Caregivers' descriptions of patients with advanced breast cancer in connection with supervision sessions in a surgical ward.

The purpose of this study was to describe the content of caregivers' (health care professionals') presentation of care situations as told at supervision sessions. For 1 year, 21 caregivers in a surgical ward of a county hospital in the middle of Sweden participated in a clinical supervision session 2 hours every third week. The participants in the supervision sessions were divided so as to form three mixed groups composed of registered nurses, practical nurses, physiotherapists, and physicians. The purpose of the supervision sessions was to give caregivers the opportunity to reflect on different care situations in a way that contributed to the development of patient care. The 38 supervision sessions were tape-recorded and transcribed verbatim. The transcripts were analyzed using a qualitative content analysis. The caregivers described difficult care situations focusing on the feelings of patients, relatives, and caregivers, with an emphasis on the caregivers' being dominant. Difficult care situations were described as giving caregivers feelings of discomfort, powerlessness, and reduced self-esteem. These feelings were described as arising in connection with caring for women with advanced breast cancer and other seriously ill patients in an organization lacking clear goals and rules. This study found that supervision sessions offering an opportunity to reflect on the difficult care situations are important for caregivers. These sessions seem therefore to be of vital importance for the future development of cancer care on the surgical ward.

Living with breast cancer: care givers' perceptions in a surgical ward.

Caring for women with breast cancer has potential for increasing care giver distress and anxiety. Knowledge of the threats implicit in the disease and treatment as well as overidentification with the patient form the basis for this outcome. In order to describe perceptions of breast cancer as an illness, semistructured interviews were carried out with 37 care givers at a surgical department. The interviews were tape-recorded and transcribed verbatim. An analysis was then carried out of the stories told by the care givers about breast cancer as an illness. The results indicated that breast cancer as an illness gave rise to predominantly negative and dark associations among the care givers. Their experiences of caring for women in critical stages of the illness over many years appear to have had a negative influence on them. Death itself, and even more so the process leading to the end, were very tangible in their stories. The article concludes that care givers on a surgical ward have a fragmented picture of the patients and need to be given opportunities to follow the total care process. Those care givers who were able to follow the women's stages of illness throughout more often had a positive picture.

The nurses transmissions of the professional role to students in nursing education.

In the reformed nursing education, introduced in Sweden in 1982, the emphasis is placed on nursing as the nurse's distinguishing characteristic. The profession comprises many coexisting functions, one of which is to transmit the professional role to the student of nursing. With the aim of acquiring knowledge concerning this transmission we analysed one topic of a questionnaire which was sent to the nurses at surgery clinics. This material was processed qualitatively. The answers crystallised into two categories discerning how the role is transmitted: (A) Conscious Approach, (B) Unconscious Approach. The results show that most of the nurses acted in a conscious manner, i.e. in a form of active influence on the students, in their transmission of the professional role. The unconscious approach, with a vague perception of, and therefore vague transmission of, the professional role is frequent.