Listening to the voices of patients with cancer and their nurses: a hermeneutic phenomenological approach to quality nursing care

The purpose of the thesis is to illuminate the meaning of quality nursing care in the three major inpatient cancer care centres in Cyprus as seen from the standpoint of patients with cancer, patients' advocates and nurses. The data are based on: a) interviews (narratives) with 25 patients with cancer and two focus groups b) a focus group with patients' advocates and c) interviews with 20 nurses working in the cancer care departments.
The rational for this study echoed a conceptualisation problem among patients, nurses and patients' advocates in relation to quality nursing care. The different interpretations held by the informants around this issue often creates problems of communication and understanding between nurse-patients and between nurses-patients' advocates. It also prevents a commonly shared concept to be adopted in the clinical setting.
In order to investigate this issue, a philosophical approach was adopted based on the philosophy of Paul Ricoeur and using the "lived experiences" of the informants as the basis of the investigation. The data were analysed using a hermeneutic phenomenological approach based on Ricoeur's interpretation theory but modified to suit the nursing paradigm.
What stands out from the study is the overlapping of the patients', patients' advocates and the nurses' experiences of quality nursing care. Based on the attributes that the
informants have used to interpret the concept of quality nursing care, a shared understanding of the concept materialised. This shared understanding formed the basis
for developing a theory of quality nursing care. Simultaneously, the study reinforced the importance of "getting the basics right" for providing quality nursing care to patients with cancer. Based on the informants' lived experiences a set of guidelines of best practice were developed, as a means for influencing nursing practice.

A Thesis submitted to Middlesex University in partial fulfilment of the requirements for the degree of Doctor of Philosophy.