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Santos LBPAD, Alvarenga WDA, Leite ACAB, Neris RR, Lima RAGD, Montigny FD, Verdon C, Nascimento LC. Compassion Fatigue: A Comprehensive Discussion on its Development and Repercussions Among Oncology Nurses. Semin Oncol Nurs 2024:151655. [PMID: 38782693 DOI: 10.1016/j.soncn.2024.151655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/27/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES This study aimed to discuss how compassion fatigue (CF) develops and its repercussions on the personal and professional lives of oncology nurses. METHODS A discursive article, with systematic searches were performed in seven databases to find publications on CF in oncology nurses. RESULTS So as to better organize the findings, three categories were developed to present and discuss issues related to CF: (1) Characteristics of CF and its developments: describes the components related to CF and the manifestation of this phenomenon; (2) Repercussions of compassion fatigue: reports on the impact of CF on the personal and professional life of oncology nurses; and (3) Resources for dealing with compassion fatigue: lists interventions, sources of support, professional personal training, qualified nursing care in the face of adversity, and gratitude and recognition. CONCLUSION the factors that trigger or protect CF are multifactorial, with the need for collective and individual interventions as a way of helping oncology nurses to protect themselves, to avoid or manage this phenomenon. CF has a direct clinical impact on the life of the oncology nurse, causing several changes. It also indirectly impacts the patient's life clinically, as it is a phenomenon that has repercussions on the provision of care. IMPLICATIONS FOR NURSING PRACTICE CF affects the personal and professional lives of oncology nurses, so nurses need to seek resources to deal with it. Nursing staff employers and managers can use the evidence from this research to help nurses manage and protect themselves from compassion fatigue.
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Affiliation(s)
| | | | - Ana Carolina Andrade Biaggi Leite
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil; Department of Health Sciences, Public University of Navarre, Pamplona, Spain
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Gerber AK, Feuz U, Zimmermann K, Mitterer S, Simon M, von der Weid N, Bergsträsser E. Work-related quality of life in professionals involved in pediatric palliative care: a repeated cross-sectional comparative effectiveness study. Palliat Care Soc Pract 2024; 18:26323524241247857. [PMID: 38737405 PMCID: PMC11085006 DOI: 10.1177/26323524241247857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/22/2024] [Indexed: 05/14/2024] Open
Abstract
Background Working in pediatric palliative care (PPC) impacts healthcare and allied professionals' work-related quality of life (QoL). Professionals who lack specific PPC training but who regularly provide services to the affected children have articulated their need for support from specialized PPC (SPPC) teams. Objectives This study had two objectives: (1) to evaluate whether the availability of a SPPC team impacted the work-related QoL of professionals not specialized in PPC; and (2) to explore the work-related QoL of professionals working in PPC without specialized training. Design Repeated cross-sectional comparative effectiveness design. Methods One hospital with an established SPPC program and affiliated institutions provided the intervention group (IG). Three hospitals and affiliated institutions where generalist PPC was offered provided the comparison group (CG). Data were collected by paper-pencil questionnaire in 2021 and 2022. The Professional Quality of Life (ProQOL 5) questionnaire was used to assess work-related QoL, yielding separate scores for burnout (BO), secondary traumatic stress (STS) and compassion satisfaction (CS). A descriptive statistical analysis was performed and general estimation equations were modelled. To increase the comparability of the IG and CG, participants were matched by propensity scores. Results The 301 participating non-PPC-specialized professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. However, none of these scores (BO: p = 0.36; STS: p = 0.20; CS: p = 0.65) correlated significantly with support from an SPPC team. Compared to nurses, physicians showed higher levels of BO (1.70; p = 0.02) and STS (2.69; p ⩽ 0.001). Conclusion Although the study sample's overall work-related QoL was satisfactory, it showed a considerable proportion of moderate BO and STS, as well as moderate CS. To provide tailored support to professionals working in PPC, evidence regarding key SPPC support elements and their effectiveness is needed. Trial registration ClinicalTrials.gov ID, NCT04236180.
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Affiliation(s)
| | - Ursula Feuz
- Institute of Nursing Science, University of Basel, Basel, Switzerland
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Karin Zimmermann
- Institute of Nursing Science, University of Basel, Bernoullistrasse 28, Basel 4056, Switzerland
- Division of Pediatric Palliative Care and Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Stefan Mitterer
- Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Michael Simon
- Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Nicolas von der Weid
- Division of Haematology–Oncology, University Children’s Hospital beider Basel (UKBB), Basel, Switzerland
| | - Eva Bergsträsser
- Division of Pediatric Palliative Care and Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
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McNall A, Breda KL, Hinderer KA. Simulation, Storytelling, and Pediatric End-of-Life Care: A Continuing Professional Development Approach for Nurse Residents. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:220-228. [PMID: 38523331 DOI: 10.1177/27527530231194596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Background: Providing end-of-life (EOL) care to pediatric patients and their families is challenging. Newly licensed nurses, especially those working with the hematology/oncology population, have little to no experience providing the specialized care needed for the dying child. An evidence-based continuing professional development activity provided a novel approach to improve the knowledge, attitudes, and comfort levels of nurse residents related to pediatric EOL care. Method: A high-fidelity simulation module of a pediatric oncology patient at the EOL was embedded into a 12-month nurse residency program. The module employed several teaching strategies including a storytelling approach. Results: Thirteen pediatric nurse residents participated in the program. While the evidence-based intervention increased participants' EOL care knowledge, their overall attitudes, and comfort levels remained unchanged. Discussion: EOL simulation with a storytelling approach is a highly valuable method of teaching new nurses how to care for a dying patient. Additional studies are needed to explore how to increase the comfort levels of new nurses in the delicate population of pediatric hematology/oncology.
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Affiliation(s)
- Avery McNall
- Connecticut Children's, Hartford, CT, USA
- Department of Nursing, University of Hartford, West Hartford, CT, USA
| | - Karen Lucas Breda
- Department of Nursing, University of Hartford, West Hartford, CT, USA
| | - Katherine A Hinderer
- Institute for Nursing Research and Evidence-Based Practice, Connecticut Children's, Hartford, CT, USA
- School of Medicine Department of Pediatrics, University of Connecticut, Farmington, CT, USA
- School of Nursing, University of Connecticut, Storrs, CT, USA
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Soheili M, Jokar F, Eghbali-Babadi M, Taleghani F. Development and psychometric evaluation of a tool to assess oncology nurses' occupational health needs. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:146. [PMID: 38784271 PMCID: PMC11114573 DOI: 10.4103/jehp.jehp_471_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/25/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Oncology nurses are confronted with various occupational hazards; consequently, it is of great importance to identify and measure their occupational health needs. Due to the fact that standard tools are not available to assess these needs, this study was conducted to develop a tool for assessing oncology nurses' occupational health needs. MATERIALS AND METHODS This study consisted of two phases from 2020 to 2021. The first phase was item generation and tool design. The initial development of the item pool was based on the result of the qualitative study and literature search. The second phase was item reduction and psychometric evaluation of the formulated tool including, face, content, and construct validity and reliability. Construct validity was assessed using exploratory factor analysis and convergent validity with the participation of 300 oncology nurses. The reliability of the tool was assessed using internal consistency (Cronbach's alpha) and test-retest (intra-cluster correlation coefficient). RESULTS The mean content validity index (CVI) of the tool was 0.95. The results of exploratory factor analysis showed that this tool consisted of 69 items and four factors, explaining 65.88% of the variance. The results of the convergent validity assessment showed a significant positive correlation between the mean scores of occupational health needs and occupational stress (P < 0.0001 and r = 0.40). Cronbach's alpha coefficient (0.98) and tool stability (0.98) confirmed the appropriate reliability of the tool. CONCLUSION The developed tool is recommended as a valid and reliable tool for assessing oncology nurses' occupational health needs that can be used both in practice and in future studies.
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Affiliation(s)
- Mozhgan Soheili
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Jokar
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Kim B, Patterson P, White K. Supportive Communication Between Emerging Adults With Cancer and Nurses During Diagnosis and Cancer Treatment: An Exploratory Qualitative Study Using Interviews. Cancer Nurs 2024:00002820-990000000-00232. [PMID: 38527159 DOI: 10.1097/ncc.0000000000001323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND Having a cancer diagnosis during early adulthood can be a significant challenge for an individual. Nurses' supportive communication plays a vital role during the diagnosis and treatment period to lessen psychological distress and promote coping. OBJECTIVE This exploratory study aimed to examine (1) the experiences of emerging adults with cancer (EAs) aged between 18 and 25 years in communicating with nurses during diagnosis and treatment and (2) nurses' experiences of providing supportive communication with this patient group. METHODS Semistructured interviews were conducted with EAs and nurses with experience caring for this patient group. Thematic analysis was conducted, guided by interpretive hermeneutic perspectives. RESULTS Eight EA participants and 7 nurse participants participated in interviews. Five themes emerged: (1) having casual conversations with nurses helped EAs cope during cancer treatment and (2) helped EAs fulfill the need for social connectedness, (3) nurses as a different form of peer-like support, (4) nurses used themselves as a therapeutic tool to foster trust and emotional safety of EAs, and (5) nurses needed to maintain professional boundaries while being compassionate. CONCLUSIONS This study highlighted a rather underdocumented aspect of supportive communication: meeting psychosocial needs through casual, day-to-day conversations. IMPLICATIONS FOR PRACTICE Having casual conversations with nurses appeared to help EAs' psychological coping during cancer treatment. These casual conversations, which on the surface seemed clinically insignificant, fulfilled their psychosocial needs. Considering the valuable interpersonal engagement that led to emotional benefits for EAs, communication training for cancer nurses needs to build their capacity to maintain both relational and emotional boundaries.
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Affiliation(s)
- Bora Kim
- Author Affiliations: The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW (Drs Kim and White); Cancer Care Research Unit, Faculty of Medicine and Health, The University of Sydney (Drs Kim, Patterson, and White); Sydney Local Health District (Drs Kim and White); and Community First Step (Dr Patterson), Sydney, Australia
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Mohammadi F, Naderi Z, Nikrouz L, Oshvandi K, Masoumi SZ, Sabetsarvestani P, Bijani M. Ethical challenges as perceived by nurses in pediatric oncology units. Nurs Ethics 2024; 31:268-280. [PMID: 37624231 DOI: 10.1177/09697330231191278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
BACKGROUND Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses' perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated. OBJECTIVE The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran. RESEARCH DESIGN The present study is a qualitative work of research with a conventional content analysis design. Data were collected via individual semi-structured interviews. The collected data were analyzed using the qualitative content analysis method. PARTICIPANTS AND RESEARCH CONTEXT The participants were 21 nurses from pediatric oncology units in state hospitals who were selected by purposeful sampling. Sampling continued until the data were saturated. The study lasted from April to October 2022. FINDINGS Three main themes, promoting psychological safety in the children, respect for the dignity of the children, and expansion of support for families, and nine subthemes were extracted from the data. ETHICAL CONSIDERATIONS The study's protocol was approved by the Research Ethics Committee of the University of Medical Sciences and ethical principles were followed throughout the study. DISCUSSION AND CONCLUSION From the nurses' perspective, the major ethical challenges in providing ethical care in pediatric oncology units were reducing tension toward promoting the patients' psychological safety, showing respect for the identity and dignity of the children with cancer, and expanding support of the patients' families. By creating the right cultural and professional context and establishing proper protocols, healthcare policymakers and administrators can take effective steps toward eliminating the barriers to providing ethical care.
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Rawlings D, Winsall M, Yin H, Devery K. "Holding back my own emotions": Evaluation of an online education module in pediatric end-of-life care. J Child Health Care 2024; 28:116-131. [PMID: 35382602 PMCID: PMC10882946 DOI: 10.1177/13674935221076214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Providing quality end-of-life care to a child who is dying in hospital can be stressful and challenging, and health professionals often feel ill-prepared and require additional support. End-of-Life Essentials offers online education modules for health professionals working in acute hospitals, including one on end-of-life care in pediatric settings. This study aimed to evaluate this module and explore learners' views on challenges faced when caring for a dying child and their family in a hospital setting. Learners comprised nurses, doctors, and allied health professionals. A quantitative pre-/post-evaluation analysis was conducted using learner data (n = 552) on knowledge and skills gained from engagement with the module, along with a qualitative thematic content analysis on learner responses (n = 395) to a post-evaluation free-text response question, between May 2019 and May 2020. Learners' post-evaluation ranks of perceived knowledge, skill, attitude, and confidence were significantly higher than pre-evaluation ranks (p < 0.001). Effect sizes were small to medium, ranging from 0.31 to 0.38 (95% confidence intervals from 0.23 to 0.45). Emerging themes from the qualitative data were dealing with emotions, and communicating effectively. This evaluation suggests that the Pediatrics module could be a useful online learning resource for health professionals. A planned longitudinal study will further investigate practice change.
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Affiliation(s)
- Deb Rawlings
- Palliative and Supportive Services, Flinders University, Bedford Park, SA, Australia
- Research Centre for Palliative Care, Death and Dying, Flinders University, Adelaide, SA, Australia
| | - Megan Winsall
- Palliative and Supportive Services, Flinders University, Bedford Park, SA, Australia
| | - Huahua Yin
- Palliative and Supportive Services, Flinders University, Bedford Park, SA, Australia
| | - Kim Devery
- Palliative and Supportive Services, Flinders University, Bedford Park, SA, Australia
- Research Centre for Palliative Care, Death and Dying, Flinders University, Adelaide, SA, Australia
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Özsavran M, Kurt A, Ayyıldız TK, Gül Z. "A Life Slips Through Our Fingers" Experiences of Nurses Working in Pediatric Intensive Care Units About Children's Death: A Qualitative Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228231225885. [PMID: 38166543 DOI: 10.1177/00302228231225885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Caring for a dying child can be an experience full of all kinds of negative emotions, pain and stress for the pediatric nurse. In this study, which was carried out in Turkey, we aimed to determine how nurses working in a pediatric intensive care unit remembered and made sense of their experiences regarding children's deaths. In-depth interviews were held with 13 nurses. The data were analyzed using the content analysis method. Three themes were identified. These were (1) Personal effects of death, (2) Difficulties in care, and (3) Coping with death. It was clear that the nurses were traumatised by their exposure to infant deaths. The findings showed that nurses experienced regret, fatigue and posttraumatic stress disorder. In addition, it was determined that nurses should be supported to cope with child deaths, which is a complicated process involving the child and the family, especially emotionally. Moreover, providing institutional support to nurses and referring them to cognitive-behavioral therapies may make it easier for them to cope with the emotional burden they carry, as well as the burnout they experience.
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Affiliation(s)
- Musa Özsavran
- Ahmet Erdogan Vocational School of Health Services, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Aylin Kurt
- Faculty of Health Sciences, Bartın University, Bartın, Turkey
| | - Tülay Kuzlu Ayyıldız
- Faculty of Health Sciences, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Zeynep Gül
- Institute of Health Sciences, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Mathews N, Alodan K, Kuehne N, Widger K, Locke M, Fung K, Gandhi S, McLean J, Hossain A, Alexander S. Prevalence and Risk Factors for Moral Distress in Pediatric Oncology Health Care Professionals. JCO Oncol Pract 2023; 19:917-924. [PMID: 37625100 DOI: 10.1200/op.23.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/31/2023] [Accepted: 07/13/2023] [Indexed: 08/27/2023] Open
Abstract
PURPOSE Moral distress (MoD) is prevalent among health care professionals (HCPs) in oncology and is associated with burnout. The objectives of this study were to quantify MoD among pediatric oncology healthcare professionals (HCPs) at a Canadian quaternary care hospital, identify root causes, and evaluate change over time. METHODS Eligible pediatric oncology HCPs were identified, and consenting participants completed the Measure of Moral Distress-Healthcare Professionals (MMD-HP) and MoD Thermometer (MDT) at baseline, followed by biweekly MDTs over 12 weeks. RESULTS A total of 139 HCPs participated. The mean MMD-HP score was 123 ± 57.0, range 9-288. Demographic risk factors identified for elevated MMD-HP scores were female sex (female 127.1 and male 83.6, P = .01) and nursing role (nurse 136.3 and most responsible physician 85.3, P = .02). Higher MMD-HP scores were found in HCPs who were currently considering resigning because of MoD compared with those who were not (169.9 v 115.4, P < .001). Situations involving administration of treatment to children with poor prognosis cancers that was perceived to be overly aggressive were ranked as the greatest environmental contributor to MoD. Baseline and mean MDT scores over time strongly correlated with MMD-HP scores (P < .0001 and P = .0003, respectively), with mean MDT scores showing no significant fluctuation over the 12-week period. CONCLUSION MoD was common among pediatric oncology HCPs. Risk factors for elevated levels of MoD included both demographic and environmental factors. Implementation of systems to improve team communication and decision making, especially in the care of patients with poor prognosis cancers, may affect HCP MoD.
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Affiliation(s)
- Natalie Mathews
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Department of Pathology and Molecular Medicine, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Khalid Alodan
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Nathan Kuehne
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kimberley Widger
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Maria Locke
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Karen Fung
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Sheila Gandhi
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer McLean
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Alomgir Hossain
- Clinical Research Services, Hospital for Sick Children, Toronto, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Sarah Alexander
- Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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Wocial LD, Hannan A. Unmasking grief: Reflections on the complicated relationship between moral distress and grief. Semin Fetal Neonatal Med 2023; 28:101445. [PMID: 37100724 DOI: 10.1016/j.siny.2023.101445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Perinatal loss often occurs in the context of discovery of a medical condition that presents patients and healthcare providers (HCPs) with difficult choices. Treatment choices are influenced by medical technology, however inescapable prognostic uncertainty, coupled with shared decision-making can lead to ethical dilemmas (Graf et al., 2023) [1]. When patients experience perinatal loss HCPs must grapple with their own emotions. Their sense of grief arises from their empathic connection with patients, bearing witness to their grief. This grief may compound HCP moral distress. Moral distress has an element of emotion, however it is more than distress in tragic situations. Moral distress is linked to HCPs feeling responsible to take action (Dudzinski, 2016) [2]. In situations of perinatal loss, it is essential to acknowledge the grief and explore how it influences the experience of moral distress. This article will reflect on the impact of HCP grief in ethically complex situation of perinatal loss.
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Affiliation(s)
- Lucia D Wocial
- The John J. Lynch, MD Center for Ethics, Medstar Washington Hospital Center, 110 Irving St., NW, EB 3110, Washington, DC, 20010, United States.
| | - Ann Hannan
- Riley Cheer Guild and Creative Arts Therapies, Indiana University Health/Riley Children's Health, 705 Riley Hospital Drive RM 4510, Indianapolis, IN, 46202, United States.
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Yazdan R, Corey K, Messer SJ, Kim EH, Roberts KE, Selwyn PA, Weinberger AH. Hospital-Based Interventions to Address Provider Grief: A Narrative Review. J Pain Symptom Manage 2023; 66:e85-e107. [PMID: 36898638 DOI: 10.1016/j.jpainsymman.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023]
Abstract
CONTEXT Provider grief, i.e., grief related to the death of patients, often forms an ongoing and profound stressor impacting healthcare providers' ability to maintain their sense of well-being, avoid feeling overwhelmed, and sustain quality and compassionate patient care over time. OBJECTIVES This narrative review presents findings on the types of interventions hospitals have offered to physicians and nurses to address provider grief. METHODS Searches of PubMed and PsycINFO were conducted for articles (e.g., research studies, program descriptions and evaluations) focused on hospital-based interventions to help physicians and nurses cope with their own grief. RESULTS Twenty-nine articles met inclusion criteria. The most common adult clinical areas were oncology (n = 6), intensive care (n = 6), and internal medicine (n = 3), while eight articles focused on pediatric settings. Nine articles featured education interventions, including instructional education programs and critical incident debriefing sessions. Twenty articles discussed psychosocial support interventions, including emotional processing debriefing sessions, creative arts interventions, support groups, and retreats. A majority of participants reported that interventions were helpful in facilitating reflection, grieving, closure, stress relief, team cohesion, and improved end-of-life care, yet mixed results were found related to interventions' effects on reducing provider grief to a statistically significant degree. CONCLUSION Providers largely reported benefits from grief-focused interventions, yet research was sparse and evaluation methodologies were heterogenous, making it difficult to generalize findings. Given the known impact provider grief can have on the individual and organizational levels, it is important to expand providers' access to grief-focused services and to increase evidence-based research in this field.
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Affiliation(s)
- Ronit Yazdan
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA; Department of Family & Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine (R.Y., K.C., P.A.S), Bronx, New York, USA.
| | - Kristen Corey
- Department of Family & Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine (R.Y., K.C., P.A.S), Bronx, New York, USA
| | - Sylvie J Messer
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA
| | - Emily H Kim
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA
| | - Kailey E Roberts
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA
| | - Peter A Selwyn
- Department of Family & Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine (R.Y., K.C., P.A.S), Bronx, New York, USA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University (R.Y., S.J.M., E.H.K., K.E.R., A.H.W.), Bronx, New York, USA; Department of Psychiatry & Behavioral Sciences, Albert Einstein College of Medicine (A.H.W.), Bronx, New York, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine (A.H.W.), Bronx, New York, USA
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Bian W, Cheng J, Dong Y, Xue Y, Zhang Q, Zheng Q, Song R, Yang H. Experience of pediatric nurses in nursing dying children - a qualitative study. BMC Nurs 2023; 22:126. [PMID: 37072761 PMCID: PMC10111798 DOI: 10.1186/s12912-023-01274-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/27/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE To explore pediatric nurses' challenges and effective coping strategies in caring for dying children. METHODS A descriptive qualitative study was adopted. Data were collected using a semi-structured interview with ten nurses from the pediatric, pediatric emergency, and neonatology departments. RESULTS Three themes were generated: stressors, consequences, and coping strategies. Ten sub-themes were generalized: negative emotions; helplessness; questioning rescue behavior; fear of communication; lack of workforce for night rescue; compassion fatigue; burnout; changes in life attitudes; self-regulation; leadership approval and no accountability. CONCLUSIONS Through qualitative research, nurses' challenges and effective coping strategies in caring for dying children were found, which provides information for nurses' career development and related policy formulation in China. CLINICAL RELEVANCE While there are many articles in China on hospice care, there is little research on the nurses' experience of caring for dying children. Many studies have mentioned the adverse consequences of caring for dying children in foreign countries, leading to post-traumatic stress disorder (PTSD). However, domestic discussion of such problems is rare, and no corresponding coping strategies exist. This study explores pediatric nurses' challenges and effective coping strategies in caring for dying children.
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Affiliation(s)
- Weina Bian
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Junxiang Cheng
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Shanxi, 030000, China
| | - Yue Dong
- Department of ICU, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, 222000, China
| | - Ying Xue
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Qian Zhang
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Qinghua Zheng
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Rui Song
- Department of Nursing, Hanzhong Central Hospital, Shaanxi, 723000, China
| | - Hongwei Yang
- Department of Statistics, Hanzhong Central Hospital, Shaanxi, 723000, China.
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Stein J, Madni A, Moody K, Kramer D, Vaughn D, Bhatia S, Sellers J, Snyder A, Lu Z, Baker JN, Levine DR. Decreasing Burnout and Improving Work Environment: The Impact of Firgun on a Pediatric Hematopoietic Cell Transplant Team. JCO Oncol Pract 2023; 19:e365-e376. [PMID: 36538744 DOI: 10.1200/op.22.00299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Oncology teams are challenged by BO, which may be alleviated by meaningful recognition. In this study, firgun-altruistic acknowledgment-was implemented on a pediatric hematopoietic cell transplant unit to evaluate its impact on staff and work environment. METHODS In this longitudinal, mixed-methods pilot study, interdisciplinary inpatient hematopoietic cell transplant providers received web-based firgun education. Electronic administration of validated surveys occurred at baseline and 8 weeks, including Perceived Stress Scale, Professional Quality of Life Scale, Maslach Burnout Inventory, Workplace Civility Index, Areas of Work Life Survey, and WHO-5. Weekly e-mails reminded participants to practice and log firgun. Wilcoxon signed test for paired data compared pre/post results. Interviews conducted at project completion were coded using MaxQDA software. RESULTS Forty-two participants enrolled; 25 completed pre/post surveys; eight were interviewed. At study end, participants reported feeling less nervous and stressed (P = .008), and less difficulty coping (P = .01; Perceived Stress Scale), while noting increased acknowledgment of others' work (P = .04) and seeking constructive feedback (P = .04; Workplace Civility Index). Marked BO was not evident overall on the Maslach Burnout Inventory; however, emotional exhaustion subscale mean (SD) scores improved from pre (19.4 [8.6]) to post (16 [6.3; P = .02]) and individual items illustrated decreased fatigue (P = .008), frustration (P = .04), and feeling "at the end of my rope" (P = .001). Postintervention participants noted increased receipt of recognition (P = .02; Areas of Work Life Survey), decreased feeling "bogged down" (P = .02), decreased affective stress (P = .04), and negative pre-occupations (P = .04; Professional Quality of Life Scale). Qualitative analysis revealed themes of improved confidence at work and enhanced feelings of trust and teamwork. CONCLUSION Firgun is a tool that can potentially reduce BO and stress in interdisciplinary providers, facilitate teamwork, and promote positive work environments in clinical oncology and beyond.
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Affiliation(s)
- Jerry Stein
- BMT Unit, Department of Pediatric Hematology Oncology, Schneider Children's Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arshia Madni
- Department of Oncology, Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN
| | - Karen Moody
- Division of Pediatrics, Section of Palliative and Supportive Care, University of Texas, M.D. Anderson Cancer Center, Houston, TX
| | - Deborah Kramer
- School of Nursing, College of Mount Saint Vincent, Riverdale, NY
| | - Dagny Vaughn
- Department of Oncology, Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN
| | - Shalini Bhatia
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Janet Sellers
- Department of Psychosocial Services, Staff Resilience Center, St Jude Children's Research Hospital, Memphis, TN
| | - Angela Snyder
- Department of Oncology, Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN
| | - Zhaohua Lu
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Justin N Baker
- Department of Oncology, Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN
| | - Deena R Levine
- Department of Oncology, Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN
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Rahmani F, Hosseinzadeh M, Gholizadeh L. Complicated grief and related factors among nursing staff during the Covid-19 pandemic: a cross-sectional study. BMC Psychiatry 2023; 23:73. [PMID: 36703151 PMCID: PMC9879561 DOI: 10.1186/s12888-023-04562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. METHODS This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. RESULTS A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. CONCLUSION Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.
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Affiliation(s)
- Farnaz Rahmani
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mina Hosseinzadeh
- grid.412888.f0000 0001 2174 8913Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Gholizadeh
- grid.117476.20000 0004 1936 7611Faculty of Health, University of Technology, Sydney, NSW Australia
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Andersson M, Fredholm A, Nordin A, Engström Å. Moral Distress, Health and Intention to Leave: Critical Care Nurses' Perceptions During COVID-19 Pandemic. SAGE Open Nurs 2023; 9:23779608231169218. [PMID: 37089200 PMCID: PMC10116007 DOI: 10.1177/23779608231169218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/03/2023] [Accepted: 03/24/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care. Aims To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave. Method Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire. Results Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork. Conclusions Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.
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Affiliation(s)
- Maria Andersson
- Swedish Red Cross University College, Huddinge, Sweden
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden
| | - Angelica Fredholm
- County Council Värmland, Karlstad, Sweden
- Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Anna Nordin
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden
- Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Åsa Engström
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden
- Åsa Engström, Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, SE-97187 Luleå, Sweden.
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Berger RS, Wright RJ, Faith MA, Stapleton S. Compassion fatigue in pediatric hematology, oncology, and bone marrow transplant healthcare providers: An integrative review. Palliat Support Care 2022; 20:867-877. [PMID: 34852865 DOI: 10.1017/s147895152100184x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Compassion fatigue (CF), which includes burnout and secondary traumatic stress, is highly prevalent among healthcare providers (HCPs). Ultimately, if left untreated, CF is often associated with absenteeism, decreased work performance, poor job satisfaction, and providers leaving their positions. To identify risk factors for developing CF and interventions to combat it in pediatric hematology, oncology, and bone marrow transplant (PHOB) HCPs. METHODS An integrative review was conducted. Controlled vocabulary relevant to neoplasms, CF, pediatrics, and HCPs was used to search PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and Web of Science MEDLINE. Inclusion criteria were the following: English language and PHOB population. Exclusion criteria were the following: did not address question, wrong study population, mixed study population where PHOB HCPs were only part of the population, articles about moral distress as this is a similar but not the same topic as CF, conference abstracts, and book chapters. RESULTS A total of 16 articles were reviewed: 3 qualitative, 6 quantitative, 3 mixed methods, and 4 non research. Three themes were explored: (1) high-risk populations for developing CF, (2) sources of stress in PHOB HCPs, and (3) workplace interventions to decrease CF. SIGNIFICANCE OF RESULTS PHOB HCPs are at high risk of developing CF due to high morbidity and mortality in their patient population. Various interventions, including the use of a clinical support nurse, debriefing, support groups, respite rooms, and retreats, have varying degrees of efficacy to decrease CF in this population.
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Affiliation(s)
- Rebecca S Berger
- Johns Hopkins All Children's Hospital, Cancer and Blood Disorders Institute, St. Petersburg, FL
| | | | - Melissa A Faith
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, FL
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, St. Petersburg, FL
| | - Stacie Stapleton
- Johns Hopkins All Children's Hospital, Cancer and Blood Disorders Institute, St. Petersburg, FL
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Федотова Т. ПЕРЕЖИВАННЯ МОРАЛЬНОГО ДИСТРЕСУ ОСОБИСТОСТЮ: ТЕОРЕТИЧНЕ ОСМИСЛЕННЯ ПРОБЛЕМИ. PSYCHOLOGICAL PROSPECTS JOURNAL 2022. [DOI: 10.29038/2227-1376-2022-40-fed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Мета статті полягає у теоретичному аналізі проблеми морального дистресу в науковій літературі, з’ясуванні основних аспектів вивчення відповідної проблематики та встановленні особливостей прояву морального дистресу шляхом вторинного аналізу результатів емпіричних досліджень науковців.
Методи. У статті застосовано методи теоретичного вивчення наукової літератури (аналіз, синтез, узагальнення, систематизація підходів науковців) стосовно висвітлення проблеми переживання морального дистресу.
Результати. Проблеми морального дистресу в науковій літературі висвітлюється здебільшого шляхом її вивчення в ході реалізації професійної діяльності медичних працівників. Моральний дистрес розглядають як моральні страждання, які виникають в особистості в ситуації наявності знань про те, яким чином потрібно діяти, але неможливості діяти відповідно, через встановлені інституційних обмежень. Виокремлюють види морального дистресу: первинний (описують власне як моральний дистрес) та реактивний (розглядається як «моральний залишок»). Емпіричними маркерами морального дистресу є: почуття гніву, розчарування та провини, неможливість втілення морального судження в дію, невпевненість у собі, відсутність наполегливості, конформізм, уявне безсилля, відсутність критичності і розуміння ситуації тощо. Фізичними наслідками тривалого переживання морального дистресу для особистості можуть бути: безсоння, нудоту, мігрені, кишково-шлункові розлади, плаксивість та значне фізичне виснаження. В якості необхідної та/або достатньої умови переживання морального дистресу, на думку науковців, можуть виступати: моральне судження/необхідність вибору, інституційне/правове обмеження, психологічний ефект/вплив, моральний конфлікт, загроза моральної цілісності та автентичності, внутрішні обмеження та моральний клімат установи. У єдності з теорією морального дистресу розглядають теорію моральної розплати, стрижнем якої є аналіз переживання моральної розплати медсестрою: легкість, ситуативна прив’язка, вирішення та рефлексія.
Висновки. Здійснений теоретичний аналіз проблеми морального дистресу засвідчив складність та неоднозначність у визначені відповідного поняття, його показників та чинників. Теоретична розвідка означеної проблематики вказує на доцільність та важливість ґрунтованого вивчення морального дистресу з урахуванням вікового, статевого та професійного аспектів, а також актуальність та необхідність розробки програми психологічної підтримки осіб, які переживають моральний дистрес, комплексу заходів для збереження психічного здоров’я вразливих верств населення в умовах військових дій.
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Cable M, Watts T, Reagon C, Kelly D. Experiences of early‐career nurses working in specialist adolescent/young adult cancer units: A narrative inquiry. J Adv Nurs 2022. [DOI: 10.1111/jan.15488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/14/2022]
Affiliation(s)
- Maria Cable
- School of Healthcare Sciences Cardiff University Cardiff UK
| | - Tessa Watts
- School of Healthcare Sciences Cardiff University Cardiff UK
| | - Carly Reagon
- School of Healthcare Sciences Cardiff University Cardiff UK
| | - Daniel Kelly
- School of Healthcare Sciences Cardiff University Cardiff UK
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Siddique S, Bhyat F, Lewis S. The lived experiences of radiotherapists treating paediatric patients: Gauteng, South Africa. J Med Imaging Radiat Sci 2022; 53:412-419. [DOI: 10.1016/j.jmir.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/03/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022]
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Macintyre MR, Brown BWJ, Schults JA. Factors Influencing Pediatric Hematology/Oncology Nurse Retention: A Scoping Review. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:402-417. [PMID: 35815893 DOI: 10.1177/27527530221099899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Nursing staff retention is an ongoing concern within pediatric hematology/oncology settings globally. Work-related stressors cause emotional burden, psychological distress, and burnout to which nurses respond by leaving their workplace. Consequently, workplace culture and functionality are negatively impacted, quality of care reduces, and potential harm to patients increases. This paper aims to identify the "most" influencing factors for intention to leave among pediatric hematology/oncology nurses. Methods: A systematic search was undertaken on 29 July 2021 across five electronic databases, Cumulative Index to Nursing and Allied Health Literature, Joanna Briggs Institute, MEDLINE, PubMed, and Web of Science, using MeSH and keywords related to pediatric hematology/oncology nurse retention. Results: The initial search yielded 283 articles. Following abstract and full-text review, nine articles met inclusion criteria. Across all studies, strong links between health service organizational factors (e.g., unit acuity and time constraints), clinician demographics (e.g., age, education, experience, and coping mechanisms), and nursing retention within pediatric hematology/oncology settings were observed. Direct patient care and long-term relationships with pediatric hematology/oncology patients were identified as the most frequent and intense stressors, while also presenting the most rewarding aspect of the nurse's work. Discussion: Clinician burnout and retention were found to be complex and multifaceted organizational and individual issues, which most importantly evolved from accumulative exposure to specialty-specific stressors. Interventions to prevent clinician burnout and improve staff retention, therefore, need to comprise individual and organizational level strategies specific to the healthcare context.
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Affiliation(s)
| | - Brandon W J Brown
- College of Medicine and Public Health, 1065Flinders University, Bedford Park, SA, Australia
| | - Jessica A Schults
- School of Nursing and Midwifery, 5723Griffith University, Nathan, QLD, Australia.,157827Metro North Hospital and Health Service, Herston Infectious Disease Institute, Herston, QLD, Australia.,1974University of Queensland, School of Nursing, Midwifery and Social Work, Saint Lucia, QLD, Australia
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Schuster M, Berbert L, Meyer S, Dwyer PA. The Impact of Psychological Capital and Workplace Social Support on Pediatric Oncology Nurses' Post Traumatic Stress Disorder (PTSD) Symptomology. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:231-242. [PMID: 35791851 DOI: 10.1177/27527530211073737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction: Work-related post traumatic stress disorder (PTSD) can develop in nurses. Pediatric oncology nursing is a potentially high-risk subspecialty for PTSD secondary to the nature of the work. This study aimed to describe the prevalence of PTSD symptomology and explore relationships between nurse psychological capital, workplace social supports, and PTSD symptomology in pediatric oncology nurses. Methods: The study utilized a cross-sectional correlational survey design. Pediatric oncology nurses working in direct patient care in the United States completed a demographics questionnaire, Psychological Capital Questionnaire (PCQ), Coworker Support Scale, Supervisor Support Scale, and the Post traumatic Checklist for Diagnostic and Statistical Manual of Mental Disorders (PCL-5). Descriptive and inferential statistics, including logistic regression models, were used to analyze data. A cutoff score of ≥31 on the PCL-5 was used to determine the prevalence of PTSD symptomology. Results: The sample included 424 nurses. The prevalence of PTSD symptomology was 13.4%. Work setting (inpatient), decreased coworker and leadership social support, and psychological capital were independently associated with PTSD symptomology. After controlling for covariates, only psychological capital was associated with PTSD symptomology. For a 1 unit decrease in PCQ score, pediatric oncology nurses were 4.25 times more likely to have PTSD symptomology. Discussion: PTSD prevalence rates in pediatric oncology nurses are aligned with rates found in other nursing specialties. Nurse psychological capital may play a protective role against PTSD symptomology. Implications for Future Research: Findings support PTSD as a serious workplace concern for nurses. Workplace programs that foster nurses' psychological capabilities should be considered to protect against the development of PTSD symptomology.
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Affiliation(s)
- Michelle Schuster
- Inpatient Hematology/Oncology Unit, 1862Boston Children's Hospital, Boston, MA, USA
| | - Laura Berbert
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, 1862Boston Children's Hospital, Boston, MA, USA
| | - Shannon Meyer
- Cardiovascular and Critical Care, 1862Boston Children's Hospital, Boston, MA, USA
| | - Patricia A Dwyer
- Satellite Clinical Operations, 1862Boston Children's Hospital, Boston, MA, USA
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22
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McIntosh R. Improving Nursing Student Resilience Using Online Simulation and Resilience-Based Content in a Pediatric Course. J Nurs Educ 2022; 61:348-351. [PMID: 35667120 DOI: 10.3928/01484834-20220404-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND New graduate nurse job satisfaction persistently decreases at 6 months postgraduation. To prepare future nurses for career resilience, schools of nursing are implementing resilience into their curriculum. METHOD A large Midwestern school of nursing developed and instituted small group discussions, individual assignments, and online simulations to foster career resilience in a required specialty course. The course, offered in the last year of nursing school, included 93 nursing students and a comparison group of 93 nursing students. RESULTS The intervention showed an increase in Connor-Davidson Resilience Scale (CD-RISC) scores. Online simulations were useful for classroom learning, helped students discover new ways of thinking, and increased understanding of course content. Differences in simulation techniques were found, and students reported benefitting more from faculty-guided simulations than self-guided simulations. CONCLUSION Nurse educators implementing resilience simulation programs can increase new graduate nurse resilience using online simulation, which is an effective technique for teaching nursing students. [J Nurs Educ. 2022;61(6):348-351.].
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Andersson M, Nordin A, Engström Å. Critical care nurses’ perception of moral distress in intensive care during the COVID-19 pandemic – A pilot study. Intensive Crit Care Nurs 2022; 72:103279. [PMID: 35688753 PMCID: PMC9167948 DOI: 10.1016/j.iccn.2022.103279] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/01/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022]
Abstract
Objectives To describe critical care nurses’ perception of moral distress during the second year of the COVID-19 pandemic. Design/Methods A cross-sectional study involving a questionnaire was conducted. Participants responded to the Italian version of the Moral Distress Scale-Revised, which consists of 14 items divided in dimensions Futile care (three items), Ethical misconduct (five items), Deceptive communication (three items) and Poor teamwork (three items). For each item, participants were also invited to write about their experiences and participants’ intention to leave a position now was measured by a dichotomous question. The data were analysed with descriptive statistics and qualitative content analysis. The study followed the checklist (CHERRIES) for reporting results of internet surveys. Setting Critical care nurses (n = 71) working in Swedish adult intensive care units. Results Critical care nurses experienced the intensity of moral distress as the highest when no one decided to withdraw ventilator support to a hopelessly ill person (Futile care), and when they had to assist another physician or nurse who provided incompetent care (Poor teamwork). Thirty-nine percent of critical care nurses were considering leaving their current position because of moral distress. Conclusions During the COVID-19 pandemic, critical care nurses, due to their education and experience of intensive care nursing, assume tremendous responsibility for critically ill patients. Throughout, communication within the intensive care team seems to have a bearing on the degree of moral distress. Improvements in communication and teamwork are needed to reduce moral distress among critical care nurses.
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Ren Y. Effect Evaluation of Mental Nursing in Nursing of Young Cancer Patients Based on Big Data. Front Public Health 2022; 10:888183. [PMID: 35570897 PMCID: PMC9099006 DOI: 10.3389/fpubh.2022.888183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
The field of mental health nursing has always been special, dynamic, and flexible in terms of enhancing individuals' quality of life. Mental health nursing is all about caring for individuals with mental health disorders with the aim of helping them recover from illness, thereby improving their living conditions. Health Education of mental nursing emphasizes on providing special care to patients and optimally fulfills the clinical outcomes of the patients. It has been widely accepted that mental illness negatively influences the well-being of individuals, irrespective of their age, origin, demography, social status, and economic status. Young patients diagnosed with cancer report that they have a poor quality of life, as they undergo several physical and psychological needs, especially after the surgery and other cancer-related treatments. Thus, this study aims to examine the effect of mental health nursing on nursing young patients with cancer, based on the big data. Thus, the study conducts longitudinal analysis of the data gathered from the young patients with cancer, monitored by mental health nurse, with advanced practice nurse (APN) interventions. Results of the study stated that APN interventions positively impacted the physical as well as psychological needs of the research subjects. Mental nursing interventions resulted in positive clinical outcomes of the patients.
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Ventovaara P, Af Sandeberg M, Petersen G, Blomgren K, Pergert P. A cross-sectional survey of moral distress and ethical climate - Situations in paediatric oncology care that involve children's voices. Nurs Open 2022; 9:2108-2116. [PMID: 35441803 PMCID: PMC9190683 DOI: 10.1002/nop2.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/19/2022] [Accepted: 04/03/2022] [Indexed: 11/28/2022] Open
Abstract
Aim To assess experiences of morally distressing situations and perceptions of ethical climate in paediatric oncology care, with a focus on situations that involve children's voices. Design Cross‐sectional survey. Methods Registered Nurses at all four paediatric oncology centres in Denmark were asked to complete a web‐based questionnaire with Danish translations of the Swedish Moral Distress Scale‐Revised (MDS‐R) and the Swedish Hospital Ethical Climate Survey‐Shortened (HECS‐S). Data analysis included descriptive statistics and non‐parametric correlation tests. Results Nurses (n = 65) perceived morally distressing situations as rather uncommon, except for those that involved shortage of time, poor continuity of care and unsafe staffing levels. Most nurses (83%) found it disturbing to perform procedures on school‐aged children against their will, and 20% reported that they do this often. Perceptions of ethical climate were positive and healthcare professionals were perceived to be attentive to children's wishes.
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Affiliation(s)
- Päivi Ventovaara
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Paediatric Haematology and Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Margareta Af Sandeberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Paediatric Haematology and Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Gitte Petersen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Klas Blomgren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Paediatric Haematology and Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Pernilla Pergert
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Paediatric Haematology and Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Ethical and Moral Conflicts in the Nursing Care of Pediatric Patients With Cancer and Their Families. Cancer Nurs 2022:00002820-990000000-00021. [PMID: 35439199 DOI: 10.1097/ncc.0000000000001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pediatric oncology nurses encounter ethical and moral dilemmas when providing comprehensive care to pediatric patients with cancer and their families. OBJECTIVE The aim of this study was to explore ethical and moral conflicts arising in the field of pediatric oncology from the perspective of nursing professionals. METHOD This qualitative secondary analysis was conducted with 10 nursing professionals from a pediatric cancer hospital through semistructured interviews and analyzed using thematic data analysis. RESULTS Two themes emerged: (1) living with conflicts intrinsic to the relationships, which describes multiple sources of conflict in the relationships of nursing professionals with the team, with the family, and with seriously ill children, summarizing trigger-sensitive topics to be addressed for its mediation; (2) developing moral resilience, which represents how nurses reframe the conflicts and make use of strategies to avoid being personally harmful. CONCLUSIONS The results highlight the challenging work environment of pediatric oncology, recognizing the multiple natures of sensitive topics to nursing professionals during clinical decision making and the incipient strategies in dealing with ethical and moral conflicts. IMPLICATIONS FOR PRACTICE This study reveals self-reflection and intuitive strategies as protective factors, which could be applied as a step to support nurses encountering ethical and moral conflicts in pediatric oncology daily practice. Furthermore, because of the limited support services for nursing professionals, it is necessary to foresee institutional policies to embrace the development of moral resilience.
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Stokar YN, Pat-Horenczyk R. Themes of end-of-life care in memorable cases of medical health professionals: A mixed methods approach. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02566-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Whiting L, O'Grady M, Whiting M, Petty J. Factors influencing nurse retention within children's palliative care. J Child Health Care 2021; 25:587-602. [PMID: 33131297 DOI: 10.1177/1367493520971426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Retention of staff presents major challenges within children's palliative care; this has substantial implications for children, families and the nursing workforce. To address this, a programme was undertaken that provided pathways of professional development for senior nurses working in this field. This study reports the views of nurses completing this programme, the overall project manager (PM) and the day-to-day programme lead (PL) as well as factors that influence nurse retention within children's palliative care nursing. The study drew on an Appreciative Inquiry approach that comprised of interviews with the PM and PL as well as focus groups and questionnaires with senior nurses from the children's palliative care sector, who participated in the training programme. Thematic analysis of data from interviews and focus groups revealed factors influencing nurse retention: speciality, positivity and making a difference, support, provision of adequate resources, tailored education/professional development and resilience. These themes were supported by the questionnaire findings. The programme was perceived as having a positive influence on nurse retention within the children's palliative care workforce. In addition, it was felt to be very beneficial in terms of shared learning and development. Participants highlighted the need for similar opportunities in the future.
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Affiliation(s)
- Lisa Whiting
- Children's Nursing, 229434University of Hertfordshire, Hatfield, UK
| | - Michele O'Grady
- Children's Nursing, 229434University of Hertfordshire, Hatfield, UK
| | - Mark Whiting
- Children's Community and Specialist Nursing, Hertfordshire Community NHS Trust, UK
| | - Julia Petty
- Children's Nursing, 229434University of Hertfordshire, Hatfield, UK
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Zarenti M, Kressou E, Panagopoulou Z, Bacopoulou F, Kokka I, Vlachakis D, Chrousos GP, Darviri C. Stress among pediatric oncology staff. A systematic review. EMBNET.JOURNAL 2021; 26:e981. [PMID: 34840964 PMCID: PMC8623911 DOI: 10.14806/ej.26.1.981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cancer is considered one of the dominant life-threatening diseases in children. Working in the field of pediatric oncology, although rewarding, can be a source of stress and emotional burden for health care providers. The aim of this systematic review was to summarise the evidence regarding the occupational stress of health care providers working with pediatric cancer patients. Extensive search of the Pubmed and Scopus databases was performed to identify studies relevant to the topic. Initial search retrieved 657 studies. The reviewing investigators, after applying the inclusion/exclusion criteria, extracted data to critically appraise the quality of evidence. The final step of search concluded in 23 studies of heterogeneous design. Results revealed two main domains of which occupational stress derived from i) the interaction of the health care provider with the patient and the family, and ii) several organisational factors, such as hierarchical structures, experience, workload, and low organisational support. Literature on the stress of pediatric oncology staff is limited. The rather small sample sizes of the studies, the heterogeneity of methodological design, the lack of assessment from a sociological point of view, as well as the limited psychometric instruments adapted to pediatric oncology staff, make the validity of the results questionable. Further research is warranted to obtain a more accurate view of the field, to identify a cause-effect relation between work-related stress and pediatric oncology staff, and, more importantly, to guide future recommendations on support systems and stress management training within pediatric oncology settings.
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Affiliation(s)
- Maria Zarenti
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Kressou
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Zacharo Panagopoulou
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Flora Bacopoulou
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ioulia Kokka
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
- Lab of Molecular Endocrinology, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Christina Darviri
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Betriana F, Tanioka T, Yokotani T, Nakano Y, Ito H, Yasuhara Y, Zhao Y, Locsin RC. Psychometric Properties of Grief Traits and State Scale for Nurses to Measure Levels of Grief. OMEGA-JOURNAL OF DEATH AND DYING 2021:302228211036862. [PMID: 34372720 DOI: 10.1177/00302228211036862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Frequent exposure to patient deaths prompts nurses to experience grief. Unresolved grief leads to harmful consequences of nurses' mental health and quality of nursing care. A cross-sectional study using an online survey was conducted to determine the psychometric properties of the Grief traits and State Scale for Nurses. Exploratory factor analysis revealed two factors measuring the level of nurses' grief traits (Cronbach's alpha: 0.84) and two factors in grief state (Cronbach's alpha: 0.86). Nurses' feelings of unable to provide good care were associated with a higher risk of grief (odds ratio (OR): 4.30, 95% confidence interval (CI): 1.45-12.75), uncomfortable feeling toward deaths (OR: 11.29, 95%CI: 1.48-85.91), and emotional exhaustion (OR: 7.12, 95%CI: 1.63-30.99). Results indicated that the scale was reliable in determining the levels of their grief. Nurse managers can use the scale to identify their nurses' levels of grief, creating opportunities to influence the resolution of the grief experiences.
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Affiliation(s)
- Feni Betriana
- Graduate School of Health Sciences, Tokushima University, Japan
| | - Tetsuya Tanioka
- Institute of Biomedical Sciences, Tokushima University, Japan
| | - Tomoya Yokotani
- Graduate School of Health Sciences, Tokushima University, Japan
| | | | - Hirokazu Ito
- Institute of Biomedical Sciences, Tokushima University, Japan
| | - Yuko Yasuhara
- Institute of Biomedical Sciences, Tokushima University, Japan
| | - Yueren Zhao
- Department of Psychiatry, Fujita Health University, Aichi, Japan
| | - Rozzano C Locsin
- Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, United States
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Abstract
With increasing demands and diminishing nurse resources in the health care landscape today, it is even more important for health care leaders to understand the value that meaningful recognition brings to their organizations. Meaningful recognition is an integral component of a healthy work environment, supporting nurse satisfaction and the patient experience. The DAISY Award as a form of meaningful recognition for the past 21 years is an evidence-based practice used in more than 4600 health care organizations worldwide. This article discusses the evidence and provides a case study for the application of The DAISY Award as a value-added strategic tool for health care leaders and their organizations.
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Hlubocky FJ, Shanafelt TD, Back AL, Paice JA, Tetzlaff ED, Friese CR, Kamal AH, McFarland DC, Lyckholm L, Gallagher CM, Chatwal M, Saltzman J, Dudzinski D, Burke JM, James TA, Page RD, Boyle DA, Gonzalez MM, Srivastava P. Creating a Blueprint of Well-Being in Oncology: An Approach for Addressing Burnout From ASCO's Clinician Well-Being Taskforce. Am Soc Clin Oncol Educ Book 2021; 41:e339-e353. [PMID: 34061565 DOI: 10.1200/edbk_320873] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Optimizing the well-being of the oncology clinician has never been more important. Well-being is a critical priority for the cancer organization because burnout adversely impacts the quality of care, patient satisfaction, the workforce, and overall practice success. To date, 45% of U.S. ASCO member medical oncologists report experiencing burnout symptoms of emotional exhaustion and depersonalization. As the COVID-19 pandemic remains widespread with periods of outbreaks, recovery, and response with substantial personal and professional consequences for the clinician, it is imperative that the oncologist, team, and organization gain direct access to resources addressing burnout. In response, the Clinician Well-Being Task Force was created to improve the quality, safety, and value of cancer care by enhancing oncology clinician well-being and practice sustainability. Well-being is an integrative concept that characterizes quality of life and encompasses an individual's work- and personal health-related environmental, organizational, and psychosocial factors. These resources can be useful for the cancer organization to develop a well-being blueprint: a detailed start plan with recognized strategies and interventions targeting all oncology stakeholders to support a culture of community in oncology.
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Affiliation(s)
- Fay J Hlubocky
- Department of Medicine, Section of Hematology/Oncology, University of Chicago Medicine, Chicago, IL
| | | | - Anthony L Back
- Seattle Cancer Care, University of Washington, Seattle, WA
| | - Judith A Paice
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Eric D Tetzlaff
- Department of Hematology Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | | | | | - Laurie Lyckholm
- Division of Hematology Oncology, University of Iowa, Iowa City, IA
| | | | | | - Joel Saltzman
- Lake Health, University Hospitals, Seidman Cancer Center, Mentor, OH
| | | | | | - Ted A James
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Ray D Page
- The Center for Cancer and Blood Disorders, Fort Worth, TX
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Murphy JM, Chin ED, Westlake CA, Asselin M, Brisbois MD. Pediatric Hematology/Oncology Nurse Spirituality, Stress, Coping, Spiritual Well-being, and Intent to Leave: A Mixed-method Study. J Pediatr Oncol Nurs 2021; 38:349-363. [PMID: 34077278 DOI: 10.1177/10434542211011061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Intense emotional demands of oncology nursing create a stressful work environment and increase the likelihood of leaving. The study aims to explore, describe, and understand how pediatric hematology/oncology nurses caring for chronically ill or dying patients use their spirituality to cope with job stress, maintain spiritual well-being (SWB), and continue to work in this specialty. Methods: A concurrent mixed-method research design consisted of a web-based survey and interview. Data collection included demographics, intent to leave questions, and four valid and reliable research instruments measuring spirituality, stress, coping, and SWB. A responsive interview guide directed interviews. Results: Quantitative analysis (n = 130) revealed moderate to high levels of spirituality, moderate stress, coping, and SWB. Stress and SWB were weakly, inversely correlated (r = -.221, p = .011) indicating lower stress was associated with greater SWB. Coping and SWB were weakly, positively correlated (r = .248, p = .005) indicating greater coping was associated with greater SWB. An intent to leave in the next year was reported by 5.4%. Emerging themes from qualitative data (n = 22) included faith-informed or existential spirituality, work environment, and emotional/psychological stressors such as feeling overwhelmed or witnessing suffering and coping through self-care and spirituality. Dimensions of SWB included spiritually based coping and life's meaning and purpose. Intent to leave was related to the work environment or travel distance. Discussion: A nurse's spirituality offers a mechanism for coping with accumulated losses and grief encountered in clinical practice and in turn supports SWB.
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Affiliation(s)
- Jane M Murphy
- Surgical Programs, 1862Boston Children's Hospital, Boston, MA, USA
| | - Elizabeth D Chin
- College of Nursing and Health Sciences, 14709University of Massachusetts Dartmouth, Dartmouth, MA, USA
| | - Cheryl A Westlake
- 388087MemorialCare Shared Services, Fountain Valley, CA, USA.,School of Nursing, Azusa Pacific University, Azusa, CA, USA
| | - Marilyn Asselin
- College of Nursing and Health Sciences, 14709University of Massachusetts Dartmouth, Dartmouth, MA, USA
| | - Maryellen D Brisbois
- College of Nursing and Health Sciences, 14709University of Massachusetts Dartmouth, Dartmouth, MA, USA
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Schuster MA. Creating the Hematology/Oncology/Stem Cell Transplant Advancing Resiliency Team: A Nurse-Led Support Program for Hematology/Oncology/Stem Cell Transplant Staff. J Pediatr Oncol Nurs 2021; 38:331-341. [PMID: 33988484 DOI: 10.1177/10434542211011046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Burnout, moral distress, compassion fatigue, and posttraumatic stress disorder are concerns for health-care staff. Due to the high mental, physical, and emotional demands of the pediatric hematology/oncology profession, workplace supports should be in place to address the needs of the staff. A nurse-led support program is one strategy to enhance staff well-being. Methods: The Hematology/Oncology/Stem Cell Transplant Advancing Resiliency Team (HART) is a nurse-led peer-to-peer on-site support program for multidisciplinary staff caring for hematology/oncology patients. HART coaches, working 8-hour shifts, covering both day and night shift hours, are present 3 days a week on the unit. HART offers a confidential space for one on one or group interactions, educational sessions, assistance with work related, patient-care based, or personal concerns, and various forms of integrative therapies. Results: There have been over 1,100 coach consults and 98 HART shifts worked. The most commonly reported changes since HART began include staff feeling more supported by leadership and staff making time for breaks during the work shift. A 25.6% increase in staff reporting to be extremely satisfied with unit support was found. Discussion: Cultivating a culture of staff support is important. Due to COVID-19, physical HART coach presence was put on hold for 4 weeks and virtual interventions were trialed. Since its return, coach consult numbers have been steadily rising. Having a support program led by coaches with direct experience understanding the emotional toll of caring for the pediatric hematology/oncology patient population was found to be well utilized, feasible through donor funding, and measurable via staff report.
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Affiliation(s)
- Michelle A Schuster
- Department of Hematology/Oncology/Stem Cell Transplant Unit, 1862Boston Children's Hospital, Boston, MA, USA
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35
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Ventovaara P, Sandeberg MA, Räsänen J, Pergert P. Ethical climate and moral distress in paediatric oncology nursing. Nurs Ethics 2021; 28:1061-1072. [PMID: 33706607 PMCID: PMC8408826 DOI: 10.1177/0969733021994169] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Ethical climate and moral distress have been shown to affect nurses' ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. RESEARCH AIM To investigate paediatric oncology nurses' perceptions of ethical climate and moral distress. RESEARCH DESIGN In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey-Shortened and the Swedish Moral Distress Scale-Revised. Data analysis includes descriptive statistics and non-parametric analyses. RESPONDENTS AND RESEARCH CONTEXT Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. ETHICAL CONSIDERATIONS According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. RESULTS Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. DISCUSSION Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. CONCLUSION Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses.
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Affiliation(s)
| | | | | | - Pernilla Pergert
- 27106Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden
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Soheili M, Taleghani F, Jokar F, Eghbali-Babadi M, Sharifi M. Oncology Nurses' Needs Respecting Healthy Work Environment in Iran: A Descriptive Exploratory Study. Asia Pac J Oncol Nurs 2021; 8:188-196. [PMID: 33688568 PMCID: PMC7934596 DOI: 10.4103/apjon.apjon_64_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/26/2020] [Indexed: 11/26/2022] Open
Abstract
Objective: The work environment of oncology nurses is often unpleasant due to the complexities of cancer treatment and care. Yet, there is limited information about their perspectives on healthy work environment (HWE) and their HWE-related needs. This study aimed to explore oncology nurses' HWE-related needs. Methods: This descriptive exploratory qualitative study was conducted in 2018–2019. Participants were 52 nurses and 11 oncology specialists, nursing instructors and managers, and occupational and environmental health experts, who had the experience of promoting nurses' work conditions. They were recruited from eight teaching specialty cancer treatment centers in different cities of Iran (Tehran, Isfahan, Mashhad, Shiraz, and Babolsar). Data were collected via semi-structured interviews. Data were analyzed via conventional content analysis. Results: Oncology nurses' HWE-related needs were grouped into the four main categories of physical–structural improvement, mental health improvement in work environment, organizational improvement, and sociocultural improvement. Conclusions: A wide range of physical–structural, mental health, organizational, and sociocultural improvements should be made to oncology nurses' work environment in order to fulfill their HWE-related needs. Health-care managers can use the findings of the present study to create HWE for oncology nurses.
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Affiliation(s)
- Mozhgan Soheili
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Jokar
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Sharifi
- Department of Internal Medicine, School of Medicine, Cancer Prevention Research Center, Seyyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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A Pilot Study of Mindfulness-Based Cognitive Therapy to Improve Well-Being for Health Professionals Providing Chronic Disease Care. J Pediatr 2020; 224:87-93.e1. [PMID: 32417086 DOI: 10.1016/j.jpeds.2020.02.081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/22/2020] [Accepted: 02/28/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To assess the efficacy of mindfulness-based cognitive therapy delivered onsite during work hours in reducing stress and improving well-being in an interdisciplinary chronic care health care team. STUDY DESIGN A longitudinal, mixed methods, observational pilot study using a survey created from validated assessment tools to measure effectiveness of training. Surveys were completed before training, and 1 and 15 months after training. Twenty-four professionals in the cystic fibrosis Centers at Cincinnati Children's Hospital and the University of Cincinnati participated in 6 mindfulness-based cognitive therapy training sessions. Sessions incorporated mindfulness, cognitive therapy, and experiential exercises for processing feelings related to stress and burnout. RESULTS The presurvey and 1-month postsurvey responses revealed statistically significant improvements for empathy, perceived stress, depersonalization, anxiety, perspective taking, resilience, and negative affect. Sustained effects were seen at 15 months for empathy, perspective taking, and depressive symptoms. The 1-month post-training surveys reported a quarter of respondents (25%) practiced skills at least 5 times in between sessions; at 15 months, 35% reported practicing at the same frequency. Participants reported using mindfulness skills for personal stressful events (74%), work-related general stress (65%), patient-related stress (30%), sleep or general relaxation (22%), and wellness (13%). CONCLUSIONS Group mindfulness-based cognitive therapy training was feasible and effective in decreasing stress for interdisciplinary cystic fibrosis care team members who elected to participate. Further investigation is needed to determine optimal dose of training, durability of perceived benefits, and generalizability to health care professionals working with other chronic disorders.
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Weaver MS, Wiener L. Taking burnout off the backburner. Pediatr Blood Cancer 2020; 67:e28235. [PMID: 32472973 DOI: 10.1002/pbc.28235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Meaghann S Weaver
- National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - Lori Wiener
- Division of Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska
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40
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Park E, Meyer RML, Gold JI. The Role of Medical Specialization on Posttraumatic Symptoms in Pediatric Nurses. J Pediatr Nurs 2020; 53:22-28. [PMID: 32339973 DOI: 10.1016/j.pedn.2020.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Comparison of medical specialization of repeated exposure to secondary trauma and Post-Traumatic Stress Disorder (PTSD) symptoms in pediatric nurses was examined. DESIGN AND METHODS The PTSD Checklist-Civilian Version (PCL-C) was administered to 182 nurses over their first year on the job at a pediatric hospital (three time-points: baseline, 3 month follow-up, and 1 year follow-up). Demographic characteristics (age groups, gender, education, and race) and previous healthcare experience on whether nurses met criteria for no, partial, or full PTSD across all three time-points was examined. Differences in unit assignment on total PTSD symptoms and symptoms of each criterion of PTSD (re-experiencing, avoidance, and arousal) were also examined. RESULTS No significant differences of both demographic characteristics and previous healthcare experience were found on these PTSD categories. However, both ICU and Hematology/Oncology units were more at risk for developing partial and full PTSD, respectively compared to other units. Nurses in the rehabilitation units had significantly higher re-experiencing, avoidance, and arousal symptoms than those assigned to medical/surgical and intensive care units. CONCLUSIONS Results demonstrate a need for hospitals to assess why nurses from certain units are reporting more PTSD symptoms and screen for PTSD symptoms and other mental health concerns throughout their career. PRACTICE IMPLICATIONS Being aware of which units may be more at-risk should inform unit-specific prevention and intervention programs to decrease negative outcomes, including burnout, compassion fatigue, and job dissatisfaction.
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Affiliation(s)
- Elizabeth Park
- The Saban Research Institute at Children's Hospital Los Angeles, Department of Anesthesiology Critical Care Medicine, University Center of Excellence in Developmental Disabilities, United States of America
| | - Rika M L Meyer
- California State University, Northridge, Department of Child and Adolescent Development, United States of America
| | - Jeffrey I Gold
- The Saban Research Institute at Children's Hospital Los Angeles, Department of Anesthesiology Critical Care Medicine, University Center of Excellence in Developmental Disabilities, United States of America; Keck School of Medicine, Departments of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences, University of Southern California, United States of America.
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Newman AR, Linder L, Haglund K. The Nurse's Role in Prognosis-Related Communication in Pediatric Oncology Nursing Practice. J Pediatr Oncol Nurs 2019; 37:313-320. [PMID: 31833447 DOI: 10.1177/1043454219891989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The experiences of pediatric oncology nurses with prognosis-related communication (PRC) remain largely unknown. The purpose of this article is to report results of focus groups wherein 15 pediatric oncology nurses from three Midwestern pediatric cancer programs provided descriptions of PRC and how they experience PRC within their daily practice. Data from focus groups were analyzed via an interpretive descriptive approach, which resulted in three themes: (1) nurses' operational definition of PRC, (2) nurses' roles in PRC, and (3) nurses' preparation for engagement in PRC. From discussions within the focus groups, nurses recognized that PRC occurs across a continuum. Nurses distinguished that the definition of PRC expands beyond simply reporting life expectancy to describing the consequences of cancer- and treatment-related toxicities and effects. When nurses are not actively invited by their physician partners to participate in PRC, nurses will often develop workarounds to ensure that they understand what was said to patients and families. This allows them to function more effectively as supporters, advocates, and informants. Nurses described little preparation to participate in such challenging conversations. Pediatric oncology nurses need to acknowledge and embrace that they are an integral part of PRC. Interprofessional communication training is necessary to enhance the comfort and confidence of nurses engaging in PRC.
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Affiliation(s)
- Amy R Newman
- Marquette University, Milwaukee, WI, USA.,Children's Hospital of Wisconsin, Wauwatosa, WI, USA
| | - Lauri Linder
- University of Utah, Salt Lake City, UT, USA.,Primary Children's Medical Center, Salt Lake City, UT, USA
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Cherven B, Jordan D, Hale S, Wetzel M, Travers C, Smith K. Nurse-Patient Connectedness and Nurses' Professional Quality of Life: Experiences of Volunteering at a Pediatric Oncology Camp. J Pediatr Oncol Nurs 2019; 37:136-147. [PMID: 31738092 DOI: 10.1177/1043454219887671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: Pediatric oncology nurses can experience burnout, vicarious traumatization, and compassion fatigue related to the unique stressors of their profession. Opportunities to enhance nurses' professional commitment and nurse-patient connectedness may mitigate these stressors. This study explored the impact of volunteering at a local oncology camp on pediatric oncology nurses' professional quality of life and connectedness with their oncology patients. Method and Sample: Pediatric oncology nurses from a single institution were invited to participate in this mixed methods study. Participants completed a survey assessing professional quality of life, professional commitment, and patient connectedness. Nurses who had oncology camp volunteer experience were invited to participate in a qualitative interview. Results: Compared with noncamp nurses (n = 23), camp nurses (n = 25) had increased odds of a low burnout score (odds ratio = 6.74, 95% confidence interval [1.10, 41.43], p = .039) and increased odds of a high compassion satisfaction score (odds ratio = 4.69, 95% confidence interval [1.14, 19.32], p = .033). Qualitative interviews supported the impact of volunteering at camp on nurses' personal and professional perspective, nursing practice, and delivery of person-centered care. Conclusion: Volunteering at a pediatric oncology camp provided nurses the opportunity to engage with patients, share experiences, and view patients as individuals while still maintaining professional boundaries. Nurses who volunteer at camp described a perspective moving beyond patient-centered to person-centered care, and for some pediatric oncology nurses, camp volunteering may be a novel way to mitigate burnout and an important tool to enhance resiliency.
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Affiliation(s)
- Brooke Cherven
- Children's Healthcare of Atlanta, Atlanta, GA, USA.,University of Alabama, Birmingham, AL, USA
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43
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Analysis of the Risk and Protective Roles of Work-Related and Individual Variables in Burnout Syndrome in Nurses. SUSTAINABILITY 2019. [DOI: 10.3390/su11205745] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aims: Burnout syndrome is a phenomenon that is becoming ever more widespread, especially in workers such as nurses who have heavy workloads and time pressures. The progression of burnout syndrome has been shown to be related to both individual and work-related variables. The objective of this study is to examine the risk and protective roles played by work-related and personal variables, both sociodemographic and psychological, in the development of burnout in nurses. Method: The sample was composed of 1236 nurses aged between 21 and 57 years, with a mean age of 31.50 years (SD = 6.18). Women accounted for 84.5% (n = 1044), and the remaining 15.5% (n = 192) were men. Exploratory tests were performed to understand the relationships between burnout and other variables, and a binary logistic regression was conducted to understand the roles of these variables in the incidence of this syndrome. Lastly, a regression tree was constructed. Results: The results show that the sociodemographic variables examined are not related to the level of burnout in nurses. However, certain work-related variables, such as spending more time with colleagues and patients and reporting good-quality relationships, exhibit a negative relationship with the occurrence of burnout. Of the psychological variables, the stress factors conflict-social acceptance and irritability-tension-fatigue, as well as informative communication, are shown to be risk factors for the appearance of burnout in nurses. In contrast, the communication skills factor, empathy, and energy-joy exert a protective function. Conclusion: Identifying the variables that influence the occurrence of burnout syndrome and understanding the manner in which they exert their influence are key elements in the development of effective prevention and intervention of burnout in nursing.
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Hopia H, Miettinen S, Miettinen M, Heino-Tolonen T. The voice of paediatric oncology nurses: A longitudinal diary study of professional development. Eur J Oncol Nurs 2019; 42:28-35. [PMID: 31446261 DOI: 10.1016/j.ejon.2019.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/21/2019] [Accepted: 07/28/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE There is a limited amount of studies with results on professional development of paediatric oncology nurses. This study seeks to increase the understanding of the factors associated with the professional development of paediatric oncology nurses through the continuous education programme from the paediatric nurses' perspective. METHOD The descriptive, qualitative study used the text of participants' electronic diaries as data during a two-year continuing professional education programme in 2016-2018. The sample consisted of 17 paediatric oncology nurses who were working in three different university hospitals. The data were analysed with the inductive content analysis method. RESULTS Professional development is linked with a strong knowledge base in nursing, which involves the use of nursing methods and up-to-date nursing practices. Professional development is also linked with the use of medical knowledge, which manifests as a deep understanding of cancers and their treatment. CONCLUSIONS Research results show that a strong knowledge base in nursing alone is not sufficient for the professional development of paediatric oncology nurses. They also need to use their medical knowledge in order to gain an adequately deep understanding of children's cancers and their treatment. Nursing must be organised so that nurses have the opportunity to compare, share, question and argue for the methods they use with their colleagues in their own unit and other hospitals. Further research is needed on the professional development of paediatric oncology nurses and factors affecting it in order for a career development model to be created for this specific yet demanding area of nursing.
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Affiliation(s)
- Hanna Hopia
- JAMK University of Applied Sciences, School of Health and Social Studies, PL 207, FI 40100, Jyvaskyla, Finland.
| | - Seija Miettinen
- Oulu University Hospital, Department of Pediatrics and Adolescence, P.O. Box, 23, FI 90029, OYS, Finland.
| | - Merja Miettinen
- Kuopio University Hospital, P.O. Box 100, FI 70029, Kuopio, Finland.
| | - Tarja Heino-Tolonen
- Tampere University Hospital, Pediatric Department, Teiskontie 35, FI 33521, Tampere, Finland.
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Vargas Celis I, Concha Méndez CA. Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.1.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To describe the factors that influence the emergence of moral distress in oncology nurses. Methodology: integrative review of the literature whose search will be performed in Web of Science databases, CINAHL (EBSCO), Scielo, Proquest, Pubmed and PsycInfo using the keywords moral distress and oncology nursing and their similes in Spanish, without restriction for years of publication until 2017. Results: The results of this review were grouped into three groups of factors each with subgroups: 1) Organizational factors: ethical climate, evasive culture and resources for ethics delivered by the organization. 2) Particular clinical situations: pain management, information delivery, futile treatment, and assistance to the patient and their family in the process of death, 3) Interpersonal relationships: poor communication, power relations, trust in the team’s competence. Conclusion: the three factors described are triggers of moral distress in oncology nurses. When there are ethical problems and the nurses do not participate in the deliberation process, these problems can be hidden and be normalized, which can diminish the moral sensitivity of the professionals, as well as the possibility of acting as moral agents.
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Tawfik DS, Profit J, Webber S, Shanafelt TD. Organizational factors affecting physician well-being. ACTA ACUST UNITED AC 2019; 5:11-25. [PMID: 31632895 DOI: 10.1007/s40746-019-00147-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose of review Symptoms of burnout affect approximately half of pediatricians and pediatric subspecialists at any given time, with similarly concerning prevalence of other aspects of physician distress, including fatigue, depressive symptoms, and suicidal ideation. Physician well-being affects quality of care, patient satisfaction, and physician turnover. Organizational factors influence well-being, stressing the need for organizations to address this epidemic. Recent findings Organizational characteristics, policies, and culture influence physician well-being, and specific strategies may support an environment where physicians thrive. We highlight four organizational opportunities to improve physician well-being: developing leaders, cultivating community and organizational culture, improving practice efficiency, and optimizing administrative policies. Leaders play a key role in aligning organizational and individual values, promoting professional fulfillment, and fostering a culture of collegiality and social support among physicians. Reducing documentation burden and improving practice efficiency may help balance job demands and resources. Finally, reforming administrative policies may reduce work-home conflict, support physician's efforts to attend to their own well-being, and normalize use of supportive resources. Summary Physician well-being is critical to organizational success, sustainment of an adequate workforce, and optimal patient outcomes. Because burnout is primarily influenced by organizational factors, organizational interventions are key to promoting well-being. Developing supportive leadership, fostering a culture of wellness, optimizing practice efficiency, and improving administrative policies are worthy of organizational action and further research.
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Affiliation(s)
- Daniel S Tawfik
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Jochen Profit
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.,California Perinatal Quality Care Collaborative, Palo Alto, CA
| | - Sarah Webber
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Tait D Shanafelt
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
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Hopia H, Heino-Tolonen T. Families in Paediatric Oncology Nursing: Critical Incidents From the Nurses' Perspective. J Pediatr Nurs 2019; 44:e28-e35. [PMID: 30528181 DOI: 10.1016/j.pedn.2018.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Paediatric oncology nurses encounter challenges with families on a daily basis. This study explores how nurses describe significant incidents when encountering families and family members during the child's hospitalisation in the paediatric oncology unit. DESIGN AND METHODS A qualitative study with a phenomenological approach in which 17 paediatric oncology nurses from three different hospitals described critical incidents related to families. The participants' written descriptions were analysed using inductive content analysis. RESULTS The results indicate three domains where critical incidents occur: 1) Families' capability and resources, 2) parents' behaviour and 3) emotional labour in paediatric oncology nursing. CONCLUSION The results indicate that paediatric oncology nurses face situations with patients' parents that can cause them stress and uncertainty, as well as burden them emotionally. Some of the incidents dealt with difficult ethical questions. Because of the challenges that families are facing, as described in the study, nurses need to focus more on helping families identify their resources and empower themselves in order to adapt to a new situation in their lives. IMPLICATIONS The results provide important information not only for paediatric nursing but also for education and management. Since the quality of family nursing does not only depend on the competence of nurses or available resources, support from management concerning the work with families of severely sick children would be beneficial to the nurses. In addition, educational interventions need to be developed in order to strengthen the capability of nurses to successfully respond to challenging situations with families.
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Affiliation(s)
- Hanna Hopia
- JAMK University of Applied Sciences, School of Health and Social Studies, Jyvaskyla, Finland.
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48
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Kazak AE, Scialla MA, Patenaude AF, Canter K, Muriel AC, Kupst MJ, Chen FF, Wiener L. The multidisciplinary pediatric psycho-oncology workforce: A national report on supervision for staff and training opportunities. Psychooncology 2018; 27:2802-2808. [PMID: 30242934 DOI: 10.1002/pon.4892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This paper presents data on licensure/certification status, supervision of multidisciplinary pediatric psychosocial staff, and training opportunities in pediatric cancer programs in the United States, data that are critical to provide care aligned with the Standards of Psychosocial Care in Pediatric Cancer (Psychosocial Standards). METHODS An online survey of psychosocial care consistent with the Psychosocial Standards was completed from a national sample of pediatric cancer programs (144/200). Licensure/certification status, availability and format of supervision for multidisciplinary staff (social workers, psychologists, psychiatrists, child life specialists/recreational therapists), and types and number of psychosocial trainees were reported. RESULTS Nearly all pediatric psychosocial providers were licensed/certified. Peer consultation was the most frequently endorsed form of staff supervision although a sizeable group of centers reported no systematic ongoing supervision. Trainees in social work and child life were most common although the size of trainee cohorts is generally small. Psychosocial trainees are more prevalent in sites with pediatric hematology/oncology medical fellowship programs and in larger programs. CONCLUSIONS A properly trained and supported psychosocial workforce is essential to providing evidence-based care consistent with the Psychosocial Standards. Psychosocial providers are appropriately licensed. However, supervision opportunities are variable and may be inadequate for the intensity of the work. It is important to address the limited opportunities for trainees in pediatric cancer programs, which may influence the pipeline for ongoing and future work in this area.
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Affiliation(s)
- Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA.,Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Michele A Scialla
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA
| | | | - Kimberly Canter
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA.,Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Anna C Muriel
- Dana-Farber Cancer Center, Harvard Medical School, Boston, MA, USA
| | | | - Fang Fang Chen
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA.,Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Lori Wiener
- National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, MD, USA
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49
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Christian BJ. Translational Research - The Joy of Caregiving and Pediatric Nursing Practice in Providing Care for Children and their Families. J Pediatr Nurs 2018; 40:81-83. [PMID: 29685767 DOI: 10.1016/j.pedn.2018.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Becky J Christian
- School of Nursing, The University of Louisville, Louisville, KY, United States.
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