Essential elements of the relationship between the nurse and the person with advanced and terminal cancer: A meta-ethnography

Abstract

Objective: The purpose of this study was to understand how the nurse-patient relationship is interpreted by nurses and patients with advanced and terminal cancer (ATC) and which aspects of this relationship are perceived to be the most valuable for patients.

Methods: A literature search was conducted using the Cumulative Index to Nursing and Allied Health (CINAHL), PubMed, and PsycINFO databases and was supported by reviewing reference lists. Nine articles were selected, and the quality of them was assessed using the Critical Appraisal Skills Program. A synthesis was performed following the seven-stage meta-ethnography described by Noblit and Hare.

Results: Four primary themes were derived from the synthesis: (a) being with and being for the person with ATC, (b) time is required for establishing the relationship, (c) the influence of the primary actors in the relationship: the nurse and the person with ATC, and (d) the effects of the relationship on both the nurse and the person with ATC. Finally, an explanatory model of the relationship between the nurse and the patient with ATC was developed, which shows that the relationship is an interpersonal process with several key elements including familiarity with one another, reciprocity, respect, and confidence. The nurses and patients with ATC perceive that their relationship is important and beneficial. The patients demand a helping and caring relationship focused on them as persons, not only as patients.

Conclusions: Patients with ATC and nurses consider their relationship to be important and beneficial. An approach to caring focused on patients as persons should be fostered among health care professionals and students.

Keywords: Cancer; Meta-ethnography; Nurse-patient relations; Oncology; Relationship; Terminally ill.