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Godinet MT, Burrage R, Van Sluytman LG, Taiapa J, Vakalahi HO. Grandparenting Among Māoris of New Zealand: Reflecting on Meanings. J Cross Cult Gerontol 2023; 38:1-18. [PMID: 36795257 DOI: 10.1007/s10823-023-09471-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
Regardless of nation and culture, grandparents have been instrumental in the survival of families and communities as well as the preservation of cultures. This study explored the meaning and roles of grandparenting among Maori grandparents in New Zealand as a possible platform for advancing the conversation on the significance of grandparents in the lives of people across cultures. Participants interviewed included 17 Māori grandparents to great, great grandparents in Aotearoa New Zealand, living in intergenerational homes. A phenomenology approach was used to analyze the data. Five themes were extracted that elucidated the meaning of the roles of grandparenting from the perspective of Māori grandparents: Elders' responsibilities from a cultural perspective; support, resources, and assets; sociopolitical and economic challenges; current state of Elders' and role in family, and benefits and rewards. Implications and recommendations are discussed towards a more systemic and culturally responsive support of grandparents.
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Affiliation(s)
- Meripa T Godinet
- University ofHawaìi Myron B. Thompson School of Social Worka, 2430 Campus Rd. Gartley Hall 213, 96822, Honolulu, HI, USA.
| | - Rachel Burrage
- University ofHawaìi Myron B. Thompson School of Social Worka, 2430 Campus Rd. Gartley Hall 213, 96822, Honolulu, HI, USA
| | | | - Julia Taiapa
- School of Māori Knowledge, Massey University, Te Pūtahi-a-Toi, Turitea Campus, Palmerston North, New Zealand
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Keane S, Ryan A, Adams N, Dowling M. Palliative care nurses' experiences of clinical supervision: a qualitative evidence synthesis. Int J Palliat Nurs 2020; 26:413-423. [DOI: 10.12968/ijpn.2020.26.8.413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Clinical supervision provides support and facilitates professional and personal development. Aim: To identify and synthesise all available qualitative research on palliative care nurses' experiences of clinical supervision. Methods: Guided by the ‘enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ) statement, eight databases were searched using a systematic search strategy (Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, Medline, Web of Science, ProQuest, Embase, Psychological and Behavioural Sciences). The findings of all included studies were analysed guided by Thomas and Harden's approach. Confidence in the review findings was determined guided by Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Findings: Nine qualitative studies were included in this synthesis and four analytic themes were identified: negative experiences and misunderstandings of clinical supervision; clinical supervision needs structure and clarity; supervisor needs to be a conductor and a producer; finding your ‘inner supervisor’. Conclusion: The review illuminates the benefits of clinical supervision as a renewal process for palliative care (PC) nurses, but also highlights the challenges in its provision. Organisations should provide designated time and opportunities for PC nurses to attend clinical supervision sessions during working hours.
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Affiliation(s)
- Sinéad Keane
- Staff Nurse, Galway Hospice Foundation, Renmore Galway, Ireland
| | - Aoife Ryan
- Assistant Psychologist, London Borough of Sutton, Sutton Civic Offices
| | - Niamh Adams
- Librarian, Irish Nurses and Midwives Organisation
| | - Maura Dowling
- Senior Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
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Hession N, Habenicht A. Clinical supervision in oncology: A narrative review. Health Psychol Res 2020; 8:8651. [PMID: 32510002 PMCID: PMC7273176 DOI: 10.4081/hpr.2020.8651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/07/2020] [Indexed: 12/02/2022] Open
Abstract
The aim of this narrative literature review is to (a) review all empirical studies of clinical supervision (CS) in oncology and to (b) highlight some CS practice issues distinctive to cancer care. This review identified empirical studies related to qualified professionals and published in English since 1995 that connected to CS and oncology. A total of 15 studies were identified with the majority as small scale, exploratory and qualitative. Psychologists were predominantly utilised as facilitators of the CS with varied sample sizes ranging from 5-230 participants. The studies were grouped into three main categories; the impact of supervision on staff, impact of supervision on professional care/development and impact of supervision in existential exploration. This review highlighted the positive impact of CS while demonstrating the need for more methodologically sound programmes of research into CS in cancer settings so detailed models of effective supervision can develop and thereby inform practice.
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Francis A, Bulman C. In what ways might group clinical supervision affect the development of resilience in hospice nurses? Int J Palliat Nurs 2020; 25:387-396. [PMID: 31437109 DOI: 10.12968/ijpn.2019.25.8.387] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Resilience is important to sustain hospice nurses through a challenging career. Clinical supervision is a commonly cited support strategy, but there is limited evidence which focuses on its influence on the development of resilience in hospice nurses. AIMS To explore how group clinical supervision might affect the development of resilience in hospice nurses. METHOD A pragmatic approach and mixed methods research design was employed. Quantitative questionnaire data and qualitative focus group data were collected from community hospice nurses participating in group clinical supervision. FINDINGS The findings identified the importance of an effective group reflective process on the benefits to be gained from clinical supervision. Clinical supervision was found to affect the development of resilience by developing confidence at work, regulating emotions, offering a coping strategy, managing expectations, and developing self-awareness. This was dependent upon individual preference and experience, the local organisational context, and wider social and political factors. CONCLUSION This research contributes insight into group clinical supervision as an intervention to support resilience in hospice nurses. It offers recommendations for practice, to enhance the development of resilience through clinical supervision, and recommendations for future research.
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Affiliation(s)
| | - Chris Bulman
- Senior Lecturer, Oxford Brookes University, Oxford
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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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Maben J, Taylor C, Dawson J, Leamy M, McCarthy I, Reynolds E, Ross S, Shuldham C, Bennett L, Foot C. A realist informed mixed-methods evaluation of Schwartz Center Rounds® in England. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06370] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundSchwartz Center Rounds®(Rounds) were introduced into the UK in 2009 to support health-care staff to deliver compassionate care, something the Francis report (Francis R.Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationery Office; 2013) identified as lacking. Rounds are organisation-wide forums that prompt reflection and discussion of the emotional, social and ethical challenges of health-care work, with the aim of improving staff well-being and patient care.ObjectivesHow, in which contexts and for whom Rounds participation affects staff well-being at work, increases social support for staff and improves patient care.Design(1) A scoping review of Rounds literature and comparison with alternative interventions; (2) mapping Rounds providers via a survey, telephone interviews and secondary data; (3) a two-wave survey of (i) new attenders/non-attenders in 10 sites to determine the impact on staff engagement and well-being; and (ii) interviews with Rounds attenders, non-attenders, facilitators, clinical leads, steering group members, board members and observations in nine case study sites to (4) describe experiences and (5) test candidate programme theories by which Rounds ‘work’ (realist evaluation).Setting(1) International literature (English); (2) all Rounds providers (acute/community NHS trusts and hospices) at 1 September 2014 (survey/interview) and 15 July 2015 (secondary data); (3) 10 survey sites; and (4 and 5) nine organisational case study sites (six of which also took part in the survey).Participants(1) Ten papers were reviewed for Rounds and 146 were reviewed for alternative interventions. (2) Surveys were received from 41 out of 76 (54%) providers and interviews were conducted with 45 out of 76 (59%) providers. (3) Surveys were received from 1140 out of 3815 (30%) individuals at baseline and from 500 out of 1140 (44%) individuals at follow-up. (4 and 5) A total of 177 interviews were conducted, as were observations of 42 Rounds, 29 panel preparations and 28 steering group meetings.Results(1) The evidence base is limited; compared with 11 alternative interventions, Rounds offer a unique organisation-wide ‘all staff’ forum in which disclosure/contribution is not essential. (2) Implementation rapidly increased between 2013 and 2015; Rounds were implemented variably; challenges included ward staff attendance and the workload and resources required to sustain Rounds; and costs were widely variable. (3) There was no change in engagement, but poor psychological well-being (12-item General Health Questionnaire) reduced significantly (p < 0.05) in Rounds attenders (25% to 12%) compared with non-attenders (37% to 34%). (4 and 5) Rounds were described as interesting, engaging and supportive; four contextual layers explained the variation in Rounds implementation. We identified four stages of Rounds, ‘core’ and ‘adaptable’ components of Rounds fidelity, and nine context–mechanism–outcome configurations: (i) trust, emotional safety and containment and (ii) group interaction were prerequisites for creating (iii) a countercultural space in Rounds where staff could (iv) tell stories, (v) self-disclose their experiences to peers and (vi) role model vulnerability; (vii) provide important context for staff and patient behaviour; (viii) shining a spotlight on hidden staff and patient stories reduced isolation and enhanced support/teamwork; and (ix) staff learned through reflection resulting in ripple effects and outcomes. Reported outcomes included increased empathy and compassion for colleagues and patients, support for staff and reported changes in practice. The impact of Rounds is cumulative and we have identified the necessary conditions for Rounds to work.LimitationsRounds outcomes relied on self-report, fewer regular attenders were recruited than desired, and it was not possible to observe staff post Rounds.ConclusionRounds offer unique support for staff and positively influence staff well-being, empathy and compassion for patients and colleagues.Future workThe adaptation of Rounds to new contexts and to increase reach needs evaluation.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Jill Maben
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Cath Taylor
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Jeremy Dawson
- Institute of Work Psychology, Management School, University of Sheffield, Sheffield, UK
| | - Mary Leamy
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | - Imelda McCarthy
- Institute of Work Psychology, Management School, University of Sheffield, Sheffield, UK
| | - Ellie Reynolds
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | | | - Caroline Shuldham
- Faculty of Society and Health, Buckinghamshire New University, High Wycombe, UK
- Independent consultant
| | - Laura Bennett
- Policy, The King’s Fund, London, UK
- Care Quality Commission, Bristol, UK
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‘At home it's just so much easier to be yourself’: older adults' perceptions of ageing in place. AGEING & SOCIETY 2014. [DOI: 10.1017/s0144686x14001214] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTBy 2050, the number of people in Australia aged over 85 is expected to quadruple. Yet, from a socio-psychological research perspective, little is known about the experiences of people who continue to live at home during late old age (85 years and over), a period when challenging problems associated with ageing escalate and threaten to compromise independence. Utilising a qualitative methodology, the subjective lived experience of 23 very old adults (19 women, four men, with a mean age of 90.7 years, range 85–101 years) who live independently in rural Australia were elicited. The aims of the research were to understand their thoughts and feelings about ageing in place at home, and what psychological, social and practical adaptive strategies they employ to cope with difficulties encountered during very old age. In-depth interviews were analysed in an interpretive phenomenological tradition of thematic analysis, interpretation of paradigm cases and interpretation of exemplars. Participants described how historical, cultural and environmental contexts shaped their everyday thoughts, activities and what was meaningful for them. The findings add to our understanding of the largely unnarrated lives of the very old, suggest a need for person-centred home-care assessment processes and aid significant others (family, friends and neighbours) to understand better what very old adults need to live independently.
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Muggleton J, Guy H, Howard R. Breaking the taboo: an interpretative phenomenological analysis of healthcare professionals’ experience of caring for palliative patients with disgusting symptoms. BMJ Support Palliat Care 2014; 5:189-95. [DOI: 10.1136/bmjspcare-2014-000698] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 09/24/2014] [Indexed: 11/03/2022]
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Best D, White E, Cameron J, Guthrie A, Hunter B, Hall K, Leicester S, Lubman DI. A Model for Predicting Clinician Satisfaction with Clinical Supervision. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.856227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tunnah K, Jones A, Johnstone R. Stress in hospice at home nurses: a qualitative study of their experiences of their work and wellbeing. Int J Palliat Nurs 2012; 18:283-9. [DOI: 10.12968/ijpn.2012.18.6.283] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | | | - Rosalynde Johnstone
- Betsi Cadwalader University Health Board, Palliative Care Department, Bodfan Eryri Hospital, Caernarfon, Gwynedd LL55 2YE, Wales
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KOIVU AIJA, SAARINEN PIRJOI, HYRKAS KRISTIINA. Stress relief or practice development: varied reasons for attending clinical supervision. J Nurs Manag 2011; 19:644-54. [DOI: 10.1111/j.1365-2834.2011.01232.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rose J, Glass N. An Australian investigation of emotional work, emotional well-being and professional practice: an emancipatory inquiry. J Clin Nurs 2010; 19:1405-14. [DOI: 10.1111/j.1365-2702.2009.02997.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Staff grief and support systems for Japanese health care professionals working in palliative care. Palliat Support Care 2009; 7:245-52. [PMID: 19538808 DOI: 10.1017/s1478951509000315] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This article is a literature report on grief issues for health care professionals, undertaken to identify Japanese nurses' grief experience when they work in palliative care units. Health care professionals' grief experience and its impact have not been well understood or identified as a significant issue in Japan. METHODS Published articles relating to this study were searched using electronic catalogues such as CINAHL and PsycINFO, books, and research publications. Key words used for the search were "grief," "palliative care," "nurse," "staff support," and "Japan." Both English and Japanese were used for the literature search in order to collect information regarding nurses' grief and support systems in Japan and elsewhere. The literature search covered the period 1990-2006 inclusive. RESULTS This article explores these issues in the literature as preparation for establishing a study that will particularly look at the influence of nurses' grief on the quality of care provided. SIGNIFICANCE OF RESULTS Consideration of Japanese culture as it relates to death and dying and to nursing culture is a significant part of this work.
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The meaning of nurse–patient intimacy in oncology care settings: From the nurse and patient perspective. Eur J Oncol Nurs 2008; 12:319-28. [DOI: 10.1016/j.ejon.2008.04.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 03/29/2008] [Accepted: 04/07/2008] [Indexed: 11/18/2022]
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Tony B, Louise B, Christine J, Majda P. Wicked spell or magic bullet? A review of the clinical supervision literature 2001-2007. NURSE EDUCATION TODAY 2008; 28:264-72. [PMID: 17624642 DOI: 10.1016/j.nedt.2007.05.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 05/08/2007] [Accepted: 05/08/2007] [Indexed: 05/16/2023]
Abstract
Clinical supervision has become an established part of nursing. Implemented in various different ways it has attracted attention from the research, educator and practice communities. The literature reported and analysed in this paper describes work that may benefit professional practice but there continue to be questions about application and method. Two new messages arise from the literature. The first underscores the responsibility of health care organisations to sustain and develop clinical supervision and the second points to the potential benefit that clinical supervision may have on patient outcomes.
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Affiliation(s)
- Butterworth Tony
- Centre for Clinical and Academic Workforce Innovation, University of Lincoln, Mill 3, Pleasley Vale Business Park, NG19 8RL, UK.
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Blomberg K, Sahlberg-Blom E. Closeness and distance: a way of handling difficult situations in daily care. J Clin Nurs 2007; 16:244-54. [PMID: 17239059 DOI: 10.1111/j.1365-2702.2005.01503.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to describe how care team members caring for patients with advanced cancer describe how they handle difficult situations in daily care. In this paper 'difficult situations' refers to those situations team members themselves describe as difficult. BACKGROUND Serious illness and impending death involve great changes in a person's life. The care of patients with advanced cancer is complex and many different factors influence each care situation. This places demands on the way care team members handle problems and difficulties in daily care. DESIGN Qualitative descriptive study. METHODS The study is based on 16 focus group discussions with care team members who were caring for patients with advanced cancer at three different care units in two Swedish cities. The focus group discussions included 77 participants. The procedure for data analysis was inspired by the phenomenological method. FINDINGS The results show that care team members handled difficult situations by balancing between being close and distancing themselves. In most situations their choice of strategy seemed spontaneous rather than being a conscious decision, although it was sometimes described as a more conscious approach. Variations of closeness and distance that were identified were Identity, Meaning, Limit-setting and touching, Prioritization, the Team and the Organization. These could also be seen as tools that could facilitate or impede the use of closeness and distance. CONCLUSIONS The results show that care team members have a need to reflect over daily care and to become aware of what governs different care actions. RELEVANCE TO CLINICAL PRACTICE If the experienced difficult situation is not handled in a way that is beneficial to the care team member, patient and relatives, it is assumed that this can result in stress, burnout and, above all, non-optimal care.
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Affiliation(s)
- Karin Blomberg
- Department of Health Sciences, Orebro University, Orebro, Sweden.
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Abstract
BACKGROUND Clinical Nurse Specialists (CNS) play a major role in the delivery of specialist palliative care services to patients with advanced cancer, in hospital, hospice and community settings across the United Kingdom. A major component of their work focuses on the delivery of emotional care and support to patients and their families. AIM This paper critically examines the literature on emotional care and support for patients with advanced cancer requiring palliative care. The aim is to increase understanding of how CNSs and patients interact and work together to produce emotionally supportive relationships. METHODS A literature search was performed using the CINAHL, MEDLINE and ASSIA CD-ROM databases and combinations of the key words: 'emotional support', 'emotional care', 'end of life', 'palliative', 'terminal illness', 'advanced cancer', 'Clinical Nurse Specialist', 'emotional labour'. Additional relevant articles were identified from the reference lists of papers identified by the literature search. FINDINGS The literature revealed a lack of clarity about the terms used to describe emotional care and support. However, at the same time, there is a taken for granted assumption that a shared understanding of these terms exists. Developing supportive nurse-patient relationships involves a complex process, one that consists of getting to 'know the patient' through the effective use of communication skills, in a variety of health care contexts. The costs of engaging in 'emotion work' are highlighted. CONCLUSIONS Existing research fails to recognize that emotional care and support as a concept is not a fixed, stable entity learnt through experience and socialization, but is moulded by the process of social interaction and by specific contexts and theoretical perspectives. Further methodologically sound research is needed to explore what happens when emotional care and support are delivered in different care settings, obtaining the views of both parties involved. Implications for the practice of CNSs are discussed.
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Affiliation(s)
- Julie Skilbeck
- Sheffield Palliative Care Studies Group, University of Sheffield and Trent Palliative Care Centre, Sheffield, UK.
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