The International Home Care Nurses Organization (IHCNO) is happy to present its 2023 Research Award to Drs. Joshua Muliira and Debra Siela to support their study, Perspectives of Nurses About Essential Competencies Needed to Transition into Hospice Home Care Nursing. Drs. Muliira and Siela are Associate Professors at Ball State University School of Nursing in Muncie, Indiana. Below they describe their research proposal.
About 65% of Americans with terminal conditions receive hospice care at the end of life (Kirk & Mahon, 2010). However, the number of nurses in hospice home care is not increasing at the pace of the demand for hospice care. Nurses who work in hospice home care encounter a range of complex, unpredictable, and ethically challenging situations (Jameson, 2021), but published studies about nurses' competencies, transitioning, and experiences in hospice home care are scarce.
Research questions are: 1) What challenges are experienced by nurses working in hospice home care? 2) What are nurses' perspectives on the essential competencies needed to provide effective hospice home care? The study will be guided by Afaf Ibrahim Meleis' Transition Theory (Im, 2021) that explains the nature of human transitions using domains such as the transition experience, facilitators and inhibitors of transition, patterns of response, outcome indicators, and the interventions needed to facilitate the transition. Transition Theory provides a comprehensive view of the critical elements that contribute to a smooth transition process.
The study will be grounded in hermeneutic phenomenology. This paradigm enables the investigation of nonconceptualized experiences of individuals as well as the significance of these experiences. It tries to grasp the meanings people give to their experiences by describing, comprehending, and interpreting the occurrences experienced, and examining aspects of human care (Kirby et al., 2018).
After ethics approval, we will recruit registered nurses with at least 6 months of hospice home care experience in rural settings. Four of the nurses will participate in a pilot study to test the interview guide. The guide may be revised based on early findings. Interviews are expected to last 1 to 2 hours and will be audio recorded and transcribed. Using the ATLAS 6.0 program, data analysis will be conducted concurrently with data gathering to assist in organizing and coding categories. Rigor will be promoted using strategies such as ensuring data saturation and using two investigators to independently assess the data and compare their results (investigator triangulation). Member checks of face-to-face conversations with at least four participants will validate findings are precise and consistent with participant experiences. At the end of the study, the investigators hope to make recommendations that assist nurses' transition to home-based hospice care.
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