Listening to the voices of patients with cancer, their advocates and their nurses: A hermeneutic-phenomenological study of quality nursing care

Charalambous, Andreas; Papadopoulos, Rena; Beadsmoore, Alan

doi:10.1016/j.ejon.2008.05.008

Cited by 50 publications

(44 citation statements)

References 35 publications

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“…Such a distance cannot be realized completely [27,41] but becoming more aware of the situation through reflection helps to limit the bias [2]. The authors are all RNs working in the following fields: clinical ethical support for all groups of professionals in a County Council (AS); researching matters of conscience in healthcare (VD); and working in anaesthetic care for many years (CFG).…”

Section: Discussionmentioning

confidence: 99%

Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

2011

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BackgroundThis study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection.The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care.MethodA phenomenological hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology.ResultsThe analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made.ConclusionThe meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a guide - in situations where no way of solving the problem seems to be good.

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Section: Discussionmentioning

confidence: 99%

Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

2011

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“…However, the complexity and ambiguity of the term, highlighted in the literature, prevents nurses moving from merely asserting the need for quality care to meeting proscribed standards of quality assurance that care provided is excellent (Charalambous, Papadopoulos & Beardsmoore, 2008). 1 In 2004, the Institute of Medicine (IOM) heralded the need for improvement in patient safety and quality of care in the US with the publication of a milestone report. 2 Their analysis of hospital death rates showed that 98,000 deaths annually were due to errors by healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

Nursing care quality: a concept analysis

2015

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“…Assuming the role of the caregiver in these situations can be burdensome and often can lead to excess stress, disempowerment and lack of effectiveness in their role [25,26]. The cultural aspect of cancer as a taboo should also be considered in these situations since largely cancer is connected to death and dying [18]. Being diagnosed with cancer brings up many emotions both for the patient and his/her family.…”

Section: Resultsmentioning

confidence: 99%

“…For many of the students, cancer is considered a terminally ill disease and therefore death and cancer have somewhat became synonymous with many negative cannotations deriving as a result. This generates the feelings and fear of death not only among students but also among professional nurses [18]. As cancer is considered a taboo topic openly communicating about cancer is often avoided [18].…”

Section: Resultsmentioning

confidence: 99%

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Undergraduate nursing students caring for cancer patients: hermeneutic phenomenological insights of their experiences

Charalambous

Kaite

2013

BMC Health Serv Res

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BackgroundThe care of patients suffering from cancer and especially those facing the death trajectory appears to be complex and demanding not only for student nurses but for professional nurses as well. The educational models often used in nursing require students to face challenging care scenarios, sometimes with minimal or no supervision and guidance. These “worst case scenarios” can be traumatic experiences that can leave the student hopeless and disappointed of themselves and in many cases can “scar” their subsequent professional career. The literature demonstrates that this can be the result of the students’ ill-preparation to care for cancer patients and deal with death and dying. The purpose of this study was to interpret the students’ experiences of coming face-to-face with cancer care during their clinical placements.MethodsThis is a hermeneutic phenomenological study influenced by the ideas of the French Philosopher Paul Ricoeur. Based on this philosophical enquiry the interpretation process included three stages: 1) naïve reading, 2) structural analysis and 3) comprehensive understanding. Data were collected through reflective/narrative diaries from the 4th grade undergraduate (pre-registration) nursing students practicing at oncology, hematology, pediatric oncology departments and hospices. Diaries of twelve students met the inclusion criteria and were included in the interpretation process. The study took place during January and May 2011.ResultsThe interpretation yielded the following themes: a) Being part of the center’s life, b) Being sympathetic, c) Being confronted by others, d) Being self-reflective, e) Being trapped in the system, f) Being caring towards the family and g) Being better in clinical practice.ConclusionsThe students emphasized the need for appropriate preparation both at a theoretical and at a clinical level, as to better confront situations involving death and dying as well as learning techniques for crisis management. The students perceived the importance of adopting a policy that is both patient and family-centered in order to provide better care.

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Listening to the voices of patients with cancer, their advocates and their nurses: A hermeneutic-phenomenological study of quality nursing care

Cited by 50 publications

References 35 publications

Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

Nursing care quality: a concept analysis

Undergraduate nursing students caring for cancer patients: hermeneutic phenomenological insights of their experiences

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