Palliative medicine physicians: doomed to burn?

Hynes, Julia; Maffoni, Marina; Argentero, Piergiorgio; Giorgi, Inés; Giardini, Anna

doi:10.1136/bmjspcare-2018-001731

Cited by 13 publications

(15 citation statements)

References 8 publications

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“…Palliative care units are, without doubt, a challenging and demanding workplace due to the different kinds of legal, emotional, relational and institutional constraints with which healthcare professionals have to deal. 27,28 In this sensitive context, a well-established law supporting healthcare providers in the management of critical situations is of paramount importance. Italy has adopted a law on advance directive(s) only recently and the feedback from clinical practice is mandatory in order to understand how the law could be a barrier or a facilitator for the empowerment of citizens and healthcare professionals.…”

Section: Resultsmentioning

confidence: 99%

“…It might be regarded as a compass to navigate properly through complex and sensitive cases involving legal, moral and ethical issues that could potentially lead to healthcare providers' moral distress and worsening of wellness. 27,28 The Italian law was described as a legal instrument that protects both sides, enhancing the empowerment of both patient and healthcare professionals, since its aim is to protect the position of each one. For the patient, it is a solid guarantee of self-determination in accordance with both the Italian Constitution and human rights.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare professionals’ perceptions about the Italian law on advance directives

Maffoni

Argentero²,

Giorgi

et al. 2019

Nurs Ethics

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Background: In the variegated legislative framework on advance directives, the first specific regulation in Italy on this issue came into force only in 2018. Research objective: This qualitative study aimed to investigate the implications of the new Italian law on advance directives in clinical practice from the perspective of those who deal with this delicate ethical issue on an everyday basis, that is, Italian healthcare professionals. Research design: A qualitative research design using semi-structured audio-recorded interviews was adopted. The data collection and analysis were performed according to the Grounded Theory approach. Participants: Nineteen healthcare professionals (16 nurses, 3 physicians) working in a palliative care unit of a research and clinical institute in Italy. Ethical considerations: The study is part of the WeDistress HELL Project (WEllness and DISTRESS in HEalth care professionals dealing with end of Life and bioethicaL issues) approved by the Ethical Committee of ICS Maugeri - Institute of Pavia (Italy). Findings: The authors identified a main overall category, ‘Pros and Cons of the Italian law on advance directives’, composed of six constituent categories: Positive welcome, Self-determination and protection, Prompts for future betterment, Uncertainties, Lack of knowledge, and Neutrality and no suggestions. Discussion: The Italian law n. 219/2017 on advance directives was seen as a legal instrument possessing both strengths and weaknesses, but able to guarantee the patient’s self-determination and support healthcare professionals in providing care according to patients’ wishes. Conclusion: An understanding of the healthcare providers’ perspective may support the discussion on advance directives and bridge the gaps that currently persist in handling ethical issues.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Healthcare professionals’ perceptions about the Italian law on advance directives

Maffoni

Argentero²,

Giorgi

et al. 2019

Nurs Ethics

Self Cite

View full text Add to dashboard Cite

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“…( 1 , 2 , 3 , 4 ) Physician burnout has reached epidemic levels in the United States, and some of the highest levels are seen in Palliative Medicine specialists ( 5 , 6 , 7 , 8 ) who face unique stressors, including constant exposure to death and dying, and high levels of distress experienced by patients and their family members. ( 9 , 10 , 11 , 12 , 13 ) These problems are exacerbated by the rapid growth in the palliative care profession, driven by increasing demands for symptom relief, improved treatments that prolong the lives of patients with serious illnesses like cancer, and higher levels of serious and chronic disease in the aging population. ( 14 , 15 , 16 ) In healthcare, burnout is associated with increases in depression, medical errors, chemical coping, suicidal ideation, poor physical health, and many other adverse effects for personnel.…”

Section: Introductionmentioning

confidence: 99%

Empowering the Health and Well-Being of the Palliative Care Workforce: Evaluation of a Weekly Self-Care Checklist

Swan¹,

Azhar²,

Anderson³

et al. 2021

Journal of Pain and Symptom Management

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Background Workplace interventions are needed to prevent burnout and support the well-being of the palliative care workforce. Intervention We implemented a 13-item self care checklist, included in a handbook on palliative care carried in the lab coat of all clinical personnel, to remind them to care for their own well-being. Measures We conducted a survey of all palliative care clinical staff to evaluate the usefulness and feasibility of checklist items and the checklist itself. We collected demographics, perceptions of professional satisfaction and burnout, and qualitative feedback aimed at improving the checklist. Outcomes Of 39 personnel contacted, 32 (82%) responded. Most (20; 62%) found the checklist useful. Exercise was the most highly ranked item, while Watching Visual Arts was the lowest ranked item. Conclusions and Lessons Learned: Numerous opportunities were identified to improve the checklist and facilitate achievement of checklist items. Survey data will be used in the next checklist version.

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“…This exhaustion is accentuated in care contexts such as the end of life since it implies that the worker becomes involved with complex and delicate vital issues (Samson and Shvartzman, 2018; Hynes et al, 2019). Integrating the clinical, emotional, and ethical dimensions at the end of life can be very demanding for the professionals in charge of providing care.…”

Section: Introductionmentioning

confidence: 99%

Psychological well-being of palliative care professionals: Who cares?

Moreno-Milan¹,

Breitbart

Herreros

et al. 2021

Pall Supp Care

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Background Traditionally, the psychological well-being of healthcare workers has been taken for granted — it has even been considered a part of the requirements that were demanded of them. When these professionals have experienced suffering and psychological depletion, they have been held accountable for this suffering, adopting an individualistic and reductionist viewpoint focused only on the professional. This approach has become obsolete due to its proven ineffectiveness, especially from an ethics of responsibility and organization viewpoint. Context The psychological well-being of the healthcare worker (and its opposites: suffering, exhaustion, and disenchantment) is advantageous to the professional's commitment to the institution, to their work performance, and to their personal life. Objective The objective of this paper is to reflect on the psychological suffering of the palliative care professional. Method We will reflect on the three levels of responsibility that influence such suffering (micro-meso-macro-ethical; worker-environment-institution). Results We will propose a global strategy for the care of psychological well-being supported by scientific evidence and key references. Significance of results We conclude with some contributions on what we have learned and still have to learn on this topic.

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Palliative medicine physicians: doomed to burn?

Cited by 13 publications

References 8 publications

Healthcare professionals’ perceptions about the Italian law on advance directives

Healthcare professionals’ perceptions about the Italian law on advance directives

Empowering the Health and Well-Being of the Palliative Care Workforce: Evaluation of a Weekly Self-Care Checklist

Psychological well-being of palliative care professionals: Who cares?

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