Moral dilemma of family caregivers of urostomy patients: a qualitative study

AI Summary

Caregiving perceived as moral obligation rooted in Confucian ethics, leading carers to self-sacrifice and moral distress.
Three core dilemmas: torn between caring and personal life; altered family roles and intimacy; conflict between ideal care and pragmatic limits.
Healthcare must provide culturally sensitive assessments, redesigned supportive interventions and ethical support systems to respect carers' moral dignity.

AI Summary

Although existing research has primarily focused on patients' physiological adaptation, quality of life, and the burden on family carers, the moral dilemmas faced by these caregivers have not been explored yet. Our analysis yielded three primary themes: (1) the tearing of care responsibility and self-life, (2) reconstruction of family roles and relationships, and (3) the contradiction between the best care and practical limitations, and eight subthemes: guilt of giving up, social alienation, sacrifice of physical and mental health, the challenge of intimacy, balance of multiple responsibilities, great economic pressure, limited knowledge and skills, and emotional collapse. CONCLUSION: This study reveals that family carers of Chinese urostomy patients perceive caregiving as a moral obligation rather than a mere action, viewing self-sacrifice as evidence of virtue within a Confucian ethical framework.

Basic summary

Support Care Cancer. 2026 Jun 6;34(7):624. doi: 10.1007/s00520-026-10860-2.

ABSTRACT

BACKGROUND: The most prevalent malignant tumor of the urinary system, bladder cancer, exhibits a rising global incidence rate. However, recent diagnostic and therapeutic techniques, such as ostomy surgery, can effectively prolong patient survival. The majority of patients require support from family carers, presenting considerable challenges to these caregivers. Although existing research has primarily focused on patients’ physiological adaptation, quality of life, and the burden on family carers, the moral dilemmas faced by these caregivers have not been explored yet.

PURPOSE: This study aimed to explore the psychological and moral dilemmas of family caregivers in a specific care situation.

METHODS: Using a descriptive research design, we conducted one-on-one qualitative interviews with 23 patients who had undergone urostomy. The interview time for each patient lasted over 60 min. All the interviewees emphasized that urostomy had significantly influenced their sexual experience. Moreover, we used thematic analysis to analyze the data.

RESULT: All the interviewees emphasized that a urostomy had significantly influenced their sexual experience. Our analysis yielded three primary themes: (1) the tearing of care responsibility and self-life, (2) reconstruction of family roles and relationships, and (3) the contradiction between the best care and practical limitations, and eight subthemes: guilt of giving up, social alienation, sacrifice of physical and mental health, the challenge of intimacy, balance of multiple responsibilities, great economic pressure, limited knowledge and skills, and emotional collapse.

CONCLUSION: This study reveals that family carers of Chinese urostomy patients perceive caregiving as a moral obligation rather than a mere action, viewing self-sacrifice as evidence of virtue within a Confucian ethical framework. Hence, providers must develop culturally sensitive assessment tools, redesign supportive interventions respecting diverse moral perspectives, and establish ethical support systems to bridge understanding between differing moral contexts. This might foster a healthcare system that genuinely honors the carers’ moral dignity.

PMID:42250123 | DOI:10.1007/s00520-026-10860-2

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