| Summary: | 碩士 === 國立臺北護理健康大學 === 護理研究所 === 104 === The purpose of this study was to explore of the illness experience of elderly hepatocellular carcinoma patients receiving continuous treatment. A qualitative design was used. Semi-structure in-depth interviews were conducted with participants who were treated at the oncology units in a teaching hospital in northern Taiwan. The data were collected with purposive sampling from June to August in 2015. Eleven participants aged 68-79 (average 71) years old, were completed the interviews.
A content analysis of the interviews revealed seven themes: sense of helplessness and eventual acceptance regarding definite diagnosis, experience of the pain and discomfort during treatment, resilience and longing for the continuation of treatment, try not to bother family members, findings ways to care for one-self, prepares to face the one’s end, and show of altruism and personal development. From the study, we found that elderly patients with incidental finding of hepatocellular carcinoma would be shocked, depressed and negative emotions. Most of them were diagnoised in intermediate and late stage and they would agree the treatment due to the confidence of the physicians. In face of unfamiliar treatment, patient were often worried and afraid. During the treatment, the severe pain, side-effects and the compulsory bed rest causes lots of torment and suffering. However, in attempt to survive, the support from family members, the disease under control and the patient liability done, and every day was earned. Due to hope and resilience, the patient continued the treatment despite the pain and discomfort. In attempt to relieve burden of the liver, patient would try new methods to alleviate discomfort and take care of themselves, by lifestyle changes and/or alternative therapy. Hopelessness when seeing the other patients died with the same problem , but they would gradually accept one’s eventual demise, hospice care was the common wishes for most patients, with continue follow up, adaptated to lifestyle and mind , getting back to normal life, changed in personality and attitude, gratitude to the medical staff , sharing the experienced and helped the other patients by the mentality of altruism.
We advised the care of elderly hepatocellular carcinoma patients receiving continuous treatment, clinical nurses should assist in understanding the treatment applied and should be in concordance with the patient’s wishes. Relevant information should be provided before treatment and provide interventions to alleviate discomfort; nurses should act as an intermediary between senile patient and their family, understand patient’s expectation from the treatment and provide timely information, undergo discussion on end-of-life and hospice care, and provide spiritual support during treatment. The results of this study can help nurses to understanding with elderly hepatocellular carcinoma patients receiving continuous treatment. It also can be made as reference to provide appropriate care and for further education.
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