Nursing students' perceptions towards cancer and caring for cancer patients in Turkey

Rehearsing empathy: exploring the role of poetry in supporting learning

Empathy is an important aspect of therapeutic relationships in health and social care settings. Health educators can foster empathy development in learners through creative writing activities. Drawing on the humanities, specifically poetry, this paper offers strategies for educators to support empathy development in learners, with a focus on service user poetry and associated creative writing activities. We discuss how poetry can enable alternative perspectives about care to emerge thereby challenging previously held assumptions about mental and physical states. Using poetry can enable a rehearsal of empathy by bringing experiences to the learner in a safe and facilitated environment. Through creative writing activities, we believe that students can learn to better understand and empathise with others, as well as explore their own feelings and experiences related to caregiving, to support self-care.

WITHDRAWN: "The closest touch to death in psychiatric nursing practice": Experiences of nursing students in a psycho-oncology unit

his article has been withdrawn at the request of the Editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.

Can Oncology Nursing Education Change the Attitude of Nursing Students toward Cancer (Cancer Stigma)? A Quasi-Experimental Study

Purpose: This study was conducted to assess the effect of the oncology nursing internship education on the attitudes of students (stigma) toward cancer patients. The study was conducted in a faculty of nursing in İzmir, Turkey. Methods: The quasi-experimental pre-test post-test design was used in this study. The sample of the study was composed of totally 84 students, who attended the course of Oncology Nursing Internship (n:43) and the course of Gynaecology and Obstetrics Nursing Internship (n:41). The Student Information Form and Questionnaire for Measuring Attitudes Toward Cancer - Community Version were used as the data collection tool in the study. The students who were interns in oncology nursing received an education on oncology nursing including 280 hours of practice and 56 hours of theory and the other group had no education on the subject. In order to assess the efficiency of the education of oncology nursing internship on cancer attitude and to compare the groups, The Questionnaire for Measuring Attitudes Toward Cancer - Community Version was applied again to both groups at the end of the semester. Results: As a result of this study, it was found that the course of oncology nursing internship increased the positive attitudes of the students toward cancer patients (t=5.591, p=0.000). Conclusion: The education programs of oncology nursing should be integrated into the nursing curricula to provide that nursing students provide more effective care services for cancer patients and develop more positive attitudes.

Examining Nursing Students' Perspectives on Cancer through Metaphors in Turkey

This study was conducted to reveal the perceptions of cancer through metaphors among second-year nursing students. This study utilized descriptive phenomenology, which is a qualitative research design. In order to reveal the metaphors that each nursing student (n = 65) considered for the concept of "cancer," they were asked to complete the following sentence: "Cancer is like ……, because ……". In analyzing the data, a content analysis approach comprising coding, the identification of themes, and grouping of data according to codes and themes was used. It was found that the nursing students produced 44 different metaphors. With the groupings made from the students' perspectives on cancer, categories of "crime/punishment," "fear/anxiety/pain," "uncertainty," "uncontrollability," and "struggle/hope" were identified. In particular, the students' metaphors of "test," "fight," "unwanted friend," "love," "naughty child," "thief," and "trouble" for the concept of cancer came to the fore. It is recommended to improve clinical education to develop positive attitudes among nursing students toward cancer.

'Who would even want to talk about death?' A qualitative study on nursing students' experiences of talking about death with terminally ill patients with cancer

OBJECTIVES

This study aimed to describe nursing students' experiences of talking about death with terminally ill patients with cancer.

METHODS

The study adopted a qualitative design, and participants (n = 28) were final-year undergraduate nursing students. Data were collected by conducting in-depth semi-structured face-to-face interviews using a pilot-tested interview guide. The researchers followed a systematic data analysis procedure which is an appropriate method of analysis when aiming to create knowledge based on experiences and meanings from cross-case analysis.

RESULTS

The responses of the nursing students were subsumed under the following three themes: (1) 'balance on the rope', (2) 'who would even want to talk about death' and (3) 'need to talk but …'. The findings suggest that many nursing students do not believe that they are competent enough to talk about death with terminally ill patients with cancer, even though they believe it is essential to end-of-life care.

CONCLUSION

The findings underscore the importance of examining students' perspectives on death, which not only shapes their experiences of caring for terminally ill patients but also influences the quality of care. Further, students feel unprepared for talking to terminally ill patients with cancer and require support to avoid ignoring calls to speak about death.

Empathic approach to reducing the negative attitudes of nursing undergraduate students towards cancer

BACKGROUND

In cases where even professional nurses have difficulty in giving care to cancer patients, student nurses may not be able to provide adequate care and sometimes develop a negative behavior or attitude towards this patient group.

OBJECTIVES

The purpose of the study was to examine the relationship between the attitudes of nursing undergraduate students towards cancer and the empathic approach.

DESIGN

The study was carried out using the cross-sectional research design.

SETTINGS

A university located in the southeast of Turkey between November-December 2020.

PARTICIPANTS

Nursing students from one Turkey nursing school.

METHODS

The research data were collected using the Personal Information Form, Questionnaire for Measuring Attitudes towards Cancer (Cancer Stigma) (QMAC) - Community Version, and Jefferson's Empathy Scale for Nursing Students (JESNS).

RESULTS

240 students volunteered to participate in the study, and the rate of the students' response to the questionnaires was 52%. Of all the nursing students, 66.2% of them were female; 45.4% had a moderate perception of their economic status; 94.2% had no chronic disease; 90.4% had no family history regarding cancer; 67.9% had never been in an oncology clinic, and 59.2 of them had received training on empathy. When nursing students' attitudes towards cancer were examined, it was seen that empathic approach (β = -0.291; p < .01) and chronic disease treatment received (β = 0.174; p = .005) were found to be significant predictors.

CONCLUSIONS

The results revealed that the nursing undergraduate students' negative perception of cancer decreased as their empathic skills increased. In addition, the students' receiving treatment for chronic diseases increased their negative perception of cancer. In order to reduce the negative attitudes of nursing students towards cancer, more trainings, lectures and seminars or clinical skills training regarding the development of empathic skills could be included in the undergraduate nursing curriculum.

Nursing Student Perceptions and Attitudes Toward Patients With Cancer After Education and Mentoring: Integrative Review

BACKGROUND

Knowledge about nursing student attitudes toward patients with cancer after an educational intervention and mentoring support is limited. This review examined the literature on this topic.

OBJECTIVE

This integrative review aims to explore the literature on the experiences of students who participate in an oncology elective or educational course on cancer and their attitudes toward cancer.

METHODS

A comprehensive search was conducted using PubMed, CINAHL, and MEDLINE databases. Each study was systematically assessed. An evidence table was completed to identify the key aspects of each study that was reviewed.

RESULTS

There is insufficient information on the impact of nursing student education on the attitudes and skills of nursing students caring for patients with cancer. An integrative review was completed on the impact of education and mentoring for nursing students on cancer care, which yielded 10 studies that were reviewed. These studies indicate that educational intervention and mentoring improve the confidence and ability of nursing students to care for patients with cancer.

CONCLUSIONS

Student nurses need to be armed with knowledge, skills, and positive attitudes while caring for patients with cancer. Nursing students perform best when they have accurate information, positive role models, and mentoring by experienced oncology professionals, to support proficiency in caring for patients with cancer. The lack of knowledge of nursing students in the areas of cancer care, treatment, and patient support requires additional education and research to promote expertise and positive attitudes toward cancer and treating patients with cancer. This will support nursing students' ability to care for patients with cancer as well as develop future educational interventions to shape nursing student attitude and knowledge. This integrative review also identifies the positive impact on the attitudes of other health care professionals who have received training or education on cancer.

Quality of Oncology Nursing Care as Perceived by Patients With Cancer: Results From Three Arab Countries

BACKGROUND

Patient satisfaction was defined as expectation and perception of the patients about real nursing care they receive.

OBJECTIVE

The aim of this study was to evaluate the quality of oncology nursing care as perceived by patients with cancer in 3 Arabic countries (Jordan, Oman, and Egypt).

METHODS

A cross-sectional design with convenience sampling approach was used. A total of 517 patients with cancer (Jordan, 200, 38.7%; Sultanate of Oman, 137, 26.5%; and Egypt, 180, 34.8%) participated and completed the study's questionnaires including sociodemographic data and the Quality of Oncology Nursing Care Scale (QONCS).

RESULTS

Moderate quality of oncology nursing care was reported by the participants. The overall mean for the quality of oncology care as measured by the QONCS-Ar (QONCS Arabic version) was highest in Oman (153.40; SD, 4.10), followed by Jordan (150.93; SD, 2.10) and then Egypt (148.0; SD, 3.80). The results were significantly different in the total score of the QONCS-Ar (F = 45.20, P < .001) among the 3 countries. The results also differed in all domains of oncology nursing care according to days of treatment and marital status.

CONCLUSION

Findings are considered a baseline for future research and highlight the importance of evaluating quality of oncology nursing care as perceived by the patients with cancer.

IMPLICATIONS FOR PRACTICE

The results from the current study can be used to develop an interventional program focusing on the needs of patients and their perceptions of care.

Acceptability and efficacy of a communication skills training for nursing students: Building empathy and discussing complex situations

Nurses must demonstrate effective communication across complex interpersonal domains, as emphasized by numerous professional healthcare organizations. However, formal communication skills training has been only modestly integrated into baccalaureate nursing programs, and of those studied systematically, there are notable methodological concerns. The current study focused on application of a well-researched communication program (Comskil) to student nurses completing summer internships at a comprehensive cancer center as part of their clinical education. The Comskil training program for student nurses is an in-person, day-long training that includes three sections: responding empathically to patients; discussing death, dying, and end-of-life goals of care; and responding to challenging family interactions. Student nurse participants provided strongly favorable perceptions of the program, with 90% indicating that they agreed or strongly agreed with all perception items. A significant pre-to post-training improvement in self-reported confidence was observed (p < .01). Additionally, pre- and post-training observational coding of standardized patient assessments indicated significant improvements in usage of the following skill categories: total skill use, information organization, and empathic communication (p < .001). Overall, these results suggest that communication skills training for student nurses is a feasible, acceptable, and effective way of increasing confidence and skills usage in complex clinical scenarios.

Altered nursing student perspectives: Impact of a pre-clinical observation experience at an outpatient oncology setting

This study examined the influence of an observation experience at an outpatient oncology setting on first-year nursing students. This experiential learning opportunity occurred prior to any formal clinical practice course. A hermeneutic phenomenology approach was used to uncover pre-licensure nursing students' perspectives about cancer, as well as their understanding of the roles and responsibilities of registered nurses in cancer care both before and following their experience. A total of 10 nursing students agreed to participate in the study. Data were collected through semi-structured interviews following which data were analyzed and interpreted to understand the meaning in the experience. Two overarching themes were identified including circles of relationships, and the many sides of outpatient oncology. This study reveals that experiential learning in the form of a low-risk, observation-only experience may be an opportunity for pre-licensure students to gain new perspectives about cancer care and nurses roles in caring for individuals and families who are impacted by cancer.

Nursing Students' Perspectives on Assisting Cancer Patients

Objective:

The objective of this study was to examine the experiences of student nurses who have provided care to cancer patients.

Methods:

A mixed method approach consisting of semistructured focus groups (n = 61) and a survey questionnaire (n = 129) was used in the study. Student nurses were first interviewed, and then, a questionnaire was developed for them to answer. Following the content analysis, three themes and 19 subthemes were identified. Frequency and percent were used for qualitative data.

Results:

Among the student nurses, 80.6% reported that working with cancer patients was “difficult.” Difficulties experienced by the student nurses included patients rejecting their care, a large number of problems cases encountered when providing care to cancer patients, communication problems (38.0%), working with patients and attendants who fear death, and problems arising from family attendants who obstruct care. The majority of students experienced patients fearing death (28.7%) and felt feelings such as pity (71.1%), sadness (50.0%), and fear of cancer (41.9%) during their internships in oncology clinics.

Conclusions:

Students should be supported by instructors and oncology nurses, and nursing curricula should contain topics on how to best approach cancer patients.

An innovation in curriculum content and delivery of cancer education within undergraduate nurse training in the UK. What impact does this have on the knowledge, attitudes and confidence in delivering cancer care?

PURPOSE

This was an evaluation of an innovation in curriculum content and delivery within undergraduate nursing education in the UK. Its purpose was to investigate the effect on knowledge, attitudes and confidence in delivering cancer care.

METHODS

The study design was a pre-test post-test survey design with a comparison group. Participants were two cohorts of undergraduate nursing students (n(intervention) = 84, n(comparison) = 91). The intervention cohort were exposed to a new 3.5 day programme of cancer education, coproduced with patients, carers and health professionals, which focused on cancer as a life changing long-term condition. The comparison cohort had been exposed to a 2 day programme produced by a lecturer.

RESULTS

Following exposure to the new model for the delivery of undergraduate nurse cancer education, the intervention cohort demonstrated good overall knowledge of the impact of cancer, more positive attitudes towards cancer treatment and more confidence in their ability to deliver cancer care. Attitudes were more positive and confidence in ability to support cancer patients at all stages of the cancer journey were greater than in the comparison group. Insights gained into the cancer patient and carer perspectives were highly valued.

CONCLUSIONS

This study has found that a new model for the delivery of cancer education focusing on survivorship and delivered in partnership with patients, carers and clinicians, may improve knowledge, attitudes and confidence in the delivery of cancer care. Further work is now needed, using a more robust experimental design, to investigate the generalisability of the results to other education programs.

Cancer awareness among university students in Turkey

BACKGROUND

One of the most important reasons for the high mortality rates of cancer is the low level of awareness, which can lead to a late diagnosis and treatments starting too late. Therefore, it is necessary for individuals, especially at younger age, to gain awareness and integrate taking the necessary precautions into their lifestyle in order to prevent cancer and ensure early diagnosis. The aim of this study was to assess the levels of awareness of factors for major cancers among students studying in two different campuses of a university in the Western Black Sea Region.

MATERIALS AND METHODS

This descriptive/cross-sectional study was performed between January-March 2014. Students studying in the 2013-2014 academic year in a university in the Western Black Sea Region in two separate campuses were the subjects.

RESULTS

The mean age was 21.01 ± 3.63. While female students (51.2%) were the majority in the health sciences campus (74.8%), male students (48.8% ) were the majority in the social sciences campus (76.5%). Some 9.6% of the students from the health sciences campus and 12.4% of the students from the social sciences campus thought that cancer was communicable, while most of the students from both campuses knew that smoking caused cancer. It can also be seen that the rate of answering questions regarding cancer correctly was higher among students studying in the health sciences campus.

CONCLUSIONS

It was determined that students who do not study at the health sciences campus have insufficient information on cancer, cancer symptoms, and the possibility of breast cancer in males and approximately half of them regarded obesity as a risk factor for cancer.

'It stays with me': the experiences of second- and third-year student nurses when caring for patients with cancer

Little is known about student nurses experiences of nursing patients with cancer in the UK. With the increasing survival of people with cancer and with cancer no longer seen as a terminal illness it is useful to understand student nurses clinical experience when nursing those with cancer. This study takes a phenomenological approach involving three focus group interviews with 20 student nurses from the second and third year of their course in one centre in the UK. All the students had experience of caring for patients with cancer. The key themes emerging from the study were: Communication, Impact on Self, Lack of Support and End-of-Life-Care. Students emphasised the need to have more knowledge and support in relation to cancer care. They describe how they lack communication skills and found it difficult to handle their emotions. A number of students found the whole experience of caring for patients with cancer emotionally distressing and draining and they describe avoiding contact with these patients by using distancing and avoidance strategies. Student nurses need additional support through demystifying cancer, using reflective practice and good mentoring in the clinical area to enable students to feel supported, and develop confidence in their capacity for care for people with cancer.

Undergraduate nursing students caring for cancer patients: hermeneutic phenomenological insights of their experiences

BACKGROUND

The care of patients suffering from cancer and especially those facing the death trajectory appears to be complex and demanding not only for student nurses but for professional nurses as well. The educational models often used in nursing require students to face challenging care scenarios, sometimes with minimal or no supervision and guidance. These "worst case scenarios" can be traumatic experiences that can leave the student hopeless and disappointed of themselves and in many cases can "scar" their subsequent professional career. The literature demonstrates that this can be the result of the students' ill-preparation to care for cancer patients and deal with death and dying. The purpose of this study was to interpret the students' experiences of coming face-to-face with cancer care during their clinical placements.

METHODS

This is a hermeneutic phenomenological study influenced by the ideas of the French Philosopher Paul Ricoeur. Based on this philosophical enquiry the interpretation process included three stages: 1) naïve reading, 2) structural analysis and 3) comprehensive understanding. Data were collected through reflective/narrative diaries from the 4th grade undergraduate (pre-registration) nursing students practicing at oncology, hematology, pediatric oncology departments and hospices. Diaries of twelve students met the inclusion criteria and were included in the interpretation process. The study took place during January and May 2011.

RESULTS

The interpretation yielded the following themes: a) Being part of the center's life, b) Being sympathetic, c) Being confronted by others, d) Being self-reflective, e) Being trapped in the system, f) Being caring towards the family and g) Being better in clinical practice.

CONCLUSIONS

The students emphasized the need for appropriate preparation both at a theoretical and at a clinical level, as to better confront situations involving death and dying as well as learning techniques for crisis management. The students perceived the importance of adopting a policy that is both patient and family-centered in order to provide better care.