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Positive reappraisal of the impact of working with patients who are suffering: A study of palliative care nurse specialists' experience
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Posters, 8th Annual BTOG Conference, 2010
The findings from the WMCIU/NCIU reports seem to corroborate our findings. There continues to be the need to improve ethnic minorities’ access to lung cancer services by working within these communities to increase awareness.
Whites South-Asians Total
Number
Surgery
Chemotherapy
Palliative
399 18 417
87 5 92
75 4 79
237 9 246
69 Positive reappraisal of the impact of working with patients who are suffering: A study of palliative care nurse specialists’ experience H.M. Davies. University of the West of England, Bristol, United Kingdom Background: Nurses who work with patients who are dying have an opportunity for personal growth but also for experiencing significant negative emotion leading to stress and ill health. Methodology: A phenomenological study of palliative care nurse specialists to determine their understanding of suffering and experience of working with patients who are suffering. Thirty-one experienced nurses were interviewed and the results analysed. Results: Positive reappraisal was used to cope with the difficulties of palliative care and over time they had developed a clear understanding of their role in the relief of suffering, which in turn influenced their ability to cope. Their learning had been experiential and practice based and had often been gained through their own negative response to the role. Conclusion: Greater planned support for nurses who wish to work with patients who are suffering may assist in both the care of their patients and their ability to cope. 70 Support needs following a diagnosis of lung cancer: The patient’s perspective M. Samson1 , A. Swinkels2 . 1 Bristol Royal Infirmary, Bristol, United Kingdom, 2 University of the West of England, Bristol, United Kingdom This qualitative phenomenological study explored the support needs of people newly diagnosed with lung cancer; semi-structured interviews were undertaken with 5 people with differing ages and socio-economic groups. Interviews were transcribed verbatim and a thematic analysis resulted in 13 initial interrelated themes. The two most significant themes as described by the participants were explored in depth; they were hope and support. The study identified that maintaining hope was the most important issue for participants. Connecting with family and friends was important as well as maintaining positive relationships with health care professionals. Setting goals and maintaining normality were also essential for the participants in the study. Participants also expressed the need for good information to allow them to make decisions about their cancer. The role of the lung cancer nurse in providing psycho-social care as well as information was paramount. This study provides an insight into the experience of people newly diagnosed with lung cancer and information that could be used to improve services. The study suggests ways in which the lung cancer nurse can improve the services. The study recommends individual sessions with the lung cancer nurse; this could be achieved with a nurse-led clinic. On-line support or group support could also be explored to meet the needs of these patients. The findings of this study are consistent with other research in the area; however a larger sample could enhance transferability of the findings. The research was undertaken as part of the dissertation process within an Msc Advanced Practice.
71 An exploration of palliative care nurse specialists’ understanding of suffering H.M. Davies. University of the West of England, Bristol, United Kingdom Background: Suffering is the individual’s response to circumstances that befall them and are perceived to have a negative impact. Nurses aim to help patients integrate suffering into their lives, which requires a deep understanding of the patient. Arguably, what suffering means to palliative care nurses will determine the focus and practical aspects of their care. Method: The study was guided by the ideas of hermeneutic phenomenology. Thirty one palliative care clinical nurse specialists working in south and mid Wales were interviewed to determine their understanding of suffering. Interviews enabled the exploration of their experiences and views. The data was analysed using the principles of phenomenological interpretation. Findings: The palliative care nurse specialists had difficulty articulating the concept of suffering but their descriptions, often using clinical scenarios, mirrored the literature. Their understanding of suffering influenced their care management. Conclusion: Education about suffering may enable palliative care nurses develop skills and knowledge in the care of patients who are suffering and help in identification of suffering in practice. 72 TELECLINIC: A nurse led telephone follow-up clinic for lung cancer patients: Improving the patient’s experience G. Drury, A. Gostage, A. Garcia-Alonso. Wrexham Maelor Hospital, Wrexham, United Kingdom Background: Access to specialist advice is vital for lung cancer patients, particularly given the high incidence and the rapidly progressive nature of the disease. Clinical nurse specialists have a crucial role in ensuring patient well-being and the development of patient-centred services to facilitate prompt identification of problems, avoiding escalation and preventing inappropriate admissions. Methods: From October 2008 to October 2009, 111 selected patients were recruited into a structured framework offering telephone follow-up. The teleclinic targeted patients whose definitive treatment was best supportive care, patients who came to the end of treatment and patients who relapsed and were not considered suitable for further treatment. Patients were given verbal and written information regarding the intervention. Calls were made monthly for at least 3 months. Thereafter agreement is reached with the patient regarding the continuation of the contact. A dedicated teleform data capture system is completed with each contact and this included situation of the patient, background, assessment and recommendations. The document was user friendly, concise and would capture only meaningful data. Results: One hundred and eleven patients were recruited resulting in 512 teleclinic contacts. The average number of calls per patient was 4.6. Duration of the call was divided in: 0 5 min: 117 5 10 min: 127 10 20 min: 242 Over 20 min: 26 In 226 calls (44.1%) advice on physical symptoms and psychological support was required; in 37 calls (7.23%) advice for physical symptoms was needed and in 107 calls (20.90%) psychological support was required. Conclusion: Only one patient required admission. Referrals to other professionals were necessary for 53 patients and 56 patients needed contacting sooner than one month. We intend to evaluate the impact of the service on the patients experience by undertaking a patient satisfaction survey and if it is favourable we need to consider expanding and developing the service.
Posters, 8th Annual BTOG Conference, 2010
The findings from the WMCIU/NCIU reports seem to corroborate our findings. There continues to be the need to improve ethnic minorities’ access to lung cancer services by working within these communities to increase awareness.
Whites South-Asians Total
Number
Surgery
Chemotherapy
Palliative
399 18 417
87 5 92
75 4 79
237 9 246
69 Positive reappraisal of the impact of working with patients who are suffering: A study of palliative care nurse specialists’ experience H.M. Davies. University of the West of England, Bristol, United Kingdom Background: Nurses who work with patients who are dying have an opportunity for personal growth but also for experiencing significant negative emotion leading to stress and ill health. Methodology: A phenomenological study of palliative care nurse specialists to determine their understanding of suffering and experience of working with patients who are suffering. Thirty-one experienced nurses were interviewed and the results analysed. Results: Positive reappraisal was used to cope with the difficulties of palliative care and over time they had developed a clear understanding of their role in the relief of suffering, which in turn influenced their ability to cope. Their learning had been experiential and practice based and had often been gained through their own negative response to the role. Conclusion: Greater planned support for nurses who wish to work with patients who are suffering may assist in both the care of their patients and their ability to cope. 70 Support needs following a diagnosis of lung cancer: The patient’s perspective M. Samson1 , A. Swinkels2 . 1 Bristol Royal Infirmary, Bristol, United Kingdom, 2 University of the West of England, Bristol, United Kingdom This qualitative phenomenological study explored the support needs of people newly diagnosed with lung cancer; semi-structured interviews were undertaken with 5 people with differing ages and socio-economic groups. Interviews were transcribed verbatim and a thematic analysis resulted in 13 initial interrelated themes. The two most significant themes as described by the participants were explored in depth; they were hope and support. The study identified that maintaining hope was the most important issue for participants. Connecting with family and friends was important as well as maintaining positive relationships with health care professionals. Setting goals and maintaining normality were also essential for the participants in the study. Participants also expressed the need for good information to allow them to make decisions about their cancer. The role of the lung cancer nurse in providing psycho-social care as well as information was paramount. This study provides an insight into the experience of people newly diagnosed with lung cancer and information that could be used to improve services. The study suggests ways in which the lung cancer nurse can improve the services. The study recommends individual sessions with the lung cancer nurse; this could be achieved with a nurse-led clinic. On-line support or group support could also be explored to meet the needs of these patients. The findings of this study are consistent with other research in the area; however a larger sample could enhance transferability of the findings. The research was undertaken as part of the dissertation process within an Msc Advanced Practice.
71 An exploration of palliative care nurse specialists’ understanding of suffering H.M. Davies. University of the West of England, Bristol, United Kingdom Background: Suffering is the individual’s response to circumstances that befall them and are perceived to have a negative impact. Nurses aim to help patients integrate suffering into their lives, which requires a deep understanding of the patient. Arguably, what suffering means to palliative care nurses will determine the focus and practical aspects of their care. Method: The study was guided by the ideas of hermeneutic phenomenology. Thirty one palliative care clinical nurse specialists working in south and mid Wales were interviewed to determine their understanding of suffering. Interviews enabled the exploration of their experiences and views. The data was analysed using the principles of phenomenological interpretation. Findings: The palliative care nurse specialists had difficulty articulating the concept of suffering but their descriptions, often using clinical scenarios, mirrored the literature. Their understanding of suffering influenced their care management. Conclusion: Education about suffering may enable palliative care nurses develop skills and knowledge in the care of patients who are suffering and help in identification of suffering in practice. 72 TELECLINIC: A nurse led telephone follow-up clinic for lung cancer patients: Improving the patient’s experience G. Drury, A. Gostage, A. Garcia-Alonso. Wrexham Maelor Hospital, Wrexham, United Kingdom Background: Access to specialist advice is vital for lung cancer patients, particularly given the high incidence and the rapidly progressive nature of the disease. Clinical nurse specialists have a crucial role in ensuring patient well-being and the development of patient-centred services to facilitate prompt identification of problems, avoiding escalation and preventing inappropriate admissions. Methods: From October 2008 to October 2009, 111 selected patients were recruited into a structured framework offering telephone follow-up. The teleclinic targeted patients whose definitive treatment was best supportive care, patients who came to the end of treatment and patients who relapsed and were not considered suitable for further treatment. Patients were given verbal and written information regarding the intervention. Calls were made monthly for at least 3 months. Thereafter agreement is reached with the patient regarding the continuation of the contact. A dedicated teleform data capture system is completed with each contact and this included situation of the patient, background, assessment and recommendations. The document was user friendly, concise and would capture only meaningful data. Results: One hundred and eleven patients were recruited resulting in 512 teleclinic contacts. The average number of calls per patient was 4.6. Duration of the call was divided in: 0 5 min: 117 5 10 min: 127 10 20 min: 242 Over 20 min: 26 In 226 calls (44.1%) advice on physical symptoms and psychological support was required; in 37 calls (7.23%) advice for physical symptoms was needed and in 107 calls (20.90%) psychological support was required. Conclusion: Only one patient required admission. Referrals to other professionals were necessary for 53 patients and 56 patients needed contacting sooner than one month. We intend to evaluate the impact of the service on the patients experience by undertaking a patient satisfaction survey and if it is favourable we need to consider expanding and developing the service.