Exploring Communication Difficulties in Pediatric Hematology: Oncology Nurses

Abstract

Caring for patients with chronic or life-threating illnesses, communication and relationships with patients and other healthcare professionals are common themes that cause concerns in oncology nurses (Dowling, 2008;Van Rooyen et al., 2008). Palsson and Norberg (1995) 5478 managing stres, the quality and safety of patient care, cost effectiveness, and the retention of nurses (Wilkinson et al., 2008; Steward et al., 2010 Materials and Methods Sample and study designThis descriptive qualitative study was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey, in December 2011. The hospital has two hematooncology wards with 51 beds and one hematopoietic stem cell transplantation unit (HSCTU) with 10 beds. A total of 55 staff nurses have been working in the wards, which included 28 staff nurses in the hemato-oncology wards and 27 staff nurses in the HSCTU. Nurses are working in two shifts: 08.00 am -04.00 pm and 04.00 pm -08.00 am. Most of the diagnoses in the wards were leukemia, lymphoma, neuroblastoma, thalassemia and aplastic anemia. The average hospitalization days were 2 months for HSCT patients and 20 days for the ward patients. The nurses had participated in orientation programs 15 days after starting their new job at the hospital. On-site workplace training was 1 hour per week for nurses. There was not any education program regarding communication for staff nurses.Qualitative data were collected from 21 pediatric hematology/oncology nursing staff by using the focus group technique, and they were divided into three groups.Before the interviews, a short data form was used to determine the descriptive characteristics of the nurses, including age, education and experience in nursing and pediatric hematology/oncology wards. The nurses' mean age was 26.80±3.5 years and mean experience 4.47±3.99 years in the profession.Pediatric nurses were selected based on voluntarism, availability during shifts and, who expressed living communication difficulties with children and familes. The focus group sizes varied from 6 to 8 participants. Three semi-structured open-ended questions were used to drive the interviews: i) What kinds of communication problems do you have with children and their families in pediatric hematology/oncology clinics? ii) How do these communication difficulties affect you? and iii) How would you feel empowered against having communication difficulties? Qualitative data were collected through interviews in a quiet, private area in the hospital's meeting rooms. Sessions lasted approximately 1 hour. The first author moderated the focus group by semi-structured form and made the clarification of the topics by sub-questions. The second author observed and noted the main topics of conversations. Before ending each interview, main topics were reviewed with the group. Data analysisThe semi-structured focus group interviews were audiotaped and transcribed verbatim. The transcript subsequently was printed for further manual analysis. Content analysis was used to assess the data (Elo and Kynga...

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