published_or_final_version / Nursing Studies / Master / Master of Nursing

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Nurses in management and clinical positions in all areas of the country are experiencing role changes due to restructuring within the health care industry. Nurses have an opportunity to embrace and enhance these changes as the trend toward Patient Focused Care continues which entails a restructuring of care delivery at all levels.Oncology nurses are specifically encouraged by the Oncology Nursing Society to mentor other nurses. The purpose of this study was to examine the concept of mentoring as related to oncology nurses who have experienced role changes due to redesigns in the health care delivery systems. The theoretical framework used in this study was Benner's "From Novice to Expert."A convenience sample of 88 oncology nurses were surveyed. The Darling Measuring Mentoring Potential Scale (MMP), a demographic questionnaire, and a cover letter were mailed. Respondent confidentiality was maintained and the procedures for protection of human subjects were followed. A descriptive correlational design was used. The research questions were analyzed using Pearson's correlation coefficient and multiple regression analysis. Means and standard deviation of mentoring characteristics were also obtained on the clustered scores. Findings of the study indicated a small, but significant difference between levels of education, role changes and mentoring potential. Levels of education and role changes accounted for 15% of the differences in mentoring potential scores. However, the mean scores for both the clustered basic and supporting mentoring characteristics were below the suggested scores as suggested for a substantial mentoring relationship.Conclusions from the study were that the concept of mentoring is still not prevalent among oncology nurses and does not play an important role in the professional lives of the respondents. The concept of mentoring needs to be formally addressed in nursing education as well as in hospital staff education and leadership programs. There needs to be continuing research regarding the concept of mentoring within the nursing profession in order to promote the benefits of this concept so that nurses may join with those in other professions to enjoy the products of mentoring. / School of Nursing

Accurate assessment of educational needs is central to the planning of effective patient education programs. Adult learning theory holds that the more agreement that exists in the educator's and the learner's assessment of learning needs, the higher the probability that effective learning will occur. This descriptive survey was carried out to compare the learning needs of cancer patients receiving chemotherapy as perceived by three groups involved in patient education: nurses, physicians, and patients themselves. Using the Assessment of Learning Needs Questionnaire (ALNQ) developed by Lauer, Murphy, and Powers (1982) and demographic data questionnaires developed by the researcher, the perceptions of patients' learning needs held by a convenience sample of 20 lymphoma patients, 24 nurses, and ten physicians were studied. Responses to the rating and ranking scales of the ALNQ were analyzed using nonparametric statistical techniques to determine the existence and location of differences in perceptions among the three groups. General comments about patient education and the ALNQ were gathered from the patient group in an interview setting and from the two care giver groups through responses to two open-ended questionnaire items. Findings revealed that the learning needs of patients undergoing chemotherapy tend to focus on concerns related to the treatment experience, and the knowledge and skills required to cope with the impact of the disease and treatment on their lives. Patients described themselves as most knowledgeable in areas relating to life experience, rather than disease or treatment related areas, and were oriented to survival in their learning needs. The three groups demonstrated considerable similarity in their perceptions of areas problematic to patients and areas in which patients have the most knowledge. However, despite presumed knowledge and expertise in dealing with the concerns of chemotherapy patients, nurses' and physicians' perceptions of patients' learning needs differed from those held by patients. The care givers perceived patients to be more concerned with learning needs related to activities of daily living than patients reported. Implications for nursing practice and education are suggested, and recommendations made for further study. / Applied Science, Faculty of / Nursing, School of / Graduate

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Background: Since the 1980s, Saudi Arabia’s socio economic transformation has led to vast social development. As a result there has been increased adoption of behaviours such as smoking and sedentary life styles, which pose a risk to health. It is anticipated that cancer incidence will double over the next two decades and it is thus vital that high quality of care is provided to meet the growing health care demands. Moreover, it is important that patients are satisfied with their care provision. This thesis begins with a narrative synthesis of the existing literature about patient satisfaction in the Saudi context and beyond. An evaluation of the key concepts for understanding patient satisfaction illuminated the lack of evidence about the assessment of patient satisfaction including specific key domains of the structure and process of care. This evaluation also indicated the need to further investigate the Saudi patient perspectives in oncology hospital setting. The aim of my study was to examine the extent to which clinical effectiveness impacts upon patient satisfaction in oncology ward settings in the Kingdom of Saudi Arabia (KSA). Methods: A sequential explanatory mixed methods design was employed. The Donabedian quality framework (1980) and Patient experience model (Reimann and Strech 2010) were used to assess patient satisfaction with quality of care provided. A quantitative phase was followed by a qualitative phase. In the first phase, the European Organisation for Research and Treatment of Cancer (EORTC) IN-PATSAT32 validated questionnaire was used to collect data from 100 adult oncology inpatients at a Cancer Centre in Riyadh. The second qualitative phase involved semi-structured telephone and face to face interviews with 22 adult oncology inpatients who previously answered the questionnaire. Synthesis occurred at the intersection of quantitative Phase 1 and qualitative Phase 2 data. The qualitative Phase 2 thus further explored the satisfaction scores of quantitative Phase1 to deepen the understanding of patient satisfaction in oncology ward settings in KSA. Findings: The main findings were that patient satisfaction levels are influenced by the clinical effectiveness of doctors and nurses, accessibility to health care and socio-demographic factors. Specifically, the interpersonal aspects of care were deemed core to patient experiences in oncology ward settings in KSA. It emerged that doctor-patient relationships, nurse shortages and language barriers are particular areas where changes could be made to improve care, thereby enhancing patient satisfaction. These findings contribute important new insights into the interpersonal aspects of care in the light of the underlying social and cultural contextual factors that influence patient satisfaction in the KSA. Conclusion: This study has provided new evidence supporting the need for stronger interpersonal relations and a more patient-centred approach in the oncology health system in KSA. In particular, the influential role of cultural issues in influencing patient satisfaction in oncology ward settings was apparent. Evidence provided by this research will make a substantial contribution to policy makers and hospital management teams in the KSA wanting to improve patient satisfaction in oncology wards and in other health care settings.

Dissertation submitted in fulfilment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2012. / Palliative care research in South Africa is at an early stage and there is an increasing need to develop a body of evidence that is relevant to South African conditions. One of the biggest challenges that palliative care in Africa faces is the projected increase in the number of cancer patients in the developing world by 2050, many of whom will need palliative care. There is a concern at present about the integration of oncology and palliative care services in South Africa and whether or not cancer patients are able to access quality palliative care. Palliative care plays an important role in improving quality of life for people and family members affected by life-threatening illness. It pursues its goal by relieving pain and other distressing symptoms in cancer patients and giving psychosocial support to patients and their families. It should begin at diagnosis and continue throughout treatment, follow-up care, and at the end of life in addition to the cancer treatment which is given Aim of the study The aim of this study was to assess the integration of palliative care in the caring of cancer patients in the selected oncology clinics in the eThekwini district in KZN. Methodology A qualitative, explorative, descriptive and contextual research design was used to guide this study. The study was participative in nature and employed a focus group methodology. The participants in this study were professional nurses who were working at the selected sites in the public urban oncology clinics for more than three months. Two focus groups were conducted within one month of each other at selected oncology sites with participation from 16 oncology nurses. Findings Findings indicated that most participants understood palliative care as end of life care when a patient is beyond curative treatment and that it is often the doctor who determines eligibility. Participants also perceived palliative care in terms of different types of medical treatment. The findings indicated nurses only contacted hospices when the patient was at the last stage of their illness, were often not aware of all the hospices in the area, and acknowledged that communication between the oncology clinics and hospices was not good. Some nurses believed that palliative care is also provided in the oncology clinic and that it is not only the hospices that provide palliative care. Only one oncology nurse who participated in the study mentioned that she is trained in palliative care, but they all showed interest in becoming more knowledgeable in this area and improving relationships between oncology clinics and the palliative care team/hospices.