Oncology patients' and professional nurses' perceptions of important nurse caring behaviors

The relationship between psychological distress and the nursing humanistic care demands in postoperative cancer inpatients: a cross-sectional study

PURPOSE

We aimed to investigate cancer patients' experiences of psychological distress after surgery and the factors that influence it, and to analyze the relationship between this and the nursing humanistic care demands.

METHODS

This study used a convenience sampling method to survey 432 cancer patients undergoing surgical treatment in the specialized cancer hospital in Beijing. The survey used socio-demographic information, the Distress Management Screening Measures, and the Nursing Humanistic Care Demands questionnaire. Questionnaire Star was used to collect data online. SPSS24.0 software was used to test the relationship between psychological distress and nursing humanistic care demands.

RESULTS

The mean scores for psychological distress and nursing humanistic care demands were 3.95 ± 2.71 and 147.02 ± 19.88, respectively, and showed a moderately positive correlation. The main issues that caused psychological distress in patients were: worry, financial problems, surroundings, nervousness, sleep, and pain. Regression analysis showed that gender, financial burden, personality trait, and need for humanistic care in nursing explained 24.5% of the total variance in the model and were independent predictors of psychological distress.

CONCLUSION

Cancer inpatients have significant psychological distress after surgery and exhibit high levels of nursing humanistic care demands. This study fills the research gap on humanistic care for psychological distress management, nursing humanistic care demands positively predicted psychological distress. Nursing staff should pay attention to the psychological suffering of patients and develop individualized care measures to alleviate their psychological suffering by accurately identifying their nursing humanistic care demands.

[Translation and transcultural adaptation of the Person-Centred Practice Inventory Staff (PCPI-S) for health professionals in Spain]

BACKGROUND

Person-centred practices - following national and international developments in health-care policies - have become a key approach in healthcare. The Person-Centred Practice Inventory - Staff is an instrument based on the theoretical framework Person-Centred Practice that focuses on the staff's perspective and how they experience person-centred practices. Here, the aim of this study is to obtain the first Spanish version of the PCPI-S translated and adapted into the Spanish context.

METHODS

The translation and adaptation of the instrument followed the Translation and Cultural Adaptation of Patient Reported Outcomes Measures - Principles of Good Practice, which included a consulting session with experts. Content validation measures on clarity and relevance were assessed for every item (I-CVI) and the survey as a whole (S-CVI/Ave).

RESULTS

No major difficulties were registered to reach an agreement on the 12 items that needed to be clarified. Regarding clarity and relevance. The validity index per item (I-CVI) obtained excellent scores for clarity in 53 items and for relevance in 59; the S-CVI/Ave showed excellent results (=90).

CONCLUSIONS

This first version of the Person-Centred Practice Inventory - Staff instrument adapted to the Spanish context is conceptually and semantically equivalent to the original one. This valuable tool will be of great help to identify the perception of healthcare professionals on person-centred practices.

Perceptions of Caring Behaviors among Patients and Nurses

The concept of caring is fundamental to nursing practice. The aim of this study was to investigate patients' and nurses' caring behaviors and the possible differences between the two groups. In this descriptive and comparative study, 310 patients and 329 nurses from six general hospitals from Greece completed the Caring Behaviors Inventory-16. The mean score of Caring Behaviors Inventory-16 for patients was 78.94 (±17.85) and for nurses 80.27 (±9.36). The items "Demonstrating professional knowledge and skills" (Mean: 5.45 ± 3.62) and "Treating my information confidentially" (Mean: 5.34 ± 1.06) were the most important caring behaviors while the items "Including me in planning care" (Mean: 4.36 ± 1.56), and "Treating me as an individual" (Mean: 4.55 ± 1.46) were the least important caring behaviors for patients. For nurses, the most important caring behavior was "Treating patients" information confidentially" (Mean: 5.43 ± 0.94) and the least important was "Returning to the patient voluntarily" (Mean: 4.57 ± 3.68). Significant differences were observed in items: "Attentively listening to me/the patient" (t = -2.05, p = 0.04), "Treating me/the patient as an individual" (t = -7.82, p = 0.00), "Being empathetic or identifying with me/the patient" (t = -2.80, p = 0.00), and "Responding quickly when I/the patient call (t = -2.01, p = 0.04). Respect, privacy, and dignity were the most important caring behaviors for nurses while for patients they were knowledge, skills, and safety.

Exploring the Emotional Concerns of Oncology Nurses: A Qualitative Study

BACKGROUND

Nursing care for patients with cancer is related to the nurses' ability to manage their emotions and having appropriate behaviors in the clinical setting. Oncology nurses are emotionally influenced by their communication with cancer patients. Thus, this qualitative study was conducted to explore nurses' emotional concerns in oncology wards.

MATERIALS AND METHODS

This qualitative content analysis was performed among 14 oncology nurses in the oncology wards of cancer hospitals in the east and southeast of Iran (South Khorasan and Sistan and Baluchestan Provinces). The study participants were selected through purposeful sampling. Data were collected through face-to-face, semi-structured interviews until data saturation was reached from January to September 2020. The interviews were analyzed after being typed word by word, based on Graneheim and Lundman (2004).

RESULTS

The themes and subthemes that emerged from the data were related to the emotional concerns of oncology nurses. The main themes included emotional involvement and attachment (feeling of frustration in nurses, nurses' suffering from painful experiences, and nurses' emotional dependence), emotional ambiguity (nurses' uncertainty emotions, avoidance of expressing real emotions, and having a positive mindset to maintain the patient's positive mood), and emotional exhaustion (persistent chronic stress, excessive worrying about possible harms, and feelings of mental and physical exhaustion).

CONCLUSIONS

Based on the study results, cancer patient nursing care can be distressing and stressful for nurses. Oncology nurses have many emotional concerns in caring for cancer patients. The experiences of oncology nurses provide new insight into how to manage their emotional concerns.

Translation, adaptation, and validation of the Filipino version of the Caring Behaviors Inventory

Background

The way patients perceive nurses' caring behaviors can potentially impact patient outcomes and satisfaction. Studies have revealed incongruence between nurses' and patients' perceptions with regard to which behaviors are considered caring.

Objective

This study aimed to conduct a cross-cultural validation and evaluation of the psychometric properties of the Caring Behaviors Inventory (CBI-16), a self-report questionnaire, from English to Filipino.

Methods

A descriptive cross-sectional design involving forward and back-translation with bilingual translators, expert validation, and a survey in a sample of patients and nurses was used. The psychometric evaluation used a sample of 142 staff nurses and 180 hospitalized patients. Exploratory factor analysis, internal consistency reliability, and inferential statistics were used for data analysis.

Results

The Filipino version of the CBI-16 (CBI-16-FIL) had excellent internal consistency (Cronbach's alpha of 0.95) and a unidimensional factor structure (accounted for 85% of total variance). The CBI-16-FIL was found to be a valid, reliable, and unidimensional tool to measure the perceptions of nurse caring behaviors in the Philippines.

Conclusion

The CBI-16-FIL can be used to measure perceptions of nurse caring behaviors. There is a need for further studies involving other cultures, dyadic samples of nurses and patients, and larger sample sizes.

Nurses' Perspectives on Inpatient Care Responsiveness at the Gazan Public Hospitals

Background

Responsiveness is one of the intrinsic goals of health systems. This study aimed at assessing the responsiveness of inpatient care in accordance to nurses' perspectives, particularly in internal medicine ‘medical’ and surgical departments, at the Gazan public general hospitals in 2020.

Methods

This cross-sectional descriptive study was conducted at 5 public general hospitals in Gaza. Data were collected from 277 nurses using an interview-based questionnaire composed mainly of 36 items to measure responsiveness on a 4-point Likert scale. Descriptive statistics, independent t-test and analysis of variance (ANOVA) using SPSS 22.0.

Results

The overall responsiveness was about 77.5%. Access to social support was the highest-performing domain but it was the less important. Dignity was the second-highest in performance but the most important domain. Choice of provider and quality of basic amenities were almost the lowest in both performance and importance. Hospital, marital status, educational level, position at work, income, department, and the experience in the current ward have led to significant differences in the level of responsiveness.

Conclusion

Supply-side should be considered to delineate the status quo of responsiveness accurately. There is a room for further improvement in the interpersonal domains of responsiveness without extravagant expenditures. Policymakers need to emphasize on better allocation of budget for client-orientation domains of responsiveness as well. Hospital characteristics had a pivotal role in creating significant differences among respondents. Likewise, socioeconomic status and cultural diversity of nurses led to significant variations in their responses, hence, this calls for robust and well-designed researches, including non-public hospitals, to determine the most influential factors.

Association between perception of caring behaviors and self-efficacy in patients with cardiovascular disease at coronary care units: a cross-sectional study

Background

Assessing and improving patient self-efficacy are among the major roles of nurses. Nurses are also responsible for providing direct patient care, and they play a major role in improving patient care quality. Therefore, it is essential to evaluate nurses’ care-giving behaviors. This study aimed to determine the association between caring behaviors and self-efficacy in patients with cardiovascular disease.

Methods

In this cross-sectional study, 400 patients with cardiovascular disease who were admitted to hospitals in Jahrom, southern Iran, were selected through a stratified sampling. The Caring Behaviors Inventory and the Strategies Used by People to Promote Health questionnaires were used to collect data. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test and Spearman correlation coefficient in SPSS ver. 22.

Results

Results showed significant relationships between perception of caring behaviors and self-efficacy (r=0.16, P=0.001) as well as subscales of respectful deference to others (r=0.12, P=0.01), assurance of human presence (r=0.12, P=0.02), and positive connectedness (r=0.18, P=0.001). Additionally, among the subscales of caring behaviors, “attentive to others’ experience,” with a mean of 5.17±1.10, was the highest priority and “positive connectedness,” with a mean of 4.81±1.31, was the lowest priority for patients. The mean self-efficacy score was 73.94±29.78, and 169 patients (43.2%) had low self-efficacy.

Conclusions

Given the positive relationship between perception of caring behaviors and self-efficacy in patients with cardiovascular disease, self-efficacy could be improved by paying more attention to patient care priorities and improving patient perception of caring behaviors.

Predictors and priority of caring behaviours in intensive care units

BACKGROUND

There is an increasing number of studies addressing nurses' perception of caring behaviours; however, on the issue of quality of care, it is important to understand why nurses focus more on certain elements of caring than others, and this needs to investigate influencing factors on, priorities, and predictors of caring behaviours.

AIMS

The main goal of this study was to determine the predictors and priorities of nurses' caring behaviours in intensive care units to improve the quality of care and patient outcomes.

METHODS

This is a cross-sectional survey of nurses working in adult and pediatric ICUs in Iran. The participants were 470 ICU nurses from eight hospitals in Iran. Data were collected over 6 months in 2018 using the Persian version of "Caring Assessment Report Evaluation Q-Care"; "Determinants of Nurse Caring Behaviors"; and a demographic data form.

RESULTS

By broad descriptive and analytical analysis, thirteen items were recognized as predictors of caring behaviours. The most important individual predictors reported as "interest in the nursing profession," "moral obligation," and "job experience," respectively. The most important perceived nursing behaviours were, respectively, subscales of "accessible," "monitors/follow-through" and "explains/facilitates."

CONCLUSION

The results provide insight into new and context-specific predictors of nurses' caring behaviours. These findings suggest that nursing managers, besides selecting skilful staff for ICUs, may consider employing those of higher "interest in the nursing profession"; "moral obligation"; and "job experience." They, also, need to be aware that organizational culture, climate, and values have a great impact on the caring behaviours of nurses. This could help them to handle the complex issue of improving the quality of care more efficiently.

Measuring invisible nursing interventions: Development and validation of Perception of Invisible Nursing Care-Hospitalisation questionnaire (PINC-H) in cancer patients

Visible nursing work is usually associated with formal work and physician-delegated tasks which are protocolised and usually well documented. Nevertheless, nurses carry out many actions and display specific attitudes and behaviours which, despite contributing to the well-being, recovery of patients and satisfaction with the attention received, are not as visible. Previous studies have been conducted in order to define 'invisible nursing interventions', but no quantitative instruments focused on measuring invisible nursing interventions have been found in the literature.

PURPOSE

To test the psychometric properties of the Perception of Invisible Nursing Care-Hospitalisation (PINC-H) questionnaire.

METHODS

Cross-sectional survey design. A self-administered questionnaire was completed by 381 participants recruited consecutively after discharge from a Spanish hospital. Data were collected from 2012 to 2020.

RESULTS

Three factors were identified from exploratory factor analysis, namely 'Caring for the person', 'Caring for the environment and the family' and 'Caring presence'. Criterion Validity Coefficient was highly significant (p < 0.001) with values ranging between 0.63 and 0.71. Cronbach's alpha was 0.96. Test-retest reliability was estimated in a subsample of 187 participants; in all the items, correlation coefficients were highly significant (p < 0.001) and within range (0.532-0.811) with a mean value of 0.680. Also, correlations between each dimension and the complete questionnaire indicated good temporal stability between measurements.

CONCLUSIONS

The instrument had satisfactory validity and reliability. PINC-H can contribute to highlight nursing interventions and behaviours which are often unseen and, thus, less valued. We argue that PINC-H will also be useful to evaluate the quality of invisible nursing care to oncology inpatients.

Sonographers' experiences of being a caring professional within private practice in the province of Gauteng

Background

Medical imaging has been driven by technological advancements. However, the concept of caring has now become a significant element in the healthcare profession. Within a South African context, there are principles that emphasise the importance of people and service delivery: the Batho Pele Principles and Ubuntu. Now more than ever, there is a greater need for a patient-centred caring environment. Therefore, there is an expectation for sonographers to be adaptive to this new environment.

Aim

The purpose of this study was to explore and describe the sonographers’ experiences of being caring professionals.

Setting

Sonographers who work within private practices in Gauteng were part of this study.

Methods

A qualitative, exploratory, descriptive, contextual, phenomenological research design was used. Focus group interviews were conducted with qualified sonographers registered with the HPCSA. Thematic analysis was used to code data into themes and categories.

Results

Four themes emerged: the effects of a caring relationship between a sonographer and a patient; circumstances limiting a sonographer in being a caring professional; sonographers’ approach to caring; educational readiness of sonographers to be caring professionals.

Conclusion

The participants in this study explained and shared their understanding of being caring professionals. They shared many stories regarding trusting relationships with patients. However, as a caring professional, many challenges were encountered, both physically and emotionally. Recommendations such as reflective journals and the practices of Jean Watson’s theory of transpersonal caring are cited to focus on the practice and education that may improve caring among sonographers.

Nursing competencies across different levels of palliative care provision: A systematic integrative review with thematic synthesis

BACKGROUND

Palliative care exists in diverse healthcare settings. Nurses play a crucial role in its provision. Different levels of palliative care provision and education have been recognized in the literature. Therefore, nurses need a set of various competencies to provide high-quality palliative care.

AIMS

To systematically synthesize the empirical evidence of (1) nursing competencies needed in palliative care and (2) whether these competencies differ across the level of palliative care.

DESIGN

Systematic integrative review with thematic synthesis. Prospero: CRD42018114869.

DATA SOURCES

CINAHL, PubMed, Academic Search Premier, Scopus and Medic databases. Studies on nursing competencies linked to palliative care reported in English, Swedish, Finnish, Spanish, Portuguese or German were considered. Search terms: 'palliative care or hospice care or end-of-life care', 'competency or professional competence or skills' and 'nursing'. Articles were independently screened and reviewed by two researchers. Quality appraisal was conducted following Hawker's criteria.

RESULTS

A total of 7454 articles were retrieved, 21 articles were included in the analysis. Six diverse nursing competencies dimensions, namely leadership, communication, collaboration, clinical, ethico-legal and psycho-social and spiritual were identified. The reports rarely defined the level of palliative care and covered a wide array of healthcare settings.

CONCLUSION

Nurses need a wide range of competencies to provide quality palliative care. Few studies focused on which competencies are relevant to a specific level of palliative care. Further research is needed to systematize the nursing competencies and define which nursing competencies are central for different levels of palliative care to enhance palliative care development, education and practice.

Patients' and Nurses' Perceptions of What Constitutes Good Nursing Care: An Integrative Review

BACKGROUND

Differences between patients' and nurses' perceptions of good nursing might be one of the barriers to optimal nursing care that matches the preferences of patients. A better understanding of the attributes of Good Nursing Care across different settings, circumstances, and patient populations will provide an integrated idea about Good Nursing Care, which can contribute to nursing theory development and future research.

PURPOSE

This study aimed to integrate the literature on patients' and nurses' perceptions of what constitutes Good Nursing Care and thereby identify the similarities and differences in patients' and nurses' perceptions of Good Nursing Care.

METHODS

A literature search of PubMed, CINAHL, and MEDLINE was conducted for article published between January 2000 and June 2017. A total of 18 studies were identified and assessed using the Mixed Method Appraisal Tool. The studies were analyzed and synthesized using Swanson's theory of caring as the theoretical framework.

RESULTS

Some dissents and agreements were found between patients and nurses regarding the crucial attributes of Good Nursing Care. While "enabling," such as providing information, coaching, and guidance, was more emphasized by patients, "being with" (being present at the bedside) was more emphasized by nurses. "Doing for," especially expert performance and enhancing physical comfort, was the most frequently mentioned attribute of Good Nursing Care by both patients and nurses.

IMPLICATIONS FOR PRACTICE

Theoretical developments regarding Good Nursing Care-characterized by a balance between sufficient nursing knowledge and competent technical skills on one hand and patient empowerment based on trusting relationships on the other hand-would promote the provision of Good Nursing Care in clinical practice.

Caring behavior and associated factors among nurses working in Jimma University specialized hospital, Oromia, Southwest Ethiopia, 2019

BACKGROUND

Nursing care behavior and nurse's perception of effective care behavior is an act, conduct, and mannerism enacted by professional nurses that convey concern, safety, and attention to the patient. Behavior associated with caring has a paramount role in linking nursing interaction to the client in experiences but, the concept is ambiguous and elusive toward different scholars to reach on common understanding. Only a few studies have been done on the caring behavior and associated factors globally, and no study was done in this study area. Therefore; the purpose of this study was to assess caring behavior and its associated factors among nurses working in Jimma University specialized hospital, southwest Ethiopia.

METHODS

An institutional-based cross-sectional study design was conducted on a sample of 224 nurses working in Jimma university specialized hospital from March 20-April 20, 2019. Data were collected by a self-administered questionnaire. Descriptive statistics including frequency table, mean, standard deviation and percentage were employed. Bivariate and multiple linear regression analysis was used with regression coefficient (β), coefficient of the determinant (R2), CI 95% and p < 0.05 were used for statistical significance.

RESULTS

The overall proportion of nurses caring behavior was 80.3% which was mostly measured in terms of professional -technical (82.9%) and psychosocial (81.3%) dimension. Job satisfaction as personal satisfaction (beta = 1.12, p = 0.00), professional satisfaction, (beta = 1.07, p = 0.00), joint participation in caring process (beta = 0.58, p = 0.00,) satisfaction with nurse management (beta = 0.85, p = 00) were significantly associated with caring behavior.

CONCLUSION

The proportion of nurses who had a high perception of caring behavior was found to be lower. Thus, all predictors have their own effect on enhancing job satisfaction, improving and creating conducive management and working environment to increase caring behavior. Further comparative studies involving multidisciplinary and patient point of view were recommended.

Nursing students' perception of patient-centred care: A qualitative study

Aim

This study aimed to explain the understanding of nursing students from the concept of patient-centred care.

Design

This is an explorative and descriptive-qualitative design.

Methods

The participants consisted of 15 nursing students who were selected through purposeful sampling, and data were collected through in-depth, semi-structured interviews and analysed using a qualitative content analysis.

Results

Data analysis led to the identification of three categories including the following: the inevitability of patient-centred care, the patient-centredness in comprehensive care and the importance of nursing process in patient-centred care. Introducing students to the concept of patient-centred care and how it can be achieved seems necessary during nursing education. Introducing a module on patient-centred care to the nursing curriculum is suggested to familiarize students with this concept.

Resiliency, the Lived Experience of Patients Undergoing Hematopoietic Stem Cell Transplantation

Background: Hematopoetic stem cell transplantation is considered as a standard treatment for cancer patients to stay hopeful toward treatment outcome. However, these patients experience many complications which might affect different aspects of their life. The aim of this study was to investigate the lived experience of patients after hematopoetic stem cell transplantation and introduce supportive care strategies. Materials and Methods: In this study, Van Manen's Hermeneutic phenomenological approach was used. Eleven patients (7 males and 4 females) were chosen by targeted sampling from visitors of Shariati Hospital's outpatient clinic. Semi-structured interviews were conducted and the final data were analyzed by MAXQDA 10 software. Results: Data analysis revealed that the main theme was resiliency with two sub-themes of "not surrendering to disease" and "feeling closer to God". Conclusion: Participants declared that transplantation was like a second chance for life and considered this opportunity as a gift from God to overcome their disease. According to our findings, spirituality aids can help patients control the disturbances following HSCT and health professionals can use constructive strategies to support patients with spiritual needs.

Perception of Caring Among Patients and Nurses

BACKGROUND

Empirical evidence supports the contention that implementing caring nurse behaviors results in improved patient experience; however, previous studies find differences between patient and nurse perceptions of caring.

SIGNIFICANCE

Good patient experience is positively related to desired clinical and financial outcomes. Nurse caring is a critical component in the patient experience.

OBJECTIVE

The purposes of this project were to evaluate the congruency between nurse and patient perceptions of nurse caring in a long-term acute care hospital and to determine how much patient perception of nurse caring changes over time.

METHOD

The study employed mixed methods using a triangulation strategy in which quantitative data from patients and qualitative data from nurses were collected simultaneously and compared for interpretation.

RESULTS

Time affected patient perception of caring significantly. Patients and nurses disagreed about the extent to which nurses ask patients what they know about their illnesses, help them deal with bad feelings, and make them feel comfortable.

CONCLUSION

Patients and nurses do not always agree about the quality of caring behaviors, but exposure to nurses over time positively affects patient perception of nurse caring.

Perinatal women's satisfaction with nurses caring behaviours in teaching hospitals in China

BACKGROUND

Adequate caring behaviours provided by nurses can increase patients' satisfaction of care. Yet few researchers have examined women's satisfaction in nurses' caring behaviours in China and then published the study in English.

AIM

The aim of this study was to identify the level of women's satisfaction with nurses' caring behaviours during the antenatal, childbirth and postnatal periods.

METHODS

A descriptive, cross-sectional study was performed using a sample of 422 postpartum women of two teaching hospitals in Wuhan, China. A structured questionnaire on socio-demographic information was completed, and a satisfaction scale of 60 items concerning nurses' caring behaviours was measured.

RESULTS

The findings showed that participants reported a good satisfaction score for nurses' caring behaviours during all three periods. Behaviours on the 'Monitor' subscale obtained the highest score (a mean score of 4.46 for the antenatal period, 4.64 for the childbirth period and 4.31 for the postnatal period). The subscale with the second highest score was 'Human respect' (4.53, 4.27 and 4.56, respectively), while the subscale with the lowest score was 'Trust' (3.78 and 3.98). The statistical significances of the demographics of the women were shown concerning their perceived satisfaction of five subscales of caring behaviours.

CONCLUSION

The study revealed no statistically significant differences in the perceived satisfaction in nurses' caring behaviours between the antenatal, childbirth and postnatal periods. However, nursing administration development projects that focus on caring are still needed. Additionally, more studies that reflect Watson's theory of human caring on the maternity population should be conducted with a larger sample size.

Perceptions of caring behaviours: A comparison of surgical oncology nurses and patients

AIMS AND OBJECTIVES

The purpose of this article was to compare surgical oncology nurses caring behaviours to perceptions of their surgical oncology inpatients and determine internal consistency of the CAT-Nurse.

BACKGROUND

Nursing practice at the H. Lee Moffitt Cancer Center & Research Institute in Tampa, FL is guided by Duffy's Quality-Caring Model© . No study using Duffy's model for both oncology nurses and patients has been found.

DESIGN

A descriptive correlation design was used adhering to the STROBE guidelines. Data were collected using CAT-Nurse and compared to data from a previous study using CAT (version V).

METHODS

Item responses were compared between nurses and patients using t tests.

RESULTS

Patients scored higher on perceptions of caring behaviours. Mutual problem solving was an area for improvement. The CAT-Nurse demonstrated internal consistency reliability.

CONCLUSION

Results from this study can make nurses more aware of the caring perceptions that are not as strong as others, and therefore may have the ability to promote transformation.

RELEVANCE TO CLINICAL PRACTICE

The results can serve as foundational knowledge for action plans aimed at increasing nurse comfort addressing lower scoring caring behaviours that would then result in improving patient perceptions which could be linked to patient satisfaction and reimbursement.

Nurses' Caring Behaviors: The Perception of Patients With Cancer at the Time of Discharge After Surgery

BACKGROUND

Duffy's Quality-Caring Model guides nursing practice at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, FL. No published studies using this model in oncology were found.

OBJECTIVES

The purpose of this article is to determine patients' perceptions of nurse caring behaviors at the time of discharge after surgery.

METHODS

A descriptive correlational design was used. Data were collected using Duffy's Caring Assessment Tool (CAT). Simple regression analyses were performed.

FINDINGS

Spearman's correlation coefficients between the scores and age, length of stay, and number of nurses caring for the patients were not significant. No significant association was found between surgical site and CAT scores, nor between gender, race, and disposition posthospitalization. Appreciation of unique meanings and mutual problem solving showed need for improvement.

Informational Needs of Patients with Cancer: A Qualitative Content Analysis

One of the most important needs of patients with cancer is informational needs. Getting relevant information about the disease can lead to a proper decision making, better response to treatment, lower levels of anxiety, and higher levels of quality of life. Therefore, the current study aimed to determine the informational needs of patients with cancer in southeast Iran. Materials and Methods: This conventional qualitative content analysis was done using a descriptiveexplorative design. Data collection was done through conducting deep semi-structured interviews from September 2017 to March 2018 in cancer treatment centers of Kerman University of Medical Science, Iran. Data saturation was achieved after interviewing with 13 patients during 15 interviews. The patients were asked to narrate their experience about informational needs of cancer patients. The following concepts were considered: the unit of analysis, meaning unit, condensation, code, sub-category, category, and main category. Results: The results of the present study showed that informational needs of these patients could be categorized under one main category called awareness-oriented needs, including three subcategories. These subcategories included lack of knowledge about the nature of the disease, inappropriate control of the disease due to lack of knowledge, and lack of knowledge about cancer treatment methods. Conclusion: Results showed that patients with cancer tended to know what is the cancer and the ways of cancer treatment and complications. Therefore, it is suggested to perform further studies cultivating the awareness of cancer patients in these areas. Therefore So, It should be noted that designing and implementation of this needs assessment provide a comprehensive way to consult and collaborate with health care professionals, patients, and their families.

Perfil de pacientes con cáncer en un centro de oncología en Bogotá

Introducción: La experiencia de vivir con un cáncer repercute significativamente en la vida, pues afecta todo el ser, lo que demanda de enfermería comprender las características del cuidado de las personas y de sus seres queridos para poderlo cuidar. Objetivo: Describir y comparar la caracterización para el cuidado de los pacientes con cáncer. Método: Estudio descriptivo comparativo realizado con 131 pacientes con cáncer atendidos en tres servicios oncológicos, determinando el perfil sociodemográfico, la carga percibida y la apropiación de las tecnologías para el cuidado. El análisis se realizó utilizando estadística descriptiva, la comparación con prueba chi cuadrado y de Kruskal-Wallis. Resultados: Predomina el género femenino, edad promedio de 54 años (SD 17,4), baja dependencia y estado cognitivo intacto, baja escolaridad, falta de ocupación laboral, nivel socioeconómico bajo y alto nivel de apoyo familiar. La percepción de bienestar es positiva en el aspecto físico, social y espiritual, para la mayoría. La apropiación de las tecnologías es media. Excepto por algunas variaciones, los pacientes presentan condiciones comunes para el cuidado. Conclusión: Los pacientes perciben apoyo, en especial familiar, bienestar físico, social y espiritual, excepto psicológico, lo que permite planear un cuidado de enfermería que garantice mejor acceso, seguridad y continuidad.

Rocky Road Ahead Of Nursing Presence in the Oncology Care Unit: A Qualitative Study

BACKGROUND:

Cancer patients need not only well-planned treatment, but also comprehensive nursing care provided with compassion, competence, and conscience. Nursing presence is an essential part of the care process in all nursing interventions.

AIM:

This study aimed to identify the barriers to the nursing presence in oncology care units.

MATERIALS AND METHODS:

A qualitative content analysis study was carried out with the participation of 27 nurses who were chosen by purposive sampling. The data collection instruments were semi-structured interviews and observation. The interviews were recorded and transcribed, and then coded and analysed by the Graneheim and Lundman’s content analysis methodology. The criteria proposed by Guba and Lincoln were used to ensure the validity of the research.

RESULTS:

From the data analysis, the researchers were able to obtain a primary theme labelled “Rocky road ahead of nursing presence” and two subthemes labelled “Difficult and stressful work environment” and “Dysfunctional rules and regulations” with several subcategories including “exposure to violence”, “shortage of nursing staff”, “inattention to the needs of nurses”, “organizational unfairness”, “excessive paperwork”, and “need for detailed documentation”.

CONCLUSION:

There are numerous challenges ahead of achieving satisfactory nursing presence and quality care in the oncology care units. The findings highlight the key role of organisational conditions in the nursing presence and the dire need to pay further attention to the motivational factors.

An exploration of factors influencing inpatient nurses’ care behaviour in an acute hospital setting

Objective

To examine factors influencing caring behaviour of nurses in Singapore.

Design

Descriptive correlational study using Care Behaviour Inventory (CBI-24) questionnaire to assess nurses’ perceptions of their caring behaviours.

Setting

Acute tertiary hospital in Singapore.

Participants

A convenience sample of 167 full time registered nurses working in subsidized wards, with more than 1 year of experience in current practising ward were recruited.

Main outcome measure(s)

Nurses’ perception of their caring behaviours.

Results

Data analysis yielded a mean CBI score of 123.11 out of 144, indicating that nurses had a positive perception of their caring behaviours. Among the 4 CBI subscales, Respectfulness and Connectedness components of CBI were ranked the lowest with a mean score of 4.2 and 4.9, respectively. This indicated that although nurses generally performed adequate caring during patient care, they appeared to be lacking in the expressive aspect of caring. Significant differences (P < 0.05) were found among subgroups of nationality, ethnicity, religion and education level. Nurses’ perception of their caring behaviours was positively correlated to their age and total working experience. Linear regression showed that age, religion, education level positively influenced nurses’ perception of their caring behaviours.

Conclusion

Findings from this study raise awareness to the caring behaviours that nurses were lacking in and also offer valuable insights to the potential factors influencing nurses’ caring behaviours. This information serves as a foundational knowledge to guide the development of interventions aimed to promote patient-centred care and improve quality of future nursing care.

Nurses', patients', and family caregivers' perceptions of compassionate nursing care

BACKGROUND

Compassion is the core of nursing care and the basis of ethical codes. Due to the complex and abstract nature of this concept, there is a need for further investigations to explore the meaning and identify compassionate nursing care.

OBJECTIVES

The purpose of this study was to identify and describe compassionate nursing care based on the experiences of nurses, patients, and family caregivers.

RESEARCH DESIGN

This was a qualitative exploratory study. Data were analyzed using the conventional content analysis method.

PARTICIPANTS AND RESEARCH CONTEXT

Nurses, hospitalized patients, and family caregivers in different educational hospitals in an urban area of Iran were selected from February 2016 to December 2017 using a purposeful sampling method (n = 34). In-depth and semi-structured interviews, focus group interviews, and field notes were used for data collection.

ETHICAL CONSIDERATIONS

The study was approved by the University's Ethics Committee. The participants were informed about the aim and method of the study, reasons for recording the interviews, confidentiality of data, and voluntary nature of participation in this study.

FINDINGS

Data from interviews and filed notes were analyzed and classified into three themes: "effective interaction," "professionalism," and "continuous comprehensive care."

DISCUSSION AND CONCLUSION

Emerged themes of this study involved holistic care in the current literature on nursing with an emphasis on effective interaction and professionalism. Nurses can understand patients' and family caregivers' comprehensive needs through interaction skills. In addition, clinical proficiency, maintaining professional ethics' standards along with holism, and continuity in care are examples of compassionate care. Education program about compassionate care can enhance the quality of nursing care.

From nurse to service user: a personal cancer narrative

This article presents a snapshot of my experience of being a nurse who became a service user with breast cancer. It begins by outlining the Humanization of Healthcare Framework ( Todres et al, 2009 ), which is a values-based context that can be used to underpin daily care. Generic applications for each of the dimensions of the framework are suggested. This framework is then used to contextualise my experience of receiving my diagnosis and the ensuing chemotherapy. Using examples from my personal narrative, I make some recommendations for 'small actions' that can contribute to more humanised and person-centred care. I also hope that this narrative prompts reflection by the reader and so improves the quality of care given to others.

Collaborative Patient-Centered Quality Improvement

Identification of patients’ and health professionals’ quality improvement preferences is an essential first step in collaborative improvement models. This includes experience-based codesign (EBCD), where service change is strategically introduced following stakeholder consultation. This study compared the number and types of improvement initiatives selected by outpatients and health professionals. Using electronic surveys designed to inform EBCD studies, 541 outpatients (71.1% consent) and 124 professionals (47.1% response) selected up to 23 general initiatives. On average, outpatients selected 2.4 (median = 1, interquartile range = 1–3) initiatives and professionals selected 10.7 (median = 10; interquartile range = 6–15) initiatives. Outpatients demonstrated a strong preference for improvements to clinic organization, such as appointment scheduling and clinic contact. Outpatients selected relatively fewer initiatives potentially reducing the complexity of service change and resources required to address preferences. Comparatively, professionals indicated a greater degree of change is needed and selected initiatives related to communication with patients and other professionals, including coordinating multidisciplinary care. Improvements to information provision were commonly selected by both groups and offered a strategic opportunity to address patients’ and professionals’ preferences. By quantifying the ways in which preferences differed, this study emphasizes the need for collaborative approaches to health service change and may be used to initiate an informed discussion on patients’ and professionals’ quality improvement preferences in tertiary care.

Who cares? A critical discussion of the value of caring from a patient and healthcare professional perspective

BACKGROUND

This study was undertaken in order to discover and illuminate the essential caring behaviours valued by both patients and staff in an orthopaedic setting within a district general hospital in the United Kingdom.

OBJECTIVES

This descriptive study was undertaken in order to acquire a greater understanding of perceptions of caring from both patient and orthopaedic healthcare professional perspectives.

METHODS

A sample of 30 patients and 53 healthcare professionals consisting of doctors, nurses, physiotherapists and occupational therapists were asked to complete the Caring Behaviours Inventory (CBI) questionnaire (Wolf et al., 1994). Data were analysed using descriptive and inferential statistics.

RESULTS

The findings revealed both similarities and differences relating to the importance of positive caring behaviours exhibited during caring interactions. Healthcare professionals working in the orthopaedic setting acknowledged the value of similar positive caring behaviours to those of the patient group but ranked the importance of these differently.

DISCUSSION

Several important insights into perceptions of caring have been gained. These relate to an overall understanding of the caring behaviours that are considered of importance to patients and healthcare professionals; the differences that exist between the caring perceptions of both groups and the factors which influence these perceptions.

The power of nursing: guiding patients through a journey of uncertainty

PURPOSE

The objective of this qualitative study was to understand the experiences of oncology nurses in patient counseling and support services in the ambulatory care setting.

METHODS AND SAMPLE

A qualitative study was conducted using grounded theory methods. Data were generated through four focus group interviews with 21 oncology nurses currently providing counseling and support services for cancer patients in Japan. The content was analyzed based on a constant comparison approach.

RESULTS

The power of nursing was identified through three themes: connecting with the patient (shared needs); personalized coordination (shared action); and realizing the patient's potential (reassurance). Oncology nurses should guide patients through the uncertain cancer trajectory by identifying patients' true needs based on an established relationship, providing personalized coordination, and developing their potential. Patient-centered care can be provided in non-physical care settings such as counseling and support services.

CONCLUSIONS

Our study describes the uniqueness and significance of nursing, and provides insights into realizing the full potential of nurses. This conceptual model can be used as a guide for practice and an educational tool to build professional identity of nurses. Oncology nurses can take a leadership role in enhancing the visibility of the nurses in multidisciplinary environments.

Factors Influencing Communication Between the Patients with Cancer and their Nurses in Oncology Wards

Aims:

The purpose of this study was to demonstrate the factors influencing nurse-patient communication in cancer care in Iran.

Materials and Methods:

This study was conducted with a qualitative conventional content analysis approach in oncology wards of hospitals in Tabriz. Data was collected through purposive sampling by semi-structured deep interviews with nine patients, three family members and five nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control.

Results:

The main theme of the research emerged as “three-factor effects” that demonstrates all the factors related to the patient, nurse, and the organization and includes three categories of “Patient as the center of communication”, “Nurse as a human factor”, and “Organizational structures”. The first category consists of two sub-categories of “Imposed changes by the disease” and the “patient's particular characteristics”. The second category includes sub-categories of “sense of vulnerability” and “perception of professional self: Pre-requisite of patient-centered communication”. The third category consists of the sub-categories of “workload and time imbalance”, “lack of supervision”, and “impose duties in context of neglecting nurse and patient needs”. Characteristics of the patients, nurses, and care environment seemed to be the influential factors on the communication.

Conclusions:

In order to communicate with cancer patients effectively, changes in philosophy and culture of the care environment are essential. Nurses must receive proper trainings which meet their needs and which focus on holistic and patient-centered approach.

Iranian caregivers, silent mediums in caring for relatives suffering from cancer

BACKGROUND

Poor interaction of treatment personnel with patients' families leads to informational contrast in families, which may ultimately increase the tension and pressure in these conditions. Considering the necessity of caregivers' contribution for an optimized treatment, continuation of care, and supporting patients, and with regard to caregivers' important role, and also considering the emphasis placed by previous studies on the significance of the caregivers' experiences and as there are a limited number of studies on eastern countries, the present study attempts to justify caregivers' understanding of their own needs for interaction with the treatment team.

MATERIALS AND METHODS

This study is a qualitative research conducted through a content analysis method with an inductive approach. 23 familial caregivers of breast cancer patients from Seyed-Al-Shohada and ayat- ollah khan sari Hospital of Isfahan and Arak were selected through purposive sampling. Data were gathered through in-depth interviews and field notes. The content was read for several iterations and units of meaning and primary codes were extracted, and then categories were extracted based on the centrality and similarity of meanings.

RESULTS

Four categories were extracted: a) caregivers' contribution and acknowledging them in the treatment system, b) training in efficient caregiving, c) efficient interaction of the medical team with caregivers, and d) easy and dynamic access to the medical services.

CONCLUSIONS

The results of the study showed that family caregivers should cooperate and interact with the medical team. They also need training from the medical team on caregiving to cancer patients. An understanding of caregivers' experiences and needs in their interaction with the medical team and identifying their needs as an important aspect in cancer care system assists in designing evidence-based healthcare interventions and a comprehensive family-cantered care program.

Oncology patients' perceptions of "the good nurse": a descriptive study in Flanders, Belgium

The image of "the good nurse" is mainly studied from the perspective of nurses, which often does not match the image held by patients. Therefore, a descriptive study was conducted to examine oncology patients' perceptions of "the good nurse" and the influence of patient- and context-related variables. A cross-sectional, comparative, descriptive design was used. The sample comprised 557 oncology patients at one of six Flemish hospitals, where they were treated in an oncology day-care unit, oncology hospital ward, or palliative care unit. Data were collected using the Flemish Care-Q instrument. Factor analysis summarised the most important characteristics of "the good nurse". We reassessed the reliability and construct validity of the Flemish Care-Q and examined the influence of patient- and context-related variables on patient perceptions. Using factor analysis, we grouped the different items of the Flemish Care-Q according to three characteristics: "the good nurse" (I) has a supportive and communicative attitude towards patient and family, (II) is competent and employs a professional attitude, and (III) demonstrates personal involvement towards patient and family. Median factor scores of Factors I, II, and III, respectively, were 8.00, 9.00, and 8.00 (varying from 1, not important, to 10, very important). In order of importance, Factors II, I, and III were identified as valuable characteristics of "the good nurse". Gender, care setting, and province were influential variables. As perceived by oncology patients, "the good nurse" has a broad range of qualities, of which competence and professionalism are the most valuable.

Trust in nurse–patient relationships

The aim of this study was to report the results of a literature review of empirical studies on trust within the nurse–patient relationship. A search of electronic databases yielded 34 articles published between 1980 and 2011. Twenty-two studies used a qualitative design, and 12 studies used quantitative research methods. The context of most quantitative studies was nurse caring behaviours, whereas most qualitative studies focused on trust in the nurse–patient relationship. Most of the quantitative studies used a descriptive design, while qualitative methods included the phenomenological approach, grounded theory, ethnography and interpretive interactionism. Data collection was mainly by questionnaires or interviews. Evidence from this review suggests that the development of trust is a relational phenomenon, and a process, during which trust could be broken and re-established. Nurses’ professional competencies and interpersonal caring attributes were important in developing trust; however, various factors may hinder the trusting relationship.

Percepción de comportamientos de cuidado de pacientes y de enfermería oncológica: estudio comparativo

Objetivo. Describir y comparar la percepción del comportamiento del cuidado de los pacientes y el personal de enfermería en servicios de hospitalización, hematología y urgencias en una institución de oncología de referencia de Bogotá. Metodología. Estudio descriptivo comparativo realizado con 131 pacientes y 78 integrantes del personal de enfermería en tres servicios oncológicos. La percepción de cuidado se valoró con el Instrumento comportamiento profesional de cuidado de Horner. La comparación se realizó con pruebas no paramétricas. Resultados. Los pacientes de 54 años en promedio, mayoría femenina, independientes, con baja escolaridad presentaron una percepción de comportamientos de cuidado de enfermería de 77,3% en promedio siendo mejor en hematología (81,3%), seguida de medicina interna (77,3%) y más baja en urgencias (73,3%). Ellos perciben en su orden atributos de cortesía, relación, compromiso e interacción. El personal de enfermería con el 19% profesional, 81% auxiliar, de mayoría femenina con más de 6 años de experiencia, presentó una percepción de comportamientos de cuidado de 85,9% siendo similar en los tres servicios. Conclusión: Las características de los pacientes y del personal de enfermería en los diferentes servicios son similares. Para los pacientes la percepción de comportamientos de cuidado de enfermería por servicios total y en las dimensiones interacción y compromiso es positiva y diferente (p < 0,05). Para el personal de enfermería la percepción de comportamientos de cuidado es similar entre servicios y superior a la de los pacientes en su totalidad y en las dimensiones cortesía e interacción.