Abstract
The goal of the study was to compare working conditions in a hospital with the conditions in a specialized hospital-based home care (HBHC) unit, which aims to replace hospital care for patients in need of institutional car. Staff (doctors included) in a HBHC unit (n=35) and on three hospital wards (n=113) participated in the study. All staff members worked regularly with severely ill cancer patients. Question about stress, job satisfaction and working conditions were asked in a self-administered questionnaire. Both groups showed a limited degree of continuous stress and a high degree of job satisfaction. Thus, the overall perception was than the working conditions were good. When significant differences were found, the responses of the HBHC staff were more positive. This included items such as more freedom to make their own decisions (P<0.001), better co-operation between day and night shifts (P<0.001), a more reasonable work load (P=0.0001), fewer problems in communication with patients (P<0.001), and fewer problems with tension (P<0.05) and with sleeping (P<0.05). The findings may be due to several factors: the HBHC staff were older, more often married, had more children, had worked longer in health care and were thus more experienced. Complementary explanations may be continuous education within the HBHC and an organization stimulating the staff's own initiative, but also capable of supporting when necessary. In conclusion, very satifactory working conditions are achievable within HBHC, despite demanding work with dying cancer patients.
Similar content being viewed by others
References
Alexander D, Ritchie E (1990) “Stressors” and difficulties in dealing with the terminal patient. J Palliat Care 6:28–33
Bailey J, Stephen S, Grout J (1980) The stress audit: identifying the stressors of ICU nursing. J Nurs Educ 19:15–19
Beck-Friis B, Strang P, Eklund G (1989) Physical dependence of cancer patients at home. Palliat Med 3:281–286
Beck-Friis B, Strang P, Sjödén P-O (1991) Work stress and job satisfaction in hospital-based home care. J Palliat Care 7:15–21
Bram P, Katz L (1989) A study of burnout in nurses working in hospice and hospital settings. Oncol Nurs Forum 16:555–560
Degner L, Gow C, Thompson L (1991) Critical nursing behaviors in care for the dying. Cancer Nurs 14:246–253
Doyle D (1982) Nursing education in terminal care. Nurse Educ Today 2:4–6
Durand R, Dickinson G, Sumner E, Lancaster C (1990) Family physicians' attitudes toward death and the terminally ill patient. Fam Pract Res J 9:123–129
Edelwich J (1980) Burn-out: stages of disillusionment in the helping professionals. Human Sciences Press, New York
Emery F (1963) Some hypotheses about the ways in which tasks may be more effectively put together to make jobs. Tavistock Institute Document T813, London
Essen L von (1988) Changes of job satisfaction among health care staff. The cancer care project. Thesis for psychologist's exam (Sweden), Department of Clinical Psychology, Uppsala University
Everly G (1976) Perceived dimensions of job satisfaction for staff registered nurses. Nurs Res 25:346–348
Freundenberger H (1975) The staff burn-out syndrome in alternative institutions. Psychother Theory Res Pract 12:73–82
Frommelt K (1991) The effect of death education on nurses' attitudes toward caring for terminally ill persons and their families. Am J Hosp Palliat Care 8:37–43
Glimelius B, Ahlbom H, Birgegård G, et al (1993) Improved care of cancer patients treated with chemotherapy. Description of a comprehensive cancer care programme and overall results. J Psychosoc Oncol (in press)
Hale C (1986) Measuring job satisfaction. Occasional paper. Nurs Times 82:43–46
Herschbach P (1981) Stress im Krankenhaus-die Belastungen von Krankenpflegekräften und Ärzten/Ärztinnen. Psychother Psychosom Med Psychol 41:176–186
Hinshaw A, Atwood J (1984) Nursing staff turnover, stress and satisfaction: models, measures, and management. Annu Rev Nurs Res 1:133–153
Hospital-Based Home Care of Motala (1989) Annual Report 1989. Motala Hospital
Kanner A, Kafry D, Pines A (1978) Conspicuous in its absence: the lack of positive conditions as a source of stress. J Hum Stress 4:33–39
Khaleque A, Rahman M (1987) Perceived importance of job facets and overall job satisfaction of industrial workes. Hum Relat 40:401–416
Levi L (ed) (1981) Quality of the working environment: protection and promotion of occupational mental health. Soc Stress Dis 4:318–324
Lucas M, McCrieght I, Watkins J, Long S (1988) Job satisfaction assessment of public health nurses. Publ Health Nurs 5:230–234
Maslach C (1976) Burned-out. Hum Behav 5:16–22
McDermott B (1983) A preventive approach to staff stress. Can Nurse 79:27–29
Moser D, Krikorian D (1982) Satisfaction and stress incidents reported by hospice nurses: a pilot study. Nurs Leadership 5:9–17
Mottaz C (1986) Gender differences in work satisfaction, work related rewards and values and the determinants of work satisfaction. Hum Relat 39:359–378
Newlin N, Wellisch D (1978) The oncology nurse: life on an emotional roller coaster. Cancer Nurs 1:447–449
Ogle M (1983) Stages of burnout among oncology nurses in the hospital setting. Oncol Nurs Forum 10:31–34
Packard T, Motowidlo S (1987) Subjective stress, job satisfaction and job performance of hospital nurses. Res Nurs Health 10:253–261
Parahoo K (1991) Job satisfaction of community psychiatric nurses in Northern Ireland. J Adv Nurs 16:317–324
Parkes C (1988) Not always. J Palliat Care 4:50–52
Pines A, Maslach C (1978) Characteristics of staff burnout in mental health settings. Hosp Community Psychiatry 29:233–237
Rirodan J (1991) Prestige: key to job satisfaction for community health nurses. Publ Health Nurs 8:59–64
Shubin S (1978) Burnout: the professional hazard you face in nursing. Nursing 78:22–27
Slavitt D, Stamps P, Piedmont E, Haase A (1978) Nurses' job satisfaction with their work situation. Nurs Res 27:14–20
Trist E (1974) Work improvement and industrial democracy. In: Commission of the European communities: conference on work organization, technical development and motivation of the individual, Brussels
Vachon ML (1979) Staff stress in care of the terminally ill. Qual Rev Bull 5:13–17
Waltman N (1990) Attitudes, subjective norms, and behavioral intentions of nurses toward dying patients and their families. Oncol Nurs Forum 17 [Suppl 1]:55–62
Yancik R (1984) Sources of work stress for hospice staff. J Psychosoc Oncol 2:21–31
Yasko J (1980) Variables which predict burnout experienced by oncology clinical nurse specialists. Cancer Nurs 6:109–116
Wilkes E (1984) Dying now. Lancet I:950–952
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Beck-Friis, B., Strang, P. & Sjödén, P.O. Caring for severely ill cancer patients. Support Care Cancer 1, 145–151 (1993). https://doi.org/10.1007/BF00366061
Issue Date:
DOI: https://doi.org/10.1007/BF00366061