Watermeyer Jennifer, Etheredge Harriet, Fabian June, Tager Sue
Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, 1 Jan Smuts Ave., Braamfontein, Johannesburg 2000, South Africa.
Wits Donald Gordon Medical Centre, School of Clinical Medicine, University of the Witwatersrand, 21 Eton Rd, Parktown, Johannesburg 2193, South Africa.
Healthcare (Basel). 2022 Oct 28;10(11):2145. doi: 10.3390/healthcare10112145.
Although the experience of hospitalisation for cancer management has been widely researched, such research from the African sub-continent is limited.
This study explored experiences of patient care in a tertiary, inpatient oncology setting in urban South Africa, from the point of view of patients and health professionals.
In-depth interviews and focus groups were conducted with participants. Participants included oncology inpatients, oncologists, nurses and nursing management (N = 46) at an oncology unit in Johannesburg, South Africa. Data were analysed by a multidisciplinary research group using reflexive thematic analysis principles.
Our results suggest that barriers to establishing effective organisational routines included communication breakdowns between patients and healthcare providers, a lack of predictability in interactions with doctors, deficient access to information and diminished confidence in nurses.
Oncology inpatients may not feel in control of their circumstances, in part due to lacking routine in the hospital setting. Ironically, nurses, who are often at the frontline of patient management, appear to be underutilised or disabled by the healthcare system as conveyors of information.
Robust organisational routines for oncology inpatients may be a good mechanism for allaying uncertainty and conferring a sense of control. Nursing staff, as the individuals with the most direct patient contact, could be instrumental in nurturing organisational routines towards improving patient perceptions of care.
尽管针对癌症治疗住院经历的研究已广泛开展，但来自非洲次大陆的此类研究却很有限。
本研究从患者和医护人员的角度，探讨了南非城市一家三级住院肿瘤治疗机构中的患者护理体验。
对参与者进行了深入访谈和焦点小组讨论。参与者包括南非约翰内斯堡一家肿瘤治疗科室的肿瘤住院患者、肿瘤学家、护士及护理管理人员（N = 46）。一个多学科研究小组运用反思性主题分析原则对数据进行了分析。
我们的结果表明，建立有效的组织常规存在诸多障碍，包括患者与医护人员之间的沟通不畅、与医生互动缺乏可预测性、信息获取不足以及对护士信心降低。
肿瘤住院患者可能感觉无法掌控自身状况，部分原因是医院环境缺乏常规。具有讽刺意味的是，护士通常处于患者管理的前线，却似乎未被医疗系统充分利用，或在作为信息传递者方面受到阻碍。
针对肿瘤住院患者建立健全的组织常规，可能是减轻不确定性并赋予掌控感的良好机制。护理人员作为与患者直接接触最多的群体，在培育组织常规以改善患者对护理的认知方面可能发挥重要作用。
