School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong.
School of Optometry, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong.
PLoS One. 2018 Jun 18;13(6):e0199183. doi: 10.1371/journal.pone.0199183. eCollection 2018.
The nursing shortage and its impact on patient care are well-documented global issues. Patients living with cancer as a chronic illness have many psychosocial problems and often lack adequate support as a result of ineffective nurse-patient communication. A review of the literature on factors influencing the delivery of psychosocial care to cancer patients indicates that the delivery of psychosocial care in routine cancer nursing within a biomedical healthcare system has not been widely explored.
To explore patients' perceptions of their experiences with nurse-patient communication in an oncological clinical environment.
A focused ethnographic study was undertaken in two oncology wards of a hospital in Hong Kong. Data were collected through observations of the ward environment, the activities and instances of nurse-patient communication, semi-structured interviews with patients, and a review of nursing documents.
Two main themes were identified: 1. Nurses' workload and the environment and 2. Nurse-patient partnership and role expectations. Within these two themes were related subthemes on: Sympathy for the busy nurses; Prioritizing calls to the nurses; Partnership through relationship; Nurses' role in psychosocial care; and Reduction of psychosocial concerns through physical care.
Many cancer patients do not expect to receive psychosocial care in the form of emotional talks or counseling from busy nurses, but appreciate the attention paid by nurses to their physiological and physical needs. Nurse-patient partnerships in cancer care may reduce the potential workload of nurses. The psychosocial needs of cancer patients could be optimized by providing good physical care through effective communication within a time-constrained oncology setting.
护理人员短缺及其对患者护理的影响是全球公认的问题。患有癌症等慢性病的患者存在许多心理社会问题，由于护士与患者之间沟通不畅，往往得不到足够的支持。对影响为癌症患者提供心理社会关怀的因素的文献进行回顾表明，在生物医学医疗体系中，常规癌症护理中的心理社会关怀提供情况尚未得到广泛探讨。
探讨患者对肿瘤临床环境中护士与患者沟通体验的看法。
在香港一家医院的两个肿瘤病房进行了一项聚焦民族志研究。通过观察病房环境、护士与患者沟通的活动和实例、对患者的半结构化访谈以及护理文件的审查来收集数据。
确定了两个主要主题：1. 护士的工作量和环境；2. 护士-患者伙伴关系和角色期望。在这两个主题中，还涉及到相关的子主题：对忙碌护士的同情；优先给护士打电话；通过关系建立伙伴关系；护士在心理社会关怀中的角色；通过身体护理减轻心理社会问题。
许多癌症患者并不期望从忙碌的护士那里获得情感交流或咨询形式的心理社会关怀，但他们欣赏护士对他们生理和身体需求的关注。在癌症护理中建立护士-患者伙伴关系可以减轻护士的潜在工作量。通过在时间受限的肿瘤环境中进行有效的沟通，为患者提供良好的身体护理，可以优化癌症患者的心理社会需求。
