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Patients' Experiences of Nurse-Led Integrative Palliative Care in Multiple Myeloma
Shulamit Ohana1, Adir Shaulov2, Freda DeKeyser Ganz1
1Department of Nursing, Henrietta Szold Hadassah Hebrew University School of Nursing, Jerusalem, Israel (Ohana and DeKeyser Ganz).
Background:
Multiple myeloma is a chronic hematological malignancy requiring continuous supportive care. Palliative care (PC) can be delivered through different models, such as consultative and integrative approaches. The subjective meaning patients attribute to these approaches has not been adequately explored.
Objective:
To explore how patients with multiple myeloma experienced a nurse-led integrative PC model integrated within standard hematology practice.
Interventions/Methods:
Fifteen patients who initially received standard care and later transitioned to nurse-led integrative PC participated in semi-structured, face-to-face interviews after 6 months in the program. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Credibility and trustworthiness were ensured through independent coding, reflexive and analytic memos, peer debriefing, and data saturation.
Results:
Five themes emerged: redefining PC, relief of symptoms, relational continuity with a dedicated nurse, increased involvement and control, and renewed hope. Patients emphasized the ongoing, relational, and empowering aspects of the nurse-led integrative approach compared with the episodic and reactive nature of standard care.
Conclusion:
Transitioning to nurse-led integrative PC altered patients' perceptions of their treatment. The model provided continuity, emotional stability, and existential meaning in addition to physical symptom relief.
Implications For Oncology Nursing Practice:
Nurse-led integrative PC can enhance patient experiences by combining symptom management with sustained relational support. Oncology nurses implementing this model may foster greater patient empowerment, hope, and engagement in care, thereby improving quality of life throughout the disease trajectory.
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