence of CNSs in the organization to better serve cancer patients in acute care settings”.

Discussion: The CNSs interviewed recognized two important time frames: the postoperative recovery process and cancer prognosis. Notably, they adopted a holistic approach to address the needs of patients and their families who were overlooked by the acute care system and the medical personnel engaged in it. They assisted in decision-making by providing information to reduce the shock associated with cancer diagnosis and to promote acceptance of the disease.

Conclusions: The CNSs advocated for the provision of support to cancer patients in acute care settings through routine appeals to organizations while helping patients establish a new normal.

Our purpose was to clarify the decision-making process in advanced cancer patients regarding communicating information about their disease to their minor children, and to obtain suggestions for nursing practice.

Semi-structured interviews were conducted with 20 patients diagnosed with advanced cancer who had children aged 6 to under 18 years old at the time of diagnosis of advanced cancer, were told by their doctors that they were not eligible for curative treatment, and were undergoing treatment or watchful waiting to prolong life or relieve symptoms, and in whom the period between diagnosis of advanced cancer and the interview was 15 years or less. The modified grounded theory approach was used.

The decision-making process in advanced cancer patients regarding communicating information about their disease to their children is divided into three core categories: (1)“choosing whether or not to communicate information about their disease to their children based on their own values,” (2)“communicating after thinking about when, from whom, and in what way to communicate,” and (3)“being unable to decide whether or not to communicate about death.” “Checking with a trusted person if they made a good decision” supports the process of (2).

The following approaches by nurses were suggested to support patients' decision-making: listening to advanced cancer patients’ thoughts and feelings that led to their decision of whether or not to communicate their disease information to their minor children; providing continued support for the decision-making process, which consists of the three core categories predicted to be followed by patients; respecting and supporting the patients’ timing of communicating the information about their disease to their children; and facilitating the patients’ narratives about difficulties of communicating about death and listening to them carefully so that they can reconstruct their own narrative and come to their own conclusions about whether or not to communicate about their death to their children.

Objectives: To elucidate the state of communication associated with hearing in elderly cancer patients undergoing chemotherapy and to obtain suggestions for communication taking into consideration the state of hearing.

Methods: This is a quantitative, descriptive study. We used an anonymous self-administered questionnaire and surveyed the medical records of elderly patients aged ≥65 years who were receiving chemotherapy on an outpatient basis for their state of hearing and communication with medical staff. After calculating the descriptive statistics of all items, difficulty hearing was classified into two groups, and communication was examined using the Mann-Whitney U test (a two-tailed p value of 0.05 was considered significant).

Results: In the subject sample of 127 patients, the mean age was 74.6 ± 5.2 years, there were 76 men (59.8%), and the most common disease was lung cancer in 41 patients (32.3%). Sixty-eight patients (53.5%) experienced difficulty hearing when communicating with medical staff, 23 patients (33.8%) complained about this to medical staff and 25 patients (36.8%) had difficulty hearing which affected their treatment and care. Furthermore, 71 patients (55.9%) were satisfied with their communication with medical staff, and the level of satisfaction was significantly lower for the group with hearing difficulties than the group without hearing difficulties (p < 0.05).

Discussion: It is important to evaluate the state of hearing of elderly patients before treatment initiation, as more than half of the patients experienced hearing difficulties in communicating with medical staff. Furthermore, the low level of satisfaction in communicating with medical staff indicates the need to improve communication methods and environment.

This study aims to reveal the process of continuing to work for adult breast cancer patients receiving outpatient postoperative adjuvant chemotherapy and obtain hints for nursing practice regarding work continuation. Semi-structured interviews were conducted with 13 adult breast cancer patients who continued work while receiving outpatient chemotherapy; the results were analyzed using M-GTA. Consequently, after deciding to receive treatment, patients made “the decision to continue working”, thinking they “cannot stop working” and want to “try continuing work while being treated”, which was supported by the “perception of possibilities for continuing work through suggestions from people with experience”. After treatment commenced, a “conflict regarding continuing work” arose between “concerns about side effects from anticancer drugs and decline in the desire to continue work” and the “desire to keep working, and not give in to the battle with cancer”. Amid this conflict, the patients themselves engaged in “physical and psychological self-regulation concerning side effects”, while maintaining the idea that they “can become their normal selves only when working”. Moreover, during treatment, “awareness of those who support the continuation of work” continually sustained the patients. While the “conflict regarding continuing work” continued with the increase or decrease in side effects, patients found value that could be obtained through work, in that “working is living,” and from the decision to receive treatment until it ended, they looked forward to the end of treatment with the idea that “work is the purpose of life”. As nursing support, it is necessary to provide information on people with working experience who had the same disease at the commencement of treatment, support for side effects and the decline in the desire to continue work during treatment, support for negotiating work styles through communication in the workplace, and support for showing gratitude for consideration from the workplace through actions.