title: Surgical nurses' work-related stress when caring for severely ill and dying patients in cancer after participating in an educational intervention on existential issues.
abstract: OBJECTIVE
  The aim of this study was to describe surgical nurses' perceived work-related stress in the care of severely ill and dying patients with cancer after participating in an educational intervention on existential issues.
  
  
  METHODS
  This article reports a mixed methods pilot study of an education programme consisting of lectures and supervised discussions conducted in 2009-2010 in three surgical wards in a county hospital in Sweden. The concurrent data collections consisted of repeated interviews with eleven nurses in an educational group, and questionnaires were distributed to 42 nurses on four occasions.
  
  
  RESULTS
  Directly after the educational intervention, the nurses described working under high time pressure. They also described being hindered in caring because of discrepancies between their caring intentions and what was possible in the surgical care context. Six months later, the nurses described a change in decision making, and a shift in the caring to make it more in line with their own intentions and patients' needs rather than the organizational structure. They also reported decreased feelings of work-related stress, decreased stress associated with work-load and feeling less disappointed at work.
  
  
  CONCLUSIONS
  Results indicate that it may be possible to influence nurses' work-related stress through an educational intervention. According to nurses' descriptions, reflecting on their ways of caring for severely ill and dying patients, many of whom had cancer, from an existential perspective, had contributed to enhanced independent decision making in caring. This in turn appears to have decreased their feelings of work-related stress and disappointment at work.
authors.affiliation: Mid Sweden University, Department of Health Sciences, Östersund, Sweden; Health Care Sciences Post Graduate School, Karolinska Institute, Stockholm, Sweden. Electronic address: cud@du.se.
authors.forename: Camilla
authors.initials: C
authors.lastname: Udo
authors.forename: Ella
authors.initials: E
authors.lastname: Danielson
authors.forename: Ingela
authors.initials: I
authors.lastname: Henoch
authors.forename: Christina
authors.initials: C
authors.lastname: Melin-Johansson
mesh_terms: D000328:Adult; D004644:Emotions; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008020:Life Support Care / Q000379:methods; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000451:nursing*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D016272:Occupational Health; D013527:Perioperative Nursing / Q000193:education*; D010549:Personal Satisfaction; D010865:Pilot Projects; D013315:Stress, Psychological / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013548:Sweden; D013727:Terminal Care / Q000379:methods; D019452:Terminally Ill
keywords: Cancer; Death; Educational intervention; Existential; Pilot study; Reflection; Stress; Surgical nurses