An exploration of communication between emerging adults with cancer and nurses in an adult cancer care setting

Abstract

Having a cancer diagnosis during early adulthood can bring significant challenges. It is important to provide supportive care with consideration of their developmental challenges. Nurses’ supportive communication plays a vital role in helping them cope and adjust to the life-changing event of cancer. This study aimed to explore the therapeutic communication between nurses and young people diagnosed with cancer, focusing on those aged between 18 and 25 (developmental literature termed this group emerging adults). In-depth interviews with eight emerging adults with cancer (EAs) and seven nurses were undertaken. Findings revealed that EAs greatly benefited from the informal conversations they had with nurses on a day-to-day basis. They established trust-based relationship with nurses from which therapeutic processes occurred organically. These informal conversations, which on the surface seemed clinically insignificant, fulfilled these young individuals’ basic psychosocial needs such as feelings of belongingness, connectedness, and acceptance. These conversations also helped them regain a sense of control and normality by talking about and making sense of their experiences. Nurses engaged in informal conversations with EAs with a therapeutic intention. For them, it was a way to ease EAs into the hospital environment and also to learn about the needs of each EA in order to provide tailored support. Challenges such as emotional exhaustion, inherent in the interpersonal nature of therapeutic communication, were noted. Some of the participants, however, learnt to draw appropriate professional boundaries that enabled them to provide compassionate therapeutic communication with EAs while protecting their own emotional wellbeing. The study documents the nature of therapeutic communication through the perspectives of EAs and nurses. It highlighted the benefit of therapeutic communication which happens at an informal, day-to-day level. Nurses and health organisations would benefit from understanding the value of the therapeutic benefits of informal conversations during the care of EAs. The findings also suggested that nurses need to build their capacities relating to therapeutic communication such as emotional regulation skills, resiliency, and the ability to maintain healthy boundaries with EAs.