br A high score was also observed in
A high score was also observed in both this study and Charalambous et al. (2017) study regarding “being respected” and “having a sense of belonging” dimensions. These findings mean that oncology nurses in Cyprus care with respect and give patients the option and adequate information in order to enable them to participate in decision-making. In addition, oncology nurses not only clarify the family's desire to be present, but also acknowledge and encourage their presence and par-ticipation in decision-making and delivery of care. Since the above characteristics are important for the eﬀective management of the symptoms and the side-eﬀects of treatment on behalf of patients diag-nosed with cancer (Charalambous et al., 2009; Peppercorn et al., 2011), it Taxol is essential to include them in oncology nursing care. As researchers explain, the cancer experience is usually accompanied by more queries than other diseases and diﬃculties to accept the situation that render treatment with respect and belonging imperative (Fredericks et al., 2012; Gachoud et al., 2012). Moreover, because of the diﬃcult nature of the disease, research findings demonstrate that most patients with cancer prefer either shared treatment decision responsibility or be in control of their treatment decision, even though older and distressed patients showed increased willingness to leave control to their physi-cians (Albrecht et al., 2014; Schuler et al., 2017).
For the other two dimensions though of quality of oncology nursing care, i.e. “being valued” and “being cared for religiously and spiri-tually”, quality of oncology nursing care was found medium to low. Previous findings (e.g. Charalambous et al., 2009; Groot et al., 2017) though stressed the importance of religious beliefs, spirituality and being valued; in fact religion and spirituality have a primary role for Cypriots and, particularly, people with a serious disease. Despite then the central role of the above in health and social life in Cyprus and the strong religious beliefs that are prevalent among Cypriots (Papazisis et al., 2014), the participants in this study felt that these needs were not adequately met as part of the provided oncology nursing care.
In particular, patients diagnosed with cancer in this study believed that nurses were not that interested to know their views on life and death or clarify and respect their religious preferences, did not initiate discussions around spiritual issues and did not facilitate the religious rituals while receiving care. The findings of this study also showed that participants thought that nurses were neither available to discuss or encourage spiritual issues nor sensitive regarding religious issues. Yet, according to Groot et al. (2017) spirituality is an inherent and im-portant part of holistic care of patients with cancer. Moreover, ac-cording to Ellington et al. (2017) emotional and spiritual needs are inextricable from physical and psychological needs, while spiritual conversations can increase patients’ satisfaction with care and improve their overall well-being.
The above perceptions regarding the limited availability of nurses may be explained by a likely deficient patient-nurse interaction because of the nurse shortage. Thus, when the nurse staﬃng ratio results to more patients per nurse, then time for closer relationships is also less, leading to negative patients perceptions about the care they receive (Suhonen et al., 2018). Hence, budget cuts and staﬀ reduction may have negative impact on patient-nurse relationships, not only because the patients feel that nurses are not available, but also because the nurses are actually pre-occupied only with what is considered essential due to time pressure (Alameddine et al., 2012; Charalambous et al., 2017; Blackman and Willis, 2014). On the other hand, limited discussions about spiritual and religious issues between nurses and patients may be related to a general reluctance of some nurses to discuss such issues or encourage people to behave spiritually and religiously because of European Journal of Oncology Nursing 41 (2019) 33–40
In addition, the above findings may be explained by a deliberate omission because of fear or inadequate training and preparation of nurses that might feel not competent enough or uncomfortable to treat patients with cancer (Astrow et al., 2018). Moreover, nurses may feel too much pressure to respond to overloaded tasks that limit their time with patients (Blackman and Willis, 2014). However, since, as Hubbard et al. (2006) found in a previous study, the inequalities observed in the provision of and access to oncology care result to family problems, it seems that shortcomings in oncology care have negative eﬀects not only to the patients but also their families. Hence it is important to find ways to provide the care that patients diagnosed with cancer need (Hendrix et al., 2013). To this end, national and international organizations, such as the European Oncology Nursing Society (2014) stress the importance of providing patient-tailored care to the patient diagnosed with cancer across the cancer continuum.