3.3. Characteristics of Predicting

3.3. Characteristics of Predicting Worsening of Symptoms One category was extracted for characteristics of predicting worsening of symptoms: ˂HPN predicts worsening of symptoms in a patient approaching natural death˃. This was composed of two sub-categories. 1) [HPN observation in a range that does not interfere with the patient’s comfort] was composed of three open codes: {HPN checks the patient’s temperature, pulse, respiration and reflexes by directly touching the patient’s body}; {HPN chooses measuring methods with the least burden according to the patient’s condition}; and {HPN is sensitive to day-to-day changes}. “Of course I look at objective data such as blood pressure or test data, but I judge the patient’s condition by touching the pulse of the patient’s body. Without monitors, I make sure to touch the patient’s body and observe carefully to sensitively check daily progress. I consider what the vital measurements are for, and observe to try to ease the patient’s pain and burden.” 2) [HPN sense that something is different from before] was composed of three open codes: {HPN senses something is different overall from the patient than before}; {The family notices a lack of vitality}; and {HPN senses that the time of death is near}. “As the time of death nears, the manner of speaking is different, the expression is dull, and I feel that the person’s appearance and atmosphere are somehow different. The family close to the patient may first notice a lack of vitality.”