The Details of Decision-Making Regarding How to Spend Daily Life among Terminally Ill Cancer Patients in the Palliative Care Unit with Life Expectancies of Approximately Three Weeks Hitomi Eguchi 1 , Noriko Akimoto 2 1Department of Nursing, Faculty of Nursing, Sanyo Gakuen University 2Graduate School of Health Sciences, Okayama University Keyword: 終末期 , がん患者 , 1日の過ごし方 , 意思決定 , terminal , cancer patient , daily life , decision-making pp.4-12
Published Date 2013/5/25
  • Abstract
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 The purposes of this study were to clarify the details of decision-making among terminally ill cancer patients with life expectancies of approximately three weeks in the palliative care unit on how they would spend their remaining days, and to consider the role of nursing in ensuring that the decisions made by the patients were supported to maintain their quality of daily life.

 Participant observation(participant-as-observer)and semi-structured interviews were conducted with 18 terminally ill cancer patients admitted to the palliative care unit with life expectancies of approximately three weeks. Data were obtained with careful consideration of each participant's health status. The data were analyzed using Krippendorff's content analysis method. The institutional ethics committee approved this study and each patient provided an informed consent.

 We found that patients wanted to spend their remaining days by doing the following : live each day with each moment in time as a separate compartment ; live each day as it is without planning ahead of time ; live life by conserving physical strength ; create or leave something that can be left behind as a memento ; spend time doing something enjoyable ; talk about the frustrations and pain with people other than family and live in tranquility ; live in such a way that bonds with special people will last even after death ; do something for others with what's left of their life ; and maintain dignity as a human being.

 Through the results, it became clear that for nurses to support patients' decisions, alleviating pain is of course a crucial issue, but most importantly, nurses should provide the best support for their patients to help them spend their precious days so that each day is the best day of their life. Nurses should actively listen to the patient ; respect the patient's decision even if the patient has no plans set for the day ; respect the desire of patients who want opportunities to maintain hope by holding craft workshops and/or seasonal events and by setting achievable goals with other patients ; be someone they can talk to, and lastly, create an environment enabling patients to become as independent as possible by taking care of themselves, and allowing the opportunity for the patients themselves to help other patients.

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電子版ISSN 2189-7565 印刷版ISSN 0914-6423 日本がん看護学会