Lived experience in patients with recurrent glioblastoma in Japan: A narrative study

Glioblastoma (GBM) is well known to have one of the poorest prognoses among all cancers. Patients with GBM in progression-free survival (PFS) may be relatively stable and can often maintain their quality of life. Thus, PFS is a desirable goal. In Japan, the median PFS is 11 months. It is difficult to grasp a patient\u27s thoughts and hopes when, after PFS, they are readmitted due to recurrence or acute deterioration. Therefore, this study aimed to describe the lived experience of illness in patients with recurrent GBM, focusing on PFS. We enrolled five patients into the study; however, only four patients completed data collection. Data were collected using semi-structured interviews. We also conducted a thematic narrative analysis. As a result, we generated one overall theme: Even in vulnerable and constrained daily lives, the aim was gaining a sense of stability—and maintaining it steadily—as far as possible, on their own. That sense of stability is fragile so that maintaining equilibrium is a precarious enterprise. Moreover, in PFS, participants were trying to maintain equilibrium by reevaluating themselves and sometimes giving up something, although they received support from people around them. We infer that it is important for nurses to assess and understand the fluctuations in that sense of stability through continuous involvement with patients. An interdisciplinary approach and lateral integration of care are important to meet the needs of GBM patients. This understanding will lead to nursing supports that help patients live with stability, pride, and dignity

The Reverence for Life Movement - A Community-based Primary Health Care Movement in Kumamoto, Japan

The purpose of this historical case study was to provide such a rich and thick description of the Reverence for Life Movement (RLM) - a community-based Primary Health Care (PHC) movement in Kumamoto, Japan from1962 to 1980 - through synthesis of historical documents and oral histories collected from participants. Based on a postmodern orientation, this case study not only focused on the objective historical facts of the movement, but also emphasized the voices of both leaders and participants of the movement. The oral histories presented a slice of lived experience and conveyed what this community-based social movement meant to the speakers, whose words impart the sense of meaning, motivation, and passion that facilitated their strong commitment to this sustainable social movement. Contextual information included a review of the development of Japan’s health care system and of its standards of rural health practice as pioneered by Dr. Toshikazu Wakatsuki. Along with the history of the RLM, the researcher attempted to analyze the RLM through the theoretical framework of a PHC-based health system as defined by the Pan American Health Organization and World Health Organization in 2007. Set against the PHC-based healthcare framework, the RLM appears as a community-based PHC movement that recruited community support and intersectoral efforts in improving health and healthcare infrastructure in Kumamoto, and impacted health policy nationally. Over the 40 years of continuous activities, the RLM has become a leading example of a sustainable social movement that not only facilitated the health of citizens and communities, but also strengthened the health care infrastructure and modeled the kind of success that grounds good national policy

Validation of the person-centered maternity care scale at governmental health facilities in Cambodia.

BackgroundWomen's childbirth experience of interpersonal care is a significant aspect of quality of care. Due to the lack of a reliable Cambodian version of a measurement tool to assess person-centered maternity care, the present study aimed to adapt the "Person-Centered Maternity Care (PCMC) scale" to the Cambodian context and further determine its psychometric properties.MethodsThe PCMC scale was translated into Khmer using the team translation approach. The Khmer version of PCMC (Kh-PCMC) scale was pretested among 20 Cambodian postpartum women using cognitive interviewing. Subsequently, the Kh-PCMC scale was administered in a survey with 300 Cambodian postpartum women at two governmental health facilities. According to the COnsensus-based Standards for the Selection of health status Measurement Instruments (COSMIN) standard, we performed psychometric analysis, including content validity, construct validity, criterion validity, cross-cultural validity, and internal consistency.ResultsThe preliminary processes of Kh-PCMC scale development including cognitive interviewing and expert review ensured appropriate levels of content validity and acceptable levels of cross-cultural validity of the Kh-PCMC scale with four-point frequency responses. The Scale-level Content Validity Index, Average (S-CVI/Avg) of 30-item Kh-PCMC scale was 0.96. Twenty items, however, performed optimally in the psychometric analysis from the data in Cambodia. The 20-item Kh-PCMC scale produced Cronbach's alpha of 0.86 for the full scale and 0.76-0.91 for the subscales, indicating adequately high internal consistency. Hypothesis testing found positive correlations between the 20-item Kh-PCMC scale and reference measures, which implies acceptable criterion validity.ConclusionsThe present study produced the Kh-PCMC scale that enables women's childbirth experiences to be quantitatively measured. The Kh-PCMC scale can identify intrapartum needs from women's perspectives for quality improvement in Cambodia. However, dynamic changes in and diverse differences of cultural context over time across provinces in Cambodia require the Kh-PCMC scale to be regularly reexamined and, when needed, to be further adjusted