Journal des soins infirmiers et des soins

Structure of Life Adjustments by Lung Cancer Patients with Decreased Performance Status

Abstract

Naoko Horii Akiko Kondo,Harumi Ejiri and Atsuko Maekawa

Purpose: The structural characteristics of life adjustments among lung cancer patients with decreased Performance Status (PS) were investigated.

Subjects and methods: Text analysis and cluster analysis were performed with data obtained from interviews of six lung cancer patients with PS 3 or 4 in one university hospital in Japan. The study was conducted from February to June 2009.

Results: The mean age of subjects was 73.6 years. The text data included 623 records, and the number of keywords was 1,398. Keywords that appeared with high frequency were, in order, People (51), now (47), Disease (45), and Doctor (32). Positive type (173) and negative type (366) were extracted from a sensitivity analysis. Life adjustments of lung cancer patients were divided with a linguistic method into 20 categories: “Time period”, “Other people”, “Actions in daily life”, “Symptoms”, “Lung cancer”, “Place of treatment”, “Medical treatment”, “Adjustment”, “Death”, “Physical condition”, “Feelings of difficulty”, “Relationships with others”, “Enjoyment”, “Doing one’s best”, “Acceptance”, “Living”, “Attentiveness to others”, “Belief”, “Nursing care” and “Thankfulness.” Four clusters were formed in the cluster analysis: Thoughts on receiving care, living on terms with one’s physical condition, adjustments with awareness of death, and actions in daily life appropriate to the time.

Discussion: Life adjustments of hospitalized lung cancer patients with decreased PS are closely related to time period, treatment, symptoms and it is conjectured that patients make adjustments to their actions in daily life and thoughts with a positive attitude and feelings when they reach the state of sensing that they will not be cured.