[Show abstract][Hide abstract] ABSTRACT: Communicating the discontinuation of anticancer treatment to patients is a difficult task. The primary aim of this study was to clarify the level of oncologist-reported burden when communicating about discontinuation of an anticancer treatment. The secondary aims were (i) to identify the sources of burden contributing to their levels and (ii) to explore the useful strategies to alleviate their burden.
A multicenter nationwide questionnaire survey was conducted on 620 oncologists across Japan (response rate, 67%).
High levels of perceived burden were reported by 47% of respondents, and 17% reported that they sometimes, often or always wanted to stop oncology work because of this burden. There was a significant association between high levels of burden and: a feeling that breaking bad news would deprive the patient of hope; concern that the patient's family would blame the oncologist; concern that the patient may lose self-control; and a feeling that there was not enough time to break the bad news. Strategies perceived to be useful by oncologists included training in how to effectively communicate to patients discontinuation of anticancer treatment, a reduction in total workload to allow sufficient time to break bad news, and development of a multidisciplinary model to facilitate cooperation with other professionals and facilities.
Many oncologists reported high levels of burden relating to communication of discontinuation of anticancer treatment. A specific communication skills training program, sufficient time for communication and development of a multidisciplinary model could help alleviate the burden on oncologists.
Japanese Journal of Clinical Oncology 08/2011; 41(8):999-1006. · 1.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Many breast cancer patients are troubled about telling their school-age children about their illness. However, little attention has been paid to the factors that encourage or discourage them from revealing the illness. This study explored decision-making by breast cancer patients about telling their children about their illness.
Participants were 30 breast cancer patients recruited from a regional cancer institution in Japan. Semi-structured interviews were conducted and content analysis was performed.
Six preparatory stages of decision-making by Japanese breast cancer patients about telling their children about their illness were identified as follows: contemplation, preparation, action-hospitalization and surgery, action-adjuvant therapy, action-diagnosis, and action-prognosis. We also identified 11 categories of positive aspects and ten categories of negative aspects about revealing their illness to children. The categories of negative aspects with higher frequency were similar to those found by previous research, but categories of positive aspects were unique. The rate of reference to negative aspects in total reduces gradually as the preparatory stage advances, and in action-diagnosis and action-prognosis stages the balance between positive and negative aspects becomes about half and half.
Patients, especially in action-hospitalization and surgery, can be expected to tell their children about their illness although they find negative aspects much more compelling than positive aspects and experience great distress. These patients have special needs for support from others.
Supportive Care in Cancer 07/2009; 18(4):439-47. · 2.09 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Research on the impact of breast cancer on Asian women's sexual lives is extremely scarce. This study investigated the sexual changes experienced by breast cancer patients in Japan following surgery, and their sexuality-related information needs.
An anonymous, cross-sectional survey of breast cancer out-patients was conducted in 2005. Data from 85 subjects, who were without recurrence and reported being sexually active pre-surgery, were analyzed.
Subjects were mainly in their 40's and 50's, and the median time since surgery was 43 months. Seventy-three (85.9%) had resumed sex after surgery with the median time being 3.5 months after surgery. Among 73 who resumed sex, 43 reported that the frequency of sex decreased, and 72 reported at least one sexually related change. The multiple logistic regression analysis revealed that those who had perceived the sexual relationship with their partner important before surgery (OR, 6.705; 95%CI, 1.320-34.051; p = 0.022) were more likely to maintain the same frequency of sex as before surgery. Perceived changes in respondents' sexual relationship did not necessarily result in deterioration of the couple's overall relationship. Regarding sexuality-related information needs, respondents wished to have information on treatment-induced sexual changes as well as sexual and general inter-couple communication strategies.
This research revealed that breast cancer patients in Japan experience various sexual problems following breast cancer treatment. Sexuality-related information should be provided to all patients, regardless of patients age or type of surgery, as a part of routine treatment information giving.
[Show abstract][Hide abstract] ABSTRACT: To date, the biological approach to breast cancer, such as pathologic subtype genetic analysis has been well investigated, and is considered to be the most important approach to under breast cancer treatment. Recently, the importance of a team approach to multidisciplinary medical treatment and holistic medical treatment has been recognized. The five following points are important: 1) recognition of patients' needs, 2) clarifying responsibility, 3) respect for each other, 4) maintaining good communication, 5) updating the system. Our original 'team approach path' is useful as a communication tool between a patient and the staff. Patient satisfaction is the purpose and a team approach is one method of carrying out medical treatment led by a patient as well as the medical treatment and informed decision based on narrative.
Breast Cancer 02/2005; 12(1):21-5. · 1.33 Impact Factor