Oncology nurses’ perceptions of their relations with family members in an ambulatory cancer care setting: A mixed methods study

Michelle Lobchuk, Sonia Udod


Trends signal an increasing prevalence of people living through and beyond a cancer diagnosis with an enhanced reliance on ambulatory cancer care services and family caregiving. Despite this trend, there has been limited focus on nurses’ experiences with providing support to families who care for patients in the community. For oncology nurses in ambulatory care settings, job satisfaction has decreased significantly as they are concerned with their ability to consistently provide safe and quality care to patients and their family. Although other studies indicated that the lack of time and limited resources are regrettably accepted aspects of nurses’ work environments, our mixed methods small-scale study addressed how work environments still can meet the growing need for enhanced support and relations among nurses, patients, and families in ambulatory cancer care.

Full Text:



Bakker, D., Conlon, M., Fitch, M., Green, E., Butler, L., Olson,

K., & Cummings, G. (2010). Canadian oncology nurse work

environments: Part I. Nursing Leadership, 22(4), 50–68.

Bakker, D., Fitch, M.I., Green, E., Butler, L., & Olson, K. (2006).

Oncology nursing: Finding the balance in a changing health care

system. Canadian Oncology Nursing Journal, 16(2), 79–98.

Beckstrand, R.L., & Kirchhoff, K.T. (2005). Providing end of life care to

patients: Critical care nurses’ perceived obstacles and supportive

behaviors. American Journal of Critical Care, 14(5), 395–403.

Beckstrand, R.L., Smith, M.D., Heaston, S., & Bond, A.E. (2008).

Emergency nurses’ perceptions of size, frequency, and magnitude

of obstacles and supportive behaviors in end-of-life care. Journal

of Emergency Nursing, 34(3), 290–300.

Canadian Association of Nurses in Oncology. (2001). Standards of

care, roles in oncology nursing and role competencies. Kanata,

ON: Author.

Canadian Cancer Society’s Steering Committee. (2010). Canadian

Cancer Statistics 2010. Toronto: Canadian Cancer Society.

Corley, M., Elswick, R., Gorman, M., & Clor, T. (2001). Development

and evaluation of a moral distress scale. Journal of Advanced

Nursing, 33, 250–256.

Cummings, G.C., Olson, K., Hayduk, L., Bakker, D., Fitch, M., Green,

E., … Conlon, M. (2008). The relationship between nursing

leadership and nurses’ job satisfaction in Canadian oncology

work environments. Journal of Nursing Management, 16, 508–

Downey, L., Engelberg, R.A., Shannon, S.E., & Curtis, J.R. (2006).

Measuring intensive care nurses’ perspectives on family-centered

end-of-life care: Evaluation of 3 questionnaires. American Journal

of Critical Care, 15(6), 568–579.

Eriksson, E. (2001). Caring for cancer patients: relative’s assessments

of received care. European Journal of Cancer Care, 10, 48–55.

Fitch, M.I. (1998). Quality of life in oncology: Nurses’ perceptions,

values and behaviours. Canadian Oncology Nursing Journal, 8(1),


Flanagan, J. (2001). Clinically effective cancer care: Working with

families. European Journal of Oncology Nursing, 5(3), 174–179.

Greco, P., Laschinger, H.K., & Wong, C. (2006). Leader empowering

behaviours, staff nurse empowerment and work engagement/

burnout. Nursing Leadership, 19 (4), 41–56.

Heaston, S., Beckstrand, R.L., Bond, A.E., & Palmer, S.P. (2006).

Emergency nurses’ perceptions of obstacles and supportive

behaviors in end-of-life care. Journal of Emergency Nursing,

(6), 477–485.

Hobbs, S.F., & Sodomka, P.F. (2000). Developing partnerships among

patients, families, and Staff at the Medical College of Georgia

Hospital and Clinics. Joint Commission on Accreditation of

Healthcare Organizations, 26(5), 268–276.

Isikhan, V., Comez, T., & Danis, M.Z. (2004). Job stress and coping

strategies in health care professionals working with cancer

patients. European Oncology Nursing Society, 8, 234–244.

Kelly, D. (1998). Caring and cancer nursing: Framing the reality

of using selected social science theory. Journal of Advanced

Nursing, 28, 728–736.

Kruijver, I.P., Kerkstra, A., Bensing, J.M., & van de Wiel, H.B. (2000).

Nurse-patient communication in cancer care: A review of the

literature. Cancer Nursing, 23(1), 20–31.

Laschinger, H.K., & Finegan, J. (2005). Empowering nurses for work

engagement and health in hospital settings. Journal of Nursing

Administration, 35(10), 439–49.

Laschinger, H.K., Almost, J., & Tuer-Hodes, D. (2003). Workplace

empowerment and magnet hospital characteristics: Making the

link. Journal of Nursing Administration, 33(7–8), 410–22.

Leahy, M., & Harper-Jacques, S. (1996). Family-nurse relationships:

Core assumptions and clinical implications. Journal of Family

Nursing, 2(2), 133–151.

Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Beverly Hills,

CA: Sage Publications, Inc.

Lindholm, L., Makela, C., Rantanen-Siljamaki, S., & Nieminen, A.L.

(2007). The role of significant others in the care of women with

breast cancer. International Journal of Nursing Practice, 13, 173–

Madsen, W.C. (2009). Collaborative helping: A practice framework

for family-centered services. Family Process, 48(1), 103–116.

McGillis Hall, L., Doran, D., & Pink, L. (2008). Outcomes of

interventions to improve hospital nursing work environments.

The Journal of Nursing Administration, 38(1), 40–46.

Mcilfatrick, S., Sullivan, K., & McKenna, H. (2006). What about the

carers?: Exploring the experience of caregivers in a chemotherapy

day hospital setting. European Journal of Oncology Nursing, 10,


McLeod, D.L., Tapp, D.M., Moules, N.J., & Campbell, M.E. (2010).

Knowing the family: Interpretations of family nursing in oncology

and palliative care. European Journal of Oncology Nursing, 14,


Morse, J.M. (1991). Negotiating commitment and involvement in

the nurse-patient relationship. Journal of Advanced Nursing, 16,


O’Brien-Pallas, L., Tomblin-Murphy, G., White, S., Hayes, L.,

Baumann, A., Higgin, A. … Wang, S. (2005). Building the future:

An integrated strategy for nursing human resources in Canada.

Research synthesis report. Ottawa: The Nursing Sector Study

Corporation. Retrieved from http://www.buildingthefuture.ca/


Patton, M. (2002). Qualitative research & evaluation methods (3rd

ed.). Thousand Oaks, CA: Sage.

Peter, E.H., Macfarlene, A.V., & O’Brien-Pallas, L.L. (2004). Analysis of

the moral habitability of the nursing work environment. Journal

of Advanced Nursing, 47(4), 356–367.

Priest, A. (2006). What’s ailing our nurses? A discussion of the major

issues affecting nursing human resources in Canada. Retrieved

from http://www.chsrf.ca/research_themes/pdf/what_sailing


Public Health Agency of Canada. (2004). Progress report on cancer

control in Canada. Ottawa: Health Canada.

Rask, M.T., Jensen, M.L., Andersen, J., & Zachariae, R. (2009).

Effects of an intervention aimed at improving nurse-patient

communication in an oncology outpatient clinic. Cancer Nursing,

(1), E1–11.

Shepard, A. (2010). Moral distress: A consequence of caring. Clinical

Journal of Oncology Nursing, 14(1), 25–27.

Sivesind, D., Parker, P.A., Cohen, L., DeMoor, C., Bumbaugh, M.,

Throckmorton, T., … Baile, W. (2003). Communicating with

patients in cancer care: What areas do nurses find most

challenging? Journal of Cancer Education, 18(4), 202–209.

Strauss, A., & Corbin, J. (1998) Basics of Qualitative Research:

Techniques and Procedures for Developing Grounded Theory.

London: Sage.

Tamayo, G.J., Broxson, A., Munsell, M., & Cohen, M.Z. (2010). Caring

for the caregiver. Oncology Nursing Forum, 37(1), E50–56.

Taylor, E.J. (2006). Prevalence and associated factors with spiritual

needs among patients with Cancer and their family caregivers.

Oncology Nursing Forum, 33(4), 725–735.

Torgerson, R. (2007). Not there yet: Improving the working conditions

of Canadian nurses. Ottawa: Office of Nursing Policy, Health


Vivar, C.G., Canga, N., Canga, A.D., & Arantzamendi, M. (2009). The

psychosocial impact of recurrence on cancer survivors and family

members: A narrative review. Journal of Advanced Nursing, 65(4),


Zangaro, G.A., & Soeken, K.L. (2007). A meta-analysis of studies of

nurses’ job satisfaction. Research in Nursing & Health, 30, 445–

Zuzelo, P.R. (2007). Exploring the moral distress of registered

nurses. Nursing Ethics, 14(3), 344–359.


  • There are currently no refbacks.