Stress and coping in hospice nursing staff : the impact of attachment style

• Main Author: Hawkins, Andrew
• Published: University of Birmingham 2004
• Subjects: 362.1756019
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408834

Purpose To critically review the research literature on levels, sources, moderators, outcomes and management of oncology and palliative care nurse stress, within the theoretical framework provided by Carson and Kuipers (1998). Method Computerised literature searches (Medline; Psych-info; Cinahl; Embase; AMEO; Journals@ovid; British Nursing Index; Web of Science) were employed to search items including: stress; burnout; anxiety; grief; nurse; dying; cancer; oncology; hospice; palliative care, and coping. Articles were also identified through hand searching key journals. The 33 articles that satisfied the inclusion criteria are then discussed, evaluated and synthesised using the guiding framework of Carson and Kuipers (1998). Results and Implications Oncology and palliative care nurses experience at least moderate levels of stress but not necessarily higher levels than nurses working in other contexts. Issues relating to the 'death and dying' of patients, nurses feeling inadequately prepared to deal with the emotional needs of patients and their families, and a number of organisational factors were highlighted as significant sources of stress. Social support, nurses developing meaning from their work, adopting realistic goals and expectations, nursing experience and increased age were found to moderate the stress experience of oncology and palliative care nurses. Although there appears to be a paucity of good quality studies evaluating the efficacy of stress management approaches, recommendations in the literature seem consistent with sources and moderators of stress for this population. Grief facilitation, training, support groups, supervision, access to confidential and independent professional support/counselling and general self care strategies are discussed in the review as potentially helpful in reducing stress for oncology and palliative care nurses. Further research is required to evaluate the efficacy of stress management approaches for this population of nurses.