ABSTRACT
Objectives: This study aimed to explore nurses’ treatment preferences for patients with advanced cancer and investigate the factors affecting these preferences. Methods: Self-administered questionnaires were distributed to nurses at two hospitals who had experience in cancer patient care. Nurses recorded their treatment preferences and nurses’ value considered in their preferences for two vignettes of patients with advanced cancer that differed in performance status (PS) and prognosis. Univariate and multivariate analyses were used in this study. Results: Of 383 nurses, 300 (valid response rate, 78.3%) responded. Multiple regression analyses revealed that regardless of patients’ prognosis or PS, nurses’ treatment preferences were associated with their values regarding respecting patient wishes and the low probability of prolonging survival through treatment. For case with one month survival prognoses, nurses valued avoidance of discomfort, associated with side effects through treatment. Nurses recommended treatment in case with prognoses of 6 months and PS of 1, while they responded with almost same percentages of recommendation of continuing and discontinuing treatment for those with prognoses of 1 month and PS of 3. Conclusions: Nurses’ treatment preferences were associated with nurses’ values. Nurses’ involvement in treatment decision-making processes after sharing goals for patients’ treatment is potentially beneficial.
ABSTRACT
Purpose: To understand the experiences of and difficulties faced by palliative care unit nurses when caring for refractory cachexia. Method: Palliative care nurses completed anonymous self-report postal questionnaires. Factor and multiple regression analyses were then carried out to interpret results. Results: A total of, 169 valid questionnaire responses were received and analyzed. Six factors were identified relating to the difficulties experienced by nurses when caring for refractory cachexia. [A feeling of helplessness and conflict among patients and families faced with decline and death] was considered the most difficult factor experienced by nurses, and typically other difficulties were considered more prominent when this factor was present. [The approach of assessment and perception of refractory cachexia care] differed according to the nurse’s years of experience, degree of involvement in patient care, and learning opportunities previously encountered. [Nurses tended to cope] more easily with the challenges faced if they had been assigned for >3 years. Conclusion: Six factors were identified as difficulties associated with the care of refractory cachexia. These findings suggest the need for thoughtful dialog with patients and their families and the importance of further educational support for nurses.
ABSTRACT
Purpose: To elucidate the actual state of difficulties and related factors of nurses in caring for patients with recurrent and metastatic malignant musculoskeletal tumor. Methods: The subjects were 315 nurses from 12 institutions that treat malignant musculoskeletal tumor. We researched the difficulties of nurses regarding cancer nursing and care of patients with malignant musculoskeletal tumor. We examined the related factors by multiple regression analysis. Result: 165 nurses responded (effective response rate 52.4%). Among “Nurses’ difficulty with cancer care”, the level of difficulty regarding communication was the highest and in own knowledge/technology, system/regional cooperation was also high. Among “Nurses’ difficulty with care for patients with malignant musculoskeletal tumor”, there was a high degree of difficulties regarding the target characteristics of care. Related factors were facility characteristics, nursing experience, nursing experience of musculoskeletal tumor, learning methods for musculoskeletal tumor nursing, and multi-professional conferences. Conclusion: Nurses caring for patients with malignant musculoskeletal tumor have specific difficulty due to total pain, age of onset, and rarity. Educational support based on related factors is therefore required.