Demoralization in medical illness: Feasibility and acceptability of a pilot educational intervention for inpatient oncology nurses.

ABSTRACTObjective:Demoralization is a common problem among medical inpatients with such serious health problems as cancer. An awareness of this syndrome, a knowledge of what defines it, and a plan for how to intervene are limited among nursing teams. Nurses are uniquely poised to efficiently provide brief interventions that address demoralization in their patients. To our knowledge, there are no interventions that train nurses to distinguish and treat demoralization in their patients. The objective of the present study was to determine the acceptability, feasibility, and impact of a novel educational intervention for nurses. METHOD: An educational training video was created and delivered to staff nurses (N = 31) at oncology staff meetings to test the feasibility and acceptability of this intervention. Assessments of nurses' knowledge about demoralization and intervention methods were administered immediately before and after the training intervention and through a web-based survey 6 weeks post-intervention. McNemar's test for dependent categorical data was utilized to evaluate change in survey responses at the three timepoints. RESULTS: Nurses' understanding of the concept of demoralization and appropriate interventions significantly improved by 30.3% from pre- to posttest (p ≤ 0.0001). These improvements persisted at 6 weeks post-intervention (p ≤ 0.0001). At 6-week follow-up, 74.2% of participants agreed or strongly agreed that the training had positively changed their nursing practice, 96.8% reported that this training benefited their patients, and 100% felt that this training was important for the professional development of nurses. SIGNIFICANCE OF RESULTS: This pilot intervention appeared feasible and acceptable to nurses and resulted in increased understanding of demoralization, improved confidence to intervene in such cases, and an enhanced sense of professional satisfaction among inpatient oncology floor nurses.

Posttraumatic growth after cancer: The role of perceived threat and cognitive processing.

This study examines the relation between perceived cognitive and physical threat after a cancer diagnosis and posttraumatic growth (PTG). In total, 169 breast, prostate, and colorectal cancer survivors completed questionnaires. Hierarchical regression models found after controlling for demographic and medical variables, depression, anxiety, and perceived threat account for 41.8% of the variance of positive cognitive processing, and these variables along with positive cognitive processing accounted for 42.7% of the variance of PTG. Positive cognitive processing mediated the pathways between perceived physical threat and PTG. Cognitive processing appears to play a key role in the emergence of PTG following cancer. By exploring survivors' cognitions and perceived threat, psychosocial providers may help cancer survivors cultivate PTG.