Purposes/Aims: This study described the unique relationships that develop while providing cancer care to American Indian (AI) populations and the underlying meaning that nurses ascribed to these experiences. Rationale/Conceptual Basis/Background: The establishment of caring relationships in order to provide high quality cancer care is particularly challenging for nurses who engage with ethnic minority populations as they contend with cultural and contextual influences different from those found in the majority population. AIs represent an Indigenous minority group in the U.S. facing a considerable cancer care inequity. Nurses who care for AI patients frequently encounter population-specific issues that impact the caring dynamic, yet their experiences and the meaning they ascribe to them are largely unknown. Methods: This was an interpretive phenomenological study with iterative data collection and analysis. Nine cancer care nurses with a minimum of three years of experience working with AI patients participated by engaging in 2-3 exploratory, open-ended, reflective interviews over a period of 9 months. Thematic reduction was completed to explicate the fundamental structures of nurse-patient relationships during cancer care. Phenomenological and hermeneutical reflective writing resulted in linguistic transformation illuminating the essential meaning for nurses within this patient-nurse phenomenon. Results: Findings include individually-situated wholistic descriptions capturing the existential experiences of each of the participants. Reduction of individually-situated themes into seven shared meta-themes included From Task to Connection; Unnerving Messaging; We Are One; the Freedom of Unconditional Acceptance; Attuning and Opening; Atoning for the Past, One Moment at a Time; and Humanizing the Inhumane. Themes were explicated in a comprehensive general structural description followed by the reconstitution of the data and self-reflection into a deeply introspective essential description, suggesting that the meaning of the AI patient-cancer care nurse relationship was expressed in contradictory yet simultaneous patterns of joy and sorrow; ease and difficulty; obligation and vocation. From one moment to the next, nurses sought synchronicity with their patient as they danced to a life rhythm that revealed and concealed; enabled and limited; connected and separated. Being in relationship provided nurses great purpose within the universal human context of caring. Implications: Results contribute to the development of interventions designed to improve both the AI cancer care experience and the support and training of the nurses who serve this population. Refinement of our praxis will result in improved outcomes for both nurses and AI patients, reflecting the inseparability of the two entities within the cancer care relationship. The complimentary and mutually dependent nature of the patient-nurse relationship implies that strengthening and improving support for one entity may in turn positively impact the other. Further research into the AI patient’s perspective of their relationships with cancer care nurses is called for.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/622966 |
| Date | January 2016 |
| Creators | Pool, Natalie Mae, Pool, Natalie Mae |
| Contributors | Koithan, Mary S., Koithan, Mary S., Rosenfeld, Anne G., Colombi, Benedict, Kahn-John, Michelle, Stauber, Leah S. |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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