DOI: 10.5176/2315-4330_WNC19.263
Authors: Mrs. Rika Matsumoto
Abstract: Purpose: This study aims to understand the present condition and issues in the nursing in wards to assist postoperative patients with gynecological cancer to find work after the discharge.
Methods: Study design: Qualitative study. Participating institution: One hospital. Study participants: one ward nurse, one outpatient nurse, and one discharge support nurse introduced by the nurse administrator of the participating hospital. The participants were given an explanation of the study outline, and showed consent to participate in the study. We conducted interviews in a meeting room using an interview guide. The interview time was set to be within 40 minutes, considering the burden on the participants. This study was approved by the ethics review committee of the university the authors belong to. There is no conflict of interest to declare. Analysis: qualitative inductive analysis.
Results: From the statements of the nurses, we extracted the following 9 categories: [Support for the individual patient], [Public relations activities inside and outside the hospital], [Lack of collaboration], [Shortage of hospital staff and a lack of sharing of information],[Patients do not want others to know they are suffering from the disease], [Lack of understanding in society for working patients with gynecological cancers], [Poor awareness of nurses about employment support], [Encouraging patients to improve their abilities] and [Engaging comprehensively with the patients through opportunities to discuss in teams].
Discussion: Nurses provided employment support based on their role in the ward they belong to. A previous study investigating cancer and employment of patients, identified the wish for the person that patients and families can consult with about employment to be a nurse [1]. Employment support by nurses is one of the needs that patients wish to have. Being able to provide and explain information to patients who need such information may be effective for patients to continue both treatment and employment.
However, there were difficulties in being able to provide the employment support. For example, all three of the ward,
outpatient, and discharge support nurses here were aware of the lack of collaboration among nurses, occupational health, and community health nurses. Considering this, it may be assumed that there is a shortage of hospital staff and a lack of sharing of information about where to report and who to consult with. A factor that makes team medicine difficult is the difficulty of sharing information, resulting in not being able to collect necessary information, and having to obtain information independently [2]. In the participating hospital nurses may not be able to play their roles fully due to the lack of information. As an issue for the future, it is necessary for nurses to become involved in patients, comprehensively by conducting discussion in teams so that information can be shared among medical professionals, patients, and other parties concerned.
Another difficulty in providing employment support includes the situation that society does not fully understand the situation of patients with gynecological cancer who do not want it to be known that they suffer from the disease and who want to work. With the cultural background in Japan making patients wish to hide gynecological diseases unlike the case of other diseases. In particular, the patients were seeking opportunities for individual consultation and interaction with other patients who had similar experiences. A previous study has suggested utilizing self-help groups where patients exchange information, and that such groups may help patients obtain information about employment, deal with work-related problems by themselves, and continue employment [3]. As future issues, it is necessary for medical institutions to strengthen peer support, establish an information desk where patients can consult, and be provided with support that may improve the ability of patients to take part in activities to find or continue employment.
Keywords: gynecological cancer, postoperative patients, nurse, work support
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