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Nurses’ experiences caring for patients surgically treated for oral cavity cancer
Ngā wheako o ngā tapuhi i te tiakitanga tūroro e mahia ana mō te mate pukupuku kōwhao waha
Anne-Marie Kell, MN, RN, NZ
Jean Gilmour, RN, PhD, Honorary Teaching Fellow, Massey University, Wellington, NZ
Kim van Wissen, RN, PhD, Teaching Fellow,School of Health, Victoria University of Wellington, Wellington, NZ
Kell, A-M., Gilmour, J., & van Wissen, K. (Published online - early view December 2017). Nurses’ experiences caring for patients surgically treated for oral cavity cancer. Nursing Praxis in New Zealand.
The aim of this study was to explore nurses’ experiences caring for patients who have had surgery for oral cavity cancer in one New Zealand hospital. Nursing care of these patients during the postoperative period includes assisting in wound care, tracheostomy management, oral care, ongoing patient education and the provision of emotional support to patients and their families. Gaining knowledge in nurses’ experiences with these patients provides an opportunity to support and teach other nurses who care for these complex patients. A qualitative descriptive design was used for this study. Three registered nurses were interviewed. Thematic analysis was used to identify themes arising from the data. The four themes were: intensity of care, acknowledging the care and challenges involved in caring for this patient group; moral conflict, focusing on nurses’ perceptions about the effects of surgery on the patients; professional uncertainty, highlighting the self-doubt that the nurses experienced; and emotional labour, revealing the emotional effort of nursing in the research clinical setting. The study findings, along with other published literature, indicate that nurses who care for people requiring extensive oral surgery experience work related stress. Recommendations from this research include offering informal debriefing, grief counselling, clinical supervision, stress management training, and continued education to retain nurses in this specialised role. Supporting nurses in this practice setting will enhance best outcomes for patient care.
Keywords / Ngā kupu matua
Oral cavity cancer/ Te mate pukupuku kōwhao waha, surgery/te poka tinana, nurses/ngā tapuhi, emotional labour/ te taumaha o te ngākau i roto i ngā mahi, support/ te awhi.
Ngā Ariā Matua
Te whāinga matua ia o tēnei rangahau he tirotiro ki ngā wheako o ngā tapuhi tiaki i ngā tūroro he mahi poka tinana tō rātou mō te mate pukupuku kōwhao waha tangata i tētahi hōhipera o Aotearoa. Ko ētahi o ngā mahi tiaki a te tapuhi i ēnei tūroro i muri i te pokanga, he taurima i te tapahanga o te waha, he whakahaere ngongo whakahā i te korokoro, he taurima i te waha, he whakaako haere tonu i te tūroro me te hora āwhina kare ā-roto ki ngā tūroro me ō rātou whānau. He mea tino nui te whakapakari i te mātauranga ki ngā wheako o ngā tapuhi ki ēnei tūroro, e whai wāhi ai rātou ki te awhi, ki te whakaako hoki i ētahi atu tapuhi tiaki i ēnei tūroro matatini. I whakamahia he hoahoa whakaahua kounga mō tēnei rangahau. Tokotoru ngā tapuhi rēhita i uia. I whakamahia he tātari ariā tāhuhu hei tautuhi i ngā ariā tāhuhu i ara ake i te raraunga. Ko ngā ariā tāhuhu e whā, inā: te taumaha o te mahi tiaki, te whakaae ki te hōhonu o te tiaki me ōna pīkauranga mō ngā tūroro i tēnei kāhui;te wehewehe i ngā mātāpono tika me ō te hē; te aro anō ki ngā kitenga o ngā tapuhi ki te pānga o te pokanga ki ngā tūroro, te rangiruatanga ngaio, te whakatairanga i te ngākau-rua mōna anō o te tapuhi, kua pā ki a rātou i ētahi wā;te taumaha o te ngākau i roto i ngā mahi, te hura i te taumaha mō ngā kare ā-roto o te tapuhi i te horopaki rangahau tiaki tūroro. Ko tā ngā kitenga he whakatau atu ko ngā tapuhi tiaki i te hunga kua tino pokaina nuitia e te kaipoka waha, ka pāngia pea e te mate hukihuki, ā, he ōrite ki ētahi atu pūrongo kua pānuitia ki te ao. Ko ētahi tohutohu mai i ēnei rangahau, kia horaina he wāhanga ōpaki i muri ki te kōrerorero te tohutohu i te tangata mō te rāwakiwaki, kia horaina hoki he whakangungu pūkenga whakahaere hukihuki, me te akoranga mutunga-kore hei pupuru i ngā tapuhi i ēnei tūranga mātanga. Mā te awhi i ngā tapuhi i tēnei horopaki mahi e whakapikia ai ngā tino putanga mō te tiaki tūroro.