Decisions and Actions of Nurses in the Outpatient Chemotherapy Unit When Reconsidering the Continuation of Cancer Treatment

Supporting patients’ decision making of whether to continue chemotherapy as the disease stage progresses poses a significant challenge in cancer nursing. This study aimed to investigate outpatient chemotherapy unit nurses’ perspectives on reconsidering treatment continuation, and their subsequent actions. In total, 14 nurses participated in focus group interviews, and the interview content was analyzed using content analysis methods. The nurses’ perspectives on determining when to reconsider treatment continuation were grouped into four categories, including “respecting the patient’s desired way of life,” and “maintaining the patient’s quality of life and ability to lead their daily life as desired.” Additionally, three categories of subsequent actions were identified, such as “engaging in discussions with patients to plan future treatment aligned with their desired way of life” and “facilitating cooperation among nurses to ensure timely intervention for treatment discontinuation.” The outpatient chemotherapy unit nurses provided daily nursing care from a clinical ethics perspective, focusing on respecting patients’ desired ways of life. They also valued collaborative efforts among medical staff to enable timely interventions.

Psychosocial reaction patterns to alopecia in female patients with gynecological cancer undergoing chemotherapy.

This study aims to clarify the psychosocial reactions of female patients with gynecological cancer undergoing chemotherapy and in the process of suffering from alopecia and to examine their nursing support. The target group comprised female patients who had received two or more cycles of chemotherapy, were suffering from alopecia, and were aged 30-65. Data were collected from semi-structured interviews, conducted from the time the patients were informed by their doctors that they might experience alopecia due to chemotherapy to the time they actually experienced alopecia and until they were able to accept the change. Inductive qualitative analysis was employed to close in on the subjective experiences of the cancer patients. The results showed the existence of six phases in the psychosocial reactions in the process of alopecia: phase one was the reaction after the doctor's explanation; phase two was the reaction when the hair starts to fall out; phase three was the reaction when the hair starts to intensely fall out; phase four was the reaction when the hair has completely fallen out; phase five was the reaction to behavior for coping with alopecia; and phase six was the reaction to change in interpersonal human relationships. The results also made it clear that there are five types of reaction patterns as follows: 1) treatment priority interpersonal relationship maintenance type; 2) alopecia agitated interpersonal relationship maintenance type; 3) alopecia agitated interpersonal relationship reduction type; 4) alopecia denial interpersonal relationship reduction type; and 5) alopecia denial treatment interruption type. It is important to find out which of the five types the patients belong to early during treatment and provide support so that nursing intervention that suits each individual can be practiced. The purpose of this study is to make clear the process in which patients receiving chemotherapy come to accept alopecia and to examine evidence-based nursing care on patients with strong mental distress from alopecia.