Wen-Chuan Lin

People who receive peritoneal dialysis (PD) have more freedom than those who are on hemodialysis. However, some PD patients have difficulty adapting to their new environment and thus remain largely homebound. When they work or travel abord, who cannot rely wholly on others, these patients must handle certain life problems alone. It is essential for nursing staff to help PD patients to prepare for overcoming typical inconveniences, improving quality of life, and handling unfamiliar environments. The present study assists patients to arrange domestic and foreign tourism and to participate in various activities. The intervention teaches the pre-assessment of tourism, the assessment and selection of the sterile environment for exchange, the arrangements for dialysate, planning for handling complications, the travel matters attention, and other tourist information using group or individual instruction. It is expected that patients with peritoneal dialysis will be more willing to leave their houses and be better prepared to travel, which should lead to their having more fun and to their greater enjoyment of life.

Background: Although the survival rate for cancer is increasing because of advances in treatment technology, cancer still comes as a great shock to the families of patients who are in the advanced stages of this disease. When a married, middle-aged man is diagnosed with advanced cancer, his spouse most often becomes his primary caregiver. However, few studies have studied the lived experience of these middle-aged spouses. Purpose: This study explores the lived experience of middle-aged female spouses of husbands diagnosed with advanced cancer. Methods: A qualitative design was used. In-depth interviews were conducted with participants whose spouses were being treated at the oncology outpatient department of a teaching hospital in northern Taiwan. The data were collected with purposive sampling over a 12-month period. Results: A content analysis of 11 participant interviews revealed four themes: simultaneously bearing all layers of stress, changing of attitudes and values, developing the effective skills of caregiving, and gaining support from the family and from religion. Conclusions/Implications for Practice: A middle-aged female spouse faces many layers of stress and many crises in caring for her husband with advanced cancer. Female spouses in Taiwan tend to rely significantly more on internal resources (family) than external resources (friends and medical professionals). It is recommended that these families use external resources such as medical and social welfare systems more actively to facilitate their successful passage through these crises. Understanding the lived experiences of these female spouses helps nurses provide appropriate nursing interventions.