Birgith Pedersen

Relatives are an important resource to hospitalised patients and hence to nursing. During the COVID-19 pandemic, visiting restriction policies were implemented in healthcare settings globally, unwillingly excluding relatives from visiting the bedsides of their loved ones. The aim of the present study was to explore how the visiting restrictions influenced relatives’ relationships with patients and collaboration with registered nurses at non-pandemic hospital wards. In total, 13 relatives were interviewed. The study was reported following the COREQ guidelines and checklist. Content analysis led to three themes: 1) being excluded from providing care and support; 2) being excluded from conveying person-centred and situational relevant knowledge to registered nurses; and 3) being excluded from assessing the health status of the hospitalised loved one. Together they describe relatives feeling worried and powerless regarding the health of their hospitalised loved one and the performed nursing care. Findings from studies such as this are pivotal to any future national or global health crisis, where visiting restriction policies are implemented.

COVID-19 restrictions prevented relatives from visiting and accompanying patients to hospital and required that nurses wore personal protective equipment. These changes affected patients’ relationships with relatives and challenged their ability to connect with nurses. Individual, semi-structured interviews with 15 patients were carried out to explore patients’ experiences of their relationships with relatives and their collaboration with nurses during in- and outpatient contacts in non-COVID-19 hospital wards. The analysis of data was guided by phenomenological hermeneutic frame of reference and the study was reported according to the COREQ checklist. The findings illustrated that patients felt lonely and insecure when separated from relatives, caught between relatives and professionals during information exchange, and experienced the absence of relatives as both beneficial and burdening. Visitor restrictions provided patients with time to heal but prevented provision of informal care. Patients had to take responsibility for maintaining contact with relatives independent of their health condition. COVID-19 restrictions created distance with nurses, which potentially led to insufficient physical and psychosocial care.

To explore the essential meaning of how sensory disturbances caused by Oxaliplatin influence self-understanding and freedom to live an everyday life among survivors after colorectal cancer.Data was...

This study aims to explore how a changed COVID-19 work environment influences nurses’ clinical decision-making. Data were collected via three focus groups totaling 14 nurses working in COVID-19 pandemic wards at a Danish university hospital. The factors influencing decision-making are described in three themes; navigating in a COVID-19 dominated context, recognizing the importance of collegial fellowship, and the complexities of feeling competent. A strong joint commitment among the nurses to manage critical situations fostered a culture of knowledge-sharing and drawing on colleagues’ competencies in clinical decision-making. It is important for nurse leaders to consider multiple factors when preparing nurses not only to work in changing work environments, but also when nurses are asked to work in environments and specialties that deviate from their usual routines.

This article discusses how existential phenomenology may serve as a frame in a mixed‐methods study of changes in weight and body composition among women in adjuvant treatment for breast cancer. In accordance with ontologically and epistemologically fundamental assumptions in nursing, we link mixed‐methods and existential phenomenology from the perspective of the French philosopher Maurice Merleau‐Ponty and his notion of a unified body subject. Letting this perspective permeate our philosophy, methodology and issues at the method level in mixed‐method research undermines the distinction between first‐ and third‐person perspective when applying and integrating different data sources in a mixed‐methods study. Applying Merleau‐Ponty's third way, the women's bodily experiences appear as gestalt; a ‘figure’ against a ground of existential threats that are grasped through insight from data integrating in joint displays, which revealed the women's experiences on a deep existential level. Existential phenomenology as a frame in mixed‐method studies can speak not only to nurses but also to a multidisciplinary audience in a shared attempt to deepen the understanding of a patient's healthcare problem.

The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses’ experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care.

Patients with cancer are expected to call an oncological emergency unit when they are unable to manage symptoms of their disease and side effects from treatment at home. Responding to calls from patients with different problems in a team of registered nurses and medical doctors requires interprofessional collaboration and learning. Therefore, this study aimed to explore conditions for team-based collaboration and learning when responding to calls from patients diagnosed with cancer in a specific setting of an oncological emergency unit. Using a frame of qualitative description three focus groups with 16 healthcare professionals from an oncological emergency unit at a Danish University Hospital were conducted. The verbatim transcribed text was analyzed using content analysis, and reported according to the COREQ guidelines. Two main themes emerged: 1) ‘Availability – a precondition for learning and collaboration’ and 2) ‘Sense of responsibility and distribution of roles’. The study demonstrated that interprofessional collaboration and learning were affected by intra and interprofessional and contextual factors. In addition to an awareness of personal attitudes, the environment and the distribution of responsibility and roles as essential preconditions for accomplishing teamwork need to be explicitly articulated if the team-based learning and collaboration are to succeed.

Purpose: To deepen the understanding of how survivors’ experience and give meaning to the embodied phenomenon of chronic sensory disturbances in everyday life after oxaliplatin treatment for colorectal cancer. Methods: Data was generated by means of a semi-structured interview guide and drawings with the aim to explore eight survivors’ lifeworld experiences. Data was analyzed through a phenomenological approach. Results: The essential meaning of sensory disturbances emerged in two main themes and four sub-themes. Theme A: ‘A peculiar experience that is difficult to logically understand’ with the subthemes; ‘An ambiguous perception in hands and feet’ and ‘Being alienated from one’s own body’. Theme B: Losing touch with the world’ with the subthemes: ‘A lack of sensory contact with physical surfaces’ and ‘Breakdown of sensitivity in hands hampers fine motor skills and social contact’. Conclusion: Sensory disturbances contributed to an ambiguous and discordant perception of an alienated body that was difficult to describe and affected the ability to act and connect to things and other people. Metaphors and drawings were valuable as means to verbalize and illustrate the changed body perception where the ‘I can’ changed into ‘I cannot’. To support the embodied connection to the world new usage patterns were required.

Background: Cancer treatment is often given on an outpatient basis. An oncological emergency telephone line has been established to improve access to cancer care and prevent life‐threatening side effects. However, healthcare professionals need to make clinical decisions without being able to assess patients face‐to‐face, which may be problematic. This study explores how healthcare professionals experience clinical decision‐making in oncological emergency telephone consultations.Methods: An exploratory qualitative approach applying three focus groups with healthcare professionals from a Danish university hospital were undertaken. Data were analysed using inductive content analysis.Results: An overall theme elucidated how healthcare professionals ended up deciding during each call whether the problem could be solved on the phone or the patient had to come for a face‐to‐face consultation or to wait and see whether the condition changed. Some decisions were easy to make, while others were moderate or difficult. The decision was influenced by several factors that could be structured into three themes: reliance on one’s own knowledge and experience, consideration of different perspectives and the influence of context.Conclusion: This study demonstrated that clinical decision‐making in oncological emergency telephone consultations includes three types of decisions that are intertwined with intra‐personal, inter‐professional and contextual factors such as personal knowledge, collaboration and workload. These factors are essential for the timely referral of patients to the right level of service.

Aims and objectives: To explore from a nurse and patient perspective what questionnaire—“Functional assessment of cancer treatment gynecological group neurotoxicity” or “Oxaliplatin‐Associated Neuropathy Questionnaire”—best describes chemotherapy‐induced peripheral neuropathy and its influence on everyday life in a comprehensive and meaningful way, prior to implementation in daily practice.Background: Patients experience chemotherapy‐induced peripheral neuropathy during and after chemotherapy for colorectal cancer with oxaliplatin. This neuropathy is difficult to describe for patients and to identify for nurses. To address the specific needs of patients and improve identification of neuropathy and its influence on everyday life, we wanted to implement a questionnaire in clinical practice.Design: A phenomenological hermeneutic frame of reference was used.Method: Semi‐structured interviews with 15 patients and two focus groups with eight cancer nurses were used for data collection. Data were organised and interpreted by content analytical steps in a hermeneutical process. COREQ checklist was used in reporting of the study.Results: The analysis resulted in two main themes (a) “To dig deeper” with sub‐themes “to identify the line between acceptable and nonacceptable chemotherapy‐induced peripheral neuropathy,” and “searching for a precise description.” (b). “When everything is interrelated” with sub‐themes “to be aware of different perspectives and understandings” and “recognise potential pitfalls.”Conclusion: Involving patients and nurses in choosing between the two questionnaires revealed that neither alone was sufficient to describe the patients’ experiences. Instead, it seems essential to implement both questionnaires, using the answers as a basis for a dialogue to address the patients’ specific needs.Relevance for clinical practice: Using patients and nurses perspectives in a complementary way may provide a solid foundation before starting an implementation process in clinical practice. However, attention must be paid to potential barriers and facilitators as well as the fact that a successful implementing process requires leadership and information sharing.