THE ANALYSIS OF DECISION MAKING, COPING ATTTTUDES AND QOL EVALUATEON BY JAPANESE PATIENTS WITH HEMATOPOIETIC MALIGNANCY GOING THROUGH PBSCT

2001 Fiscal Year Final Research Report Summary

• Project/Area Number: 12672325
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Clinical nursing
• Research Institution: Kagawa Medical University
• Principal Investigator: IMAI-KISHI Keiko KAGAWA MEDICAL UNIVERSITY, PROFESSOR, 医学部, 教授 (00254558)
• Co-Investigator(Kenkyū-buntansha): MORI Kazue OSAKA FURITSU KANGO DAIGAKU, GRADUATE STUDENT, 教授 (10210113) ; MANABE Yoshiki KAGAWA MEDICAL UNIVERSITY, LECTURER, 医学部, 講師 (40181812) ; TANAKA Terukazu KAGAWA MEDICAL UNIVERSITY, PROFESSOR, 医学部, 教授 (20155146) ; KINSYO Takami KAGAWA MEDICAL UNIVERSITY, ASSISTANT, 医学部, 助手 (00335861) ; SUGIMOTO Tomoko KAGAWA MEDICAL UNIVERSITY, ASSISTANT, 医学部, 助手 (00314922)
• Project Period (FY): 2000 – 2001
• Keywords: patient decision making / coping / cultural values / QOL / medical technology / human values

Research Abstract

This is a descriptive study. Six patients with hematopoietic malignancy going through PBSCT were selected for interview on decision making, coping attitudes during hospitalization and out patient department. There were six semstructeured questions. Two nurse investigators interviewed patients. The research period is from April 2000 to January 2001 at K. Hospital in Kagawa Prefecture. The findings were the followings: 1) All the patients experienced shock and disbelief of their diagnosis.: 2) Doctors explanations made patients decide to take PBSCT, because that was suggested as only way to survive.: 3) Patients did not expect own death. : 4) Patient families reacted almost similar ways as patients. : 5) Patients coped with fear with hope. : 6) All patients believed that medical sciences would save life.
The year 2001 to 2002, cultural influences on health behaviors and attitudes on general population were surveyed by questionnaires. Out of 1000 people, 453 responded at T city in Kagawa. The results of answers were analyzed according to Hofstede (1980) cultural concepts (power distance, individualism / collectivism, uncertainty avoidance, masculinity / femininity).
The findings: Many patients were influenced by family decisions on treatment choices. There were power distances between patients and medical doctors. Doctors and patients have high degree of uncertainty avoidance.
One hundred nineteen nurses out of 300 nurses who specialised in patient care in hematopoietic malignancy and PBSCT were asked to answer questionnaire on cultural influences on patients care in 2001, November to December in Kagawa. Hofstede (1980) cultural concepts were used for analysis. The findings for QOL of these patients: 1) to reduce the power distance between nurses and doctors between nurses and patients, between doctors and patients. 2) to reduce medical science technological uncertainties by explaining visible actual certainty. 3) to reduce nurses ethical dilemma by improving communication among doctors, nurses, patients and nurses.