A model for nurses to facilitate supportive care to men diagnosed with prostate cancer and their families in the intermediate hospital Oshakati: A hospital based approach
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Date
2022
Authors
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Journal ISSN
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Publisher
University of Namibia
Abstract
Namibia appears to have no existing guidelines to facilitate supportive care for men
diagnosed with prostate cancer (PCa) in the oncology departments at the Intermediate Hospital Oshakati (IHO). In King et al.’s (2015) opinion it is crucial for healthcare workers involved in delivering care for men diagnosed with PCa and their families to maximise their quality of life through supportive care. The purpose of this study was to develop a model for nurses to facilitate supportive care for men diagnosed with PCa and their families at the IHO.
The study adopted a pragmatic worldview to achieve its objectives. In applying a pragmatic paradigm, the researcher adopted a convergent, parallel, mixed methods study, employing both a quantitative, descriptive, cross-sectional and a qualitative, exploratory, descriptive and contextual design. The study was conducted in four phases of theory generation, as proposed by Chinn and Kramer (2018): Phase 1 comprised an analysis of concepts based on five research objectives that correspond with the five elements of the study population, namely, published research materials on PCa, nurses, men diagnosed with PCa, family members of men diagnosed with PCa, and oncology departments at the IHO. Qualitative data were collected by means of a scoping review and in depth, individual, face-to-face interviews with 11 men, 7 family members and 14 nurses in order to explore and describe (1) best practices for the supportive care provided by nurses in the oncology departments for men diagnosed with PCa and their families, (2) the experiences of men diagnosed with PCa of the supportive care received from nurses in oncology departments, (3) the experiences of the families of men diagnosed with PCa of supportive care received from nurses in oncology departments, and (4) the experiences of nurses in facilitating supportive care for men diagnosed with PCa and their families in the oncology departments. A non-probability purposive sampling method was used to select information rich participants. All responses were audio taped and transcribed verbatim.
Qualitative data were manually analysed by means of content analysis, using the Tesch’s eight steps of open coding. The following themes and sub-themes were accordingly identified: two themes and eight sub-themes for objective 1, two themes and seven sub-themes for objective 2, two themes and four sub-themes for objective 3, and three themes and six sub-themes for objective 4. Each theme was discussed, verified with direct quotations from the interviews and supported by relevant and appropriate literature. Quantitative data were collected using a five-point Likert scale questionnaire to assess the oncology departments in terms of facilitating supportive care for men diagnosed with PCa and their families. Thirty-five registered nurses answered the questionnaires. Quantitative data were analysed using the Statistical Package for the Social Sciences, version 25 (SPSS-25). The study revealed that men diagnosed with PCa are rarely offered psychological and spiritual support to enable them to cope more successfully with the hardships they face after being diagnosed with the disease.
Nurses, for their part, experience various interventions regarding supportive care, as well as a shortage of resources, the lack of a conducive environment and a lack of support, as well as barriers that hinder the facilitation of supportive care for men and family. On the other hand, family members of men with PCa felt devalued in the healthcare system, as they were often excluded from decision-making regarding treatment. The findings also reveal a lack of psychological and spiritual supportive care by nurses for families.
In phase 2, a conceptual framework based on Dickoff et al.’s (1968) practice oriented theory and the four main concepts gleaned from the concept analysis (support, physical, social, psychological and spiritual support) was developed. In phase 3 of the study, the model for nurses to facilitate supportive care for men diagnosed with PCa and their families in IHO was developed. The model was developed based on four theories, namely: practice oriented theory, systems theory, holistic theory and the nursing process theory. The model was described in line with the five descriptive components, as proposed by Chinn and Kramer (2018), namely, purpose, concepts, definitions, relationships, structure and assumptions. Each component of the model was described in terms of the way it contributes to the purpose of the model. The model was evaluated in accordance with the criteria for evaluating the nursing model, as proposed by Fawcett (2005) and Parse (2005). In phase 4, guidelines for operationalising the model were developed to provide direction for nurses and members of the multidisciplinary team involved in the model facilitation process. The guidelines were developed in terms of aims and activities to address the challenges and barriers that hinder the facilitation of supportive care for men diagnosed with PCa in health facilities. Based on the study findings, recommendations are made in terms of nursing practice, nursing education, and nursing research.
Description
A dissertation submitted in fulfillment of the requirements for the Degree of Doctor of Philosophy in Nursing Science
Keywords
Prostate cancer, Hospitals in Namibia, Supportive care