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Stokar YN. Sense of failure in end of life care: Perspectives from physicians and nurses. Soc Sci Med 2024; 348:116805. [PMID: 38569282 DOI: 10.1016/j.socscimed.2024.116805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
Limited knowledge exists regarding sensed failure resulting provision of end-of-life (EOL) care. Among medical health professionals (MHP), a sense of failure is associated with impaired patientcare and reduced worker wellbeing, including higher rates of burnout and secondary traumatic stress. As part of a larger mixed-methods study on the effects of EOL-care provision on MHP in general hospitals, semi-structured in-depth interviews were conducted with 22 physicians and nurses at three tertiary Israeli hospitals, representing a wide range of medical specialties, training, experience, and cultural backgrounds. Qualitative thematic analysis of the interviews led to the identification of the theme 'sense of failure' with the sub-themes 'sources' and 'lived meanings' of the sensed failure. Apart from the source 'losing a patient' all other identified sources were recognized as work-related risk factors, including 'unsupportive environments' and 'shortcomings of the medical practice.' Two of the lived meaning 'sense of personal responsibility' and 'moral injury' were also recognized as work-related risk factors. Surprisingly, albeit the adverse context of EOL-care, the two remaining lived meanings 'learning from failure' and 'sense of purpose' were recognized as protective resilience factors. Changes in workplace norms by focusing on leadership and mentoring programs and implementation of evidence based interventions aimed at reducing the sense of failure and enhancing feelings of purpose are recommended. Finally, the findings described in the study would benefit from continued studies on larger scales.
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Affiliation(s)
- Yaffa Naomi Stokar
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel; Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
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Holdsworth LM, Siden R, Wong BO, Verano M, Lessios AS, Tabor HK, Schapira L, Aslakson R. "Like not having an arm": a qualitative study of the impact of visitor restrictions on cancer care during the COVID-19 pandemic. Support Care Cancer 2024; 32:288. [PMID: 38622350 PMCID: PMC11018646 DOI: 10.1007/s00520-024-08473-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Visitor restriction policies to prevent the spread of COVID-19 among patients and clinicians were widespread during the pandemic, resulting in the exclusion of caregivers at key points of cancer care and treatment decision-making. The aim of this study was to explore how visitor restrictions impacted cancer treatment decision-making and care from patient and physician perspectives. METHODS Sixty-seven interviews, including 48 cancer patients and 19 cancer and palliative care physicians from four academic cancer centers in the USA between August 2020 and July 2021. RESULTS Visitor restrictions that prevented caregivers from participating in clinic appointments and perioperative hospital care created challenges in cancer care that spanned three domains: practical, social, and informational. We identified eight themes that characterized challenges within the three domains across all three groups, and that these challenges had negative emotional and psychological consequences for both groups. Physicians perceived that patients' negative experiences due to lack of support through the physical presence of caregivers may have worsened patient outcomes. CONCLUSIONS Our data demonstrate the tripartite structure of the therapeutic relationship in cancer care with caregivers providing critical support in the decision-making and care process to both patients and physicians. Caregiver absences led to practical, psychosocial, and informational burdens on both groups, and likely increased the risk of burnout among physicians. Our findings suggest that the quality of cancer care can be enhanced by engaging caregivers and promoting their physical presence during clinical encounters.
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Affiliation(s)
- Laura M Holdsworth
- Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Rachel Siden
- Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Bonnie O Wong
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Mae Verano
- Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Anna Sophia Lessios
- Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Holly K Tabor
- Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Rebecca Aslakson
- Department of Anesthesiology, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
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Mitra LG, Sharma J, Walia HS. Improving Work-life Balance and Satisfaction to Improve Patient Care. Indian J Crit Care Med 2024; 28:326-328. [PMID: 38585310 PMCID: PMC10998519 DOI: 10.5005/jp-journals-10071-24689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
How to cite this article: Mitra LG, Sharma J, Walia HS. Improving Work-life Balance and Satisfaction to Improve Patient Care. Indian J Crit Care Med 2024;28(4):326-328.
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Affiliation(s)
- Lalita G Mitra
- Department of Anaesthesia, Critical Care and Pain, Homi Bhabha Cancer Hospital and Research Centre, New Chandigarh, Punjab, India
| | - Jagdeep Sharma
- Department of Anaesthesia, Critical Care and Pain, Homi Bhabha Cancer Hospital and Research Centre, New Chandigarh, Punjab, India
| | - Harsimran S Walia
- Department of Anaesthesia, Critical Care and Pain, Homi Bhabha Cancer Hospital and Research Centre, New Chandigarh, Punjab, India
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Wan DWJ, Goh LSH, Teo MYK, Loh CJL, Yak GHK, Lee JJH, Ravindran N, Abdul Rahman ND, Chiam M, Ong EK, Somasundaram N, Lim YY, Phua GLG, Krishna LKR. Enhancing self-care education amongst medical students: a systematic scoping review. BMC MEDICAL EDUCATION 2024; 24:37. [PMID: 38191374 PMCID: PMC10773141 DOI: 10.1186/s12909-023-04965-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/11/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Reports of emotional, existential and moral distress amongst medical students witnessing death and suffering of patients during their clinical postings have raised awareness on the need for better psycho-emotional support during medical school. Furthermore, the stress experienced by medical students stemming from the rigours of their academic curriculum underlines the need for greater awareness on mental health issues and better self-care practices across medical training. With such programmes lacking in most medical schools, we propose a systematic scoping review (SSR) to map and address our research question, "what is known about self-care education interventions amongst medical students?". METHODS We adopted the Systematic Evidence-Based Approach to guide a systematic scoping review (SSR in SEBA) of relevant articles published between 1st January 2000 and 30th June 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles were independently and concurrently thematically and content analysed, with complementary categories and themes combined using the Jigsaw Approach. The domains created from the Funnelling Process framed the discussion. RESULTS A total of 6128 abstracts were identified, 429 full-text articles evaluated, and 147 articles included. The 6 domains identified were definition, topics, pedagogy, influences, outcomes and assessment. Most interventions were promising, though peer-led mindfulness-based interventions showed most promise in enhancing engagement, positively impacting personal wellbeing, and improving patient care. Overall, however, self-care education was poorly recognized, adopted and integrated into curricula. CONCLUSION Greater dedicated time and conducive practice environments within medical school curricula is required to enhance medical student wellbeing. Host organizations must ensure faculty are appropriately selected to instil the importance of self-care, be trained to assess and personalize self-care interventions and provide longitudinal assessment and support. Further study into assessing self-care capabilities is required.
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Affiliation(s)
- Darius Wei Jun Wan
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Laura Shih Hui Goh
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Mac Yu Kai Teo
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Celestine Jia Ling Loh
- Obstetrics and Gynaecology, KK Women's and Children's Hospital (KKH), 100 Bukit Timah Road, Singapore, 229899, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Gerald Hng Kai Yak
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Joanna Jing Hui Lee
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Nila Ravindran
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Nur Diana Abdul Rahman
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eng Koon Ong
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Assisi Hospice, 823 Thomson Road, Singapore, 574627, Singapore
| | - Nagavalli Somasundaram
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ying Yin Lim
- Division of Palliative Care, Alexandra Hospital, 378 Alexandra Rd, Singapore, 159964, Singapore
| | - Gillian Li Gek Phua
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
| | - Lalit Kumar Radha Krishna
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road L3 9TA, Liverpool, UK.
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore.
- PalC, The Palliative Care Centre for Excellence in Research and Education, Singapore, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Yazdan R, Corey K, Messer SJ, Kim EH, Roberts KE, Selwyn PA, Weinberger AH. Hospital-Based Interventions to Address Provider Grief: A Narrative Review. J Pain Symptom Manage 2023; 66:e85-e107. [PMID: 36898638 DOI: 10.1016/j.jpainsymman.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023]
Abstract
CONTEXT Provider grief, i.e., grief related to the death of patients, often forms an ongoing and profound stressor impacting healthcare providers' ability to maintain their sense of well-being, avoid feeling overwhelmed, and sustain quality and compassionate patient care over time. OBJECTIVES This narrative review presents findings on the types of interventions hospitals have offered to physicians and nurses to address provider grief. METHODS Searches of PubMed and PsycINFO were conducted for articles (e.g., research studies, program descriptions and evaluations) focused on hospital-based interventions to help physicians and nurses cope with their own grief. RESULTS Twenty-nine articles met inclusion criteria. The most common adult clinical areas were oncology (n = 6), intensive care (n = 6), and internal medicine (n = 3), while eight articles focused on pediatric settings. Nine articles featured education interventions, including instructional education programs and critical incident debriefing sessions. Twenty articles discussed psychosocial support interventions, including emotional processing debriefing sessions, creative arts interventions, support groups, and retreats. A majority of participants reported that interventions were helpful in facilitating reflection, grieving, closure, stress relief, team cohesion, and improved end-of-life care, yet mixed results were found related to interventions' effects on reducing provider grief to a statistically significant degree. CONCLUSION Providers largely reported benefits from grief-focused interventions, yet research was sparse and evaluation methodologies were heterogenous, making it difficult to generalize findings. Given the known impact provider grief can have on the individual and organizational levels, it is important to expand providers' access to grief-focused services and to increase evidence-based research in this field.
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Affiliation(s)
- Ronit Yazdan
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA; Department of Family & Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine (R.Y., K.C., P.A.S), Bronx, New York, USA.
| | - Kristen Corey
- Department of Family & Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine (R.Y., K.C., P.A.S), Bronx, New York, USA
| | - Sylvie J Messer
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA
| | - Emily H Kim
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA
| | - Kailey E Roberts
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA
| | - Peter A Selwyn
- Department of Family & Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine (R.Y., K.C., P.A.S), Bronx, New York, USA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA; Department of Psychiatry & Behavioral Sciences, Albert Einstein College of Medicine (A.H.W.), Bronx, New York, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine (A.H.W.), Bronx, New York, USA
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Naert MN, Pruitt C, Sarosi A, Berkin J, Stone J, Weintraub AS. A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in maternal-fetal medicine physicians in the United States. Am J Obstet Gynecol MFM 2023; 5:100989. [PMID: 37127208 DOI: 10.1016/j.ajogmf.2023.100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Compassion fatigue is secondary traumatic distress experienced by providers from ongoing contact with patients who are suffering. Compassion satisfaction is emotional fulfillment from caring for others. Burnout is distress related to dissonance between job demands and available resources. Although burnout is well-studied, compassion satisfaction and compassion fatigue are neglected components of physician well-being. Because of recurrent exposure to adverse outcomes, maternal-fetal medicine providers may be at particular risk for compassion fatigue. OBJECTIVE This study aimed to better characterize both clinical and nonclinical drivers of work-related distress vs satisfaction. STUDY DESIGN The modified Compassion Fatigue and Satisfaction Self-Test and a questionnaire of professional and personal characteristics were distributed electronically to maternal-fetal medicine providers nationally. Multivariable regression models were constructed for compassion fatigue, burnout, and compassion satisfaction as a function of potential predictors. RESULTS The survey response rate was 24% (n=366), primarily consisting of White physicians working in academic medical centers. Significant predictors of lower burnout scores included employment at 1 institution for >20 years, discussing work-related distress with friends, and having one's most recent involvement in decision-making for a periviable fetus >6 months ago; distress because of coworkers and personal factors predicted higher scores. Female sex, self-report of significant emotional depletion, use of mental health services, and having other maternal-fetal medicine physicians as part of the care team for a fetus with severe anomalies were significant predictors of higher compassion fatigue scores, whereas White race and having social work as part of the care team for a maternal mortality predicted lower scores. Personal spiritual practice was a significant predictor of higher compassion satisfaction score, whereas employment at current institution for <5 years predicted lower scores. CONCLUSION Compassion fatigue, compassion satisfaction, and burnout are associated with several modifiable risk factors, such as practice type, having a multidisciplinary team, and emotional support outside of the workplace; these are potential targets for intervention.
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Affiliation(s)
- Mackenzie N Naert
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Naert, Berkin, and Stone); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Dr Naert).
| | - Cassandra Pruitt
- Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Pruitt, Sarosi, and Weintraub); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr Pruitt)
| | - Alex Sarosi
- Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Pruitt, Sarosi, and Weintraub); Division of Plastic Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY (Dr Sarosi)
| | - Jill Berkin
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Naert, Berkin, and Stone)
| | - Joanne Stone
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Naert, Berkin, and Stone)
| | - Andrea S Weintraub
- Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY (Drs Pruitt, Sarosi, and Weintraub)
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Anestis E, Eccles FJR, Fletcher I, Simpson J. Neurologists' lived experiences of communicating the diagnosis of a motor neurodegenerative condition: an interpretative phenomenological analysis. BMC Neurol 2023; 23:178. [PMID: 37138217 PMCID: PMC10155430 DOI: 10.1186/s12883-023-03233-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/29/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Receiving the diagnosis of a motor neurodegenerative condition (MNDC) can be a life-changing experience. Although several studies of individuals' experiences have indicated dissatisfaction with aspects of how an MNDC diagnosis was communicated, few studies have addressed doctors' experiences of breaking bad news for these conditions, especially from a qualitative perspective. This study explored UK neurologists' lived experience of delivering an MNDC diagnosis. METHODS Interpretative phenomenological analysis was used as the overarching method. Eight consultant neurologists working with patients with MNDCs took part in individual, semi-structured interviews. RESULTS Two themes were constructed from the data: 'Meeting patients' emotional and information needs at diagnosis: a balancing act between disease, patient and organization-related factors', and 'Empathy makes the job harder: the emotional impact and uncovered vulnerabilities associated with breaking bad news'. Breaking the news of an MNDC diagnosis was challenging for participants, both in terms of achieving a patient-centred approach and in terms of dealing with their own emotions during the process. CONCLUSIONS Based on the study's findings an attempt to explain sub-optimal diagnostic experiences documented in patient studies was made and how organizational changes can support neurologists with this demanding clinical task was discussed.
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Affiliation(s)
- Eleftherios Anestis
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
| | - Fiona J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Ian Fletcher
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Rico-Mena P, Güeita-Rodríguez J, Martino-Alba R, Castel-Sánchez M, Palacios-Ceña D. The Emotional Experience of Caring for Children in Pediatric Palliative Care: A Qualitative Study among a Home-Based Interdisciplinary Care Team. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040700. [PMID: 37189949 DOI: 10.3390/children10040700] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023]
Abstract
The healthcare providers caring for children with life-threatening illnesses experience considerable compassion fatigue. The purpose of this study was to describe the feelings and emotions of professionals working in an interdisciplinary pediatric palliative home care team. A qualitative case study was conducted, comprising 18 participants. A purposeful sampling technique approach was used including the home-based interdisciplinary pediatric palliative team. Data were collected via semi-structured interviews and researchers' field notes. A thematic analysis was performed. Two themes emerged: (a) changing life for the better, which described how professionals value life more and helping children and families provides compassion satisfaction, which is comforting and explains their dedication to care; (b) adverse effects of work highlighted the emotional burden of caring for children with life-limiting or life-threatening illnesses, which can affect their job satisfaction and may lead to burnout, showing how experiencing in-hospital child deaths with suffering leads professionals to develop an interest in specializing in pediatric palliative care. Our study provides information on possible causes of emotional distress in professionals caring for children with life-threatening illnesses and highlights strategies that can help them to reduce their distress.
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Affiliation(s)
- Patricia Rico-Mena
- Physical Therapy and Health Sciences Research Group, Faculty of Sport Sciences, Department of Physiotherapy, Chiropody and Dance, Universidad Europea de Madrid, 28670 Madrid, Spain
- International Doctorate School, Rey Juan Carlos University, 28008 Madrid, Spain
| | - Javier Güeita-Rodríguez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science, Rey Juan Carlos University, 28922 Alcorcón, Spain
| | - Ricardo Martino-Alba
- Pediatric Palliative Care Unit, Hospital Universitario Infantil Niño Jesús, 28009 Madrid, Spain
| | - Marina Castel-Sánchez
- Physical Therapy and Health Sciences Research Group, Faculty of Sport Sciences, Department of Physiotherapy, Chiropody and Dance, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science, Rey Juan Carlos University, 28922 Alcorcón, Spain
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Francis L, Robertson N. Healthcare practitioners' experiences of breaking bad news: A critical interpretative meta synthesis. PATIENT EDUCATION AND COUNSELING 2023; 107:107574. [PMID: 36459829 DOI: 10.1016/j.pec.2022.107574] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To provide an overview of healthcare practitioners' experiences of breaking bad news. METHOD Interpretative meta synthesis of 14 qualitative papers identified through a systematic search. Data were extracted and constructs elicited via reciprocal translational analysis. RESULTS Findings comprised four inter-connected themes: (1) Discomfort, particularly difficult emotional and physical responses to breaking bad news; (2) Relational distress, connected to attachment and identification with patients; (3) Inadequate clinician, indicating the fear and rumination about the possibility of getting it wrong and the subsequent self-blame; and (4) Only human, highlighting a culture of invulnerability where practitioner self-care is deprioritised. CONCLUSIONS Breaking bad news provokes significant distress for practitioners, particularly where they experience strong attachment to or identification with a patient. Breaking bad news was understood as an isolating experience and staff's non-disclosure of difficulties appeared to sustain a culture of invulnerability in which admission of distress was not encouraged. PRACTICE IMPLICATIONS Given the adverse impacts and potential for practitioner burnout, organisations should acknowledge ramifications and offer time for staff to process the delivery of bad news, promote a culture of collective care and provide space for reflective practice.
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Affiliation(s)
- Laura Francis
- School of Psychology and Vision Sciences, University of Leicester, George Davies Centre, Lancaster Road, Leicester LE1 7HA, UK.
| | - Noelle Robertson
- School of Psychology and Vision Sciences, University of Leicester, George Davies Centre, Lancaster Road, Leicester LE1 7HA, UK.
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Powers CR, Snipes GE, Harbin KB, Fischer A, Anderson N, Cheng K, Ford-Scales K, Siefert BC. Integration of the Verbatim Exercise into a Hospice and Palliative Medicine Fellowship. Palliat Med Rep 2023; 4:133-138. [PMID: 37180053 PMCID: PMC10171960 DOI: 10.1089/pmr.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 05/15/2023] Open
Abstract
One of the more challenging aspects of specialty level training in any medical fellowship is learning to communicate mindfully and effectively with patients and families in the face of serious illness. For the past five years, our accredited Hospice and Palliative Medicine (HPM) fellowship program has been integrating the "verbatim"-an exercise with a long and integral history in the training of health care chaplains. Verbatims are word-for-word accounts of a clinician's encounter with a patient and/or the patient's family. The verbatim serves as a formative educational exercise offering a method to hone one's clinical skills and competencies, while providing a unique space to practice self-awareness and self-reflection. Although sometimes difficult and intense for the fellow, we have found this to be a helpful exercise in improving the fellow's ability to make meaningful connections with patients and leading to improved outcomes of communication episodes. This potential growth in self-awareness supports both resiliency and mindfulness, which are essential skills for longevity and reduction of burnout risk in the field of HPM. The verbatim invites all participants to reflect on their own participation in facilitating whole person care to patients and families. Out of the six HPM milestone metrics for fellowship training, the verbatim exercise supports achievement in at least three of the milestones. We present survey data over the past five years of our fellowship in support of the utility of this exercise and for consideration to include this exercise in a palliative medicine fellowship. We offer additional suggestions for further study of this formative tool. This article delineates the verbatim technique and its specific integration into our accredited ACGME Hospice and Palliative Medicine fellowship training program.
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Affiliation(s)
- Christopher R. Powers
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
- Address correspondence to: Christopher R. Powers, MD, MS, FAAHPM, Spartanburg Regional Medical Center, Spartanburg, SC 29303, USA.
| | - Garrett E. Snipes
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
| | | | - Andrew Fischer
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
| | - Nancy Anderson
- Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA
| | - Kevin Cheng
- Novant Health Presbyterian Medical Center, Charlotte, North Carolina, USA
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Self-Care for Nurses and Midwives: Findings from a Scoping Review. Healthcare (Basel) 2022; 10:healthcare10122473. [PMID: 36553999 PMCID: PMC9778446 DOI: 10.3390/healthcare10122473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022] Open
Abstract
Self-care for health care professionals is essential in order to optimize the care they provide and to prevent serious consequences for their health. This scoping review aimed to identify (a) the concepts used in the literature to describe self-care; (b) interventions that influence self-care. The scoping review was conducted according to the criteria and methodology by Arksey and O'Malley, from November 2020 to January 2021, by consulting the following databases: Pubmed, CINAHL, Scopus, PsycInfo, Cochrane Library, Joanna Briggs Library. Various keywords and MesH terms were used for the search, including self-care, nurses, midwives, nursing, midwifery, self-compassion, and self-awareness. Eighteen studies were included. The concept of self-care is related to three constructs: (a) Mindfulness; (b) Compassion; and (c) Resilience. In the literature, self-care interventions can be distinguished as (a) mindfulness-based; (b) educational; (c) multimodal approach; and (d) mind-body interventions. In recent years, the concept of self-care is a topic of great interest in the literature; dealing with self-care from both a theoretical and a practical-personal and professional-perspective has become more important in order to promote practitioners' well-being. This scoping review helps to clarify the terms related to self-care and looks at tested interventions to improve the well-being of caregivers.
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12
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Sansó N, Leiva JP, Vidal‐Blanco G, Galiana L, West M. The measurement of compassionate leadership: Adaptation and Spanish validation of the compassionate leadership self-reported scale. Scand J Caring Sci 2022; 36:1165-1179. [PMID: 35355300 PMCID: PMC9790542 DOI: 10.1111/scs.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/12/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND A culture of shared leadership is widespread among palliative care teams based on a commitment to valuing and including all people equally. As compassion is a core value for end-of-life care work, compassionate leadership may be the best way to lead in palliative care. AIMS The aims of this study were twofold: (1) to adapt and validate the Compassionate Leadership Self-reported Scale in a sample of palliative care professionals; and (2) to study the relation between compassionate leadership and associated concepts of self-compassion, awareness and self-care. METHODS A cross-sectional survey of 296 Spanish end-of-life care professionals was conducted. Analyses included descriptive statistics, a confirmatory factor analysis (CFA) with four-correlated factors, reliability estimates and a structural model. RESULTS Results suggested there were medium to high levels of compassionate leadership in the sample. The CFA showed an adequate overall fit: χ2 (98) = 277.595 (p < 0.001); CFI = 0.986; SRMR = 0.047; RMSEA = 0.088 [0.076, 0.100]. Reliability estimates for four subscales of compassionate leadership (attending, understanding, empathising and helping) were also adequate, ranging from 0.72 to 0.96. Finally, the structural model predicting compassionate leadership suggested that the dimensions of attending and understanding were most highly related to positive self-compassion and awareness; empathising, to self-care and awareness; and helping, to positive self-compassion and self-care. CONCLUSION The Compassionate Leadership Scale has adequate psychometric properties when used to assess compassionate leadership in the context of end-of-life care. Our results indicate that self-compassion, awareness and self-care are important correlates of such compassionate leadership.
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Affiliation(s)
- Noemí Sansó
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsMallorcaSpain,Balearic Islands Health Research Institute (IDISBA)MallorcaSpain
| | - Juan P. Leiva
- Support and Palliative Care TeamHospital ManacorMallorcaSpain
| | | | - Laura Galiana
- Department of Methodology for the Behavioral SciencesUniversity of ValenciaValenciaSpain
| | - Michael West
- The King’s FundLondonUK,Department of Organizational PsychologyLancaster UniversityLancasterUK,Aston UniversityBirminghamUK
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Zaman N, Mujahid K, Ahmed F, Mahmud S, Naeem H, Riaz U, Ullah U, Cox B. What are the barriers and facilitators to seeking help for mental health in NHS doctors: a systematic review and qualitative study. BMC Psychiatry 2022; 22:595. [PMID: 36071392 PMCID: PMC9450826 DOI: 10.1186/s12888-022-04202-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The mental health of healthcare professionals is reaching a breaking point, and the COVID-19 pandemic has exacerbated current mental health issues to unprecedented levels. Whilst some research has been carried out on the barriers that doctors face when seeking mental health help, there is little research into factors which may facilitate seeking help. We aimed to expand the research base on factors which act as barriers to seeking help, as well as gain insight into facilitators of help-seeking behaviour for mental health in NHS doctors. METHODS We conducted a systematic literature review which identified the barriers and facilitators to seeking help for mental health in healthcare professionals. Following this, we conducted semi-structured interviews with 31 NHS doctors about their experiences with mental health services. Finally, through thematic analysis, key themes were synthesised from the data. RESULTS Our systematic literature review uncovered barriers and facilitators from pre-existing literature, of which the barriers were: preventing actions, self-stigma, perceived stigma, costs of seeking treatment, lack of awareness and availability of support, negative career implications, confidentiality concerns and a lack of time to seek help. Only two facilitators were found in the pre-existing literature, a positive work environment and availability of support services. Our qualitative study uncovered additional barriers and facilitators, of which the identified barriers include: a negative workplace culture, lack of openness, expectations of doctors and generational differences. The facilitators include positive views about mental health, external confidential service, better patient outcomes, protected time, greater awareness and accessibility, open culture and supportive supervisors. CONCLUSION Our study began by identifying barriers and facilitators to seeking mental health help in healthcare workers, through our systematic literature review. We contributed to these findings by identifying themes in qualitative data.. Our findings are crucial to identify factors preventing NHS doctors from seeking help for their mental health so that more can be done on a national, trust-wide and personal level to overcome these barriers. Likewise, further research into facilitators is key to encourage doctors to reach out and seek help for their mental health.
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Affiliation(s)
- Nadia Zaman
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK.
| | - Khadeejah Mujahid
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK
| | - Fahmid Ahmed
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK
| | - Simran Mahmud
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK
| | - Hamza Naeem
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK
| | - Umar Riaz
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK
| | - Umayair Ullah
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK
| | - Benita Cox
- Imperial College Business School, Exhibition Road, London, SW7 2AZ, UK
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14
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Reddy SK, Yennurajalingam S, Tanco K, Anderson AE, Guzman D, Williams J, Liu D, Bruera E. Frequency and Prediction of Burnout Among Physicians Who Completed Palliative Care Fellowship Training - A 10 Year Survey. J Pain Symptom Manage 2022; 64:e15-e21. [PMID: 35183705 DOI: 10.1016/j.jpainsymman.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 10/19/2022]
Abstract
CONTEXT Palliative Care (PC) physicians are vulnerable to burnout given the nature of practice. Reports suggest that burnout frequency is variable across different countries. OBJECTIVE The main objective of our study was to determine knowledge, attitudes and frequency of burnout among Hospice and Palliative Medicine (HPM) Fellowship graduates trained at a comprehensive cancer center. METHODS We conducted a survey to determine the knowledge, attitudes, and frequency of burnout in former fellows, consisting of the Maslach Burnout Inventory (MBI) and 41 custom questions. Palliative care fellows who trained at a Comprehensive Cancer Center from 2008 to 2018 were included in the survey. RESULTS Eighty-four percent of the 52 eligible physicians completed surveys. Median age was 38 years, with 68% females. Seventy-seven percent practiced PC more than 50% of time. Median practice duration was four years, and 84% were board certified. Most common disease types treated were cancer (89%), cardiac (43%) and pulmonary (43%). Burnout rate was high at 52% (n=20). The median scores for emotional exhaustion were 25.5, depersonalization 9, and personal accomplishment 48. Female gender (P=0.07) and having administration as a component in the job description (P=0.044) were associated with risk of burnout. Clinical care setting, work hours/week, frequency of weekend calls, and size of team were not significantly associated with burnout. CONCLUSION Burnout among former fellows trained in HPM between 2008 and 2018 is high. More research is needed to develop strategies to better prevent and manage burnout among HPM fellowship trained PC physicians.
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Affiliation(s)
- Suresh K Reddy
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Sriram Yennurajalingam
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberson Tanco
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aimee E Anderson
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diana Guzman
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Janet Williams
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diane Liu
- Department of Biostatistics,The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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15
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Santerre-Theil A, Brown TL, Körner A, Loiselle CG. Exploring healthcare professionals' experiences with informal family cancer caregiving. Support Care Cancer 2022; 30:7745-7754. [PMID: 35701633 PMCID: PMC9197331 DOI: 10.1007/s00520-022-07207-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/06/2022] [Indexed: 11/26/2022]
Abstract
Caring for a family member with cancer is often associated with significant cognitive, emotional, and physical demands. Although considerable research has explored informal cancer caregiver role burden, research has seldom focused on the experiences of individuals who hold the dual role of informal caregiver and healthcare professional. This qualitative study begins to explore this dual role experience. Participants (N = 12) who had at least 1 year of prior professional experience and cared for a family member with cancer were recruited conveniently from a large university-affiliated hospital in Montreal, Quebec. Individual face-to-face semi-structured interviews were conducted. Using thematic analysis, key themes were developed from verbatim transcripts: (1) salient dual role advantages, (2) significant challenges related to this role, (3) changes in professional practice as a consequence of informal caregiving, and (4) important palliative and end-of-life care access issues. Whereas professional knowledge helped advocate on behalf of patients, the dual role often came with over-solicitation from others, enhanced sense of responsibility, increased burden, and significant distress. Further study of critical ramifications linked to jointly enacting informal and professional caregiving across various health contexts should continue to inform supportive care strategies for this understudied yet increasingly prevalent segment of the caregiver population.
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Affiliation(s)
- Ariane Santerre-Theil
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
| | - Tyler L Brown
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Annett Körner
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada
- Psychosocial Oncology Program, McGill University Health Centre, Montreal, QC, Canada
| | - Carmen G Loiselle
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada.
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
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16
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Granek L, Nakash O. Oncology Healthcare Professionals’ Mental Health during the COVID-19 Pandemic. Curr Oncol 2022; 29:4054-4067. [PMID: 35735432 PMCID: PMC9222050 DOI: 10.3390/curroncol29060323] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
The paper begins by reviewing the literature on oncology healthcare professionals’ (HCP) mental health. We summarize and present the current data on HCP mental health in order to understand the baseline state of oncology HCPs’ mental health status prior to the COVID-19 pandemic. At each juncture, we will discuss the implications of these mental health variables on the personal lives of HCPs, the healthcare system, and patient care. We follow by reviewing the literature on these parameters during the COVID-19 pandemic in order to better understand the impact of COVID-19 on the overall mental health of HCPs working in oncology. By reviewing and summarizing the data before and after the start of the pandemic, we will get a fuller picture of the pre-existing stressors facing oncology HCPs and the added burden caused by pandemic-related stresses. The second part of this review paper will discuss the implications for the oncology workforce and offer recommendations based on the research literature in order to improve the lives of HCPs, and in the process, improve patient care.
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Affiliation(s)
- Leeat Granek
- School of Health Policy and Management and Department of Psychology, Faculty of Health, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
- Correspondence: ; Tel.: +1-416-736-2100
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, MA 01063, USA;
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17
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Addressing the Mental Health Crisis: The COVID-19 Pandemic's Escalating Impact on Behavioral Health. Prof Case Manag 2022; 27:158-160. [PMID: 35363664 DOI: 10.1097/ncm.0000000000000570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Olesen LK, la Cour K, With H, Handberg C. Reflections of family caregivers and health professionals on the everyday challenges of caring for persons with amyotrophic lateral sclerosis and cognitive impairments: a qualitative study. Palliat Care Soc Pract 2022; 16:26323524221077702. [PMID: 35187490 PMCID: PMC8855464 DOI: 10.1177/26323524221077702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022] Open
Abstract
Aims and objectives: To explore reflections of family caregivers and health professionals
regarding the challenges involved in caring for persons with amyotrophic
lateral sclerosis and cognitive and/or behavioral impairments
(PALS/CIs). Background: Family caregivers of PALS/CIs are highly burdened and at great risk of
psychological sequela. Professionals working with these families can be
negatively affected on their well-being and are at risk of burnout. Design: The design was a qualitative interview study. Methods: One focus group and 10 individual semi-structured interviews were conducted
with seven family caregivers and nine professionals after the death of a
PALS/CIs. The analysis was guided by the interpretive description
methodology and the theory of sense of coherence. This study adheres to the
COREQ guidelines and the ICMJE recommendations. Results: The family caregivers’ challenges regarding coping with everyday needs
related to the sick person were associated with ‘Accepting that nothing else
matters’, ‘Adjusting to new roles while balancing’, and ‘Realizing different
values in relationships’; whereas the professionals’ challenges were related
to ‘Collaboration a balancing act’, ‘Working in a home of sorrow’, and
‘Coordinating threads to tie’. Conclusion: Family caregivers found coping with the complexity of the diseases a
challenge, and their everyday life needed constant adjustment to new roles,
coping with inappropriate behavior, and navigating through the progression
of the diseases of their sick relatives while collaborating with numerous
professionals. The professionals struggled with coordinating and
collaborating with the families and with other colleagues due to the
severeness and complexity of diseases. Relevance to clinical practice: Findings point to the importance of relationships for caregivers and
professionals and a need to provide support through an online palliative
rehabilitation program that encompass coping strategies in relation to the
diseases. Trial registration details: Id no. NCT 04638608.
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Affiliation(s)
- Lene Klem Olesen
- National Rehabilitation Center for Neuromuscular Diseases (RCFM), Kongsvang Allé 23, 8000 Aarhus, Denmark
| | - Karen la Cour
- Research Unit of User Perspectives, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Heidi With
- National Rehabilitation Center for Neuromuscular Diseases (RCFM), Aarhus, Denmark
| | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases (RCFM), Aarhus, Denmark
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19
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Marchini F, Caputo A, Langher V, Giuliani C, Convertino A, Mazzilli R, Faggiano A, Napoli A. Understanding care relationships in diabetes practice: A psychodynamic interview-based exploratory study. PLoS One 2022; 17:e0263226. [PMID: 35176064 PMCID: PMC8853562 DOI: 10.1371/journal.pone.0263226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/17/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To explore the subjective experience of physicians working in diabetic settings about their care relationships in order to find some unique clues contributing to physician professional health and capacity to manage patients’ adherence. Research design and methods An interview-based exploratory study has been carried out involving 18 physicians (77.8% female) with at least 3 years of clinical practice in diabetes care. In-depth interviews about the emotional experience with patients with diabetes were conducted and audio recorded. Interviews transcripts were analyzed through a computer-based text analysis which allowed the identification of thematic domains (Cluster Analysis) and latent factors (Correspondence Analysis) viewed through a psychodynamic and constructivist lens. Results Six thematic domains emerged respectively referring to: Concern (8.43%), Control (14.42%), Ambivalence (22.08%), Devotion (22.49%), Guilt (19.29%) and Strive for Achievement (13.30%). Moreover, three latent dimensions were taken into account, which explained 69.20% of data variance: Affect Repression (28.50%), Tendency to Repair (22.70%) and Anxiety Pattern (18.00%). Conclusions Overall, the results of the present study confirm the challenging nature of diabetes care. In particular, physicians ongoing effort to restore patients’ psychological integrity in chronic condition constitute the most novel finding above all. In this regard, the need for emotional labor in physicians’ education and training is suggested in order to both prevent burnout symptoms (e.g. depersonalization) and promote shared decision making in care relationships. However, findings should be treated as preliminary given the convenience nature of the sample and its reduced size.
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Affiliation(s)
- Francesco Marchini
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
- Italian Center of Analytical Psychology, CIPA, Roma, Italy
- * E-mail:
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Viviana Langher
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Giuliani
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Alessio Convertino
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Rossella Mazzilli
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Angela Napoli
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
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20
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Wyatt JP, Ampadu GG. Reclaiming Self-care: Self-care as a Social Justice Tool for Black Wellness. Community Ment Health J 2022; 58:213-221. [PMID: 34478022 PMCID: PMC8414023 DOI: 10.1007/s10597-021-00884-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 08/19/2021] [Indexed: 11/20/2022]
Abstract
Black communities face multiple stressors including racism, discrimination, and navigating systems of oppression, all of which affect their mental health and wellbeing. In recent years, the practice of self-care has gained popularity as a strategy to cope with stress and to improve overall health. However, the current discourse often focuses on individual self-care behaviors and excludes systemic and community level factors that encourage, sustain, or inhibit self-care practices. This paper contextualizes a conceptual model of self-care with intersectionality theory and the psychology of liberation framework, in relation to the lived experiences of Black communities. The paper aims to underscore the necessity of self and community care as a tool for social justice, preservation, and resistance against oppressive systems that threaten the mental health and wellness of this community.
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Affiliation(s)
- Janan P Wyatt
- Department of Psychiatry, Yale School of Medicine, Program for Recovery and Community Health, Erector Square, 319 Peck St., Bldg. 1, New Haven, CT, 06513, USA.
| | - Gifty G Ampadu
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 3340 Bainbridge Ave., Bronx, NY, 10467, USA
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21
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Wilson CA, Metwally H, Heavner S, Kennedy AB, Britt TW. Chronicling moral distress among healthcare providers during the COVID-19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours. Int J Ment Health Nurs 2022; 31:111-127. [PMID: 34644443 PMCID: PMC8653372 DOI: 10.1111/inm.12942] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic has presented many novel situations that have amplified the presence of moral distress in healthcare. With limited resources to protect themselves against the virus and strict safety regulations that alter the way they work, healthcare providers have felt forced to engage in work behaviours that conflicted with their professional and personal sense of right and wrong. Although many providers have experienced moral distress while being physically in the workplace, others suffered while at home. Some healthcare providers worked in facilities that were unable to open during the pandemic due to restrictions, which could contribute to a sense of powerlessness and guilt. The current study assessed whether the ability to see patients each week impacted the relationship between an employee's moral distress and their mental health strain, burnout, and maladaptive coping. A total of 378 healthcare providers responded to weekly surveys over the course of 7 months (April 2020-December 2020). Hierarchical linear modeling techniques were used to examine the study variables over time. Results showed that moral distress predicted an individual's mental health strain and burnout, even after controlling for the prior week. However, moral distress was not a significant predictor of maladaptive coping. Interestingly, there was not a significant difference between the average ratings of moral distress between those who were able, and those who were not able to see patients, meaning that both groups experienced symptoms of moral distress. However, cross-level moderation results indicated that the ability to see patients magnified the relationships between moral distress and mental health strain and burnout over time. Implications of the results and recommendations for how moral distress should be addressed among healthcare providers are discussed.
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Affiliation(s)
| | | | | | - Ann Blair Kennedy
- University of South Carolina School of Medicine Greenville Campus, Greenville, South Carolina, USA
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22
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Gamskjaer T, Werlauff U, Handberg C. Investigating job satisfaction in palliative rehabilitation: Reflections and perspectives of health professionals working with amyotrophic lateral sclerosis. J Eval Clin Pract 2022; 28:108-119. [PMID: 34269500 DOI: 10.1111/jep.13599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/11/2022]
Abstract
STUDY RATIONALE Amyotrophic lateral sclerosis is a progressive neurodegenerative disease which causes impairment of the motor functions in the upper and lower limbs and bulbar muscles with a median survival time is three years from the first appearance of symptoms. There is massive psychological impact on health professionals to persons with amyotrophic lateral sclerosis, hence the work leads to multiple challenges and stressful and demanding situations with high risk of experiencing diminished personal well-being including burnout, moral distress, and compassion fatigue. AIM To investigate reflections and perspectives from health professionals working within palliative rehabilitation for elements of importance in relation to job satisfaction. METHODS AND MATERIALS The design was qualitative and based on the phenomenological-hermeneutical methodology by Paul Ricoeur's interpretation theory. Data consisted of two semi-structured focus group interviews with a total of 12 specialized health professionals: Nurses, Psychologists, Physicians, Occupational Therapists, Physiotherapists, and Social workers, working within a hospital setting of specialized palliative rehabilitation for people with amyotrophic lateral sclerosis and their families. RESULTS The analysis revealed insight into four themes: fundamental drive, working conditions, value of collegiality and work-life balance. Fundamental drive was deeply rooted in the professionals' sense of having a meaningful job. Working conditions such as self-management were important for job satisfaction as were good collegial relations. Finally, a good balance between working life and private life was considered important for job satisfaction. CONCLUSION Our study indicates that work within the field of palliative rehabilitation is experienced as enriching and beneficial under the right circumstances and in an appreciatory working environment. We found elements like autonomy, mastery, purpose, collegiality, and work-life balance to be of great importance. Our findings can help guide managements and health professionals in other palliative rehabilitation contexts to ensure satisfied employees and to optimize the quality of care.
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Affiliation(s)
- Tine Gamskjaer
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Bertuzzi L, El Aarbaoui T, Heron M, Gosselin A, Roy-de-Lachaise L, Fossi L, Della Corte F, Vignier N, Melchior M, Schreiber M, Vandentorren S, Vuillermoz C. Longitudinal survey on the Psychological Impact of the COVID-19 Pandemic in Healthcare Workers (PsyCOVer) in France: study protocol. BMJ Open 2022; 12:e053009. [PMID: 35058260 PMCID: PMC8783967 DOI: 10.1136/bmjopen-2021-053009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 01/05/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION In the pandemic, healthcare professionals face even higher levels of stress. It is therefore a priority to estimate the impact of the pandemic on mental health and to propose targeted strategies to improve resilience. The aims of the study were to (1) assess the mental health of healthcare professionals working with patients with COVID-19 and identify social determinants that may increase the risk of negative outcomes; and (2) test the effectiveness of an intervention to improve the resilience of healthcare professionals in France. METHODS AND ANALYSIS To evaluate the first objective, a national longitudinal study will be carried out among healthcare professionals working with patients with COVID-19. Participants will be recruited via an internet link that will be widely disseminated on social media, mailing lists, medical boards and French medical journals. Primary outcomes are mental health distress/symptoms and resilience. Secondary outcomes are burnout, social and occupational supports and substance use. To meet the second objective, an interventional study will be conducted. The main outcome is the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter program. Qualitative analyses will be conducted to understand the strategies used to cope with the pandemic. ETHICS AND DISSEMINATION The study protocol was approved by the Sorbonne Université Ethical Committee (No 2020-CER-2020-27) and was declared to French Commission on Information Technology and Liberties, CNIL (N°2222413, 20-05-2021). The results of this study will provide a better understanding of mental health and social inequalities in mental health among healthcare professionals working in the pandemic; data about the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter interventional program in France.
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Affiliation(s)
- Leticia Bertuzzi
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
| | - Tarik El Aarbaoui
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
| | - Mégane Heron
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
| | - Anne Gosselin
- SAGESUD Team, CEPED, Paris, France
- French Collaborative Institute On Migrations/CNRS, Aubervilliers, France
| | - Laurine Roy-de-Lachaise
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
| | - Larissa Fossi
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
| | - Francesco Della Corte
- CRIMEDIM, Università degli Studi del Piemonte Orientale Amedeo Avogadro Scuola di Medicina, Novara, Italy
| | - Nicolas Vignier
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
- Centre d'Investigation Clinique Antilles Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Maria Melchior
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
- French Collaborative Institute On Migrations/CNRS, Aubervilliers, France
| | - Merritt Schreiber
- Harbor-UCLA Medical Center/David Geffen School of Medicine at UCLA, The Lundquist Institute, Torrance, California, USA
| | | | - Cécile Vuillermoz
- Social epidemiology research team, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
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Kotera Y, Ozaki A, Miyatake H, Tsunetoshi C, Nishikawa Y, Kosaka M, Tanimoto T. Qualitative Investigation into the Mental Health of Healthcare Workers in Japan during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010568. [PMID: 35010828 PMCID: PMC8744919 DOI: 10.3390/ijerph19010568] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/02/2022] [Accepted: 01/02/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has negatively impacted the mental health of healthcare workers in many countries including Japan. While many survey-based findings have reported the serious state of their wellbeing among healthcare workers, the first-hand experience of the mental health and coping in this population remains to be evaluated. Accordingly, this study aimed to appraise them using constructionist thematic analysis on semi-structured interviews attended by a purposive and snowball sample of 24 healthcare workers in Japan conducted in December 2020-January 2021. Four themes were identified: (1) increased stress and loneliness, (2) reduced coping strategies, (3) communication and acknowledgement as a mental health resource, and (4) understanding of self-care. Participants noted that the characteristics of Japanese work culture such as long hours, collectivism and hatarakigai (i.e., meaning in work) to explain these themes. These findings suggest that robust support at an organizational and individual level, capturing intrinsic values, are particularly important for this key workforce to cope with increased stress and loneliness, leading to better patient care.
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Affiliation(s)
- Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- Correspondence:
| | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan;
- Medical Governance Research Institute, Tokyo 108-0074, Japan;
| | | | - Chie Tsunetoshi
- Department of Community Health Nursing, University of Fukui, Fukui 910-1104, Japan;
| | - Yoshitaka Nishikawa
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan;
| | - Makoto Kosaka
- Orange Home-Care Clinic, Fukui 910-0018, Japan; (H.M.); (M.K.)
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Sapeta P, Centeno C, Belar A, Arantzamendi M. Adaptation and continuous learning: integrative review of coping strategies of palliative care professionals. Palliat Med 2022; 36:15-29. [PMID: 34554042 PMCID: PMC8793319 DOI: 10.1177/02692163211047149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Coping is essential to manage palliative care professionals' challenges. The focus has been on the effects of coping mechanism; however, little is known about coping itself in palliative care. AIM To synthesise evidence of coping strategies in palliative care professionals, and how different strategies play roles over time. DESIGN Systematically conducted integrative review. DATA SOURCES PubMed; CINAHL; Medline; PsycINFO and B-ON were searched (1996-2021) combining 'coping' AND 'palliative care'. A predefined data extraction sheet was developed to report data. Two researchers performed constant comparative analysis using Nvivo®. RESULTS Thirty-one studies were included. Four main strategies with recurrent reference to time were found: (a) proactive coping, involving activities to achieve self-confidence and control situations and emotions; (b) self-care based coping, including self-protection and self-awareness activities, with behavioural disconnection; (c) self-transformation coping, involving activities to accept limits; and (d) encountering deep professional meaning, is a coping mechanism based on meaning, frequently considering the deepest meaning of work. The dynamic and influencing factors were training, team interaction, professional motivation and family. They were usually protective factors, though sometimes they represented risk factors. The emotional burden associated with healthcare and systemic stressors were always risk factors. An explanatory model describes a complex and dynamic process, in which everyday strategies and more introspective strategies are combined. CONCLUSIONS The model showed a process of adaptation and learning to persevere in palliative care. It changes over time under factors and strategies, and evolves in a personal and professional transformation, parallel to the working life. It would be worth assessing coping in healthcare professionals who chose to leave palliative care and to investigate the reasons they did so and their coping mechanisms.
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Affiliation(s)
- Paula Sapeta
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - Carlos Centeno
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
- Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Alazne Belar
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
| | - María Arantzamendi
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
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Galiana L, Sansó N, Muñoz-Martínez I, Vidal-Blanco G, Oliver A, Larkin PJ. Palliative Care Professionals' Inner Life: Exploring the Mediating Role of Self-Compassion in the Prediction of Compassion Satisfaction, Compassion Fatigue, Burnout and Wellbeing. J Pain Symptom Manage 2022; 63:112-123. [PMID: 34271144 DOI: 10.1016/j.jpainsymman.2021.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 12/26/2022]
Abstract
CONTEXT Palliative care professionals are exposed to suffering on a daily basis. Working in such an environment frequently raises existential issues, psychological challenges, and emotional distress, that can detract from compassionate care. Identifying factors that help professionals cope with frequent exposure to issues related to mortality, such as compassion, could enhance palliative care providers' and patients' quality of life and wellbeing. OBJECTIVES To improve our understanding of the factors associated with professionals' inner life studying the role of self-compassion as a mediating variable between self-care and awareness and professionals' quality of life, and quantifying the impact of compassionate care. METHODS A cross-sectional online survey of palliative care professionals was conducted through the Spanish Society of Palliative Care. 296 professionals answered the survey. RESULTS The model tested showed an adequate fit (χ2(212) = 476.688 (P < .001), CFI = .907, RMSEA = .066 [.058,.073], and SRMR = .068), and the hypotheses were supported. Self-care and awareness predicted coping with death and self-compassion, which in turn predicted professional quality of life. Self-compassion had the greatest predictive power. Professional quality of life showed a statistically significant and positive effect on personal wellbeing, explaining more than 50% of its variance (R2 = .574; P < .001). CONCLUSION For palliative care professionals, the cultivation of self-compassion is equally needed as compassion for others. Professional quality of life and compassionate care are related to professionals' wellbeing: when professionals take care of themselves, this will lead in a more compassionate care, but also in healthier, happier professionals.
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Affiliation(s)
- Laura Galiana
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Noemí Sansó
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain; Balearic Islands Health Research Institute (IDISBA), Palma, Spain.
| | | | | | - Amparo Oliver
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Philip J Larkin
- Chair of Palliative Care Nursing, Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Kase SM, Gribben JL, Guttmann KF, Waldman ED, Weintraub AS. Compassion fatigue, burnout, and compassion satisfaction in pediatric subspecialists during the SARS-CoV-2 pandemic. Pediatr Res 2022; 91:143-148. [PMID: 34211128 PMCID: PMC8245661 DOI: 10.1038/s41390-021-01635-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/27/2021] [Accepted: 05/21/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to explore factors contributing to compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS) during the severe acute respiratory syndrome coronavirus-2 pandemic in pediatric subspecialists. METHODS The Compassion Fatigue and Satisfaction Self-Test (CFST) and a questionnaire of personal/professional characteristics were distributed electronically to pediatric subspecialists. RESULTS There were no significant differences in pre- and early-pandemic CF, BO, and CS scores. Nearly 40% of respondents felt their contributions to the pandemic were not valued by their institutions. Higher CF scores were significantly associated with: higher BO score; "I have put myself at increased risk through my work"; working in one's specialty >50% of time; distress about mental health and/or future uncertainty. Higher BO scores were significantly associated with: higher CF score; "Self-care is not a priority"; emotional depletion. Higher CS scores were significantly associated with: "My institution values my contribution to the COVID-19 crisis"; workplace debriefs; pet therapy. CONCLUSIONS The pandemic has only increased the need for physicians to receive social/emotional support from their institution and to feel their workplace contributions are valued. Successful pre-pandemic workplace interventions may not adequately support physicians during the pandemic. Further study is needed to identify supports that best counter the pandemic's unprecedented challenges. IMPACT The sentiment "My institution has valued my contribution to the Covid-19 crisis" was the only significant factor associated with lower BO scores and was also associated with higher CS scores in pediatric subspecialists. This study is the first comparison of pre- and early-pandemic CF, BO, and CS scores in a national cohort of pediatric subspecialists. When considering interventions to promote CS and mitigate CF and BO for pediatric subspecialists during and after the pandemic, institutional leadership must offer wellness programming focused on social/emotional supports and prioritize a culture that explicitly recognizes and values every physician's contributions.
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Affiliation(s)
- Samuel M. Kase
- grid.59734.3c0000 0001 0670 2351Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Jeanie L. Gribben
- grid.413734.60000 0000 8499 1112Weill Department of Medicine, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY USA
| | - Katherine F. Guttmann
- grid.59734.3c0000 0001 0670 2351Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Elisha D. Waldman
- grid.413808.60000 0004 0388 2248Division of Palliative Care, Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - Andrea S. Weintraub
- grid.59734.3c0000 0001 0670 2351Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY USA
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Orman S, Albright JA, Vutescu ES, Eberson CP. The Impact of a Resident's Sense of Control on Burnout in Orthopaedic Surgery Residency. JBJS Rev 2021; 9:01874474-202112000-00009. [PMID: 34962897 DOI: 10.2106/jbjs.rvw.21.00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Physician burnout is a barrier to the patient-centered approach to health care. » One of the driving factors of resident burnout is the decreased level of control that residents have over their everyday lives. » Providing residents with a sense of control over their lives and their jobs increases job satisfaction and leads to a decrease in reports of negative effects on health, rest, participation in extracurricular activities, and time with family.
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Affiliation(s)
- Sebastian Orman
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island
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29
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A time for self-care? Frontline health workers' strategies for managing mental health during the COVID-19 pandemic. SSM - MENTAL HEALTH 2021; 2:100053. [PMID: 34913042 PMCID: PMC8660664 DOI: 10.1016/j.ssmmh.2021.100053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 11/22/2022] Open
Abstract
Frontline healthcare workers have experienced detrimental mental health impacts during the COVID-19 pandemic including anxiety, emotional distress, stress, fatigue, and burnout. But little is known about how these healthcare professionals take care of their own mental health in the midst of considerable personal, occupational and social disruption. In this article, we use qualitative data from an Australian national survey to examine the self-care strategies frontline healthcare professionals employed to manage their mental health and wellbeing during the crisis. Findings reveal how healthcare workers sought to adjust to disruption by adopting new self-care practices and mindsets, while encountering numerous personal and professional struggles that undermined their capacity for self-care. Feeling socially connected and valued were critical dimensions of caring for self, illustrating the importance of locating self-care in the social domain. These findings, we argue, highlight the need to expand conceptions of self-care away from those that focus primarily on the individual towards approaches that situate self care as collective and relational.
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30
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Ward V, Freeman S, Callander T, Xiong B. Professional experiences of formal healthcare providers in the provision of medical assistance in dying (MAiD): A scoping review. Palliat Support Care 2021; 19:744-758. [PMID: 33781368 DOI: 10.1017/s1478951521000146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This scoping review describes the existing literature which examines the breadth of healthcare providers' (HCP's) experiences with the provision of medical assistance in dying (MAiD). METHOD This study employed a scoping review methodology: (1) identify research articles, (2) identify relevant studies, (3) select studies based on inclusion/exclusion criteria, (4) chart the data, and (5) summarize the results. RESULTS In total, 30 papers were identified pertaining to HCP's experiences of providing MAiD. Fifty-three percent of the papers were from Europe (n = 16) and 40% of studies were from the USA or Canada (n = 12). The most common participant populations were physicians (n = 17) and nurses (n = 12). This scoping review found that HCPs experienced a variety of emotional responses to providing or providing support to MAiD. Some HCPs experienced positive emotions through helping patients at the end of the patient's life. Still other HCPs experienced very intense and negative emotions such as immense internal moral conflict. HCPs from various professions were involved in various aspects of MAiD provision such as responding to initial requests for MAiD, supporting patients and families, nursing support during MAiD, and the administration of medications to end of life. SIGNIFICANCE OF RESULTS This review consolidates many of the experiences of HCPs in relation to the provision of MAiD. Specifically, this review elucidates many of the emotions that HCPs experience through participation in MAiD. In addition to describing the emotional experiences, this review highlights some of the roles that HCPs participate in with relation to MAiD. Finally, this review accentuates the importance of team supports and self-care for all team members in the provision of MAiD regardless of their degree of involvement.
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Affiliation(s)
- Valerie Ward
- Northern Medical Program, University of Northern British Columbia, Prince George, BC, Canada
| | - Shannon Freeman
- School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
| | - Taylor Callander
- Northern Medical Program, University of Northern British Columbia, Prince George, BC, Canada
| | - Beibei Xiong
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
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31
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Waddimba AC, Bennett MM, Fresnedo M, Ledbetter TG, Warren AM. Resilience, Well-being, and Empathy Among Private Practice Physicians and Advanced Practice Providers in Texas: A Structural Equation Model Study. Mayo Clin Proc Innov Qual Outcomes 2021; 5:928-945. [PMID: 34585086 PMCID: PMC8456060 DOI: 10.1016/j.mayocpiqo.2021.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective To investigate structural relationships of latent constructs such as occupational wellbeing, resilience, work meaningfulness, and psychological empowerment with affective and cognitive clinical empathy among a community of physicians and advanced practice providers. Methods We conducted a cross-sectional observational study. We gathered data by an anonymous self-administered multidimensional questionnaire disseminated electronically between March and May 2016. Participants were physicians and advanced practice providers belonging to the Health Texas Provider Network, a group private practice affiliated with the Baylor Scott and White Health system. We excluded allied health care staff (eg, nurses) and trainees (eg, residents, medical students). We pursued a 3-step strategy: (1) confirmatory factor analysis of a theory-driven measurement model, (2) a modified structural equation model from which pathways with nonsignificant path coefficients were deleted, and (3) multigroup analyses of the modified model. Results Cognitive empathy was the strongest predictor of affective empathy. We observed modest positive associations of resilience with cognitive and affective empathy and of well-being and meaning with affective but not with cognitive empathy. Resilience, meaning, and psychological empowerment were surprisingly negatively associated with well-being, suggesting diminished self-care among practitioners. Effects of psychological empowerment on empathy and well-being were mediated by resilience and meaning. Conclusion Cognitive empathy directly influenced affective empathy; well-being and meaningfulness exerted direct positive effects on affective but not on cognitive empathy, whereas resilience had direct positive associations with both empathy dimensions. Resilience and meaning manifested direct, negative associations with well-being, revealing clinicians’ disproportionate focus on patient care at the expense of self-care.
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Key Words
- APP, advanced practice provider
- AVE, average variance extracted
- BIC, Bayesian information criterion
- CD-RISC, Connor-Davidson Resilience Scale
- CD-RISC-10, 10-item short form of the Connor-Davidson Resilience Scale
- CFA, confirmatory factor analysis
- CFI, comparative fit index
- GFI, goodness of fit index
- HTPN, Health Texas Provider Network
- IRI, Interpersonal Reactivity Index
- LPA, latent profile analysis
- MCPWBI, Mayo Clinic Physician Well-being Index
- PEI, Psychological Empowerment Instrument
- RMSEA, root mean square error of approximation
- SE, standard error
- SRMR, standardized root mean square residual
- TIPI, 10-Item Personality Inventory
- TLI, Tucker-Lewis Index
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Affiliation(s)
- Anthony C Waddimba
- Baylor Scott and White Research Institute, Dallas, TX.,Health Systems Science, Department of Surgery, Baylor University Medical Center, Dallas, TX
| | | | - Michelle Fresnedo
- Baylor Scott and White Research Institute, Dallas, TX.,Division of Trauma, Acute Care, and Critical Care Surgery, Baylor University Medical Center, Dallas, TX
| | - Thomas G Ledbetter
- Chief Medical Office, Baylor Scott and White Medical Center, Waxahachie, TX
| | - Ann Marie Warren
- Baylor Scott and White Research Institute, Dallas, TX.,Division of Trauma, Acute Care, and Critical Care Surgery, Baylor University Medical Center, Dallas, TX
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32
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Affiliation(s)
- Brett Gartrell
- Wildbase, Tāwharau Ora, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Bridey White
- Wildbase, Tāwharau Ora, School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Rabow MW, Huang CHS, White-Hammond GE, Tucker RO. Witnesses and Victims Both: Healthcare Workers and Grief in the Time of COVID-19. J Pain Symptom Manage 2021; 62:647-656. [PMID: 33556494 PMCID: PMC7864782 DOI: 10.1016/j.jpainsymman.2021.01.139] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 01/03/2023]
Abstract
Heathcare Workers (HCWs) recognize their responsibility to support the bereaved loved ones of our patients, but we also must attend to our own professional and personal grief in the COVID-19 pandemic. COVID-19 grief is occurring in the setting of incomplete grief, disenfranchised grief, fractured US governmental leadership, and evidence of great mistrust, systemic racism, and social injustice. In the intensity and pervasiveness of COVID-19, HCW fears for themselves, their colleagues, and their own loved ones are often in conflict with professional commitments. Even at the dawn of promising national and global vaccination programs, significant HCW morbidity and mortality in COVID-19 has already become clear, will continue to grow, and these effects likely will last far into the future. Given the risks of complicated grief for HCWs in the setting of COVID-19 deaths, individual HCWs must put every effort into their own preparation for these deaths as well as into their own healthy grieving. Equally importantly, our healthcare systems have a primary responsibility both to prepare HCWs and to support them in their anticipatory and realized grief. Special attention must be paid to our HCW trainees, who may have not yet developed personal or professional grief management strategies and are coming into healthcare practice during a time of great disruption to both teaching and clinical care.
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Affiliation(s)
- Michael W Rabow
- Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, CA.
| | - Chao-Hui S Huang
- Center for Palliative and Supportive Care, Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | | | - Rodney O Tucker
- Center for Palliative and Supportive Care, Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
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34
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Stilos K(K, Ford B, Chakraborty A, Takahashi D. Spiritual Care as Part of an Interprofessional Model for Debriefing on an Oncology Unit. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2021; 75:158-162. [PMID: 34763574 PMCID: PMC8592097 DOI: 10.1177/15423050211021387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Health care clinicians who care for seriously ill and dying patients have been known to be at higher risk for burnout and moral distress. When not well supported in their workplace, clinicians may suffer additional adverse outcomes to their overall wellbeing. Self-care is one way to help mitigate these adverse outcomes. The literature has described formalized debriefing not only as a self-care strategy but an intervention to promote healthy team development. The focus of this paper will showcase how social work and spiritual care practitioners in our institution worked collaboratively to support an inpatient oncology unit to address issues related to burnout by providing staff with monthly debriefing sessions intended to enhance self-care and wellness in the workplace.
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Affiliation(s)
- Kalli (Kalliopi) Stilos
- Kalli (Kalliopi) Stilos, Department of Nursing, Faculty of Nursing, University of Toronto, Toronto, Ontario M5S, Canada.
| | - Bill Ford
- Sunnybrook Health Sciences Centre, Canada
| | - Anita Chakraborty
- Sunnybrook Health Sciences Centre, Canada; University of Toronto, Canada
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35
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Aging on the Autism Spectrum: Self-care Practices and Reported Impact on Well-Being. J Autism Dev Disord 2021; 52:3512-3522. [PMID: 34379240 DOI: 10.1007/s10803-021-05229-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
The population aging on the Autism Spectrum (AS) faces disproportionate physical and mental health comorbidities. This research describes self-care practices, including physical activity (PA), nutrition, and spirituality, and the impact of these practices on the health and well-being of older adults on the AS. Researchers conducted semi-structured interviews (N = 30) with older adults (age 50+ years) on the AS on the following topics: health, employment, relationships, and services/supports. Data were analyzed using Dedoose software and a constant comparative method. Participants described self-reported health benefits of their PA. Participants who engaged with organizations reported receiving instrumental support and fulfillment. Several themes emerged regarding socialization and routines in self-care in older adults on the AS, which may inform interventions.
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Parrello S, Fenizia E, Gentile R, Iorio I, Sartini C, Sommantico M. Supporting Team Reflexivity During the COVID-19 Lockdown: A Qualitative Study of Multi-Vision Groups In-person and Online. Front Psychol 2021; 12:719403. [PMID: 34421770 PMCID: PMC8377588 DOI: 10.3389/fpsyg.2021.719403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The professional self is often hindered by a lack of self-care and poor work-life balance, and cannot be considered an unlimited resource. Given this, the reflexive team is an important organizational tool for protecting workers' well-being. The non-profit organization Maestri di Strada (MdS) ("Street Teachers") conducts action research (AR) in the area of socio-education. The main tool used by the group to protect the well-being of its members is a guided reflexivity group, inspired by the Balint Group and termed the Multi-Vision Group (MG). In March 2020, because of the COVID-19 lockdown, the MdS team had to quickly revamp its working model, and MGs were held online for the first time. Aim: Through qualitative research that takes a longitudinal approach, the aim of this study is to evaluate the efficacy of the MG in supporting the team's reflexivity in this new online format. Methods: This article considers MGs during two different time periods: pre-pandemic (T1) and early pandemic (T2). During T1, the MdS team met 18 times in person, while during T2 the team met 12 times through an online platform (always under the guidance of a psychotherapist). During all sessions in both time periods, a silent observer was present in the meetings, and they subsequently compiled narrative reports. The textual corpora of the reports were submitted for a Thematic Analysis of Elementary Contexts through T-Lab Plus, in order to examine the main content of the groups' discourse. Results: The results (five clusters in T1; and five in T2) show that, during T2, the group devoted considerable time to experiences tied to the pandemic (T21: schools facing the pandemic crisis; T2.2: the pandemic: death, inner worlds, and thought resistance; T2.3: kids' stories involving physical distancing and emotional proximity). The group also came up with innovative educational initiatives that defied the lockdown (T2.4: fieldwork: the delivery of "packages of food for thought"; T2.5: the MdS group: identity and separation). Based on these findings, the MG most likely contributed to the emergence of MdS as a "resilient community," capable of absorbing the shock of the pandemic and realizing a fast recovery response.
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Affiliation(s)
- Santa Parrello
- Department of Humanities, Section of Psychology and Educational Sciences, University of Naples “Federico II”, Naples, Italy
| | | | - Rosa Gentile
- Associazione Maestri di Strada ONLUS, Naples, Italy
| | - Ilaria Iorio
- Associazione Maestri di Strada ONLUS, Naples, Italy
| | | | - Massimiliano Sommantico
- Department of Humanities, Section of Psychology and Educational Sciences, University of Naples “Federico II”, Naples, Italy
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Assaf RR, Pham PK, Schmidt AR, Gorab A, Chang TP, Liu DR. Pediatric emergency department shift experiences and moods: An exploratory sequential mixed-methods study. AEM EDUCATION AND TRAINING 2021; 5:e10572. [PMID: 34124518 PMCID: PMC8171774 DOI: 10.1002/aet2.10572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/18/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The objective was to investigate the impact of affective, social, behavioral, and cognitive factors on pediatric emergency department (PED) provider mood changes during clinical shifts, with the introduction of a novel on-shift measure. METHODS The nominal group technique was used to generate the ED experience survey (EDES), encompassing factors that may influence PED provider mood. Providers were alerted via experience sampling method to complete the EDES and positive and negative affect schedule at randomly generated times. Analyses were conducted using multilevel modeling of moods within shifts within persons. RESULTS Measures were completed 221 times during 137 shifts by 52 PED providers. Positive mood tended to increase with higher self-rated capacity to deal with challenging patient situations (p < 0.001). Having to repeat patient assessments was negatively associated with positive mood during the beginning, but not rest of shift (p = 0.01). Changes in positive mood varied across provider groups (p < 0.001). Negative mood tended to decrease with higher self-rated quality of interactions with patients/families (p < 0.001). Needing a restroom break during any time on duty was associated with negative mood (p < 0.001). Furthermore, negative mood was associated with the need to process emotions during the shift beginning (p = 0.01). Finally, not knowing about patients' outcomes was associated with negative mood during the shift end (p < 0.001). CONCLUSIONS PED providers' mood during shifts are impacted by ED-specific factors spanning physical, social, behavioral, affective, and cognitive features. Future research may explore potential entry points for mitigation of clinician stress to support provider well-being and ultimately improve patient care.
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Affiliation(s)
- Raymen R. Assaf
- Pediatric Emergency DepartmentHarbor UCLA Medical CenterTorranceCaliforniaUSA
| | - Phung K. Pham
- Division of Emergency and Transport MedicineChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
| | - Anita R. Schmidt
- Division of Emergency and Transport MedicineChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
| | | | - Todd P. Chang
- Division of Emergency and Transport MedicineChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
- Department of PediatricsKeck School of Medicine at University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Deborah R. Liu
- Division of Emergency and Transport MedicineChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
- Department of PediatricsKeck School of Medicine at University of Southern CaliforniaLos AngelesCaliforniaUSA
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Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, Münter L. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front Public Health 2021; 9:679397. [PMID: 34026720 PMCID: PMC8137852 DOI: 10.3389/fpubh.2021.679397] [Citation(s) in RCA: 194] [Impact Index Per Article: 64.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/12/2021] [Indexed: 12/27/2022] Open
Abstract
The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during times of crisis and other challenging working conditions and to highlight the importance of prioritizing and protecting the mental health and well-being of the healthcare workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other mental health challenges among healthcare workers. Second, we consider how public health emergencies exacerbate these concerns, as reflected in emerging research on the negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further, we consider potential approaches for overcoming these threats to mental health by exploring the value of practicing self-care strategies, and implementing evidence based interventions and organizational measures to help protect and support the mental health and well-being of the healthcare workforce. Lastly, we highlight systemic changes to empower healthcare workers and protect their mental health and well-being in the long run, and propose policy recommendations to guide healthcare leaders and health systems in this endeavor. This paper acknowledges the stressors, burdens, and psychological needs of the healthcare workforce across health systems and disciplines, and calls for renewed efforts to mitigate these challenges among those working on the frontlines during public health emergencies such as the COVID-19 pandemic.
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Affiliation(s)
| | - John A Naslund
- Department of Global Health and Social Medicine and Harvard Medical School, Boston, MA, United States
| | | | - Shekhar Saxena
- Department of Global Health and Population, School of Public Health, Harvard University, Boston, MA, United States
| | | | - Christoffel Grobler
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Lars Münter
- Danish Committtee for Health Education, Copenhagen, Denmark
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Stilos KK, Burgoyne K. Incorporating reflective writing & art therapy in my palliative care practice. Can Oncol Nurs J 2021; 31:205-212. [PMID: 34036159 PMCID: PMC8128433 DOI: 10.5737/23688076312205212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The specialty of palliative care routinely focuses on the complex needs of patients living with incurable illness and their families’ emotional and psychosocial concerns. Healthcare professionals who work with patients with advanced illness sometimes suffer from frustration and anxiety when they return home from caring for dying patients. The psychosocial care that increases patient and family satisfaction is sometimes lost when nurses are suffering (Pendry, 2007; Freeman, 2013). Continuous exposure to such difficult situations and the accumulation of unrecognized feelings and attitudes can lead to physical and psychological challenges (Pereira et al., 2011). As such, nurses have a duty to maintain their health to the best of their ability. To encourage nurses in promoting emotional health, Freeman’s (2013) CARES tool (Comfort, Airway management, Restlessness and delirium, Emotional and spiritual support, and Self-care) was integrated into our organization’s Comfort Measures Order Set for imminently dying patients (prognosis <72 hours) (Stilos, Wynntchuk et al., 2016).
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Affiliation(s)
- Kalliopi Kalli Stilos
- Advance Practice Nurse for the In-Patient Palliative Care Consult Team Adjunct Clinical Faculty, University of Toronto's Lawrence Bloomberg Faculty of Nursing, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 H337,
| | - Katherine Burgoyne
- Recreation Therapy & Creative Arts Therapies Department in the Veterans Centre, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 H337,
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Stilos KK, Burgoyne K. Intégrer l’écriture réflexive et l’art-thérapie à sa pratique de soins palliatifs. Can Oncol Nurs J 2021; 31:213-220. [PMID: 34036160 PMCID: PMC8128431 DOI: 10.5737/23688076312213220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
La spécialité des soins palliatifs se concentre bien souvent sur la prise en charge des besoins complexes des patients souffrant d’une maladie incurable et des préoccupations émotionnelles et psychosociales de leur famille. Les professionnels de la santé qui travaillent avec des patients atteints d’une maladie à un stade avancé sont parfois anxieux et frustrés lorsqu’ils rentrent chez eux après s’être occupés de patients mourants. Quelquefois, lorsque les infirmières souffrent, elles ne peuvent plus assurer les soins psychosociaux qui contribuent à la satisfaction des patients et de leur famille (Pendry, 2007; Freeman, 2013). L’exposition permanente à des situations aussi difficiles et l’accumulation de sentiments et de comportements qui ne sont pas pris en compte peuvent conduire à des difficultés physiques et psychologiques (Pereira et al., 2011). C’est pourquoi les infirmières se doivent de préserver au mieux leur santé. Pour inciter les infirmières à promouvoir la santé émotionnelle, nous avons intégré l’outil CARES (Comfort, Airway management, Restlessness and delirium, Emotional and spiritual support, Self-care [confort, prise en charge des voies respiratoires, agitation et délire, soutien affectif et spirituel et autosoins]) de Freeman (2013) à l’ensemble des mesures de confort définies par notre organisme pour les patients mourants (pronostic < 72 heures) (Stilos, Wynntchuk et al., 2016).
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Affiliation(s)
- Kalliopi Kalli Stilos
- Infirmière en pratique avancée au sein de l'équipe de consultation en soins palliatifs pour les patients en ambulatoire, Faculté clinique auxiliaire, Faculté de soins infirmiers Lawrence Bloomberg de l'Université de Toronto, Centre des sciences de la santé de Sunnybrook, 2075, Bayview Avenue, Toronto (Ontario) M4N 3M5 H337,
| | - Katherine Burgoyne
- Service de récréothérapie et de thérapies par les arts créatifs au Veterans Centre, Centre des sciences de la santé de Sunnybrook 2075, Bayview Avenue, Toronto (Ontario) M4N 3M5 H337,
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Cosentino C, D'apice C, Del Gaudio M, Bertoletti C, Bini M, Liotti MC, Melli E, Tesa F, Sarli L, Artioli G. Effectiveness of Expressive Writing protocol in Palliative Care Healthworkers: a quantitative study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021010. [PMID: 33855988 PMCID: PMC8138804 DOI: 10.23750/abm.v92is2.11468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Palliative Care professionals are exposed to intense emotional environment. This puts them at risk for Compassion Fatigue and Burnout. The protective factors that can counter their onset are Compassion Satisfaction, Organizational Commitment and Resilience. Expressive Writing is a valid tool for adapting to traumatic events and enhancing psychological well-being. Aim of this study is to evaluate the effect of the Expressive Writing in Palliative Care professionals on Compassion Satisfaction, Organizational Commitment, Resilience, Compassion Fatigue and perceived distress. METHODS Prospective experimental study with experimental/control groups and pre/post measurements. 50 Palliative Care professionals were recruited in Northern and Central Italy. Participants filled: Organizational Commitment Questionnaire; ProQol - revision III; Resilience Scale for Adults; Impact of Event-Scale Revised; Emotion Thermometer; ad hoc questionnaire for the evaluation of protocol usefulness. RESULTS Wilcoxon test demonstrated change in Continuative Commitment (Z = -3.357, p = .001), anger (Z = -2.214, p = .027), sleep (Z = -2.268, p = .023), help (Z = -2.184, p = .029), intrusiveness (Z = -2.469, p = .014), hyperarousal (Z = -2.717, p = .007), and total IES (Z = -2.456 , p =, 014). Mann Whitney test showed a significantly lower score on post-test Intrusiveness in the experimental group (U = 202, p = .038). CONCLUSIONS The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.
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Affiliation(s)
| | - Clelia D'apice
- Department of medicine and Surgery, University of Parma, Italy .
| | | | - Chiara Bertoletti
- Post Graduate Specialization in Palliative Care, University of Parma, Italy.
| | - Manuela Bini
- Post Graduate Specialization in Palliative Care, University of Parma, Italy.
| | | | - Elisa Melli
- Post Graduate Specialization in Palliative Care, University of Parma, Italy.
| | - Francesca Tesa
- Post Graduate Specialization in Palliative Care, University of Parma, Italy.
| | - Leopoldo Sarli
- Department of medicine and Surgery, University of Parma, Italy .
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Abstract
OBJECTIVE The provision of end-of-life (EOL) care has complex effects on both the professional and personal well-being of medical health personnel (MHP). Previous studies have mostly focused on negative or positive influences as mutually exclusive effects. This study offers a new conceptualization by applying a dialectical lens, looking at secondary traumatic stress (STS) and post-traumatic growth (PTG) as dual possible coexisting phenomena. The creation of four theoretically possible profiles, based on the combinations of high or low levels in each dimension, offers a practical translation of this idea toward intervention development. METHOD Data were collected at a large tertiary pediatric medical center (n = 1,123) aiming at assessing all personnel. Research methods included collecting demographic data and using validated scales to assess STS, PTG, burnout, compassion satisfaction, and both personal and professional social support. RESULTS We classified four response profiles according to the STS and PTG levels: (1) Dialectical-impact, high STS/high PTG, (2) Growth-dominant, high PTG/low STS, (3) Stress-dominant, high STS/low PTG, and (4) Limited-impact, low STS/low PTG. The four profiles differed based on profession, but not other demographics. Physicians were represented significantly higher in the Stress-dominant profile; nurses were highly represented in the Dialectical-impact profile. A significant difference was found when adding reported EOL care as a distinct factor with a higher relative proportion of the "dialectical" response among those reporting providing EOL care. SIGNIFICANCE OF RESULTS Findings from this study point toward the recognition and understanding of the complexity resulting from the provision of EOL care. A more complex profile classification, including the dialectical profile, may reflect a broader tendency to ways that MHP are affected by their work. Introducing "dialectical thinking" can lead to more personalized and precise intervention planning for MHP. Tailored interventions promoting personal and professional well-being, based on individual profiles, can contribute to more effective interventions and better resource utilization.
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Ausar K, Lekhak N, Candela L. Nurse spiritual self-care: A scoping review. Nurs Outlook 2021; 69:660-671. [PMID: 33750610 DOI: 10.1016/j.outlook.2021.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/20/2021] [Accepted: 01/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The health care research on spirituality has focused on patients. Less is known about the spiritual self-care of nurses who work with these patients in all types of challenging environments. Nurse spiritual self-care may be helpful in reducing workplace stress and burnout. PURPOSE The purpose of this review was to provide a comprehensive understanding of the conceptual definitions, theory and measurement of nurse spiritual self-care as reflected in the current literature. METHODS The review framework was aligned with the recommendations consistent with the Joanna Briggs Institute guidance for scoping reviews. FINDINGS Ten studies were included. Three included explicit definitions and five explicitly stated theories. Five quantitative, four qualitative, and one mixed measurement of concept were found. DISCUSSION This scoping review identified conceptualizations, theoretical frameworks, and measurements that can be foundational to future research in this area. Our paper highlights the need for further research on nurse spiritual self-care.
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Affiliation(s)
- Kweisi Ausar
- William F. Harrah College of Hospitality, University of Nevada Las Vegas, Las Vegas, NV.
| | - Nirmala Lekhak
- School of Nursing, University of Nevada Las Vegas, Las Vegas, NV.
| | - Lori Candela
- School of Nursing, University of Nevada Las Vegas, Las Vegas, NV.
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Arantzamendi M, Sapeta P, Collette N, Sesma AB, Pérez-Solero MTT, Echarri FI, Centeno C. Insight and Inner Peace in Palliative Care Professionals after an Art Therapy Workshop Focused on Personal Self-Care: A Preliminary Experience. Palliat Med Rep 2021; 2:34-39. [PMID: 34223501 PMCID: PMC8241372 DOI: 10.1089/pmr.2020.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 11/12/2022] Open
Abstract
Background: Emotional exhaustion is a problem many palliative care (PC) professionals face during their activity. Art therapy is emotionally beneficial for palliative patients who experience suffering, but its impact on professionals' experience of suffering has not been researched. Objective: To examine the immediate reactions of professionals after an art therapy workshop focused on personal self-care, also considering previously used coping strategies. Design: A four-hour art therapy workshop was designed including a generic qualitative study of participants. Participants were PC professionals and their reactions were examined using an ad hoc questionnaire with open-ended questions. Descriptive analysis of quantitative variables and thematic analysis of open-ended questions were conducted. Results: Seventeen professionals participated voluntarily. They rated the workshop positively, using words such as "calm" and "relaxation" to express the effects of the workshop, which they considered therapeutic and a source of self-awareness. For some, it allowed them to release emotions; for others, it enabled introspection and opened up a more elaborated emotional response. They thought artistic expression would be useful for their colleagues, or even for their own personal development. In the workshop, professionals opened up and explained how they face intense moments on a day-to-day basis: how they approach the situation, or how they try to control their surroundings; how they disconnect/distance themselves; and how they consider circumstances as a learning process and source of self-nurturing. Participants described art therapy as calming, healing the most intense feelings, and feeding the soul. Conclusion: Professionals reacted immediately with enthusiasm to art therapy, positively assessing its effects. Some attributed effects are in line with daily strategies of connecting with one's inner self. Others are about promoting self-awareness and inner peace, while providing healing opportunities. Art therapy may play a role in self-care for the PC professional, and should be researched further. Research Ethics Committee of the Universidad de Navarra approved the study (Number: 2019.167).
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Affiliation(s)
- María Arantzamendi
- Instituto Cultura y Sociedad (ICS), Universidad de Navarra, Grupo ATLANTES, Pamplona, España.,IdisNA-Instituto de Investigación Sanitaria de Navarra, Pamplona, España
| | - Paula Sapeta
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - Nadia Collette
- Unidad de Cuidados Paliativos, Hospital Santa Creu i Sant Pau, Barcelona, España
| | | | | | | | - Carlos Centeno
- Instituto Cultura y Sociedad (ICS), Universidad de Navarra, Grupo ATLANTES, Pamplona, España.,IdisNA-Instituto de Investigación Sanitaria de Navarra, Pamplona, España.,Departamento de Medicina Paliativa, Clínica Universidad de Navarra, Pamplona, España
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Apostol C, Cranwell K, Hitch D. Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness. BMC Palliat Care 2021; 20:2. [PMID: 33397343 PMCID: PMC7781397 DOI: 10.1186/s12904-020-00695-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 12/11/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The term 'life limiting conditions' refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition. METHODS A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for 2 years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. RESULTS One hundred three occupational therapists responded (n = 55 pre, n = 48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. CONCLUSIONS The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.
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Affiliation(s)
| | | | - Danielle Hitch
- Occupational Therapy, Western Health, Sunshine, Australia
- Occupational Therapy, Deakin University, Geelong, Australia
- Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St, Albans, Victoria 3021 Australia
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Palliative Care for Children with Lung Diseases. Respir Med 2021. [DOI: 10.1007/978-3-030-81788-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Baguley SI, Dev V, Fernando AT, Consedine NS. How Do Health Professionals Maintain Compassion Over Time? Insights From a Study of Compassion in Health. Front Psychol 2020; 11:564554. [PMID: 33447247 PMCID: PMC7802760 DOI: 10.3389/fpsyg.2020.564554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/04/2020] [Indexed: 12/30/2022] Open
Abstract
Although compassion in healthcare differs in important ways from compassion in everyday life, it provides a key, applied microcosm in which the science of compassion can be applied. Compassion is among the most important virtues in medicine, expected from medical professionals and anticipated by patients. Yet, despite evidence of its centrality to effective clinical care, research has focused on compassion fatigue or barriers to compassion and neglected to study the fact that most healthcare professionals maintain compassion for their patients. In contributing to this understudied area, the present report provides an exploratory investigation into how healthcare professionals report trying to maintain compassion. In the study, 151 professionals were asked questions about how they maintained compassion for their patients. Text responses were coded, with a complex mixture of internal vs. external, self vs. patient, and immediate vs. general strategies being reported. Exploratory analyses revealed reliable individual differences in the tendency to report strategies of particular types but no consistent age-related differences between older and younger practitioners emerged. Overall, these data suggest that while a range of compassion-maintaining strategies were reported, strategies were typically concentrated in particular areas and most professionals seek to maintain care using internal strategies. A preliminary typology of compassion maintaining strategies is proposed, study limitations and future directions are discussed, and implications for the study of how compassion is maintained are considered.
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Affiliation(s)
- Sofie I. Baguley
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Vinayak Dev
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | | | - Nathan S. Consedine
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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Mistraletti G, Gristina G, Mascarin S, Iacobone E, Giubbilo I, Bonfanti S, Fiocca F, Fullin G, Fuselli E, Bocci MG, Mazzon D, Giusti GD, Galazzi A, Negro A, De Iaco F, Gandolfo E, Lamiani G, Del Negro S, Monti L, Salvago F, Di Leo S, Gribaudi MN, Piccinni M, Riccioni L, Giannini A, Livigni S, Maglione C, Vergano M, Marinangeli F, Lovato L, Mezzetti A, Drigo E, Vegni E, Calva S, Aprile A, Losi G, Fontanella L, Calegari G, Ansaloni C, Pugliese FR, Manca S, Orsi L, Moggia F, Scelsi S, Corcione A, Petrini F. How to communicate with families living in complete isolation. BMJ Support Palliat Care 2020:bmjspcare-2020-002633. [PMID: 33060189 DOI: 10.1136/bmjspcare-2020-002633] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 12/23/2022]
Abstract
IMPORTANCE During the SARS-CoV-2 pandemic, a complete physical isolation has been worldwide introduced. The impossibility of visiting their loved ones during the hospital stay causes additional distress for families: in addition to the worries about clinical recovery, they may feel exclusion and powerlessness, anxiety, depression, mistrust in the care team and post-traumatic stress disorder. The impossibility of conducting the daily meetings with families poses a challenge for healthcare professionals. OBJECTIVE This paper aims to delineate and share consensus statements in order to enable healthcare team to provide by telephone or video calls an optimal level of communication with patient's relatives under circumstances of complete isolation. EVIDENCE REVIEW PubMed, Cochrane Database of Systematic Reviews, Database of Abstracts and Reviews of Effectiveness and the AHCPR Clinical Guidelines and Evidence Reports were explored from 1999 to 2019. Exclusion criteria were: poor or absent relevance regarding the aim of the consensus statements, studies prior to 1999, non-English language. Since the present pandemic context is completely new, unexpected and unexplored, there are not randomised controlled trials regarding clinical communication in a setting of complete isolation. Thus, a multiprofessional taskforce of physicians, nurses, psychologists and legal experts, together with some family members and former intensive care unit patients was established by four Italian national scientific societies. Using an e-Delphi methodology, general and specific questions were posed, relevant topics were argumented, until arriving to delineate position statements and practical checklist, which were set and evaluated through an evidence-based consensus procedure. FINDINGS Ten statements and two practical checklists for phone or video calls were drafted and evaluated; they are related to who, when, why and how family members must be given clinical information under circumstances of complete isolation. CONCLUSIONS AND RELEVANCE The statements and the checklists offer a structured methodology in order to ensure a good-quality communication between healthcare team and family members even in isolation, confirming that time dedicated to communication has to be intended as a time of care.
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Affiliation(s)
- Giovanni Mistraletti
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milano, Italy
- SC Anestesia e Rianimazione, Ospedale San Paolo - Polo Universitario, ASST Santi Paolo e Carlo, Milano, Italy
| | - Giuseppe Gristina
- Società Italiana Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Roma, Italy
| | - Sara Mascarin
- Educational Services for Health and Social Development, Officina Comunicativa, Treviso, Italy
| | - Emanuele Iacobone
- Department of Intensive Care and Anesthesia, Central Hospital of Macerata, Macerata, Italy
| | - Ilaria Giubbilo
- General and Neurosurgical ICU, Ospedale dell'Angelo, Aulss 3 Serenissima Veneto, Venezia, Italy
| | - Silvia Bonfanti
- Department of Palliative Care, Azienda USL di Piacenza, Piacenza, Italy
| | - Federico Fiocca
- Anestesia e Rianimazione 1, ASST Spedali Civili, Brescia, Italy
| | - Giorgio Fullin
- General and Neurosurgical ICU, Ospedale dell'Angelo, Aulss 3 Serenissima Veneto, Venezia, Italy
| | - Ennio Fuselli
- UOC Anestesia Rianimazione 1 Dip.to Emergenza Accettazione, A. O. San Camillo-Forlanini, Roma, Italy
| | - Maria Grazia Bocci
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Terapia Intensiva, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Davide Mazzon
- UOC Anestesia e Rianimazione, Ospedale di Belluno, Aulss 1 Dolomiti, Belluno, Italy
| | | | - Alessandro Galazzi
- Direction of Healthcare Professions, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Fabio De Iaco
- Emergency Department, Martini Hospital, ASL Città di Torino, Torino, Italy
| | - Enrico Gandolfo
- Emergency Department, Martini Hospital, ASL Città di Torino, Torino, Italy
| | - Giulia Lamiani
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - Silvia Del Negro
- UOC Clinical Psychology, ASST Santi Paolo e Carlo, Milano, Italy
| | - Laura Monti
- Servizio Psicologia Ospedaliera, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Fabrizia Salvago
- Dipartimento di Neuroscienze, Azienda Ospedaliera G Brotzu, Cagliari, Italy
| | - Silvia Di Leo
- Psycho-oncology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Mariassunta Piccinni
- Department of Political Science, Law and International Studies, Università degli Studi di Padova, Padova, Italy
| | | | - Alberto Giannini
- Unit of Pediatric Anesthesia and Intensive Care, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Sergio Livigni
- Department of Anesthesia and Intensive Care, San Giovanni Bosco Hospital, Torino, Italy
| | - Carla Maglione
- Società Italiana Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Napoli, Italy
| | - Marco Vergano
- Department of Anesthesia and Intensive Care, San Giovanni Bosco Hospital, Torino, Italy
| | - Franco Marinangeli
- Department of Anesthesiology and Intensive Care, University of L'Aquila, L'Aquila, Italy
| | - Luisa Lovato
- UO Anestesia e Rianimazione 1, Ospedale Santa Chiara, Trento, Italy
| | | | - Elio Drigo
- Associazione Nazionale Infermieri di Area Critica (Aniarti), Udine, Italy
| | - Elena Vegni
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
- UOC Clinical Psychology, ASST Santi Paolo e Carlo, Milano, Italy
| | - Sally Calva
- Educational Services for Health and Social Development, Officina Comunicativa, Torino, Italy
| | - Anna Aprile
- Department of Molecular Medicine, Università degli Studi di Padova, Padova, Italy
| | | | - Lucia Fontanella
- Dipartimento di Scienze del Linguaggio e Letterature moderne e comparate, Università degli Studi di Torino, Torino, Italy
| | | | | | | | - Salvatore Manca
- SC Medicina e Chirurgia di Accettazione e di Urgenza, Ospedale di Oristano, Oristano, Italy
| | - Luciano Orsi
- Società Italiana di Cure Palliative (SICP), Milano, Italy
| | - Fabrizio Moggia
- DATeR Processo Assistenziale nelle Cure Palliative, Azienda USL di Bologna, Bologna, Italy
| | - Silvia Scelsi
- Dipartimento Infermieristico e delle professioni tecnico sanitarie, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Antonio Corcione
- UOC Anestesia e TIPO, Azienda dei Colli, Ospedale Monaldi-Cotugno, Napoli, Italy
| | - Flavia Petrini
- Perioperative Medicine, Pain Therapy, ICU and Emergency Department, ASL2 - Chieti Pescara University, Chieti, Italy
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Amiel GE, Ulitzur N. Caring for the Caregivers: Mental and Spiritual Support for Healthcare Teams During the COVID-19 Pandemic and Beyond. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:839-840. [PMID: 32929697 PMCID: PMC7490205 DOI: 10.1007/s13187-020-01859-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Gilad E Amiel
- Department of Urology and the Service of Spiritual Support, RAMBAM Healthcare Campus, Haifa, Israel.
| | - Nirit Ulitzur
- Department of Urology and the Service of Spiritual Support, RAMBAM Healthcare Campus, Haifa, Israel
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Abstract
OBJECTIVE Few studies have examined burnout in psychosocial oncology clinicians. The aim of this systematic review was to summarize what is known about the prevalence and severity of burnout in psychosocial clinicians who work in oncology settings and the factors that are believed to contribute or protect against it. METHOD Articles on burnout (including compassion fatigue and secondary trauma) in psychosocial oncology clinicians were identified by searching PubMed/MEDLINE, EMBASE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Web of Science Core Collection. RESULTS Thirty-eight articles were reviewed at the full-text level, and of those, nine met study inclusion criteria. All were published between 2004 and 2018 and included data from 678 psychosocial clinicians. Quality assessment revealed relatively low risk of bias and high methodological quality. Study composition and sample size varied greatly, and the majority of clinicians were aged between 40 and 59 years. Across studies, 10 different measures were used to assess burnout, secondary traumatic stress, and compassion fatigue, in addition to factors that might impact burnout, including work engagement, meaning, and moral distress. When compared with other medical professionals, psychosocial oncology clinicians endorsed lower levels of burnout. SIGNIFICANCE OF RESULTS This systematic review suggests that psychosocial clinicians are not at increased risk of burnout compared with other health care professionals working in oncology or in mental health. Although the data are quite limited, several factors appear to be associated with less burnout in psychosocial clinicians, including exposure to patient recovery, discussing traumas, less moral distress, and finding meaning in their work. More research using standardized measures of burnout with larger samples of clinicians is needed to examine both prevalence rates and how the experience of burnout changes over time. By virtue of their training, psychosocial clinicians are well placed to support each other and their nursing and medical colleagues.
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