Managing Strong Emotions: Nurses’ Recognition and Responses to Personal Emotions When Approaching Parents With Cancer and Their Dependent Children

Abstract

Care for sick parents and their dependent children (<18 years) has become a pertinent issue in health care. Nurses play an important role in caring for parents with cancer as well as their children. By utilizing a constructivist grounded theory approach, the aim of this study was to expand the research-based knowledge of nurses’ experiences of personal emotions in this research field and to develop a subsequent explanatory theory extending the existing concept of emotional labor. Interviews with 12 nurses were conducted and analyzed. The nurses experienced this area of work as particularly emotionally challenging and attempted to manage personal emotions through regulating and processing strategies. Through this process, they sought for emotional strength by balancing their private lives and work lives to manage work-related emotions. An increased awareness of emotional labor may strengthen nurses’ emotional competence in nursing.

Keywords

parental cancer family children nursing constructivist grounded theory emotions emotional labor emotional competence qualitative interview Norway Europe

Get full access to this article

View all access options for this article.

References

Aamotsmo

Bugge

K. E.

(2014). Balance artistry: The healthy parent’s role in the family when the other parent is in the palliative phase of cancer—Challenges and coping in parenting young children. Palliative and Supportive Care, 12, 317–329. https://doi.org/310.1017/S1478951513000953

Arber

Odelius

(2018). Experiences of oncology and palliative care nurses when supporting parents who have cancer and dependent children. Cancer Nursing, 41(3), 248–254. https://doi.org/10.1097/ncc.0000000000000491

Archer

M. S.

(2000). Being human: The problem of agency. Cambridge University Press.

Armistead

Klein

, & Forehand. (1995). Parental physical illness and child functioning. Clinical Psychology Review, 15(5), 409–422. https://doi.org/10.1016/0272-7358(95)00023-I

Ashkanasy

N. M.

Zerbe

W. J.

Härtel

C. E. J.

(2015). Managing emotions in a changing workplace. In Ashkanasy

N. M.

Zerbe

W. J.

Härtel

C. E. J.

(Eds.), Managing emotions in the workplace (pp. 3–17). Routledge.

Badolamenti

Sili

Caruso

Fida

(2017). What do we know about emotional labour in nursing? A narrative review. British Journal of Nursing, 26(1), 48–55. https://doi.org/10.12968/bjon.2017.26.1.48

Bakker

Strickland

MacDonald

Butler

Fitch

Olson

Cummings

(2013). The context of oncology nursing practice. An integrative review. Cancer Nursing, 36(1), 72–88. https://doi.org/10.1097/ncc.0b013e31824afadf

Banerjee

S. C.

Manna

Coyle

Shen

M. J.

Pehrson

Zaider

Hammonds

Krueger

C. A.

Parker

P. A.

Bylund

C. L.

(2016). Oncology nurses’ communication challenges with patients and families: A qualitative study. Nurse Education Practice, 16, 193–201. https://doi.org/10.1016/j.nepr.2015.07.007

Birkeland

Weimand

B. M.

Ruud

Høie

M. M.

Vederhus

J.-K.

(2017). Perceived quality of life in partners of patients undergoing treatment in somatic health, mental health, or substance use disorder units: A cross-sectional study. Health and Quality of Life Outcomes, 15, Article 172. https://doi.org/10.1186/s12955-017-0750-5

10.

Blanch

A. K.

Nicholson

Purcell

(1994). Parents with severe mental illness and their children: The need for human services integration. Journal of Mental Health Administration, 21(4), 388–396. https://doi.org/10.1007/BF02521357

11.

Charmaz

(2014). Constructing grounded theory (2nd ed.). SAGE.

12.

Davey

Niño

Kissil

Ingram

(2012). African American parents’ experiences navigating breast cancer while caring for their children. Qualitative Health Research, 22(9), 1260–1270. https://doi.org/10.1177/1049732312449211

13.

Dencker

Rix

B. A.

Bøge

Tjørnhøj-Thomsen

(2017). A qualitative study of doctors’ and nurses’ barriers to communicating with seriously ill patients about their dependent children. Psycho-Oncology, 26, 2162–2167. https://doi.org/10.1002/pon.4440

14.

Dunne

Sullivan

Kernohan

(2005). Palliative care for patients with cancer: District nurses’ experiences. Journal of Advanced Nursing, 50(4), 372–380. https://doi.org/10.1111/j.1365-2648.2005.03402.x

15.

Faccio

Ferrari

Pravettoni

(2018). When a parent has cancer: How does it impact on children’s psychosocial functioning? A systematic review. European Journal of Cancer Care, 27, e12895. https://doi.org/10.1111/ecc.12895

16.

Fawcett

T. N.

(2011). Cancer: A journey of discovery. In Fawcett

T. N.

McQueen

(Eds.), Perspectives on cancer care (pp. 8–23). Wiley-Blackwell.

17.

Fineman

(2003). Understanding emotion at work. SAGE.

18.

Franklin

Arber

Reed

Ream

(2018). Health and social care professionals’ experiences of supporting parents and their dependent children during, and following, the death of a parent: A qualitative review and thematic synthesis. Palliative Medicine, 33(1), 49–65. https://doi.org/10.1177/0269216318803494

19.

Funk

L. M.

Peters

Roger

K. S.

(2017). The emotional labor of personal grief in palliative care: Balancing caring and professional identities. Qualitative Health Research, 27(14), 2211–2221. https://doi.org/10.1177/1049732317729139

20.

Golsäter

Enskär

Knutsson

(2019). Parents’ perceptions of how nurses care for children as relatives of an ill patient: Experiences from an oncological outpatient department. European Journal of Oncology Nursing, 39, 35–40. https://doi.org/10.1016/j.ejon.2019.01.004

21.

Golsäter

Henricson

Enskär

Knutsson

(2016). Are children as relatives our responsibility? How nurses perceive their role in caring for children as relatives of seriously ill patients. European Journal of Oncology Nursing, 25, 33–39. https://doi.org/10.1016/j.ejon.2016.09.005

22.

Götze

Friedrich

Brähler

Romer

Menhert

Ernst

(2017). Psychological distress of cancer patients with children under 18 years and their partners—A longitudinal study of family relationships using dyadic data analysis. Supportive Care in Cancer, 25, 255–264. https://doi.org/10.1007%2Fs00520-016-3411-z

23.

Grandey

A. A.

(2003). When “the show must go on”: Surface acting and deep acting as determinants of emotional exhaustion and peer-rated service delivery. Academy of Management Journal, 46(1), 86–96. https://doi.org/10.2307/30040678

24.

Gray

Smith

(2009). Emotional labour and the clinical settings of nursing care: The perspectives of nurses in East London. Nurse Education in Practice, 9, 253–261. https://doi.org/10.1016/j.nepr.2008.08.009

25.

Hammer

M. J.

Cartwright-Alcarese

Budin

W. C.

(2019). Theoretical frameworks and philosophies of care. In Payne

J. K.

Murphy-Ende

(Eds.), Current trends in oncology nursing (2nd ed., pp. 1–46). Oncology Nursing Society.

26.

Henderson

(2001). Emotional labor and nursing: An under-appreciated aspect of caring work. Nursing Inquiry, 8(2), 130–138. https://doi.org/10.1046/j.1440-1800.2001.00097.x

27.

Hochschild

A. R.

(1979). Emotion work, feeling rules, and social structure. American Journal of Sociology, 85(3), 551–575. https://doi.org/10.1086/227049

28.

Hochschild

A. R.

(1983). The managed heart: Commercialization of human feeling. University of California Press.

29.

Holmberg

Nilsson

Elmqvist

Lindqvist

(2020). Nurses’ encounters with children as next of kin to parents with a cancer diagnosis on oncology wards. Nordic Journal of Nursing Research, 40(1), 33–40. https://doi.org/10.1177%2F2057158519868437

30.

Huizinga

G. A.

Visser

Zelders-Steyn

Y. E.

Teule

J. A.

Reijneveld

S. A.

Roodbol

P. F.

(2011). Psychological impact of having a parent with cancer. European Journal of Cancer, 47(3), 239–246. https://doi.org/10.1016/S0959-8049(11)70170-8

31.

Iversen

Anell

Häkkinen

Kronborg

Ólafsdóttir

(2016). Coordination of health care in the Nordic countries. Nordic Journal of Health Economics, 4(1), 41–55. https://doi.org/10.5617/njhe.2846

32.

Kreitler

(2019). Psycho-oncology for the clinician. The patient behind the disease. Springer.

33.

Lewis

Ashkanasy

N. M.

(2020). Emotions in nursing. In Burke

Pignata

(Eds.), Handbook of research on stress and well-being in the public sector (pp. 106–121). Edward Elgar.

34.

Mayer

J. D.

Salovey

(1997). What is emotional intelligence? In Salovey

Sluyter

(Eds.), Emotional development and emotional intelligence: Implications for educators (pp. 3–31). Basic Books.

35.

McQueen

A. C. H.

(2004). Emotional intelligence in nursing. Journal of Advanced Nursing, 47(1), 101–108. https://doi.org/10.1111/j.1365-2648.2004.03069.x

36.

Mitschke

D. B.

(2008). Cancer in the family: Review of the psychosocial perspective of patients and family members. Journal of Family Social Work, 11(2), 166–184. https://doi.org/10.1080/10522150802175159

37.

Morris

J. N.

Martini

Preen

(2016). The well-being of children impacted by a parent with cancer: An integrative review. Supportive Care in Cancer, 24, 3235–3251. http://dx.doi.org/10.1007/s00520-016-3259-2

38.

Norwegian Directorate of Health. (2019). Pårørendeveilederen. Nasjonal veileder [National guidelines for relatives]. Retrieved November 4, 2020, from https://www.helsedirektoratet.no/veiledere/parorendeveileder?fbclid=IwAR1iccVON8eowi9rM8Ld9wGVf5nTWMviQUW1Z7PKlyOWtvpfS_wkzRhd2nU

39.

Norwegian Ministry of Health and Care Services. (2013). Together—Against cancer. National Cancer Strategy 2013-2017. https://www.regjeringen.no/contentassets/07cd14ff763444a3997de1570b85fad1/i-1158_together-against_cancer_web.pdf

40.

Norwegian Ministry of Health and Care Services. (2017). Leve med kreft [Living with cancer]. https://www.regjeringen.no/contentassets/266bf1eec38940888a589ec86d79da20/regjeringens_kreftstrategi_180418.pdf

41.

The Norwegian National Research Ethics Committees. (2016). Guidelines for research ethics in the social sciences, humanities, law and theology. The Norwegian National Research Ethics Committees. https://www.forskningsetikk.no/globalassets/dokumenter/4-publikasjoner-som-pdf/60127_fek_guidelines_nesh_digital.pdf

42.

Ortega-Campos

Vargas-Román

Velando-Soriano

Suleiman-Martos

Cañadas-de

Fuente

G. A.

Albendín-García

Gómez-Urquiza

J. L.

(2020). Compassion fatigue, compassion satisfaction, and burnout in oncology nurses: A systematic review and meta-analysis.Sustainability, 12, Article 72. https://doi.org/10.3390/su12010072

43.

Park

E. M.

Check

D. K.

Song

M.-K.

Reeder-Hayes

K. E.

Hanson

L. C.

Yopp

J. M.

Rosenstein

Mayer

D. K.

(2017). Parenting while living with advanced cancer: A qualitative study. Palliative Medicine, 31(3), 231–238. https://doi.org/10.1177%2F0269216316661686

44.

Park

E. M.

Deal

A. M.

Check

D. K.

Hanson

L. C.

Reeder-Hayes

K. E.

Mayer

D. K.

Yopp

J. M.

Song

M.-K.

Muriel

A. C.

Rosenstein

D. L.

(2016). Parenting concerns, quality of life, and psychological distress in patients with advanced cancer. Psycho-Oncology, 25, 942–948. https://doi.org/10.1002/pon.3935

45.

Peters

(2018). Compassion fatigue in nursing: A concept analysis. Nursing Forum, 53, 466–480. https://doi.org/10.1111/nuf.12274

46.

Phillips

C. S.

Volker

D. L.

(2019). Riding the roller coaster. A qualitative study of oncology nurses’ emotional experience in caring for patients and their families. Cancer Nursing, 43(5), 283–290. https://doi.org/10.1097/ncc.0000000000000734

47.

Pierce

Hope

H. F.

Kolade

Gellatly

Osam

C. S.

Perchard

Kosidou

Dalman

Morgan

Di Prinzio

Abel

K. M.

(2020). Effects of parental mental illness on children’s physical health: Systematic review and meta-analysis. The British Journal of Psychiatry, 217(1), 354–363. https://doi.org/10.1192/bjp.2019.216

48.

Riley

Weiss

M. C.

(2016). A qualitative thematic review: Emotional labour in healthcare settings. Journal of Advanced Nursing, 72(1), 6–17. https://doi.org/10.1111/jan.12738

49.

Rohan

Bausch

(2009). Climbing Everest: Oncology work as an expedition in caring. Journal of Psychosocial Oncology, 27, 84–118. https://doi.org/10.1080/07347330802616043

50.

Sandgren

Thulesius

Fridlund

Petersson

(2006). Striving for emotional survival in palliative cancer nursing. Qualitative Health Research, 16(1), 79–96. https://doi.org/10.1177/1049732305283930

51.

Schiena

Hocking

Joubert

Wiseman

Blaschke

(2019). An exploratory needs analysis of parents diagnosed with cancer. Australian Social Work, 72(3), 325–335. https://doi.org/10.1080/0312407X.2019.1577472

52.

Shah

B. K.

Armaly

Swieter

(2017). Impact of parental cancer on children. Anticancer Research, 37(8), 4025–4028. https://doi.org/10.21873/anticanres.11787

53.

Sherwood

Cherian

U. K.

Horton-Deutsch

Kitzmiller

Smith-Miller

(2018). Reflective practices: Meaningful recognition for healthy work environments. Nursing Management, 24(10), 30–34. http://dx.doi.org/10.7748/nm.2018.e1684

54.

Smith

K. B.

Profetto-McGrath

Cummings

(2009). Emotional intelligence and nursing: An integrative review. International Journal of Nursing Studies, 46(12), 1624–1636. https://doi.org/10.1016/j.ijnurstu.2009.05.024

55.

Smith

(1992). The emotional labour of nursing: Its impact on interpersonal relations, management and the educational environment in nursing. Palgrave Macmillan.

56.

Smith

(2012). The emotional labour of nursing revisited. Can nurses still care? (2nd ed.). Palgrave Macmillan.

57.

Theodosius

(2008). Emotional labour in health care: The unmanaged heart of nursing. Routledge.

58.

Turner

Clavarino

Yates

Hargraves

Connors

Hausmann

(2007). Oncology nurses’ perceptions of their supportive care for parents with advanced cancer: Challenges and educational needs. Psycho-Oncology, 16, 149–157. https://doi.org/10.1002/pon.1106

59.

UNCRC. (1989). United Nations Convention on the Rights of the Child. https://www.ohchr.org/Documents/ProfessionalInterest/crc.pdf

60.

UNICEF Office of Research-Innocenti. (2018). Key findings on families, family policy and the sustainable development goals: Synthesis report. https://www.unicef-irc.org/publications/pdf/Families_and_SDGs_Synthesis_Report.pdf

61.

United Nations. (2015). Transforming our world: The 2030 agenda for sustainable development. https://sustainabledevelopment.un.org/content/documents/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf

62.

United Nations. (2016). Sustainable development goals and family policies. United Nations Department of Economic and Social Affairs. https://www.un.org/esa/socdev/family/docs/egm16/summary.pdf

63.

Wells-English

Giese

Price

(2019). Compassion fatigue and satisfaction: Influence on turnover among oncology nurses at an urban cancer center. Clinical Journal of Oncology Nursing, 23(5), 487–493. https://doi.org/10.1188/19.cjon.487-493