LeBaron VT, Palat G, Sinha S, Chinta SK, Jamima BJB, Pilla UL, Podduturi N, Shapuram Y, Vennela P, Rapelli V, Lalani Z, Beck SL. Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India.
Indian J Palliat Care 2017;
23:188-198. [PMID:
28503040 PMCID:
PMC5412128 DOI:
10.4103/ijpc.ijpc_153_16]
[Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT
Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training.
AIM
The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care.
METHODS
Qualitative ethnography.
SETTING
The study was conducted at a government cancer hospital in urban South India.
SAMPLE
Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study.
DATA COLLECTION
Data were collected over 9 months (September 2011- June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews.
ANALYSIS
Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns.
RESULTS
Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training.
CONCLUSIONS
Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.
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