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EAHIL conference, 2006, Cluj-Napoca

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  • It seems as if more people have access to information via the Internet and that there is also an increase in how people expect to use these information resources as well as in their own expectations to have access to these. There are, however, also many people who do not have access to computers or the Internet and who do not have the information literacy and technology skills to use these.
  • CAS are services that help people to keep up with the latest information and has been used by library and information services for many years. The many CAS that have become available for free or at reasonable fees for the WWW has opened new opportunities to keep up-to-date. Although we focused on oncology nurses, there are many similar services available for other healthcare professionals. We have identified examples of CAS for oncology nurses in an article to be published in The Electronic Library , and hope that this study can inspire library and information services to do the same for other healthcare professionals. Although there are many reasons for using CAS, the question, however, is whether there is really a need for this amongst oncology nurses (or other professionals).
  • Information resources, including CAS, is no longer only available to those who can afford to pay for information. WWW CAS is available to those who are aware of the services and who knows how to use them. We hope that the exploratory study with oncology nurses can help us to refine our methodology and research questions to expand the study to a wider group of oncology nurses in South Africa. We also hope that we would be able to do internationally comparative studies, and eventually expand the project to other health care professionals, and cancer patients. As we will point out the environment in which the nurses work can have an important impact on their information seeking behaviour. We will therefore briefly explain the research setting and the participants for the project. Although the research methods we chose were valid, we did experience some problems that need to be considered in future projects. Our findings are especially important in shaping further research projects as well as research questions. Although we will only deal with a few selected findings, more detail is offered in the full paper. The same applies to the recommendations.
  • The environment and the institutional setting in which the nurses work seems to have a very important impact on their need for information (including the use of CAS), as well as their opportunities to use these. Although the staff from the medical oncology clinic and the oncology hospital wards share the same patients, there are marked differences between their funding structures, access to ICT, staff structure, etc. It appears as if the national health regulations and health infrastructure may also have an important impact. We explain these in more detail in the full paper.
  • The participants are from Pretoria. The fact that we knew most of them personally made it slightly easier to ensure their participation.
  • Our selection of research methods was based on a literature survey of studies on the information behaviour of oncology nurses and other healthcare professionals, as well as models of information behaviour. Although the methods and the instruments for collecting the data seemed valid, we experienced some problems that need to be addressed in further research. Although we tested the questionnaire with three participants, the staff from the medical oncology clinic felt that it took too much time, and that they did not always understand the questions. The 2 focus group interviews with the staff from the medical oncology clinic was very useful, but very small. It had to be adapted around their other responsibilities. We realised that we will not be able to use these methods with the hospital staff who are working with a serious staff shortage, and more demanding work circumstances. We therefore decided to use individual interviews based on the questionnaire for the hospital staff. Although this took a lot of our time, it was certainly more convenient for the participants.
  • Most of the tasks are of a routine nature, and staff relies on the oncologists for instructions. It is therefore the oncologists’ responsibility to keep track of new regulations, new drugs, new findings on side effects, etc. Tasks that seems to be more on the terrain of the nursing staff and social worker are patient education and patient counselling, and especially the offering of emotional support to patients and their families. Interestingly enough, it has been reported that cancer patients show an increase in the use of the Internet. They are also asking more sophisticated questions which are often directed at the nursing staff. There is, however, serious concern about the quality of the resource they are using.
  • Some of these are also mentioned in other reported studies to which we refer in the full paper.
  • Some of these barriers are also mentioned in other reported studies.
  • Research has shown that some tasks are not requiring information to solve a problem, and therefore people will not experience the need to search for information, or the need to keep up with new information or developments. In our study the management (i.e. the head oncologists as well as the hospital unit manager) felt that the oncologists are sufficiently keeping track of developments concerning cancer treatment and since nursing staff relies on them, there is no need to expect them to use CAS. The nurses agreed with this, although they admitted that there are some types of information that might be nice to have.
  • Although almost all participants indicated that they are interested in CAS, they felt that most of their information needs are covered, and that they actually lack the time, skills and facilities to use WWW CAS. They, however, showed a strong interest in learning to use the Internet for personal reasons (e.g. meeting with everyday life needs, helping children with assignments). This might be a good slant to promote the use of CAS, and to make them aware of information that may be important to oncology nurses and that are not monitored by the oncologists.
  • Although participants had very high praise for the oncologists’ awareness of developments in their professional field, and although both the clinic staff and hospital staff relies very heavily on them, some participants were concerned about the fact that information is not always shared adequately, and that in the hospita,l training opportunities and conference attendance, are often limited to senior staff members.

EAHIL conference, 2006, Cluj-Napoca EAHIL conference, 2006, Cluj-Napoca Presentation Transcript

  • Exploring the need for current awareness services (CAS) via the WWW: oncology nurses as an example Prof Ina Fourie & Mrs. Retha Claasen-Veldsman Department of Information Science University of Pretoria South Africa
  • Introduction
    • Society marked by changes in
      • Access to information
      • ICT & information literacy skills required
    • Changes affect society, patients and healthcare professionals
      • Oncology nurses
    • Seeming urgency for information: “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. A Delphi study on the research priorities of European oncology nurses. European Journal of Oncology Nursing, 6(3):134)
  • Increase in WWW and current awareness services (CAS) (often available for free)
      • Discipline specific resources (e.g. oncology nursing)
        • Professional associations
        • Professional journals
          • Tables of contents
          • Tables of contents services
          • RSS feeds
        • Electronic newsletters
        • Book alerting services
        • Discussion groups
        • Weblogs
        • Websites with noteworthy content
          • Monitoring software
        • Portals
      • Resources from related disciplines (e.g. social work, nursing)
  • Scope of this paper
    • Purpose of study
    • Setting
      • Limited empirical survey in South Africa
      • Participants
    • Research methods
    • Findings
    • Recommendations
  • Purpose of study
    • Exploratory research on the information seeking behaviour of oncology nurses
      • Refinement of research methods and research focus
    • Exploration of the need for and interest in WWW CAS
  • Setting
    • Medical oncology clinic
    • Hospital oncology wards
      • Ward 1:
        • Treatment: chemotherapy, stem cell transplants, etc.
      • Ward 2:
        • Terminally ill patients & children: palliative care, pediatric care
  • & Team Hospital Oncology Clinic Head oncologist Hospital Oncology Wards (2) Management Patients Pretoria South Africa Staff Setting Unit manager
  • Participants (convenience sample)
    • Medical oncology clinic
      • Head oncologist (1)
      • Oncology nurses
      • (5 sisters)
      • Oncology social worker (1)
    • Hospital oncology wards
      • Unit manager
      • (sister) (1)
      • Oncology nurses (sisters, staff nurses,
      • assistant nurses) (16)
      • Care workers (2)
  • Research methods
    • Self-administered individual questionnaire
      • Medical oncology clinic only
    • Individual semi-structured interviews & limited focus group interviews
      • Need to deal with realities
    • Individual semi-structured interviews with management
      • Head oncologist (1 hour)
      • Unit manager of hospital wards (1 hour)
  • Findings: Task environment - functions & daily tasks
    • 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)
  • Findings: Perceived impact of functions & daily tasks
    • Medical oncology clinic
      • Tiredness
        • Spend great deal of time on feet
      • Numerous interruptions
        • No privacy to search for information
      • Emotional impact
      • Routine nature of tasks
    • Hospital wards
      • Tiredness ( very long shifts )
        • Spend great deal of 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
  • Findings: Influences & barriers to the use of information & WWW CAS
    • Medical oncology clinic
      • Staff
        • Time
        • Access (ICT & privacy)
        • Daily tasks
        • Skills
      • Management
        • Nature of tasks & task perception
          • Value of information
        • Lack of 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
  • Findings: Perceived value of & need for information
    • Medical oncology clinic
      • Management’s perception
        • Oncologists very up-to-date
        • Some staff members showing interests
        • Sufficient opportunities for staff
        • Adequate awareness
      • Staff’s perception
        • Relies on oncologists
        • Conference and seminar opportunities
        • Information nice to have, but not essential
    • Hospital oncology wards
      • Management’s perception
        • Relies on oncologists
        • Few opportunities
        • ICT skills should be part of continuing education
      • Staff’s perception
        • Relies on oncologists
        • Relies on hospital ward management
        • Relies 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.)
  • Findings: perceived value of information (cont.) i Patient well-being
    • Mostly adequate information from:
    • Oncologists
    • Sister-in-charge
    • Hospital management
    • Colleagues
    • Reference works
    • 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
  • International trends & scientific research Other institutions Management Staff Patients Head oncologist & oncologists Good awareness Limited awareness Unit manager
  • Recommendations: we need to …
    • Acknowledge that most of their daily tasks are not information intensive
      • Patient education, counselling & emotional support are important tasks not necessarily monitored by the oncologists (should explore potential of WWW CAS)
      • Need to consider affective dimensions of information
    • Find ways to face the realities of professional life
    • (i.e. physical and emotionally demanding nature of work), for example:
      • Promoting a culture of using CAS that links to everyday life information needs
      • Offering easier, tailor-made access to WWW CAS (e.g. portals)
      • Training in ICT and information literacy skills
      • (tailor-made)
      • Stress time-saving impact of CAS
  • Conclusion
    • Need to learn from the exploratory study
      • Wider sample: South Africa as well as comparative studies with other countries
    • Need to adapt research methods
      • E.g. linking data collection to a free workshop on computer skills and using the WWW, or to the use of a CAS website for oncology nurses
    • Adapt focus of research questions
    • (e.g. collaboration, communities of practice)
    • Need to learn from studies on the information seeking behaviour of other healthcare professionals as well as cancer patients
  • Contact details
    • Prof Ina Fourie
    • Department of Information Science,
    • Lynnwood Road, University of Pretoria
    • Pretoria, 0002
    • South Africa
    • email: [email_address]
    • Mrs. Retha Claasen-Veldsman
    • Department of Information Science,
    • Lynnwood Road, University of Pretoria
    • Pretoria, 0002
    • South Africa
    • email: [email_address]