It is important that healthcare providers encourage patients to express meanings they attribute to their illness to provide them with appropriate supportive interventions. They should also individually assess patients' decision-making preferences, invite them to participate in decision making, and provide them with tailored means necessary for such participation without making any assumptions based on patients' ethnic/cultural background.

Shared decision making may be new to patients from non-Western cultures, necessitating assessment, education, and support. Non-Western patients may value having family and friends accompany them when a cancer diagnosis is given, but assumptions based on culture alone should not be made. Nurses should determine patient preferences for diagnosis disclosure, information, and participation in decision making.

The aim of this study was to explore Jordanian women's experiences of information exchange following diagnosis of early stage breast cancer. A purposive sample of 28 women who had surgery for early stage breast cancer within 6 months prior to the interview and had treatment at three hospitals in Central and Northern Jordan was recruited for the study. Data were collected using semi-structured individual interviews focused on women's communication experiences at diagnosis and during cancer treatment. Interviews were audio taped, transcribed verbatim in Arabic, and analyzed using conventional content analysis. Three main themes associated with information exchange were revealed as follows: (1) knowledge about breast cancer and its treatment, (2) communication of cancer diagnosis and treatment, and (3) educating on treatment side effects. Misconceptions about breast cancer risk factors, consequences of breast cancer treatment, and breast cancer-related symptoms were common among participants. Women made important health-related decisions based on misconceptions. Physician's information giving, availability, and responses to women's questions varied by their level of education and the type and location of treatment facility. Informational exchange experiences vary among Jordanian women diagnosed with breast cancer and raise concern over opportunities offered these women to engage in informed decision making. Findings suggest a need for nurses to assess the information needs of Jordanian women newly diagnosed with breast cancer and provide education tailored to individual needs. There is also a need to develop Arabic educational materials and make these available for patients at treatment facilities in all regions of Jordan.

No abstract

Background: The World Health Assembly urges members to build palliative care (PC) capacity as an ethical imperative. Nurses provide PC services in a variety of settings, including the home and may be the only health care professional able to access some disparate populations. Identifying current nursing services, resources, and satisfaction and barriers to nursing practice are essential to build global PC capacity. Objective: To globally examine home health care nurses' practice, satisfaction, and barriers, regarding existing palliative home care provision. Design: Needs assessment survey. Setting/Subjects: Five hundred thirty-two home health care nurses in 29 countries. Measurements: A needs assessment, developed through literature review and cognitive interviewing. Results: Nurses from developing countries performed more duties compared with those from high-income countries, suggesting a lack of resources in developing countries. Significant barriers to providing home care exist: personnel shortages, lack of funding and policies, poor access to end-of-life or hospice services, and decreased community awareness of services provided. Respondents identified lack of time, funding, and coverages as primary educational barriers. In-person local meetings and online courses were suggested as strategies to promote learning. Conclusions: It is imperative that home health care nurses have adequate resources to build PC capacity globally, which is so desperately needed. Nurses must be up to date on current evidence and practice within an evidence-based PC framework. Health care policy to increase necessary resources and the development of a multifaceted intervention to facilitate education about PC is indicated to build global capacity.

We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.ResultWe had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How "developed" a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.Significance of resultsDespite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.

No abstract

No abstract