Factors Associated with Difficulties Faced by Ward Nurses When Providing Support to Families of Patients with Advanced Cancer in Surrogate Decision-making

This study aimed to describe the types of support that ward nurses provide to families of patients with advanced cancer in surrogate decision-making and the factors associated with the difficulties these nurses experienced . An anonymous self-administered questionnaire survey was conducted among 285 nurses practicing in the cancer wards of four facilities. In total, 230 (80.7%) nurses provided support in surrogate decision-making, such as attending discussions. Additionally, 41 (17.8%) of the respondents often experienced difficulties performing this task. Results of a binary logistic regression analysis showed that the factors associated with the nurses’ recognition of difficulties were frequency of surrogate decision-making support requirements (OR=2.41, P=0.009) and incomprehension of the relationships between patients and their families (OR=2.41, P=0.009). To promote nurses’ support in surrogate decision-making, we suggest routinely collecting information on the relationships between patients and their families.

Status of Exercise and Related Factors in Survivors of Breast Cancer

Purpose: The present study aimed to clarify the status of exercise and related factors among survivors of breast cancer. Methods: Questionnaires were distributed to survivors of breast cancer. The question items addressed the status of exercise participation, knowledge about the effects of exercise and need for support. Factors associated with exercise participation were analyzed using logistic regression analysis. Results: Among 293 valid responses (rate, 84.2%). Fifty-eight point four percent participated in exercise and 41.3% decreased exercise participation after being diagnosed with breast cancer. Furthermore, 91.9% needed support from health care providers regarding exercise. About 70% of respondents were aware that exercise improves sleep, but <50% knew that exercise ameliorates symptoms associated with breast cancer. Among seven factors, age, employment status and chemotherapy were associated with exercise status. Conclusion: Breast cancer survivors who are younger, employed and undergoing chemotherapy might not participate in exercise. The preventive effects of exercise on breast cancer and the importance of continuing daily exercise should be promoted. Health care providers should provide support for patients to participate in exercise considering the influence of treatment and physical capabilities.

Relation between Anxiety and Depression and Personal Attributes or Difficulties in Daily Life in Patients after Total Laryngectomy

Objective: This study aimed to reveal the relationship between anxiety and depression and personal attributes or difficulties in daily life in patients after total laryngectomy. Methods: An anonymous questionnaire was mailed to 135 members of a self-help patient group. The questionnaire included the following items: personal attributes, difficulties in daily life, and anxiety and depression (according to the Nottingham Adjustment Scale-Japanese Laryngectomy Version). Multiple regression analysis was conducted with anxiety-depression score as the dependent variable and personal attributes and difficulties in daily life as independent variables. Results: Among the 57 patient respondents, 43 provided valid answers and were selected for analysis (valid response rate: 36.8%, 41 men and 2 women, mean age: 67.5±10.6 years). Results revealed that presence of anxiety and depression were significantly associated with patient age (β=−0.369, p=0.004) and difficulties pertaining to speech/performance during outings and engaging in hobbies (β=0.419, p=0.002). Conclusions: Our findings indicate that there is an increased risk of anxiety and depression in patients are young or middle aged and have difficulties in outings and engaging hobbies. Therefore, in clinical practice, nurses should carefully assess the mental state and difficulties in daily life in these patients after total laryngectomy. Moreover, nurses should continuously provide psychosocial support to patients and their families in order to help patients prevent psychological problems even after they are discharged from hospital.

Qualitative Study of Outpatients’ Eating-related Distress and Struggle in Cancer Center Hospital

<p>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.</p>