Experiences of work-related stress and coping among palliative care staff in South Africa: a qualitative study

Abstract

Palliative care staff are exposed to a plethora of work-related stressors that negatively affect their psychological well-being and work engagement. Using qualitative interviews, this study sought to explore the experiences of work-related stress and coping among a multidisciplinary group of 12 palliative care staff employed by a non-governmental hospice in South Africa. Data were analysed using the principles of thematic analysis. Four domains of stressors were implicated in the experience of work-related stress: stressors accruing from the nature of work and were specific to palliative care; stressors relating to working in the community; those deriving from certain encounters with patients and families; and organisational stressors. Broader structural factors pertinent to the socio-political and economic context in South Africa and the perception of palliative care were interwoven with the experience of work-related stress. Receiving social support from co-workers, professionals, and family and friends; accepting limits; setting work–life boundaries; relying on personal resources and reconstructing the hospice in positive ways were coping strategies deployed by staff to manage stress. Arguably much of the experience of work-related stress and coping among palliative care staff in South Africa is similar to that reported in resource-rich contexts. However, the particularities of the broader socio-political and economic environment and its subsequent impact on palliative care organisations appear to augment and expand work-related stress for these practitioners. Deployment of intra-individual and interpersonal coping resources could be supplemented with efforts to address structural factors contributing to the subjective experience of stress.

Adaptation and continuous learning: integrative review of coping strategies of palliative care professionals

“…Of the 31 articles, 16 used qualitative methodology. Nine articles used generic qualitative designs, 30 – 38 five used grounded theory, 39 – 43 one phenomenology, 44 and the last one ethnography. 45 On the other hand, eleven studies were quantitative (descriptive and/or correlation studies), 13 , 46 – 55 , four used mixed methodology (quantitative and qualitative).…”

“…• • accept limits, as persons, and recognise the need to maintain professional boundaries, 13,32,33,37,38,40,42,43 overcome initial frustrations, 39,44 consider that it is not their fault that the patients are ill, and recognise their own limits. Coping strategies based on meaning and purpose in life were statistically related to better scores in the burnout dimensions.…”

The work stress of Chinese senior executives: Work stressors and coping strategies

“…Similarly, external counselling services can also be used to manage emotional distress resulted from the workplace (Smith et al, 2020). Overall, social coping can be facilitated by informal resources (i.e.…”

“…Surprisingly, there is only fragmented research findings about social resources (being external to organisations) and social coping in a work stress context. For instance, palliative care workers in South Africa were found to use professional counselling services more to cope with their emotional distress rather than approaching their coworkers, given the time constraint and perceived unwillingness of sharing personal concerns in the workplace (Smith et al, 2020). These palliative care workers also looked for a sense of comfort and relaxation from their families and friends through routine interactions and using humor rather than discussing details of their work because they did not want to worry their families and friends (Smith et al, 2020).…”

“…For instance, palliative care workers in South Africa were found to use professional counselling services more to cope with their emotional distress rather than approaching their coworkers, given the time constraint and perceived unwillingness of sharing personal concerns in the workplace (Smith et al, 2020). These palliative care workers also looked for a sense of comfort and relaxation from their families and friends through routine interactions and using humor rather than discussing details of their work because they did not want to worry their families and friends (Smith et al, 2020). However, a quantitative study of social workers in Israel showed no effect of social support from friends and families on reducing job burnout (Ben-Porat & Itzhaky, 2014).…”