Exploring the need of oncology nurses to use current awareness services (CAS) available via the WWW: a South African p

1. Exploring the need of oncology nurses to use current awareness services (CAS) available via the WWW: a South African perspective Prof Ina Fourie & Mrs. Retha Claasen-Veldsman Department of Information Science University of Pretoria South Africa

2. Introduction • Society marked by changes in • Access to information • WWW & current awareness services (CAS) • ICT skills required • Information literacy skills required • Changes affect both patients and health care professionals such as doctors, nurses • Oncology nurses • Seeming urgency for information vs practical realities • Perceived value of information

3. WWW and current awareness services (CAS) • Oncology nursing resources • Professional associations • Professional journals • Tables of contents • Tables of contents services • RSS feeds • Electronic newsletters • Book alerting services • Discussion groups • Websites with noteworthy content • Monitoring software • Portals • Other related resources

4. Scope of this paper • Purpose of the research project • Setting • Limited empirical survey to offer South African perspective • Medical Oncology Clinic • Hospital Oncology Wards (2) • Participants • Literature survey • Empirical survey • Findings • Suggestions

5. Purpose of study • Enabling oncology nurses & health care professionals to exploit WWW CAS available for free • Developing a theoretical model of the information behaviour of oncology nurses & health care professionals • Developing mechanisms to support the information needs & information behaviour of cancer patients • Interventions • Link between role players and changing environment

6. Literature survey • Information behaviour of • Oncology nurses • Oncologists • Nurses (in general as well as different types) • Cancer patients • Models of information behaviour • Other findings from information behaviour (cont.)

7. Literature survey (cont.) • Pressures and demands faced by oncology nurses: “Throughout Europe cancer nurses are striving to meet the challenges of providing quality nursing care amid changing environments that are characterized by advances in drugs and technologies, ageing populations, increasing rates of cancer, increased survival rates, rising costs and increasing economic constraints” (Baker & Fitch as cited by Browne, Robinson & Richardson, 2002:134) • How do oncology nurses stay up to date? (cont.)

8. Literature survey (cont.) • Evidence-based practices • Life-long learning • Increased use of ICT • Increased need for patient education and support • Changes in health care environment • Growing demand for improved health care services • New roles

9. Hospital Oncology wards (2) Oncology clinic Management Head oncologist Staff Mother Company Patients Pretoria South Africa Hospital & Team

10. Medical Oncology Clinic Head oncologist (1) Oncology nurses (5 sisters) Oncology social worker (1) Hospital Oncology Wards Ward 1: treatment: chemoterapy, stem cell transplants, etc. Ward 2: terminally ill patients & children: palliative care, pediatric care Unit manager (sister) (1) Oncology nurses (sisters, staff nurses, assistant nurses) (16) Care workers (2) Participants (convenience sample)

11. Research methods • Questionnaire • Individual interviews & limited group interviews (need to deal with realities) • Individual semi-structured interviews with management • Head oncologist (1 hour) • Unit manager of hospital wards (1 hour)

12. Hospital Oncology wards (2) Oncology clinic Management Head oncologist Staff Mother Company Patients Pretoria South Africa Hospital & Team

13. Medical Oncology Clinic Administration of treatment (e.g. chemotherapy) Monitoring/observation of patients Feedback to oncologists Administrative tasks Sharing information with patients Self-treatment, implications of processes Queries Counselling of patients, family and staff Hospital Oncology Wards Intensive administration of treatment (e.g. chemotherapy, medication) Intensive monitoring & observation of patients Feedback to oncologists Care of hospitalised patients Offering of emotional support to patients/family/friends Patient education Interaction with oncologists (and other doctors) Administrative tasks Staff training Supporting of hospital staff (i.e. role of care workers) Functions & daily tasks

14. Medical Oncology Clinic Tiredness Much time on feet Numerous interruptions No privacy to search for information Emotional impact Routine nature of tasks Hospital Wards Tiredness (very long shifts) Much time on feet Numerous interruptions No privacy to search for information Emotional impact (strong) Numerous interruptions No privacy to search for information Difficult to balance work with personal life, continuous education Insufficient staff and time to do what is really important Routine nature of tasks Perceived impact of functions & daily tasks

15. Medical Oncology Clinic Management Oncologists very up-to-date Some staff members showing interests Opportunities for staff Adequate Staff Rely on oncologists Conference and seminar opportunities Information nice to have, but not essential Hospital Oncology Wards Management Rely on oncologists Few opportunities ICT skills should be part of continuing education Staff Rely on oncologists Rely on hospital ward management Rely on patients (limited) Information nice to have, but not essential More ambitious -- higher need for information Close to retiring age -- less need for information (cont.) Perceived value of information

16. Perceived value of information (cont.) • Mostly adequate: • Oncologists • Sister-in-charge • Hospital management • Colleagues • Reference works i Patient well-being • Patients • Workshops, seminars, • conferences • Nice to have… • Medical/drug related • information • Job opportunities • Training opportunities • Personal use • Mostly unaware/ unfamiliar: • WWW CAS • ICT skills • Information literacy

17. International trends & scientific research Good awareness Limited awareness Management Head oncologist & oncologists Staff Patients Other institutions

18. Medical Oncology Clinic Staff Time Access (ICT & privacy) Daily tasks Skills Management Nature of tasks & task perception Value of information Personal motivation Hospital Oncology Wards Staff Time Demands of the job (physical & emotional) Funding Access (ICT & privacy) Daily tasks Skills Opportunities Management Time, demands of job, skills, daily tasks, access, funding Staff shortages Barriers to use of information & WWW CAS

19. Developing a culture of keeping up in a dynamic field • Acknowledging the nature and demands of their jobs • Need to find ways to face the realities of professional life • Need to find ways to explore what CAS may offer • Management’s mindset • Staff’s mindset • Exploring and stimulating interest in CAS • Expanding our knowledge and understanding • Information behaviour in the oncology health care environments • Information behaviour of patients • Expanding knowledge of opportunities for intervention

20. Point of departure for staff: understanding yourself… Me – who I am i My personal life My job & work place Oncology profession Society

21. Point of departure for management: understanding information behaviour in the larger context: Own awareness of information Dissemination to other role players i Opportunities for information acquisition and use Oncology information infrastructure Demands of society

22. Conclusion • Exploratory study • Interventions (planning in progress) • Workshop • Self-paced study package • Portal • Linking needs of staff, management and patients • Communities of practice • Collaboration • Flow theory