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Surgical nurses’ attitudes towards caring for patients dying of cancer: a pilot study of an educational intervention on existential issues
Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Health Care Sciences Post Graduate School Karolinska Institute Stockholm Sweden .
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.ORCID iD: 0000-0001-9623-5813
Institute of Health and Care Sciences The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
Department of General Surgery Östersund Hospital Östersund Sweden .
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2014 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 23, no 4, p. 426-440Article in journal (Refereed) Published
Abstract [en]

This is a randomised controlled pilot study using a mixed methods design. The overall aim was to test an educational intervention on existential issues and to describe surgical nurses' perceived attitudes towards caring for patients dying of cancer. Specific aims were to examine whether the educational intervention consisting of lectures and reflective discussions, affects nurses' perceived confidence in communication and to explore nurses' experiences and reflections on existential issues after participating in the intervention. Forty-two nurses from three surgical wards at one hospital were randomly assigned to an intervention or control group. Nurses in both groups completed a questionnaire at equivalent time intervals: at baseline before the educational intervention, directly after the intervention, and 3 and 6 months later. Eleven face-to-face interviews were conducted with nurses directly after the intervention and 6 months later. Significant short-term and long-term changes were reported. Main results concerned the significant long-term effects regarding nurses' increased confidence and decreased powerlessness in communication, and their increased feelings of value when caring for a dying patient. In addition, nurses described enhanced awareness and increased reflection. Results indicate that an understanding of the patient's situation, derived from enhanced awareness and increased reflection, precedes changes in attitudes towards communication.

Place, publisher, year, edition, pages
2014. Vol. 23, no 4, p. 426-440
Keywords [en]
Existential, Intervention, Mixed methods, Pilot study, Randomised controlled study, Surgical nurses
National Category
Nursing
Identifiers
URN: urn:nbn:se:miun:diva-17411DOI: 10.1111/ecc.12142ISI: 000337744500002Scopus ID: 2-s2.0-84902550403OAI: oai:DiVA.org:miun-17411DiVA, id: diva2:571235
Note

Published online 29 Jan 2014.

Available from: 2012-11-21 Created: 2012-11-21 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Existential issues in surgical care: Nurses’ experiences and attitudes in caring for patients with cancer
Open this publication in new window or tab >>Existential issues in surgical care: Nurses’ experiences and attitudes in caring for patients with cancer
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

Place, publisher, year, edition, pages
Östersund: Mittuniversitetet, 2012
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 136
Keywords
cancer care, educational intervention, existential, nurses, surgical care
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-17414 (URN)978-91-87103-42-1 (ISBN)
Public defence
2012-12-13, F234, Östersund, 10:15 (Swedish)
Opponent
Supervisors
Available from: 2012-11-22 Created: 2012-11-21 Last updated: 2012-11-30Bibliographically approved

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Udo, CamillaMelin-Johansson, ChristinaDanielson, Ella

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