Nursing ETDs

Publication Date

Fall 12-1-2020


Due to the nursing shortage in Sri Lanka, patients need informal caregivers, known as bystanders, to help provide patient care. This study described bystanders’ perspectives on informal, hospital-based care to bedridden patients with cancer in Sri Lanka. In this qualitative descriptive study, 17 bystanders at Apeksa/Cancer Hospital, Sri Lanka, were recruited using snowballing sampling. Data were collected through telephone interviews and analyzed using content and thematic analyses. Findings showed that paid and unpaid bystanders cover all caregiving tasks with minimum interaction with nurses. Unpaid bystanders described the need for same-sex bystanders and additional help with patients’ mobilization and specialized care. Paid bystanders discussed sleepless nights’ effects, bullying, and monopoly. Recommendations include the provision of a bystander for every bedridden patient, basic facilities (adequate sleeping and sanitary facilities), quality foods, and caregiver training. Government-level policies are needed to accept the bystander service to improve quality patients care in Sri Lanka.

Degree Name


Level of Degree


Department Name

College of Nursing

First Committee Member (Chair)

Barbara I Damron, PhD, RN, FAAN

Second Committee Member

Beth Tigges PhD, RN, PNP, BC

Third Committee Member

Nancy Ridenour, PhD, APRN, BC, FAAN

Fourth Committee Member

Charlotte Nirmalani Gunawardena, Ph.D.


Bystander, informal care, informal hospital-based care, bedridden patients, cancer, Sri Lanka



Document Type