Cancer patients' perceptions of nursing: Expectations & realities, a phenomenological study.

PURPOSE: Determining the perception and expectations of cancer patients will inform nurses' understanding of how to conduct nursing care to meet patients' needs. Studies have mainly used quantitative methods to understand nursing image from the perspective of the public and the profession, and there are no recent studies to date on nursing image from the perspective of cancer patients. The aim of this qualitative study was to explore cancer patients' experiences and perceptions of nursing within the conceptual framework of Watson's Human Care Theory. METHODS: In total, 19 phenomenological semi-structured interviews were conducted with cancer patients between November 2022 and January 2023. Data were analyzed using Assarroudi et al.'s content analysis. RESULTS: Three themes emerged from the phenomenological analysis of the interviews: (1) nursing image, (2) expectations, and (3) realities. Patients stated that nurses act as assistants and that health services cannot be provided without them. Under the main theme of 'expectations,' five subthemes emerged: psychosocial care, physical care, ethics, individual characteristics, and no expectations, while the theme of 'realities' contained two subthemes: (1) satisfaction with nurse behaviors, and (2) dissatisfaction with nurse behaviors. CONCLUSIONS: Our study provides important insight for nurses working with cancer patients in the management of patient care and treatment. Empowering cancer nurses will increase patient care satisfaction. We recommend the implementation of programs designed to support nurses and improve nursing communication skills. We also recommend that the technical and psychosocial aspects of nursing care should be considered as a whole.

Compassion Fatigue Resiliency Program Effects on Oncology-Hematology Nurses' Professional Quality of Life, Stress Levels, and Patients' Care Satisfaction: Nurse, Nurse Manager, and Patient Perspectives, a Mixed-Methods Study.

OBJECTIVES: This study aimed to evaluate the effects of the Compassion Fatigue Resiliency Program applied to oncology-hematology nurses on the professional quality of life and stress levels of nurses, on the satisfaction of cancer patients, and on the perspectives of nurse managers. DATA SOURCES: An experimental embedded mixed-methods design was conducted between December 20, 2022, and February 20, 2023. The study included 15 oncology-hematology nurses, 19 cancer patients, and 6 nurse managers. Qualitative interviews were conducted with patients and pre-tests were applied to patients and nurses. The Compassion Fatigue Resiliency Program was implemented for the nurses. Then qualitative interviews were repeated with the same patients; focus group interviews were conducted with the nurse managers; post-tests were applied to patients and nurses who participated in the training; and narrative feedback was collected. Quantitative data analysis was carried out using the Wilcoxon signed-rank test. Qualitative data were processed using an inductive approach to thematic analysis. CONCLUSION: Compassion satisfaction decreased after the Compassion Fatigue Resiliency Program. Qualitative results showed that the training program improved nurses' effective communication skills and ability to cope with stress. The program improved nurses' approach to patients and communication, and patients' care satisfaction levels increased. IMPLICATIONS FOR NURSING PRACTICE: The Compassion Fatigue Resiliency Program should be included in hospital in-service training programs and implemented and sustained. With this, compassion fatigue of nurses can be reduced or prevented, which will help to avoid the nurse shortages that already existing and increasing.

Medical errors room: The effect of simulation training on increasing the awareness of nursing students about the medical errors they may encounter in psychiatry clinics.

AIM: This study aimed at investigating the effect of simulation training on increasing the awareness of nursing students about medical errors they may encounter in psychiatry clinics. METHODS: This study was quasi-experimental and included pre-test and post-test control groups. The intervention group (n = 41) was provided with "Medical Errors Room" simulation training while the control group (n = 41) was trained by using the presentation method. RESULTS: Considering the increase in the awareness of all students about medical errors, it was determined that the awareness of the students in the intervention group was higher than the students in the control group (p < 0.05). CONCLUSION: It was concluded that with the "Medical Error Room" simulation training, the awareness of nursing students, who will be among the health professionals of the future, about medical errors can be increased.

The effect of a nurse-led intervention program on compassion fatigue, burnout, compassion satisfaction, and psychological distress in nurses: A randomized controlled trial.

PURPOSE: This study evaluated the effect of a nurse-led intervention program on compassion fatigue, burnout, compassion satisfaction, and psychological distress in nurses. DESIGN AND METHODS: A randomized controlled trial was conducted. A total of 48 clinical nurses were randomly allocated to intervention or control groups. The nurse-led intervention program was based on a cognitive-behavioral approach. The study outcomes were compassion fatigue, burnout, compassion satisfaction, and psychological distress. FINDINGS: It was determined that the psychological distress scores of the nurses participating in the program at the first follow-up were significantly lower than the control group. There was no significant difference between the groups in terms of compassion fatigue, burnout, and compassion satisfaction. PRACTICAL IMPLICATIONS: To reduce the psychological distress of nurses, cognitive behavioral approach-based programs can be useful.

Examination of risk assessment tools developed to evaluate risks in mental health areas: A systematic review.

The purpose of this research was to identify and examine risk assessment tools evaluating at least two risk dimensions to evaluate the risk assessments of patients in mental health areas in a more comprehensive and standard manner. This systematic review was prepared according to the PRISMA guidelines. The databases to be scanned and the keywords to be entered were identified before scanning the literature. The keywords risk assessment, risk management, mental health, psychiatry, risk assessment scales, and risk assessment tools were scanned. The CINAHL, EMBASE, PsycInfo, Medline, APA PsycNET, Science Direct, Pubmed, ProQuest, and Google Scholar databases were searched. All full-text articles published between December 30th, 1970, and January 1st, 2020, were examined. A total of 7385 papers were investigated using the keywords listed above, and 18 studies meeting the inclusion criteria were identified. The tools involved were SPC, FACE, Clinical Risk Management, Threshold Assessment Grid, Risk Assessment for People with Mental Health Problems, Psychogeriatric and Risk Behavior Assessment Scale, Sainsbury Risk Assessment Tool, Risk Assessment Management and Audit Systems, Generic Integrated Risk Assessment for Forensic Environments, FRAME, Brief Risk Assessment, Clinical Assessment of Risks to Self & Others, RIO, The Risk Assessment and Management, Risk Assessment and Management Self-Efficacy Study, Galatean Risk and Safety Tool, Short-Term Assessment of Risk and Treatability, and Psychiatric Risk Assessment Scale.

Post-Traumatic Growth in the Early Survival Phase: From Turkish Breast Cancer Survivors' Perspective.

OBJECTIVE: The purpose of this descriptive phenomenological study was to explore the nature of post-traumatic growth (PTG) in Turkish breast cancer survivors in the post-treatment first two years. MATERIALS AND METHODS: Semi-structured in-depth interviews were conducted with 13 breast cancer survivors. Data were collected between August 2015 and January 2016 in the medical oncology outpatient clinic of a university hospital in Turkey. RESULTS: Two main themes were identified. They are as follows: making sense of the cancer (questioning life and death and religious meaning) and positive restoring (changes in values and increased coping skills). CONCLUSION: Health care professionals should be aware of these positive changes in the post-treatment period in accordance with aspects of PTG and they should be designed programs directed towards facilitating and enhancing post-traumatic growth in the breast cancer survivors.

After the Psychoeducational Intervention: Turkish Breast Cancer Survivors' Experiences.

OBJECTIVE: To explore breast cancer survivors' life experiences and perceptions about participating in a psychoeducational intervention that aimed at reducing psychological distress and in improvement of the quality of life. MATERIALS AND METHODS: This study was a post-trial qualitative descriptive study. Data were collected at semi-structured interviews three months after the psychoeducational intervention. Interviews were conducted with 32 Turkish breast cancer survivors. Obtained data were analyzed with inductive content analysis. RESULTS: The data were categorized into three themes: personal growth, unmet needs and recommendations about the quality of the psychoeducation. Survivors explained that they had positive changes in their self-concept, view of life and relationships after the psychoeducational intervention. In addition, they mentioned the unmet needs to join support groups and raise public awareness to decrease stigma over breast cancer patients in the society. CONCLUSION: The results of the present study provide new insights into experiences of breast cancer survivors who participated a psychoeducational intervention and provide guidance for attempts to improve survivorship care via psychoeducation to professionals. Psychoeducational interventions should be continuously offered to provide psychosocial support for breast cancer survivors. Future research into psychoeducation for breast cancer survivors should be restructured to involve social support.

Fear of Recurrence in Turkish Breast Cancer Survivors: A Qualitative Study.

PURPOSE: Fear of recurrence (FOR) of cancer is a distressing symptom and can negatively affect breast cancer survivors' quality of life and psychological well-being. The purpose of this qualitative study was to explore Turkish breast cancer survivors' experiences related to FOR. DESIGN: The data were collected through semistructured interviews, which were conducted with 12 breast cancer survivors. RESULTS: The data were categorized into four themes: the quality of fear, triggers, effects on life, and coping. FOR survivors' lives in multiple aspects, and the women found it difficult to manage their fear. IMPLICATIONS: Nurses should be aware of FOR in survivors during follow-up care. In addition, it is essential to consider the impact of FOR on life, and survivors should be referred to appropriate resources and support services.

Secondary traumatic stress experiences of nurses caring for cancer patients.

AIM: The aim of this study was to explore secondary traumatic stress experiences of nurses caring for cancer patients. METHODS: A qualitative descriptive approach was taken in the study. The team conducted semi-structured in-depth interviews with 13 oncology nurses. We evaluated the responses collected using content analysis. RESULTS: Three distinct themes emerged from the interviews: cycle of desperation, coping, and change. CONCLUSION: Based on the results obtained, it is suggested that programs containing cognitive restructuring techniques be developed; peer support groups may enable senior nurses to guide inexperienced nurses.

Effect of a nurse-led intervention programme on professional quality of life and post-traumatic growth in oncology nurses.

AIM: To evaluate the effects of a nurse-led intervention programme on compassion fatigue, compassion satisfaction, and burnout, which are indicators of the professional quality of life and post-traumatic growth of oncology nurses. METHOD: The study was designed in a single group with pre-test and post-test comparisons. The nurse-led intervention programme was carried out in two face-to-face sessions and two counselling follow-up sessions by phone with 43 nurses who care for oncology patients at a university hospital. The nurse-led intervention sessions consisted of a lecture on a relevant topic, background reading, baksi dance and mandala painting; motivational text messages and counselling. The Professional Quality of Life-IV Scale and the Post-Traumatic Growth Inventory were used, and data were evaluated using the "paired groups t test" analysis. Data for the study were acquired between March and April 2016. RESULTS: The evaluation carried out before and 5 weeks after the intervention showed that compassion fatigue and burnout decreased, while compassion satisfaction and all subscales scores of post-traumatic growth inventory increased. CONCLUSION: This nurse-led intervention programme was effective in improving the professional quality of life and post-traumatic growth of oncology nurses.

Home-Based Psychoeducational Intervention for Breast Cancer Survivors.

BACKGROUND: It is important to manage psychological distress and improve the quality of life (QOL) in patients after breast cancer treatment. OBJECTIVE: The aim of this study was to evaluate the effects of a home-based, psychoeducational program on distress, anxiety, depression, and QOL in breast cancer survivors. METHODS: The study was a single-group pretest and posttest quasi-experimental design. The data were collected using the Distress Thermometer, the Hospital Anxiety and Depression Scale, and the Turkish version of the World Health Organization Quality of Life Instrument, short form. The home-based, individual, face-to-face psychoeducational program was structured according to breast cancer survivors' needs and the Neuman Systems Model. RESULTS: A total of 32 Turkish breast cancer survivors participated in this study. There were statistically significant differences in the mean scores for distress, anxiety, and depression in the breast cancer survivors over 4 measurements. The mean scores for all subscales of the QOL at 6 months postintervention were significantly higher than the mean scores at baseline. CONCLUSIONS: The results indicated that the psychoeducational program may be effective in reducing distress, anxiety, and depression and in improving the QOL in breast cancer survivors. IMPLICATIONS FOR PRACTICE: Psychoeducational programs may be effective and should be considered as part of the survivorship care for breast cancer survivors.

Experiences of Newly Diagnosed Breast Cancer Patients in Turkey.

PURPOSE: The purpose of this qualitative study is to describe the experiences of women in Turkey during the diagnostic phase of breast cancer. DESIGN: In the research, the phenomenological approach was used. The data were collected through semistructured in-depth interviews. The sample comprised nine breast cancer patients in the diagnostic phase. RESULTS: The data were categorized into four themes: facing the breast cancer diagnosis, uncertainty, avoidance, and holding on to life. Women experience intense uncertainty about the disease, treatment, and social relationships and thus exhibit avoidance behavior. IMPLICATIONS: Nurses should be aware of psychosocial difficulties suffered during the diagnostic phase and provide care for patients. It is important that nurses provide information about the diagnostic phase to women with breast cancer and encourage them to ask questions and express their feelings.

Work stress and emotional exhaustion in nurses: the mediating role of internal locus of control.

BACKGROUND: Burnout is a major problem for nursing. There is a strong relationship between work stress and emotional exhaustion. Although studies report a negative correlation between the internal locus of control and emotional exhaustion and work stress, the number of studies available on the subject is limited. PURPOSE: This study intends to examine the extent to which the relationship between work stress and emotional exhaustion is mediated by nurses' internal locus of control. METHODS: The study adopted a cross-sectional survey design. The data were analyzed using structural equation modeling techniques. The study sample consisted of 347 nurses who worked in a university hospital in Izmir, Turkey and who agreed to participate in the study. The Work-Related Strain Inventory was used to evaluate the nurses' work stress level, Maslach Burnout Inventory was used to evaluate their emotional exhaustion levels, and the Locus of Control Scale was used to evaluate the internal locus of control. The variables of the study were based on the Neuman Systems Model. RESULTS: Work stress was positively related to internal locus of control (ß3 = .21, p < .001), which was, in turn, negatively associated with emotional exhaustion (ß = -.03, p > 0.1). Internal locus of control was negatively related to emotional exhaustion (ß = -.14, p < .001). Work stress is directly (ß = .87, p < .001) and indirectly related to emotional exhaustion (mediated by internal locus of control ß = .84, p < .001). Work stress is directly (ß = .87, p < .001) and indirectly related to emotional exhaustion (mediated by internal locus of control, ß = .84, p < .001). CONCLUSION: Although the relationship between emotional exhaustion and work stress was mediated, the impact of internal locus of control was limited. It is recommended that different variables be included in future studies so that they can mediate the relationship between work stress and emotional exhaustion.

Breast Cancer and Posttraumatic Growth.

The current methods for early diagnosis and increased treatment options have improved survival rates in breast cancer. Breast cancer diagnosis effects individuals in physical, psychological and social dimensions either positively or negatively. In the literature, usually the negative effects encountered in the period after the diagnosis of breast cancer are mostly described, with limited data on the positive effects. Nevertheless, the identification of positive changes and defining its determinants is important in supporting and strengthening posttraumatic growth in this group. The objective of this review is to explain posttraumatic growth and its determinants in breast cancer during the post-treatment period in accordance with the relevant literature. In our evaluation, it was noticed that breast cancer survivors experience posttraumatic growth in the post-treatment period, but the literature is limited in explaining the nature of posttraumatic growth and its determinants. Both qualitative and quantitative research that will provide in-depth information on the subject, explaining culture-specific posttraumatic growth and related factors, are required.

Experiences of Turkish women with breast cancer during the treatment process and facilitating coping factors.

BACKGROUND: Breast cancer is the most common type of cancer among women in Turkey and around the world. Treatment adversely affects women's physical, psychological, and social conditions. The purpose of this study was to identify the experiences of Turkish women with breast cancer and the facilitating coping factors when they receive chemotherapy. METHODS: A phenomenological approach was used to explain the experiences and facilitating factors of breast cancer patients during the treatment period. Data were collected through individual semi-structured interviews. The sample comprised 11 women with breast cancer receiving treatment. RESULTS: At the end of the interviews conducted with women with breast cancer, two main themes were identified: adjustment and facilitating coping factors. The adjustment main theme had two sub-themes: strains and coping. Women with breast cancer suffer physical and psychological strains as well as stress related to social and health systems. While coping with these situations, they receive social support, turn to spirituality and make new senses of their lives. The facilitating coping factors main theme had four sub-themes: social support, disease-related factors, treatment-related factors and relationships with nurses. It has been determined that women receiving good social support, having undergone preventive breast surgery and/or getting attention and affection from nurses can cope with breast cancer more easily. CONCLUSIONS: Women with breast cancer have difficulty in all areas of their lives in the course of the disease and during the treatment process. Therefore, nurses should provide holistic care, teaching patients how to cope with the new situation and supporting them spiritually. Since family support is very important in Turkish culture, patients' relatives should be informed and supported at every stage of the treatment.

Identifying an optimal treatment for schizophrenia: a 2-year randomized controlled trial comparing integrated care to a high-quality routine treatment.

OBJECTIVE: This study used repeated outcome measures over a 2-year period to compare the clinical and social benefits of routine schizophrenia treatment with those of evidence-based pharmacological and psychosocial treatment strategies. METHOD: One hundred patients who were diagnosed with schizophrenia according to DSM-IV criteria were randomly assigned to 24 months of either optimal case management (OCM) or routine case management (RCM). OCM involved minimally effective doses of antipsychotic medication with compliance training, an identical treatment programme with the addition of manual-based communication and problem solving training to help patients and caregivers manage stress, social skills training, supported employment, cognitive-behavioural strategies for residual psychotic and non-psychotic symptoms, as well as anger management and substance use counselling. RCM involved minimally effective doses of antipsychotic medication with compliance training, the monitoring of side effects, education about schizophrenia and its optimal treatment, detection of early warning signs and supportive psychotherapy to address practical problems. The symptoms, impairment, disability, unmet needs, quality of life of the patients were examined by blinded researchers every 6 months. RESULTS: Statistically and clinically significant advantages were observed for OCM versus RCM on all measures. Most of these advantages increased throughout the 24-month period. CONCLUSIONS: This study helps demonstrate the importance of psychosocial interventions in the treatment of schizophrenia. Recent advances in evidence-based psychosocial strategies can be implemented into routine clinical practice with additional clinical and social benefits.

Conceptualization of burnout from the perspective of the Neuman systems model.

Due to an incomplete match between Neuman's definition of the core response and proposed examples, the core response has been interpreted as solely physiological in nature. As a result, the majority of Neuman systems model-based research has focused on either identification of stressors or the relations between stressors, the flexible line of defense, and normal line of defense invasion while the core response has been largely neglected. The purpose of this paper is to argue for a broader conceptualization of the core response as any and/or all of the person variables proposed by Neuman. The burnout process, which is both psychological and spiritual in nature, was developed as a core response exemplar.

Examination of the effect of education about electroconvulsive therapy on nursing practice and patient satisfaction.

INTRODUCTION: Electroconvulsive therapy (ECT) procedures require the work of a multidisciplinary team that includes an anesthesiologist, a psychiatrist, and a treatment nurse. Electroconvulsive therapy is treated like a minor surgical procedure that requires preoperative preparation and postoperative care. AIM: This research was conducted as a quasi-experimental study for the purpose of evaluating the effect of education about ECT given to nurses who work on a psychiatric ward. SAMPLE: The research pretest sample was composed of 52 ECT procedures in which nurses participated in managing that were conducted between April and October 2006 on the psychiatric ward of Dokuz Eylül University Hospital. The posttest sample was composed of 52 ECT procedures in which nurses participated in managing that were conducted between January and March 2007 on the same psychiatric ward. DATA COLLECTION TOOL: The observation form for the determination of nursing care in ECT and satisfaction form, which were developed by the researcher from expert opinion, were used for data collection. Data obtained were analyzed using the test for significance between 2 means. RESULTS: The nurses included in the research received a total score of 4 for nursing care in ECT procedure before education and X = 11.5 after education. The difference in the mean scores for nursing care in ECT procedure before and after education was found to be statistically significant (P < 0.05). The mean score for patient satisfaction with nursing care in ECT procedure before education was X = 2.5 and that after education was X = 4.1. The difference between the 2 means was found to be statistically significant. CONCLUSIONS: Education given to nurses about ECT improved nursing practice and increased patient satisfaction. For this reason, it is recommended that nursing care in ECT continuing education be planned and given at regular intervals.