The Lived Experience of Work-Related Loss and Grief Among Pediatric Oncology Nurses

Teresa M. Conte, PhD, CPNP

Disclosures

Journal of Hospice and Palliative Nursing. 2014;16(1):40-46. 

In This Article

Methods/Procedure

Purposive sampling was selected for this study. Purposive sampling is most appropriate to use when the researcher is looking for a predefined group of individuals who have relevant knowledge in a specific field. Participants who meet certain criteria and have certain common experience are sought when getting a purposeful sample. Therefore, the sample is specific, not random. Pediatric oncology nurses working in outpatient and inpatient departments of a children's hospital located on the West Coast of the United States were invited to participate in this study via a flier posted in the nursing staff lounge and a one-time e-mail sent to the nursing staff. A nurse practitioner from the participating institution agreed to assist the researcher with the recruitment and consent process for this study. Inclusion criteria for this study required licensure as a registered nurse, employment in a pediatric oncology setting, direct patient contact for a minimum of 50% of work hours, and the ability to read and converse in English.

Recruitment efforts yielded a sample of 11 pediatric oncology nurses with varying levels of clinical expertise. All 11 met the inclusion criteria and participated in the study.

The principal investigator (PI) has 15 years of pediatric oncology nursing experience. The PI understood that this experience could potentially affect the research study because of preconceived notions about the results of the study. To remove any possible bias, the researcher used reflexive bracketing. Reflexive bracketing helps the researcher identify possible areas of bias or preconceived ideas and brackets them so that they have a minimal effect on the study. The researcher recognizes that her experiences may or may not be the same as the subjects in the study, which allows for the researcher to analyze and report the findings of the subjects alone, with no influence on what the researcher experienced in her career.

Rigor for this study was maintained by using Lincoln and Guba's[9] established guidelines of value, applicability, consistency, and neutrality. Truth value was maintained by reporting the experiences of the participants in a clear and objective way. In addition, an outside reader experienced in phenomenological research reviewed the transcripts and the extracted data to check for appropriateness. Member checks were performed by returning the transcripts and the data extracted from them to the participants for their review and comments. To ensure applicability, the investigator provided full, rich descriptions of the data so that others reading it would have a clear picture of it. Consistency was demonstrated through a systematic approach to data collection using the same questions for each of the participants and conducting each interview in the same step-by-step process. Neutrality was maintained throughout the data collection and analysis.

Technology and Study Setting

The study took place via the Internet using computers equipped with WIMBA software (Blackboard Inc, Washington, DC). This software allows for audio conferencing via a secure server. At the onset of each interview, the PI would open the access to the WIMBA site and invite the participant to a secure logon site where the interview would be conducted and audio recorded. The PI was set as the administrator of the study Web site so that she was the only individual who could access the recordings stored on the Web site. The interviews were recorded, encrypted, and sent to a transcription service via a secure server. The completed transcripts were encrypted and sent via the same secure server back to the PI. The transcripts were then stored in a password-protected file on the PI's laptop located in a locked office.

Interviews

Following institutional review board approvals, written consent was obtained by the nurse practitioner at the participating institution from all nurses in the study. Consent to participate, the ability to withdraw from the study, and identification of support services were also reviewed verbally between the PI and each participant before interviews commenced.

Unstructured interviews were scheduled at a time convenient for the nurses and lasted from 45 to 80 minutes. Each participant was asked the following questions:

  1. Tell me about a time in your career that stands out in your mind because it shows what it is like to experience loss as a pediatric oncology nurse.

  2. Tell me about a time in your career that stands out in your mind because it shows what it is like to experience grief as a pediatric oncology nurse.

The investigator allowed each participant to answer the questions fully without trying to clarify statements. Follow-up questions or probes were asked only when it was necessary to engage the nurses in the exploration of the phenomenon. Data collection occurred over a period of 3 months.

The researcher made the decision to conduct a single interview with each study participant. This decision was based on the time commitment for the participants and their availability. The participants were able to provide rich descriptions of their experiences through their interviews. Upon completion of the data analysis, the results were e-mailed to each of the participants for review and accuracy, and they were invited to provide feedback or any additional information, concerns or comments to the researcher. None of the participants gave any comments or had any concerns with the results.

Analysis

All interviews were transcribed verbatim, and the transcripts were read and reviewed for accuracy by the PI before analysis began. Colaizzi's[10] method was used to analyze the data. This method utilizes a step-by-step approach to reviewing, organizing, and interpreting the data that are extracted from the transcripts of the interviews with the study participants. Analysis proceeded as follows: Each transcript was read multiple times, significant statements were extracted and then clustered into themes, an exhaustive description of the phenomena was developed, fundamental structure was formed, and the findings were validated.[10] The researcher gave the raw data and the analysis to an independent, doctorally prepared nurse researcher with qualitative nursing research experience who was able to verify the results of the analysis.

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