Human Care Theory and Influences on the Life Quality Index of Cancer Patients in Household Life

doi:10.4236/eng.2013.510B052

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Engineering, 2013, 5, 252-254

http://dx.doi.org/10.4236/eng.2013.510B052 Published Online October 2013 (http://www.scirp.org/journal/eng)

Human Care Theory and Influences on the Life Quality

Index of Cancer Patients in Household Life

Yali Sun, Ling Gao*, Ying Dong, Ling Gong

Beihua University, Jilin, China

Email: *[email protected]

Received June 2013

ABSTRACT

To investigate the influences of the application of human care theory on the life quality and happiness of cancer patients

after they received a community nursing care which was implemented by the human care theory. The quality life and

the happiness index of 93 patients with cancer living in the six communities in Jillin were assessed, the assessment of

the life quality was based on a life quality scale (SF-36) and that of the happiness index was based on Memorial Uni-

versity of Newfoundland Scale of Happiness (MUNSH). The community nurses cared for these patients by applying the

theory of human care and the life quality and the happiness index of the patients were observed after the care. The re-

sults showed that there were significant differences in the score of 5 dimensions in the eight dimensions of the life qual-

ity between before the care and after the care (<0.05), and there were significant differences in the average sores of the

positive emotion, positive experience, negative emotion, negative experience and level of happiness included in the

happiness index between before the care and after the care (<0.05), suggesting that the theory of human care can be

used for the care of patients with cancer and the application of the theory can effectively improve the life quality and the

happiness index of the patients, strengthen their problem-solving abilities and let them have a positive attitude towards

their lives.

Keywords: Community Nurses; Theory of Human Care; Patients with Cancer; Quality of Life; Happiness Index

1. Introduction

With the progress of the times and the rapid development

of medical science, cancer has threaten to human health

and put tremendous psychological burden on the patients

and their families, causing a significant decrease in the

life quality and the happiness index of the timorous pa-

tients [1,2]. Because of the advance in medical technol-

ogy, the survival period of patients with cancer has been

significantly prolonged. In the present time, the quality

of life has been more and more concerned by the whole

society. In this study, the change in the quality of life of

tumorous patients was observed and studied after the

implementation of humane care which was given to the

tumorous patients [3].

2. Materials and Methods

2.1. General Information

93 Cases of patients with malignant tu mor were selected.

They were made a definite diagnosis before March 2011

and their sick years were 1 ± 0.6. After the combined

treatment in a hospital, they live their home lives, they

can take care of themselves, their vital signs were stable,

there was no communication barrier in language for them,

all of them had received an education at least in a junior

high school, and most of them were voluntary to partici-

pate in the community health educational activities. The

average age was (57 ± 7.2) years. There were 59 male

and 47 female patients including 15 cases of pancreatic

cancer, 18 cases of breast cancer, 16 cases of cervical

cancer, 6 cases of rectal cancer, 22 cases of gastric can-

cer, 11 cases of lung cancer and 5 cases of esophageal

cancer. The selected requirement for the community

nurses who would implement the human care included

that they had to have at least more than 10 years of clini-

cal experience, and they should have gained some under-

standing in the theoretical connotation of human care, the

knowledge of human care, the skill for communication

with patients, and knowing about the concept of humane

care and the status of human care. 12 nurses who met the

selected requirement were appointed to carry out the

human care for the patients in their own communities.

2.2. Methods

The 93 patients selected were assessed on the existing

quality of life. Based on the quality life scale (SF-36) [4],

*Corresponding a uthor.

Y. L. SUN ET AL.

253

the assessment was conducted according to 8 dimensions

and 35 items. The eight dimensions included the physio-

logical function (10 items), physical performance (4

items), general health (5 items), body pain (2 items), vi-

tality (4 items), social communication function (2 items),

emotional functions (3 items) and mental health (5 ite ms).

The score of the physiological function was 10～30

points, the score of body pain was 2 ~ 11 points, and all

the other items were 1 ~ 5 points. The score for each item

was positively proportion al to the quality of life.

The happiness indexes of 93 Patients selected were

assessed and assessment was conducted based on Me-

morial University of Newfoundland scale of Happiness

(MUNSH) [5]. MUNSH contains 24 items. Among the

24 items, 10 items are considered to reflect the positive

and negative emotions, 5 items the positive emotion (PA),

5 items the negative emotion (NA), 14 items positive and

negative experiences, 7 items the positive experience

(PE), and 7 items the negative experience (NE). The total

happiness index: PA-NA + PE-NE. The determination of

score was based on the following rule: that the answer to

each item was “yes” was recorded 2 points, that the an-

swer to each item was “I don’t know” was recorded 1

point, and that the answer to each item was “No” was

recorded 0 point; that the answer to item 19 was “the

residence where he or she is living now” was recorded

points and “any other residence” was recorded 0 point;

that the answer to item 23 was “satisfactory” was rec-

orded 2 points and “unsatisfying” was recorded 0 point.

The range of the total average point was from −24 to +24

points. In order to be easy to calculate the score, 24, as

the constant, was added, and the score range was from 0

to 48; the higher the score the higher the happiness index.

The community nurses implemented their human care

by applying the 10 factors for the human care described

in the theory of human care set up by Dr. Watson J. The

patients were made three appointments a week, the time

for each appointment was not less than 60 minutes, the

care was implemented in a way of a small course or sep-

arately aiming at the particular case for different patients

and the appointment could not be missed. During the

care, the human care were particularly emphasized,

science and humanities knowledge was integrated and

used to communicate with the patients, and the human

care was completed based on 10 factors proposed in the

theory of human care. 10 factors for human included

forming a value system of the human altruism; inculcat-

ing a trust and hope; developing a sensitivity of them-

selves and others; building up a relationship in helping,

trusting and caring; encouraging and accepting the ex-

pression of positive emotions and negative emotions

from the clients; applying scientific methods to solve

problems in the decision-making system; providing a

psychological, social and spiritual environment to sup-

port, protect and correct them; helping meet individual

needs; allowing the presence of existentialism, phenom-

enology and spiritual power. The community nurses

should follow the nature of human care to give the pa-

tients with cancer a psychological support and cultural

care, answer any questions for them or explain the re-

lated successful stories and so on.

After the community human care was implemented

over 3 months, the life quality and the happiness index of

the 93 patients was assessed again based on the life qual-

ity scale (SF-36) and MUN SH.

2.3. Statistical Method

SPSS soft ware was used to analyze the survey data in

this study. The least significant difference (LSD) and

SNK variance analysis methods were applied to compare

a pair of data obtained before the care and after the care.

P < 0.05 meant a significant difference.

3. Results

The results showed that both patients’ life quality and

happiness index after the human care were different from

those before the human care, there were significant dif-

ferences in 5 dimensions which could reflect the life

quality of the patien ts, such as physical performance, life

vitality, social communication ability, emotion al function

and spiritual health (<0.05), which were shown in Table

1 in detail; average scores of the positive emotion and

positive experience were significantly increased after the

care (<0.05), those of the negative emotion and the nega-

tive experience were significantly decreased (<0.05), and

the difference in the total average sore of the happiness

index was significant before and after the application of

the human care theory (<0.05), which were shown in

Table 2 in detail. The assessment on the life quality and

Table 1. Comparison in SF-36 score between before and

after the implementation of the human care theory (points)

Xs±

Dimensions

Average sore at the

first assess Average sore after

the human care p values

Physiological

function

13.21 ± 6.12 13.91 ± 4.62 >0.05

Phusical

performance

6.06 ± 2.22 7.81 ± 1.82 <0.05

General health

10.03 ± 3.57 10.52 ± 4.89 >0.05

Physical pain

6.25 ± 3.09 6.94 ± 4.99 >0.05

Life vitality

8.71 ± 4.28 12.29 ± 5.97 <0.05

Social contact

function

6.42 ± 5.83 8.97 ± 2.72 <0.05

Emotional

functions

4.14 ± 3.36 5.76 ± 1.79 <0.05

Spiritual health

8.63 ± 4.18 13.11 ± 2.79 <0.05

Y. L. SUN ET AL.

254

Table 2. Compar ison in happiness betw een before and after

the implementation of the human care theory (points)

Xs±

Items

Before the

implementation

Before the

implementation

p values

Positive emotion

2.75 ± 2.8 4.82 ± 2.5 <0.05

Negative emotion

7.26 ± 2.4 4.31 ± 3.7 <0.05

Positive experience

4.13 ± 2.6 6.82 ± 3.3 <0.05

Negative experience

11.03 ± 2.7 9.25 ± 2.6 <0.05

Total happiness score

12.59 ± 2.8 22.08 ± 3.7 <0.05

happiness index of patients with cancer based on SF-36

and MUNSH demonstrated that the application of human

care theory could improve the life quality and happiness

index of patients with cancer.

4. Discussion

It is well known that the daily life of cancer patients is

limited, their life skills are decreased significantly, their

social activities are reduced, they are always lack of in-

terpersonal communications and emotional support, and

often show a negative attitude to the present life, and

moreover, the disease can cause the decrease in their

body resistan ces to directly affect th e life quality of them

and the happiness index. Community nurses applied the

human care theory to give a respect to the personality of

the patients and look after the m with a personalized care,

which can give the patients an individualized treatment.

The care emphasized on patient-centered and the service

for the clients with love, patience and in an all-around

way, which could improve the life quality of patients

with cancer significantly. The results in this study

showed that compared with those before the implementa-

tion, there were significant differences in the factors

which can be used to assess the life quality of patients

with cancer, such as the physiological performance, so-

cial function, emotional function, mental health and vi-

tality after the implementation of the human care theory

(p < 0.05), there was no significant difference in physio-

logical function, general health and body pain (p > 0.05),

and the happiness index of the patients was significantly

elevated after the implementation of the human care

theory. Therefore, the theory and the method of human

care should be applied universally, and all nurses should

understand the meaning of human care theory and the

knowledge of human care in their future work. It is be-

lieved that the application of the human care theory will

be a new developme nt in nursi ng.

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