A Qualitative Investigation into Nurses' Experiences of Reflection in Caring for Cancer Patients

ABSTRACT

This qualitative study was undertaken to study the use of reflection by nurses for treating cancer care patients. The researcher chose the research design of Hermeneutic phenomenology for this study. This study was conducted by taking interview of 10 nurses to get their views on reflection. The nurses were asked unstructured questions to get their views on use of reflection on cancer care. The nurses were asked the benefits associated with reflection. During the interview the nurses also quoted few cases in which they used reflection. The researcher did in-depth study of the literature to compile the literature review. For this study, the researcher divided the literature review in two parts. The first part of literature review dealt with the nursing profession and caring. The second section discussed the literature on reflection. The reflection section of literature review discussed the types of reflection and how it could be implemented in nursing profession. The chapter three dealt with the methodology section. The researcher laid the foundation for research design for this research. The fourth chapter discussed the findings of the research and the following chapter discussed the discussion, conclusion and recommendations for future research.

TABLE OF CONTENTS

ABSTRACTII

CHAPTER 1: INTRODUCTION1

Background to the Study1

Aim of the Study2

The Nature of the Study2

Significance3

Objectives of the Study4

Research Question4

CHAPTER 2: LITERATURE REVIEW5

Section 16

Caring as a Concept6

The Care giving Experience8

Caring for Cancer Patients and their Families11

Professional Nurse Caring12

Nursing Process15

Section 218

Reflective Practice18

Reflection in medical field20

Reflection-On-Action22

Implementation of the Reflective Practice22

Reflection in Nursing Practice25

CHAPTER 3: METHODOLOGY32

Hermeneutic Phenomenology32

Qualitative versus quantitative research38

Instrument for data collection38

Research design38

Rationale40

Population/sample41

Research Setting41

Data Collection Method41

Ethical Considerations42

Autonomy42

Beneficence42

Non-Maleficience43

Confidentiality43

Storage of Data45

Credibility45

Dependability46

Data Analysis46

CHAPTER 4: FINDING48

Interview analysis48

Experience48

Areas of Experience48

Understanding of Reflection48

Using reflection49

Reflection helpful in cancer care49

Challenges to reflecting49

Positive aspects to reflection50

Why do you use reflection?51

Does reflection promote learning?52

Example of using reflection for cancer patients52

CHAPTER 5: DISCUSSION AND CONCLUSION54

Discussion54

Themes56

What is reflection?56

Occasions when reflection is used56

Types of situations56

Challenges to Reflection56

Attitudes57

New learning as a result of reflection57

Examine practice59

Triggers for using reflection59

Summary59

Discussion of the Findings60

Stages of reflection61

Research Related to Reflection and Reflective Journaling65

Analysis of Stories65

Story Interpretations66

Egocentric Focused Reflection67

Near-miss Critical Thinking68

Practice Implications69

Study Limitations71

Research Implications73

Conclusion73

REFERENCES75

CHAPTER 1: INTRODUCTION

Background to the Study

Reflection enables the practitioner to explore, understand and develop meaning and also highlights contradictions between theory and practice (An Bord Altranais, 2000). Reflection has been a term used by various researchers and educators as a tool to enhance the professional development of the nurse which in turn implies better nursing care for patients. Furthermore, reflection can be described as a means of critically analyzing practice so as to promote learning, professional integrity and ultimately improve patient care. The nursing care of patients with cancer has been described as stressful, challenging and emotionally demanding, requiring advanced skills and knowledge. However, with the need to improve patient care and ensure high standards of care (Wood, 2000), there needs to be further exploration into the use of reflection in nurses' clinical practice.

Reflection has been discussed as an important aspect within the nursing field. Dewey (1933) argued that even though experiences are the basis of ...