1.Difficulties Faced by Family Caregivers for Terminal Cancer Patient Cessation of Home-based
Kiyomi Kawase ; Naoko Inamura ; Erika Onuki ; Nami Ikenaga ; Saori Fuziyama ; Chihoko Wada
Palliative Care Research 2017;12(2):194-202
The aims of this study were to clarify difficulties experienced by families facing the cessation of home-based care for terminal cancer patients, and to review the associated necessary nursing practices. We conducted semi-structured interviews with ten families. A qualitative research design was selected for this study, and the data was interpreted using content analysis techniques. The results were integrated into seven major categories: “unable to assess present symptoms for lack of understanding terminal cancer symptoms,” “feeling emotional pain during the patient’s aggravated condition,” “difficulties in coping with various patients’ physical symptoms: problems regarding inexperienced care,” “exhausted by living 24 hours a day with patient: lack of support, because of constraints from important people in the caregiver’s life,” and “difficulties faced by primary family caregivers in preparing a treatment environment.” Family caregivers were not able to prepare a treatment environment, because of a lack of understanding the symptoms of terminal cancer and an unwillingness to admit experiencing mental and physical burdens. The findings of this study suggested that the role of a nurse is to understand the family’s condition and values, provide required information in advance, and to adjust and prepare the treatment environment.
2.Signs and symptoms associated with postsurgical dysfunctions among upper gastroesophageal cancer patients: an analysis of the published reports
Keiko Iino ; Shigeaki Watanuki ; Yurie Koyama ; Kyoko Suzuki ; Chihoko Wada ; Michiko Mori ; Miho Kurihara ; Kyoko Okada ; Chisato Ichikawa ; Hideo Uesugi ; Tomiko Ichihashi ; Yoko Hisabe ; Kaori Yagasaki ; Hiroko Komatsu
Palliative Care Research 2013;8(2):701-720
Purpose: The review of the published reports was performed with the aim of systematic collection and integration of information related to "signs and symptoms" along with their changes among patients after upper gastroesophageal surgeries. Methods: The PubMed and the Japanese healthcare literature database were searched by the following keywords:"gastric cancer" "esopha∗ cancer" "surgery" and "symptom" As a result, 37 articles related to gastric or esophagus cancer were identified. The data were extracted according to each sign and symptom, and were evaluated and discussed. Results and Conclution: Standardized instruments for gastrointestinal symptoms included evaluations about dysphagia, difficulty in swallowing, reflux etc. The incidence of signs and symptoms, or postsurgical recovery processes are different among individual patients. Healthcare professionals should support patients continuously and systematically so that patients can take appropriate health maintenance behavior according to their signs and symptoms.
3.Qualitative Study of Outpatients’ Eating-related Distress and Struggle in Cancer Center Hospital
Yasutaka Kimura ; Makiko Murase ; Tamae Hiramatu ; Mayumi Tsukagoshi ; Chihoko Wada ; Yoichi Shimizu ; Ayako Mori ; Miki Hosoya ; Kyoko Toju ; Yuko Shimizu ; Maki Obana ; Misae Maruguchi
Palliative Care Research 2017;12(2):239-249
Purpose: The purpose of this study was to clarify the state of eating -related distress and struggle in the daily lives of cancer outpatients in cancer center hospital. Methods: Cancer outpatients who consented to participate in the study filled out self-administered questionnaires regarding eating distress and the means of coping with them. The data were qualitatively analyzed via content analysis method. Results: Data from 176 patients who responded that they experienced eating difficulties were analyzed. A total of 222 codes were extracted for eating-related distress, and these were classified into five categories, which included eating-related symptoms accompanying the disease and its treatment, difficulties related to food preparation, and concerns about eating outside food. A total of 224 codes were extracted for eating-related struggle made by the patients, and these were classified into eight categories, which included adjusting eating methods to make food easier to eat, controlling one’s feelings when unable to eat certain foods, and adjustments related to food preparation. Conclusions: The study results suggested that cancer outpatients require care not only at early stages after treatment for eating-related symptoms but also related to food preparation and concerns when eating outside food.
4.Difficulties in daily life of post thoracic esophagectomy cancer patients after hospital discharge
Shigeaki Watanuki ; Keiko Iino ; Yurie Koyama ; Miho Kurihara ; Chisato Ichikawa ; Kyoko Okada ; Hideo Uesugi ; Chie Asanuma ; Hiroyuki Daiko ; Takeo Fujita ; Kyoko Suzuki ; Chihoko Wada ; Michiko Mori ; Yoko Hisabe ; Kaori Yagasaki ; Hiroko Komatsu
Palliative Care Research 2014;9(2):128-135
Purpose: This study aimed at identifying difficulties among post thoracic esophagectomy cancer patients during outpatient follow-up. Methods: Patients who had radical esophagectomy at a cancer center hospital in Japan were prospectively observed and were interviewed by a certified nurse assigned at esophageal surgical outpatient division. Their responses were documented in medical records and were analyzed by content analysis method. This study was approved by the study hospital's research ethics committee. Results: The data from 66 patients were obtained. Content analysis yielded 221 extracts, 25 categories, and 65 codes of difficulties, including: concerns or signs/symptoms associated with dietary intake, physical activity, and anxiety. Implications: The majority of post-thoracoabdominal esophagectomy patients experienced multiple dysfunctions and symptoms after discharge. The results underscore the significance of nurses' role in assessing and instructing patients to address these issues.
5.Content analysis of nurses' interventions for post thoracic esophagectomy cancer patients at the outpatient clinic
Keiko Iino ; Shigeaki Watanuki ; Yurie Koyama ; Miho Kurihara ; Chisato Ichikawa ; Kyoko Okada ; Hideo Uesugi ; Chie Asanuma ; Hiroyuki Daiko ; Takeo Fujita ; Kyoko Suzuki ; Chihoko Wada ; Michiko Mori ; Yoko Hisabe ; Kaori Yagasaki ; Hiroko Komatsu
Palliative Care Research 2014;9(3):110-117
Background: Patients having thoracic esophagectomy, a standardized treatment for esophageal cancer patients in Japan, are known to have various postsurgical signs and symptoms for a period of time. The current status of nursing interventions at outpatients need to be clarified. Purpose: This study aimed at identifying the nurses' interventions for cancer patients at the outpatient setting who previously had thoracic radical esophagectomy. Methods: Patients who had esophagectomy at a cancer center hospital in Japan were prospectively observed and interviewed by outpatient nurses between January 2009 and December 2010. Their documented responses in medical record were prospectively investigated and were qualitatively analyzed via content analysis method. This study was approved by the study hospital's research ethics committee. Results and discussion: The data analysis of nursing interventions for 66 patients yielded 372 extracts, 12 categories, and 74 codes. Nurses were assessing patients' signs and symptoms affected by postsurgical changes, and were utilizing patients' active self-monitoring skills. The results also showed the significance of facilitating postsurgical recovery in relation to nutritional intake and physical activity in patients' daily life. Implications: Based upon the study results, the development of a systematic program is underway, which facilitates esophageal cancer patients' postsurgical recovery.