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Complexity in caring for patients with advanced cancer
Carol Tishelman1, Britt-Marie Bernhardson, Karin Blomberg
1Department of Nursing, Karolinska Institute, Stockholm, Sweden. carol.tishelman@omv.ki.se
Journal of Advanced Nursing
|February 6, 2004
Summary
Clinical staff face complex challenges in advanced cancer care, balancing ideals with system realities. Improving patient care requires addressing organizational structures, relationships, and enhancing knowledge through reflective practice.
Area of Science:
- Nursing Research
- Oncology Care
- Healthcare Management
Background:
- Acknowledged gap between nursing research and practice.
- Need for collaborative relationships to influence research agendas.
- Initiation of a multi-centre project to improve advanced cancer care quality via knowledge exchange.
Purpose of the Study:
- Explore clinical staff reasoning on care provision for advanced cancer patients.
- Analyze 20 focus group discussions across three healthcare facilities in Sweden.
- Utilize grounded theory and interactive process analysis by a multidisciplinary team.
Main Methods:
- Conducted 20 focus group discussions with clinical staff.
- Employed grounded theory for initial analysis.
- Incorporated interactive process considerations during analysis.
Main Results:
- Caregiving for advanced cancer patients is complex, marked by tension between ideals and system realities.
- Practitioners highlighted the importance of care organization, patient-family-professional relationships, and integrated knowledge.
- Reflective practice, use of self, and ethical reasoning were crucial in daily practice.
Conclusions:
- Sustainable change in advanced cancer care necessitates influencing organizational structures and working relationships.
- Increasing knowledge is essential for effecting sustainable change.
- Integrated approaches addressing both systemic and knowledge-based factors are required.