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Surgical nurses' work-related stress when caring for severely ill and dying patients with cancer after participating in an educational intervention on existential issues
Mid Sweden University, Department of Health Sciences, Östersund, Sweden, Health Care Sciences Post Graduate School, Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0003-2853-0575
2013 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 5Article in journal (Refereed) Published
Abstract [en]

Aim

The aim of this study was to describe surgical nurses' perceived work-related stress in the care of severely ill and dying patients with cancer after participating in an educational intervention on existential issues.

Methods and sample

This article reports a mixed methods pilot study of an education programme consisting of lectures and supervised discussions conducted in 2009–2010 in three surgical wards in a county hospital in Sweden. The concurrent data collections consisted of repeated interviews with eleven nurses in an educational group, and questionnaires were distributed to 42 nurses on four occasions.

Results

Directly after the educational intervention, the nurses described working under high time pressure. They also described being hindered in caring because of discrepancies between their caring intentions and what was possible in the surgical care context. Six months later, the nurses described a change in decision making, and a shift in the caring to make it more in line with their own intentions and patients' needs rather than the organizational structure. They also reported decreased feelings of work-related stress, decreased stress associated with work-load and feeling less disappointed at work.

Conclusions

Results indicate that it may be possible to influence nurses' work-related stress through an educational intervention. According to nurses' descriptions, reflecting on their ways of caring for severely ill and dying patients, many of whom had cancer, from an existential perspective, had contributed to enhanced independent decision making in caring. This in turn appears to have decreased their feelings of work-related stress and disappointment at work.

Place, publisher, year, edition, pages
Elsevier, 2013. Vol. 17, no 5
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:du-11707DOI: 10.1016/j.ejon.2013.02.002ISI: 000325600800006OAI: oai:DiVA.org:du-11707DiVA: diva2:588956
Available from: 2013-01-16 Created: 2013-01-16 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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