Process of Patients Telling Children about Newly Diagnosed Breast Cancer

Objective: This study aims to determine the process of patients with newly diagnosed breast cancer in Japan telling their children about the disease, and how they have thought about it after the diagnosis. Methods: Semi-structured interviews were conducted with 15 patients with newly diagnosed breast cancer who had 3- to 14-year-old children. Narratives of participants about how they told their children about the disease were analysed by a qualitative and descriptive study design using the Modified Grounded Theory Approach (M-GTA). Results: In the process by which patients with newly diagnosed breast cancer tell their children about the disease, participants were [Maintaining mental balance in the face of the threat of the cancer] after the breast cancer diagnosis, and used the “Facing the cancer through the relationship with the children” as the core category in the process. The participants had [Determined to tell the children about the disease], while [Being worried about the influence of cancer on the children], [Thinking about the benefits of not hiding the cancer], and [Feeling difficulty in communicating the diagnosis of cancer to their children]. They were [Encouraged to tell about the disease to the children] by people around them, and did tell the children that they had a “disease” or “cancer”. The participants who told the children that they had the disease while [Determining the impact on the children] repeated the [Making herself look unconcerned] in the process. Those who told the children that they had cancer while [Determining the impact on the children] repeated [Talking openly about cancer and death] between parents and children. Conclusions: The participants came to face their own cancer by maintaining mental balance in the face of the threat of the cancer and telling their children about the disease. Nurses need to assist these patients to be able to deal openly with their children from the early stage of the diagnosis and solve problems by family members.

The Process of Support by Nursing Professionals for Families Having a Member with Borderline Personality Disorder

The purpose of this study was to explore the process of family support provided by nurses to families with a borderline personality disorder (BPD) patient. Semi-structured interviews were conducted with 16 nurses who had provided care to BPD patients. Data obtained from the interviews were qualitatively analyzed using a modified grounded theory approach. As an overall core category of family support processes practiced by nurses for families with BPD patients, family support practiced without awareness that the nurses were supporting families was extracted. Through this process, nurses held perceptions that were premises for family support, which were formed through their individual nursing experiences and perspectives. Nurses also had diverse perceptions concerning the image of families. Through the integration of perceptions that were premises for family support and perceptions of an image of the family, nurses underwent a process of “determination and ambivalence about the need for family support.” Then, nurses provided “family support practice” when they acknowledged the need for family support. During the “family support practice,” nurses had difficulties in providing family support. When family support was not successfully provided, nurses provided “family support practice with seeking more effective ways through trial and error.” For cases in which nurses did not acknowledge the need for intervention, they intentionally chose “not to provide family support.” Furthermore, during the “family support practice,” nurses had contradictory perspectives of family support. Such family support processes ultimately led to an awareness of the same family support required for the future. Family support was provided with “family support practice” and “family support practice with seeking more effective ways through trial and error.” In some cases, however, the process ended in “not to provide family support intentionally.” Experiences and perspectives in providing family support are important factors in carrying out future family support. Developing the positive implications of these factors and reducing psychological strain on nurses may ensure smooth implementation of family support. Thus, nurses need to recognize that they are supporting the family, which is identified as a core category.