Kazuko Akashi, Yoshie Imai, Shingen Nakamura, 高橋 真美子 and Hirokazu Miki : Attitudes toward treatment among patients with hematologic malignancies at first relapse: A qualitative analysis of age-specific characteristics, Journal of Cancer Supportive Care, 1, 1, 2-9, 2026.
(Summary)
Objective: To elucidate attitudes toward treatment among patients with hematologic malignancies at first re- lapse, with a focus on age-specific differences, in order to draw implications for nursing support. Methods: Semi-structured interviews were conducted with 15 patients who had begun treatment for a first re- lapse of a hematologic malignancy. Data were analyzed using an inductive qualitative approach. Results: Among patients under the age of 65 years, three categories emerged: (1) constructing a personal ap- proach to complete treatment based on prior experience and current circumstances; (2) resolving to survive through mental discipline, especially now that relapse has occurred; and (3) situating the treatment process as a part of life and aspiring to grow so as to make that time meaningful. Among patients aged 65 years or older, four categories were identified: (1) trusting in the efficacy of treatment, enduring suffering, and concentrating solely on completing treatment; (2) anticipating physical frailty, preparing in advance, and undertaking treatment with complete readiness; (3) maintaining equanimity by moderating emotional fluctuations; and (4) relinquishing hope for cure, yielding oneself to the course of treatment, and accepting all out- comes. Conclusion: A distinctive age-related feature of attitudes toward treatment at first relapse was that patients perceived their stance not as fixed at a single point, but as unfolding along the course of their lives. These findings highlight the need for nursing support that attends to the temporal significance of patients' perspectives and recog- nizes age-specific differences.
橋本 理恵子, 勝島 詩恵, 三木 恵美, Yoshie Imai, Kazuko Akashi and KAGEYAMA Megumi : The Meaning of Exercise for Patients with Recurrent or Advanced Cancer Receiving Palliative Chemotherapy, Journal of Cancer Supportive Care, 1, 1, 30-35, 2026.
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Kazuko Akashi, Yoshie Imai, Shingen Nakamura, Yusaku Maeda, Ryohei Sumitani, Masahiro Oura, Kimiko Sogabe, Shiroh Fujii, Takeshi Harada and Hirokazu Miki : Preparedness for the future in patients with relapsed or refractory hematopoietic malignancies in the treatment process: a qualitative study, Annals of Palliative Medicine, 14, 1, 43-56, 2025.
(Summary)
This study aims to clarify how patients with relapsed or refractory (R/R) hematological malignancies prepare for the future and set treatment goals. R/R hematological malignancies often require intensive therapies, including stem cell transplantation and CAR-T cell therapy, which pose high risks of adverse events. Many patients continue aggressive treatment until the end of life for pain relief or even a potential cure, despite the significant symptom burden. Understanding each patient's treatment motivations and preferences is essential to aligning care with their individual values. By examining their experiences, current health status, and treatment goals, this study seeks to provide a basis for holding early discussions on future care, contributing to individualized decision-making support for patients facing limited treatment options and uncertain prognoses. A qualitative descriptive study design was used to conduct semi-structured interviews with 16 patients with relapsed/refractory hematopoietic malignancies who were hospitalized for chemotherapy. The four main themes expressed by the participants were (I) I want to live through the treatment until the end of my life because I know recovery is difficult; (II) my current treatment depends on how much my body can endure; (III) I want to keep trying, but I am at the limit of what I can do now; and (IV) I want to continue even if the treatment is limited because I think it will help someone else. Patients with hematopoietic malignancies who are undergoing treatment may be motivated by a variety of different factors to continue with treatment. Discussing patients' goals and wishes with respect to treatment is critically important to ensure that such treatment is aligned with patients' preferences.
(Keyword)
Hematopoietic malignancy / relapsed or refractory hematopoietic malignancy (R/R hematopoietic malignancy); / patient preference / preparedness for the future / patient goals