Learning to provide humanistic care and support in the context of chronic illness: Insights from the narratives of healthcare professionals in hemato-oncology.

PURPOSE: To document the process by which healthcare professionals (HCPs) support people living with and beyond hematological cancer and detail how they learned from their personal and clinical experience. METHOD: Using a narrative approach, we conducted nine semi-structured interviews with HCPs, including nurses, from a specialized care centre who support patients with hematological cancer. Interviews aimed to capture experiential learning gained from their practice. We performed a hybrid inductive/deductive content analysis on data using a framework based on sociological and educational models of experiential learning. RESULTS: Among healthcare professionals, analysis revealed the need to provide care and support that is 'humane' and adapted to each patient. Learning to provide this type of care proved to be challenging. Over the course of their clinical experience, healthcare professionals learned to adapt the support they provided by straddling a boundary between sympathy and empathy. Learning outcomes were associated with personal-professional development among participants. CONCLUSION: Our findings bring to light an overlooked facet of patient support in the context of cancer care, which is the acquisition of the soft skills required to deliver humanistic care and support. This learning process requires time and involves navigating between the realms of sympathy and empathy. Experiential learning is intertwined with the complexity of the often long-term patient-professional relationship that characterizes hemato-oncology. This unique relationship offers rewards for healthcare professionals on both personal and professional fronts.

Reconnaître l'expérience vécue de la maladie : la recherche «â€ˆCroiser les expériences ¼.

INTRODUCTION: The action-training research project "Crossing Experiences: Towards a Transformation of Care Action in Chronic Illness" aims to offer an introduction to narrative approaches (NA), including moments of biographical narration and moments of explanation, to a mixed audience composed of patient-peer caregivers, care professionals and family caregivers interested in intervening in therapeutic patient education (TPE) programs. OBJECTIVE: To present the initial results of the training component of this research and to identify the forms of enunciation revealing traces of the construction of an emancipatory approach to care and support relationships within the framework of TPE programs. METHODOLOGY: The NAs were presented and then applied to different stages of TPE during three days of training. Collective discussions with participants were recorded. The ex-post content analyses carried out on the basis of these discussions sought to identify what interest(s) the NAs could offer, particularly in terms of experiential knowledge. RESULTS: The design of the training, centred on ethics and a non-directive, comprehensive approach, made it possible to develop an atmosphere of confidentiality, favouring the learning and practice of the DAs involved. These were implemented at different stages of the TPE process, by both carers and patients and carer-partners, and were accompanied by the adoption of an educational stance conducive to the coconstruction of care. DISCUSSION: The results show the potential of NAs to collaborate in strengthening democracy in health through the legitimisation of experiential knowledge that emerges from lived experience. CONCLUSIONS: Training in NA based on the narration of experiences and learning acquired and their explicitation through a relationship based on respect provides avenues for collaborative work in TPE by bringing out forms of mediation, capable of grasping the dimensions of life before, during and after the disease, which are formative for people. The use of NAs is also a lever for transforming the educational process, by allowing patients and caregivers to become partners with TPE caregivers.