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Ploukou S, Papakosta-Gaki Ε, Panagopoulou E, Benos A, Smyrnakis E. Unmet Needs in the Process of Chemotherapy Provision in Pancreatic Cancer Patients from the Healthcare Provider Perspective: A Phenomenological Study in Greece. Zdr Varst 2024; 63:73-80. [PMID: 38517148 PMCID: PMC10954243 DOI: 10.2478/sjph-2024-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Pancreatic cancer is the fourth leading cause of cancer death overall, with 1.5 years life expectancy and minimal therapeutic progress in the last decades. Despite the burden it causes, there is little research on the needs of this specific population. This study aimed to explore healthcare professionals' views on providing care and patients' unsatisfied needs. Methods This qualitative descriptive study was carried out at a cancer hospital in Northern Greece. A total of 12 participants (6 physicians and 6 nurses), treating patients with pancreatic cancer undergoing chemotherapy, were recruited through purposive sampling and underwent face-to-face semi-structured interviews. Data were analyzed through the thematic analysis method in NVivo12 software. Results The analysis highlighted two themes: "needs of patients with pancreatic cancer" consisted of 6 subthemes ("daily activities", "symptoms management", "psychological support", "information needs", "multidisciplinary care" and "end-of-life care") and "needs of healthcare professionals" had 3 subthemes ("psychological support", "education" and "organizational support"). Several symptoms are identified and affect the daily activities of these patients, and psychological support is important for the majority of them, even at the time of diagnosis. The participants express dissatisfaction with the absence of palliative care structures and services and stated that an interdisciplinary approach would improve the quality of care. Conclusions Healthcare professionals report a wide range of unsatisfied needs of patients with pancreatic cancer, with the majority expressing their concerns about the complete lack of patient support in the last stages of their lives.
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Affiliation(s)
- Stella Ploukou
- Laboratory of Primary Health Care, General Practice and Health Services Research - Medical School, Aristotle University of Thessaloniki, Greece
| | - Εleni Papakosta-Gaki
- Laboratory of Primary Health Care, General Practice and Health Services Research - Medical School, Aristotle University of Thessaloniki, Greece
| | - Efharis Panagopoulou
- Laboratory of Primary Health Care, General Practice and Health Services Research - Medical School, Aristotle University of Thessaloniki, Greece
| | - Alexios Benos
- Laboratory of Primary Health Care, General Practice and Health Services Research - Medical School, Aristotle University of Thessaloniki, Greece
| | - Emmanoui Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research - Medical School, Aristotle University of Thessaloniki, Greece
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Haverfield MC, De Leon G, Johnson A, Jackson VL, Basu G, Dodge J. Transforming the discharge conversation through support and structure: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 6:100203. [PMID: 39022593 PMCID: PMC467064 DOI: 10.1016/j.ijnsa.2024.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/19/2024] [Accepted: 04/28/2024] [Indexed: 07/20/2024] Open
Abstract
Background System level demands and interpersonal barriers can disrupt nurse delivery of high-quality information at discharge, which can contribute to a lack of caregiver preparedness to manage care of the patient and ultimately affect patient health. Objective To synthesize evidence on effective nurse communication with informal caregivers during hospital discharge of adult patients with cognitive decline or Alzheimer's disease and related dementia. Design A scoping review of inpatient nurse communication with informal caregivers. Methods Collected research (published between 2011 and 2023) from three databases (MEDLINE, PsycINFO, and CINAHL), along with a separate search for gray literature (N = 18), to extract and synthesize recommended communication practices evidenced to improve the nurse care experience and support caregiver activation and preparedness. Results Extraction synthesis of strategies resulted in two themes with corresponding sub-themes: Support (Information exchange, Space and time to determine preparedness, and Positive reinforcement of caregiver efforts) and Structure (Setting shared expectations, Informational resources, and Standardization). Conclusions We offer practical recommendations for both interpersonal and policy level facilitation of nurse delivery of high-quality information at discharge to caregivers of patients with serious illness.
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Affiliation(s)
- Marie C. Haverfield
- Department of Communication Studies, San José State University, CA, United States
| | - Gisselle De Leon
- Department of Communication Studies, San José State University, CA, United States
| | - Angelica Johnson
- Department of Communication Studies, San José State University, CA, United States
| | - Victoria L. Jackson
- Betty Irene Moore School of Nursing, University of California, Davis, CA, United States
| | - Geetali Basu
- Dr. Martin Luther King Junior Library, San José State University, CA, United States
| | - Jane Dodge
- Dr. Martin Luther King Junior Library, San José State University, CA, United States
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Lyu XC, Jiang HJ, Lee LH, Yang CI, Sun XY. Oncology nurses' experiences of providing emotional support for cancer patients: a qualitative study. BMC Nurs 2024; 23:58. [PMID: 38245735 PMCID: PMC10800062 DOI: 10.1186/s12912-024-01718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND A high percentage of cancer patients may experience emotional distress. Oncology nurses are expected to play an important role in recognizing emotional distress and planning and delivering care that meets the individual needs of each patient. However, few studies have focused on the experiences of clinical nurses in such cases. This study adopted a qualitative research method to gain an in-depth understanding of the experience of nursing staff in caring for cancer patients with emotional distress. METHODS A qualitative descriptive design and semi-structured interviews were used in this study. Twenty-one oncology nurses were interviewed, and the qualitative content analysis suggested by Graneheim & Lundman (2004) was used to interpret the data. RESULTS Six themes were identified, as follows: (1) dictating the abnormality of emotion, (2) soothing and comforting patients, (3) a lack of psychology knowledge and communication skills, (4) negative impacts of a lack of time, (5) managing emotional labor, and (6) reflecting on the experiences. CONCLUSION Hospital administrators should arrange pre-employment education and training as well as on-the-job education to help nurses in caring for cancer patients with emotional distress. They should also focus attention on the personal emotional states of nursing staff in a timely manner and provide psychological support and emotional counseling as necessary.
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Affiliation(s)
- Xiao-Chen Lyu
- Department of Nursing, First Affiliated Hospital of Wannan Medical College, Anhui, China
| | - Hai-Jiao Jiang
- Intensive Care Unit, First Affiliated Hospital of Wannan Medical College, Anhui, China
| | - Li-Hung Lee
- Department of Nursing, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung City, 433304, Taiwan
| | - Cheng-I Yang
- Department of Nursing, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung City, 433304, Taiwan.
| | - Xiang-Yun Sun
- Department of Oncology, First Affiliated Hospital of Wannan Medical College, Anhui, China
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Koppel PD, Park HYK, Ledbetter LS, Wang EJ, Rink LC, De Gagne JC. Rapport between nurses and adult patients with cancer in ambulatory oncology care settings: A scoping review. Int J Nurs Stud 2024; 149:104611. [PMID: 37879272 DOI: 10.1016/j.ijnurstu.2023.104611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Although the importance of the nurse-patient relationship in oncology is established, a consolidated body of research describing nurse-patient rapport, especially in ambulatory care, is lacking. OBJECTIVES This scoping review aimed to explore knowledge about rapport between adult patients with cancer and their nurses in ambulatory oncology care, including nurse, patient, nurse-patient dyad, and system-level factors that influence rapport. METHODS A scoping review was conducted to explore sources of evidence and gaps in knowledge pertinent to future research. The Joanna Briggs Institute methodology for Systematic Reviews was used with searches in MEDLINE, CINAHL, and ProQuest Dissertations and Theses Global databases. Experimental, descriptive observational, and qualitative study designs that focused on patients with cancer and their nurses within an ambulatory care setting were included. Results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS The search strategy collected 4538 studies of which 10 met study criteria after screening. Forward and backward citation tracking of included articles resulted in 4 additional studies. In total, 14 studies were extracted and analyzed. Synthesis of results from the individual sources resulted in three key observations: (a) there is an absence of studies that focus directly on nurse-patient rapport; (b) the majority of extracted data on rapport-related factors described aspects of nurses' attitudes; and (c) there was minimal information on patient, nurse-patient dyad, and system-level factors reported in these studies. CONCLUSIONS The lack of studies focused specifically on nurse-patient rapport in oncology ambulatory care indicates a notable gap in our empirical understanding of relationship-based care, a hallmark of cancer care provision. TWEETABLE ABSTRACT Nurse-patient rapport in oncology ambulatory care requires additional research @paula_koppel.
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Affiliation(s)
| | | | | | - Emily J Wang
- School of Nursing, Duke University, Durham, NC, USA
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5
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Erami E, Taghadosi M. Factors Contributing to Grief Experience Among Oncology Nurses: A Qualitative Study. Semin Oncol Nurs 2023; 39:151472. [PMID: 37507268 DOI: 10.1016/j.soncn.2023.151472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/08/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES Care provision to patients with cancer can cause varying levels of grief for oncology nurses. Grief in turn significantly affects nurses' personal and professional life. However, there is limited information about the contributing factors to grief experience among oncology nurses. The aim of this study was to explore the contributing factors to grief experience among oncology nurses. DATA SOURCES This qualitative study was conducted in Iran from May 2020 to October 2021. Participants were 18 oncology nurses purposively selected from several hospitals in Iran. Data were gathered via in-depth semistructured interviews and analyzed via the conventional content analysis method proposed by Graneheim and Lundman. Lincoln and Guba's criteria were used to ensure trustworthiness. CONCLUSION The four categories of the contributing factors to oncology nurses' grief experience were exposure to patients' painful death, depressing work atmosphere, knowing the heavy financial burden of cancer for patients, and patients' helplessness in the healthcare system. Oncology nurses experience deep grief due to a wide range of personal, professional, environmental, and sociocultural factors. IMPLICATIONS FOR NURSING PRACTICE The findings of this study can be used to better understand the contributing factors to grief experience among oncology nurses, determine their needs, and develop strategies to strongly support them.
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Affiliation(s)
- Elahe Erami
- PhD Candidate in Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghadosi
- Associate Professor of Nursing Education, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
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6
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Ziarat HM, Seyedfatemi N, Mardani-Hamooleh M, Farahani MA, Vedadhir A. Nursing in oncology ward with intertwined roles: a focused ethnography. BMC Nurs 2023; 22:83. [PMID: 36964551 PMCID: PMC10036964 DOI: 10.1186/s12912-023-01250-8] [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: 12/31/2022] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Characteristics of nursing care in the oncology ward depend on this ward's specific context. This study aimed to investigate the nursing care in the oncology ward regarding the culture of this ward. METHODS This qualitative study was conducted in an oncology ward using a focused ethnographic approach. The whole nursing team of the selected ward (N = 16) participated in the study through purposeful sampling. Three methods of observation, interview, and field documents were used for data collection. Data were analyzed by Spradley's (1980) ethnographic method. RESULTS 'Nursing in the oncology ward with intertwined roles' emerged as the main theme. This theme included the following subthemes: 'Robin Hood nurse,' 'a secretive nurse,' 'a negligent nurse,' 'a snitching nurse,' 'a complaining nurse,' 'an apathetic senior nurse,' 'a stigmatized training nurse,' 'a brazen-bodied nurse,' 'a compassionate nurse,' 'a moonlighting nurse,' and 'a drug bartender.' CONCLUSION This study provided a deep cultural insight into nursing care in the oncology ward, considering the particular culture of this ward and emphasizing the nurses' intertwined roles. These roles are on a spectrum, with positive roles, such as compassion, on one side and negative roles, such as negligence, on the other. The results of this study can be provided to nursing managers; therefore, by being aware of nurses' roles considering the specific subculture of the oncology ward, they can provide psychological interventions to improve the mental health of reluctant and complaining nurses and ethics-based training for secretive, negligent, and snitching nurses to provide quality care to the patient.
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Affiliation(s)
- Hadiseh Monadi Ziarat
- Department of Nursing, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Naima Seyedfatemi
- Department of Nursing, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Marjan Mardani-Hamooleh
- Department of Nursing, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
- Department of Psychiatric Nursing, Iran University of Medical Sciences, Zafar Str, Vanak Sq, PO Box 1419733171, Tehran, Iran.
| | - Mansoureh Ashghali Farahani
- Department of Nursing, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Öztürk S, Hiçdurmaz D. A qualitative study on the perspectives and needs of oncology nurses about recognition and management of suicide risk in cancer patients. J Clin Nurs 2023; 32:749-763. [PMID: 35343003 DOI: 10.1111/jocn.16304] [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: 11/07/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
AIMS To determine the perspectives and needs of the oncology nurses in recognising and managing the risk of suicide in cancer patients. BACKGROUND Cancer patients are one of the groups with a high risk of suicide. The perspectives and needs of oncology nurses regarding their recognition and management of suicide risk in such patients need to be clarified. DESIGN AND METHODS This qualitative descriptive study used a sample of 33 oncology nurses that were sampled by maximum variation sampling from different oncology units and hospitals. Data were collected with in-depth interviews via a semi-structured interview form and analysed with content analysis. The COREQ guideline was followed for the reporting of the study. RESULTS Three main themes and eight subthemes were identified, namely 'An uncertain atmosphere: sensing the risk of suicide but not seeing the picture' (Subthemes: Inability to identify suicide risk, Unclear responsibilities and Distress as a result of uncertainty), 'Efforts to give meaning to and compensate losses of patients' (Subthemes: Attributions to cancer-related losses of patients and Interventions to alleviate distress related to loss) and 'Hindrances beyond the nurse' (Subthemes: Stigma towards psychosocial problems and getting help, Disagreement with the Physician and A lack of institutional culture on suicide prevention). CONCLUSIONS Our study revealed that oncology nurses have insufficient knowledge and skills and unclear roles in recognising and managing suicide risk. In addition, nurses have difficulty in helping patients due to the insufficient support of team members, stigmas of patients and their relatives towards getting help, patient workloads, and inadequate institutional support in risk management. Training programmes aiming to increase nurses' awareness, knowledge and skills should be developed and embedded into current in-service education programmes and undergraduate education curricula as part of professional improvement. RELEVANCE TO CLINICAL PRACTICE The results of the study can contribute to planning the content and scope of suicide prevention training peculiar to oncology nursing.
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Affiliation(s)
- Sevda Öztürk
- Department of Psychiatric Nursing, Hacettepe University Faculty of Nursing, Ankara, Turkey
| | - Duygu Hiçdurmaz
- Department of Psychiatric Nursing, Hacettepe University Faculty of Nursing, Ankara, Turkey
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8
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Höglander J, Holmström IK, Lövenmark A, Van Dulmen S, Eide H, Sundler AJ. Registered nurse-patient communication research: An integrative review for future directions in nursing research. J Adv Nurs 2023; 79:539-562. [PMID: 36534429 DOI: 10.1111/jan.15548] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 11/02/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
AIM To explore communication research in nursing by investigating the theoretical approaches, methods, content and perspectives in research on real-time registered nurse (RN)-patient communication. DESIGN An integrative review of real-time communication between RNs and patients. DATA SOURCES Empirical research papers were searched in PubMed, CINAHL Plus and Medline. The results from the database searches were supplemented with results from manual searches in reference lists. REVIEW METHODS A total of 1369 articles published between January 1996 and December 2021 were screened, which resulted in the inclusion of 52 articles. RESULTS The integration of various theories, such as nursing or communication theories, is weak in most of the included studies. RN-patient communication appears to influence relationship building. Even when nurses strive to meet patients' needs, they often focus primarily on nursing routines and physical care. The topic of the communication varies depending on the situation and different communication styles are used. When a patient-centred approach is adopted, the interpersonal communication becomes quite symmetrical, with complementary roles of nurses and patients. Within a more asymmetric communication context, nurses dominate communication, choose topics and function as instructors. How the nurses communicated subsequently influenced the patients' communication styles and strategies. CONCLUSION Communication is multifaceted, contains different strategies and is important for building trust and facilitating patient-centred care. The importance of RNs' communication for interaction and relationship-building seems to be well established within research, but few studies focused on patients' communication with RNs. IMPACT This integrative review gives an overview of the width and depth of observational studies on RN-patient communication research. The variety of studies indicates that this area is a less well-grounded field of research. Future research is warranted to support nurses in their communication, especially regarding the exploration of patients' communication and desired communication skills in nurse-patient interactions. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was included in this integrative review.
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Affiliation(s)
- Jessica Höglander
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Annica Lövenmark
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Sandra Van Dulmen
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.,Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.,Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Turnbull M, Yu C, Wu XI. Practitioner accounts of end-of-life communication in Hong Kong, Mainland China and Taiwan: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 106:31-41. [PMID: 36273978 DOI: 10.1016/j.pec.2022.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Communication at the end-of-life (EOL) is complex and multidimensional. Although culture is acknowledged as a key influence, there remains a gap in knowledge about intracultural aspects of EOL communication in the Chinese context. This review presents a synthesis of practitioners' accounts of communication at the EOL in Hong Kong, Mainland China and Taiwan. METHODS This review was registered prospectively on PROSPERO (CRD42021297052). Five databases were systematically searched using the terms 'communication', 'End-of-Life', 'Hong Kong', 'China' and 'Taiwan'. Empirical research published between 2015 and 2021 was downloaded and appraised. Fifteen articles were included in the review. RESULTS Findings highlight the influence of Chinese culture and philosophy, inadequate communication skills training and psychological support for practitioners and legislative and organisational factors. CONCLUSION Education and training for practitioners and public education about the EOL needs strengthening. Enhanced understanding of how culture influences EOL communication will strengthen service delivery and enhance awareness in multicultural communities. PRACTICE IMPLICATIONS EOL workers need practical and workplace-based support to engage in meaningful communication practices. The influence of culture and the readiness of patients and families to engage in communication are also important considerations.
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Affiliation(s)
- Margo Turnbull
- Department of English and Communication, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Carol Yu
- Department of English and Communication, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
| | - Xiaoyan Ivy Wu
- Department of English and Communication, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
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10
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Alikari V, Gerogianni G, Fradelos EC, Kelesi M, Kaba E, Zyga S. Perceptions of Caring Behaviors among Patients and Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010396. [PMID: 36612719 PMCID: PMC9819105 DOI: 10.3390/ijerph20010396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/08/2022] [Accepted: 12/23/2022] [Indexed: 05/30/2023]
Abstract
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.
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Affiliation(s)
- Victoria Alikari
- Department of Nursing, University of Peloponnese, 22100 Tripoli, Greece
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | | | | | - Martha Kelesi
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Evridiki Kaba
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Sofia Zyga
- Department of Nursing, University of Peloponnese, 22100 Tripoli, Greece
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Wanko Keutchafo EL, Kerr J, Baloyi OB. A Model for Effective Nonverbal Communication between Nurses and Older Patients: A Grounded Theory Inquiry. Healthcare (Basel) 2022; 10:2119. [PMID: 36360461 PMCID: PMC9690069 DOI: 10.3390/healthcare10112119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 08/24/2023] Open
Abstract
Nonverbal communication is an inevitable art to be effectively mastered by nurses. Nurse nonverbal communication has many benefits when it is effective. For instance, nonverbal communication is important to convey affective and emotional information, and demonstrate respect for and build therapeutic relationships with older patients. As the older population is growing fast worldwide, effective nonverbal communication with older patients is an essential skill for nurses and will improve patients' satisfaction and the quality of care. Therefore, this article presents a model to guide effective nonverbal communication between nurses and older patients. A Grounded Theory approach guided the study. Data were collected between July 2018 and January 2020 through overt participant observations and individual interviews. Purposive and theoretical sampling were used to select 13 clinically experienced nurses, 4 nursing students, and 8 older adults. Data analysis encompassed open coding, axial coding, and selective coding. The results showed that effective nonverbal communication emerged as the co-phenomenon hinged within context and/or environment and is influenced by certain factors. This model, which is in support of person-centered communication and care, advocates for effective nonverbal communication between nurses and older patients.
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Affiliation(s)
- Esther L. Wanko Keutchafo
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
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12
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Mickelson Weldingh N, Kirkevold M. What older people and their relatives say is important during acute hospitalisation: a qualitative study. BMC Health Serv Res 2022; 22:578. [PMID: 35488250 PMCID: PMC9052562 DOI: 10.1186/s12913-022-07981-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the growing population of older people across the world, providing safe and effective care is an increasing concern. Older persons in need for hospitalisation often have, or are susceptible to develop, cognitive impairment. Hospitals need to adapt to ensure high-quality care for this vulnerable patient group. Several age-friendly frameworks and models aiming at reducing risks and complications have been promoted. However, care for older people must be based on the persons' reported needs, and relatives are often an important part of older persons' social support. The primary aim of this study was to explore older peoples' and their relatives' experiences of acute hospitalisation and determine what is important for them to experience a good hospital stay. The study was not limited to patients with cognitive impairment; but included a wider group of older individuals vulnerable to developing delirium, with or without an underlying chronic cognitive impairment. METHODS This study had a qualitative research design in which people aged 75 years or older and their relatives were interviewed during an acute hospitalisation. The study was conducted at two medical wards at a large university hospital in Norway, and included a total of 60 participants. All interviews were informed by a semi-structured interview guide and were thematically analysed. RESULTS Four major themes were identified in the older people's and the relatives' descriptions of how they experienced the hospital stay and what was important for them during the hospital stay: being seen and valued as a person, individualised care, patient-adapted communication and information, and collaboration with relatives. The themes span both positive and negative experiences, reflecting great variability in the experiences described. The presence of these four characteristics promoted positive experiences among patients and relatives, whereas the absence or negative valuation of them promoted negative experiences. CONCLUSIONS The findings underscore the interrelatedness of older people and their relatives and that patients and relatives are quite consistent in their experiences and opinions. This suggests that listening to the concerns of relatives is important, as they can voice the older patient's needs and concerns in situations where older people might find it difficult to do so. Furthermore, the results underscore how 'small things' matter in relation to how health professionals capture the patient's individual values, need for care, information and involvement of relatives and that these are essential to ensure predictability and security and a good stay for older people and their relatives.
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Affiliation(s)
- Nina Mickelson Weldingh
- Division of Research and Innovation, Department of Research Support Service, Akershus University Hospital, Lørenskog, Norway
| | - Marit Kirkevold
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Gimson E, Greca Dottori M, Clunie G, Yan Zheng C, Wiseman T, Joyce E, McGregor A, McNair H. Not as simple as "fear of the unknown": A qualitative study exploring anxiety in the radiotherapy department. Eur J Cancer Care (Engl) 2022; 31:e13564. [PMID: 35191096 PMCID: PMC10909434 DOI: 10.1111/ecc.13564] [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: 07/08/2021] [Revised: 11/17/2021] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Little is understood about the anxiety experienced by cancer patients undergoing radiotherapy or investigative imaging. Our aim was to identify sources of anxiety, the points along the cancer journey where anxiety occurred and methods to alleviate it. METHODS Six focus groups were conducted with cancer patients (n = 17), caregivers (n = 3) and healthcare practitioners (HCPs; n = 10) in the radiotherapy department. Patients described specific elements in the care pathway which induced anxiety, while HCPs focused on their perception of the patient experience. Thematic analysis was used to analyse data. RESULTS Three broad themes emerged: The Environment, The Individual and The Unknown. The physical environment of the hospital, inside the scanner for example, emerged as a key source of anxiety. The impact of cancer on patients' individual lives was significant, with many feeling isolated. The majority of participants described anxiety associated with the unknown. HCPs reported difficulty in identifying the anxious patient. CONCLUSIONS Anxiety is experienced throughout the cancer pathway. Common sources include the physical environment and the uncertainty associated with having cancer. Identifying both anxiety-inducing factors, and the anxious patients themselves, is crucial to enable targeted interventions to alleviate anxiety.
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Affiliation(s)
- Eliza Gimson
- Faculty of Life Sciences and MedicineKing's College LondonLondonUK
| | | | - Gemma Clunie
- Faculty of MedicineDepartment of Surgery & Cancer, Imperial College LondonLondonUK
| | | | - Theresa Wiseman
- Applied Health ResearchThe Royal Marsden NHS Foundation TrustLondonUK
| | | | | | - Helen McNair
- The Royal Marsden NHS Foundation Trust, Translational Therapeutic RadiographyThe Institute of Cancer ResearchLondonUK
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14
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Ayvat İ, Atli Ozbas A. Experiences and views of nurses about unmet needs of older cancer patients receiving chemotherapy: A qualitative study. Palliat Support Care 2022; 21:1-8. [PMID: 35139980 DOI: 10.1017/s1478951522000098] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The aim is to understand the experiences and views of oncology nurses about the unmet care needs of older cancer patients receiving chemotherapy. Nurses play the key role in evaluating and determining the needs of this special group. METHOD A phenomenological descriptive qualitative study with convenience sampling was used. Participants were referred by the Turkish Oncology Nursing Society. The study participants were 12 nurses aged 34-53 years, with oncology experience between 5 and 27 years. The data were collected using semi-structured face-to-face interviews. Interviews were transcribed verbatim with concurrent analyses and data collection. Thematic content analysis was used to determine common domains. RESULTS The study data were categorized into 3 contexts, 12 themes, and 37 subthemes. The first context, "unmet needs", includes physical care, psychological care, and social care themes. The second context, "barriers to meeting those needs", comprises the theme of patient characteristics, attitude of family, attitude of the nurses/healthcare team, health system, and culture. The last context is "suggestions for meeting needs". Nurses play an important role in identifying and meeting unmet psychosocial needs. SIGNIFICANCE OF RESULTS The study indicated that older cancer patients had problems in identifying, expressing, and making demands for their needs and that their culture contributed to this situation. Nurses serving in the outpatient chemotherapy units should conduct a holistic assessment of older cancer patients, be aware that these patients may not be able to express their needs, be more sensitive toward them, and ensure that the voice of the older patients is heard.
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Affiliation(s)
- İrem Ayvat
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Azize Atli Ozbas
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
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15
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Wanko Keutchafo EL, Kerr J, Baloyi OB, Duma SE. Conditions Influencing Effective Nurse Nonverbal Communication With Hospitalized Older Adults in Cameroon. Glob Qual Nurs Res 2022; 9:23333936221098751. [PMID: 35647218 PMCID: PMC9131379 DOI: 10.1177/23333936221098751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
Effective communication between nurses and patients is an important factor to quality nursing care but ineffective nonverbal communication could take a toll on health care. Therefore, understanding the factors that influence nonverbal communication between nurses and hospitalized older adults could help solve communication problems, thus improve nursing care. A sample of 13 nurses and 4 student nurses from two hospitals in Cameroon participated in the study. Data were collected using participant observations and semi-structured interviews, and analyzed using open coding and constant comparative analysis. Three categories were identified as influencing factors: nurse views of hospitalized older adults, hospitalized older adult-related factors, and nurse intrinsic factors. Effective nurses' nonverbal communication with hospitalized older adults relies mostly on nurses' intrinsic factors. Identification and nurturing of the positive nurse intrinsic factors are important to develop effective nonverbal communication skills among nurses.
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Affiliation(s)
| | - Jane Kerr
- University of KwaZulu-Natal, Durban, South Africa
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16
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Ma RH, Zhao XP, Ni ZH, Xue XL. Paediatric oncology ward nurses' experiences of patients' deaths in China: A qualitative study. BMC Nurs 2021; 20:197. [PMID: 34649533 PMCID: PMC8518223 DOI: 10.1186/s12912-021-00720-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Considering cancer death is second only to accidental death in the number of lives claimed each year,nurses in paediatric oncology wards often experience helplessness, sadness, frustration and such other adverse emotions when they witness children's death due to cancer.However,there is a lack of qualitative studies on nurses who witness the death of children in paediatric oncology wards in China. METHOD A qualitative study was conducted using a semi-structured interview guide with 22 paediatric oncology ward nurses. Interviews were recorded and simultaneously translated and transcribed. Thematic analysis was used to analyse the data. RESULTS The analysis resulted in the identification of three main thematic categories: Different emotional expression, Different copingstrategies, A weak support system. Nursing managers should pay attention to problems faced by nurses in paediatric oncology wards, and take targeted measures in terms of continuing training courses, improving the psychological adaptability of oncology professional nurses, and providing them substantive support. CONCLUSION Nurses in paediatric oncology wards have strong stress responses to facing the death of children. They reported experiencing complex psychological feelings and have different coping attitudes. Healthcare authorities should recognise and understand the needs of paediatric oncology ward nurses, who often witness the death of children. Appropriate and effective support measures should be planned and implemented for these nurses to maintain their mental health, thus enabling them to better serve patients.
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Affiliation(s)
- Ruo Han Ma
- Children's Hospital of Soochow University, No.92, Zhongnan St, Suzhou, 215025, China.,Medical College of Soochow University, No.199 Renai Rd, Suzhou, 215123, China
| | - Xue Ping Zhao
- School of Nursing, Medical College of Soochow University, No.1 Shizi St, Suzhou, 215000, China
| | - Zhi Hong Ni
- Children's Hospital of Soochow University, No.92, Zhongnan St, Suzhou, 215025, China.
| | - Xiao Ling Xue
- Global Institute of Software Technology, No.5, Qinshan Rd, Suzhou, 215163, China.
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17
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Arbour C, Tremblay M, Ogez D, Martineau-Lessard C, Lavigne G, Rainville P. Feasibility and acceptability of hypnosis-derived communication administered by trained nurses to improve patient well-being during outpatient chemotherapy: a pilot-controlled trial. Support Care Cancer 2021; 30:765-773. [PMID: 34374847 PMCID: PMC8636401 DOI: 10.1007/s00520-021-06481-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/28/2021] [Indexed: 12/25/2022]
Abstract
Purpose This pilot-controlled trial aimed to examine the feasibility and acceptability of hypnosis-derived communication (HC) administered by trained nurses during outpatient chemotherapy to optimize symptom management and emotional support — two important aspects of patient well-being in oncology. Methods The trial was conducted in two outpatient oncology units: (1) intervention site (usual care with HC), and (2) control site (usual care). Nurses at the intervention site were invited to take part in an 8-h training in HC. Participants’ self-ratings of symptoms and emotional support were gathered at predetermined time points during three consecutive outpatient visits using the Edmonton Symptom Assessment Scale and the Emotional Support Scale. Results Forty-nine patients (24 in the intervention group, 25 in the control group) with different cancer types/stages were recruited over a period of 3 weeks and completed the study. All nurses (N = 10) at the intervention site volunteered to complete the training and were able to include HC into their chemotherapy protocols (about ± 5 min/intervention). Compared to usual care, patients exposed to HC showed a significant reduction in physical symptoms during chemotherapy. In contrast, perception of emotional support did not show any significant effect of the intervention. Participants exposed to HC report that the intervention helped them relax and connect on a more personal level with the nurse during chemotherapy infusion. Conclusions Our results suggest that HC is feasible, acceptable, and beneficial for symptom management during outpatient chemotherapy. While future studies are needed, hypnosis techniques could facilitate meaningful contacts between cancer patients and clinicians in oncology. Trial registration Clinical Trial Identifier: NCT04173195, first posted on November 19, 2019 Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06481-6.
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Affiliation(s)
- Caroline Arbour
- Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-L'Île-de-Montréal, 5400 Boul. Gouin Ouest, Room: E-1381, Montreal, QC, H4J 1C5, Canada. .,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.
| | - Marjorie Tremblay
- Hôpital de La Cité-de-La-Santé, CISSS de Laval, Laval, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - David Ogez
- Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre de Recherche de L'Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
| | - Chloé Martineau-Lessard
- Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-L'Île-de-Montréal, 5400 Boul. Gouin Ouest, Room: E-1381, Montreal, QC, H4J 1C5, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Gilles Lavigne
- Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-L'Île-de-Montréal, 5400 Boul. Gouin Ouest, Room: E-1381, Montreal, QC, H4J 1C5, Canada.,Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - Pierre Rainville
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada.,Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L'Île-de-Montréal, Montreal, QC, Canada
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18
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Farzi S, Taleghani F, Yazdannik A, Esfahani MS. Communication culture in cancer nursing care: an ethnographic study. Support Care Cancer 2021; 30:615-623. [PMID: 34357456 DOI: 10.1007/s00520-021-06388-2] [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: 12/23/2020] [Accepted: 06/21/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE This study aimed to explore the communication culture in nursing care of patients with cancer. METHODS This ethnographic study was conducted in 2018-2019. Data were collected through participatory observation (318 h of observing nurses, patients, and family behaviors), semi-structured interviews (8 interviews with nurses), and informal interactions. Data were analyzed using Spradley's framework. RESULTS The study results in five cultural components of "communication determinants," "experimental acquisition of communication skills," "gradual empathetic communication," "avoidant communication with patient," and "communication with family as caregiver." "Communication between nurse, patient and family is an experimental, gradual and avoidant relationship" was the study's cultural statement. CONCLUSION In this study, the nurse-patient communication was influenced by factors related to the patient, the nurse and the care environment, and nurses acquired communication skills experimentally. There were two patterns of empathetic and avoidant communication between the nurse and the patient. For having high-quality care, nurses' behavioral patterns must be improved and changed in some cases. Nursing professors, managers, and nurses can use these results in training, hiring, orienting novice nurses, and empowering oncology nurses. Training communication skills to nurses and changing managers and nurses' approach to move from task-oriented care to holistic care help improve nurses' communication patterns.
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Affiliation(s)
- Saba Farzi
- Student Research Center, school of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing & Midwifery Care Research Center, School of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ahmadreza Yazdannik
- Nursing & Midwifery Care Research Center, School of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Sharifi Esfahani
- Department of Internal Medicine, School of Medicine, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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Alshammari M, Duff J, Guilhermino M. Psychometric evaluation of the Arabic version of the patient-centered communication instrument for adult cancer patients. Int J Qual Health Care 2021; 33:6020182. [PMID: 33274737 DOI: 10.1093/intqhc/mzaa159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/30/2020] [Accepted: 12/04/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This study aimed to examine the validity and reliability of the Arabic version of the patient-centered communication instrument. METHODS A self-administered instrument was used over 4 months by 318 participants living with cancer in Saudi Arabia. The instrument contained 36 items assessing patient-centered communication (PCC-36) experiences. The PCC-36 instrument was translated into Arabic following the World Health Organization guidelines for translating instruments before undergoing psychometric evaluation. This involved confirmatory factor analysis for each of the PCC-36 functions and testing the reliability and internal consistency of the PCC-36 measures. RESULTS The Arabic-translated PCC-36 version demonstrated a good correlation between items, with confirmatory factor analysis showing a good fit of the data (comparative fit index = 0.922, Tucker-Lewis index = 0.910, root mean square error approximation = 0.059, ${\chi ^2}$ = 1214.4, df = 579, P < 0.001). Internal consistency of the total six PCC-36 functions was confirmed by a Cronbach's alpha of 0.97. CONCLUSIONS The study proved that the PCC-36 Arabic version is a valid and reliable instrument for the measurement of patient communication experiences in cancer care in Saudi Arabia, with similar properties to the original, and that this instrument may be used in 22 different Arab countries to measure and improve cancer patients' communication experiences.
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Affiliation(s)
- Mukhlid Alshammari
- School of Nursing and Midwifery, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia
| | - Jed Duff
- School of Nursing,Queensland University of Technology, 2 George St, Brisbane City, QLD 4000, Australia
| | - Michelle Guilhermino
- School of Nursing and Midwifery, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia
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20
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McCarthy B, O'Donovan M, Trace A. A new therapeutic communication model "TAGEET" to help nurses engage therapeutically with patients suspected of or confirmed with COVID-19. J Clin Nurs 2021; 30:1184-1191. [PMID: 33350012 DOI: 10.1111/jocn.15609] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/09/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022]
Abstract
AIM To design and present a new communication model "TAGEET" to help nurses engage therapeutically with patients suspected of or confirmed with COVID-19. BACKGROUND COVID-19 is a highly contagious disease that brings with it fear and anxiety for all involved inclusive of nurses and patients. New guidelines for nurses to follow such as attention to physical distance coupled with the wearing of defined personal protective equipment, gloves, long-sleeved disposable gown, FFP2 face mask and eye protection place additional strain on nurses to engage therapeutically with patients. Evidence suggests that the wearing of face masks and personal protective equipment acts as barriers to effective therapeutic engagement with patients. We found an absence of communication models to help nurses engage therapeutically with patients. DESIGN This is a position paper that draws on previous research to inform the design of a new model for nurses to engage therapeutically with patients suspected of or confirmed with COVID-19. METHOD We reviewed the literature on caring for patients in isolation, the barriers to therapeutic communication and the psychological impact of infectious diseases on nurses and patients. CONCLUSION Remaining emotionally present to self, whilst being present to others can be challenging for nurses in a pandemic environment. We believe that the "TAGEET" model (T-Tune-in, A-Approach and introduce, G-Ground self, E-Engage and respond, E-End encounter, T-Tune-out), although devised for nurses to engage therapeutically with patients suspected of or confirmed with COVID-19 could be used by all healthcare professionals in any challenging clinical environment. RELEVANCE TO CLINICAL PRACTICE This new therapeutic communication model will provide support for nurses with how to manage self in the context of caring for others in a COVID-19 environment.
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Affiliation(s)
- Bridie McCarthy
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Moira O'Donovan
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Anna Trace
- School of Applied Psychology, University College Cork, Cork, Ireland
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21
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Tetteh L, Aziato L, Mensah GP, Vehviläinen-Julkunen K, Kwegyir-Afful E. Burns pain management: The role of nurse-patient communication. Burns 2020; 47:1416-1423. [PMID: 33277090 DOI: 10.1016/j.burns.2020.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/12/2020] [Accepted: 11/20/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nursing is an embodiment of knowledge, clinical work, and interpersonal communication. Effective nursing care has a distinct influence on the overall satisfaction and experience of the patient. Communication is said to be indispensable in the delivery of quality healthcare. Effective communication between nurses and patients has proven to yield better results with pain control and improved psychological status of patients. OBJECTIVES The aim of the study is to explore nurses' perceptions on the role of communication in the management of burns pain. METHODS A qualitative design with purposive sampling was carried out to recruit 11 registered nurses from a Reconstructive Plastic Surgery and Burns Center in Ghana. To identify the participants' perception on the role of nurse-patient communication in the management of burns pain, a face to face semi-structured interviews were conducted using an interview guide to collect data. RESULTS Thematic analysis was done with various themes emerging. Helping patients manage pain, early detection of patient's distress, improved patient participation in their care were some of the positive effects of nurse-patient communication whiles reduced level of cooperation during caregiving, and endurance of pain by the patient were the results of poor nurse-patient communication. Language and time factor were the barriers that were identified to hinder effective communication between nurses and patients. CONCLUSIONS Due to the subjective nature of pain, the current study highlights the need for increased communication for an effective assessment and management of pain among patients with burns. It is, therefore, imperative that nurses be well trained in communication with an emphasis on patient-centered communication.
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Affiliation(s)
- Linda Tetteh
- University of Ghana College of Health Sciences, School of Nursing and Midwifery, P.O. Box LG 43, Legon, Accra, Ghana
| | - Lydia Aziato
- University of Ghana College of Health Sciences, School of Nursing and Midwifery, P.O. Box LG 43, Legon, Accra, Ghana
| | - Gwendolyn Patience Mensah
- University of Ghana College of Health Sciences, School of Nursing and Midwifery, P.O. Box LG 43, Legon, Accra, Ghana
| | - Katri Vehviläinen-Julkunen
- University of Eastern Finland, Faculty of Health Sciences, Department of Nursing Science, FI-70211, Kuopio, Finland; Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Emma Kwegyir-Afful
- University of Salford, School of Health and Society, Manchester, Frederick Road, M6 6PU, United Kingdom.
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22
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Peršolja M. The quality of nursing care as perceived by nursing personnel: Critical incident technique. J Nurs Manag 2020; 29:432-441. [PMID: 33051916 DOI: 10.1111/jonm.13180] [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: 07/17/2020] [Revised: 09/26/2020] [Accepted: 10/04/2020] [Indexed: 11/28/2022]
Abstract
AIMS To identify the determinants of the quality of nursing care from the perceptions of nursing personnel. BACKGROUND The quality of nursing care is often measured with standards, expectations, satisfaction and outcomes, but in developing countries, it relies mostly on negative indicators. METHODS A descriptive qualitative study was used. Semi-structured interviews based on the critical incident technique were conducted with a convenience sample of 136 nursing personnel who told 225 stories. RESULTS Seven quality determinants of nursing care were identified as follows: standard of care, triage and assessment, emergency care, communication with the patient or family, communication with colleagues, multidisciplinary teamwork and helping colleagues. The most important one was the standard of care. CONCLUSION Quality nursing care is based on the degree of excellence nursing personnel show with regard to their competences in technical care, communication and teamwork. A key attribute of quality nursing care is defined by the related standards, and the focus is mostly on the nursing care process. IMPLICATIONS FOR NURSING MANAGEMENT These findings can increase awareness of the determinants of nursing quality and the qualities of the nursing personnel involved and can help managers to evaluate nursing practice, select new employees and organise teams.
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Affiliation(s)
- Melita Peršolja
- Faculty of Health Sciences, University of Primorska, Nova Gorica, Slovenia
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23
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Patients' Experience of Communication During Their Course of Treatment in an Oncology Outpatient Clinic: Qualitative Study. Cancer Nurs 2020; 45:E187-E196. [PMID: 33038098 DOI: 10.1097/ncc.0000000000000891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Communication between patients and healthcare professionals becomes increasingly important as patients with cancer are primarily treated in outpatient settings, where the time to communicate is brief. There is a need to understand patients' experiences of communication to ensure person-centered communication during treatment. OBJECTIVE The aim of this study was to explore how patients experience communication with healthcare professionals during their course of treatment in an oncology outpatient clinic to elucidate how their needs for support are met. METHODS Data were generated through semistructured qualitative interviews in patients with cancer who received treatment in an oncology outpatient clinic (n = 18). Interpretive description methodology and symbolic interactionism inspired the analytical approach. RESULTS Three overarching communication categories were generated, namely, verbal practices, relational practices, and nonverbal practices, which reflect distinct characteristics and the quality of the communication. Communication was characterized as being informative, cheerful, and routinized, which the patients found supportive and, contrarily, superficial, task focused, lacking continuity in care, and missing existential dimensions. CONCLUSION The communication practice in the oncology outpatient clinic especially supported patients in managing their treatment and side effects. However, psychological, social, and existential concerns were rarely addressed, requiring the patient to self-manage these issues in everyday life while living with cancer. IMPLICATIONS FOR PRACTICE Patients are socialized by verbal and nonverbal communication practices in the outpatient clinic, which influences their expectations of what to talk about during their treatment. Methods are needed to support person-centered communication in outpatient settings, so patient care needs are met more broadly.
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24
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Wu LF, Chang LF, Hung YC, Lin C, Tzou SJ, Chou LJ, Pan HH. The Effect of Practice toward Do-Not-Resuscitate among Taiwanese Nursing Staff Using Path Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176350. [PMID: 32878243 PMCID: PMC7503820 DOI: 10.3390/ijerph17176350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/16/2020] [Accepted: 08/26/2020] [Indexed: 11/16/2022]
Abstract
This study aimed to elucidate the predictors and the effects of path modeling on the knowledge, attitude, and practice toward do-not-resuscitate (DNR) among the Taiwanese nursing staff. This study was a cross-sectional, descriptive design using stratified cluster sampling. We collected data on demographics, knowledge, attitude, and practice as measured by the DNR inventory (KAP-DNR), Mindful Attention Awareness Scale, General Self-Efficacy Scale, and Dispositional Resilience Scale. Participants were 194 nursing staff from a medical center in northern Taiwan in 2019. The results showed that participation in DNR signature and education related to palliative care were significant positive predictors of knowledge toward DNR. The DNR predictors toward attitude included DNR knowledge, mindfulness, self-efficacy, dispositional resilience, and religious belief of nurses. Generally, the critical predictors of DNR practice were DNR attitude, dispositional resilience, and male nurses. In path modeling, we identified that self-efficacy, dispositional resilience, master’s degree, and religious belief directly influenced practice constituting DNR. Based on the findings of this study, we propose that nurses should improve their self-efficacy and dispositional resilience through training programs. Encouraging staff to undertake further education and have religious beliefs can enhance the practice of DNR and provide better end-of-life care.
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Affiliation(s)
- Li-Fen Wu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei City 11490, Taiwan; (L.-F.W.); (L.-F.C.)
- Department of Nursing, Tri-Service General Hospital, Taipei City 11490, Taiwan;
| | - Li-Fang Chang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei City 11490, Taiwan; (L.-F.W.); (L.-F.C.)
- Department of Nursing, Tri-Service General Hospital, Taipei City 11490, Taiwan;
| | - Yu-Chun Hung
- Department of Nursing, Tri-Service General Hospital, Taipei City 11490, Taiwan;
| | - Chin Lin
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City 11490, Taiwan;
| | - Shiow-Jyu Tzou
- Department of Nursing, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan;
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80284, Taiwan
| | - Lin-Ju Chou
- Department of Nursing, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan;
- Correspondence: (L.-J.C.); (H.-H.P.); Tel.: +886-7-7496751 (L.-J.C.); +886-2-87923100 (ext. 18776) (H.-H.P.)
| | - Hsueh-Hsing Pan
- Department of Nursing, Tri-Service General Hospital, Taipei City 11490, Taiwan;
- School of Nursing, National Defense Medical Center, Taipei City 11490, Taiwan
- Correspondence: (L.-J.C.); (H.-H.P.); Tel.: +886-7-7496751 (L.-J.C.); +886-2-87923100 (ext. 18776) (H.-H.P.)
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25
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Artioli G, Foà C, Bertuol M, Benzi L, Deiana L, Meneghetti C, Neri C, Pigoni L, Zanotti M, Sarli L. The impact of a "narrative interview" intervention in oncology. A study protocol for a feasibility study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:38-47. [PMID: 32573505 PMCID: PMC7975842 DOI: 10.23750/abm.v91i6-s.10016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Oncological diagnosis determines a biographical breakdown and requires the person to adapt to the disease. If patients, after diagnosis, ask professionals for 'compassionate care', research on these issues is still underdeveloped. There are currently no studies that use the narrative interview as an intervention tool. The objectives of the study are to evaluate: (1) the feasibility of the narrative interview intervention on cancer patients in the first diagnosis; (2) the impact of the narrative medicine intervention on the patient's self-perception, his psychological distress and adaptation to the disease. METHODS It is a mixed-method study, with an intervention (narrative interview) and quantitative evaluation before/after intervention and qualitative evaluation post-intervention (reflective writing). The analysis will use the Psychological Distress Inventory scale for the assessment of psychological distress and the Mini-Mental Adjustment to Cancer Scale for the assessment of disease adaptation. Adult patients, with oncological pathology will be recruited one month after the communication of the diagnosis, regardless of the type of tumor. The Wilcoxon test for paired data will be used to verify pre-post-intervention differences. The 'reflective writings' will be subjected to thematic analysis. DISCUSSION AND CONCLUSION The study evaluates the feasibility of the narrative interview intervention as a primary outcome. Secondly, the impact of the intervention is assessed in relation to: a) identification of risk or protective factors on psychological distress and adaptation to the disease; b) re-elaboration of the patient's experiences and experiences related to his/her own illness.
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Affiliation(s)
| | - Chiara Foà
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Maria Bertuol
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Linda Benzi
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Laura Deiana
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Chiara Meneghetti
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Cecilia Neri
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Laura Pigoni
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Martina Zanotti
- Post graduate Specialization in "Case /Care management in hospital and on the territory for health professions", University of Parma, Italy.
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Italy.
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