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Background： While the number of older cancer patients increases as the society ages, the current status of the pain control is not well characterized among older patients. To improve the quality of care, it is necessary to understand the current status. Objectives： The aim of this study was to describe the pain control for older cancer patients in comparison to younger counterparts and characterize it. Methods： During four months in 2013, Aomori Prefectural Central Hospital started asking all hospitalized cancer patients about their pain every day using a standardized pain questionnaire. In addition, a questionnaire adopted to the outpatient setting was distributed to the patients who visited outpatient department of the hospital. The information about pain, quality of life (QOL) and the medical histories were included in the data analyses. Their responses were compared between outpatients versus inpatients and older ( ≥65 years) versus younger (＜65 years) patients. Results： The response rate was 57.0％. Pain management was less adequate among outpatients than among inpatients, with pain relief rate of 28.9％ for the former and 52.6％ for the latter (P＜0.001). Among outpatients, the pain relief rate for the older patients was particularly low (older：24.7％ vs younger：35.8％, P＜0.01). Conclusion： Pain management for older patients in the outpatient settings needs a particular attention for improvement. Resources should be allocated to enable better detection and relief of pain among outpatients.
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<b>Background:</b> 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. <b>Purpose:</b> This study aimed at identifying the nurses' interventions for cancer patients at the outpatient setting who previously had thoracic radical esophagectomy. <b>Methods:</b> 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. <b>Results and discussion:</b> 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. <b>Implications:</b> Based upon the study results, the development of a systematic program is underway, which facilitates esophageal cancer patients' postsurgical recovery.
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<b>Purpose:</b> This study aimed at identifying difficulties among post thoracic esophagectomy cancer patients during outpatient follow-up. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Implications:</b> 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.
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<b>Purpose</b>: 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. <b>Methods</b>: 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. <b>Results and Conclution</b>: 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.
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The purpose of this study was to explore the meaning of the lived experience of having outlook toward self of patients with advanced non-small cell lung cancer receiving standard therapy. Unstructured interviews were conducted with five Co-researchers. The dates were gathered from verbatim interviews, then the transcripts were analyzed using the procedural steps based of phenomenological approach of Colaizzi. As a result, three in five common meanings in their experiences are the following: 1) Life-oriented with their life because of raising awareness of the end of their life, 2) Being as what they are because of knowing what they were for themselves, 3) Being not isolated because they were isolated. When considered based on the above three common meanings, having outlook toward self must be viewed as a searching one's life as being that it starts at the time of raising awareness of mortality and as a one's positive effort to live fully as oneself in later life. Palliat Care Res 2011; 6(2): 222-226
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PURPOSE: The aim of hospice care is to provide the best possible quality of life both for people approaching the end of life and for their families and carers. The Korean government has been implementing a pilot project for hospital hospice services and trying to develop the national hospice system. To assist in the development of the Korean hospice system, the Korean government supported the present study comparing the hospice systems of three countries, United States, Japan, and Taiwan, which currently have a developed hospice system. METHODS: Data from three countries were collected in the following ways: reviewing hospice related literature, searching government documents on the Internet, collecting government hospice data, surveying six hospice institutions in each country, and conducting an international workshop. RESULTS: The hospice system was evaluated by comparing hospice management systems and hospice cost systems. The comparison of the hospice management system included five items of hospice infra structures and four items of hospice services. The hospice cost system included four items: funding source, hospital hospice cost, day care hospice cost, and home hospice cost. CONCLUSIONS: Based on the comparison of three countries, the most interesting thing was that home hospice care accounted for more than 90% of all hospice services in the United States and Taiwan. The results of this study will aid the countries that are in the process of developing a hospice system including Korea, which has been implementing a pilot project only for hospital hospice services.
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Humans , Caregivers , Day Care, Medical , Financial Management , Hospice Care , Hospices , Internet , Japan , Korea , Pilot Projects , Quality of Life , Taiwan , United StatesABSTRACT
<b>Purpose</b>: This study investigates the situation surrounding the use of massage to relieve cancer pain by nurses in hospices and palliative care wards all over Japan and factors affecting this usage. <b>Methods</b>: We conducted a survey of 989 nurses with two or more years of clinical experience employed at approved palliative care wards around Japan, using a questionnaire prepared by researchers. <b>Results</b>: The questionnaire was answered by 606 nurses, and 95.7% of the subjects used massage in their routine nursing care. They recognized the benefits, such as comfort, reducing anxiety and so on. From a multivariate logistic model, 'a great number of years of clinical experience in cancer nursing' (OR: 2.51, 95%CI: 1.20-4.80) and 'the superior assessment ability for the use of massage' (OR: 1.18, 95%CI: 1.09-1.27) had a significant impact on the active use of massage. <b>Conclusion</b>: In order to use massage more effectively it is necessary to develop knowledge acquired through clinical experience and improve nurse's assessment ability. Palliat Care Res 2010; 5(1): 101-113