Analysis of the experiences of nurses who return to nursing after cancer

"Returning beyond cancer"-a journey of professional reinvention for nurses

PURPOSE

Nurse cancer survivors (NCSs) face significant challenges in adapting to returning to work (RTW) and require special attention and support. Little is known about the meaning NCSs attribute to their work, the changes in their personal feelings, and their needs in coping with these changes after RTW. This interpretive phenomenological study aimed to explore NCSs' feelings and experiences after RTW in greater depth to help improve their quality of working life (QWL).

METHODS

Semi-structured interviews were conducted with 15 NCSs in China between March 2023 and August 2023. The transcripts were analyzed using interpretative phenomenological analysis (IPA).

RESULTS

The data was categorized into four themes: (1) psychological odyssey, (2) accessing social support, (3) benefiting from professional background, and (4) realization of professional values.

CONCLUSION

This study uses IPA to explore the work experiences of NCSs and ways to improve their QWL. It is recommended that managers pay attention to the psychology of their RTW, enhance support, encourage the use of professional strengths, and value their insights and professional development.

Bridging Experience and Practice: A Grounded Theory Study of Nurses' Hospitalisation Experiences as Patients or Family Members

AIMS

This study aimed to develop a grounded theory that explains how nurses' experiences as patients or family members influence their provision of patient-centred care.

DESIGN

A grounded theory approach.

METHODS

Twenty clinical nurses in South Korea participated; nine had experiences as patients and 11 as family members during hospitalisation. Data were collected through semi-structured, in-depth interviews from January to October 2021. Participants were purposively sampled for diverse experiences, and all interviews were audio-recorded and transcribed verbatim. Data analysis followed grounded theory using the constant comparative method, with theoretical saturation reached after 20 interviews.

RESULTS

The theory developed was built around the core category of 'transforming nursing practice through empathy and reflection in hospitalization experiences'. Participants experienced healthcare services in a wide range of areas, including nursing interactions, patient rights, the healthcare delivery system and hospital facilities. Based on these experiences, participants developed a deep understanding and empathy for the emotions and needs of patients and families, gaining new insights and reflections on their nursing practice. It led to a transformation in participants' attitudes and behaviours towards patient-centred care.

CONCLUSION

This study demonstrates that reflective practice and empathy developed through personal hospitalisation are important factors in leading to the shift towards patient-centred care. These findings provide a theoretical framework for emphasising experiential learning opportunities in nursing education and training to apply patient-centred approaches in practice.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Experiential learning approaches, such as simulation, role playing or caregiver training, can bridge the gap between clinical practice and patient expectations. Supportive work environments that encourage reflection on patient experiences help nurses maintain patient-centred practices despite challenges, leading to professional growth and improved patient outcomes.

REPORTING METHOD

This study adhered to the COREQ checklist for reporting.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

Views and Experiences of Nurses Receiving Care as Inpatients: An Empirical Qualitative Study From Ankara

AIM

To determine the views and experiences of inpatient nurses receiving care.

BACKGROUND

Switching from the care provider role to being a patient allows nurses to realise patients' real care expectations and to test their colleagues' care practices. Nurses' experience as inpatients is essential for understanding patients' care-related expectations and improving care quality by reflecting on their practices.

DESIGN

This qualitative study used a descriptive phenomenological design.

METHODS

Data were collected from nine volunteer nurses between July 2018 and June 2020 in Ankara, Türkiye, through face-to-face interviews using semi-structured questionnaires and audio recordings. The research data were analysed by following the descriptive phenomenological data analysis steps. The Consolidated Criteria for Reporting Qualitative Research [COREQ] checklist was used to report study findings.

RESULTS

Three themes emerged from the views and experiences of nurses receiving inpatient care: care-receiving experiences, components of good nursing care and change in perception of care.

CONCLUSION

It is important to reveal the opinions and experiences of hospitalised nurses regarding care to understand the expectations of the care recipients and to increase the quality of the care provided. The study revealed that the experiences of nurses receiving inpatient care improved their professional sensitivity and this was reflected in the quality of the nursing care they provided.

IMPLICATION FOR NURSING

Nurses can provide higher quality and humanistic care by combining their professional knowledge and skills with the increased awareness of the inpatient experience of nurses. No patient or public contribution.

Nurses' returning to work after cancer: A focus group study

BACKGROUND

Nurses diagnosed with cancer face unique challenges when returning to work, yet there is limited understanding of their transition.

PURPOSE

To explore nurses' return-to-work experiences post cancer diagnosis and clarify related facilitators and challenges.

METHODS

This focus group study employed a content analysis with constant comparative approach and member checking. This study recruited nurses treated for any type of cancer who had experience returning to clinical positions.

FINDINGS

Five focus groups with 17 female nurses (mean age=51.8) were performed; 47.1% had breast cancer. Four main themes were identified: (a) motivation, incentives, and the need to return to work; (b) setbacks hindering the return; (c) navigating new work dynamics; and (d) evolving professional role during the return to work.

DISCUSSION

This study illustrates personal and professional growth and struggles that attend returning to work as a nurse with cancer. This insight informs strategies to support continuing these nurses' careers.

The experiences and challenges of nurses who become patients in a hospital setting: A scoping review of the literature

AIM

This scoping review aimed to identify and describe evidence regarding the experiences of nurses when they become patients or when nurses care for other health professional-patients in a hospital setting.

DESIGN

A scoping review of internationally published peer-reviewed literature.

DATA SOURCES

A systematic search of peer-reviewed evidence was conducted in electronic databases: CINAHL, Medline, Scopus, ProQuest and PsycINFO.

METHODS

Critical appraisal, data extraction and summary were performed independently by two reviewers according to the scoping review framework developed by Arksey and O'Malley. Twenty-three publications from 1999 to 2021 were included in this scoping review.

RESULTS

This scoping review highlighted seven key themes as follows: (1) the challenges for nurse-patients and caregivers; (2) role ambiguity when a nurse becomes a patient; (3) the need for personalized care to consider the nurse's professional experience; (4) the requirement to not make assumptions about the registered nurse's knowledge; (5) loss of control and vulnerabilities of being a patient; (6) the impact of the valuable small things that carers did and (7) the impact of being a nurse-patient on their future practice.

CONCLUSION

While some aspects of nurse-patients' experiences are common to non-healthcare professional-patients, this review highlights there are unique challenges when nurses become patients themselves. Future research should focus on exploring nurses' experience of caring for other healthcare professional-patients and strive to better understand how to meet nurses' unique needs when they become patients themselves.

IMPACT

This review advances knowledge on an under-explored topic, highlighting the unique and challenging experience when nurses become patients in a hospital setting. Nurses should be aware of the unique needs of nurse-patients to provide person-centred quality care.

PATIENT OR PUBLIC CONTRIBUTION

There was no direct patient or public contribution to this scoping review, although one of the authors did have experience as a nurse-patient in the last 3 years.

Moving beyond the patients’ views on the process of return to work after cancer: A qualitative evidence synthesis on articles published between 2008 and 2017

BACKGROUND: Important qualitative findings have accumulated on return to work after cancer from the perspective of various stakeholders. OBJECTIVE: The aim of this paper was to critically appraise the evidence produced between 2008–2017 on several key stages of the return to work process against the key stakeholders identified in the articles included. METHODS: A systematic search was done on four databases to identify relevant papers. Papers were selected based on pre-defined selection criteria. A qualitative evidence synthesis was performed on the articles included. RESULTS: A total of 57 articles were included in the analysis. Using the secondary thematic analysis, this study identified three categories of articles relative to the stakeholders included: articles focusing on patients’ experience (n = 41); articles dealing with multiple stakeholders, including patients (n = 12); and articles drawing on stakeholders other than patients (n = 4). The analysis also revealed five key stages of the return to work process which follow a sequential order and provide a comprehensive image of the process. CONCLUSIONS: More research is required on how employers view and are able to facilitate the return to work process after cancer. New forms of support must be planned and delivered by health professionals for patients who return on the labour market. The five stages model proposed in this study can help employers and policymakers to plan and deliver tailored legislation and guidance for RTW facilitation. All stakeholders must be further trained to embrace the idea that return to work is a complex process which continues long after the survivor returns to work.

Factors Affecting Quality of Work Life in a Sample of Cancer Survivor Female Nurses

Background and objectives: Identifying the factors affecting the Quality of Work Life (QWL) of cancer survivor female nurses is important and necessary to overcome the various challenges experienced by these professionals upon returning to work following recovery from the disease. Therefore, this study aimed to identify the factors affecting the level of nurses’ QWL. Materials and Methods: A cross-sectional survey was conducted among 115 registered female nurses who had survived cancer, in general hospitals and clinics in South Korea. SPSS statistics version 21 was used for ordinary least squares, and Stata version 12.0 was used for quantile regression analysis. Results: Workplace spirituality affected all quantiles of QWL except the 90% quantile; fatigue was an affecting factor in the 20%, 30%, and 70% quantiles; and job stress in the 20%, 30%, 40%, and 60%, 70%, 80% quantiles. For workplace spirituality, the effect size was 0.33 (p < 0.001) in the 10% quantile, increasing to 0.45 (p < 0.001) in the 80% quantile. Conclusions: Based on the results of this study, suggestions for clinical practice include providing the mediating strategies and programs to manage fatigue and job stress as well as workplace spirituality. Job-related factors such as shift work should also be considered.

Effect of Workplace Spirituality on Quality of Work Life of Nurse Cancer Survivors in South Korea

OBJECTIVE

Return to work is known to have a positive effect on the quality of work life of cancer survivors, including the nurse cancer survivors, along with other factors, such as workplace spirituality. The aim of this study was to identify the effect of workplace spirituality and its constituent concepts on the quality of work life of nurse cancer survivors.

METHODS

A cross-sectional survey comprising the nursing workplace spirituality (NWS) and quality of nursing work life (QNWL) scales was completed by 130 cancer survivor nurses between October 15, 2018, and May 15, 2019, in two general hospitals in metropolitan areas, and snowball sampling was used in parallel. The data were analyzed using SPSS 22 software, determining descriptive statistics, and conducting an independent t-test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression.

RESULTS

The average scores for all NWS and QNWL subdomains were medium. Age, nursing tenure, and the factors of NWS were positively correlated with QNWL, especially the harmony between the workplace and the individual (r = 0.65, P < 0. 001). In the second hierarchical regression, controlling general characteristics, harmony between the workplace and the individual (β = 0.38, P ≤ 0.001), and relationship with colleagues (β = 0.19, P = 0.031) were significant predictors of QNWL explaining 59.0% of the variance. This model was found to be suitable (F = 16.29, P ≤ 0.001).

CONCLUSIONS

Effective and practical organizational systems and intervention programs based on organizational support, including colleagues' support for increasing the quality of work life for nurse cancer survivors, are required.

Return to work after a cancer diagnosis: a meta-review of reviews and a meta-synthesis of recent qualitative studies

PURPOSE

Returning to work (RTW) after cancer treatment can be challenging, but when desired, has many benefits. While there are many qualitative studies (reviews and recent studies) available on cancer survivors' experience of returning to work, synthesis of these qualitative studies is lacking. We aimed to summarise the existing qualitative reviews and recent studies following the last published review, to examine cancer survivors' motivations for and experiences of RTW, and to highlight factors within both the survivors and his or her environment that influence RTW.

METHOD

A set of systematic reviews focusing on RTW were identified. A systematic search for individual papers published on RTW since the last review was also completed. Data extraction and bias assessment were conducted, with 25% double-coded to ensure reliability. A meta-ethnographic approach was utilised to synthesise the findings of each.

RESULTS

Seven systematic reviews and 12 individual papers between 2017 and 2019 were identified. Quality was variable. Most reviews and studies focused on women with breast cancer. Three major themes were identified: person factors, employment factors and wider contextual factors including family, social and cultural variables.

CONCLUSIONS

We identified gaps in research on the RTW experiences of people with cancers other than breast, men, those with low incomes and more diverse populations.

IMPLICATIONS FOR CANCER SURVIVORS

Cancer survivors need to consider personal, employer and wider contextual factors when deciding whether and when to RTW. Future interventions to support survivors should be informed by these findings, addressing the diverse range of potential factors related to RTW in an individual survivor.

A model of identity grounded in the acute season of survivorship

OBJECTIVE

Survivorship literature generally focuses on the cancer experience after diagnosis and treatment. However, acute survivorship, beginning with diagnosis and ending at the completion of treatment, has a lasting impact on the well-being of patients. The purpose of this study was to generate a theoretical understanding of how identity is affected during acute survivorship.

METHODS

Using grounded theory and interviews with patients, their families, and their friends, the impact of the acute survivorship phase on the identity of patients was explored in Manitoba, Canada. Forty-two interviews were carried out, involving 18 patients with early malignancies and 15 friends and family members.

RESULTS

The theory which evolved suggests that identity can be viewed as a construct of 3 concepts: values, social domains, and routine. Following diagnosis identity is disrupted as patients face challenges integrating the health care recipient social domain into their established routine. Patients indicated that the impact of the cancer diagnosis on their identities could have been minimized through earlier provision of the necessary information to re-establish routine.

CONCLUSIONS

The theory that emerged from this study articulates the impact of the early cancer experience on the identity of patients. It also provides a framework for predicting which interventions may improve the cancer experience. Exploring how to best provide information that helps patients re-establish and maintain their routines after diagnosis is an important future direction.