The experiences of palliative care professionals and their responses to work‐related stress: A qualitative study

Abstract

Objectives Previous qualitative research has demonstrated that palliative care professionals (PCPs) deal with a wide array of emotionally challenging issues associated with the care they provide. Although previous research has identified self‐care strategies PCPs engage in, there is a lack of focus on what responses are helpful and/or unhelpful. The aim of the current study is to understand and describe the experiences of PCPs and to explore the helpful and unhelpful responses to work‐related stress they employ. Design This was a qualitative study of the experiences of working PCPs in a hospice setting. Methods Nine semi‐structured interviews were conducted and subsequently analysed using the framework method. Results The current study revealed five overarching themes: (1) Sources of Meaning and Purpose (making a difference, personal growth), (2) Sources of Stress (emotional challenges, patient family dynamics, work environment factors, public perception, uncontrollability of symptoms), (3) Personal Impact (life engagement, perceptions of death), (4) Unhelpful Responses (self‐doubt, emotional suppression, rumination, overidentifying, lack of self‐care), and (5) Helpful Responses (acceptance, being present, perspective taking, being able to switch off, social support, active self‐care). Conclusions The experiences of PCPs can be interpreted from or directly mapped onto the psychological (in)flexibility model in Acceptance and Commitment Therapy (ACT). It is suggested that ACT training for professionals may encourage more reliable and explicit helpful responses and reduce the impact of unhelpful responses. Thus, an ACT training intervention may enhance wellbeing and effectiveness in PCPs.

Influence of Palliative Care Qualifications on the Job Stress Factors of General Practitioners in Palliative Care: A Survey Study

“…As practical implications, the need for offers for stress reduction [ 56 ] such as supervision, quality circles [ 19 ], stress management training [ 24 , 57 ], and collegial case consultation (intervision) [ 19 ] can be deduced. According to our data, especially female GPs and physicians with more professional experience can benefit from this, while access to such offers should be open to all GPs regardless of the level of qualification.…”

“…PC-related job stress factors of GPs are not well researched. Most studies about job stress factors of PC providers focus on inpatient settings and mostly but not exclusively on specialised PC facilities and wards [ 11 , 23 , 24 , 25 ]. We hypothesise that GPs with lower PC qualifications perceive PC-related job stress factors as more burdensome because they are less well trained [ 26 , 27 , 28 ].…”

Research Evaluating Staff Training Online for Resilience (RESTORE): Protocol for a single-arm feasibility study of an online Acceptance and Commitment Therapy intervention to improve staff wellbeing in palliative care settings

“…The intervention will cover key ACT processes including being present, finding purpose, perspective taking and engaging in life values (Table 1). The content has been informed by previous interventions delivered by the team for health professionals in other settings, as well as research on occupational stress, wellbeing, self-compassion and resilience in palliative care 3,15,[25][26][27][28] . The content is described in a draft manual, which will be revised and shared on the ISRCTN registry on completion of the study.…”

Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing

“…Palliative care work is generally viewed as rewarding, bringing meaning, and purpose to professional care staff. [1][2][3] However, alongside positive experiences, stress, distress and burnout are common. [4][5][6] Some stressors are typical of those identified across healthcare settings such as unmanageable workloads, shift work, staff shortages and lack of training on specific issues.…”

“…Previous research identified common responses to workplace stressors in palliative care staff including emotional suppression, over-identification with patient suffering, and neglect of self-care behaviours. 2,6 These kinds of responses are typically targetted by Acceptance and Commitment Therapy. Acceptance and Commitment Therapy is efficacious in treating stress, anxiety and depression in a broad range of populations, including occupational contexts where emotional labour is high.…”