Making the decision for home hospice: perspectives of bereaved Japanese families who had loved ones in home hospice.

OBJECTIVE: The aim of the study was to evaluate whether family members believed that the decision for home hospice had been the acceptable choice and to identify factors related to families accepting that the decision was good. METHODS: In June 2007, a cross-sectional anonymous questionnaire was distributed to bereaved family members of terminal cancer patients in Japan who died at home in the previous 6 months. The questionnaire included questions about whether the family member believed that the decision for home hospice had been the acceptable choice and the decision-making process. RESULTS: A total of 286 responses from 14 home hospices were analyzed. A total of 92% of the participants indicated that the decision for home hospice had been the acceptable choice. Multivariate logistic regression analysis indicated that the following subjects were more likely to believe that the decision for home hospice had been the acceptable choice: those who (i) considered the patient's desire ahead of the family situation (P < 0.001); (ii) decided based on knowledge of all options (P < 0.001); (iii) decided based on agreement with patient, family and medical staff (P = 0.007); (iv) decided based on the patient and family only (P = 0.026); and (v) had patients who were enrolled in home hospice for <60 days (P = 0.032). CONCLUSIONS: It is important to encourage discussion about end-of-life care and to assist the patient and family in the decision-making process by providing information on all available options through open communication.

[The subjectivity of attitudes toward life support care].

PURPOSE: The purpose of this study was to categorize adult's subjectivity of their attitudes towards life sustaining treatment, and thereby understand the differences among these life sustaining treatment types using Q methodology. METHODS: Q-methodology, which provides a method of analyzing the subjectivity of each item, was used. Thirty selected Q-statements received from 52 adults were classified into a shape of normal distribution using a 7 point scale. The collected data was analyzed using a QUANL pc program. RESULT: Four types of attitudes toward life sustaining treatment were identified. Type I is called one's autonomy type. Type II is called potentiality of resuscitation type. Type III is called DNR (Do not resuscitation) type. Type IV is calledone's effort type. CONCLUSION: The results of the study indicate that different approaches of life support care programs are recommended based on the four types of life sustaining treatment attitudes among Korean adults.

Study on nursing college students' subjectivity in their attitude toward jobs.

PURPOSE: The purpose of the study was to categorize nursing students' subjectivity in their attitude toward their jobs, and thereby understand the differences among these attitude types. METHODS: The study used a Q-method to measure nursing students' attitude toward jobs identity types. In-depth and objective interviews and literature review formed Q sample. The P sample consisted of 25 nursing students. RESULTS: The results of the study show that nursing students can be categorized into three types, depending on their attitudes toward their jobs. The first type, "interest-oriented" students, strongly disagree to the following: giving priority to job over marriage, standing unfair treatment in the workplace, the importance of promotion opportunity, irresponsibility, and uncertainty. The "reward-oriented" students, on the other hand, strongly disagree to the following: indifference to career prospects, employment-related relocation of residence, irresponsibility, standing difficulties, and compromises with others. The third type of nursing students is the possession-oriented students, who strongly disapprove of irresponsibility, refusal to compromise with reality, standing unfair job allocation or promotion and career uncertainty. CONCLUSIONS: The study on nursing college students' attitude toward their jobs is meaningful in the following aspects: First, the study clarifies nursing college students' attitudes toward their job by categorizing it. Second, the study confirms the changing attitudes of nursing students toward jobs with the change of times and calls for proper educational programs to foster healthy career attitudes. Third, proper decision-making as regards jobs and job allocation for nurses, or their career attitudes, is beneficial to individuals, the medical industry, and society.

[Personality-based career attitudes of nursing students].

PURPOSE: The purpose of this study was to explore the structure and characteristics of nursing college students' personality-based career attitudes. METHOD: A Q-methodology was used to identify factors in nursing students' personality-based career attitudes. A Q sample was collected from in-depth and objective interviews and literature reviews. A P sample consisted of 27 nursing students. RESULT: Results revealed three factors: Deliberateness-oriented, Positive-oriented, and Negative-oriented. The 'Deliberateness-oriented' factor was characterized by preference of logical and objective ways in evaluation and trying to seek deep relationships with only a small number of people. The 'Positive-oriented' factor showed creative, autonomous and sociable traits and put value on extensive interpersonal relations. The 'Negative-oriented' factor focused on possibility and enjoyed artistic actions. All 3 factors were negative in NGO or political activities. CONCLUSION: Based on this result, curriculum development for nursing students should give students a variety of experiences. These findings will be the basic data for finding appropriate positions within the work place for nursing students and help them select appropriate careers for their own personality types.