Thesis (MS)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Sexuality is one quality of being human. Sexual health must be addressed as a significant and integral element of total health care. Nurses caring for patients with oncology and neuromuscular related disabilities are presented with situations concerning sexual dysfunctions that require judgement, knowledge and sensitivity. Yet, studies have shown that nurses demonstrate low sexual knowledge levels and conservative sexual attitudes. They often neglect this aspect of patient care. The sexual attitudes of nurses may be a significant obstacle to their effective functioning in the field of sexual counseling. This proposed study will investigate sexual attitudes of oncology nurses and rehabilitation nurses. / 2999-01-01

Introduction: Oncology nurses provide end-of-life (EOL) care to their patients daily. Oncology nurses' perceptions regarding how to provide quality care to dying patients could be an important addition to the ongoing research on quality EOL care. The purpose of this study was to determine the impact of specific obstacle and supportive behaviors in EOL care as perceived by hospital-based oncology nurses. This study extended the work of Beckstrand, Moore, Callister, and Bond (2009). Methods: A 69-item questionnaire adapted from previous studies (Beckstrand & Kirchhoff, 2005; Beckstrand, Smith, Heaston, & Bond, 2008) was sent to 1,000 nurses who were members of the Oncology Nursing Society (ONS) and who had provided EOL care to dying oncology patients. Three mailings of the questionnaire yielded 380 usable responses from 907 eligible respondents, which resulted in a 41.9% return rate. Oncology nurses were asked to rate obstacle and supportive items on both size and frequency of occurrence as they related to oncology patients in a hospital setting. Results: Obstacle items which received the three highest perceived impact scores were: (1) dealing with anxious family members, (2) families not accepting what the physician is telling them about the patient's poor prognosis, and (3) being called away from the patient and family because of the need to help with a new admit or to help another nurse care for his/her patients. Supportive behavior items which received the three highest impact scores were: (1) allowing family members adequate time to be alone with the patient after he or she has died, (2) providing a peaceful, dignified bedside scene for family members once the patient has died, and (3) allowing families unlimited access to the dying patient even if it conflicts with nursing care at times. Implications: Oncology nurses are dedicated to providing the best EOL care to their patients and patients' families. This study identified obstacle and supportive behavior items with the largest impact on providing quality EOL care. Recommendations: Results of this research demonstrated the need for more EOL education and guidance in forming teams of nurses, social and palliative care workers, and physicians to support the giving of quality care. Nurses also reported the need for more time to support the dying patient and family.

O presente estudo teve como objeto as condições de trabalho e a saúde dos enfermeiros no contexto organizacional de uma instituição oncológica. A minha experiência profissional em oncologia em uma Instituição, referência em oncologia clínica e cirúrgica, que desenvolve ações no âmbito assistencial, de ensino e pesquisa, possibilitou-me observar o processo de trabalho dos enfermeiros. Verifiquei a incidência freqüente de licenças médicas para tratamento da saúde e a ocorrência de transtornos de ordem física e mental relacionados ao estresse, trabalho em turnos, sobrecarga de trabalho por déficit de recursos humanos, além das dificuldades do enfermeiro em lidar com situações adversas relacionadas ao tratamento de clientes oncológicos. Trata-se de um estudo não experimental, de caráter descritivo, com abordagem quantitativa e aporte qualitativo. Este estudo possibilitou identificar os fatores de risco no trabalho a que estavam expostos os enfermeiros oncológicos, descrevendo as condições do ambiente de trabalho e a percepção dos enfermeiros sobre os problemas de saúde que foram provocados ou agravados pelo trabalho. Concluiu-se que as condições de trabalho podem interferir diretamente na saúde desses profissionais, haja vista que o problemas de saúde apontados pelos enfermeiros estão intimamente ligados ao cuidado realizado por estes profissionais. Dos problemas provocados pelo trabalho, destacam-se: lesão por material pérfuro-cortante (67%), estresse (52%), mudanças de humor (50%), doenças de pele (46%) dores lombares (45%) e depressão (33%). O estudo evidenciou que deve haver um empenho por parte da organização e da própria categoria para reivindicar melhores condições de trabalho com o objetivo de transformar o processo de trabalho, facilitando a realização das atividades relacionadas ao cuidar e da promoção da saúde do cuidador. A conscientização sobre a possibilidade de adoecimento pelo trabalho deve incentivar o profissional na realização de práticas seguras e na utilização de dispositivos de segurança, principalmente pela implementação de medidas preventivas que possam possibilitar um estilo de trabalho mais saudável. / The present study it had as object the conditions of work and the health of the nurses in the context of a oncology institution. My professional experience in oncology in an Institution, reference in clinical and surgical oncology, that develops action in the care scope, of education and research, made possible to observe me the process of work of the nurses, verified the frequent incidence of medical licenses for treatment of the health and the occurrence of related upheavals of physical and mental order to stress it, work in turns, overload of work for deficit of human resources, beyond the difficulties of the nurse in dealing with related adverse situations to the treatment of oncológicos customers. One is about a not experimental study, of descriptive character, with quantitative boarding and arrives in port qualitative. This study work made possible to identify to the factors of risk no the one that were displayed the oncology nurses, describing the conditions do surrounding of dos work and the perception nurses on the health problems that had been provoked or aggravated of work. It was concluded that the work conditions can intervene directly with the health of these professionals, has since the problems of health pointed by the nurses are closely on to the care carried through for these professionals. Of the problems provoked for the work, they are distinguished: Injury for drill-cutting material (67%), stress (52%), mood changes (50%), skin illnesses (46%) lumbar pains (45%)e depression (33%). The study it evidenced that it must have a persistence on the part of the organization and the proper category demanding better conditions of work, with the objective to transform the work process, facilitating the accomplishment of the activities related when taking care of and of the promotion of the health of the caregiver. The awareness on the possibility of sickness for the work must stimulate the professional in the accomplishment of practical insurances and the use of security devices, mainly for the implementation of writs of prevention that can make possible a style of more healthful work.

O presente estudo teve como objeto as condições de trabalho e a saúde dos enfermeiros no contexto organizacional de uma instituição oncológica. A minha experiência profissional em oncologia em uma Instituição, referência em oncologia clínica e cirúrgica, que desenvolve ações no âmbito assistencial, de ensino e pesquisa, possibilitou-me observar o processo de trabalho dos enfermeiros. Verifiquei a incidência freqüente de licenças médicas para tratamento da saúde e a ocorrência de transtornos de ordem física e mental relacionados ao estresse, trabalho em turnos, sobrecarga de trabalho por déficit de recursos humanos, além das dificuldades do enfermeiro em lidar com situações adversas relacionadas ao tratamento de clientes oncológicos. Trata-se de um estudo não experimental, de caráter descritivo, com abordagem quantitativa e aporte qualitativo. Este estudo possibilitou identificar os fatores de risco no trabalho a que estavam expostos os enfermeiros oncológicos, descrevendo as condições do ambiente de trabalho e a percepção dos enfermeiros sobre os problemas de saúde que foram provocados ou agravados pelo trabalho. Concluiu-se que as condições de trabalho podem interferir diretamente na saúde desses profissionais, haja vista que o problemas de saúde apontados pelos enfermeiros estão intimamente ligados ao cuidado realizado por estes profissionais. Dos problemas provocados pelo trabalho, destacam-se: lesão por material pérfuro-cortante (67%), estresse (52%), mudanças de humor (50%), doenças de pele (46%) dores lombares (45%) e depressão (33%). O estudo evidenciou que deve haver um empenho por parte da organização e da própria categoria para reivindicar melhores condições de trabalho com o objetivo de transformar o processo de trabalho, facilitando a realização das atividades relacionadas ao cuidar e da promoção da saúde do cuidador. A conscientização sobre a possibilidade de adoecimento pelo trabalho deve incentivar o profissional na realização de práticas seguras e na utilização de dispositivos de segurança, principalmente pela implementação de medidas preventivas que possam possibilitar um estilo de trabalho mais saudável. / The present study it had as object the conditions of work and the health of the nurses in the context of a oncology institution. My professional experience in oncology in an Institution, reference in clinical and surgical oncology, that develops action in the care scope, of education and research, made possible to observe me the process of work of the nurses, verified the frequent incidence of medical licenses for treatment of the health and the occurrence of related upheavals of physical and mental order to stress it, work in turns, overload of work for deficit of human resources, beyond the difficulties of the nurse in dealing with related adverse situations to the treatment of oncológicos customers. One is about a not experimental study, of descriptive character, with quantitative boarding and arrives in port qualitative. This study work made possible to identify to the factors of risk no the one that were displayed the oncology nurses, describing the conditions do surrounding of dos work and the perception nurses on the health problems that had been provoked or aggravated of work. It was concluded that the work conditions can intervene directly with the health of these professionals, has since the problems of health pointed by the nurses are closely on to the care carried through for these professionals. Of the problems provoked for the work, they are distinguished: Injury for drill-cutting material (67%), stress (52%), mood changes (50%), skin illnesses (46%) lumbar pains (45%)e depression (33%). The study it evidenced that it must have a persistence on the part of the organization and the proper category demanding better conditions of work, with the objective to transform the work process, facilitating the accomplishment of the activities related when taking care of and of the promotion of the health of the caregiver. The awareness on the possibility of sickness for the work must stimulate the professional in the accomplishment of practical insurances and the use of security devices, mainly for the implementation of writs of prevention that can make possible a style of more healthful work.

Compassion fatigue is viewed as a disconcerting issue facing healthcare professionals in the clinical care milieu, and nurses are identified as the most susceptible population among healthcare professionals. The purpose of this project was to create positive social change by helping oncology nurses find ways to enhance self-care and self-awareness, thereby reducing the risk of compassion fatigue and burnout among healthcare professionals. This project investigated an educational module on compassion fatigue that focused on (a) identifying the occurrence rates of compassion fatigue among oncology nurses, (b) evaluating the demographic features that were associated with the most frequent rates of compassion fatigue, and (c) educating nurses about ways to decrease or alleviate this problem. The 5 participants for this project included oncology nurses working at a healthcare facility in east Texas. The project was conducted using a quantitative methodology with a descriptive design. Data were collected using a structured questionnaire consisting of 5 Likert-type items. The analysis of the information received shows the high levels of compassion fatigue among nurses include (a) staff shortages that require working for long hours under unusual strenuous conditions, such as shifts lasting more than 12 hours without allotted breaks; (b) wearing heavy protective gear that results in a number of adverse reactions; and (c) the fear of contracting the potentially fatal diseases and/or bringing such illnesses back to the families of staff members. The outcome of the project consisted of an education module for oncology nurses that provide information about issues related to compassion fatigue, and compassion satisfaction. Positive social change may occur by improving the quality of patient care and self-transcendence for healthcare professionals.

In attempting to give more years of life to cancer patients, their Quality of Life (QoL) during this time has frequently been compromised. Assessment of patients’ QoL provide nurses with an opportunity to know about the whole range of patients’ needs and desires. These information would be potentially very useful for health care professionals particularly nurses for planning, conducting and evaluating the nursing care of cancer patients. Questionnaire survey research carried out in countries other than Australia identified a varied amount of agreement between cancer patients and nurses about cancer patients’ QoL. However, based on the literature review, no research study has been found in Australia that provides a detailed understanding of how nurses and cancer patients are similar or different in their perceptions of cancer patients’ QoL. A research study, therefore, was conducted to answer the following key questions: (a) what differences and/or similarities are there between patients’ and nurses’ perceptions of cancer patients’ QoL; (b) why do these differences and/or similarities exist? A research study with a mixed approach was undertaken to answer the research questions. In the first phase, a survey by questionnaire was conducted. The main aims were to identify: (a) the level of agreement between cancer patients’ and nurses’ scores on the World Health Organisation’s Quality of Life Brief questionnaire (WHOQoL-BREF); and (b) variables that may influence the level of agreement between them. Each patient and nurse was invited to complete the WHOQoL-BREF questionnaire, which was considered as an appropriate tool for evaluating cancer patients’ QoL. This questionnaire considers QoL across four domains or dimensions: physical, psychological, social relationship and environmental. In the first phase of the study, 166 cancer patients and 95 nurses were recruited from three major hospitals in Adelaide, South Australia. The patients had a range of cancer diagnoses with breast cancer being the most prevalent. Most patients were being treated as inpatients with chemotherapy being their primary treatment. The mean age of nurses was approximately 37 years and their clinical experience with cancer patients averaged approximately eight years. Intraclass Correlation Coefficient (ICC) between patients’ and nurses’ scores ranged from ‘poor’ in the social relationship and psychological domains up to ‘moderate’ in the physical domain indicating that generally nurses were different in their perceptions from those of cancer patients. Another major finding of this phase was that nurses underestimated cancer patients’ QoL in the social relationship and environmental aspects, which consisted of more personal and private issues. Having finished the first phase, the second phase was conducted based on the principles of a classical version or mode of grounded theory. The aim here was to include an interpretive perspective and explore the reasons why nurses may differ in their perceptions about cancer patients’ QoL in comparison to cancer patients. In this phase, three cancer patients and 10 nurses took part in semi-structured interviews. Participants were selected from different inpatient and outpatient oncology services and a palliative setting. Differences in patients’ and nurses’ perceptions about cancer patients’ QoL and their implications for nursing clinical practice were discussed further in the light of six important categories found in the second phase including: QoL meanings, QoL aspects, Cues-based QoL assessment; Purpose-based QoL assessment; Facilitators of QoL assessment; and Barriers to QoL assessment. It emerged that QoL has individualised meanings and nurses generally have difficulties understanding their patients’ personal perspective or definition of QoL. Another interpretive outcome that may explain why nurses differed in their perceptions when compared with cancer patients is that nurses’ assessment of cancer patients’ QoL in oncology wards is mainly made during their interaction with patients when providing care. Such an assessment has a focus on physical cues and may not facilitate nurses developing a more holistic picture of cancer patients’ QoL. Participants in the interpretive phase indicated that time limitations, focus on care tasks, and discontinuity of care, all work against nurses developing a more accurate understanding of cancer patients’ QoL. Conversely, it was found that building a relationship and stronger rapport with patients is the main facilitator in improving nurses’ understanding of cancer patients’ QoL.

Thesis (M. (Nursing)) -- University of Limpopo, 2022 / Caring for terminally ill cancer patients is considered stressful and heartbreaking. Oncology nurses often consider leaving the nursing profession because of the high levels of stress experienced by these health care professionals. The aim of this study was to investigate the experiences and the practices of nurses who care for terminally ill cancer patients in the Pietersburg Provincial Hospital in the Capricorn District of the Limpopo Province. The objectives of this study were to explore and describe the experiences and practices of nurses who care for terminally ill cancer patients and further to describe the relationship between certain demographic variables and nurses’ experiences of death. An additional objective was to develop recommendations and strategies that might assist management of the Pietersburg Provincial Hospital with the development of appropriate skills and the implementation of emotional support that could assist nurses who care for dying cancer patients in the oncology wards. The study followed a phenomenological, descriptive, exploratory and contextual research design, which assisted the researcher to describe and explore the experience and practices of nurses caring for terminally ill cancer patients. Semi-structured interview method was used to collect data, making use of an interview guide, was used because it is a more free-flowing approach, with its structure being limited only by focusing on the research. Field notes were captured during the data collection session by the researcher. A voice recorder was used to capture all the interview sessions. The initial data analysis started with the researcher listening to the recordings and transcribing verbatim all statements made by the participants. Tesch’s open coding data analysis method was used by following the proposed eight steps to analyse qualitative data as outlined in Creswell (2013). Ethical standards as set in Babbie (2013) were adhered to by the researcher. The researcher requested permission to conduct the study from the Limpopo Department of Health Ethics Research Committee and informed consent was obtained from the participants before collecting data. Privacy of the participants was ensured as participants were never called by their names. In the study participants shared different views with respect to caring for dying cancer patients. Some participants regarded caring for cancer patients as stressful and heartbreaking. Other oncology nurses blamed the management for not providing them with courses to assist them with caring for dying cancer patient, nor providing debriefing sessions for them. On the other hand, some oncology nurses believed that relocating to other wards was a better solution. The participants suggested the following improvements for caring for dying cancer patients; oncology nurses should be offered short courses to assist them with the challenges that they come across with regard to caring for dying cancer patients. Oncology nurses need support from the management and colleagues in order to cope with the workload. Oncology nurses need psychological assistance to help them with the psychological stressors they experience. Family members and patients need health education on how to deal anticipatory grief. / University of Limpopo