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Maloney KW. Seeking Common Ground: A Grounded Theory of the Nurse-Patient Relationship in Cancer Infusion Care. Cancer Nurs 2024; 47:299-306. [PMID: 36881641 DOI: 10.1097/ncc.0000000000001215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND The nurse-patient relationship represents a valuable connection in cancer care. Largely studied within inpatient settings, the nature and influence of this central relationship in ambulatory settings remain relatively unexamined. The notable shift to ambulatory settings like infusion centers warrants examination of the nurse-patient relationship in this context. OBJECTIVE The aim of this study was to develop a grounded theory of the nurse-patient relationship in ambulatory cancer infusion care. INTERVENTIONS/METHODS Using grounded theory methodology, 11 nurses were interviewed using a semistructured interview guide. Data collection continued until data saturation occurred with the primary concepts. RESULTS The grounded theory, entitled Seeking Common Ground, includes 6 primary concepts. The concepts "we are all human"; "we work in a busy, complex environment"; "we seek common ground with patients"; "we use connections to support meaningful encounters"; "we find meaning in the relationships created"; and "we are governed by the push and pull of time" abstract the nurse-patient relationship from the nurses' perspective, emphasizing fundamental human connections. CONCLUSIONS The grounded theory Seeking Common Ground depicts the profound connection that nurses form with their patients in the ambulatory infusion setting. Underscoring the value of the nurse-patient relationship as foundational to the nursing profession must be driven through practice, education, and policy. IMPLICATIONS FOR PRACTICE Consideration of educational aspects within nursing across all levels to influence clinical practice will remain key.
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Affiliation(s)
- Kristen W Maloney
- Author Affiliation: Department of Nursing, The Hospital of the University of Pennsylvania, Philadelphia
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Soheili M, Taleghani F, Jokar F, Eghbali-Babadi M, Sharifi M. Oncology Nurses' Needs Respecting Healthy Work Environment in Iran: A Descriptive Exploratory Study. Asia Pac J Oncol Nurs 2021; 8:188-196. [PMID: 33688568 PMCID: PMC7934596 DOI: 10.4103/apjon.apjon_64_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/26/2020] [Indexed: 11/26/2022] Open
Abstract
Objective: The work environment of oncology nurses is often unpleasant due to the complexities of cancer treatment and care. Yet, there is limited information about their perspectives on healthy work environment (HWE) and their HWE-related needs. This study aimed to explore oncology nurses' HWE-related needs. Methods: This descriptive exploratory qualitative study was conducted in 2018–2019. Participants were 52 nurses and 11 oncology specialists, nursing instructors and managers, and occupational and environmental health experts, who had the experience of promoting nurses' work conditions. They were recruited from eight teaching specialty cancer treatment centers in different cities of Iran (Tehran, Isfahan, Mashhad, Shiraz, and Babolsar). Data were collected via semi-structured interviews. Data were analyzed via conventional content analysis. Results: Oncology nurses' HWE-related needs were grouped into the four main categories of physical–structural improvement, mental health improvement in work environment, organizational improvement, and sociocultural improvement. Conclusions: A wide range of physical–structural, mental health, organizational, and sociocultural improvements should be made to oncology nurses' work environment in order to fulfill their HWE-related needs. Health-care managers can use the findings of the present study to create HWE for oncology nurses.
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Affiliation(s)
- Mozhgan Soheili
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Jokar
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Sharifi
- Department of Internal Medicine, School of Medicine, Cancer Prevention Research Center, Seyyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Use of Personal Health Records to Support Diabetes Self-management: An Integrative Review. Comput Inform Nurs 2020; 39:298-305. [PMID: 33315699 DOI: 10.1097/cin.0000000000000682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
More than 30 million persons in the United States have diagnosed or undiagnosed diabetes. Persons with chronic types of diabetes must learn self-management principles and techniques and perform self-care behaviors to reduce the risk of diabetes-related complications. An electronic personal health record is one type of technology commonly used to support diabetes self-management. This integrative review examines research on how personal health records incorporate or address the American Association of Diabetes Educators self-care behaviors, diabetes-related psychosocial concerns, and the diabetes-related clinical quality-of-care measures of hemoglobin A1c, low-density lipoprotein cholesterol, and blood pressure. In the majority of studies reviewed, participants showed improvement in the self-care behavior or physiological outcome examined. Findings were inconclusive about the impact of personal health record use on diabetes distress. Results also revealed a lack evidence of patient specific factors influencing intention to use a personal health record for management of type 2 diabetes mellitus. Despite evidence that personal health record use improves diabetes self-management, they are underutilized. Implications for practice include understanding what influences intention to use a personal health record. Further research is also needed to determine the impact of personal health record use on diabetes distress.
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Alotaibi T, Al Anizi CA. The impact of advanced nurse practitioner (ANP) role on adult patients with cancer: A quantitative systematic review. Appl Nurs Res 2020; 56:151370. [PMID: 33280789 DOI: 10.1016/j.apnr.2020.151370] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 01/06/2023]
Abstract
AIM This study aims to identify how Advanced Nurse Practitioners (ANPs) can contribute to oncology care. BACKGROUND The position of ANPs has grown significantly in recent years and ANPs have been shown to make significant contributions to various areas of healthcare. Due to improvements in research and techniques elder cancer patients are living longer, as beneficial, as this is to patients it is putting a strain on the provision of care as support is required at various stages. As there have been discussions about how ANPs +. can be most effectively employed this study identifies that ANPs, due to their skills and knowledge, may be able to assist elderly patients with long-term conditions specifically oncology patients. Therefore, research has been undertaken to identify how ANPs are currently employed in oncology. METHODS A systematic review was conducted in order to gain background information into how the role of ANPs in oncology is perceived and to gain understanding of some of the issues that they face and identify the skills that they have in order to be able to make a positive contribution. This was followed by a study of quantitative Randomized Control Trials, which looked at the roles of ANPs in oncology. Thematic Analysis was conducted in order to gain a perspective of how ANPs are best currently employed with elderly oncology patients. RESULTS Five studies were reviewed which showed that ANPs provide support to elder patients which helps to alleviate stress and improve the quality of life of cancer patients. Furthermore, it was seen that ANPs can aid patients in symptom management. CONCLUSION This study has shown that ANPs are effectively used in clinical support for cancer patients. Further studies are required to verify the extent of this support and to determine if this support is effective only in the short term or can it be applied just as effectively over a period of time. ANPs have high-level knowledge and skills but more research is required to determine how they work effectively.
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Affiliation(s)
- Taghreed Alotaibi
- Princess Nourah bint Abdulrahman University, Nursing College, Community Health Nursing Department, Airport Road, Building 4, Flat 2.4, Riyadh, Saudi Arabia.
| | - Co Amira Al Anizi
- Princess Nourah bint Abdulrahman University, Nursing College, Community Health Nursing Department, Airport Road, Building 4, Flat 2.4, Riyadh, Saudi Arabia.
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Lau GJ, Loiselle CG. E-health tools in oncology nursing: Perceptions of nurses and contributions to patient care and advanced practice. Can Oncol Nurs J 2018; 28:118-124. [PMID: 31148816 DOI: 10.5737/23688076282118124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
As oncology nurses confront a rapidly evolving field with increased workplace pressure, the integration of evidence-based connected health platforms within practice presents promise. This study explores nurses' perceptions regarding the utility of e-health tools, with a focus on the Oncology Interactive Navigator (OINTM), as a potential contributor to their practice and interactions with patients. Focus groups with oncology nurses were conducted at two time points: prior to exposure to the OINTM (T1, n=8) and four weeks post unrestricted tool access (T2, n=7). Using qualitative constant comparison analysis, three themes emerged: (1) Key factors driving e-health use are multidimensional and evolving; (2) Dual role of e-health in meeting patient needs and supporting practice; (3) E-health as a catalyst for professional development and networking. E-health is appealing to oncology nurses, as it serves to advance practice and support patient care. Future research should explore best practices for optimal clinical implementation among all stakeholders involved.
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Affiliation(s)
- Garnet J Lau
- Ingram School of Nursing, McGill University; Garnet Lau is now at Clinical Research Program, Jewish General Hospital
| | - Carmen G Loiselle
- Department of Oncology and Ingram School of Nursing, McGill University and Hope & Cope, Lady Davis Institute, and Segal Cancer Centre, Jewish General Hospital
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Stahlke Wall S, Rawson K. The Nurse Practitioner Role in Oncology: Advancing Patient Care. Oncol Nurs Forum 2017; 43:489-96. [PMID: 27314191 DOI: 10.1188/16.onf.489-496] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore and describe the characteristics of the nurse practitioner (NP) role in cancer care in a Canadian province, identify the ways in which NPs add value to cancer care, and suggest ways in which organizations can better support the NP role.
. RESEARCH APPROACH Exploratory, qualitative design.
. SETTING Three cancer care facilities in a western Canadian province.
. PARTICIPANTS 12 NPs in cancer care, 12 physicians working with NPs, and 5 administrators responsible for implementing the role.
. METHODOLOGIC APPROACH Interpretive description, a qualitative method aimed at systematically exploring and analyzing a topic and applying the findings back into practice.
. FINDINGS Each group had a different perspective on the role and its value. Physicians regarded these high-level practitioners as "help" within their own practices. Administrators tended to use NPs to manage patient workload within the traditional physician-focused system, but they could see value in NP-led innovation. The NPs themselves envisioned a nontraditional, holistic, patient-centered approach to care that challenged the interventionist focus of the medical model. Suggestions for enhancing the potential of the role were offered by all groups.
. CONCLUSIONS Lack of clarity about the NP role persists. Traditional professional hierarchies and expectations about care delivery continue to affect role implementation.
. INTERPRETATION Nursing leaders must be proactive about NP role implementation to maximize its potential. Additional research is needed about the outcomes of the role and the process of implementation.
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Wazqar DY, Kerr M, Regan S, Orchard C. An integrative review of the influence of job strain and coping on nurses' work performance: Understanding the gaps in oncology nursing research. Int J Nurs Sci 2017; 4:418-429. [PMID: 31406786 PMCID: PMC6626143 DOI: 10.1016/j.ijnss.2017.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/07/2017] [Accepted: 09/14/2017] [Indexed: 11/25/2022] Open
Abstract
Nursing is known to be a stressful profession that can lead to physical and psychological health issues and behavioural problems. In oncology, workload among nurses is believed to be increasing in conjunction with rapidly increasing numbers of patients with cancer and staff shortages worldwide, therefore it is essential to sustain a quality oncology nurse workforce. Numerous studies have presented evidence on job strain, effects of coping strategies, and nurses' work performance within healthcare settings, but few have focused on oncology settings and none of these on nurses working in Saudi Arabia. The purpose of this review was to summarize empirical and theoretical evidence concerning job-related stressors in nurses, particularly oncology nurses, and the interrelationships among job strain, coping strategies, and work performance in this population. Search strategies identified studies published on studies in peer-reviewed journals from 2004 to 2016. Twenty-five nursing studies were found examining the relationships among the concepts of interest. Common job-related stressors among oncology nurses were high job demands, dealing with death/dying, lack of job control, and interpersonal conflicts at work. Job strain was found to be significantly linked to coping strategies, and negatively associated with work performance among nurses in general. There is no existing empirical evidence to support the relationship between coping strategies and work performance among oncology nurses. The present evidence is limited, and a considerable amount of research is required in the future to expand the oncology nursing literature. Research is needed to investigate job-related stressors and their effects on oncology nurses.
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Affiliation(s)
- Dhuha Youssef Wazqar
- Faculty of Nursing, King Abdulaziz University, Al-Sharafeyah Street, P. Box: 42828, Jeddah, 21551, Saudi Arabia
| | - Mickey Kerr
- Arthur Labatt Family School of Nursing, University of Western Ontario, 1151 Richmond Street London, Ontario, N6A3K7, Canada
| | - Sandra Regan
- Arthur Labatt Family School of Nursing, University of Western Ontario, 1151 Richmond Street London, Ontario, N6A3K7, Canada
| | - Carole Orchard
- Arthur Labatt Family School of Nursing, University of Western Ontario, 1151 Richmond Street London, Ontario, N6A3K7, Canada
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Stahlke S, Rawson K, Pituskin E. Patient Perspectives on Nurse Practitioner Care in Oncology in Canada. J Nurs Scholarsh 2017; 49:487-494. [PMID: 28605117 DOI: 10.1111/jnu.12313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to add to what is known about patient satisfaction with nurse practitioner (NP) care, from the perspective of breast cancer patients who were followed by an NP. METHODS AND DESIGN This study utilized Interpretive Description, a qualitative method aimed at making sense of the experiential aspects of health care and developing practical knowledge for improved care. Nine patients receiving NP-led care in an outpatient breast cancer clinic were interviewed about their perspectives on and experiences with NP-led care. Interview transcripts were thematically analyzed. FINDINGS The NP role has long been regarded as a way of addressing many contemporary health system problems, although there continue to be barriers to the effective utilization of the role, including public and patient misunderstandings. This study revealed that, despite persistent traditional role understandings about health professionals, the patient participants appreciated the benefits of NP care and were highly satisfied with both the physical care and holistic support they received during the course of their treatment. CONCLUSIONS AND CLINICAL RELEVANCE Today's healthcare system is characterized by accessibility issues, unmet patient need, workforce issues, and funding pressures. This research supports and enriches what is known about the benefits and usefulness of NP-provided care from the viewpoint of those receiving the care. The findings offer guidance to NPs in the clinical setting regarding patient needs and optimal care strategies.
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Affiliation(s)
- Sarah Stahlke
- Associate Professor, University of Alberta, Faculty of Nursing, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
| | - Krista Rawson
- Senior Practice Consultant-Advanced Practice Nursing, Alberta Health Services-Cancer Control, Calgary, Alberta, Canada
| | - Edith Pituskin
- Assistant Professor, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Lagerlund M, Sharp L, Lindqvist R, Runesdotter S, Tishelman C. Intention to leave the workplace among nurses working with cancer patients in acute care hospitals in Sweden. Eur J Oncol Nurs 2015; 19:629-37. [PMID: 25935682 DOI: 10.1016/j.ejon.2015.03.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 02/12/2015] [Accepted: 03/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine associations between perceived leadership and intention to leave the workplace due to job dissatisfaction among registered nurses (RNs) who care for patients with cancer. We also examine intention to leave in relation to proportion of cancer patients, length of time in practice, perceived adequacy of cancer care education, and burnout. METHODS AND SAMPLE The data originated from the Swedish component of RN4CAST, based on a survey of RNs working with in-patient care in all acute care hospitals in Sweden. The 7412 RNs reporting ≥10% patients with cancer on their unit were included in this analysis. Data were collected on perceptions of work environment, burnout, future employment intentions, and demographic characteristics. Additional questions related to cancer care. KEY RESULTS About 1/3 of all RNs intended to leave their workplace within the next year. Intention to leave was more prevalent among RNs reporting less favourable perceptions of leadership, who had worked ≤ two years as RN, who reported having inadequate cancer care education, and with higher burnout scores. Associations between leadership and intention to leave were stronger among RNs in the profession > two years, who reported having adequate cancer care education, and with lower burnout scores. CONCLUSIONS Perception of leadership is strongly associated with intention to leave among RNs in both specialized and general cancer care. This suggests a crucial area for improvement in order to reduce turnover rates.
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Affiliation(s)
- Magdalena Lagerlund
- Department of Learning, Informatics, Management and Ethics (LIME), C7, Karolinska Institutet, SE-I71 77 Stockholm, Sweden.
| | - Lena Sharp
- Department of Learning, Informatics, Management and Ethics (LIME), C7, Karolinska Institutet, SE-I71 77 Stockholm, Sweden; Regional Cancer Centre, Stockholm-Gotland, Box 6909, SE-102 39 Stockholm, Sweden.
| | - Rikard Lindqvist
- Department of Learning, Informatics, Management and Ethics (LIME), C7, Karolinska Institutet, SE-I71 77 Stockholm, Sweden.
| | - Sara Runesdotter
- Department of Learning, Informatics, Management and Ethics (LIME), C7, Karolinska Institutet, SE-I71 77 Stockholm, Sweden.
| | - Carol Tishelman
- Department of Learning, Informatics, Management and Ethics (LIME), C7, Karolinska Institutet, SE-I71 77 Stockholm, Sweden; The Innovation Center, Karolinska University Hospital, Stockholm, Sweden.
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Raga-Chardi R, Iglesias-Parra MR, García-Mayor S, Kaknani S, García-Guerrero A, Morales-Asencio JM. Acquiring Competence in Oncology Nursing Skills Through the Use of Film: A Study Protocol. Int J Nurs Knowl 2014; 27:5-9. [DOI: 10.1111/2047-3095.12066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Rosa Raga-Chardi
- Department of Oncology; Hospital Regional de Malaga; Malaga Spain
| | | | | | - Shakira Kaknani
- Faculty of Health Sciences; University of Malaga; Malaga Spain
| | - Alfonso García-Guerrero
- Faculty of Health Sciences; University of Malaga and District of Primary Health Care Malaga-Guadalhorce; Malaga Spain
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Browall M, Koinberg I, Falk H, Wijk H. Patients' experience of important factors in the healthcare environment in oncology care. Int J Qual Stud Health Well-being 2013; 8:20870. [PMID: 23924604 PMCID: PMC3737438 DOI: 10.3402/qhw.v8i0.20870] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 12/30/2022] Open
Abstract
Background and objective The aim of this study was to describe what factors of the healthcare environment are perceived as being important to patients in oncology care. Design A qualitative design was adopted using focus group interviews. Setting and participants The sample was 11 patients with different cancer diagnoses in an oncology ward at a university hospital in west Sweden. Results Analysis of the patients’ perceptions of the environment indicated a complex entity comprising several aspects. These came together in a structure consisting of three main categories: safety, partnership with the staff, and physical space. The care environment is perceived as a complex entity, made up of several physical and psychosocial aspects, where the physical factors are subordinated by the psychosocial factors. It is clearly demonstrated that the patients’ primary desire was a psychosocial environment where they were seen as a unique person; the patients wanted opportunities for good encounters with staff, fellow patients, and family members, supported by a good physical environment; and the patients valued highly a place to withdraw and rest. Conclusions This study presents those attributes that are valued by cancer patients as crucial and important for the support of their well-being and functioning. The results show that physical aspects were subordinate to psychosocial factors, which emerged strongly as being the most important in a caring environment.
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Affiliation(s)
- Maria Browall
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
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