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Factors influencing nurses’ attitudes towards caring for dying patients in oncology settings in the Western Cape MetropoleDe Kock, Freda 03 1900 (has links)
Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The National Cancer Association of South Africa estimates that over 80,000 of
South Africans currently die from cancer each year, whilst statistics show an
increase in newly diagnosed cancer cases. Despite an improvement in cure
rates, cancer, because of its association with pain, suffering and death, still
affects human beings in their totality. It has been demonstrated that effective
psychosocial care, as provided by oncology nurses, improve the outcomes for
cancer patients. Therefore, nurses’ attitudes towards caring for patients that are
dying are of vital importance to the quality of care provided to these patients.
Attitudes towards caring for patients that are dying may be influenced by the
demographic factors of oncology nurses, such as age, workplace and years of
experience in oncology. It may also depend on the degree of work satisfaction
and by the nature of the work environment, particularly regarding the level of
support being offered to the nurse. The purpose of this study hence was to
explore the influences of demographic and work environment factors on nurses’
attitudes towards caring for patients that are dying in oncology settings in the
Western Cape Metropole. The objectives of this study were to determine
oncology nurses’ attitudes towards caring for patients that are dying, to
determine the degree of work satisfaction experienced by these nurses, to
determine the perceived supportive nature of their work environments, and to
establish and examine any relationships between oncology nurses’ attitudes
towards caring for patients that are dying and demographic factors, work
satisfaction and a supportive work environment. This study was theoretically
underpinned by Paterson and Zderad’s (quoted in Praeger, 2002) humanistic
nursing theory and Peplau’s (quoted in Belcher & Brittian Fish, 2002)
interpersonal relations in nursing theory, because of their relevance to palliative
care. A quantitative research approach, with a descriptive design, was selected
to conduct the study. The target population was all the oncology nurses, caring
for patients that are dying in palliative and oncology settings in the Western
Cape Metropole. A convenience sample of 127 oncology nurses was selected
in three different, but typical oncology settings, namely a state hospital, a private hospital and three hospices. Data was collected by means of a selfreporting
questionnaire. A pilot study was done, in order to assure the validity
and reliability of the data collection instrument. Ethical approval was obtained in
advance from the Ethical Research Committee of the Faculty of Health
Sciences of the University of Stellenbosch. Written consent was obtained
beforehand from the managers of the three oncology settings where the
research was conducted, as well as from the participants.
The main findings of this study were that the majority of the respondents
displayed positive attitudes towards caring for patients that are dying. In
addition, most of the respondents experienced a high degree of work
satisfaction and also regarded their work environments as supportive.
Significant relationships were found between positive attitudes towards caring
for patients that are dying and:
• hospice settings;
• higher age and;
• rank of the professional nurse.
The overall recommendation that was made was that continuing education in all
aspects of palliative care be regarded as an essential strategy in maintaining
and further enhancing positive attitudes amongst oncology nurses towards
caring for patients that are dying. In addition, coping strategies needed to be
widely implemented to help oncology nurses cope with their emotions and
anxieties. / AFRIKAANSE OPSOMMING: Die Nasionale Kankervereniging van Suid-Afrika beraam dat meer as 80,000
Suid-Afrikaners huidig jaarliks aan kanker sterf, terwyl statistieke ‘n toename in
die aantal nuwe gevalle van kanker toon. Ten spyte van ‘n toename in die
sukses van behandeling, beïnvloed kanker, weens sy assosiasie met pyn,
lyding en die dood, steeds die mens in sy totaliteit. Dit is bewys dat effektiewe
psigososiale versorging deur onkologiese verpleegkundiges die uitkomstes van
pasiënte met kanker verbeter. Daarom is die ingesteldhede van
verpleegkundiges, jeens die versorging van pasiënte wat sterwend is, van
kardinale belang in die kwaliteit van versorging wat aan hierdie pasiënte gebied
word. Sodanige ingesteldhede mag deur demografiese faktore, soos ouderdom,
werkplek, en jare ondervinding in onkologie, beїnvloed word. Dit mag ook van
die mate van werksbevrediging en van die aard van die werksomgewing,
spesifiek met betrekking tot die mate van ondersteuning wat aan die
verpleegkundige gebied word, afhang. Die doel van hierdie studie was dus om
die invloed van demografiese en werksomgewingsfaktore op die ingesteldhede
van onkologiese verpleegkundiges, jeens die versorging van pasiënte wat
sterwend is in onkologiese afdelings in die Wes-Kaapse Metropool, te
ondersoek. Die doelwitte van hierdie studie was om die ingesteldhede van
verpleegkundiges jeens die versorging van pasiënte wat sterwend is te bepaal,
om hulle mate van werksbevrediging te bepaal, om hul persepsie van die
ondersteunende aard van hul werksomgewing te bepaal, en om enige verband
tussen onkologiese verpleegkundiges se ingesteldhede jeens die versorging
van pasiënte wat sterwend is en demografiese faktore, werksbevrediging en
die aard van ‘n ondersteunende werksomgewing te bepaal en te ondersoek.
Hierdie studie is teoreties, vanweë hul relevansie tot palliatiewe sorg, deur
Paterson en Zderad (aangehaal in Praeger, 2002) se humanistiese teorie en
Peplau (aangehaal in Belcher & Brittian Fish, 2002) se interpersoonlike
verhouding in verplegingsteorie, onderskraag. ‘n Kwantitatiewe
navorsingsbenadering, met ‘n beskrywende ontwerp, is gekies om die studie
mee uit te voer. Die populasie het al die onkologiese verpleegkundiges, wat sterwende en palliatiewe pasiënte in kankerafdelings in die Wes-Kaapse
Metropool versorg, ingesluit. ‘n Gerieflikheidsteekproef van 127 onkologiese
verpleegkundiges, in drie verskillende, maar tipiese kankerinstellings, is gekies,
naamlik ‘n staatshospitaal, ‘n privaathospitaal en drie hospitiums. Datainsameling
is deur middel van ‘n self-gerapporteerde vraelys gedoen. ‘n
Loodsstudie is uitgevoer om die geldigheid en betroubaarheid van die vraelys te
verseker. Etiese goedkeuring is vooraf vanaf die Etiese Navorsingskomitee van
die Fakulteit Gesondheidswetenskappe van die Universiteit van Stellenbosch
verkry. Skriftelike toestemming is ook vooraf vanaf die bestuur van die
instellings, waar die navorsing gedoen is, sowel as van die deelnemers verkry.
Die hoofbevindings van hierdie studie was dat die meerderheid van die
respondente positiewe ingesteldhede jeens die versorging van pasiënte wat
sterwend is openbaar het. Boonop het die meeste respondente ’n hoë mate van
werksbevrediging ervaar en hul werksomgewing as ondersteunend beskou.
Beduidende verbande is getrek tussen positiewe ingesteldhede jeens die
versorging van pasiënte wat sterwend is, en:
• versorging in hospitiums;
• hoër ouderdom en;
• rang van professionele verpleegkundige.
Die algemene aanbeveling wat gemaak kon word was dat deurlopende
opleiding in alle aspekte van palliatiewe sorg, as ‘n grondliggende strategie
beskou moet, ten einde positiewe ingesteldhede ten opsigte van die versorging
van pasiënte wat sterwend is onder onkologiese verpleegundiges te behou en
verder aan te moedig. Voorts behoort strategieë geïmplementeer te word om
onkologiese verpleegkundiges te help met die hantering van hul emosionale
behoeftes en vrese.
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