In this grounded theory study, the authors analyze interviews and participant observation data related to palliative cancer nursing in hospitals. Striving for Emotional Survival emerged as the pattern of behavior through which nurses deal with their main concern, the risk of being emotionally overloaded by their work. It involved three main strategies: Emotional Shielding through Professional Shielding or Cold Shielding; Emotional Processing through Chatting, Confirmation Seeking, Self-Reflecting, or Ruminating; and Emotional Postponing through Storing or Stashing. Emotional Competence is a property of Striving for Emotional Survival that explains more or less adequate ways of dealing with emotional overload. The theory Striving for Emotional Survival can be useful in the nurses' daily work and provides a comprehensive framework for understanding how nurses deal with emotional difficulties. The authors suggest that health care organizations encourage self-care, prioritize time to talk, and offer counseling to nursing staff with emotionally difficult working conditions.
Andershed, B., & Ternestedt, B. M. (1997). Patterns of care of patients with cancer before and after the establishment of a hospice ward. Scandinavian Journal of Caring Sciences, 11, 42-50.
2.
Andræ, M. (1994). Facing death: Physicians' difficulties and coping strategies in cancer care. Unpublished doctoral dissertation, Umeå University, Umeå, and Uppsala University, Uppsala, Sweden.
3.
Artinian, B. M. (1995). Risking involvement with cancer patients. Western Journal of Nursing Research, 3, 292-304.
4.
Astuto, M., Favara-Scacco, C., Crimi, E., Rizzo, G.,& Di Cataldo, A. (2002). Pain control during diagnostic and/or therapeutic procedures in children. Minerva Anestesiologica, 9, 695-703.
5.
Berterö, C. (1999). Caring for and about cancer patients: Identifying the meaning of the phenomenon “caring” through narratives. Cancer Nursing, 6, 414-420.
6.
Boeije, H. R., Nievaard, A. C., & Casparie, A. F. (1997). Coping strategies of enrolled nurses in nursing homes: Shifting between organizational imperatives and residents' needs. International Journal of Nursing Studies, 5, 358-366.
7.
Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). Adual representation theory of posttraumatic stress disorder. Psychological Review, 4, 670-686.
8.
Carmack, B. J. (1997). Balancing engagement anddetachment in caregiving. Journal of Nursing Scholarship, 2, 139-143.
9.
Clark, D. (1993). Whither the hospices? In D. Clark (Ed.), The future for palliative care: Issues of policy and practice (pp. 167-177). Philadelphia: Open University Press.
10.
Cohen, M. Z. (1995). The meaning of cancer and oncology nursing: Link to effective care. Seminars in Oncology Nursing, 1, 59-67.
11.
Cohen, M. Z., Haberman, M. R., Steeves, R.,& Deatrick, J. A. (1994). Rewards and difficulties of oncology nursing. Oncology Nursing Forum, 21(8 Suppl.), 9-17.
12.
Cohen, M. Z., & Sarter, B. (1992). Love and work: Oncology nurses' view of the meaning of their work. Oncology Nursing Forum, 10, 1481-1486.
13.
Cordova, M. J., Cunningham, L. L., Carlsson, C. R.,& Andrykowski, M. A. (2001). Social constraints, cognitive processing, and adjustment to breast cancer. Journal of Counseling and Clinical Psychiatry, 4, 706-711.
14.
Corner, J. (2002). Nurse's experiences of cancer. European Journal of Cancer Care, 3, 193-199.
15.
Decruyenaere, M., Evers-Kiebooms, G., Denayer, L., Welkenhuysen, M., Claes, E., Legius, E., et al. (2000). Predictive testing for hereditary breast and ovarian cancer: Apsychological framework for pre-test counselling. European Journal of Human Genetics, 2, 130-136.
16.
Dubik-Unruh, S., & See, V. (1989). Children of chaos: Planning for the emotional survival of dying children of dying families. Journal of Palliative Care, 2, 10-15.
17.
Escot, C., Artero, S., Gandubert, C., Boulenger, J. P., & Ritchie, K. (2001). Stress levels in nursing staff working in oncology. Stress & Health, 5, 273-279.
18.
Faulkner, A. (1996). Care of oncology patients: Caring for the carers. Complementary Therapies in Nursing & Midwifery, 3, 59-61.
19.
Forsgärde, M., Westman, B., & Jansson, L. (2002). Professional carers' struggle to be confirmed: Narratives within the care of the elderly and disabled. Scandinavian Journal of Caring Sciences, 16, 12-18.
20.
Glaser, B. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press.
21.
Glaser, B. (1998). Doing grounded theory: Issues and discussions. Mill Valley, CA: Sociology Press.
22.
Glaser, B. (2001). The grounded theory perspective: Conceptualization contrasted with description. Mill Valley, CA: Sociology Press.
23.
Glaser, B. (2003). The grounded theory perspective (Vol. 2). Mill Valley, CA: Sociology Press.
24.
Glaser, B.,& Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Mill Valley, CA: Sociology Press.
25.
Grossman, R. (2003). Voicelessness and emotional survival. Retrieved March 23, 2003, from http://www.viocelessness.com/essay.html
26.
Irurita, V. F., & Williams, A. M. (2001). Balancing and compromising: Nurses and patients preserving integrity of self and each other. International Journal of Nursing Studies, 38, 579–589.
27.
Katz, J. T. S. (1989). Context and care: Nurses' accounts of stress and support on a cancer ward. Unpublished doctoral dissertation, University of Warwick, United Kingdom.
28.
Krebs, L. U., Myers, J., Decker, G., Kinzler, J., Asfahani, P., & Jackson, J. (1996). The oncology nursing image: Lifting the mist. Oncology Nursing Forum, 8, 1297-1304.
29.
Levinson, A. E. (2000). When a parent's survival is threatened: The role of anger and unconscious fantasy among adolescents whose parents have cancer. Dissertation Abstracts International, 61 (4), 2208B.
30.
Litz, B. T., Orsillo, S. M., Kaloupek, D., & Weathers, F. (2000). Emotional processing in posttraumatic stress disorder. Journal of Abnormal Psychology, 1, 26-39.
31.
McCaughan, E., & Parahoo, K. (2000). Medical and surgical nurses' perceptions of their level of competence andeducational needs in caring for patients with cancer. Journal of Clinical Nursing, 3, 420-428.
32.
McMillan, S. C., Tittle, M., Hagan, S., Laughlin, J., & Tabler, R. E. (2000). Knowledge and attitudes of nurses in veterans hospitals about pain management in patients with cancer. Oncology Nursing Forum, 9, 1415-1423.
33.
McNeal, L. J. (1997). The effects of perceived non-work social support and hope upon oncology nurses' occupational stress. Unpublished doctoral dissertation, University of North Carolina at Greensboro.
34.
Morse, J. M., Anderson, G., Bottorff, J. L., Yonge, O., O'Brien, B., Solberg, S. M., et al. (1992). Exploring empathy: Aconceptual fit for nursing practice?Image: The Journal of Nursing Scholarship, 4, 273-280.
35.
O'Brien, S., Dalton, J. A., Konsler, G., & Carlson, J. (1996). The knowledge and attitudes of experienced oncology nurses regarding the management of cancer-related pain. Oncology Nursing Forum, 3, 515-521.
36.
Penson, R. T., Dignan, F. L., Canellos, G. P., Picard, C. L., & Lynch, T. J., Jr. (2000). Burnout: Caring for the caregivers. Oncologist, 5, 425-434
37.
Perlman, S. D. (1999). The therapist's emotional survival: Dealing with the pain of exploring trauma. Northvale, NJ: Jason Aronson.
38.
Pert, C. B., Dreher, H. E., & Ruff, M. R. (1998). The psychosomatic network: Foundations of mind-body medicine. Alternative Therapies in Health and Medicine, 4, 30-41.
39.
Plante, A.,& Bouchard, L. (1995). Occupational stress, burnout, and professional support in nurses working with dying patients. Omega: Journal of Death & Dying, 2, 93-109.
40.
Radziewicz, R. M. (2001). Self-care for caregiver. Nursing Clinics of North America, 4, 855-869.
41.
Saunders, J. M., & Valente, S. M. (1994). Nurses' grief. Cancer Nursing, 4, 318-325.
42.
Suls, J.,& Fletcher, B. (1985). The relative efficacy of avoidant and nonavoidant coping strategies: Ametaanalysis. Health Psychology, 3, 249-288.
43.
Stanton, A. L., Danoff-Burg, S., Cameron, C. L., Bishop, M., Collins, C. A., Kirk, S. B., et al. (2000). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 5, 875-882.
44.
Thulesius, H., Håkansson, A.,& Petersson, K. (2003). Balancing: Abasic process in end-of-life cancer care. Qualitative Health Research, 13, 1353-1377.
45.
Vachon, M. L. (1995). Staff stress in hospice/palliative care: A review. Palliative Medicine, 2, 91-122.
46.
Vachon, M. L. (1998). Caring for the caregiver in oncology and palliative care. Seminars in Oncology Nursing, 2, 152-157.
