Health practitioners’ emotional reactions to caring for hospitalized children in Lomé, Togo: a qualitative study

Abstract

BackgroundHealth practitioners frequently encounter dying, death and suffering. While providing health care can be stressful, the literature on how different health practitioners cope with the emotional challenges associated with their work is sparse. Further, much of this literature is based on studies conducted in high-income countries. In this study, we explored emotional distress and associated coping strategies among health practitioners working in a pediatric oncology department in a large teaching hospital in Lomé, Togo.MethodsWe undertook a cross-sectional qualitative research involving in-depth interviews with 21 health practitioners (doctors, nurses, and nursing assistants) as well as facility-based observations Interview data were collected using a semi-structured discussion guide. All interviews were audio-recorded while observational notes were hand-written and ultimately typed. All data were transcribed, coded and analyzed thematically.ResultsWe found that practitioners experienced significant emotional distress. Their emotional distress was compounded by the seriousness of the illnesses they treated, the lack of appropriate medical equipment, and treatment failures that caused their patients to suffer. The health practitioners’ narratives suggested that a key reason for their emotional distress was a mismatch between their professional training and the realities of providing care in a resource-constrained setting. They also reported not receiving any training on how to cope with the emotional stresses associated with care and preventable patient deaths.ConclusionCaring for patients is a source of significant emotional distress. The emotional stress experienced by health practitioners is compounded in resource-limited settings where weak health systems undermine practitioners’ ability to provide quality care. Results underscore the need to train health professionals to positively cope with the emotional stresses associated with patient care and for health systems improvements to ensure quality care.

Emotional and Psychological Experiences of Nursing students caring for Dying Patients: A phenomenology study at Mulago National Hospital, Uganda

“…In this study students expressed anger, anxiety, fear and depression which are likely to be triggered more often during care of dying patients as nurses frequently interact with the patients. Similar to a study done in Togo [15],results from this study highlighted pressure and failure to save the dying patient could have triggered anger, anxiety and emotional distress during physical process of care of dying patients. Studies have shown that interactions with dying patients stimulate negative feelings of anxiety, stress and burnout and perceptions [16].…”

Stress among pediatric oncology staff. A systematic review

“…Although most health care providers experienced high levels of stress, no support systems were provided by the hospitals' administration systems. Health care practitioners in the study of Kpassagou and Soedje reported increased emotional distress due to the lack of training in coping with loss of a life and prolonged patient suffering (Kpassagou and Soedje, 2017). Even in cases where support was provided, only one study concluded that health care providers benefited from it with respect to their stress levels (Chang et al, 2007).…”

Are we teaching health science students in the United States what they need to know about death and dying coping strategies?

“…However, these activities and behaviors are extremely hazardous and may result in adverse outcomes. Unfortunately, these basic and essential elements of coping with the death and dying process are often never discussed with health science students [ 10 ]. Regardless of the instructional methodology, the introduction and development of death and dying education for health science students must be addressed.…”