Exploring patients', caregivers' and nurses' experience of day hospital chemotherapy: a phenomenological study

Abstract

The aim of this study was to explore patients', caregivers' and nurses' experiences of day hospital chemotherapy and how this compared to their experiences of inpatient care in an acute general hospital in Northern Ireland. More specifically the study objectives focused on the patients' experience, the caregivers' experience, the nurses' experience and the commonalities and differences between these perspectives. Ethical approval for the research and access to the study participants was granted.

A Heideggerian hermeneutic phenomenological methodology was adopted. This involved carrying out in-depth focused interviews with a purposive sample of 30 patients, 10 caregivers and 10 nurses. A narrative approach was used to elicit participant narratives regarding their experiences. Data were analysed using a two stage approach identified by Polkinghome ( 1995). This involved the paradigmatic analysis of narratives followed by the narrative analysis and the construction of case studies. The trustworthiness and rigour of the study were addressed to ensure credibility, transferability, dependability and confirmability.

The findings identified a number of categories comprising the experience of day hospital chemotherapy and the change from inpatient care. This resulted in the development of a transitional conceptual framework, based on the work of Meleis et al (2000) incorporating the key constructs of types, conditions and responses to transition. The types of transition included: health-illness and organisational transition. The conditions for transition uncovered personal and environmental factors that were seen to facilitate or hinder participants' experiences. Personal factors included the positive and negative perceptions of the day hospital. Environmental factors included: organisational issues associated with time, space and continuity of care; the health care professional characteristics; wider 'system issues' and support/comradeship gained from others. The responses to transition identified a process of transition and adaptation. For the patients this focused on personal aspects such as keeping positive and coping. For the nurses and caregivers this focused more on functional outcome activities associated with role changes. Recommendations for practice, education, management/policy-makers and research are offered in the context of these findings. The limitations of the study are also acknowledged.

The theory generated from the research provides a knowledge base for cancer nursing and the care of patients receiving chemotherapy treatment and their caregivers. This is important in the current context of health care and nursing where the experience of the patient and their caregiver should be at the centre of service delivery.

Date of Award	May 2003
Original language	English
Supervisor	Kate Sullivan (Supervisor), Hugh Mc Kenna (Supervisor) & Patrick Johnston (Supervisor)