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在加纳资源有限的环境中,影响护理宫颈癌患者的护士复原力的个人和工作场所因素。

Personal and workplace factors influencing the resilience of nurses caring for women with cervical cancer in a resource-constrained setting in Ghana.

作者信息

Oware Jennifer, Iddrisu Merri, Konlan Kennedy Dodam, Dzansi Gladys

机构信息

Department of Adult Health, School of Nursing and Midwifery, University of Ghana, Legon, Greater Accra Region, Ghana.

出版信息

PLoS One. 2024 Dec 3;19(12):e0314764. doi: 10.1371/journal.pone.0314764. eCollection 2024.

Abstract

INTRODUCTION

Cervical cancer has been identified as the fourth most common form of malignancy affecting and killing women globally. Nurses caring for cervical cancer patients are exposed to emotional and psychological distress due to late presentation and the burden of care. Resilience has been identified as one of the effective ways of helping nurses to cope well with the stress of oncology nursing, but this remains undetermined in Ghana.

AIM

This study explored personal and workplace factors influencing the resilience of nurses caring for women diagnosed with advanced cervical cancer (stage III and IV) in a resource-constrained setting in Ghana.

METHOD

Using a qualitative approach, we recruited twenty nurses and midwives who had worked for a year and above caring for advanced-stage cervical cancer patients at the national referral hospital in Ghana. We conducted in-depth interviews between July, 2022 to September, 2022 which were audio-taped with participants' consent. Transcription was done verbatim, and analysis conducted using thematic analysis approach with the aid of NVivo 10.0.

RESULTS

The results revealed experience as a safety toolkit, inherent desire to help/care for the patient, emotional numbness and maintaining professional outlook as personal factors influencing resilience among the participants. Regarding the workplace factors influencing resilience, we identified the main theme of demands of caregiving for advanced cervical cancer patients with the following sub-themes; severity of cases managed, nature of care rendered, activities of care given, reshuffling, schedules and gender mirroring as an exacerbator of psychological suffering.

CONCLUSION

Resilience among nurses and midwives caring for terminally ill cervical cancer patients is influenced by longer years of service, intrinsic motivation to work as a nurse, and the defense strategy of emotional numbness and professionalism at the individual level. Also, the huge demand of caregiving serves as a major workplace factor affecting the resilience of nurses and midwives. We recommend strategies such as regular ward conferences and in-service trainings aimed at enhancing job-experience, inherent desire to render care and professionalism be adopted in resource-constrained settings to improve nurses' resilience. In addition, political actors and management of hospitals must prioritize allocation of resources for advanced cervical cancer care with particular focus on providing more specialized nurses and midwives.

摘要

引言

宫颈癌已被确认为全球影响女性并导致女性死亡的第四大常见恶性肿瘤形式。由于患者就诊延迟以及护理负担,护理宫颈癌患者的护士会面临情感和心理困扰。韧性已被视为帮助护士有效应对肿瘤护理压力的方法之一,但在加纳这一点仍未得到验证。

目的

本研究探讨了在加纳资源有限的环境中,影响护理被诊断为晚期宫颈癌(III期和IV期)女性患者的护士韧性的个人因素和工作场所因素。

方法

采用定性研究方法,我们招募了20名在加纳国家转诊医院护理晚期宫颈癌患者一年及以上的护士和助产士。在2022年7月至2022年9月期间,我们在征得参与者同意的情况下进行了深入访谈,并进行了录音。逐字转录后,借助NVivo 10.0使用主题分析法进行分析。

结果

结果显示,经验作为一种安全工具包、帮助/护理患者的内在愿望、情感麻木以及保持专业态度是影响参与者韧性的个人因素。关于影响韧性的工作场所因素,我们确定了晚期宫颈癌患者护理需求的主要主题以及以下子主题:所管理病例的严重程度、提供护理的性质、给予护理的活动、人员调配、排班以及性别镜像作为心理痛苦的加剧因素。

结论

护理晚期宫颈癌患者的护士和助产士的韧性受到服务年限较长、作为护士工作的内在动力以及个人层面情感麻木和专业精神的防御策略的影响。此外,巨大的护理需求是影响护士和助产士韧性的主要工作场所因素。我们建议在资源有限的环境中采用定期病房会议和在职培训等策略,以增强工作经验、提供护理的内在愿望和专业精神,从而提高护士的韧性。此外,政治行为者和医院管理层必须优先为晚期宫颈癌护理分配资源,尤其要注重提供更多专业护士和助产士。

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