Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/24356
Appears in Collections:Faculty of Health Sciences and Sport eTheses
Title: Psychosocial support within the everyday work of hospice ward nurses: an observational study
Authors: Hill, Hazel Catherine
Supervisor(s): Evans, Josie
Forbat, Liz
Paley, John
Keywords: Nursing
Psychosocial
Palliative
Hospice
Observation
Issue Date: Jul-2016
Publisher: University of Stirling
Citation: Hill, H.C., Evans, J. and Forbat, L., 2015. Nurses respond to patients’ psychosocial needs by dealing, ducking, diverting and deferring: an observational study of a hospice ward. BMC Nursing, 14:60 DOI: 10.1186/s12942-015-0112-8
Hill, H.C., Paley, J. and Forbat, L., 2014. Observations of professional-patient relationships: A mixed-methods study exploring whether familiarity is a condition for nurses' provision of psychosocial support. Palliative Medicine, 28 (3), pp.256-263 http://pmj.sagepub.com/content/early/2013/08/07/0269216313499960 DOI: 10.1177/0269216313499960
Abstract: Abstract Psychosocial support is said to be an inherent component of nursing care and a major focus of palliative care. Literature exists which outlines perceptions of the psychosocial needs of patients and how psychosocial support should be provided. However, there is a lack of empirical evidence on how psychosocial support is operationalised in practice. This study provides a valuable and substantial new contribution to the evidence on the psychosocial needs expressed by patients in a hospice ward and how nurses immediately respond to these needs within their everyday practice. A study gathering data via observations with matched interviews of patients and nurses, organisational, documentary, and demographic variables, was conducted over an eight month period. Thirty-eight nurses (registered and auxiliary) and 47 patients were included in a maximum variation sampling strategy. Data was analysed using constant comparative qualitative techniques. Patients expressed a wide variety of psychosocial needs, often only signalling them whilst receiving care for other reasons. Considering these needs in relation to Maslow’s (1943) hierarchy of needs suggests that in-patients more commonly express prerequisites to physiological care and ‘lower level’ safety needs rather than the more thoroughly researched and espoused ‘higher’ level psychosocial needs. The nurses reacted to these psychosocial needs with a range of responses which indicated a diminishing level of immediate support: ‘dealing’, ‘deferring’, ‘diverting’ and ‘ducking’. The majority of the nurses were observed using each of these responses at some point during data collection. A variety of the responses were used for each type and context of psychosocial need. These responses were influenced by the ward’s workplace culture. This study demonstrates a requirement for more thorough consideration of the true psychosocial needs of patients, which appear to vary dependent on the context of care. Consideration should be v given to workplace culture and its influence over psychosocial support, with nurses being supported to expand their response repertoire so that patients’ psychosocial needs are acknowledged more. Increasing nurses’ knowledge of the reality of psychosocial support through education and research will encourage formalisation of the place of psychosocial support in the planning, documentation and provision of care. This study shows that ward nurses can offer psychosocial support as an inherent component of their everyday work. Findings derived from this research indicate that developing an understanding of how patients express psychosocial needs in practice, through a consideration of Maslow’s (1943) hierarchy of needs, may increase recognition and support of psychosocial needs and enable nurses to respond more comprehensively.
Type: Thesis or Dissertation
URI: http://hdl.handle.net/1893/24356

Files in This Item:
File Description SizeFormat 
Psychosocial Support Within the Everday Work of Hospice Ward Nurses_Hill HC_2016.pdfPhD Thesis3.17 MBAdobe PDFUnder Embargo until 1/1/2018     Request a copy

Note: If any of the files in this item are currently embargoed, you can request a copy directly from the author by clicking the padlock icon above. However, this facility is dependant on the depositor still being contactable at their original email address.

This item is protected by original copyright



Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

If you believe that any material held in STORRE infringes copyright, please contact library@stir.ac.uk providing details and we will remove the Work from public display in STORRE and investigate your claim.