Background: The oncology setting is characterized by various complexities, and healthcare professionals may experience stressful conditions associated with ethical decisions during daily clinical practice. Moral distress (MD) is a condition of distress that is generated when an individual would like to take action in line with their ethical beliefs but in conflict with the healthcare facility’s customs and/or organization. This study aims to describe the MD of oncology health professionals in different care settings. Methods: Descriptive quantitative study was conducted in the Operating Units of the Istituti Fisioterapici Ospitalieri in Rome between January and March 2022. The investigated sample consisted of the medical and nursing staff on duty at the facility, who were given a questionnaire through a web survey. Besides a brief sociodemographic form, the MD Scale-Revised questionnaire was used for data collection. Results: The sample consisted of nurses (51%) and physicians (49%), predominantly working in surgeries (48%), and having 20–30 years of service (30%). MD was higher among healthcare professionals, in medicine than that ing in corporate organizations, surgeries, or outpatient clinics (p = 0.007). It was not related to the profession (p = 0.163), gender (p = 0.103), or years of service (p = 0.610). Conclusions: This paper outlines the prevalence of MD in care settings and describes its relationship with profession, gender, and seniority. There is no patient care without the care of health professionals: knowing and fighting MD improves the safety of the treatments provided and the quality perceived by patients.
Background: Communication is an important aspect in making patients competent to define, process, and manage their disease condition as well as to intercept and satisfy psychosocial needs. Communication between patient and nurse is central to the learning and orientating process since the nurse has the greatest frequency and continuity of relationship with patients and their families. This study aims to investigate the quality of communication between patient and nurse and the factors that promote or hinder effective communication from the oncology patient’s perspective within an inpatient hospital setting. Methods: A descriptive qualitative study was conducted with one-to-one semi-structured interviews analyzed using the Framework Analysis methodology. The population consisted of oncologic patients admitted to the Medical Oncology Units of the Regina Elena National Cancer Institute in Rome. Data were analyzed using Ritchie and Spencer’s Framework Analysis. Results: The sample comprised 20 patients, with an average age of 61.35, admitted to the Medical Oncology Units of the Regina Elena National Cancer Institute in Rome. Three themes emerged: positive communication as an element of care, factors fostering communication, and factors hindering communication. Conclusions: The sample interviewed deems the quality of communication satisfactory. Familiar communication style, direct language, and caring are factors fostering communication. In contrast, lack of communication between medical and nursing staff, shortage of staff, and lack of time are considered communication barriers. Advanced communication competencies in nurses are crucial for effectively addressing the emotional and psychosocial needs of cancer patients, fostering a more empathetic and supportive care environment.
Background/Objectives: In the context of evolving healthcare systems, effective communication represents a fundamental skill for ensuring quality care and addressing the psychosocial needs of oncology patients. In line with the new challenges of nursing education, this study explores communication between nurses and oncology patients, analyzing facilitating and hindering factors from the nurses’ perspective within the hospital setting. Methods: A descriptive qualitative study was conducted using one-on-one semi-structured interviews. The interviews lasted from 15 to 30 min. The study population consisted of nurses working in the Medical Oncology units of the Regina Elena Institute in Rome (IRE). Data were analyzed using the Framework Analysis method by Ritchie and Spencer. Results: The sample consisted of 20 nurses with an average age of 33.5 years. Six main themes emerged: communication as the pillar of the care relationship between technical and human aspects, the need for a balance between closeness and personal protection, the influence of language and personalized approaches on communication, the stimulation of specific training needs, and barriers to nursing communication. Conclusions: Nurses recognize communication as an integral part of the care process and as a key competency for addressing the complex needs of oncology patients. However, inadequate training, time constraints, and staff shortages represent significant barriers, highlighting the need to invest in specific training programs and organizational strategies to improve the quality of care.
Background: Telenursing comprises a set of tools and interventions enabling nurses to provide remote care. This study aims to assess the impact of telenursing interventions on the supportive care needs of patients with melanoma and lung cancer who are receiving targeted therapies. Methods: This six-month monocentric, double-arm, randomised, controlled trial study protocol will assess the effect of telenursing on the supportive care needs (primary outcome) in 40 patients (20 in each group) after one month. The secondary outcomes will be monitored at baseline, one, three and six months: supportive care needs (at three and six months), therapeutic adherence, quality of life, usability and satisfaction, performance status, patient-reported outcomes and main adverse events. The SPIRIT guidelines will be used for the reporting. Results: The results from this trial will assess the impact of a telenursing intervention on cancer care. Conclusions: This trial could be a starting point for more extensive studies on telenursing interventions to promote nurses’ skills, as well as the quality and safety of care in patients with cancer, highlighting the impact of more outstanding nursing contributions on cancer care. Trial and Protocol Registration: The study protocol was approved by the relevant Italian Ethics Committee Lazio Area 5 (RS1851/23, 2773; 6 September 2023) and was registered on ClinicalTrials.gov (trial registry number NCT06254196).
5 December 2024 in Brain, Behavior, & Immunity - Health
This article analyzes the main coordination needs linked to the diagnosis and treatment of oncological diseases, presenting the various integration tools that our healthcare organization adopted to guarantee continuity of care at the IRCCS IFO (Istituto di Ricovero e Cura a Carattere Scientifico Istituti Fisioterapici Ospitalieri) in Rome. The object of investigation is the disease management team (DMT) organization for the diagnosis and treatment of people suffering from oncological disease and the consequences in terms of improving their management. The study focuses, in particular, on the analysis of the different organizational methods chosen for the management of activities related to diagnosis and treatment paths. The results, although preliminary, highlight a great variability in the adoption of integrated organizational models by the different DMTs compatible with the heterogeneity of oncological diseases. The results of this study have highlighted that, despite the diversity of the different DMTs created for different oncological pathologies, DMTs guarantee a patient-centered approach and the creation of shared databases, which facilitates the evaluation of progress and the identification of areas for improvement. This analysis has allowed us to obtain a useful map of the models used by the different DMTs, also laying the foundations for more precise evaluations of their effectiveness. The correct evaluation of the effectiveness of DMTs acquires great importance today, especially if we consider that empirical evidence is not yet in agreement on the real effectiveness of this tool with respect to both the qualitative dimension and the efficiency of interventions.
Background: Telenursing could improve continuity of care in patients with cancer. This study aims to explore the expectations and perceptions of patients with lung cancer and melanoma toward telenursing. Methods: A descriptive qualitative study using a phenomenological approach was conducted on a convenience sampling of twenty patients aged 18 years or over from a Cancer Center. With the consent of patients and the relevant Ethics Committee, in-depth open-ended face-to-face interviews were conducted until data saturation. The phenomenon’s essence was achieved through themes emerging from the qualitative data analysis. Results: Patients’ perceptions and expectations were related to areas explored by a general theme on the nurse–patient relationship’s importance. Four themes and eleven sub-themes were focused on misconceptions about lack of use, patients’ potential and fears, the home as a place of care, and the caring relationship. Fifteen patients perceived the internet as a chaotic “bubble”. Conclusions: Despite the lack of previous use, patients consider telenursing positively as “a bridge between home and care”, especially in the advanced stages of the disease. They highlighted strengths and weaknesses of telenursing, such as having “someone for you”, connection, fear of psychological addiction, loss of privacy, and lack of empathy. This study was not registered.