Exploring the nurse’s role in supporting the psychosocial support needs of women with breast cancer in Saudi Arabia: a case study

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Date

2023

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The University of Manchester

Abstract

Background: Psychosocial support is important in breast cancer care. Numerous countries have established specialist breast cancer nursing roles to ensure consistent provision of psychosocial support. In Saudi Arabia, however, specialist breast cancer nursing is underdeveloped and variable. The specialist role is generally unrecognised, with psychosocial support being offered sporadically by social workers, physicians and sometimes primary nurses (i.e. non-specialist nurses assigned to direct patient care). Hospitals with specialist cancer units are more progressive with some starting to embrace the concept of specialist nursing. However, these hospitals vary in how they conceptualise specialist nursing in terms of job title, expectations, post registration education and training required. Aim: To explore the role of nurses in supporting the psychosocial support needs of women with breast cancer in Saudi Arabia. Objectives: (1) to explore the need for psychosocial support for women with breast cancer in Saudi Arabia; (2) to investigate the capacity and capability of (specialist) nurses in meeting the psychosocial support needs of women with breast cancer in Saudi Arabia. Methods: The design was a single embedded case study underpinned by a pragmatic constructivist philosophy. Data were collected from one tertiary hospital in Saudi Arabia during June to August 2021 using semi-structured interviews and non-participant observations. Relevant documents were also a data source. Purposive non-probability sampling was used to interview 31 key stakeholders, including 12 women with breast cancer, 11 primary nurses, 2 nurse coordinators (similar to a nurse specialist's holistic role in the West, but with less recognition and benefits), and 6 physicians. Data were analysed using framework analysis by Richie et al., (2014). Findings: Three broad themes extracted: reaction and response to breast cancer diagnosis and treatment, reality vs. Idealism: professionals’ perceptions of current and ideal breast cancer service, and closing the gap between the ideal and the reality. Discussion: Discussion of the findings was structured around four overlapping concepts; the significance of religion, culture, and family in how women react and respond to breast cancer diagnosis and treatment, medical paternalism, organisational culture, and who should provide psychosocial support. Conclusion: There is a clear and pressing need for psychosocial support, particularly in the form of informal support such as information-giving, reassurance, acting as a single point of contact, care coordination, signposting, and providing financial and spiritual support. Nurse coordinators have proven to play a pivotal role in meeting this need. They have demonstrated their proficiency in offering informal support that aligns with the holistic approach commonly seen in Western-style specialist nursing, all while respecting the cultural and religious preferences of their patients. However, certain conditions were considered crucial for a more effective provision of support, most notably, ensuring a sufficient number of coordinators to cover the huge demand in the breast cancer service, and defining the role in terms of title, expectations, recognition and benefits. This clarity was deemed critical for enhancing the satisfaction of nurse coordinators and expanding their capacity to take on additional psychosocial responsibilities within their existing role or as part of a stand-alone position, if deemed necessary.

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Keywords

breast cancer* or breast neoplasm* or breast tumor* or breast tumour*, psychosocial or psycho-social or psycho social or psycho-oncology or psycho oncology or psychooncology or psychological, support* or care or intervention*, nurs*

Citation

(Slagour, 2023)

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