Abstract
Cancer patients suffer from emotional issues and/or distress, for which they require appropriate care. However, effective communication that translates into recognition of patients’ cues/concerns remains an issue. Barriers to effective communication include nurse shortages, time constraints and limited healthcare communication training for cancer nurses. Exploring how nurses fare in communicating with patients by responding to their cues/concerns for emotional and/or informational needs is important. This ethnographic study examined a busy cancer ward and its nursing care as a subculture. Content analysis from patient interviews was conducted, and a statistical analysis of the nurses’ cue-responding behaviours. Findings revealed that despite no emotional counselling, nurses exhibited positive cue-responding behaviours and patients expressed appreciation for this care. This conclusion is striking at a time when nurses stated there was no time to talk to patients and Hong Kong faces a shortage of nurses, even as the emphasis on holistic care is growing. Findings challenge the cultural expectations of emotional care in oncology wards. The perception that emotional care must be addressed separately from the nurses’ everyday physical and technical care is challenged and should be re-assessed with reintegration of the physical with the emotional in the nursing care provided to patients.
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References
Abrahamson, K., Durham, M., Norton, K., Doebbeling, B. N., Doebbeling, C. C., & Anderson, J. G. (2011). Provision of psychosocial care for cancer patients: Service delivery in urban and rural settings. Journal of Primary Care & Community Health, 2(4), 220–224.
Annunziata, M., Giovannini, L., & Mussatti, B. (2012). Assessing the body image: Relevance, application and instruments for oncological settings. Supportive Care in Cancer, 20, 901–907.
AWMF. (2014). Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Psychoonkologische Diagnostik, Beratung und Behandlung von erwachsenen Krebspatienten. AWMF Registernummer: 032/051OL. Retrieved from www.awmf.org/uploads/tx_szleitlinien/032-051OLl_S3_Psychoonkologische_Beratung_Behandlung_2014-01_1.1.pdf.
Bracher, M., Corner, D. J., & Wagland, R. (2016). Exploring experiences of cancer care in Wales: A thematic analysis of free-text responses to the 2013 Wales Cancer Patient Experience Survey (WCPES). British Medical Journal Open, 6(9), e011830.
Braeken, A. P., Kempen, G. I., Eekers, D. B. P., Houben, R. M., van Gils, F. C., Ambergen, T., et al. (2013). Psychosocial screening effects on health-related outcomes in patients receiving radiotherapy. A cluster randomised controlled trial. Psycho-Oncology, 22(12), 2736–2746.
Chan, C. W., Molassiotis, A., Yam, B. M., Chan, S. J., & Lam, C. S. (2001). Traveling through the cancer trajectory: Social support perceived by women with gynecological cancer in Hong Kong. Cancer Nursing, 24(5), 387–394.
Chan, E. A., Wong, F., Cheung, M. Y., & Lam, W. (2018). Patients’ perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study. PLoS ONE, 13(6), 1–17.
Chen, M. L., Chang, H. K., & Yeh, C. H. (2000). Anxiety and depression in Taiwanese cancer patients with and without pain. Journal of Advanced Nursing, 32(4), 944–951.
Chen, Y. C. (2001). Chinese values, health and nursing. Journal of Advanced Nursing, 36(2), 270–273.
Cheng, H., Sit, J. W., Chan, C. W., So, W. K., Choi, K. C., & Cheng, K. K. (2013). Social support and quality of life among Chinese breast cancer survivors: Findings from a mixed methods study. European Journal of Oncology Nursing, 17(6), 788–796.
de Leeuw, J., Prins, J. B., Uitterhoeve, R., Merkx, M. A., Marres, H. A., & van Achterberg, T. (2014). Nurse-patient communication in follow-up consultations after head and neck cancer treatment. Cancer Nursing, 37(2), E1–E9.
Ding, Y., Hu, Y., & Hallberg, I. R. (2015). Chinese women living with cervical cancer in the first 3 months after diagnosis: A qualitative study. Cancer Nursing, 38(1), 71–80.
Dong, S. T., Butow, P. N., Tong, A., Agar, M., Boyle, F., Forster, B. C., … Lovell, M. R. (2016). Patients’ experiences and perspectives of multiple concurrent symptoms in advanced cancer: A semi-structured interview study. Supportive Care in Cancer, 24(3), 1373‒1386.
Dunn, J., Ng, S. K., Holland, J., Aitken, J., Youl, P., Baade, P. D., et al. (2013). Trajectories of psychological distress after colorectal cancer. Psycho-Oncology, 22(8), 1759–1765.
Echlin, K. N., & Rees, C. E. (2002). Information needs and information-seeking behaviors of men with prostate cancer and their partners: A review of the literature. Cancer Nursing, 25(1), 35–41.
Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136.
Ferlay, J., Shin, H. R., Bray, F., Forman, D., Mathers, C., & Parkin, D. M. (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International Journal of Cancer, 127(12), 2893–2917.
Goldberg, D. P., Hobson, R. F., Maguire, G. P., Margison, F. R., O’Dowd, T., Osborn, M., et al. (1984). The clarification and assessment of a method of psychotherapy. British Journal of Psychiatry, 144, 567–575.
Gordon, S. (2006). The new Cartesianism: Dividing mind and body and thus disembodying care. In S. Nelso & S. Gordo (Eds.), The complexities of caring: Nursing reconsidered. Ithaca, NY: Cornell University Press.
Hack, T. F., Ruether, J. D., Pickles, T., Bultz, B. D., Chateau, D., & Degner, L. F. (2012). Behind closed doors II: Systematic analysis of prostate cancer patients’ primary treatment consultations with radiation oncologists and predictors of satisfaction with communication. Psycho-Oncology, 21(8), 809–817.
Hammersley, M., & Atkinson, P. (2007). The process of analysis. In M. Hammersley & P. Atkinson (Eds.), Ethnography: Principles in practice (3rd ed., pp. 158–190). London: Routledge.
Heaven, C. M., & Green, C. (2001). Medical Interview Aural Rating Scale. Manchester, England: Psychological Medical Group, Christie Hospital, Stanley House.
Helman, C. G. (2007). Culture, health and illness: An introduction for health professionals (2nd ed.). London: CRC Press.
Hill, J., Holcombe, C., Clark, L., Boothby, M. R. K., Hincks, A., Fisher, J., … Salmon, P. (2011). Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer. Psychological Medicine, 41(7), 1429‒1436.
Hinz, A., Krauss, O., Hauss, J. P., Höckel, M., Kortmann, R. D., Stolzenburg, J. U., et al. (2010). Anxiety and depression in cancer patients compared with the general population. European Journal of Cancer Care, 19(4), 522–529.
Horden, A. (2008). Intimacy and sexuality after cancer: A critical review of the literature. Cancer Nursing, 31, E9–17.
Hsu, C. Y., O’Connor, M., & Lee, S. (2009). Understandings of death and dying for people of Chinese origin. Death Studies, 33(2), 153–174.
Jacobsen, P. B. (2009). Clinical practice guidelines for the psychosocial care of cancer survivors: Current status and future prospects. Cancer, 115(S18), 4419–4429.
Lai, A. (2006). Eye on religion: Cultural signs and caring for Chinese patients. Southern Medical Journal, 99(6), 688–689.
Lam, W. W., Au, A. H., Wong, J. H., Lehmann, C., Koch, U., Fielding, R., et al. (2011). Unmet supportive care needs: A cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Research and Treatment, 130(2), 531–541.
Lam, W. W., Fabrizio, C., Ho, E., Chan, L., & Fielding, R. (2009). Perceived importance of evidence-based psychosocial clinical guidelines for Hong Kong Chinese women with breast cancer: Opinions of patients and health care providers. Supportive Care in Cancer, 17(3), 219–229.
Lau, L. K. P., Mok, E., Lai, T., & Chung, B. (2013). Quality-of-life concerns of Chinese patients with advanced cancer. Social Work in Health Care, 52(1), 59–77.
Lee, Y. M., Francis, K., Walker, J., & Lee, S. M. (2004). What are the information needs of Chinese breast cancer patients receiving chemotherapy? European Journal of Oncology Nursing, 8(3), 224–233.
Li, W. W., Lam, W. W., Au, A. H., Ye, M., Law, W. L., Poon, J., … Fielding, R. (2013). Interpreting differences in patterns of supportive care needs between patients with breast cancer and patients with colorectal cancer. Psycho-Oncology, 22(4), 792‒798.
Lin, M. F., Lee, A. Y., Chou, C. C., Liu, T. Y., & Tang, C. C. (2017). Factors predicting emotional cue-responding behaviors of nurses in Taiwan: An observational study. Psycho-Oncology, 26(10), 1548–1554.
Liu, J. E., Mok, E., & Wong, T. (2005). Perceptions of supportive communication in Chinese patients with cancer: Experiences and expectations. Journal of Advanced Nursing, 52(3), 262–270.
Liu, P., Rigoulot, S., & Pell, M. D. (2015). Culture modulates the brain response to human expressions of emotion: Electrophysiological evidence. Neuropsychologia, 67, 1–13.
Matthews, A. K., Sellergren, S. A., Manfredi, C., & Williams, M. (2002). Factors influencing medical information seeking among African American cancer patients. Journal of Health Communication, 7(3), 205–219.
Muzzalti, B., Bomben, F., Flaiban, C., Mella, S., & Annunziata, M. A. (2016). Psychological distress in cancer patients: From recognition to management. In A. Compare, C. Elia, & A. G. Simonelli (Eds.), Psychological distress. Hauppauge, NY: Nova Science Publishers Inc.
National Comprehensive Cancer Network. (2017). NCCN clinical practice guidelines in oncology. Retrieved from https://www.nccn.org/professionals/physician_gls/f_guidelines.asp#supportive.
Novy, D. M., & Aigner, C. J. (2014). The biopsychosocial model in cancer pain. Current Opinion in Supportive and Palliative Care, 8(2), 117–123.
Sandvik, M., Eide, H., Lind, M., Graugaard, P. K., Torper, J., & Finset, A. (2002). Analyzing medical dialogues: Strength and weakness of Roter’s Interaction Analysis System (RIAS). Patient Education and Counseling, 46(4), 235–241.
Sawer, A., Ayers, S., & Field, A. (2010). Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: A meta-analysis. Clinical Psychology Review, 30, 436–447.
Sheldon, L. J., Blonquist, T. M., Hilaire, D. M., Hong, F., & Berry, D. L. (2015). Patient cues and symptoms of psychosocial distress: What predicts assessment and treatment of distress by oncology clinicians. Psycho-Oncology, 24, 1020–1027.
So, W. K., Chan, C. W., Choi, K. C., Wan, R. W., & Mak, S. S. (2013). Perceived unmet needs and health-related quality of life of Chinese cancer survivors at 1 year after treatment. Cancer Nursing, 36(3), E23–E32.
Song, Y., Lv, X., Liu, J., Huang, D., Hong, J., Wang, W., et al. (2016). Experience of nursing support from the perspective of patients with cancer in mainland China. Nursing & Health Sciences, 18(4), 510–518.
Soussain, C., Ricard, C., Fike, J. R., Mazeron, J. J., Psimaras, D., & Dlattre, J. Y. (2009). CNS complications of radiotherapy and chemogherapy. Lancet, 7(374), 1639–1651.
Stone, P. C., & Minton, O. (2008). Cancer-related fatigue. European Journal of Cancer, 44, 1097–1104.
Tang, S. T., Liu, T. W., Lai, M. S., Liu, L. N., Chen, C. H., & Koong, S. L. (2006). Congruence of knowledge, experiences, and preferences for disclosure of diagnosis and prognosis between terminally-ill cancer patients and their family caregivers in Taiwan. Cancer Investigation, 24(4), 360–366.
Uitterhoeve, R., Bensing, J., Dilven, E., Donders, R., de Mulder, P., & van Achterberg, T. (2009). Nurse-patient communication in cancer care: Does responding to patient’s cues predict patient satisfaction with communication. Psycho-Oncology, 18(10), 1060–1068.
Uitterhoeve, R., Bensing, J. M., Grol, R. P., Demulder, P. H. M., & van Achterberg, T. (2010). The effect of communication skills training on patient outcomes in cancer care: A systematic review of the literature. European Journal of Cancer Care, 19(4), 442–457.
Weis, J. (2015). Psychosocial care for cancer patients. Breast Care, 10, 84–86.
Welton, J. M. (2016). Nurse staffing and patient outcomes: Are we asking the right research question? International Journal of Nursing Studies, 63, A1–A2.
Wong, W. S., Fielding, R., Wong, C., & Hedley, A. (2009). Confirmatory factor analysis and sample invariance of the Chinese Patient Satisfaction Questionnaire (ChPSQ-9) among patients with breast and lung cancer. Value in Health, 12(4), 597–605.
Wu, L. F., Koo, M., Tseng, H. C., Liao, Y. C., & Chen, Y. M. (2015). Concordance between nurses’ perception of their ability to provide spiritual care and the identified spiritual needs of hospitalized patients: A cross-sectional observational study. Nursing & Health Sciences, 17(4), 426–433.
Zhang, J. E., Wong, F. K., You, L. M., & Zheng, M. C. (2012). A qualitative study exploring the nurse telephone follow-up of patients returning home with a colostomy. Journal of Clinical Nursing, 21(9–10), 1407–1415.
Zheng, M. C., Zhang, J. E., Qin, H. Y., Fang, Y. J., & Wu, X. J. (2013). Telephone follow-up for patients returning home with colostomies: Views and experiences of patients and enterostomal nurses. European Journal of Oncology Nursing, 17(2), 184–189.
Zheng, R., Johnson, J., Wang, Q., & Hu, J. (2014). A need for cancer patient education from the perspective of Chinese patients and nurses: A comparison study. Supportive Care in Cancer, 22(9), 2457–2464.
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This study was funded by the General Research Fund, PolyU 156003/15H.
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Chan, E.A. (2020). What Happens to the Holistic Care of Patients in Busy Oncology Settings?. In: Watson, B., Krieger, J. (eds) Expanding Horizons in Health Communication. The Humanities in Asia, vol 6. Springer, Singapore. https://doi.org/10.1007/978-981-15-4389-0_4
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