• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1779-1784
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• 2016

Background: Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Materials and Methods: Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Results: Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. Conclusions: While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.5063-5069
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• 2014

Background: Cancer is a disease which affects not only patients but also their families physically and emotionally. The purpose of this study was to determine the needs, challenges and ways of coping of caregivers of cancer patients. Materials and Methods: In the study, a phenomenological approach was used. Data were collected through semi-structured individual interviews. The study sample comprised 16 family members providing care for a cancer patient. Results: The study findings are grouped under four main themes: the impact of caregiving, masking feelings, experienced challenges and expectations, and coping. During the caregiving process, patient relatives are affected physiologically, psychologically and socially. It was determined that patient relatives hid their feelings and avoided talking about the disease for fear that they might upset the patient, and that they had difficulty in coping with the patient's reactions during the treatment process. Family members had difficulties arising from the health system, hospital conditions and treatment in addition to transportation and financial problems. Support is very important in coping, but it was determined that some of the relatives of patients did not receive adequate support. Patient relatives expect that health care professionals should provide them with more information about their patient's condition and the course of the disease that their patients should be dealt with by the physicians specialized in cancer, and that psychological support should be provided both for them and for their patient. Conclusions: During the caregiving process, family members are faced with many difficulties and they exhibit different coping behaviors which health care professionals should take into account.

• The Korean Journal of Rehabilitation Nursing
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• v.8 no.1
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• pp.50-58
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• 2005

Purpose: The purpose of this study was to increase our understanding of the terminal cancer patients and their families concerns. I analyzed the counseling contents of terminal cancer patients and their relatives who referred to hospice office. Method: Data was collected from January 2004 to November 2004. During the counseling, I took notes the key points and contents. 109 patients and/or their families's counseling records were analyzed with the descriptive statistics and content analysis. Result: 73.4% of patients knew their current terminally ill status. The mobility of 86.2% of the patients was worse than ECOG 3 level. Patients have uncontrolled pain(28.4%), emotional distress(55.0%), and physical distress(49.5%). Caregivers of the patients were spouse(46.8%), sons and daughters(24.8%). Family members had problems to tell the bad news to their family cancer patient. 95.4% of the patient and family members was informed about the hospice and palliative care services, and 35.8% of them was referred to the hospice and palliative organizations. Frequently asked questions were 'what is hospice?', 'how much is the cost of hospice services?' etc. Conclusion: Care planning for terminal cancer patients must include patient. Also, professionals should consider and offer accessible, effective and empathetic counseling services to patients and families.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6913-6917
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• 2015

Background: Due to the rapid progress of industrialization, the expansion of the nuclear family, and an increase in women's social activities, the burden of care of cancer patients has increased, so that all family members are now involved in care. We compared the health-related quality of life (HRQOL) between members of families of cancer patients (hereafter, cancer families) and members of cancer-free families (non-cancer families). Materials and Methods: The data were from the Community Health Survey (2012). The study population included respondents at least 30 years of age. Data were adjusted for the following covariates: sex, age, education, marital status, household income, economic activity, household type, chronic disease, and perceived health status. Frequency analysis, analyses of variance, and multiple linear regression analysis were performed. Results: Among 163,495 respondents, 3,406 (2.1%) were part of a cancer family and 160,089 (97.9%) were part of a non-cancer family. Cancer families had lower EQ-5D scores than non-cancer families. However, by subgroup, the scores had significant association between cancer and non-cancer families only for females and for those who worked. Conclusions: There was a significant relationship between HRQOL scores and being a family member of a cancer patient. This indicates that the responsibility for care has been extended to the entire family, not only the primary caregiver.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.153-169
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• 1996

This study was designed to identify, describe and classify orientations of cancer patient's family members to death and to identify factors related to their attitudes on death. Death to the male is understood as a comprehensive system and believed to be highly subjective experience. Therefore attitude on death is affected by personalities. As an attempt to measure the subjective meaning toward death, the unstructured Q-methodology was used. Korean Death Orientation Questonaire prepared by Kim was used. Item-reliability and Sorting-reliability were tested. Forty five cancer patients' family members hospitalized in one university medical center in Seoul were sampled. Sorting the 65 Q-itmes according to the level of personal agreement ; A forced normal distribution into the 11 levels, were carried out by the 45 P-samples. The demographic data and information related to death orientation of the P-sample was collected through face to face in depth interviews. Data was gathered from August 30 till September 22, 1995. The Z-scores of the Q-items were computed and principal component factor analysis was carried out by PC-QUANL Program. Three unique types of the death orientation were identified and labeled. Type I consists of twenty P-samples. Life and death was accepted as people's destiny, They firmly believed the existence of life after life. They kept aloof from death and their concern was facing the and of the life with dignity, They were in favor of organ donation. Type II consists of Nine P-Samples. They considered that death was the end of everything and did not believed the life after life. They were very concerned about the present life. Type III consists of Sixteen P-samples. They regarded the death as a natural phenomena. And they considered that the man is just a traveller and is bound to head for the next life which is believed to be free of agony, pain or darkness. They neither feared death nor its process. Their conserns were on the activities to prepare themselves for the eternal-life after death. Thus, it was concluded that there were three distinctiven type of attitudes on death among cancer patient family members, and their death attitudes were affected by demographic and socio-cultural factors such as sex, education, and religion.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.384-395
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• 2000

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.275-288
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• 1997

The purpose of the study is to explore and describe the lived experience of family members with gastric cancer patients using the grounded theory methodology. The participants were ten spouses of gastric cancer patients who had some kind of treatment at the hospital. They were asked open-ended and descriptive questions in order for them to talk about their experiences in their own terms. As the interveiw progressed the questions became more specific to discuss themes and working hypotheses that emerged from the analysis of previous interviews. All interviews were tape-recorded and transcribed for the analysis. Constant the core category that was emerged from the comparative analysis is “magmaggam” which can be described as a psychological distress due to a high level of uncertainty regarding the health of the patient and the future of the caregivers. Psychological distress includes several emotional feelings such as frustration. anxiety, fear, guilty, and self depreciation. Subcategories or strategies related to the core category are 1) managing illness, 2) using folk medicine, 3) giving the patient a reason to live, 4) being patient, 5) losing reality, 6) anticipatory experience on the patient's death and parting, and 7) changing interpersonal relationships. The results of this study would help clinical nurses to develop nursing intervention to help spouses of gastric cancer patients establish efficient coping strategies in dealing with the problems they face.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4275-4279
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• 2016

Background: Cancer is a major health problem due to the aging population with increasing deaths. Family functioning is affected by cancer diagnosis and treatment. The aim of this study was to comparative analysis of the perception of family functioning by heads of families with and without cancer members during illness, focusing on changes or probable changes. Materials and Methods: This comparative study was conducted on two groups (families with a member of the cancer and controls without a family member with cancer). The families were of patients referred to the clinics and hospitals of Imam Khomeini, Taleghani and Omid of Urmia city, the number of samples being 148 for cases and 176for the control group. To collect the data, valid and reliable family functioning (FAD) was applied, a 60-item questionnaire with seven dimensions, with heads of families. To analyze the data SPSS- 23 Software was used for descriptive and analytical statistics. Significance level was defined p <0.05. Results: Among the seven items : problem solving, communication, roles, emotional response, emotional involvement, behavior control and overall functioning, only differences for average scores of problem-solving were statistically significant. Discussion: Contrary to common perception of severe damage for family functioning in families with cancer members, results of this study indicate that functioning in terms of family caregivers is more or less similar to that of the families with other diseases. Only in problem-solving item do these families experience more difficulty. Conclusion: According to the research findings, in nursing from families with cancer patient, it is recommended to focus more on the problem-solving item of the families.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.55-66
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• 1990

This research is focused on the attitudes toward dying and hospice. 4subjects groups are Ca. patient, Ca. patien's family, elderly, medical personnel. A 40 questionare was filled out by each participant. For this study chi-square and T-test was done. The result were as follows : 1. Telling the truth 61.2% of all subject groups agreed upon telling the impending death. About 40% of elderly groups and cancer patient group were disagreed which is the highest percentage in all groups. Particularly medical personnel group were remarkably high in telling the truth. 2. Attitudes of medical personnels 43.3% of all groups agreed upon medical personnels prefer to avoid dying patient. In medical personnel group. 44% of respondents disagred comparably higher than other group. But 37.7% of medical personnel agreed. It showed that medical personnels admitted their negative feelings toward dying patient in considerable degree. 3. Attitudes toward mechanical assistance for life-expanding or hopeless patient. 44.8% of all groups disagreed upon mechanical assistance for hopeless case. Elderly (54.9%) and medical personnels (50%) disagreed, which is higher than cancer patient (33.3%) and (22.8%) of cancer patient's family. 4. Special facility and educational preperation for dying patient. 67.4% of all groups agreed upon the needs of special facility for dying, 81.3% of medical personnels agreed which is highest percentage in all group. 5. Attitudes of family members of dying patient. 82.3% of all groups agreed upon the family members feel annoyed at dying patient. 34% of cancer patient's family member and 48% of cancer patients group agreed, but elderly group showed highest percentage(84%). 6. Perception of dying patient about imminent death. 58.3% of all group thought dying patients are aware of their impanding death even though they had not beent told. 77.3% of medical personnel agreed which is highest percentage in all group.