Page 100 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

100
WOUND CARE

increased autonomy in clinical practice and the design of much-needed quality improvement

projects.

A respondent to the semi-structured qualitative interviews equated inter-professional

practice with holistic care and highlighted the ‘permeable inter-professional boundaries’ that

exist in the clinical setting (Cameron, 2011). For example, often in the ambulatory setting

educational resources provided to patients may be interchangeably used by nursing, radiation

therapy, oncologist and nutrition. Exploring the concept of ‘inter-professional practice’ using

nursing care as a frame of reference raises questions, such as:

1) How do nurses ‘individualize’ care when working from standardized procedures?

2) How do nurses hold their voice in an inter-professional work setting?

3) What is the experience of the patient in all of this? and

4) How is a patient preference handled if they do not want dressing removed?

Thus, exploring the role of nurses in inter-professional practice inevitably takes us to how nurses

promote patient-centred care, an overarching theme evident in the data. Toward this end, the

subsequent section discusses this theme.

Person-centred nursing framework. A framework of care adapted from McCance,

McCormack, and Dewing (2011) is helpful in providing some explanations to the emerging

questions that explore person-centredness in radiation wound management practice. McCance,

McCormack, and Dewing present the Person- Centred Nursing (PCN) framework developed by

McCance and McCormack (2010) that includes four constructs: engagement, having sympathetic

presence, sharing decision-making and providing holistic care. The PCN framework is

explained: