The nurse's relationship-based perceptions of patient quality of life.

PURPOSE/OBJECTIVES To explore patients' quality of life (QOL) as defined by RNs in adult and pediatric oncology settings and to examine, from the perspectives of clinical nurses, the knowledge that is needed to apply QOL research outcomes in clinical practice. DESIGN Qualitative research design using a focus group technique to explore the research questions. SETTING Three sites (i.e., a pediatric research center in western Tennessee and oncology nurses from a chapter of the Oncology Nursing Society [ONS] in Central Florida and another in upstate New York). SAMPLE 24 oncology nurses working with adult or pediatric patients or both. METHODS Oncology nurses were approached at work or through their local ONS chapters for a focus group discussion. FINDINGS 47 unique themes were reported by all five focus groups in response to three questions. The most frequently reported themes were (a) Using the Patient's Standard, (b) Nursing Strategies, (c) Differences Decrease QOL Care, (d) Maintaining Social Interests, (e) Insightful Relations With Patient, and (f) Nurse-Patient Communication. CONCLUSIONS Nurses' assessments of QOL primarily are based on their established relationships with their patients. From these relationships, nurses derive perceptions of patients' QOL and clinical direction for interventions to positively influence QOL. Based on these findings, the investigators developed a conceptual model of the nurses' relationship-based perceptions of patients' QOL. IMPLICATIONS FOR NURSING The current QOL measures have minimal importance to nurse clinicians. Because nurse clinicians rely on their relationships with patients to assess QOL, available tools should be made more clinically useful. Further research should be conducted using the new conceptual model, specifically to learn more about how nurses complete a QOL assessment within the context of the nurse-patient relationship.