Is the Electroconvulsive Therapy Video on YouTube Supportive Information for Patients and Their Primary Caregivers?

BACKGROUND: Electroconvulsive therapy (ECT) is a significant contemporary medical treatment modality for various mental disorders that have not responded to other treatments. YouTube is a valuable place to get health-related educational content that can have a big impact on patients' and their primary caregivers' behaviors and decisions. OBJECTIVE: The aim of the study is to analyze the content of YouTube videos related to ECT to investigate the quality and reliability of videos as supportive information for patients and their primary caregivers. METHODS: A total of 250 videos related to ECT that are available on YouTube were analyzed. The Global Quality Scale and the modified DISCERN tool were used to assess the quality and reliability of the videos. Details of the content of the video, caregiver appearance, methods of information presentation, source of the video, and video parameters were analyzed as well. RESULT: The analysis revealed that the median total score of Global Quality Scale was 3 (interquartile range, 2; min-max, 1-5), which means the video quality was medium. The median total score of the modified DISCERN tool was 3 (interquartile range, 1; min-max, 0-5), which means the videos were highly reliable. Most of the video sources in the included videos were educational (41.2%, n = 103) from formal caregivers, and there was no significant difference between Global Quality Scale scores, video parameters, and modified DISCERN scores. CONCLUSIONS: YouTube is considered a supportive source of information related to ECT but needs more encouragement from formal caregivers to disseminate high-quality and reliable healthcare content on YouTube platforms to ensure access to accurate information.

Associated Factors Influencing Quality of Life and Knowledge Among Type 2 Diabetic Patients: A Cross-sectional Study.

BACKGROUND: The assessment of the quality of life (QoL) among type 2 diabetic patients is associated with different factors. Evidence shows that these patients usually suffer from a lack of knowledge about the disease, inadequate self-care, and low QoL. OBJECTIVE: The study aimed to assess knowledge of the QoL of type 2 diabetes patients and its possible associated factors. METHODS: This cross-sectional descriptive correlational study recruited type 2 diabetic patients conveniently from out-clinics to achieve the objective of the study. The Diabetes Quality of Life Brief Clinical Inventory (DQOL) and the Diabetes Knowledge Questionnaire 18 (DKQ-18) along with a demographic questionnaire were used for patient assessment. RESULTS: A total of 184 patients participated in the study. Patients' knowledge of diabetes was found to be low (8.57 out of 18), with no statistical differences between male and female participants (p=0.259). The average DQOL score was 2.87 out of 5, indicating moderate satisfaction and self-care behavior. DKQ-18 and DOQL were found to be correlated (r= 0.216, p=0.003). However, the patient's age was found to be a significant factor that influences patients' QoL (F=4.27, p=0.040), whereas patients' knowledge contributed weakly to the variation of QoL (F=1.70, p=0.084). CONCLUSION: Irrespective of knowledge and educational background, the patient's age is influential in enhancing better QoL among type 2 diabetic patients.

Perceived Relationship Between Horizontal Violence and Patient Safety Culture Among Nurses.

Objective: Despite the value of undertaking patient safety culture, its association with horizontal violence in nursing workplace is still understudied. This study aimed to investigate the association between the perceived patient safety culture and its relationship with horizontal violence among nurses working in Jordan. Methods: A cross-sectional correlational design was used. Nurses working in major governmental hospitals in Jordan were conveniently recruited to complete an online self-administered questionnaire, which included the following tools: Hospital Survey on Patient Safety Culture and Negative Behaviours in Healthcare (NBHC) Survey. The survey was designed to measure attitudes and perceptions on patient safety culture at multiple levels of a healthcare organization with ten dimensions. The Negative Behaviours in Healthcare (NBHC) survey was developed as an adaptation of the Lateral Violence in Nursing Survey (LVNS) with 25 items and two open-ended questions. Results: A total of 330 nurses responded to the questionnaire. Nurses moderately perceived patient safety culture (HSOPS mean = 3.5, SD = 1.1). Low incidence of horizontal violence was claimed (mean = 2.1, SD = 1.1). However, it was associated with moderate negative correlation with patient safety culture (r = -0.53, p < 0.001). Regression model revealed that patient safety culture explained an additional 53% of the variance of horizontal violence after controlling the effects of age and length of clinical experience (R-square change: 0.560, SE: 19.7, P: 0.001, CI: 1.21-1.57). Conclusion: Despite its low incidence, patient safety culture was found influential to the horizontal violence based on the perspectives of nurses in Jordan. Patient safety culture can be incorporated with other factors that contribute to the development of horizontal violence in nursing workplace.

The efficacy of using psychotherapy treatments for obsessive-compulsive disorder on minimizing suicidal thoughts and behaviours: A scoping review.

BACKGROUND: Suicidal thoughts and behaviours (STBs) are significant public health challenges that affect a variety of individuals and communities. Despite numerous efforts to discover and refine psychotherapy treatments to minimize STBs, the efficacy of STB treatments remains unclear. OBJECTIVE: Conduct a scoping review to assess the efficacy of using psychotherapy treatments to minimize STBs among individuals with obsessive-compulsive disorder (OCD). METHOD: A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR) to screen 163 studies published between 2010 and 2021. RESULTS: A total of seven articles that fulfil the eligibility criteria reported that psychotherapy treatments for obsessive-compulsive disorder were found to be effective and applicable approaches to minimize the severity of the OCD symptoms and STBs, despite variance in studies' target samples, types of interventions, periods and indicators. CONCLUSION: The current review has provided evidence showing the significant effects of psychotherapy treatments on various health-related aspects of life for individuals diagnosed with obsessive-compulsive disorder, and it is recommended to use them for enhancing treatment outcomes and minimizing STBs. IMPLICATION FOR PRACTICE: This scoping review verifies the formalization and incorporation of psychotherapy treatments for OCD to minimize STBs into standard practice and highlights the importance of mental health professionals being part of the implementation of these treatments.

Promoting Nurses' Self-Efficacy in Advanced Cardiac Life Support Through High-Fidelity Simulation.

Background Self-efficacy in resuscitation is influenced by various educational models, including high-fidelity simulation (HFS). Method Sixty-two nurses who were enrolled in an Advanced Cardiac Life Support (ACLS) course using HFS were recruited for this pretest-posttest, quasi-experimental study. Self-efficacy was assessed three times-twice via the participants' self-report and once via the instructor's assessment-using the Resuscitation Self-Efficacy Scale (RSES). Results The four dimensions of self-efficacy-recognition, debriefing and recording, responding and rescuing, and reporting-improved after the HFS education (t = 4.89, SE = 1.84, p < .001, confidence interval [-12.7, -5.33]). The instructor's scoring was higher than the participants' scoring in two of the four dimensions. The score on the ACLS written examination was positively correlated with the posttest RSES score (r = 0.303, p = .017). Despite minimal variations between demographic subgroups, nurses who had never been involved in resuscitation exhibited a significant improvement in self-efficacy after the HFS ACLS education (t = 4.72, SE = 2.54, p < .001, confidence interval [-17.3, -6.7]). Conclusion Self-efficacy can be a core measurable outcome that gauges nurses' clinical competency concerning HFS education for ACLS. [J Contin Educ Nurs. 2022;53(4):185-192.].

Congruency of nurse-patient pain scoring in the emergency department: a cross-sectional observational study.

Aim: To examine the congruency between patient self-reporting and nurse assessment of pain in the emergency department (ED) through the use of the numerical rating scale (NRS) and visual analogue scale (VAS). Materials & methods: Patient self-reporting of pain and nurse assessments were concurrently conducted using the NRS and VAS. Results & conclusion: Self-reported pain assessment was collected from 200 ED patients in parallel with their corresponding nurse-reported pain scores, conducted by 67 ED nurses. Although nurse-patient pain scoring was associated with a high congruency using both NRS and VAS (88.2 and 91.5%, respectively), nurses still underestimated patients' pain intensity using both tools (t = 2.37 and 2.60; p = 0.007 and 0.010 and CI: 0.17-1.1 and 0.06-0.46, respectively). Some nurse-patient characteristics showed relationships with a discrepancy in pain scoring.

This study was conducted to answer the following question: to what extent do emergency department nurses match their pain assessment with their patients pain assessment? The study used two common pain assessment tools: numerical rating scale (pain scored from 1 to 10) and visual analogue scale (pain scored using five facial expressions). The results indicated that nurses slightly underestimated patients' pain but not to a great extent. Differences between nurse and patient pain assessments were the lowest when using visual analogue scale, meaning that this method of pain assessment facilitates greater matching between nurse and patient assessments. It was noted that patients who frequently visit the emergency department had greater matching between their pain assessment and their nurse's assessment.

Nurses' experiences of psychosocial care needs of children with thalassaemia and their families in Jordan: A phenomenological study.

AIM: To explore the experiences of Jordanian nurses regarding the psychosocial care needs of children with thalassaemia and their families. DESIGN: A descriptive phenomenological approach was employed. METHODS: A purposive sampling strategy was used to select 10 nurses who had experience in caring for children with thalassaemia. Unstructured, face-to-face interviews were conducted. Coliazzi's data analysis process was applied. RESULTS: The analysis revealed three major themes: (1) valuing psychosocial support; (2) caring for paediatric patients needs certain competencies in nurses and (3) barriers to providing psychosocial care. Nurses expressed the importance of providing psychosocial care. A lack of specialists in psychosocial care as well as a lack of screening tools, and entertainment facilities for children was identified to be impeding effective psychosocial care. Implementing training programmes for nurses concerning providing psychosocial care and making the appropriate changes in nursing curricula at the educational level are recommended.

Patients' Evaluation of the Quality of Emergency Care Services in Jordan: Integration of Patient Centeredness Model.

BACKGROUND AND PURPOSE: Accreditation is viewed to enhance the total quality of healthcare. The present study aims at assessing patients' perspectives toward the quality of emergency healthcare services at different hospitals with different characteristics in Jordan. The elements of patients' perception were aligned with the conceptual framework of Patient Centeredness Model. METHODS: This descriptive cross-sectional study was carried out in four emergency departments from different healthcare sectors and accreditation statuses in Jordan. Less urgent/nonurgent, alert, and cooperative patients were identified directly after the completion of emergency treatment. The perspectives of patients about the quality of emergency services were evaluated by 10 domains articulated in a validated accident and emergency questionnaire. RESULTS: A total of 276 patients were enrolled in the study. Private sector scored higher in all assessment domains in both accredited and nonaccredited hospitals in comparison with the government sector. Accredited government hospitals scored higher in patients' evaluation for "doctor and nurse," "investigations," "pain," and "overall respect of medical staff" domains than nonaccredited government hospitals. The overall experience was significantly different between accredited and nonaccredited government hospitals. IMPLICATIONS FOR PRACTICE: Quality of emergency care services should be assessed through various dimensions related to patients' perspectives. Patients' perception toward the quality of emergency health services is evidently enhanced by accreditation especially in the government sector.

Estimating the time point for nutritional failure in patients suffering from acute brain attacks in the intensive care unit.

BACKGROUND: Severe brain attack patients demonstrate hypermetabolic state and gastrointestinal dysfunction, leading to faster onset of nutritional failure. AIM: To estimate the time point where the development of nutritional failure is more probable among patients with acute brain attacks in the intensive care unit (ICU). METHODS: Direct bedside observation for selected nutritional parameters was performed. When enteral nutrition was initiated, observation was performed at five points over 9 days. FINDINGS: 84 patients with 55% mortality risk and on mechanical ventilation were included. Over the observation period, gastric residual volume increased (144 ml vs 196 ml), body weight decreased (79.4 kg vs 74.3 kg), and serum albumin reduced (3.6 g/dl to 3.1 g/dl). Caloric attainment and malnutrition score deteriorated, and feeding-related complications increased. Nutritional failure was evidently prevalent between the third and fifth day of observation. CONCLUSION: An earlier period of enteral nutrition entails higher probability of nutritional failure among severe brain attack patients in the ICU.

The Impact of a School-based, Nurse-delivered Asthma Health Education Program on Quality of Life, Knowledge, and Attitudes of Saudi Children with Asthma.

More than two million people have asthma in Saudi Arabia: 13% aged 6-10 years. Asthma is one of the most common childhood illnesses. Little has been explored about children's ability to learn more about their own asthma in Saudi Arabia. The study was designed to assess the impact of a school-based, nurse-delivered asthma health education program on asthmatic children's knowledge and attitude toward asthma, quality of life, anxiety level, and school absenteeism. A quasi-experimental, non-equivalent group, pretest-posttest design was used. The education program was developed from existing evidence. The Pediatric Asthma Quality of Life Questionnaire, Spence Anxiety Tool, Asthma Knowledge Questionnaire, and Asthma Attitude Questionnaire were employed for data collection. Intervention (n = 130) and control (n = 98) groups were drawn from 10 schools in Ha'il region, Saudi Arabia. Descriptive and inferential statistics were used to examine differences within and between groups. Knowledge of asthma increased significantly more in the intervention group than in the control group. Attitude toward asthma was not changed by the intervention. Anxiety scores reverted to pretest level by posttest II. The intervention group had significantly better total quality of life scores than the control group, and school absenteeism reduced significantly after the delivery of the program. It was concluded that the asthma education program impacted positively on students' knowledge, quality of life, and school attendance. However, asthma education did not change attitudes toward the condition, and the impact on anxiety was not persistent. The results emphasize the benefits of the provision of health education directly to children. Asthma education should be integrated into the Saudi national child health program.

Barriers to effective nurse-patient communication in the emergency department.

BACKGROUND: It has been identified that ineffective nurse-patient communication in the emergency department can lead to frustration, mistrust and inadequate pain management. Therefore, it is important to recognise the potential barriers to effective communication, including nurse and patient-related factors. AIM: To identify what emergency nurses perceive as barriers to nurse-patient communication, and if there is any difference in the perception of communication barriers between nurses' demographic subgroups. METHOD: A total of 199 emergency nurses were recruited using convenience sampling, from nine hospitals in the West Bank, Palestine. These nurses completed a 27-item questionnaire that encompassed six domains of barriers that may affect nurse-patient communication: demographic, knowledge-related, environmental, social, economic and psychological factors. RESULTS: Of the six domains covered by the questionnaire, environmental factors scored the highest, meaning that emergency nurses perceived these to be the most significant barriers to effective nurse-patient communication. This was followed by knowledge-related and psychological factors. Knowledge-related factors were perceived to be a greater communication barrier by male nurses more than female nurses, and by younger nurses more than older nurses. CONCLUSION: To enhance nurse-patient communication, it is important to establish a comfortable working environment and to provide ongoing training for nurses to develop their communication skills.

The transactional model of stress and coping as guidance for understanding adolescent patients' experience with thalassemia: Case report.

PURPOSE: This case report investigated the transactional model of stress and coping as guidance for nursing care of an adolescent patient with thalassemia. SOURCES USED: A case study of a 15-year-old female patient with ß-thalassemia major. Data were collected using patient medical records, an interview with the patient and physical examination. RESULTS: Four issues related to coping were isolated: Worsening physical symptoms; psychosocial consequences, coping process, and building supportive networks. These issues and the patient's adaption are explored via the transactional model. CONCLUSIONS: Having thalassemia was cognitively appraised by the patient as a stressful and taxing situation with detrimental consequences, such as changes in physical appearance, stigmatization, and depression. Nurses should evaluate each patient's physical and psychosocial needs, utilizing appropriate theoretical models for designing a suitable care plan. As the case study demonstrates, the transactional model was an effective guide for nurses in planning care of an adolescent patient with thalassemia.

Prognostic Performance of NUTRIC Score in Quantifying Malnutrition Risk in the Critically Ill in Congruence With the Bioelectrical Impedance Analysis.

BACKGROUND: There is still no concrete guidance for assessing malnutrition risk in the critically ill. Nutrition Risk in the Critically Ill (NUTRIC) score is undertaken cautiously compared with other validated tools such as bioelectrical impedance analysis (BIA). This study aimed to assess the malnutrition risk in the critically ill using NUTRIC score and assess its congruency with the BIA. METHODS: In this cross-section observational study, intensive care unit (ICU) patients from various etiologies were assessed using the earlier tools in addition to other prognostic markers (Acute Physiologic Assessment and Chronic Health Evaluation II [APACHE II] and Sequential Organ Failure Assessment [SOFA] scores), caloric attainment, and feeding complications. RESULTS: Of a total 411 assessed patients, 313 (76.2%) were enterally fed, and 318 (77.4%) were mechanically ventilated. Mean age was 60.7 years, and the median of the assessment since admission was the 12th day. Of those enterally fed patients, 57.9% attained the caloric requirements. Both APACHE II and SOFA scores were compatible in ascertaining ICU mortality at a moderate level (17.88 and 7.17, respectively). The NUTRIC score and phase angle (PA) measured by BIA revealed no differences in the malnutrition risk between patients with and without enteral nutrition. However, regression indicated that the NUTRIC score has explained only 1.1% of the variance of PA after controlling other covariates (ß = -0.222, P = .009, confidence interval = -0.31 to -0.05). CONCLUSIONS: NUTRIC score has a limited prediction to the urgency of aggressive nutrition therapy within the early period of ICU admission.

Validation study of the Arabic version of the Brief Fatigue Inventory (BFI-A).

BACKGROUND: Fatigue is the most reported and most distressing symptom among patients with cancer. However, no questionnaire that measures fatigue and fatigue interference with life has been translated into Arabic. AIMS: This study aimed to translate and validate the Arabic version of the Brief Fatigue Inventory (BFI-A). METHODS: The BFI was translated into Arabic using the forward-backward translation technique. This cross-sectional study collected data from cancer patients through a self-administered questionnaire that included the BFI-A, Insomnia Severity Index (ISI), Zung Depression Scale (ZDS), MD Anderson Symptom Inventory total score (MDASI), and Medical Outcome Study Short Form 36 (SF-36) Vitality Subscale. Descriptive and inferential statistics were used including mean, standard deviation, internal consistency, and correlation coefficient using Pearson's correlation. RESULTS: A total of 79 patients were recruited in Amman, Jordan, in 2015. Mean of the total BFI-A was 4.01 (2.4), showing that 83.5% had nonsevere fatigue. Cronbach's α coefficient of the BFI-A was 0.93. The correlations between total BFI-A scores and BFI-A items were significant (P < 0.05) and ranged from 0.75 to 0.86. BFI-A showed a significant correlation (P< 0.05) with the following tools: ISI = 0.70, ZDS = 0.69, MDASI = 0.75, and SF-36 Vitality Subscale = -0.57. CONCLUSIONS: This study suggests that the BFI-A is a reliable and valid tool to assess fatigue among Arab cancer patients.

The Performance of Emergency Department Nurses Across Sectors in Jordan: An Application of the Work Functioning Model.

Work functioning is a relatively new conceptual model developed to embrace various aspects surrounding work performance, work participation, and individual capacity. The assessment of work performance (AWP) in nursing has gained inconsistent evidence due to examining it from multidimensional aspects. This study aimed to perform the AWP in nurses working in the emergency departments (EDs) at different healthcare sectors in Jordan. A descriptive, cross-sectional design was used in which ED nurses completed a questionnaire. ED nurses were recruited conveniently from four referral hospitals located in Amman (two government and two private hospitals). The Nursing Work Functioning Questionnaire (NWFQ), in addition to the demographic questionnaire were completed. A total of 179 ED nurses participated in the study (100 government and 79 private nurses). A few differences were found between government and private sector nurses in respect to work functioning domains. Overall, nurses from both sectors reported minimal impairments in their performance represented in seven domains. However, ED nurses from the private sector claimed more frequent work incidences compared to ED nurses from the government sector (p = .043). In addition, associate nurses showed higher avoidance behavior than registered nurses in both sectors (p = .031). Contrary to former studies, this study found minimal discrepancies in work performance between government and private sectors, and employing the work functioning model is useful to gain a thorough understanding of the AWP.

Quality of nursing work life and related factors among emergency nurses in Jordan.

OBJECTIVES: The objective of this study is to assess quality of nursing work life (QNWL) and related factors among nurses working in emergency room (ER). METHODS: A cross-sectional descriptive design was employed. Data were collected from a convenient sample of nurses working in ER Eligible participants were required to complete a demographic and work related variables sheet, the Brooks Quality of Nursing Work Survey (BQNWLS). RESULTS: A total of (186) nurses participated in the study. Study participants reported a BQNWL mean score of (M = 140.15, SD = 28.34) indicating a moderate BQNWL. Additionally, the participants scored moderate levels on all BQNWL subscales. The mean score of BQNWL was statistically better for nurses who had training courses on emergency department (t = -2.663, P = 0.008). However, no other statistically significant differences were found in BQNWL scores in regarding to demographic and work related variables. CONCLUSION: The results of this study reported a noticeable alteration in QNWL among nurses working in ER. The nurses had a moderate QNWL levels. Also, the results emphasized on the importance of conducting further interventional research studies in the future to establish effective measures to enhance nurse QNWL. Consequently, this may improve the provided nursing care for the patients and their families.

The impact of introducing the Modified Early Warning Score 'MEWS' on emergency nurses' perceived role and self-efficacy: A quasi-experimental study.

BACKGROUND: Early warning Score is a bedside track and trigger system used to facilitate early detection and management of deteriorating patients. Although emergency department nurses are the key to implement this task, their interaction and contribution to provide an estimate of patients' severities is still suboptimal and neglected. AIM: This study aimed to introduce an educational programme using the Modified Early Warning Score (MEWS) to nurses working in the emergency departments and to assess the programme impact on nurses' self-efficacy and perceived role. METHODS: This non-equivalent, multi-centre, quasi-experimental study, assigned two groups of emergency nurses into intervention and control. The intervention group received three interactive educational sessions totalling 12 h relevant to the application of MEWS in emergency situations using a validated programme called 'COMPASs'. The other group received no intervention. Both groups were assessed for self-efficacy and perceived role in the pre-test, immediate post-test, and three months later follow-up phase. RESULTS: A total of 232 participants were divided into intervention and control groups (118 and 114, respectively), having no variations in age, gender, or experience as registered nurses. The intervention group showed a significant improvement in the self-efficacy scores for the nurses (F: 152.21, df: 2, p < 0.001). Similarly, the intervention nurses exhibited a significant improvement in the perceived role scores after the intervention (F: 121.20, df: 2, p < 0.001). The control group showed no changes in either variable across the three phases. While older nurses with longer experience showed higher self-efficacy after the programme, the perceived role explained an additional 57.0% of the variance in self-efficacy after controlling these two demographics (Beta: 0.743, p < 0.001, CI: 1.18-1.66). CONCLUSION: The existence of an early warning system in the emergency department is able to enhance nurses' self-efficacy and perceived role coinciding with nursing interactions with the multidisciplinary team.

Predictors of uncertainty among postdischarge coronary artery bypass graft patients in Jordan.

Uncertainty impacts negatively on adaptation and disease outcomes. During recovery, coronary artery bypass graft (CABG) patients experience uncertainty, symptom distress, and learning needs. This study aimed to examine predictors associated with uncertainty among CABG patients. This cross-sectional correlational study recruited CABG patients conveniently from out-patient clinics 1 month after discharge. Participants completed a self-administered questionnaire which included: demographic questionnaire, Mishel's Uncertainty of Illness Scale, Cardiac Symptoms Survey, and Cardiac Patients Learning Needs. A total of 161 participants completed the study questionnaires. Participants showed a moderate level of uncertainty, less cardiac symptom distress, and high learning needs. Uncertainty was significantly correlated with learning needs while less correlated with symptom distress. Hierarchal multiple regression revealed that gender, employment status, education level, and learning needs are factors associated with uncertainty among CABG patients. It was concluded that symptom distress does not necessarily induce uncertainty. Intensive care professionals should undertake individual's characteristics to anticipate uncertainty.

Dimensions of Phenomenology in Exploring Patient's Suffering in Long-Life Illnesses: Qualitative Evidence Synthesis.

BACKGROUND: Patients' suffering has been increasingly investigated by health-care researchers especially in the chronically ill. Suffering is viewed as a progressive negative consequence that associated with pain, impaired self-esteem, and social alienation. This qualitative evidence synthesis aimed to provide further insights into the application of phenomenology in explaining suffering among patients with chronic illnesses. METHODS: Studies included in this qualitative evidence synthesis study were retrieved by searching from the following electronic databases: CINAHL, PubMed Central, and EBSCO. FINDINGS: Phenomenology is regarded as influential to generate in-depth evidence about suffering that are grounded in chronically ill patients' perspectives. The philosophical constructs of suffering suggested fundamental dimensions such as stress, distress, hopelessness, and depression along with pain. Evidence encompasses the entire manifestation of suffering in which all interrelated meanings are understood and referred to a unique structure. Hermeneutic phenomenology was adopted as an effective strategy to elucidate human experience leading to the discovery of the embedded meanings of life experience. CONCLUSION: The phenomenological approach provides nursing research with the pathway to explore patients' suffering experiences in the chronically ill.