Themes and goals in cancer outpatient – cancer nurse consultations

Hildfrid Brataas, Sigrid Thorsnes, Owen Hargie

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    Abstract

    Communication between nurses and patients is a pivotal dimension in cancer care. However, one aspect that has received little investigation is the nature of goal-related communications between patient and nurse. This study was designed to investigate the goal-directed communications of nurse–patient interactions in outpatient cancer clinics in Norway. The field study was a naturalistic inquiry involving audio-recordings of eight naturally occurring patient–nurse conversations. Data were content analysed for recurring communication themes and patterns of communication goals. Data revealed three main themes: the medical treatment plan, the patient’s cancer situation and prognosis and the patient’s psychosocial reactions to their illness. The extent to which each theme was discussed and the types of nurses’ and patients’ goals varied depending upon the patient’s situation. Nurses should be participative in goal-setting and pay great attention to patients’ goals and be particularly sensitive to signs of uncertainty. More research is required in order to fully understand the processes involved and help nurses to effectively deal with the core issues involved in these consultations.
    LanguageEnglish
    Pages184-191
    JournalEuropean Journal of Cancer Care
    Volume19
    Issue number2
    DOIs
    Publication statusPublished - 2010

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    Outpatients
    Referral and Consultation
    Nurses
    Neoplasms
    Communication
    Norway
    Ambulatory Care Facilities
    Uncertainty
    Research

    Cite this

    Brataas, Hildfrid ; Thorsnes, Sigrid ; Hargie, Owen. / Themes and goals in cancer outpatient – cancer nurse consultations. In: European Journal of Cancer Care. 2010 ; Vol. 19, No. 2. pp. 184-191.
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    title = "Themes and goals in cancer outpatient – cancer nurse consultations",
    abstract = "Communication between nurses and patients is a pivotal dimension in cancer care. However, one aspect that has received little investigation is the nature of goal-related communications between patient and nurse. This study was designed to investigate the goal-directed communications of nurse–patient interactions in outpatient cancer clinics in Norway. The field study was a naturalistic inquiry involving audio-recordings of eight naturally occurring patient–nurse conversations. Data were content analysed for recurring communication themes and patterns of communication goals. Data revealed three main themes: the medical treatment plan, the patient’s cancer situation and prognosis and the patient’s psychosocial reactions to their illness. The extent to which each theme was discussed and the types of nurses’ and patients’ goals varied depending upon the patient’s situation. Nurses should be participative in goal-setting and pay great attention to patients’ goals and be particularly sensitive to signs of uncertainty. More research is required in order to fully understand the processes involved and help nurses to effectively deal with the core issues involved in these consultations.",
    author = "Hildfrid Brataas and Sigrid Thorsnes and Owen Hargie",
    note = "Reference text: Barnes R. (2005) Conversation analysis: a practical resource in the health care setting. Medical Education 1, 113–115. Beach W. & Anderson J. (2003) Communication and cancer? Part II: conversation analysis. Journal of Psychosocial Oncology 4, 1–22. Beach W., Easter D., Good J. & Pigeron F. (2005) Disclosing and responding to cancer ‘fears’ during oncology interviews. Social Science & Medicine 4, 893–910. Beaver K., Craven O., Witham G., Tomlinson M., Susnerwala S., Jones D. & Luker K. (2007) Patient participation in decision making: views of health professionals caring for people with colorectal cancer. Journal of Clinical Nursing 4, 725–733. Berger C. (2002) Goals and knowledge structures in social interaction. In: Handbook of Interpersonal Communication, 3rd edn (eds Knapp M. & Daly J.), pp. 181–212. Sage, Thousand Oaks, CA, USA. Botti M., Endacott R., Watts R., Cairns J., Lewis K. & Kenny A. (2006) Barriers in providing psychosocial support for patients with cancer. Cancer Nursing 4, 309–316. Brataas H. (2002) Pasientfortellinger i klinisk praksis (Patient narratives in nursing practice). Norsk Tidsskrift for Sykepleieforskning 2, 90–105. Carlson L., Feldman-Stewart D., Tishelman C. & Brundage M. (2005) Patient–professional communication research in cancer: an integrative review of research methods in the context of a conceptual framework. Psycho-Oncology 10, 812–828. Dickson D. & McCartan P. (2005) Communication, skill and health care delivery. In: Community Health Care Nursing, 3rd edn (eds Sines D., Appleby F. & Frost M.), pp. 40–56. Blackwell, Oxford, UK. Dickson D., Hargie O. & Morrow N. (1997) Communication Skills Training for Health Professionals. Chapman & Hall, London, UK. Feldman-Stewart D., Brundage M. & Tishelman C. (2005) A conceptual framework for patient-professional communication: an application to the cancer context. Psycho-Oncology 10, 801–809. Finchman L., Copp G., Caldwell K., Jones L. & Tookman A. (2005) Supportive care: experiences of cancer patients. European Journal of Oncology Nursing 3, 258–268. Gillotti C., Thompson T. & Mnurseeilis K. (2002) Communicative competence in the delivery of bad news. Social Science & Medicine 7, 1011–1023. Hack T., Degner L. & Parker P. (2005) The communication goals and needs of cancer patients: a review. Psycho-Oncology 10, 831–845. Halkowski T. (2005) Realising the illness: patients’ narratives of symptom discovery. In: Communication in Medical Care:Interaction Between Primary Care Physicians and Patients (eds Heritage J. & Maynard D.), pp. 86–114. Cambridge University Press, Cambridge, UK. Hargie O. (2006a) Skill in theory: communication as skilled performance. In: The Handbook of Communication Skills (ed. Hargie O.), pp. 7–36. Routledge, London, UK. Hargie O. (2006b) Skill in practice: an operational model of communicative performance. In: The Handbook of Communication Skills (ed. Hargie O.), pp. 37–70. Routledge, London, UK. Hargie O. & Dickson D. (2004) Skilled Interpersonal CommunicationResearch, Theory and Practice. Routledge, London, UK. Hurley K., Miller S., Costalas J., Gillespie D. & Daly M. (2001) Anxiety/uncertainty reduction as a motivation for interest in prophylactic oophorectomy in women with a family history of ovarian cancer. Journal of Women’s Health and Gender-Based Medicine 2, 93–94. Kinnersley P., Edwards A., Hood K., Cadbury N., Ryan R., Prout H., Owen D., MacBeth F., Butow P. & Butler C. (2007) Interventions before consultations for helping patients address their information needs. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD004565. DOI:10.1002/14651858. CD004565.pub2. Kruijver I., Kerkstra A., Bensing J. & van deWiel H. (2000) Nurse–patient communication in cancer care: a review of the literature. Cancer Nursing 1, 20–31. McCormack B. & McCance T. (2006) Development of a framework for person-centred nursing. Journal of Advanced Nursing 5, 472–479. Manuel J., Burwell S., Crawford S., Lawrence R., Farmer D., Hege A., Phillips K. & Avis N. (2007) Younger women’s perceptions of coping with breast cancer. Cancer Nursing 2, 85–94. Maynard D. & Heritage J. (2005) Conversation analysis, doctor–patient interaction and medical communication. Medical Education 4, 428–435. Oettingen G., Bulgarella C., HendersonM. & Gollwitzer P. (2004) The self-regulation of goal pursuit. Motivational Analyses of Social Behavior (eds Wright R., Greenberg J. & Brehm S.), pp. 225–244. Lawrence Erlbaum, Mahwah NJ, USA. Patton M.Q. (1990) Qualitative Evaluation and Research Methods, 2nd edn. Sage, London, UK. Polit D.F. & Beck C.T. (2006) Essentials of Nursing Research. Methods, Appraisal, and Utilization, 6th edn. Lippincott Williams & Wilkins, Philadelphia, PA, USA. Rutten L., Arora N., Bakos A., Aziz N. & Rowland J. (2005) Information needs and sources of information among cancer patients: a systematic review of research (1980–2003). Patient Education and Counseling 3, 250–261. Sandelowski M. (1995) Sample size in qualitative research. Research in Nursing and Health 2, 179–183. Sanson-Fisher R., Girgis A., Boyes A., Bonevski B., Burton L. & Cook P. (2000) The unmet supportive care needs of patients with cancer. Cancer 1, 226–237. Street R. (2003) Interpersonal communication skills in health care contexts. In: Handbook of Communication and Social Interaction Skills (eds Greene J. & Burleson B.), pp. 909–933. Lawrence Erlbaum Associates, Mahwah, NJ, USA. Thorne S., Kuo M., Armstrong E., McPherson G., Harris S. & Hislop T. (2005) Being known’: patients’ perspectives of the dynamics of human connection in cancer care. Psycho- Oncology 10, 887–898. Van der Molen B. (2000) Relating information needs to the cancer experience. 2. Themes from six cancer narratives. European Journal of Cancer Care 1, 48–54.",
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    Themes and goals in cancer outpatient – cancer nurse consultations. / Brataas, Hildfrid; Thorsnes, Sigrid; Hargie, Owen.

    In: European Journal of Cancer Care, Vol. 19, No. 2, 2010, p. 184-191.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Themes and goals in cancer outpatient – cancer nurse consultations

    AU - Brataas, Hildfrid

    AU - Thorsnes, Sigrid

    AU - Hargie, Owen

    N1 - Reference text: Barnes R. (2005) Conversation analysis: a practical resource in the health care setting. Medical Education 1, 113–115. Beach W. & Anderson J. (2003) Communication and cancer? Part II: conversation analysis. Journal of Psychosocial Oncology 4, 1–22. Beach W., Easter D., Good J. & Pigeron F. (2005) Disclosing and responding to cancer ‘fears’ during oncology interviews. Social Science & Medicine 4, 893–910. Beaver K., Craven O., Witham G., Tomlinson M., Susnerwala S., Jones D. & Luker K. (2007) Patient participation in decision making: views of health professionals caring for people with colorectal cancer. Journal of Clinical Nursing 4, 725–733. Berger C. (2002) Goals and knowledge structures in social interaction. In: Handbook of Interpersonal Communication, 3rd edn (eds Knapp M. & Daly J.), pp. 181–212. Sage, Thousand Oaks, CA, USA. Botti M., Endacott R., Watts R., Cairns J., Lewis K. & Kenny A. (2006) Barriers in providing psychosocial support for patients with cancer. Cancer Nursing 4, 309–316. Brataas H. (2002) Pasientfortellinger i klinisk praksis (Patient narratives in nursing practice). Norsk Tidsskrift for Sykepleieforskning 2, 90–105. Carlson L., Feldman-Stewart D., Tishelman C. & Brundage M. (2005) Patient–professional communication research in cancer: an integrative review of research methods in the context of a conceptual framework. Psycho-Oncology 10, 812–828. Dickson D. & McCartan P. (2005) Communication, skill and health care delivery. In: Community Health Care Nursing, 3rd edn (eds Sines D., Appleby F. & Frost M.), pp. 40–56. Blackwell, Oxford, UK. Dickson D., Hargie O. & Morrow N. (1997) Communication Skills Training for Health Professionals. Chapman & Hall, London, UK. Feldman-Stewart D., Brundage M. & Tishelman C. (2005) A conceptual framework for patient-professional communication: an application to the cancer context. Psycho-Oncology 10, 801–809. Finchman L., Copp G., Caldwell K., Jones L. & Tookman A. (2005) Supportive care: experiences of cancer patients. European Journal of Oncology Nursing 3, 258–268. Gillotti C., Thompson T. & Mnurseeilis K. (2002) Communicative competence in the delivery of bad news. Social Science & Medicine 7, 1011–1023. Hack T., Degner L. & Parker P. (2005) The communication goals and needs of cancer patients: a review. Psycho-Oncology 10, 831–845. Halkowski T. (2005) Realising the illness: patients’ narratives of symptom discovery. In: Communication in Medical Care:Interaction Between Primary Care Physicians and Patients (eds Heritage J. & Maynard D.), pp. 86–114. Cambridge University Press, Cambridge, UK. Hargie O. (2006a) Skill in theory: communication as skilled performance. In: The Handbook of Communication Skills (ed. Hargie O.), pp. 7–36. Routledge, London, UK. Hargie O. (2006b) Skill in practice: an operational model of communicative performance. In: The Handbook of Communication Skills (ed. Hargie O.), pp. 37–70. Routledge, London, UK. Hargie O. & Dickson D. (2004) Skilled Interpersonal CommunicationResearch, Theory and Practice. Routledge, London, UK. Hurley K., Miller S., Costalas J., Gillespie D. & Daly M. (2001) Anxiety/uncertainty reduction as a motivation for interest in prophylactic oophorectomy in women with a family history of ovarian cancer. Journal of Women’s Health and Gender-Based Medicine 2, 93–94. Kinnersley P., Edwards A., Hood K., Cadbury N., Ryan R., Prout H., Owen D., MacBeth F., Butow P. & Butler C. (2007) Interventions before consultations for helping patients address their information needs. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD004565. DOI:10.1002/14651858. CD004565.pub2. Kruijver I., Kerkstra A., Bensing J. & van deWiel H. (2000) Nurse–patient communication in cancer care: a review of the literature. Cancer Nursing 1, 20–31. McCormack B. & McCance T. (2006) Development of a framework for person-centred nursing. Journal of Advanced Nursing 5, 472–479. Manuel J., Burwell S., Crawford S., Lawrence R., Farmer D., Hege A., Phillips K. & Avis N. (2007) Younger women’s perceptions of coping with breast cancer. Cancer Nursing 2, 85–94. Maynard D. & Heritage J. (2005) Conversation analysis, doctor–patient interaction and medical communication. Medical Education 4, 428–435. Oettingen G., Bulgarella C., HendersonM. & Gollwitzer P. (2004) The self-regulation of goal pursuit. Motivational Analyses of Social Behavior (eds Wright R., Greenberg J. & Brehm S.), pp. 225–244. Lawrence Erlbaum, Mahwah NJ, USA. Patton M.Q. (1990) Qualitative Evaluation and Research Methods, 2nd edn. Sage, London, UK. Polit D.F. & Beck C.T. (2006) Essentials of Nursing Research. Methods, Appraisal, and Utilization, 6th edn. Lippincott Williams & Wilkins, Philadelphia, PA, USA. Rutten L., Arora N., Bakos A., Aziz N. & Rowland J. (2005) Information needs and sources of information among cancer patients: a systematic review of research (1980–2003). Patient Education and Counseling 3, 250–261. Sandelowski M. (1995) Sample size in qualitative research. Research in Nursing and Health 2, 179–183. Sanson-Fisher R., Girgis A., Boyes A., Bonevski B., Burton L. & Cook P. (2000) The unmet supportive care needs of patients with cancer. Cancer 1, 226–237. Street R. (2003) Interpersonal communication skills in health care contexts. In: Handbook of Communication and Social Interaction Skills (eds Greene J. & Burleson B.), pp. 909–933. Lawrence Erlbaum Associates, Mahwah, NJ, USA. Thorne S., Kuo M., Armstrong E., McPherson G., Harris S. & Hislop T. (2005) Being known’: patients’ perspectives of the dynamics of human connection in cancer care. Psycho- Oncology 10, 887–898. Van der Molen B. (2000) Relating information needs to the cancer experience. 2. Themes from six cancer narratives. European Journal of Cancer Care 1, 48–54.

    PY - 2010

    Y1 - 2010

    N2 - Communication between nurses and patients is a pivotal dimension in cancer care. However, one aspect that has received little investigation is the nature of goal-related communications between patient and nurse. This study was designed to investigate the goal-directed communications of nurse–patient interactions in outpatient cancer clinics in Norway. The field study was a naturalistic inquiry involving audio-recordings of eight naturally occurring patient–nurse conversations. Data were content analysed for recurring communication themes and patterns of communication goals. Data revealed three main themes: the medical treatment plan, the patient’s cancer situation and prognosis and the patient’s psychosocial reactions to their illness. The extent to which each theme was discussed and the types of nurses’ and patients’ goals varied depending upon the patient’s situation. Nurses should be participative in goal-setting and pay great attention to patients’ goals and be particularly sensitive to signs of uncertainty. More research is required in order to fully understand the processes involved and help nurses to effectively deal with the core issues involved in these consultations.

    AB - Communication between nurses and patients is a pivotal dimension in cancer care. However, one aspect that has received little investigation is the nature of goal-related communications between patient and nurse. This study was designed to investigate the goal-directed communications of nurse–patient interactions in outpatient cancer clinics in Norway. The field study was a naturalistic inquiry involving audio-recordings of eight naturally occurring patient–nurse conversations. Data were content analysed for recurring communication themes and patterns of communication goals. Data revealed three main themes: the medical treatment plan, the patient’s cancer situation and prognosis and the patient’s psychosocial reactions to their illness. The extent to which each theme was discussed and the types of nurses’ and patients’ goals varied depending upon the patient’s situation. Nurses should be participative in goal-setting and pay great attention to patients’ goals and be particularly sensitive to signs of uncertainty. More research is required in order to fully understand the processes involved and help nurses to effectively deal with the core issues involved in these consultations.

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    DO - 10.1111/j.1365-2354.2008.01040.x

    M3 - Article

    VL - 19

    SP - 184

    EP - 191

    JO - European Journal of Cancer Care

    T2 - European Journal of Cancer Care

    JF - European Journal of Cancer Care

    SN - 0961-5423

    IS - 2

    ER -