Silence as an element of care: A meta-ethnographic review of professional caregivers’ experience in clinical and pastoral settings

Bassett, Lynn; Bingley, Amanda; Brearley, Sarah

doi:10.1177/0269216317722444

Cited by 21 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It involves letting go of ego and a shift of focus from self to other that is integral to compassionate care. 26 It is essential to preserve this silence that is on the verge of extinction in a world that lives in a hurry. The kind of silence that allows us to meditate, contemplate and feel.…”

Section: Resultsmentioning

confidence: 99%

"Silences in palliative care-the primacy of human presence "

Simões¹

2018

HPMIJ

View full text Add to dashboard Cite

Our world is very noisy. It's the shrill sound of deafening music, the unbearable screams of hysterical people, is the constant aggression to our ears coming from mobile commercial advertising, and finally, there is a foreign conspiracy, under various forms of protest, against the need for peace and stillness. The world must think. We need, everyone, to hear more. Life calls for silence and reflection. Respect the patient's silence implicit a deep respect for his personality, a sublime professional act that demonstrate the ethic of the health professional. It is, probably, in the moment of serene acceptance of death, that haunt the quiet periods of silence. The patient no longer wants explanations, is mind grasps the great truth. At such moments the health professionals should not abandon the patient. They must maintain this silence, a understanding glance, the gentle touch of hands. They must establish a better dialogue, never a empty set of words. Caring is also carefully listening, being present, sharing the silence, complicity; be challenged by the lack of words. It's welcoming. This article is based on a narrative review of the literature related with the therapeutic use of silence in end-of-life care.

show abstract

Section: Resultsmentioning

confidence: 99%

"Silences in palliative care-the primacy of human presence "

Simões¹

2018

HPMIJ

View full text Add to dashboard Cite

show abstract

“…For the clinicians who took part in this study, concepts of caring through silence—through not speaking to patients and their relatives about ECTP—emerged in the interlocking of temporal, emotional and structural resources. These deployments of silence, notably, diverged from notions of ‘silence as an element of care’,19 which posit that intentional silence in interactions between patients and clinicians can communicate compassion, understanding and respect for lived experience. The silences in which the participating clinicians engaged were intentional, but not interactional.…”

Section: Discussion: Putting Care In Contextmentioning

confidence: 99%

Caring in the silences: why physicians and surgeons do not discuss emergency care and treatment planning with their patients — an analysis of hospital-based ethnographic case studies in England

et al. 2022

View full text Add to dashboard Cite

BackgroundDespite increasing emphasis on integrating emergency care and treatment planning (ECTP) into routine medical practice, clinicians continue to delay or avoid ECTP conversations with patients. However, little is known about the clinical logics underlying barriers to ECTP conversations.ObjectiveThis study aims to develop an ethnographic account of how and why clinicians defer and avoid ECTP conversations, and how they rationalise these decisions as they happen.DesignA multisited ethnographic study.SettingMedical, orthopaedic and surgical wards in hospitals within four acute National Health Service trusts in England.ParticipantsThirty-four doctors were formally observed and 32 formally interviewed. Following an ethnographic case study approach, six cases were selected for in-depth analysis.AnalysisFieldnote data were triangulated with interview data, to develop a ‘thick description’ of each case. Using a conceptual framework of care, the analysis highlighted the clinical logics underlying these cases.ResultsThe deferral or avoidance of ECTP conversations was driven by concerns over caring well, with clinicians attempting to optimise both medical and bedside practice. Conducting an ECTP conversation carefully meant attending to patients’ and relatives’ emotions and committing sufficient time for an in-depth discussion. However, conversation plans were often disrupted by issues related to timing and time constraints, leading doctors to defer these conversations, sometimes indefinitely. Additionally, whereas surgeons and geriatricians deferred conversations because they did not have the time to offer detailed discussions, emergency and acute medicine clinicians deferred conversations because the high-turnover ward environment, combined with patients’ acute conditions, meant triaging conversations to those most in need.ConclusionOvercoming barriers to ECTP conversations is not simply a matter of enhancing training or hospital policies, but of promoting good conversational practices that take into account the affordances of hospital time and space, as well as clinicians’ understandings of caring well.

show abstract

“…However, authentic encounters require sharing silence and time. Sharing silence with someone could be a way to find peace and a moment of relief from suffering, especially in situations when words may fail (Bassett, Bingley, & Brearley, ), and might alleviate existential loneliness. Nevertheless, a shortage of time poses challenges for staff, especially in hospital care.…”

Section: Discussionmentioning

confidence: 99%

The context of care matters: Older people's existential loneliness from the perspective of healthcare professionals—A multiple case study

Sundström

Blomqvist

Edberg

et al. 2019

Int J Older People Nursing

View full text Add to dashboard Cite

Aim To explore existential loneliness among older people in different healthcare contexts from the perspective of healthcare professionals. Background Professionals meet and care for older people in most care contexts and need to be prepared to address physical, psychological, social and existential needs. Addressing existential loneliness can be both challenging and meaningful for professionals and is often not prioritised in times of austerity. Design A multiple case study design was used. Methods Focus group interviews were conducted with healthcare professionals (n = 52) in home, residential, hospital and palliative care settings. The analysis was performed in two steps: firstly, a within‐case analysis of each context was conducted, followed by a cross‐case analysis. Findings Differences and similarities were observed among the care contexts, including for the origin of existential loneliness. In home care and residential care, the focus was on life, the present and the past, compared to hospital and palliative care, in which existential loneliness mainly related to the forthcoming death. The older person's home, as the place where home care or palliative care was received, helped preserve the older person's identity. In hospital and palliative care, as in institutional care, the place offered security, while in residential care, the place could make older people feel like strangers. Creating relationships was considered an important part of the professionals’ role in all four care contexts, although this had different meanings, purposes and conditions. Conclusions The context of care matters and influences how professionals view existential loneliness among older people and the opportunities they have to address existential loneliness. Implications for practice Support for professionals must be tailored to their needs, their education levels and the context of care. Professionals need training and appropriate qualifications to address existential loneliness related to existential aspects of ageing and care.

show abstract

Silence as an element of care: A meta-ethnographic review of professional caregivers’ experience in clinical and pastoral settings

Cited by 21 publications

References 27 publications

"Silences in palliative care-the primacy of human presence "

"Silences in palliative care-the primacy of human presence "

Caring in the silences: why physicians and surgeons do not discuss emergency care and treatment planning with their patients — an analysis of hospital-based ethnographic case studies in England

The context of care matters: Older people's existential loneliness from the perspective of healthcare professionals—A multiple case study

Contact Info

Product

Resources

About