Clinician distress in seriously ill patient care: A dimensional analysis

Abstract

Background: Caring for patients with serious illness may severely strain clinicians causing distress and probable poor patient outcomes. Unfortunately, clinician distress and its impact historically has received little attention. Research purpose: The purpose of this article was to investigate the nature of clinician distress. Research design: Qualitative inductive dimensional analysis. Participants and research context: After review of 577 articles from health sciences databases, a total of 33 articles were eligible for analysis. Ethical considerations: This study did not require ethical review and the authors adhered to appropriate academic standards in their analysis. Findings: A narrative of clinician distress in the hospital clinician in the United States emerged from the analysis. This included clinicians’ perceptions and sense of should or the feeling that something is awry in the clinical situation. The explanatory matrix consequence of clinician distress occurred under conditions including: the recognition of conflict, the recognition of emotion, or the recognition of a mismatch; followed by a process of an inability to feel and act according to one’s values due to a precipitating event. Discussion: This study adds three unique contributions to the concept of clinician distress by (1) including the emotional aspects of caring for seriously ill patients, (2) providing a new framework for understanding clinician distress within the clinician’s own perceptions, and (3) looking at action outside of a purely moral lens by dimensionalizing data, thereby pulling apart what has been socially constructed. Conclusion: For clinicians, learning to recognize one’s perceptions and emotional reactions is the first step in mitigating distress. There is a critical need to understand the full scope of clinician distress and its impact on the quality of patient-centered care in serious illness.

Mindfulness and compassion training on daily work with patients and within the multiprofessional palliative care team: a retrospective self-assessment study

“…This finding supports and explains the CSA Gain results, which indicate a high gain in knowledge (e.g., Item 19 with 49.4%), but a rather low gain in attitude change (e.g., Item 14 with 12.7%) and dealing with feelings of discomfort such as healthy distancing (e.g., Item 17 with 13.9%) or striving for self-care (e.g., Item 6 with 21.5%). The literature suggests that recognizing one’s own perceptions and emotional responses may be the first step in alleviating stress [ 47 ]. In order for this to be possible, knowledge is first a prerequisite, whereby handling and changes only happen subsequently.…”