A qualitative study was conducted in an attempt to improve our understanding of the spiritual distress of terminally ill cancer patients in Japan. The subjects were inpatients at four approved palliative care units in Japan. The patients were interviewed and they expressed their own experiences in which spirituality was considered to be identifiable. Literal records of the interviews were analyzed using constant comparative analyses as proposed in relation to the grounded theory approach. The analysis included 11 inpatients and a variety of expressions of distress were obtained. After the conditions of the subjects were evaluated in order to search for common factors related to distress, consciousness of the gap between the patient's aspirations and the present situation were found to cause gap-induced distress. Distress was classified into three categories: distress due to the gap between the present situation and how the individual wanted to live, how the individual wished to die, and the individual's wish to maintain relations with others. The aspirations causing the gap were then interpreted from the viewpoint of spirituality as "anchors in life" for Japanese patients with terminal cancer. It was also revealed that in patients who possessed pictures of how they wished to die as their "anchors in life" and who were in a severe physical condition, distress increased and they became confused after their physical symptoms were relieved following admission to PCU.
The major problem underlying the practice of prognostic disclosure is the absence of mutual understanding of how such information will be utilized. These findings affirm that it should be used to empower patients to participate in the decision-making process.
Aim: The purpose of this study was to prepare scales to assess the difficulties, coping, and adaptation experienced by nurses involved with cancer care in order to extract the constructing factors of each scale and to investigate the correlations between the scales and sociodemographic-related factors. Methods: The subjects were 155 full-time staff nurses who provided care to cancer patients undergoing chemotherapy or radiotherapy at outpatient, day-care or short-stay wards in 14 oncology and general hospitals throughout Japan. The participants completed a questionnaire that consisted of questions relating to demographic information and three item lists: the difficulties, coping, and adaptation associated with providing care to patients undergoing cancer therapy. Results: Based on the results of the factor analysis for each scale, four factors of the Difficulties scale, three factors of the Coping scale, and five factors of the Adaptation scale were identified. A stepwise multiple regression analysis was performed by using the Adaptation scale score as a criterion variable and the Difficulties and Coping scale scores, and demographic factors as independent variables. The standardized partial regression coefficient was significant for coping and age in descending order.
Conclusion:The results of this study suggested that coping plays a significant role as a predictor of adaptation.
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