Processus de facilitation d'une pratique réflexive, de type codéveloppement, auprès d'infirmières pivots en oncologie et son influence sur leur pratique professionnelle

Two categories of competencies influence all professional practice: disciplinary skills and relational skills. According to the conceptual model of this study, reflective practice (RP) helps the professional develop the latter, by way of a deepening of consciousness and a self-critique of the tacit components of one’s practice, such as one’s values and beliefs, perceptions and action strategies, in order to render them more effective and satisfying when problem solving. In this study, RP sought to  help a group of oncology pivot nurses (OPNs) reflect and act on the components of their practice that contributed to certain persistent relational difficulties experienced with nursing leaders, colleagues and families, which in turn, they felt had an impact on the health experience of families affected by cancer.             The literature review conducted in this study however, supports that there are an insufficient number of studies regarding the influence of RP on nursing practice and on the development of relational competencies by nurses.  The following theoretical and methodological gaps have, amongst others, been reported: the RP studied was not always based on a clear  conceptual model and the aim sought by RP wasn`t always stated; no study has documented in what way RP had been developed and, once acquired, in what manner it had contributed to the results; and finally, none of the identified studies  explored the influence of the integration of RP by the nurse, and took into account the perspectives of the families that benefited from their care. Taking these gaps into consideration, this study used a participatory action research approach in order to document the facilitation of RP and its influence on the relational competencies of OPNs’ as well as on other areas like personal, organizational and clinical ones.  Six OPNs took part in the intervention of the study for a one year period. Five colleagues from care teams and a dozen family members affected by cancer participated in the evaluation of its influence.  The study results suggest that the OPNs who develop a deeper RP, that is one that involves their feelings and internal needs, are able to establish more mutual relationships with colleagues and families because of important changes made with regards to their values and principles, perceptions and action strategies.  The results of the study also support that these changes in nursing practice yielded positive effects. The OPNs spoke about improved work related satisfaction and of benefits on their health.  The majority of OPNs and participant colleagues in the study reported a calmer work climate and more satisfactory team processes, for example, when problem-solving. Finally, when OPNs integrate a more mutual approach, families reported  a reduction of their  concerns and of their psychological distress, a greater capacity to make sense of their cancer experience, a higher quality of communication within their family or with the health care team.

Keyphrases: Oncology pivot nurse, Reflective practice, Participatory action research, Family approach, Family cancer experience