A grounded theory analysis of oncology nurses' perceptions of early palliative care in the context of ambulatory care.
Bibliographic record
Abstract
96 Background: In early palliative care (EPC), palliative supports and resources are provided at an earlier stage in the treatment trajectory. As major care providers, nurses play a pivotal role in ensuring the success of EPC as an emerging model of care delivery. In this study, we examine nurses’ perceptions of EPC in the context of ambulatory oncology care and explore how EPC fits within the broader professional mandate of nursing. Methods: We recruited nurses from several ambulatory care oncology clinics in a tertiary cancer hospital in Ontario, Canada. Nurses participated in semi-structured interviews seeking to qualitatively examine their attitudes and perceptions about EPC. Constructivist grounded theory guided our methods and analysis. Results: A total of 20 nurses that included six staff nurses, ten nurse practitioners, and four advanced practice nurses completed interviews. Participants worked in a variety of clinic settings such as breast, pancreatic, head and neck, and hematology. The core category Perceiving EPC as Synonymous with Fundamental Nursing Care encompasses three subcategories: (1) Prioritizing immediate care needs – recognizing the need for EPC to manage immediate pain and symptom management concerns; (2) Care coordination – viewing EPC as linking resources and organizing interprofessional care; and (3) Safeguarding and preventative care – initiating EPC to protect against difficult transitions between phases of treatment and to prevent being unprepared for active dying. Conclusions: This was the first study to qualitatively examine nurses’ perception of EPC. Nurses not only recognize the value of EPC to ensure good quality care for patients with cancer and their families, but also perceive this care as deeply embedded within the core values of nursing. Recognizing how nurses view EPC has implications for expanding the professional scope of nursing in palliative care and for preparing nurses for the complexities of this work.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".