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Koppel PD, Park HYK, Ledbetter LS, Wang EJ, Rink LC, De Gagne JC. Rapport between nurses and adult patients with cancer in ambulatory oncology care settings: A scoping review. Int J Nurs Stud 2024; 149:104611. [PMID: 37879272 DOI: 10.1016/j.ijnurstu.2023.104611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Although the importance of the nurse-patient relationship in oncology is established, a consolidated body of research describing nurse-patient rapport, especially in ambulatory care, is lacking. OBJECTIVES This scoping review aimed to explore knowledge about rapport between adult patients with cancer and their nurses in ambulatory oncology care, including nurse, patient, nurse-patient dyad, and system-level factors that influence rapport. METHODS A scoping review was conducted to explore sources of evidence and gaps in knowledge pertinent to future research. The Joanna Briggs Institute methodology for Systematic Reviews was used with searches in MEDLINE, CINAHL, and ProQuest Dissertations and Theses Global databases. Experimental, descriptive observational, and qualitative study designs that focused on patients with cancer and their nurses within an ambulatory care setting were included. Results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS The search strategy collected 4538 studies of which 10 met study criteria after screening. Forward and backward citation tracking of included articles resulted in 4 additional studies. In total, 14 studies were extracted and analyzed. Synthesis of results from the individual sources resulted in three key observations: (a) there is an absence of studies that focus directly on nurse-patient rapport; (b) the majority of extracted data on rapport-related factors described aspects of nurses' attitudes; and (c) there was minimal information on patient, nurse-patient dyad, and system-level factors reported in these studies. CONCLUSIONS The lack of studies focused specifically on nurse-patient rapport in oncology ambulatory care indicates a notable gap in our empirical understanding of relationship-based care, a hallmark of cancer care provision. TWEETABLE ABSTRACT Nurse-patient rapport in oncology ambulatory care requires additional research @paula_koppel.
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Affiliation(s)
| | | | | | - Emily J Wang
- School of Nursing, Duke University, Durham, NC, USA
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2
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Wilkinson M. Hyperacute stroke and the specialist nursing impact: exploring the cause and context of feelings of secondary traumatic stress - a qualitative inquiry. J Res Nurs 2022; 27:343-354. [PMID: 35832877 PMCID: PMC9272500 DOI: 10.1177/17449871211018739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Secondary traumatic stress (STS) has been defined as the stress resulting from helping or wanting to help a traumatised or suffering person. The hyperacute nature of stroke specialist nurses' work places them at risk of developing STS. AIMS To explore the factors that are influential in stroke specialist nurses' experience of STS development within hyperacute practice. METHODS This study is qualitative with a narrative design. Data were collected from a purposive sample of stroke specialist nurses (20 female and 2 male) working in hyperacute services during the years 2016 and 2017. Data were analysed using Polkinghorne's approach. RESULTS This research identified four themes: exposure to acute suffering and death- young presentations; moral distress; interactions with relatives and problematic healthcare systems. CONCLUSION The findings from this study suggest that stroke specialist nurses are exposed to multiple triggers which are commensurate with the potential for STS development. The findings contribute a new understanding of the emotional burden of hyperacute specialist stroke nursing that has implications for patient safety and satisfaction, services provision and staff well-being.
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Affiliation(s)
- Mark Wilkinson
- Stroke Nurse Consultant, Department of Stroke Medicine,
Royal Liverpool and Broadgreen University Hospitals NHS Trust, UK
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3
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Wickline MM, Berry DL, Belza B. Bearing Witness in Oncology Nursing: Sharing in Suffering Across the Cancer Care Trajectory. Clin J Oncol Nurs 2021; 25:470-473. [PMID: 34269345 DOI: 10.1188/21.cjon.470-473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bearing witness in oncology nursing is a critical practice for supporting patients with cancer, and yet it is an understudied phenomenon most described at the end of life. A literature review was performed to better understand the importance of bearing witness across the cancer care trajectory and to elucidate how the practicing oncology nurse can operationalize this skill in the clinical setting. Studies suggest that oncology nurses who successfully bear witness in their practice not only assist patients and families in meaning-finding, but also sustain themselves for the difficult work of oncology through the deeply gratifying gift they receive from the experience.
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Gullick J, Wu J, Reid C, Tembo AC, Shishehgar S, Conlon L. Heideggerian structures of Being-with in the nurse-patient relationship: modelling phenomenological analysis through qualitative meta-synthesis. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2020; 23:645-664. [PMID: 32894396 DOI: 10.1007/s11019-020-09975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 06/11/2023]
Abstract
Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse-patient relationship. We firstly considered and secured the most relevant Heideggerian elements to nurse-patient Being-with (Dasein-with, circumspection, solicitude, and discourse). Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode (task-orientated busyness, existential abandonment, rough handling and deficient modes of concern in potentially violent encounters), and the authentic self-mode (seeking connection [knowing], and openness [unknowing], which exposed their emotional vulnerability). Through circumspection (making room for, deseverance and directionality), technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement (solicitude) was expressed through either leaping-in care (also perceived as 'power over') or leaping-ahead care (moving the patient towards independence). There was a place for both inauthentic (idle talk) and authentic discourse (including non-verbal and spiritual discourse) that nurses wove through the ontic everydayness of nursing tasks.
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Affiliation(s)
- Janice Gullick
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia.
| | - John Wu
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
- University of Sydney (Sydney Conservatorium of Music and University Library), Sydney, NSW, Australia
| | - Cindy Reid
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
| | - Agness Chisanga Tembo
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
- Maitland Hospital (Intensive Care Unit), Maitland, NSW, Australia
| | - Sara Shishehgar
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - Lisa Conlon
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
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5
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Cramond L, Fletcher I, Rehan C. Experiences of clinical psychologists working in palliative care: A qualitative study. Eur J Cancer Care (Engl) 2020; 29:e13220. [PMID: 31903695 DOI: 10.1111/ecc.13220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 08/09/2019] [Accepted: 12/17/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Compassion fatigue refers to the emotional and physical exhaustion felt by professionals in caring roles, whereas compassion satisfaction encompasses the positive aspects of helping others. Levels of compassion satisfaction and fatigue have been found to be inconsistent in palliative care professionals, which could have serious implications for patients, professionals and organisations. OBJECTIVES This study explored the experiences of clinical psychologists working in palliative care, all worked with adults with cancer, to gain an understanding of the impact this work has on their self and how they manage this. METHODS A qualitative approach was taken, using semi-structured interviews and interpretative phenomenological analysis. RESULTS Three superordinate themes were identified: commitment, existential impact on the self and the oracle. The participants' experiences were characterised by the relationship between themselves and their patients, the influence of working in palliative services on their world view and the impact of organisational changes. Differences between working as a clinical psychologist in palliative care versus non-palliative settings were considered. CONCLUSIONS Professionals working in palliative care should be supported to reflect on their experiences of compassion and resilience, and services should provide resources that facilitate staff to practice positive self-care to maintain their well-being.
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Affiliation(s)
- Laura Cramond
- Department of Clinical Health Psychology, Royal Bolton Hospital, Bolton NHS Foundation Trust, Bolton, UK
| | - Ian Fletcher
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Claire Rehan
- Department of Clinical Health Psychology, Royal Bolton Hospital, Bolton NHS Foundation Trust, Bolton, UK
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6
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7
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Brown-Johnson C, Schwartz R, Maitra A, Haverfield MC, Tierney A, Shaw JG, Zionts DL, Safaeinili N, Thadaney Israni S, Verghese A, Zulman DM. What is clinician presence? A qualitative interview study comparing physician and non-physician insights about practices of human connection. BMJ Open 2019; 9:e030831. [PMID: 31685506 PMCID: PMC6858153 DOI: 10.1136/bmjopen-2019-030831] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE We sought to investigate the concept and practices of 'clinician presence', exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts. DESIGN In 2017-2018, we conducted qualitative semistructured interviews with 10 physicians and 30 non-medical professionals from the fields of protective services, business, management, education, art/design/entertainment, social services, and legal/personal services. SETTING Physicians were recruited from primary care clinics in an academic medical centre, a Veterans Affairs clinic, and a federally qualified health centre. PARTICIPANTS Participants were 55% men and 45% women; 40% were non-white. RESULTS Qualitative analyses yielded a definition of presence as a purposeful practice of awareness, focus, and attention with the intent to understand and connect with individuals/patients. For both medical and non-medical professionals, creating presence requires managing and considering time and environmental factors; for physicians in particular, this includes managing and integrating technology. Listening was described as central to creating the state of being present. Within a clinic, presence might manifest as a physician listening without interrupting, focusing intentionally on the patient, taking brief re-centering breaks throughout a clinic day, and informing patients when attention must be redirected to administrative or technological demands. CONCLUSIONS Clinician presence involves learning to step back, pause, and be prepared to receive a patient's story. Building on strategies from physicians and non-medical professionals, clinician presence is best enacted through purposeful intention to connect, conscious navigation of time, and proactive management of technology and the environment to focus attention on the patient. Everyday practice or ritual supporting these strategies could support physician self-care as well as physician-patient connection.
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Affiliation(s)
- Cati Brown-Johnson
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States
| | - Rachel Schwartz
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, United States
| | - Amrapali Maitra
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Marie C Haverfield
- Department of Communication Studies, San Jose State University, San Jose, California, United States
| | - Aaron Tierney
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, United States
| | - Jonathan G Shaw
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States
| | - Dani L Zionts
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States
| | - Nadia Safaeinili
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States
| | - Sonoo Thadaney Israni
- Presence Center, Stanford University School of Medicine, Stanford, California, United States
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Abraham Verghese
- Presence Center, Stanford University School of Medicine, Stanford, California, United States
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Donna M Zulman
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, United States
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, United States
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8
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Slater PJ, Edwards RM. Needs analysis and development of a staff well-being program in a pediatric oncology, hematology, and palliative care services group. J Healthc Leadersh 2018; 10:55-65. [PMID: 30532608 PMCID: PMC6241859 DOI: 10.2147/jhl.s172665] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Around 170 multidisciplinary staff of the Oncology Services Group at Queensland Children's Hospital, Brisbane, care for children with oncology, hematology, and palliative care needs from throughout Queensland and northern New South Wales. A series of challenges impacted staff resilience and retention, and strategies were needed to improve staff well-being and enable them to flourish despite the inherent work stressors. METHODS A needs analysis was conducted using themes from Discovery Interviews with 51 staff, surveys related to "The Work Stressors Scale - Pediatric Oncology" and "The Work Rewards Scale - Pediatric Oncology" completed by 59 staff, and an organizational staff survey responded to by 51 staff. RESULTS The needs analysis informed the development of a customized Oncology Staff Well-being Program with a range of strategies aligned to a PERMA framework for flourishing (positive emotion, engagement, relationships, meaning, and accomplishment). Positive emotion areas included education on topics such as well-being, resilience, responding to escalating behaviors, grief and loss, and self-care. Staff attended the available mindfulness sessions, debriefing and counselors on site, developed self-care plans, and followed a well-being Facebook Group. Engagement was supported through exploring character strengths, improving communication, supporting innovation, and addressing frustrations and safety concerns. Relationships within the team were addressed through team building and social events. Meaning of the work was emphasized through sharing family updates and end of treatment celebrations. Accomplishments of staff were acknowledged in newsletters and meetings. CONCLUSION The needs analysis drove a multifaceted approach to staff well-being with the development of strategies which aligned to a framework that would empower staff to flourish at work. Implementation and evaluation are ongoing and will be reported in a subsequent paper.
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Affiliation(s)
- Penelope J Slater
- Oncology Services Group, Queensland Children's Hospital, South Brisbane, QLD, Australia,
| | - Rachel M Edwards
- Nursing Learning and Workforce Development, Queensland Children's Hospital, South Brisbane, QLD, Australia
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Slater PJ, Edwards RM, Badat AA. Evaluation of a staff well-being program in a pediatric oncology, hematology, and palliative care services group. J Healthc Leadersh 2018; 10:67-85. [PMID: 30532609 PMCID: PMC6241860 DOI: 10.2147/jhl.s176848] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Challenges experienced by staff in the Oncology Services Group at Queensland Children's Hospital led to issues with staff retention, well-being, and stress on team culture. Therefore, a customized program was developed through a needs analysis to improve the well-being and resilience of oncology staff, enabling them to cope with stressors and critical incidents inherent in their everyday work and to flourish. The program included education, on-site counselors, mindfulness sessions, debriefing, well-being resources, and improved engagement, support, and communication. METHODS Evaluation of the program in the first year examined program participation, staff feedback following education workshops and mindfulness sessions, staff retention rates, and the results of an annual organizational staff survey and a program outcome survey. RESULTS Approximately 76% of staff attended the Introduction to Well-being workshop, and 98% of responses to survey questions were positive. Staff also provided positive feedback on the other well-being workshops and sessions embedded within existing education programs. Employee Assistance Program counseling sessions had an 81% uptake, with a wide variety of presenting issues, 62% related to work. All participants in mindfulness sessions agreed that it was a valuable tool to improve clinical practice, 94% said it had an immediate positive impact on their well-being, and 70% agreed that they were applying mindfulness principles outside the sessions. Staff retention and turnover improved. Staff reported a positive effect on awareness of self-care, addressing risks to resilience, seeking support from trusted colleagues, coping with critical incidents, and the ability to interact positively with patients and families. CONCLUSION The evaluation showed a positive impact on staff well-being. Although there was a wide variety of successful interventions reported in the literature, sustainability needs to be considered. Feedback on this program found that staff appreciated being listened to, valued, and supported through the strategies, and the ongoing program will continue to monitor staff needs and be responsive in building their resilience and well-being.
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Affiliation(s)
- Penelope J Slater
- Oncology Services Group, Queensland Children's Hospital, Brisbane, QLD, Australia,
| | - Rachel M Edwards
- Nursing Learning and Workforce Development, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Ashraf A Badat
- Oncology Services Group, Queensland Children's Hospital, Brisbane, QLD, Australia,
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10
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Caring for Aging Populations: Examining Compassion Fatigue and Satisfaction. JOURNAL OF ADULT DEVELOPMENT 2018. [DOI: 10.1007/s10804-018-9315-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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11
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Mohammadipour F, Atashzadeh-Shoorideh F, Parvizy S, Hosseini M. An explanatory study on the concept of nursing presence from the perspective of patients admitted to hospitals. J Clin Nurs 2017; 26:4313-4324. [PMID: 28178371 DOI: 10.1111/jocn.13758] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To clarify the concept of nursing presence through patients' perception. BACKGROUND The holistic caring process at the bedside must incorporate the concept of nursing presence. Most of the research about nursing presence is based on nurses' experiences, and research into patients' experiences is minimal. According to goals of patient centredness, the association between the patient satisfaction and nursing presence, and patients' ability to understand this concept, it is important to explore this concept from the patients' perspective. DESIGN A qualitative approach. METHODS Based on purposive sampling technique, 12 patients were recruited. After participant observation, 15 interviews were carried out with participants. Data were transcribed verbatim and analysed using conventional qualitative content analysis. RESULTS Five main categories were drawn from the data including informed concentration, task-centred/patient-centred relationship, clarification of meanings, comprehensive participation and accountable encounter. Data analysis alongside the authors' reflections resulted in the emergence of one overarching theme, 'coconstructed interaction', which shows the notion that effective nurse-patient interaction enhances cooperation, coordination and collaboration in caring and improves nursing outcomes. CONCLUSIONS Accordingly, the nursing presence would be ideal for patient-centred caring. RELEVANCE TO CLINICAL PRACTICE Knowing the perspectives of patients is important as the evaluation of nursing care quality should rely on outcome indicators that are sensitive to patients. For instance, client satisfaction and health status acceptance, especially as it relates to coping, comfort level, hope, and participation in decision-making, are included in the nursing outcomes' classification system. Thus, the findings of this study may facilitate improvement in the quality of care by continuous improvement in knowledge, attitudes and abilities of nurses. It is therefore recommended that managers and clinical nurses, by relying on these findings, design the caring activities so that nurses' presence can act as a facilitating factor for improving quality assurance.
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Affiliation(s)
- Fatemeh Mohammadipour
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Tehran and Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Department of Nursing Management, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soroor Parvizy
- Pediatric Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Bergkvist K, Fossum B, Johansson UB, Mattsson J, Larsen J. Patients' experiences of different care settings and a new life situation after allogeneic haematopoietic stem cell transplantation. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28252234 DOI: 10.1111/ecc.12672] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/29/2022]
Abstract
Over the past 20 years, considerable healthcare resources have shifted from an inpatient to an outpatient setting. To be in an outpatient setting or at home after allogeneic haematopoietic stem cell transplantation (allo-HSCT) has been shown to be medically safe and beneficial to the patient. In this study we describe patients' experiences of different care settings (hospital or home) and a new life situation during the acute post-transplant phase after HSCT. Semi-structured interviews were conducted with 15 patients (six women and nine men) 29-120 days after HSCT. An inductive qualitative content analysis was performed to analyse the data. The analysis resulted in four categories: To be in a safe place, To have a supportive network, My way of taking control, and My uncertain return to normality. The findings showed that patients undergoing HSCT felt medically safe regardless of the care setting. The importance of a supportive network (i.e. the healthcare team, family and friends) was evident for all patients. Both emotional and problem-focused strategies were used to cope with an uncertain future. Being at home had some positive advantages, including freedom, having the potential for more physical activity, and being with family members. The study highlights some key areas thought to provide more personalised care after HSCT.
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Affiliation(s)
- K Bergkvist
- Sophiahemmet University, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - B Fossum
- Sophiahemmet University, Stockholm, Sweden.,Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - U-B Johansson
- Sophiahemmet University, Stockholm, Sweden.,Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - J Mattsson
- Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden.,Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - J Larsen
- The Red Cross University College, Stockholm, Sweden
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Morrison CF, Morris EJ. The Practices and Meanings of Care for Nurses Working on a Pediatric Bone Marrow Transplant Unit. J Pediatr Oncol Nurs 2017; 34:214-221. [DOI: 10.1177/1043454216688637] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bone marrow transplant (BMT) units are stressful work environments with high staff burnout, anxiety, and turnover. A qualitative study was undertaken to better understand care for nurses within the context of their clinical practice on a pediatric BMT unit. Understanding care practices for BMT nurses will allow us to design interventions and provide appropriate support for this subspecialty of nurses. Focus groups were held with 24 nurses as key participants, and 2 focus groups with general participants: unit management (N = 2) and caregivers of inpatients (N = 7). Data were analyzed using a thematic analysis. Data were transcribed verbatim and coded to consensus by members of the research team. Five themes emerged from the data: ( a) experiencing stressful situations that impede care, ( b) growing and developing personally and professionally, ( c) providing trustworthy and respectful care, ( d) acquiring meaningful coping skills, and ( e) sharing with others versus isolation. Stress management, professional development, and interdisciplinary communication were areas that emerged for potential intervention.
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Affiliation(s)
| | - Edith J. Morris
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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14
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Sinclair S, Raffin-Bouchal S, Venturato L, Mijovic-Kondejewski J, Smith-MacDonald L. Compassion fatigue: A meta-narrative review of the healthcare literature. Int J Nurs Stud 2017; 69:9-24. [PMID: 28119163 DOI: 10.1016/j.ijnurstu.2017.01.003] [Citation(s) in RCA: 210] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 01/08/2017] [Accepted: 01/09/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Compassion fatigue describes a work-related stress response in healthcare providers that is considered a 'cost of caring' and a key contributor to the loss of compassion in healthcare. OBJECTIVE The purpose of this review was to critically examine the construct of compassion fatigue and to determine if it is an accurate descriptor of work-related stress in healthcare providers and a valid target variable for intervention. DESIGN Meta-narrative review. DATA SOURCES PubMed, Medline, CINAHL, PsycINFO, and Web of Science databases, Google Scholar, the grey literature, and manual searches of bibliographies. REVIEW METHODS Seminal articles and theoretical and empirical studies on compassion fatigue in the healthcare literature were identified and appraised for their validity and relevance to our review. Sources were mapped according to the following criteria: 1) definitions; 2) conceptual analyses; 3) signs and symptoms; 4) measures; 5) prevalence and associated risk factors; and 6) interventions. A narrative account of included studies that critically examines the concept of compassion fatigue in healthcare was employed, and recommendations for practice, policy and further research were made. RESULTS 90 studies from the nursing literature and healthcare in general were included in the review. Findings emphasized that the physical, emotional, social and spiritual health of healthcare providers is impaired by cumulative stress related to their work, which can impact the delivery of healthcare services; however, the precise nature of compassion fatigue and that it is predicated on the provision of compassionate care is associated with significant limitations. The conceptualization of compassion fatigue was expropriated from crisis counseling and psychotherapy and focuses on limited facets of compassion. Empirical studies primarily measure compassion fatigue using the Professional Quality of Life Scale, which does not assess any of the elements of compassion. Reported risk factors for compassion fatigue include job-related factors, fewer healthcare qualifications and less years experience; however, there is no research demonstrating that exemplary compassionate carers are more susceptible to 'compassion fatigue'. CONCLUSION In the last two decades, compassion fatigue has become a contemporary and iconic euphemism that should be critically reexamined in favour of a new discourse on healthcare provider work-related stress.
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Affiliation(s)
- Shane Sinclair
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
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15
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Durkin M, Beaumont E, Hollins Martin CJ, Carson J. A pilot study exploring the relationship between self-compassion, self-judgement, self-kindness, compassion, professional quality of life and wellbeing among UK community nurses. NURSE EDUCATION TODAY 2016; 46:109-114. [PMID: 27621200 DOI: 10.1016/j.nedt.2016.08.030] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 08/12/2016] [Accepted: 08/25/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Compassion fatigue and burnout can impact on performance of nurses. This paper explores the relationship between self-compassion, self-judgement, self-kindness, compassion, professional quality of life, and wellbeing among community nurses. AIM To measure associations between self-compassion, compassion fatigue, wellbeing, and burnout in community nurses. METHOD Quantitative data were collected using standardised psychometric questionnaires: (1) Professional Quality of Life Scale; (2) Self-Compassion Scale; (3) short Warwick Edinburgh Mental Wellbeing Scale; (4) Compassion For Others Scale, used to measure relationships between self-compassion, compassion fatigue, wellbeing, and burnout. PARTICIPANTS A cross sectional sample of registered community nurses (n=37) studying for a postgraduate diploma at a University in the North of England took part in this study. RESULTS Results show that community nurses who score high on measures of self-compassion and wellbeing, also report less burnout. Greater compassion satisfaction was also positively associated with compassion for others, and wellbeing, whilst also being negatively correlated with burnout. CONCLUSION High levels of self-compassion were linked with lower levels of burnout. Furthermore when community nurses have greater compassion satisfaction they also report more compassion for others, increased wellbeing, and less burnout. The implications of this are discussed alongside suggestions for the promotion of greater compassion.
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Affiliation(s)
- Mark Durkin
- School of Health and Human Sciences, University of Bolton, BL3 5AB, UK.
| | - Elaine Beaumont
- School of Nursing, Midwifery, Social Work & Social Sciences Mary Seacole Building, (Room MS3.17), University of Salford, Frederick Road, Salford, Greater Manchester M6 6PU, UK.
| | | | - Jerome Carson
- School of Education and Psychology, University of Bolton, BL3 5AB, UK.
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16
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Experience of nurses caring for child with hematopoietic stem cell transplantation in general pediatric ward: a descriptive phenomenological approach. Cancer Nurs 2016; 37:E32-9. [PMID: 25140638 DOI: 10.1097/ncc.0000000000000097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most studies on hematopoietic stem cell transplantation (HSCT) have focused on patients, survivors, or their family members, such as siblings and parents. Little attention has been paid to nurses caring for HSCT pediatric patients and in particular in a Taiwanese context. OBJECTIVE The objective of this study was to explore nurses' lived experience caring for HSCT children in isolation within a general pediatric ward. METHOD A Husserlian phenomenological approach informed the exploration of the meaning and essence of the nurses' caring experience. Data were collected using semistructured interviews. RESULTS Twelve nurses were interviewed. Analysis of interviews yielded 3 main themes: being worried about ruining transplantation success, feeling loss of control in handling suffering, and reflecting upon the value of HSCT. CONCLUSIONS Nurses felt the stress of caring for HSCT children because of the heavy workload and the pressure of responsibility. Witnessing the suffering of patients/families was particularly stressful. However, nurses were helped to overcome this stress by looking at the value and meaning of HSCT. IMPLICATIONS FOR PRACTICE Nurses need practical support from nursing leaders in terms of carefully organizing patient care, controlling the nurse-to-patient ratio, and offering a safe work environment by providing systematic formal training on HSCT and receiving proper supervision. Understanding and learning are gained from nurses who are able to seek meaning from HSCT through appreciating every caregiving effort and through valuing how their nursing role contributes to the quality of patients' care.
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17
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Ledoux K. Understanding compassion fatigue: understanding compassion. J Adv Nurs 2015; 71:2041-50. [PMID: 25981240 DOI: 10.1111/jan.12686] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 11/26/2022]
Abstract
AIM A discussion of how the construct of compassion fatigue is understood in nursing. BACKGROUND Compassion fatigue is a topic commonly found in nursing literature. DESIGN Discussion paper. DATA SOURCES The literature from 1992-2012 on compassion fatigue was examined. The literature from 1998-2012 on compassion was examined. IMPLICATIONS FOR NURSING There are multiple and diverse understandings and definitions of what compassion fatigue is. So much so, there are equally multiple, diverse and conflicting strategies to mitigate it. To understand better what compassion fatigue is, an examination of what compassion is was undertaken. Much is written that nurses are, or should be compassionate. Compassion is an archetype of nursing. However, there is little in the nursing literature defining what compassion is. Literature on compassion outside of nursing was then examined. There is a growing body of theory and research about compassion in other disciplines. None of the multiple definitions of nurse compassion fatigue match this understanding of compassion. The tools most often used to measure nurse compassion fatigue do not appear to measure the construct of compassion. CONCLUSION To understand what nurse compassion fatigue is, we must first understand what nurse compassion is.
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Affiliation(s)
- Kathleen Ledoux
- University of Western Ontario - Arthur Labatt Family School of Nursing, London, Ontario, Canada
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18
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Efstathiou N, Walker W. Intensive care nurses' experiences of providing end-of-life care after treatment withdrawal: a qualitative study. J Clin Nurs 2014; 23:3188-96. [DOI: 10.1111/jocn.12565] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nikolaos Efstathiou
- School of Health and Population Sciences (Nursing); College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - Wendy Walker
- Centre for Health and Social Care Improvement; School of Health and Wellbeing; University of Wolverhampton; Wolverhampton UK
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19
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Hospital care or home care after allogeneic hematopoietic stem cell transplantation – Patients' experiences of care and support. Eur J Oncol Nurs 2013; 17:389-95. [DOI: 10.1016/j.ejon.2012.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 12/13/2012] [Accepted: 12/17/2012] [Indexed: 11/21/2022]
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20
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East L, Hutchinson M. Moving beyond the therapeutic relationship: a selective review of intimacy in the sexual health encounter in nursing practice. J Clin Nurs 2013; 22:3568-76. [DOI: 10.1111/jocn.12247] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Leah East
- School of Health and Human Sciences; Southern Cross University; Lismore NSW Australia
| | - Marie Hutchinson
- School of Health and Human Sciences; Southern Cross University; Lismore NSW Australia
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21
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Zamanzadeh V, Valizadeh L, Sayadi L, Taleghani F, Howard F, Jeddian A. Emotional Labour of Caring for Hematopoietic Stem Cell Transplantation Patients: Iranian Nurses' Experiences. Asian Nurs Res (Korean Soc Nurs Sci) 2013; 7:91-7. [DOI: 10.1016/j.anr.2013.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 01/14/2013] [Accepted: 03/20/2013] [Indexed: 11/24/2022] Open
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