Kagoshima University Faculty of Medicine, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan.
Eur J Oncol Nurs. 2020 Apr;45:101721. doi: 10.1016/j.ejon.2020.101721. Epub 2020 Jan 18.
Many patients with advanced cancer choose palliative chemotherapy. Considering its purpose of palliation and not treatment, it is important to consider the life of family caregivers. Family caregivers who experience bereavement undergo extreme stress, which is particularly high among patients' spouses. The present study aims to clarify the experiences of the spouses of patients at the hospitals in Japan after the notification of palliative chemotherapy discontinuation until bereavement.
We interviewed the spouses of 13 patients who received palliative chemotherapy using a semistructured interview guide. Each spouse was interviewed twice. The interviews were transcribed verbatim, and key concepts were identified using a grounded theory analytic approach.
After the hospital's recommendation for palliative chemotherapy discontinuation, the spouses had "bewilderment over having to discontinue palliative chemotherapy" and experienced "difficulty in facing bereavement." The spouses having "difficulty to give up hope for the patient's survival," felt "bafflement over caregiving at the terminal stage," which would be their responsibility in the future. Further, they had "hesitation in being honest to the patient" and were engaged in "knowing how to live with the patient until bereavement."
Nurses need to encourage the patients and spouses to honestly express how they feel from the early stages of palliative chemotherapy. Furthermore, nurses should help spouses with how they face bereavement. This result may help prevent anticipatory grief, which may lead to excessive stress and emotional distress on the family caregivers.
许多晚期癌症患者选择姑息化疗。鉴于其姑息而非治疗的目的，考虑到家庭照顾者的生活是很重要的。经历丧亲之痛的家庭照顾者承受着极端的压力，尤其是患者配偶。本研究旨在阐明日本医院在通知停止姑息化疗至丧亲期间，接受姑息化疗的患者的配偶的经历。
我们使用半结构化访谈指南对 13 名接受姑息化疗的患者的配偶进行了访谈。每位配偶接受了两次访谈。访谈内容逐字记录，并使用扎根理论分析方法识别关键概念。
在医院建议停止姑息化疗后，配偶们感到“不得不停止姑息化疗的困惑”，并经历了“面对丧亲之痛的困难”。配偶们“难以放弃对患者生存的希望”，对未来将由他们负责的“临终关怀感到困惑”。此外，他们在“对患者诚实感到犹豫”，并致力于“了解如何与患者一起生活直到丧亲之痛”。
护士需要鼓励患者和配偶从姑息化疗的早期阶段诚实地表达他们的感受。此外，护士应该帮助配偶面对丧亲之痛。这一结果可能有助于预防预期悲伤，这可能导致家庭照顾者过度的压力和情绪困扰。
