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Do oncology nurses provide more care to cancer patients with high levels of emotional distress?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
2010 (English)In: Oncology Nursing Forum, ISSN 0190-535X, E-ISSN 1538-0688, Vol. 37, no 1, e34-e42 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE/OBJECTIVES: To investigate nurses' planning and implementation of individualized patient care in relation to patients' emotional distress as assessed by nurses and whether nurses and patients perceived the implemented care in a similar manner. DESIGN: Prospective, comparative. SETTING: Five oncologic-hematologic wards in Sweden. SAMPLE: 90 individual nurse-patient pairs were recruited and 81 were intact after three consecutive days. Each pair consisted of a patient with cancer and a nurse responsible for that patient's care. METHODS: Nurse-patient pairs were followed using questionnaires. Outcome measures were nurses' identification of patients' emotional distress, care planning, and nurse-patient ratings of implemented care. MAIN RESEARCH VARIABLES: Patients' emotional distress and nurses' implemented care. FINDINGS: Nurses identified a variety of emotional issues among patients and planned individual nursing interventions. Nurse and patient perceptions of implemented care demonstrated weak correlations for individually planned interventions and nurses' general caring behavior. With one exception, nurse self-reports did not indicate any differences in nurses' caring behavior directed to more and less distressed patients. Nurses reported providing comfort more frequently to patients with high levels of emotional distress, but this was not substantiated in patients' ratings. CONCLUSIONS: Nurses showed an intention to provide individualized care. However, with one exception, nurses did not report providing more care to patients with cancer with high levels of emotional distress than to less distressed patients. IMPLICATIONS FOR NURSING: To ensure individualized care, nurses in cancer care should closely validate the accuracy of their interpretation of patients' needs and their planning of care in collaboration with the patients.

Place, publisher, year, edition, pages
2010. Vol. 37, no 1, e34-e42 p.
Keyword [en]
Cancer patients, emotional distress, nurses caring behaviour
National Category
Nursing
Research subject
Caring Sciences in Medical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-101327DOI: 10.1188/10.ONF.E34-E42PubMedID: 20044330OAI: oai:DiVA.org:uu-101327DiVA: diva2:212634
Available from: 2009-04-23 Created: 2009-04-23 Last updated: 2017-12-13Bibliographically approved
In thesis
1. The Insider and Outsider Perspective: Clinical importance of agreement between patients and nurses in cancer care concerning patients’ emotional distress, coping resources and quality of life
Open this publication in new window or tab >>The Insider and Outsider Perspective: Clinical importance of agreement between patients and nurses in cancer care concerning patients’ emotional distress, coping resources and quality of life
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: It is a well-known phenomenon that nurses and other oncology staff have a tendency to ascribe patients with cancer more problems and suffering than the patients themselves report. Aim: The overall aim of the present thesis was therefore to gain increased knowledge and understanding of dis/agreement between patients with cancer and nurses regarding their perception of patients’ situation and of the importance of patient-nurse dis/agreement in clinical practice. Methods: A prospective comparative design was used. Data were collected from a sample of 90 consecutively recruited patient-nurse pairs. Each pair consisted of a patient with cancer, newly admitted to a ward, and a nurse responsible for that patient’s care. Data were collected from the pairs with corresponding self-administrated questionnaires on two occasions: directly after the admission interview and on the patient’s third day on the ward. Results: At the group level, a distinct pattern was shown in which nurses ascribed the patients more emotional distress, less coping resources and a lower quality of life than the patients themselves reported. In short, the results revealed the following clinical importance of patient-nurse dis/agreement. With respect to how nurses act in relation to their perceptions of patients’ emotional distress, patient-nurse dis/agreement did not seem to be important; with few exceptions, nurses’ implemented care did not differ when it was directed at more as compared to less distressed patients. Further, nurses’ general tendency to overestimate cancer patients’ problems and suffering had no influence on patients’ satisfaction with received care and nurses’ satisfaction with provided care. However, patients cared for by nurses who underestimated their level of depression were less satisfied with those nurses’ care. In addition, the more frequently the nurse had implemented care characterized by a trusting relationship, the higher patients’ and nurses’ satisfaction with received/provided care. Conclusions: Initial patient-nurse dis/agreement concerning patients’ situation appears to be of little significance to nurses’ caring behaviour and to patients’ and nurses’ subsequent evaluation of received and provided care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 69 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 459
Keyword
cancer care, patient-nurse agreement, emotional distress, coping resources, quality of life, implemented care, trusting relationship, satisfaction with care, work satisfaction
National Category
Nursing
Research subject
Caring Sciences in Medical Sciences
Identifiers
urn:nbn:se:uu:diva-101337 (URN)978-91-554-7533-8 (ISBN)
Public defence
2009-06-11, Universitetshuset, sal IX, Övre slottsgatan 2, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-05-19 Created: 2009-04-23 Last updated: 2010-12-15Bibliographically approved

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