Supporting Cancer Patients With Palliative Care Needs

Abstract

The aim of this study was to examine UK district nurses' perceptions of their role in supporting palliative care cancer patients. Patients with cancer are living longer with the disease. District nurses are the largest UK workforce caring for people with cancer at home, the preferred place of care. Meeting patients' supportive and palliative care needs is complex. Little is known about district nurses' supportive role in the early phase of palliative care. Semistructured interviews were conducted with 34 district nurses. Data were analyzed thematically, with assistance from Atlas/ti. A dominant theme emerging from the interviews was ambiguity in the district nurses' supportive role in early palliative care. District nurses discussed the importance of making contact early on to support cancer patients and their families but had difficulty articulating this "support." Ambiguity, lack of confidence, and perceived skill deficits presented district nurses with dilemmas that were difficult to resolve. District nurses have great potential for meeting cancer patients' supportive and palliative care needs, a potential not currently realized. Education alone is unlikely to improve practice without an understanding of the tensions faced by district nurses in their work. Recognizing and addressing dilemmas in the everyday work of district nurses is central to moving practice forward.

Creating a sense of security in palliative home care: Interviews with public health nurses

“…This was confirmed by research [21], which found that it is crucial to come in at an early stage to establish a good relationship. Establishing a relationship with the patient and relatives early creates the conditions for person-centred care in palliative care.…”

Improving communication with palliative care cancer patients at home – A pilot study of SAGE & THYME communication skills model

“…Other evidence suggests however that DNs lack confidence in communication skills and in assessing cancer patients' psycho-social needs; also that they lack time for this work (Dunne et al, 2005;Aitken, 2006;Addington-Hall et al, 2006;Griffiths et al, 2007).…”

“Doing Good Care”—a study of palliative home nursing care

“…In our study, we found that early contact with the patient is essential and that homecare nurses sometimes contact the patient already in the hospital. Griffiths et al (2007) also showed the importance of an early contact. Yet, Pateman, Wilson, McHugh and Luker (2003) found that patients could experience this early contact as negative.…”

“…Community nursing has shown to offer stimulation and appreciation, especially from patients and relatives, but also a possibility for nurses to use all their professional skills (Dunne et al, 2005;Goodman et al, 1998). However caring for palliative cancer patients in their homes has also been shown to be stressful (Bertero, 2002;Dunne et al, 2005), emotionally burdensome (Griffiths et al, 2007) and causing feelings of powerlessness (de Schepper, Francke & Abu-Saad, 1997). The knowledge of community nurses' role has increased during the last years, but there is a paucity of knowledge on community nurses in palliative home nursing care.…”