THE ANALYSIS OF DECISION MAKING, COPING ATTTTUDES AND QOL EVALUATEON BY JAPANESE PATIENTS WITH HEMATOPOIETIC MALIGNANCY GOING THROUGH PBSCT

这是一项描述性研究。选择6例接受PBSCT的恶性血液病患者，对住院期间和门诊期间的决策、应对态度进行访谈。有六个半结构化的问题。两名护士调查员采访了病人。研究时间为2000年4月至2001年1月，在香川县K.医院进行。结果如下：1)所有患者都经历了休克和对自己的诊断的怀疑：2)医生的解释使患者决定接受PBSCT，因为这被认为是唯一的生存方式。3)患者没有想到自己会死亡。：4)患者家属的反应与患者几乎相似。(5)患者带着希望应对恐惧。6)所有患者都相信医学会拯救生命。2001~2002年，通过问卷调查的方式调查了文化对普通人群健康行为和态度的影响。在1000人中，有453人在香川的T市做出了回应。…根据Hofstede(1980)的文化概念(权力距离、个人主义/集体主义、不确定性回避、男性化/女性化)对回答结果进行分析。结果：许多患者在治疗选择上受到家庭决策的影响。病人和医生之间存在着权力距离。医生和患者具有高度的不确定性回避。2001年11月至12月，香川医院邀请了119名专门从事血液系统恶性肿瘤和外周血干细胞移植患者护理的护士，回答了关于文化对患者护理影响的问卷调查。Hofstede(1980)的文化概念被用于分析。这些患者的生活质量调查结果：1)减少护士与医生、护士与病人、医生与病人的权力距离。2)通过解释可见的实际确定性来减少医学技术的不确定性。3)加强医、护、患、护之间的沟通，减少护士的伦理困境。较少

This is a descriptive study. Six patients with hematopoietic malignancy going through PBSCT were selected for interview on decision making, coping attitudes during hospitalization and out patient department. There were six semstructeured questions. Two nurse investigators interviewed patients. The research period is from April 2000 to January 2001 at K. Hospital in Kagawa Prefecture. The findings were the followings: 1) All the patients experienced shock and disbelief of their diagnosis.: 2) Doctors explanations made patients decide to take PBSCT, because that was suggested as only way to survive.: 3) Patients did not expect own death. : 4) Patient families reacted almost similar ways as patients. : 5) Patients coped with fear with hope. : 6) All patients believed that medical sciences would save life.The year 2001 to 2002, cultural influences on health behaviors and attitudes on general population were surveyed by questionnaires. Out of 1000 people, 453 responded at T city in Kagawa. … More The results of answers were analyzed according to Hofstede (1980) cultural concepts (power distance, individualism / collectivism, uncertainty avoidance, masculinity / femininity).The findings: Many patients were influenced by family decisions on treatment choices. There were power distances between patients and medical doctors. Doctors and patients have high degree of uncertainty avoidance.One hundred nineteen nurses out of 300 nurses who specialised in patient care in hematopoietic malignancy and PBSCT were asked to answer questionnaire on cultural influences on patients care in 2001, November to December in Kagawa. Hofstede (1980) cultural concepts were used for analysis. The findings for QOL of these patients: 1) to reduce the power distance between nurses and doctors between nurses and patients, between doctors and patients. 2) to reduce medical science technological uncertainties by explaining visible actual certainty. 3) to reduce nurses ethical dilemma by improving communication among doctors, nurses, patients and nurses. Less