What Happens to the Holistic Care of Patients in Busy Oncology Settings?
- 23 Downloads
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.
KeywordsNursing Cancer Ethnography Descriptive content analysis
This study was funded by the General Research Fund, PolyU 156003/15H.
- 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.Google Scholar
- 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.CrossRefGoogle Scholar
- 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.Google Scholar
- 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.Google Scholar
- 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.Google Scholar
- 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.CrossRefGoogle Scholar
- Heaven, C. M., & Green, C. (2001). Medical Interview Aural Rating Scale. Manchester, England: Psychological Medical Group, Christie Hospital, Stanley House.Google Scholar
- Helman, C. G. (2007). Culture, health and illness: An introduction for health professionals (2nd ed.). London: CRC Press.Google Scholar
- 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.Google Scholar
- 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.Google Scholar
- 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.Google Scholar
- National Comprehensive Cancer Network. (2017). NCCN clinical practice guidelines in oncology. Retrieved from https://www.nccn.org/professionals/physician_gls/f_guidelines.asp#supportive.
- 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.CrossRefGoogle Scholar
- 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.CrossRefGoogle Scholar