Thai Oncology Nurses' Perceptions of Patient Participation in Acute Cancer Care.

PURPOSE: Patient participation in care is considered a core component of high-quality nursing care and medical treatment. In the context of cancer care in Thailand, we know very little about the way patient participation in care is perceived and enacted. The aim of this study was to explore Thai oncology nurses' perceptions and understandings of patient participation in their own care during hospitalization. METHODS: A qualitative descriptive research approach using focus groups was applied. Two focus group interviews (N = 16) were conducted with registered nurses who provide care in oncology units of one tertiary care university hospital in Bangkok, Thailand. The transcribed interviews were analyzed using qualitative content analysis. RESULTS: In this study, nurses were aware of the value of patient participation during hospitalization but acknowledged that current processes to involve patients in their care were not as effective as they could be. Facilitating participation is seen as a means of supporting patients to make decisions independently that are in line with their treatment plans, in particular, decisions related to self-care and illness-related symptoms. This raises the potential for conflict when patients make choices that are contrary to recommendations. Barriers to facilitating participation identified were high clinician workloads and lack of time, and ambiguity of existing guidelines for supporting lifestyle decisions. CONCLUSION: Facilitating patient participation is complex in acute cancer care. Patient participation is recognized by nurses as a positive way of promoting independence in patients. However, balancing patient autonomy with nurses' perceived professional responsibilities is challenging in practice.

Comparing the meanings of fatigue in individuals with cancer in Thailand and Canada.

BACKGROUND: Illness is experienced in social contexts; its meaning is rooted in local beliefs and values as well as one's personal and family situation. Health professionals are steeped in knowledge of disease but know much less about illness. OBJECTIVES: The objective of the study was to learn more about the social construction of illness by comparing the meanings of fatigue in Thai and Canadian individuals with cancer. METHODS: Using an ethnoscience design, 10 Thai adults receiving chemotherapy for advanced lung cancer or colorectal cancer were interviewed twice. They were asked to sort words and phrases about fatigue from their first interview using Q-sort, triadic, and dyadic approaches; to name each pile; and to describe the similarities and differences between the piles. The card sorts were used to understand the relationships among key ideas in each interview. A table summarizing the card sorts was constructed, and patterns in the data were identified. RESULTS: Two segregates in the Thai data were identified: essential/constant and intermittent, with essential/constant including 2 segregates (feeble and altered cognition), and intermittent including 2 segregates (loss of mental strength and difficulty sleeping). The primary meanings of fatigue in the Thai data were related to temporality, whereas the primary meanings of fatigue in the Canadian data were related to the location of the fatigue (mind/body). CONCLUSION: These findings help us understand the social construction of fatigue, a common symptom in cancer. IMPLICATIONS FOR PRACTICE: Further research in relation to links between fatigue and other related-symptoms is needed with the goal of developing cross-cultural interventions for managing fatigue in the future.