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Kachimanga C, McGlashan J, Cunningham N, Hoyle L. Communication to adult patients undergoing cancer care by non-specialist nurses: a scoping review protocol. BMJ Open 2024; 14:e081326. [PMID: 38508653 PMCID: PMC10961544 DOI: 10.1136/bmjopen-2023-081326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Little is known regarding how non-specialist nurses communicate with patients living with cancer when the patients are receiving care outside of their cancer units/teams. This scoping review aims to identify, examine and report on the currently available evidence about communication by non-specialist nurses when caring for adults living with cancer outside of their cancer care unit/teams. METHODS AND ANALYSIS A scoping review following the JBI methodology for scoping reviews will be conducted. We will search for empirical studies that meet the inclusion criteria in six databases (MEDLINE, PubMed, CINAHL, Embase, Scopus and PsycINFO). Handsearching in references of included articles will be performed to find additional articles. The population of interest will be non-specialist nurses. Three concepts will be explored, namely (1) all adult patients living with cancer, (2) a focus on three stages of the cancer continuum of care (cancer diagnosis, treatment and survivorship) and (3) a focus on communication between non-specialist nurses and patients living with cancer. We will include studies describing all healthcare settings outside patients' specialised cancer units or oncology teams. After article selection, two reviewers will independently screen titles and abstracts and perform a full-text article review, risk of bias assessments and data extraction. A third reviewer will resolve all disagreements. A narrative summary will provide an overview of how the results relate to the research aims and questions. The included articles will be limited to English and published between 2012 and 2023. ETHICS AND DISSEMINATION No ethical approval is required since we will use publicly available empirical research sources. This review will provide current research on communication by non-specialist nurses with patients with a cancer diagnosis outside of an oncology setting, evidence that will support effective communication. As such, we aim to disseminate the findings in academic conferences and peer-reviewed journals.
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Zhao J, Wang Y, Xiao B, Ye F, Chen J, Huang Y, Li T, Chen X, Ma H, Zhang Q, Zou Z. Behaviors and influencing factors of Chinese oncology nurses towards hospice care: a cross-sectional study based on social cognitive theory in 2022. BMC Palliat Care 2024; 23:53. [PMID: 38395799 PMCID: PMC10885468 DOI: 10.1186/s12904-024-01385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Although there is growing demand for hospice care in China due to its aging population and increasing cancer rates, the sector remains slow to expand. Oncology nurses are the primary providers of hospice care, but little is known about their behaviors towards hospice care and related factors. METHODS This cross-sectional study conveniently sampled 933 oncology nurses from six grade A tertiary hospitals in Hubei Province between January to March 2022. The questionnaire was composed of seven parts: general information (including sociodemographic and work-related information), hospice care behaviors, hospice care knowledge, hospice care attitudes, hospice care self-efficacy, hospice care outcome expectancy, and hospice care environment. Data were analyzed using descriptive analysis, independent sample t-tests, one-way ANOVA, Pearson's correlation, multiple linear regression, random forest regression, and BP neural network model analysis. RESULTS A total of 852 questionnaires were valid. The mean score of hospice care behaviors was 50.47 ± 10.56, with a mean item score of 3.61 ± 0.75. The three highest scoring behaviors were "pain assessment of patients (4.21 ± 0.91)", "satisfying the physical and mental needs of dying patients (4.04 ± 0.92)", and "creating good relationships between the medical staff and family members (4.02 ± 0.87)". The two lowest-scoring behaviors were "proactively recommending medical institutions for hospice care to terminally ill patients and their families (2.55 ± 1.10)" and "proactively talking to patients and families about death-related topics for patients who are critically ill and cannot be reversed (2.87 ± 1.03)." Multiple linear regression, random forest regression, and BP neural network models all showed that the frequency of sharing hospice care experiences with colleagues, hospice care attitudes, hospice care self-efficacy, and hospice care environments were positively associated with hospice care behaviors. CONCLUSIONS The frequency of hospice care behaviors among Chinese oncology nurses is generally at a moderate to high level. The results provide a basis for promoting hospice care behaviors among oncology nurses in order to improve the quality of life for terminally ill cancer patients.
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Affiliation(s)
- Jing Zhao
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Yu Wang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Binbin Xiao
- Renmin Hospital of Wuhan University, No.238 Jiefang Road, WuChang Distirct, Wuhan, Hubei Province, 430060, China
| | - Fucheng Ye
- Wuhan University of Technology, Wuhan, China
| | - Jianfei Chen
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Yingjuan Huang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Ting Li
- Hubei Cancer Hospital, Wuhan, China
| | - Xiaoli Chen
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Hongmei Ma
- Renmin Hospital of Wuhan University, No.238 Jiefang Road, WuChang Distirct, Wuhan, Hubei Province, 430060, China.
| | - Qing Zhang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China.
| | - Zhijie Zou
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China.
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Ziwei K, Mengjiao C, Yongjie Z, Mengqi Z, Yeqin Y. Optimizing palliative care education through undergraduate nursing students' perceptions: Application of importance-performance analysis and Borich needs assessment model. NURSE EDUCATION TODAY 2023; 122:105719. [PMID: 36738533 DOI: 10.1016/j.nedt.2023.105719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND With the aging of the population and the increasing trend of chronic illnesses, the demand for palliative care is growing. Undergraduate nursing students will be the main providers of palliative care in the future. Therefore, it's important to enhance their capability for palliative care. OBJECTIVES The purpose of this study was to optimize palliative care education, based on undergraduate nursing students' perceptions and educational needs through the application of the importance-performance analysis and Borich needs assessment model. DESIGN A cross-sectional descriptive study. SETTING Nursing department in Wenzhou, China. PARTICIPANTS A total of 448 full-time undergraduate nursing students were recruited for the study. METHODS Importance-performance analysis was used to identify items that obtain high priority for improvement, and the Borich needs assessment model and the Locus for focus model were used to prioritize educational needs. The three methods were integrated to determine the top-priority content to meet undergraduate nursing students' educational needs in palliative care. RESULTS The items located in Quadrant II of Importance-performance analysis, ranked in the first 10 in Borich needs assessment, and located in Quadrant I of the Locus for focus model were defined as top-priority content. These included: "respiratory symptoms: pleural effusion, superior vena cava syndrome, respiratory difficulty," "Care of terminal symptoms," "Awareness of dying," "Care of remains," "Cooperation between interdisciplinary teams," and "Rights and interests of dying patients." CONCLUSION Several years of development of palliative care education have made nursing students aware of its importance. However, they have reported that education remains insufficient. A greater focus on palliative care education is needed to ensure they are better prepared. Specific attention should be given to cooperation between interdisciplinary teams, dealing with death and dying, rights and interests of people who were dying.
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Affiliation(s)
- Ke Ziwei
- Department of Nursing, Taizhou Hospital Affiliated to Wenzhou Medical University, Tazihou 317000, Zhejiang, China
| | - Chen Mengjiao
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Zhang Yongjie
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Zhang Mengqi
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Yang Yeqin
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
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Lind S, Bengtsson A, Alvariza A, Klarare A. Registered nurses' experiences of caring for patients in hospitals transitioning from curative to palliative care: A qualitative study. Nurs Health Sci 2022; 24:820-827. [PMID: 36053985 PMCID: PMC10087325 DOI: 10.1111/nhs.12982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 06/01/2022] [Accepted: 08/11/2022] [Indexed: 12/27/2022]
Abstract
The aim of this study was twofold: to illuminate registered nurses' experiences of palliative care and of caring for patients transitioning from curative to palliative care in hospitals. A qualitative descriptive design was used. Group interviews were conducted with 11 registered nurses in three different hospital settings. Content analysis was performed. The results are presented in four themes: "Understanding palliative care in a hospital setting"; "Involving, supporting, and caring for patients and families"; "Striving for consensus and common goals of care"; and "Struggling with the hospital environment." The registered nurses described struggling with the interpretation of palliative care and with how to transfer it into clinical practice in their specific care settings. Teamwork and collaboration were challenging and goals of care incongruent within the team. Further implementation of a palliative care approach, with core components symptom relief, teamwork, communication and relationship, and family support, is crucial to improve both patient care and the conditions enabling registered nurses to provide good care for the patients and their families in hospital settings.
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Affiliation(s)
- Susanne Lind
- Palliative Research Centre, Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | | | - Anette Alvariza
- Palliative Research Centre, Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Capio Palliative care, Dalen hospital, Stockholm, Sweden
| | - Anna Klarare
- Palliative Research Centre, Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Department for Women's and Children's Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
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Flaherty SJ, Delaney H, Matvienko-Sikar K, Smith V. Maternity care during COVID-19: a qualitative evidence synthesis of women's and maternity care providers' views and experiences. BMC Pregnancy Childbirth 2022; 22:438. [PMID: 35619069 PMCID: PMC9132752 DOI: 10.1186/s12884-022-04724-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/03/2022] [Indexed: 01/16/2023] Open
Abstract
Background As COVID-19 continued to impact society and health, maternity care, as with many other healthcare sectors across the globe, experienced tumultuous changes. These changes have the potential to considerably impact on the experience of maternity care. To gain insight and understanding of the experience of maternity care during COVID-19, from the perspectives of women and maternity care providers, we undertook a qualitative evidence synthesis (QES). Methods The population of interest for the QES were pregnant and postpartum women, and maternity care providers, who provided qualitative data on their experiences of maternity care during COVID-19. The electronic databases of MEDLINE, CINAHL, EMBASE, PsycINFO and the Cochrane COVID study register were systematically searched from 01 Jan 2020 to 13 June 2021. The methodological quality of the included studies was appraised using a modified version of the quality assessment tool, based on 12-criteria, designed by the Evidence for Policy and Practice Information coordinating Centre (EPPI-Centre). Data were extracted by two reviewers independently and synthesised using the Thomas and Harden framework. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Results Fifty records relating to 48 studies, involving 9,348 women and 2,538 maternity care providers, were included in the QES. The methodological quality of the studies varied from four studies meeting all 12 quality criteria to two studies meeting one quality criterion only. The synthesis revealed eight prominent themes. Five of these reflected women’s experiences: 1) Altered maternity care (women), 2) COVID-related restrictions, 3) Infection prevention and risk, 4) ‘the lived reality’ – navigating support systems, and 5) Interactions with maternity services. Three themes reflected maternity care providers’ experiences: 6) Altered maternity care (providers), 7) Professional and personal impact, and 8) Broader structural impact. Confidence in the findings was high or moderate. Conclusion Although some positive experiences were identified, overall, this QES reveals that maternity care during COVID-19 was negatively experienced by both women and maternity care providers. The pandemic and associated changes evoked an array of emotive states for both populations, many of which have the potential to impact on future health and wellbeing. Resource and care planning to mitigate medium- and longer-term adverse sequelae are required. PROSPERO registration CRD42021232684. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04724-w.
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Affiliation(s)
| | - Hannah Delaney
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland.,Health Research Board-Trials Methodology Research Network (HRB-TMRN), National University of Ireland, Galway, Ireland
| | | | - Valerie Smith
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland.
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Alshammari F, Jenny Sim RN, Lapkin S, Moira Stephens RN. Registered nurses’ knowledge, attitudes and beliefs about end-of-life care in non-specialist palliative care settings: A mixed studies review. Nurse Educ Pract 2022; 59:103294. [DOI: 10.1016/j.nepr.2022.103294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 11/17/2021] [Accepted: 01/04/2022] [Indexed: 11/16/2022]
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Wu X, Zhou Z, Zhang Y, Lin X, Zhang M, Pu F, Zhang M. Factors Associated with Behaviors Toward End-of-life Care Among Chinese Oncology Nurses: A Cross-Sectional Study. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:310-316. [PMID: 34775137 DOI: 10.1016/j.anr.2021.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/02/2021] [Accepted: 10/25/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The goal of this study was to describe the current status of oncology nurses' behaviors toward end of life (EOL) care in China and to explore the factors associated with oncology nurses' behaviors toward EOL care. METHODS A cross-sectional design was applied and a convenience sample of 1038 oncology nurses from 22 grade A hospitals were recruited into this study. A general social demographic data questionnaire was administered, and the Chinese version of Nurses' Behaviors of Caring for Dying Patients Scale was used to assess nurse behavior toward EOL care. The total score ranges from 40 to 200 points. Data were analyzed with SPSS 26.0 software. RESULTS Chinese oncology nurses' average score of holistic EOL care behaviors was 2.97 ± 0.59. Oncology nurses provide physical care most (3.81 ± 0.76), followed by family care (3.02 ± 0.86), and spiritual care (2.37 ± 0.67). Multiple regression analysis showed that a higher frequency of sharing EOL care experience with colleagues, in-service palliative care education, higher level of head nurse support for EOL patient care, more cases of EOL care, higher working position, and nurse's perceived high level of support were positively associated with behavior toward EOL care. These six factors explained 16.2% of the total variance. CONCLUSIONS The results may help provide a basis for converting behavior for EOL care among oncology nurses and design interventions to better improve quality of life for EOL patients with cancer in China.
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Affiliation(s)
- Xiaoyu Wu
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhihuan Zhou
- Department of Neurosurgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yiheng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoyan Lin
- Department of Neurosurgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Meng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fulin Pu
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Rushton C, Edvardsson D. A genealogy of what nurses know about 'the good death': A socio-materialist perspective. Nurs Philos 2021; 22:e12365. [PMID: 34428347 DOI: 10.1111/nup.12365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
In this article, we report the outcome of a sociological inquiry into nursing knowledge of death and dying, specifically 'the good death'. A genealogical approach informed by actor-network theory and appreciative inquiry were used to compose a broad socio-material account of how nurses concern themselves with the care of the dying and end-of-life care. Our enquiry revealed similarly to other studies, that there was no shared or overarching model of care. Key themes derived from nurses' translations of 'the good death' were re-presented pictorially as six pillars and two processes to comprise a new diagram of The Personalised Ideal Death.
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Affiliation(s)
- Carole Rushton
- School of Nursing and Midwifery, College of Science, Health and Engineering, Latrobe University, Melbourne, Victoria, Australia
| | - David Edvardsson
- School of Nursing and Midwifery, College of Science, Health and Engineering, Latrobe University, Melbourne, Victoria, Australia
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Saunders R, Glass C, Seaman K, Gullick K, Andrew J, Wilkinson A, Davray A. Clinical staff perceptions on the quality of end-of-life care in an Australian acute private hospital: a cross-sectional survey. AUST HEALTH REV 2021; 45:771-777. [PMID: 34370967 DOI: 10.1071/ah20329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/17/2021] [Indexed: 11/23/2022]
Abstract
ObjectiveTo explore the perceptions of clinical staff on the quality of end-of-life care in an acute private hospital.MethodsA descriptive cross-sectional study with a convenience sample of clinical staff in an acute private hospital were surveyed using a validated end-of-life survey. Data from the surveys were analysed using descriptive statistics for quantitative responses and inductive content analysis for the open-ended responses.ResultsOverall, 133 staff completed the survey. Of these, 107 had cared for a dying patient in the hospital. In total, 87.6% of participants felt confident in their ability to recognise a dying patient and 66.7% felt confident in their ability to talk to the patient and family. Almost one-third had not received specific training in the area.ConclusionsHospitals need to take the lead in ensuring end-of-life care processes are embedded across clinical areas. This includes providing staff with end-of-life care education and support in the delivery of end-of-life care. These strategies will facilitate safe and quality end-of-life care, including better collaboration between patients, families and staff.What is known about the topic?Key to providing quality end-of-life care in hospitals are strategic guidelines that support good clinical governance and adequately trained staff to deliver the care.What does the paper add?This study highlights the importance of clinical staff in all areas having skills and confidence in providing care to dying patients and their families.What are the implications for practitioners?It is important that all health practitioners implement strategies to overcome gaps in staff education and support, to ensure all patients and families receive quality end-of-life care.
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Affiliation(s)
- Rosemary Saunders
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia. ; ; ; and Corresponding author.
| | - Courtney Glass
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia. ; ;
| | - Karla Seaman
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia. ; ;
| | - Karen Gullick
- Hollywood Private Hospital, Monash Avenue, Nedlands, WA 6009, Australia. ; ;
| | - Julie Andrew
- Hollywood Private Hospital, Monash Avenue, Nedlands, WA 6009, Australia. ; ;
| | - Anne Wilkinson
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia. ; ;
| | - Ashwini Davray
- Hollywood Private Hospital, Monash Avenue, Nedlands, WA 6009, Australia. ; ;
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Boz İ, Teskereci G. Experiences of gynecologic oncology nurses regarding caring behaviors: a hermeneutic phenomenological study. J Psychosom Obstet Gynaecol 2021; 42:29-39. [PMID: 32054381 DOI: 10.1080/0167482x.2020.1726316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
PURPOSE This study aims to explore the caring behaviors experiences of gynecologic oncology nurses. METHODS This study was conducted with phenomenological hermeneutical approach. This study was carried out 14 nurses working on women with gynecologic cancer. Data were collected through individual interview method by using semi-structured interview guide. Data were analyzed using a phenomenological hermeneutical method. RESULTS Caring behaviors experiences of gynecologic oncology nurses were explained by the themes "missed caring behaviors", "transition from work-centered to care-centered approach", and "transition to caring-healing approach". The first theme, "missed caring behaviors" included two subthemes: "focusing on routines" and "superficial relationships". The second theme, "transition from routine to care-centered" included three subthemes: "barrier perception", "off the record" and "controlled attachment". The last theme, "transition to caring-healing" consisted of the subthemes "ideal care conscience", "presenting presence", "looking through her window", "healing with caring behaviors". The main theme was reached as "caring behaviors: the focus of nursing". CONCLUSION This study suggests that gynecologic oncology nurses need to adequately and efficiently improve on caring behaviors in an intense caring environment.
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Affiliation(s)
- İlkay Boz
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Gamze Teskereci
- Kumluca Health Science Faculty, Akdeniz University, Antalya, Turkey
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A Network Analysis of Research Topics and Trends in End-of-Life Care and Nursing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010313. [PMID: 33406715 PMCID: PMC7795048 DOI: 10.3390/ijerph18010313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/20/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022]
Abstract
This study identified the trends in end-of-life care and nursing through text network analysis. About 18,935 articles published until September 2019 were selected through searches on PubMed, Embase, Cochrane, Web of Science, and Cumulative Index to Nursing and Allied Health Literature. For topic modeling, Latent Dirichlet Allocation (K = 8) was applied. Most of the top ranked topic words for the degree and betweenness centralities were consistent with the top 1% through the semantic network diagram. Among the important keywords examined every five years, "care" was unrivaled. When analyzing the two- and three-word combinations, there were many themes representing places, roles, and actions. As a result of performing topic modeling, eight topics were derived as ethical issues of decision-making for treatment withdrawal, symptom management to improve the quality of life, development of end-of-life knowledge education programs, life-sustaining care plan for elderly patients, home-based hospice, communication experience, patient symptom investigation, and an analysis of considering patient preferences. This study is meaningful as it analyzed a large amount of existing literature and considered the main trends of end-of-life care and nursing research based on the core subject control and semantic structure.
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Nevin M, Hynes G, Smith V. Healthcare providers' views and experiences of non-specialist palliative care in hospitals: A qualitative systematic review and thematic synthesis. Palliat Med 2020; 34:605-618. [PMID: 32020829 DOI: 10.1177/0269216319899335] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Healthcare providers working in hospitals are frequently exposed to patients with palliative care needs. For most patients, these reflect non-specialist rather than specialist palliative care needs. Embedding palliative care principles early in patients' disease trajectories within acute care delivery in hospitals, however, is a challenge. How to best understand the experiences of those providing non-specialist palliative care in hospitals has not been systematically assessed. AIM To synthesise the evidence on healthcare providers' views and experiences of non-specialist palliative care in hospitals. DESIGN A qualitative systematic review and thematic synthesis using Thomas and Harden's thematic synthesis framework. DATA SOURCES Databases of MEDLINE, CINAHL, PsycINFO and EMBASE were searched from date of inception to March 2018. Studies were eligible for inclusion if they reported on healthcare providers' views and experiences of non-specialist palliative care in hospitals. Studies were appraised for quality but not excluded on that basis. The review was prospectively registered with the International Prospective Register of Systematic Reviews. RESULTS Thirty-nine papers of 37 studies were included, representing 985 hospital healthcare providers' views and experiences. Four major analytical themes emerged; 'Understanding of Palliative Care', 'Complexities of Communication', 'Hospital Ecosystem' and 'Doctors and Nurses - a Different Lens'. CONCLUSIONS Non-specialist palliative care in hospitals is operationalised as care in the last weeks and days of life. The organisation of acute care, inter-disciplinary working practices, clinician attitudes, poor communication structures and lack of education and training in palliative care principles exacerbates poor implementation of this care earlier for patients in hospitals.
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Affiliation(s)
- Mary Nevin
- School of Nursing & Midwifery, Trinity College Dublin, The University of Dublin, Ireland
| | - Geralyn Hynes
- School of Nursing & Midwifery, Trinity College Dublin, The University of Dublin, Ireland
| | - Valerie Smith
- School of Nursing & Midwifery, Trinity College Dublin, The University of Dublin, Ireland
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Uhrenfeldt L, Fegran L, Aagaard H, Ludvigsen MS. Significant others' experience of hospitalized patients' transfer to home: A systematic review and meta-synthesis. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2018; 139:1-9. [PMID: 30477973 DOI: 10.1016/j.zefq.2018.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 11/05/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Significant others are individuals representing family members or neighbors, friends, colleagues or members of the same household, who act as relatives or surrogates. Significant others play an important role when patients are transferred or discharged after hospitalization. OBJECTIVE The objective of this review is to identify, appraise and synthesize the best available evidence exploring significant others' experiences of the discharge or transfer of adult patients after hospitalization. METHODS A qualitative comprehensive systematic review and meta aggregation. TYPES OF PARTICIPANTS Participants of this review are the 'significant other(s); persons who are important or influential to the patient's life. PHENOMENA OF INTEREST How the significant others' experience hospitalized patients' transitions and the psychosocial and existential issues during transfer from hospital to home. CONTEXT Studies that investigate the organizational culture during hospitalization. TYPES OF STUDIES Studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. SEARCH STRATEGY The search aimed at finding published and unpublished studies in English, German, Danish, Swedish and Norwegian, and was unrestricted by time. Eleven electronic databases and eleven websites were searched. CRITICAL APPRAISAL Methodological validity of the qualitative papers was assessed independently by two reviewers using the standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. DATA EXTRACTION Data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. DATA SYNTHESIS Qualitative research findings were synthesized. RESULTS A total of 189 findings from twelve studies were aggregated into three categories. An aggregated finding was generated based on the primary studies: SOs existential strength is linked to preparations for the discharge including care planning meeting(s) and learning-by-doing care activities led by health care providers during hospitalizations. CONCLUSIONS The studies in this review provided useful and credible statements from caregivers' voices that are not previously aggregated nor presented. The findings enlighten both positive and burdensome experiences in the everyday life of caring for a significant other after discharge.
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Affiliation(s)
- Lisbeth Uhrenfeldt
- Danish Centre of Systematic Reviews: a Joanna Briggs Institute Centre of Excellence, Aalborg University, Aalborg, Denmark; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
| | - Liv Fegran
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Hanne Aagaard
- Lovisenberg Diaconal University College, Oslo, Norway; Section for Nursing, Aarhus University, Aarhus, Denmark
| | - Mette Spliid Ludvigsen
- Danish Centre of Systematic Reviews: a Joanna Briggs Institute Centre of Excellence, Aalborg University, Aalborg, Denmark; Randers Regional Hospital, Randers and Department of Clinical medicine, Aarhus University, Aarhus, Denmark
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