The "Cost of Caring" for Cancer Patients: Mixed Methods Research With Victories and Hazards Exposed

2.50
Hdl Handle:
http://hdl.handle.net/10755/621810
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
The "Cost of Caring" for Cancer Patients: Mixed Methods Research With Victories and Hazards Exposed
Author(s):
Freeman-Gibb, Laurie; Pfaff, Kathryn A.; Patrick, Linda J.
Lead Author STTI Affiliation:
Tau Upsilon
Author Details:
Laurie Freeman-Gibb, PhD, RN, ANP, Professional Experience: -I have been working as an RN for 29 years. My career began on a standard medical-surgical floor. I went from there to a medical ICU where I became interested in Oncology nursing. I then was the nurse educator for the ICU when I went back to school for my Masters and joined STTI. I became a Nurse Practitioner and was employed in Oncology, my area of expertise is breast cancer. From there I worked briefly in GI as an NP while working part-time on my PhD. I currently am an assistant professor full time at the University of Windsor, for the last eight years. I am doing research on fear of cancer recurrence, compassion fatigue and on nursing students satisfaction with nursing education. Author Summary: Dr. Freeman-Gibb is a well known international speaker and researcher on topics related to oncology nursing and student satisfaction. She is currently a tenure track assistant professor at the University of Windsor Ontario Canada. Laurie is very actively involved in the community and currently is a sitting board member of the largest acute care system in the city of Windsor.
Abstract:

Compassion fatigue (CF) is a form of secondary traumatic stress and burnout (Figley, 1995). CF is experienced as emotional and physical erosion on a personal level, and occurs when helping professionals are unable to refuel or regenerate (Joinson, 1992; Figley, 1995). As CF most commonly occurs during and/or following prolonged interactions with individuals who are in distress, it is also thought to be the result of stress coupled with ongoing self-sacrifice (Potter et al., 2013). The prevalence is particularly high in oncology settings (Potter et al., 2013; Vachon, 2012; Yu, Jiang, & Shen, 2016). The ‘cost of caring’ intensely impacts on patient and organizational outcomes in that caregivers become unable to nurture or empathize with persons in their care (Figley, 1995). The results can impact on patient satisfaction, patient safety due to increased sick days and reduced productivity of staff, along with higher turnover rates (Hooper, Craig, Janvrin, Wetsel, & Reimels, 2010). Initially thought to only be a nursing related phenomenon (Joinson, 1992) it is now known that all healthcare providers are at risk for CF (Hooper et al., 2010).

A six-week pilot CF resiliency (CFR) program was developed and offered to interprofessional healthcare providers and staff at a regional cancer centre in Ontario, Canada. The intervention was offered as a two-hour program after the workday in the hospital setting and based on the CF – Accelerated Recovery Program (ARP) (Gentry, Baranowsky, & Dunning, 2002; Traumatology Institute, 2012). It was evaluated using an experimental embedded mixed methods research study design (Creswell & Plano Clark, 2010) to evaluate the impact of the pilot CFR Program. The purpose of this presentation is to examine the use an experimental embedded mixed methods research study design and discuss the best ways to achieve victories and avoid research hazards when doing workplace interventional studies.

In keeping with a mixed methods design a combination of qualitative and quantitative methods was used to evaluate the CFR program. The use of a mixed methods design provided a better understanding of the complex phenomena of compassion fatigue than either approach alone (Molina-Azorin, 2016). Standardized instruments to measure CF and related concepts were administered before and after the educational program intervention. Focus groups and individual interviews were conducted at mid-intervention and at completion of the CFR program. The qualitative and quantitative data were analyzed separately and merged to produce the overall findings. Researcher triangulation was used throughout all phases and processes of the study enhancing the inferences made.

After ethical approval was granted from both the university and the healthcare system Faculty of Nursing members drove the research component separately from the educational intervention undertaking that was totally supported by the cancer care facility. Initial support from the cancer care facility extended to assistance with study packet photocopying, communication with participants interested in the educational intervention and other administrative oversight.

The mixed methods design used a phase one quantitative data collection through voluntary recruitment prior to the initiation of the CFR program. Complete study packets from clerks, managers, registered nurses, physician’s, radiation therapists and other care workers for analysis were received. The research team was available during this portion to assist with question on how to fill in the questioners. At the end of the quantitative data collection a separate form asked participants if they would consent to being contacted at the mid point of the educational intervention to participate in 3 scheduled focus groups or an individual interview to discuss their experiences as the qualitative section of the method used. Final data collection was done at the end of the last session of the educational intervention and again participants were asked if they would like to be contacted to participate in focus groups or have an individual interview.

Our Victories:

The working relationship between the cancer center staff and the faculty members was excellent. Recruitment into the educational program and initial enrolment into the study portion exceeded our expectations. It was also thrilling to have participation from so many segments of the healthcare team. Initial assistance with study packets and having a room in the hospital dedicated to the study and then to the educational intervention made it convenient for staff and for the research team. Financial support from the management team supported the endeavour and encouraged participation in the educational intervention.

Encountered Hazards:

Support from the cancer center management team was withdrawn halfway through the educational program when the main program champion changed jobs. This significantly impacted the educational sessions and planned activates. Hospital printing of the study packets for final data collection had errors that were not correctable therefore valuable data was lost. Expecting multidisciplinary groups to learn together has its own set of concerns that must be addressed prior to doing this type of education. Many participants did not complete the program nor stay for final data collection again significantly impacting the results. Focus groups were poorly attended with many participants’ preferring individual interviews, which can be costly and time consuming.

Conclusion

Mixed methods design can acquire rich data on areas that are not well researched. Use of this methodology can be complicated but truly does allow for a more complete analysis of the situation. Describing how to successfully embed qualitative and quantitative methods will assist other nursing researchers in the future use this methodology. Multiple victories and hazards were encountered when doing the research component of this program. Bringing awareness of them and the impact they had on doing this type of research is necessary to assist other nurse researchers in avoiding the same issues in future research endeavours.

Keywords:
Interprofessional; Researchers; Mixed Methods Design
Repository Posting Date:
13-Jul-2017
Date of Publication:
13-Jul-2017
Other Identifiers:
INRC17PST
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleThe "Cost of Caring" for Cancer Patients: Mixed Methods Research With Victories and Hazards Exposeden_US
dc.contributor.authorFreeman-Gibb, Laurieen
dc.contributor.authorPfaff, Kathryn A.en
dc.contributor.authorPatrick, Linda J.en
dc.contributor.departmentTau Upsilonen
dc.author.detailsLaurie Freeman-Gibb, PhD, RN, ANP, Professional Experience: -I have been working as an RN for 29 years. My career began on a standard medical-surgical floor. I went from there to a medical ICU where I became interested in Oncology nursing. I then was the nurse educator for the ICU when I went back to school for my Masters and joined STTI. I became a Nurse Practitioner and was employed in Oncology, my area of expertise is breast cancer. From there I worked briefly in GI as an NP while working part-time on my PhD. I currently am an assistant professor full time at the University of Windsor, for the last eight years. I am doing research on fear of cancer recurrence, compassion fatigue and on nursing students satisfaction with nursing education. Author Summary: Dr. Freeman-Gibb is a well known international speaker and researcher on topics related to oncology nursing and student satisfaction. She is currently a tenure track assistant professor at the University of Windsor Ontario Canada. Laurie is very actively involved in the community and currently is a sitting board member of the largest acute care system in the city of Windsor.en
dc.identifier.urihttp://hdl.handle.net/10755/621810-
dc.description.abstract<p><span>Compassion fatigue (CF) is a form of secondary traumatic stress and burnout (Figley, 1995). CF is experienced as emotional and physical erosion on a personal level, and occurs when helping professionals are unable to refuel or regenerate (Joinson, 1992; Figley, 1995). As CF most commonly occurs during and/or following prolonged interactions with individuals who are in distress, it is also thought to be the result of stress coupled with ongoing self-sacrifice (Potter et al., 2013). The prevalence is particularly high in oncology settings (Potter et al., 2013; Vachon, 2012; Yu, Jiang, & Shen, 2016). The ‘cost of caring’ intensely impacts on patient and organizational outcomes in that caregivers become unable to nurture or empathize with persons in their care (Figley, 1995). The results can impact on patient satisfaction, patient safety due to increased sick days and reduced productivity of staff, along with higher turnover rates (Hooper, Craig, Janvrin, Wetsel, & Reimels, 2010). Initially thought to only be a nursing related phenomenon (Joinson, 1992) it is now known that all healthcare providers are at risk for CF (Hooper et al., 2010).</span></p> <p>A six-week pilot CF resiliency (CFR) program was developed and offered to interprofessional healthcare providers and staff at a regional cancer centre in Ontario, Canada. The intervention was offered as a two-hour program after the workday in the hospital setting and based on the <em>CF – Accelerated Recovery Program (ARP)</em> (Gentry, Baranowsky, & Dunning, 2002; Traumatology Institute, 2012). It was evaluated using an experimental embedded mixed methods research study design (Creswell & Plano Clark, 2010) to evaluate the impact of the pilot CFR Program. The purpose of this presentation is to examine the use an experimental embedded mixed methods research study design and discuss the best ways to achieve victories and avoid research hazards when doing workplace interventional studies.</p> <p>In keeping with a mixed methods design a combination of qualitative and quantitative methods was used to evaluate the CFR program. The use of a mixed methods design provided a better understanding of the complex phenomena of compassion fatigue than either approach alone (Molina-Azorin, 2016). Standardized instruments to measure CF and related concepts were administered before and after the educational program intervention. Focus groups and individual interviews were conducted at mid-intervention and at completion of the CFR program. The qualitative and quantitative data were analyzed separately and merged to produce the overall findings. Researcher triangulation was used throughout all phases and processes of the study enhancing the inferences made.</p> <p>After ethical approval was granted from both the university and the healthcare system Faculty of Nursing members drove the research component separately from the educational intervention undertaking that was totally supported by the cancer care facility. Initial support from the cancer care facility extended to assistance with study packet photocopying, communication with participants interested in the educational intervention and other administrative oversight.</p> <p>The mixed methods design used a phase one quantitative data collection through voluntary recruitment prior to the initiation of the CFR program. Complete study packets from clerks, managers, registered nurses, physician’s, radiation therapists and other care workers for analysis were received. The research team was available during this portion to assist with question on how to fill in the questioners. At the end of the quantitative data collection a separate form asked participants if they would consent to being contacted at the mid point of the educational intervention to participate in 3 scheduled focus groups or an individual interview to discuss their experiences as the qualitative section of the method used. Final data collection was done at the end of the last session of the educational intervention and again participants were asked if they would like to be contacted to participate in focus groups or have an individual interview.</p> <p>Our Victories:</p> <p>The working relationship between the cancer center staff and the faculty members was excellent. Recruitment into the educational program and initial enrolment into the study portion exceeded our expectations. It was also thrilling to have participation from so many segments of the healthcare team. Initial assistance with study packets and having a room in the hospital dedicated to the study and then to the educational intervention made it convenient for staff and for the research team. Financial support from the management team supported the endeavour and encouraged participation in the educational intervention.</p> <p>Encountered Hazards:</p> <p>Support from the cancer center management team was withdrawn halfway through the educational program when the main program champion changed jobs. This significantly impacted the educational sessions and planned activates. Hospital printing of the study packets for final data collection had errors that were not correctable therefore valuable data was lost. Expecting multidisciplinary groups to learn together has its own set of concerns that must be addressed prior to doing this type of education. Many participants did not complete the program nor stay for final data collection again significantly impacting the results. Focus groups were poorly attended with many participants’ preferring individual interviews, which can be costly and time consuming.</p> <p>Conclusion</p> <p>Mixed methods design can acquire rich data on areas that are not well researched. Use of this methodology can be complicated but truly does allow for a more complete analysis of the situation. Describing how to successfully embed qualitative and quantitative methods will assist other nursing researchers in the future use this methodology. Multiple victories and hazards were encountered when doing the research component of this program. Bringing awareness of them and the impact they had on doing this type of research is necessary to assist other nurse researchers in avoiding the same issues in future research endeavours.</p>en
dc.subjectInterprofessionalen
dc.subjectResearchersen
dc.subjectMixed Methods Designen
dc.date.available2017-07-13T13:34:32Z-
dc.date.issued2017-07-13-
dc.date.accessioned2017-07-13T13:34:32Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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