Nurse Moral Distress and Cancer Pain Management

LeBaron, Virginia; Beck, Susan L.; Black, Fraser; Palat, Gayatri

doi:10.1097/ncc.0000000000000136

Cited by 25 publications

(23 citation statements)

References 32 publications

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“…[1622] The challenges and opportunities discussed below are based on interviews and observations collected during 9 months of in-country immersion fieldwork by the first author.…”

Section: Methodsmentioning

confidence: 99%

“…[1622] In brief, the original project was a qualitative, ethnographic study designed to explore the experiences of nurses who care for patients with advanced cancer in India.…”

Section: Methodsmentioning

confidence: 99%

“…The translated interviews were analyzed using a qualitative software program (Dedoose version 4.5.91) to organize the text to answer specific questions and identify the main messages or themes. [16] Field notes were organized chronologically and iteratively analyzed for patterns that confirmed or contradicted interview findings. Field note and interview data were integrated into a narrative account that addressed the a priori research questions.…”

Section: Methodsmentioning

confidence: 99%

“…[1112131415] However, this is not an easy task as nurses who provide cancer care in LMICs face numerous challenges, including an overwhelming volume of highly symptomatic patients, limited access to essential supplies and medications, lack of specialized oncology and palliative care training, and institutional and professional dynamics of power, stigma, and hierarchy that can make the nurse feel disempowered and helpless. [910161718192021]…”

Section: Introductionmentioning

confidence: 99%

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Recommendations to support nurses and improve the delivery of oncology and palliative care in India

LeBaron

Palat

Sinha

et al. 2017

Indian J Palliat Care

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Context:Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training.Aim:The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care.Methods:Qualitative ethnography.Setting:The study was conducted at a government cancer hospital in urban South India.Sample:Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study.Data Collection:Data were collected over 9 months (September 2011– June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews.Analysis:Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns.Results:Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training.Conclusions:Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.

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“…[1622] The challenges and opportunities discussed below are based on interviews and observations collected during 9 months of in-country immersion fieldwork by the first author.…”

Section: Methodsmentioning

confidence: 99%

“…[1622] In brief, the original project was a qualitative, ethnographic study designed to explore the experiences of nurses who care for patients with advanced cancer in India.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Recommendations to support nurses and improve the delivery of oncology and palliative care in India

LeBaron

Palat

Sinha

et al. 2017

Indian J Palliat Care

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“…When the pain is not controlled, relatives are frustrated, and their resentment is usually a source of job dissatisfaction for the medical staff [9].…”

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confidence: 99%

Knowledge and Attitudes of Nurses Working at King Abdulaziz University Hospital toward Cancer Pain Management

Al‐Wassia¹

2016

OJN

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Objective: This survey aims to identify the levels of knowledge and attitudes among nurses regarding cancer pain management. Methods: This cross-sectional survey was undertaken at King Abdulaziz University Hospital, Jeddah, between September 4 and September 27, 2015. The survey instrument was a pre-set questionnaire comprising 39 closed-ended format questions. Participants were asked questions to assess their knowledge and attitudes about cancer pain management and adherence to frequent misconceptions regarding opioid therapy. The chi-square test was used to compare differences between variables. Results: One hundred twenty-eight questionnaires were completed and analyzed. A mean sample score of 41.3% was achieved on pain-related knowledge questions. The average score on all 39 questions was 16.1 ± 4.6 (range, 0 -24). Nurses on the male medical ward were most knowledgeable compared with those on other wards (p < 0.001). They were also most likely to score highest on questions that assessed knowledge of pain management (p < 0.001). Conversely, nurses on the female surgical ward were most likely to score highest on issues related to pain assessment (p < 0.001) and experience in managing breakthrough cancer pain (p < 0.001). Likewise, nurses on the male surgical and female medical wards appeared to be more knowledgeable on issues related to patient compliance (p = 0.002). Conclusion: Optimization of inpatient supportive procedures should be a specific task at King Abdulaziz University Hospital until an oncology unit with nurses specialized in cancer care is established.

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Chasing the Science

Jones-Bonofiglio

2020

The International Library of Bioethics

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Nurse Moral Distress and Cancer Pain Management

Abstract: Improving job-related conditions is prerequisite to creating an environment where MD can manifest. Educational initiatives in LMICs must account for the role of the oncology nurse and their contextual moral and professional obligations.

Cited by 25 publications

References 32 publications

Recommendations to support nurses and improve the delivery of oncology and palliative care in India

Recommendations to support nurses and improve the delivery of oncology and palliative care in India

Knowledge and Attitudes of Nurses Working at King Abdulaziz University Hospital toward Cancer Pain Management

Chasing the Science

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