Department of Adult Health, School of Nursing and Midwifery, University of Ghana, Legon, Greater Accra Region, Ghana.
BMC Palliat Care. 2024 Jul 16;23(1):174. doi: 10.1186/s12904-024-01507-2.
Cervical cancer is one of the causes of female deaths worldwide. Cervical cancer incidence is rising with almost three thousand (2797) women in Ghana being diagnosed with the condition each year, with almost two thousand (1,699) of them dying from its complications Nurses caring for cervical cancer patients are exposed to emotional and psychological distress due to late presentation, the burden of care, patients' suffering and the alarming number of deaths associated with it. Improving positive patient outcomes require identifying the challenges and support systems available to nursing staff so as to harness these support systems for improving care outcomes.
This study explored the challenges and support systems of nurses caring for women with advanced cervical cancer in Accra, Ghana.
In this study, we adopted an exploratory qualitative design. The study was conducted among eleven (11) nurses and nine (9) midwives engaged at the national referral hospital in Ghana who were providing care for patients with advanced cervical cancer for over a year who were purposively sampled. The data was collected using in-depth interviews with a pre-tested semi-structure interview guide from the twenty participants. We recorded the interviews using an audio-tape. The audio files were transcribed verbatim and thematic analysis was undertaken with the aid of Nvivo 10.0.
The challenges when rendering nursing care faced by participants of this study were exposure to frequent deaths, inadequate resources, and workload. Most participants lamented that they received absolutely no support from their workplace, hence their only form of support was from their family and friends. They also added that most of them were general nurses and midwives with no special training in oncology nursing or palliative nursing.
Nurses and midwives experience resource, knowledge and skill challenges when caring for patients with advanced cervical cancer. However, the nurses and midwives had emotional attachment to their jobs and their patients and were not distracted by their bad experiences. We recommend improving resource allocation for cervical cancer care through the National Health Insurance Authority (NHIA), Ghana and increased training of nurses in oncology and palliative nursing by the Ministry of Health, Ghana to improve knowledge and skills of the nurses and midwives caring for women with advanced cervical cancer to improve their quality of care. Further, hospitals must make it a priority to have more nurses and midwives trained in oncology and end of life care to improve the knowledge and skills of nurses and midwives caring for advanced cervical cancer patients. Also, these findings should trigger policy-level discussions at the Ministry of Health, Ghana on the training of specialized nurses and midwives in cancer and end of life care to help Ghana meet the sustainable development goal targets related to health.
宫颈癌是全球女性死亡的原因之一。在加纳,每年有近三千名(2797 名)女性被诊断出患有宫颈癌,近两千名(1699 名)女性死于该病的并发症。由于晚期就诊、护理负担、患者痛苦以及与之相关的惊人死亡人数,护理宫颈癌患者的护士会面临情绪和心理困扰。提高患者的积极治疗效果需要确定护士面临的挑战和可用的支持系统,以便利用这些支持系统来改善护理结果。
本研究探讨加纳阿克拉照顾晚期宫颈癌妇女的护士的挑战和支持系统。
在这项研究中,我们采用了探索性定性设计。该研究在加纳国家转诊医院进行,参与者为 11 名护士和 9 名助产士,他们从事为晚期宫颈癌患者提供护理工作超过一年,并采用目的抽样法进行抽样。数据是通过对 20 名参与者使用预先测试的半结构化访谈指南进行深入访谈收集的。我们使用录音带记录访谈。将音频文件逐字转录,并在 Nvivo 10.0 的帮助下进行主题分析。
本研究参与者在提供护理时面临的挑战包括频繁死亡、资源不足和工作量过大。大多数参与者感叹他们没有从工作场所得到任何支持,因此他们唯一的支持来自他们的家人和朋友。他们还补充说,他们大多数是普通护士和助产士,没有接受过肿瘤护理或姑息护理的特殊培训。
护士和助产士在照顾晚期宫颈癌患者时会遇到资源、知识和技能方面的挑战。然而,护士和助产士对他们的工作和患者有着情感上的依恋,不会因为他们的不良经历而分心。我们建议通过加纳国家健康保险管理局(NHIA)改善宫颈癌护理的资源分配,并通过加纳卫生部增加护士在肿瘤学和姑息护理方面的培训,以提高照顾晚期宫颈癌妇女的护士和助产士的知识和技能,从而提高他们的护理质量。此外,医院必须优先培训更多接受过肿瘤学和临终关怀培训的护士和助产士,以提高照顾晚期宫颈癌患者的护士和助产士的知识和技能。此外,这些发现应该在加纳卫生部引发政策层面的讨论,讨论对专门的护士和助产士进行癌症和临终关怀培训的问题,以帮助加纳实现与健康相关的可持续发展目标。