A grounded theory analysis of oncology nurses' perceptions of early palliative care in the context of ambulatory care. Academic Article uri icon

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abstract

  • 96 Background: In early palliative care (EPC), palliative supports and resources are provided at an earlier stage in the treatment trajectory. As major care providers, nurses play a pivotal role in ensuring the success of EPC as an emerging model of care delivery. In this study, we examine nurses’ perceptions of EPC in the context of ambulatory oncology care and explore how EPC fits within the broader professional mandate of nursing. Methods: We recruited nurses from several ambulatory care oncology clinics in a tertiary cancer hospital in Ontario, Canada. Nurses participated in semi-structured interviews seeking to qualitatively examine their attitudes and perceptions about EPC. Constructivist grounded theory guided our methods and analysis. Results: A total of 20 nurses that included six staff nurses, ten nurse practitioners, and four advanced practice nurses completed interviews. Participants worked in a variety of clinic settings such as breast, pancreatic, head and neck, and hematology. The core category Perceiving EPC as Synonymous with Fundamental Nursing Care encompasses three subcategories: (1) Prioritizing immediate care needs – recognizing the need for EPC to manage immediate pain and symptom management concerns; (2) Care coordination – viewing EPC as linking resources and organizing interprofessional care; and (3) Safeguarding and preventative care – initiating EPC to protect against difficult transitions between phases of treatment and to prevent being unprepared for active dying. Conclusions: This was the first study to qualitatively examine nurses’ perception of EPC. Nurses not only recognize the value of EPC to ensure good quality care for patients with cancer and their families, but also perceive this care as deeply embedded within the core values of nursing. Recognizing how nurses view EPC has implications for expanding the professional scope of nursing in palliative care and for preparing nurses for the complexities of this work.

publication date

  • November 1, 2017