Nursing Presence in Pediatric Oncology: A Scoping Review

Background: Nursing presence creates meaningful and trusting relationships that facilitate healing for the patient and enhances the nurse's clinical experience. Although nursing presence has been linked to better health outcomes especially in chronic illnesses and end-of-life, little is known about its contribution in pediatric oncology. Purpose: The purpose of this scoping review was to explore how nursing presence is understood and expressed in pediatric oncology. Methods: Arksey and O’Malley’s (2005) framework was used to guide the review, with Clarke and Braun’s (2013) thematic analysis process used for collating, summarizing, and reporting the results. Key search terms were developed for searches between January 1999 and July 2020 in CINAHL, MEDLINE, and Psych INFO databases. Initially, 4,357 studies were identified with a final sample of nine articles meeting specific inclusion and exclusion criteria. Gray literature retrieved from the search was used to inform the review. Findings: Most notably, there is a limited understanding of nursing presence in pediatric oncology setting. However, findings revealed five themes that can be identified with nursing presence: Being With or Being There, Therapeutic Relationships, Communication, Family-centered Approach, and Perceived Outcomes of Nursing Presence. Nurses in pediatric oncology are in an ideal position to provide nursing presence in order to improve the quality of care in pediatric oncology settings. Discussion: There is a need to establish a comprehensive evidence-based understanding of the construct of nursing presence in pediatric oncology that health care providers can utilize to enhance their clinical practice and health research.

Mental healthcare users’ self-reported medication adherence and their perception of the nursing presence of registered nurses in primary healthcare

Background: Medication adherence remains a challenge in the management of mental healthcare users (MHCUs), despite it being regarded as crucial for better health outcomes. Nurses at primary healthcare (PHC) facilities can play an important role through nursing presence in enhancing MHCUs’ medication adherence.Aim: This article aimed to investigate the relationship between MHCUs’ self-reported medication adherence and their perception of the nursing presence by registered nurses in PHC.Setting: An urban health district in Gauteng province, South Africa.Methods: A quantitative, descriptive correlational, cross-sectional design was used. The sample included 180 MHCUs. Data were collected using the Medication Adherence Rating Scale and the Presence of Nursing Scale.Results: The overall adherence level of respondents was partially adherent, with an average score of 6.45 out of a total score of 10. Respondents also reported a low level of perceived nursing presence demonstrated by registered nurses, with an average score of 72.2 out of 125. The results indicated a positive correlation between respondents’ self-reported medication adherence and their perceived nursing presence of registered nurses as evidenced by the positive value of the correlation coefficient of 0.69 with a corresponding significance probability value of 0.000 (r = 0.69; p = 0.00).Conclusion: The level of perceived nursing presence demonstrated by registered nurses played a significant role in influencing MHCUs’ level of medication adherence. The registered nurses can improve MHCUs’ medication adherence by demonstrating nursing presence skills such as good listening skills and taking care of MHCUs as individuals and not as a disease.Contribution: The results of this study confirm that there is a correlation between nursing presence and medication adherence. This holds significant value for future research in nursing presence. These findings also provide registered nurses in PHC with a valuable tool to improve medication adherence, namely nursing presence.

Nurses' Presence at the Patient Bedside: Challenges Experienced by Nurses

Background: Nursing presence is one of the important dimensions of care. The presence of nurses improves the outcome of treatment, self-care, satisfaction and reduces patients' loneliness and anxiety. The literature review shows that most studies have conducted on concept analysis of the nursing presence while nurses face many challenges to present at the patient bedside. The study aimed to identify the challenges of nurses' presence at patients' bedside from the perspective of nurses. Methods: This is a qualitative content analysis study. In-depth semi-structured interviews were conducted with nineteen nurses. Data analysis performed using Zhang's eight stages approach. Results: Three categories emerged: (1) professional challenges with sub-categories: shortage of medical staff, improperly scheduled visits and rounds, time-consuming supervision, inadequate competence, and cultural unfamiliarity, (2) job attenuation with sub-categories: ignoring the needs of nurses, inappropriate management styles (3) unsuitable environment with sub-categories: inadequate medical facilities, ward congestion, and non-standard hospital environment. Conclusions: This study identified the challenges and barriers of nurses' presence at the patient's bedside in different dimensions from the clinical nurses' perspective. Nursing managers must adopt appropriate strategies to solve the challenges of nurses' presence at patients' bedside to achieve the positive benefits of the more effective nurses' presence at patients' bedside.

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Was ist zu diesem Thema bereits bekannt? Patient_innen sind oft der Ansicht: „Für mich ist es nicht nur wichtig, was Pflegende machen, sondern wie sie für mich da sind“. Wie wird eine neue Perspektive eingebracht? Das „Nursing Presence“-Konzept beruht auf „absoluter“ Aufmerksamkeit für Patient_innen. Sprache und Handlung stehen nicht mehr im Vordergrund der Begegnung. Dadurch entsteht ein gewaltfreies Mit-Sein. Der „peripersonale“ Schutzraum der Patient_innen bleibt weitgehend unangetastet. Was sind die Auswirkungen für die Praxis? „Nursing Presence“ kann „Verletzungsverhältnisse“ unterbrechen, die durch Sprache und Handlung entstehen. Dadurch ist es möglich, „pflegebezogenes Leiden“ („suffering related to care“) vozubeugen.

Nursing presence from the perspective of cancer patients: A cross-sectional study

Background & Aim: Nursing presence is an essential element of nursing care. Since the perception of nursing presence is influenced by different factors depending on the culture within which patients receive nursing care, this study aimed to investigate Iranian patients' nursing presence with cancer. Methods & Materials: In this cross-sectional study, 130 cancer patients were selected by random sampling from an oncology teaching hospital. Data was collected by the Presence of Nursing Scale and analyzed by SPSS software. Results: The results showed that the mean score of nursing presence (in a range of 0 to 125) was 101.91±16.19. According to the results, the highest and lowest scores belonged to the items "I trusted in these nurses" and "These nurses met my spiritual needs" with a mean score of 4.38±0.81 and 3.68±1.16, respectively. Data analysis by Pearson correlation coefficient showed no significant correlation between the mean score of nursing presence and quantitative variables such as patients' age, length of stay in the hospital, and the number of hospitalization (p>0.05). Conclusion: Although the total score of nursing presence was high, improvements in some items such as fulfilling the spiritual needs of cancer patients seem necessary. Evaluation of nursing presence by valid measures, encouraging nurses to spend more time and interacting with their patients, and providing special courses on nursing presence could help nurses improve and implement oncology nursing.

EXTENT OF HEMODIALYSIS NURSES’ PRESENCE AS PERCEIVED BY PATIENTS

Background: Nursing presence is an essential nurse caring behavior of being with the patient. This is particularly true for those with chronic renal disease and who regularly undergo maintenance hemodialysis treatment in the hospital setting. When nursing presence is perceived by patients in a nurse-patient relationship, it is more likely to result in enhanced satisfaction with the quality of nursing care. Thus, it is important for hemodialysis nurses to be aware of the relevance of nurse-patient interactions in planned care considering that these interactions are integral to the extent to which nursing presence is experienced and perceived by patients.Objective: This study aims to determine the hemodialysis nurses’ extent of nursing presence as perceived by patients undergoing hemodialysis treatment in two hospitals in Iligan City, Philippines.Methods: Utilizing the descriptive research design, the study was conducted in two hospitals in Iligan City, Philippines. A total of 121 hemodialysis patients were purposely selected to determine their perception as to the extent of hemodialysis nurse’s nursing presence utilizing the 25-item Presence of Nursing Scale (PONS) instrument. Descriptive statistics were used for data analysis.Result: The overall rating by the hemodialysis patients in both hospitals was “always" on the hemodialysis nurses’ extent of nursing presence with an average mean score of 4.47 in all 25 items of the PONS. The highest rated item which reflects that the nurse cares for the patient as a person had an average mean score of 4.63 (always) while the lowest rated item indicating that the nurse is meeting the spiritual needs of the patient had an average mean score of 4.23 (always).Conclusion: The nurse-patient relationship is enhanced by the presence of nurses who are more responsive and interactive with the patients, resulting in patients who are more satisfied with nursing care. Thus, it is suggested that nurses in dealing with patients of varying backgrounds should consider their unique needs when giving information, explanations, health education and nursing care.