Data analysis leads to the extraction of the two main categories include "Deficiency in management of disease" with three sub-categories. Another category is "The need for sympathetic and knowledgeable caregivers" with the five sub-categories.
Deficiency in management of disease
At the onset of cancer and symptoms of disease progression, patients faced with multiple physical difficulties. These physical complications considered as one of the basic needs of these patients. Patients felt unable to manage their symptoms and complications. In this regard, they expressed the need for help.
Need to get rid of annoying physical symptoms
Among the most critical problems that have been reported by patients were complications from chemotherapy. Patients were faced with many challenges to overcome these complications and found themselves close to death. During the chemotherapy process, patients had several experiences:
"Chemotherapy is like putting a bomb inside my body and then pressing its button. I have high pain tolerance, but when my white blood cells go down, I have a terrible condition. It's so painful. (P10) »
Need for a caregiver in daily routine
The majority of patients, after the onset of the disease and particularly during treatment, expressed their most crucial concern to do their daily routine, the fear of losing independence, the need for a caretaker to do their daily activities, and to fail to do things that they had done before.
"When I had chemotherapy and hospitalized, it was tough for me to pick up or move something and I needed someone to do it for me (p6)"
"The side-effects after chemotherapy are considerable. The patient suffers from these complications, and because of that, he/she becomes overwhelmed and disabled. (P11 Oncology Nurse) "
Feeling frustrated and giving up treatment
At a stage where the patient is suffering from frequent hospitalizations, he becomes disconcerted and, when his treatment fails, he feels frustrated, and the possibility of a decision to give up the treatment increases.
"It's an unfortunate thing when his mood breaks down, and he says I'm not going to get well. I'll die. Who has recovered well from this illness? (P13 .mother of a patient)
Need for sympathetic and knowledgeable caregivers
According to the experiences of participants, this category included four sub-categories:
Need for sympathy and interaction with a nurse
Participants in this study mentioned empathy and the nurse-patient relationship as one of the main criteria for care. Some participants were satisfied with this relationship. They considered the treatment team as an essential factor in their treatment and recovery. However, some others thought this relationship and the competence and ability of nurses in oncology weak and mentioned the need for nursing education.
"Those times that I was eating my soup like a cat because I could not move my hands. The nurse said, Do you want me to put it in your mouth? I said no. She sat on the chair next to me. Suddenly I saw her crying. It was a good sense of empathy for me (P3)."
“New nurses should receive training, but that is no longer enough. Nurses need more expertise in practice. (P11 oncology nurse). "
Need for hearing the truth about the disease
According to patients' experiences, from the moment they diagnosed with the disease, thousands of ambiguous questions about the nature of the disorder come to mind, so they felt needed an informed person to clarify the issues in their minds. Some of the patients said that hearing the truth would help them to enter the stage of disease acceptance and fight their illness.
"I needed a person to explain to me what this disease was overall. How does this happen? Because this disease is like a giant, which creates fear and horror (P1)."
“The doctor told me, 0.7 mm of the tumor remained after the operation, and there is a significant danger. I liked her honesty because she did not hide my illness (p8). "
Need for appropriate therapeutic interaction from Physicians
According to the results, it was essential to establish a productive therapeutic relationship between the doctor and the patient in the process of treatment. Many patients said that if a person diagnosed with cancer, he or she should first be mentally prepared.
"When I received my tests, the nurse said, "Madam, you have cancer, you need chemotherapy." As soon as she said this, I fell into a fit and collapsed. She didn't try to prepare my mind and then tell me (P4). "
Inadequate qualification of Physicians' secretary about the patient
One of the problems, as the participants stated, was the inappropriate behavior of Physicians' secretaries to the patients. Therefore, participants expressed that the oncologists' secretaries needed to be trained and informed about the psychological and physical condition of cancer patients.
"The secretaries should also be trained. They are so bad-tempered, and they want to fight. I even saw several times that they started fighting with the patients' companion (P10)."
Need for a psychologist for psychological adaptation
Since the onset of disease and the psychological crisis, patients may not have the ability to communicate appropriately and accept the condition. Therefore, the need for counseling by an informed person is essential. Unfortunately, there is currently no provision of psychological services in oncology departments, and this burden has imposed on nurses.
"We don't have psychoanalysts in our sections. There are some cases that the patient has a terrible psychological state and needs a psychologist (P12 oncology nurse)".