Continuous video recording: a new clinical research tool for studying the nursing care of cancer patients

Aim. The aim of this study was to clarify issues around the patient-nurse i nteraction during pulsed dose rate (PDR) brachytherapy. Background. Cancer diagnosis, response and survival rates as well as the si de-effects of radiation therapy are well described in international literat ure. However, no scientific data apparently exist on the reactions and beha viour of cancer patients during stressful irradiation treatments nor on nur sing performance in these situations. The study involved gynaecological and anal cancer patients. Treatment needles (10-20 cm) were implanted in the t umours of these patients during the PDR brachytherapy. This treatment was a dministered during a 15-30-minute period each hour, for a duration of 30-60 hours. Patients were partially isolated and immobilized, and typically pos itioned on the back or side. In preparation for the therapy, patients had t o fast and drink sparingly. Observation and nursing care could only be perf ormed during pauses in the treatment. Method. This paper is based on 142 hours of continuous video recording of p atients undergoing PDR brachytherapy. Data were collected on five patients and 17 nurses. Findings. The study shows that nurses were with patients for approximately 1/4 of the available time. The majority (75%) of any communication with pat ients centred around physical care. Although patients were in a stressful s ituation, they did not anticipate receiving any psychological support from nursing staff. Patients showed individual patterns of behaviour and coping. Conclusions. Continuous video recording, as a research tool can document ac curately interaction and behaviour between cancer patients and nursing staf f. Video recording discloses examples of both eminent and negligent nursing care and as such can be a useful tool for instruction and for future resea rch. The credibility, validity and limitations of using video recording are discussed.