“The Group Initial Session”

The worker and the group agreed to hold their meetings to encourage regular attendance even if the
patients were experiencing the side effects that usually follow chemo therapy.

The ward nursing supervisor was invited by “Miss J” to attend the first group session where the patients
two, main areas of concern were reiterated. It was emphasized that the meetings were not meant to
serve as “gripe sessions” but due to factors in themselves or external factors such as their families, the
hospital which hamper not only their adjustment in the hospital, but their medical recovery. The nursing
supervisor said she would cooperate if the patients requests were reasonable.

The first two sessions discussing the patients medical condition and consequences, and also the problem
they had about to hospital policies and practice. In relation to these, the group and the worker agreed to
hold weekly sessions for 3 months after which period, they expected the following goals to have been
achieved.

By the end of their second session, the worker and the group had agreed that of the eleven remaining
sessions, four sessions would focus on the patients problem relating to the hospital. The group members
expressed the need to spend more time on the latter because these had been aggravating their already
“bad” medical/physical conditions. They expressed their sense of helplessness and powerlessness
especially because they were only “charity patients “. They said they were thankful and wanted to
cooperate with the hospital but they thought many policies and practices were unjust and inhuman
(“hindi makatarungan at hindi Maka tao”). The group asked the worker for help in dealing with the
following specific concerns:

1) The requirement to wear the hospital uniform: the members said that the smell of the uniform
usually induces vomiting; there are blood stains on the uniform even after laundry and
disinfection and patients feared this might cause infection to which they were very susceptible;
being already bald (because of chemotherapy), wearing the uniform made them look like
prisoners.
2) The food rationing system: patients use of personal varied size-plates to get their food at the
counter during meal time results in an unequal quantity of food being given, with patients
towards the end of the line getting very little; the same problem was being experienced by
patients for whom a high protein, high calorie diet had been prescribed by the doctors.
3) Cruel/inhuman treatment of patients care givers/watchers by hospital security personnel, e.g.,
being hit by the guards night stick when found resting their heads on the patients bed.
4) Chemotherapeutic drugs are often not available at the hospital pharmacy forcing patients to buy
them outside at prohibitive prices.
5) Access to hospital and community resources through the hospital referral service: the group is
asking for assistance (e.g., funds for drugs) on a more regular basis because the doctors require
them to take their medication according to schedule.
The Group problem solving activities
The following is a brief summary of what happened during the rest of the group sessions:

Session 3. Sharing of individual situations. The members expressed their thoughts and feelings, their
fears and concerns relating to their illness, their roles as wives, mothers, and employees, and their
family’s financial problems. A great deal of crying and mutual support took place. Themes/topics for
future sessions were agreed on and corresponding plans were made for activities to be undertaken.

Session 4. The worker invited Dr. Z and the Chief of the trophoblastic section to facilitate an information
education session about the disease: its nature, implications, treatment, and prognosis. Sexuality-
related concerns which were raised in the previous meeting, were taken up. A very important
clarification was make about why doctors prohibit sexual contact during the period