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Objective: The mean age of cancer diagnosis has decreased, while the mean age of first marriage and child delivery has increased in Japan in recent years. Accordingly, an increasing number of pregnant women are being diagnosed with cancer. Pregnant cancer patients must consider simultaneously receiving cancer treatment and continuing their pregnancy and make related decisions. Healthcare professionals (HCPs) who support patients and their families experience conflict over which care should be prioritized between that for the patient and that of the fetus. Supporting pregnant cancer patients and their families in such complicated situations is challenging. This study aimed to explore the process of support for continuing cancer treatment for, and pregnancy in, cancer patients, based on shared decision-making (SDM) between the patient, her family, and HCPs. Methods: This was a qualitative, descriptive study carried out with six nurses, five clinicians, and three obstetricians with experience of providing decision-making support to a pregnant cancer patient and her family. Individual interviews and a focus group interview were conducted. Results: We identified ten categories, of which the following five are integral to the process of providing support for pregnant cancer patients: “Preparing for SDM with the patient and her family;” “HCPs working in a team while clarifying their individual roles and responsibilities;” “confirming the intentions of the patient and her family in setting the orientation;” “improving the system for HCPs to provide support to the patient during cancer treatment,” and “providing the patient with support that helps her make informed decisions.” Conclusions: Decision-making support is provided to both the patient and her family, and HCPs work in teams to provide support. Moreover, HCPs continue to provide support to the patient and her family after a decision has been made.

Hospice care was introduced in Japan in the 1970s. There are currently an estimated 21 programs, which are primarily hospital-based. This paper provides an overview of the history, current state, and future trends of hospice care in Japan. Four programs are described, including staffing information, length of stay, and prognoses of patients. Hospice care in Japan is compared to hospice care in the United States and major differences are described. Lastly, the concept of "truth telling" is explored within the context of the Japanese culture. The discussion is based on a review of the literature and a mailed survey completed by 16 Japanese hospice programs during July 1992. The paper is in four sections: An overview of Japan. The history, current state, and future trends of hospice care in Japan. The major differences between hospice care in Japan and the United States. An exploration of "truth telling" within the context of the Japanese culture.

Aims and objectives To clarify the adjustment ability of outpatients with cancer, associated factors and the relationship between adjustment ability and associated factors. Design Quantitative study. Methods Anonymous self‐reported questionnaire (adjustment ability scale of outpatients with cancer) responses, patient background information and possible associated factors were collected from 369 cancer outpatients. Results The mean ± SD adjustment ability score was 110.5 ± 27.2. Several factors were associated with adjustment ability. The Functional Assessment of Cancer Therapy‐General Scale, used to measure quality of life (QOL), was significantly higher in people with an adjustment ability score >95. The factor that was most related to the adjustment ability score was how people think about asking for support from others. The adjustment ability was higher among people who thought, “I should be supported by others for the things I cannot do by myself”.

AimsTo develop an adjustment ability scale for outpatients with cancer and to investigate its reliability and validity.DesignQuantitative study.MethodsA proposed adjustment ability scale was prepared based on scale development guidelines. Its reliability and validity were statistically analysed using data obtained from 369 patients.ResultsSix factors were extracted from the factor analysis. Cronbach's α coefficient was 0.95 and the test–retest reliability coefficient was 0.83. A correlation coefficient of .48 was determined between the adjustment ability scale and the Mental Adjustment to Cancer scale (Japanese version), which assesses psychological adaptations via the cognitive‐behavioural responses of patients with cancer. The correlation coefficient between the scale and the Functional Assessment of Cancer Therapy‐General (Japanese version 4), which measures quality of life among patients with cancer, was 0.15.