“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.36367/ntqr.16.2023.e789 |
Resumo: | Abstract: Treatment for kidney failure, such as dialysis, can result in a tremendously high physical and psychosocial symptom burden on patients and their families. Kidney supportive care (KSC), including advance care planning, involves early identification and treatment of symptoms that improve the quality of life for people receiving dialysis. The delay or lack of engagement in KSC by dialysis nurses until the end of life may result in people dying without receiving optimal palliative care services. Purpose and Questions: Our overarching purpose is to develop a theory about the process of engagement in KSC by dialysis nurses, and this paper is about a sub-question: What are the personal, professional, organizational, and environmental factors that shape nurses’ attitudes/beliefs toward and knowledge of supportive care in dialysis? Methods: We followed Charmaz’s constructivist grounded theory method. Through initial purposeful and subsequent theoretical sampling, 23 nurses with work experience in outpatient hemodialysis, home hemodialysis, and peritoneal dialysis settings from across Canada were recruited to participate in two interviews, each using the Zoom© teleconferencing platform. Concurrent data collection and analysis were undertaken. Results: Findings at the focused coding stage comprise contextual factors impacting such engagement. The core category of Fragmenting Care is explained by four categories of contextual factors and their related concepts and sub-concepts: (1) structural (lack of dedicated time, language barrier, knowledge gap); (2) inter-relational (patient-related factors; nurse-related factors [discomfort with having the conversation, lack of self-confidence, multi-dimensional tensions—them versus us]); (3) cultural-dialysis (biomedical focus, ambiguous responsibility, inopportune conversations); and (4) systemic (lack of conceptual clarity). Implications: These collective factors have not been illuminated previously, and while challenging, they help to better understand and therefore address engagement in KSC by dialysis nurses. Conclusion: Effecting change to normalize KSC is a priority requiring solutions compatible with complex systems. |
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“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive CareKidney failureDialysisSupportive careNursingConstructivist grounded theoryAbstract: Treatment for kidney failure, such as dialysis, can result in a tremendously high physical and psychosocial symptom burden on patients and their families. Kidney supportive care (KSC), including advance care planning, involves early identification and treatment of symptoms that improve the quality of life for people receiving dialysis. The delay or lack of engagement in KSC by dialysis nurses until the end of life may result in people dying without receiving optimal palliative care services. Purpose and Questions: Our overarching purpose is to develop a theory about the process of engagement in KSC by dialysis nurses, and this paper is about a sub-question: What are the personal, professional, organizational, and environmental factors that shape nurses’ attitudes/beliefs toward and knowledge of supportive care in dialysis? Methods: We followed Charmaz’s constructivist grounded theory method. Through initial purposeful and subsequent theoretical sampling, 23 nurses with work experience in outpatient hemodialysis, home hemodialysis, and peritoneal dialysis settings from across Canada were recruited to participate in two interviews, each using the Zoom© teleconferencing platform. Concurrent data collection and analysis were undertaken. Results: Findings at the focused coding stage comprise contextual factors impacting such engagement. The core category of Fragmenting Care is explained by four categories of contextual factors and their related concepts and sub-concepts: (1) structural (lack of dedicated time, language barrier, knowledge gap); (2) inter-relational (patient-related factors; nurse-related factors [discomfort with having the conversation, lack of self-confidence, multi-dimensional tensions—them versus us]); (3) cultural-dialysis (biomedical focus, ambiguous responsibility, inopportune conversations); and (4) systemic (lack of conceptual clarity). Implications: These collective factors have not been illuminated previously, and while challenging, they help to better understand and therefore address engagement in KSC by dialysis nurses. Conclusion: Effecting change to normalize KSC is a priority requiring solutions compatible with complex systems.Ludomedia2023-08-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.36367/ntqr.16.2023.e789https://doi.org/10.36367/ntqr.16.2023.e789New Trends in Qualitative Research; Vol. 16 (2023): Qualitative Research: Practices and Challenges; e789New Trends in Qualitative Research; Vol. 16 (2023): Qualitative Research: Practices and Challenges; e789New Trends in Qualitative Research; Vol. 16 (2023): Qualitative Research: Practices and Challenges; e7892184-777010.36367/ntqr.16.2023reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://publi.ludomedia.org/index.php/ntqr/article/view/789https://publi.ludomedia.org/index.php/ntqr/article/view/789/861Copyright (c) 2023 New Trends in Qualitative Researchinfo:eu-repo/semantics/openAccessJovina Concepcion BachynskiLenora DuhnIdevania CostaPilar Camargo-Plazas2023-10-01T07:00:07Zoai:ojs.publi.ludomedia.org:article/789Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:28:15.395797Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care |
title |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care |
spellingShingle |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care Jovina Concepcion Bachynski Kidney failure Dialysis Supportive care Nursing Constructivist grounded theory |
title_short |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care |
title_full |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care |
title_fullStr |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care |
title_full_unstemmed |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care |
title_sort |
“We’re not There yet”: Exploring Contextual Factors Shaping Canadian Dialysis Nurses’ Engagement in Kidney Supportive Care |
author |
Jovina Concepcion Bachynski |
author_facet |
Jovina Concepcion Bachynski Lenora Duhn Idevania Costa Pilar Camargo-Plazas |
author_role |
author |
author2 |
Lenora Duhn Idevania Costa Pilar Camargo-Plazas |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Jovina Concepcion Bachynski Lenora Duhn Idevania Costa Pilar Camargo-Plazas |
dc.subject.por.fl_str_mv |
Kidney failure Dialysis Supportive care Nursing Constructivist grounded theory |
topic |
Kidney failure Dialysis Supportive care Nursing Constructivist grounded theory |
description |
Abstract: Treatment for kidney failure, such as dialysis, can result in a tremendously high physical and psychosocial symptom burden on patients and their families. Kidney supportive care (KSC), including advance care planning, involves early identification and treatment of symptoms that improve the quality of life for people receiving dialysis. The delay or lack of engagement in KSC by dialysis nurses until the end of life may result in people dying without receiving optimal palliative care services. Purpose and Questions: Our overarching purpose is to develop a theory about the process of engagement in KSC by dialysis nurses, and this paper is about a sub-question: What are the personal, professional, organizational, and environmental factors that shape nurses’ attitudes/beliefs toward and knowledge of supportive care in dialysis? Methods: We followed Charmaz’s constructivist grounded theory method. Through initial purposeful and subsequent theoretical sampling, 23 nurses with work experience in outpatient hemodialysis, home hemodialysis, and peritoneal dialysis settings from across Canada were recruited to participate in two interviews, each using the Zoom© teleconferencing platform. Concurrent data collection and analysis were undertaken. Results: Findings at the focused coding stage comprise contextual factors impacting such engagement. The core category of Fragmenting Care is explained by four categories of contextual factors and their related concepts and sub-concepts: (1) structural (lack of dedicated time, language barrier, knowledge gap); (2) inter-relational (patient-related factors; nurse-related factors [discomfort with having the conversation, lack of self-confidence, multi-dimensional tensions—them versus us]); (3) cultural-dialysis (biomedical focus, ambiguous responsibility, inopportune conversations); and (4) systemic (lack of conceptual clarity). Implications: These collective factors have not been illuminated previously, and while challenging, they help to better understand and therefore address engagement in KSC by dialysis nurses. Conclusion: Effecting change to normalize KSC is a priority requiring solutions compatible with complex systems. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-08-29 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.36367/ntqr.16.2023.e789 https://doi.org/10.36367/ntqr.16.2023.e789 |
url |
https://doi.org/10.36367/ntqr.16.2023.e789 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://publi.ludomedia.org/index.php/ntqr/article/view/789 https://publi.ludomedia.org/index.php/ntqr/article/view/789/861 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 New Trends in Qualitative Research info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 New Trends in Qualitative Research |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Ludomedia |
publisher.none.fl_str_mv |
Ludomedia |
dc.source.none.fl_str_mv |
New Trends in Qualitative Research; Vol. 16 (2023): Qualitative Research: Practices and Challenges; e789 New Trends in Qualitative Research; Vol. 16 (2023): Qualitative Research: Practices and Challenges; e789 New Trends in Qualitative Research; Vol. 16 (2023): Qualitative Research: Practices and Challenges; e789 2184-7770 10.36367/ntqr.16.2023 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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