Hazel Hill, PhD, Lecturer in Adult Nursing, School of Nursing, Midwifery and Health, University of Stirling, Scotland. This post relates to a longer article that has been selected as ‘Editor’s choice’ in the March issue of Palliative Medicine.
My interest in palliative care started as a student nurse and I have been fortunate to make a career in this speciality of healthcare. I have worked in a variety of settings where palliative care is provided, from staff nurse to specialist and into education, throughout which time I always held an interest in research. However, I had struggled for years with an idea commonly encouraged in nursing research: that in order to carry out research, you must first decide what your theoretical perspective towards research is. I could not settle my mind to any of the perspectives introduced to me, seeing values and problems in each. When the opportunity arose to carry out the research, which has evolved into my PhD thesis, it was one I couldn’t miss.
Funding had been released for a research nurse practitioner post in a hospice in Scotland. The key aims of the post were to use research to enhance professional development and to add to the evidence base on the provision of psychological and social care in palliative care. The initial proposal for the project was that data should be collected by observation in order to give true insight into the practice of psychosocial care rather than patient and practitioner perceptions of it. Nursing was selected as the focus profession because of the intimacy of nurses’ relationships with patients, and the researcher was to work as a supernumerary member of the nursing team.
This study gave me the opportunity to be involved in direct patient care again, while maintaining an educational role and carrying out an exciting piece of research. From a methodological perspective it also struck a chord with me: the design of the study was centred on how actual care was carried out, not on an arbitrary belief system. Exploration of research methodologies allowed me to see that observation did not equal ethnography, as I had been lead to believe, but introduced me to ‘real world’ (Robson 2002) or ‘mixed-method’ research.
Real world research can enable participants to understand their roles and develop their practice (Robson 2002), and the findings discussed in the Palliative Medicine article do exactly this by challenging a myth commonly expressed, and by identifying one of the ways in which the nurses in the hospice really supported their patients’ psychosocial needs. Dispensing with the idea that it is necessary to build a relationship with patients in order to provide psychosocial care, and concentrating on having confidence in our skills and being attentive to patients, is something all healthcare workers should consider.
Robson, C. 2002. Real World Research, 2nd ed. Malden: Blackwell Publishing.
Download a free copy of the full article published in Palliative Medicine…
This post relates to a longer article, ‘Observations of professional-patient relationships: a mixed methods study exploring whether familiarity is a condition for nurses’ provision of psychosocial support’, Hazel C Hill, John Paley and Liz Forbat. Palliat Med March 2014: 28 (3): 256-63. First published online on 9 August 2013, doi: 10.1177/0269216313499960.
EAPC members and registered users of the EAPC website can download a free copy of this article and other ‘Editor’s choice’ papers from the EAPC website. (Just follow the instructions in the top right-hand corner of the home page to register or login, and scroll down to download the article). Click here to view other EAPC-originated papers on the EAPC website. (The paper is currently available to download from the EAPC home page – choose the title from the list of ‘Publication Highlights’).
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Palliative care in critical care settings
A forthcoming Special Edition of Palliative Medicine is focused on developing our knowledge of the care of patients nearing the end of their lives in intensive and critical care settings. For more information and guidance please read the journal’s Author Guidelines. Deadline for submissions is 30 April 2014. For further information please contact the Editorial Office: firstname.lastname@example.org