Nursing Problems Encountered by Certified Nurse Specialists and Certified Nurses in Cancer Nursing While Providing Nursing Care to Patients with Cancer and Dementia and their Families

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  • がん関連領域の専門・認定看護師が捉える認知症を有するがん患者・家族に対する看護上の課題

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<p>The purpose of this study was to clarify the nursing problems encountered by certified nurse specialists (CNS) and certified nurses (CN) in cancer nursing while providing nursing care to patients with cancer and dementia and their families. Semi-structured interviews were conducted of 11 nursing professionals from 8 facilities. Qualitative analysis of the interview contents revealed the following six problems: [Difficulty in decision support that respects patients receiving treatment], [Difficulty in family support to reduce confusion between cancer and dementia], [Difficulty in adjusting the living environment to suit the patient], [Lack of education of nursing staff who provide nursing care for patients with both cancer and dementia], [Lack of collaboration to utilize expertise in cancer and dementia nursing] and [Difficulty in supporting to ensure patient safety and quality of life (QOL) in cancer treatment]. From the results, it appears that CNS and CN cannot fully understand the patients’ will or intention due to impaired memory/judgment of the latter associated with dementia, and cannot be confident in providing nursing support due to poor evidence of the efficacy of cancer therapy and effects of treatment on the QOL in cancer patients with dementia. They were faced with an ethical dilemma in that too much emphasis on safety measures led to a decrease in the QOL of cancer patients with dementia. The results suggest the importance of improving the quality of cancer nursing provided by nurses inside and outside hospital facilities for patients who are transferred to another treatment/recuperation facility.</p>

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