title: Nurses' experiences caring for patients and families dealing with malignant bowel obstruction.
abstract: Malignant bowel obstruction (MBO) is a well-recognised complication of advanced abdominal and pelvic cancers. Often surgical intervention is not feasible, resulting in complex symptoms and an unpredictable course. Although symptom management is a crucial part of nursing care, psychosocial and emotional issues frequently emerge for patients and families. This qualitative study explored the perspectives of nurses from a palliative care unit, in-patient acute care oncology units, ambulatory cancer setting, and the community on their experiences of caring for patients with MBO and their families. Six individual interviews and two focus groups were conducted. Eight overarching messages were identified related to nurses' experiences. Highlights include aspects of patients' and families' emotional distress, and the nurse-patient relationship in relieving suffering. Nurses have an important and privileged role that involves identifying MBO signs and symptoms, having knowledge of treatment and symptom management options, and helping patients transition from a curative to a palliative philosophy of care.
authors.affiliation: Advanced Practice Nurse (APN), Palliative Care Consult Team.
authors.forename: Patricia
authors.initials: P
authors.lastname: Daines
authors.affiliation: APN, Palliative Care Consult Team.
authors.forename: Kalli
authors.initials: K
authors.lastname: Stilos
authors.affiliation: APN, After Cancer Treatment Transition Clinic, Womens College Hospital, Toronto.
authors.forename: Shari
authors.initials: S
authors.lastname: Moura
authors.affiliation: Head, Nursing-Cancer Program.
authors.forename: Margaret
authors.initials: M
authors.lastname: Fitch
authors.affiliation: Research Coordinator, Cancer Program.
authors.forename: Alison
authors.initials: A
authors.lastname: McAndrew
authors.affiliation: Doctoral Student, Institute of Health Policy Management and Evaluation, University of Toronto.
authors.forename: Ashlinder
authors.initials: A
authors.lastname: Gill
authors.affiliation: Surgical Oncologist, Cancer Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario.
authors.forename: Frances
authors.initials: F
authors.lastname: Wright
mesh_terms: D000328:Adult; D001293:Attitude to Death; D003142:Communication; D004645:Empathy; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000451:nursing*; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*