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Existential issues among health care staff in surgical cancer care: Discussions in supervision sessions
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.ORCID iD: 0000-0003-2853-0575
2011 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 15, no 5, 447-453 p.Article in journal (Refereed) Published
Abstract [en]

Purpose The aim was, through analysis of dialogues in supervision sessions, to explore if health care staff in surgical care discussed existential issues when caring for cancer patients. Method A secondary analysis of the content of twelve tape-recorded supervision sessions (18 h) was conducted. The study analysed the dialogue content in supervision sessions involving a group of eight participants who worked at a surgical clinic at a county hospital in central Sweden. The sessions were held every third week during the course of one year. Results The analysis showed that surgical health care staff contemplates existential issues. The staff discussed their existential dilemmas, which hindered them from meeting and dealing with patients’ existential questions. This is illustrated in the themes: “feelings of powerlessness”, “identifying with patients”, and “getting close or keeping one’s distance”. The staff also discussed the fact that patients expressed existential distress, which is illustrated in the themes: “feelings of despair” and “feelings of isolation”. Conclusions This study shows that there are existential issues at a surgical clinic which health care staff need to acknowledge. The staff find themselves exposed to existential dilemmas when caring for cancer patients. They are conscious of patients’ existential issues, but lack strategies for dealing with this. This study highlights a need to provide support to staff for developing an existential approach, which will boost their confidence in their encounters with patients.

Place, publisher, year, edition, pages
Edinburgh: Churchill Livingstone , 2011. Vol. 15, no 5, 447-453 p.
Keyword [en]
Cancer care; Existential issues; Existential dilemmas; Health care staff; Qualitative secondary analysis; Surgical care
Identifiers
URN: urn:nbn:se:du-6124DOI: 10.1016/j.ejon.2010.11.010ISI: 000297777100010OAI: oai:dalea.du.se:6124DiVA: diva2:520511
Available from: 2011-12-13 Created: 2011-12-13 Last updated: 2015-10-26Bibliographically 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
Mittuniversitetet, 2012
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 136
Keyword
cancer care, educational intervention, existential, nurses, surgical care
National Category
Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-11708 (URN)978-91-87103-42-1 (ISBN)
Public defence
2012-01-13, F234, Östersund, 10:15 (Swedish)
Opponent
Supervisors
Available from: 2013-01-16 Created: 2013-01-16 Last updated: 2015-10-26Bibliographically approved

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Citation style
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