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Fabiś A, Muszyński M. Strategies of coping with existential concerns in educationally active older adults. Aging Ment Health 2024:1-9. [PMID: 39097933 DOI: 10.1080/13607863.2024.2385449] [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: 03/19/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES Old age is the stage of life when people are the most vulnerable to existential experience. These concerns intensify in late adulthood when individuals become increasingly prone to reflection and inclined to evaluate their lives. The study aimed to explore how older people who are active learners dealt with their existential concerns. METHOD The study was based on the qualitative approach and grounded theory. The data collection methods were narrative interviews and semi-structured interviews. Eighteen interviews were conducted. The narrators were students of Universities of the Third Age. RESULTS An in-depth analysis of the collected empirical material revealed three themes that helped us understand how study participants differentiated their ways of dealing with self-perception of aging, effectiveness, and performing developmental tasks. This also allowed us to distinguish three main strategies educationally active older adults used to cope with existential concerns: repression, escape, and engagement. CONCLUSION The study's results indicate that confrontation or avoidance of existential problems can be perceived as a factor contributing to developing an older person's identity in two different ways. On the one hand, the readiness to face existential concerns leads to maturity in old age, a high level of social adaptation, supporting others, and, at the same time, focusing on oneself while ignoring existential concerns, which may contribute to held age identities that are younger than actual age.
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Affiliation(s)
- Artur Fabiś
- Department of Pedagogy, WSB University, Dąbrowa Górnicza, Poland
| | - Marcin Muszyński
- Department of Andragogy and Social Gerontology, University of Lodz, Łódź, Poland
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Chan WCH, Yu CTK, Leung GSM, Lin MKY, Leung MMM, Kwok DKS, Wu JKW. Developing a storybook package for bereaved siblings: a pilot study of the effectiveness for enhancing the perceived knowledge and confidence of health and social care professionals in Hong Kong. DEATH STUDIES 2024:1-12. [PMID: 38907952 DOI: 10.1080/07481187.2024.2369889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
A pilot randomized controlled trial was conducted to examine the effectiveness of a storybook package for enhancing the perceived knowledge and confidence of health and social care professionals in working with bereaved child siblings and their parents before and after the loss. Open-ended questions were asked to collect feedback, and thematic analyses were conducted to generate the themes. Quantitative findings provided preliminary but not strong evidence of its effectiveness, but qualitative findings showed that participants perceived their knowledge about supporting bereaved siblings and their parents was enhanced and considered the storybook package a useful tool for facilitating their practice. Participants also reflected on how real and specific the stories in the storybook should be. This study is the first step in developing an evidence-based practice tool for health and social care professionals. Future studies are required to further examine its effectiveness for practice.
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Affiliation(s)
- Wallace Chi Ho Chan
- Department of Social Work, Education, Community Wellbeing, Northumbria University, Newcastle Upon Tyne, UK
| | | | | | | | - Miranda Mei Mui Leung
- Retired Advanced Practice Nurse, Pediatric Palliative Care Team, Hong Kong Children's Hospital, Hong Kong, China
| | - Denis Ka Shaw Kwok
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Beserra VDS, Brito C. [Difficult situations and feelings in palliative oncology care]. CAD SAUDE PUBLICA 2024; 40:e00116823. [PMID: 38359275 PMCID: PMC10876151 DOI: 10.1590/0102-311xpt116823] [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] [Received: 06/26/2023] [Revised: 08/28/2023] [Accepted: 09/29/2023] [Indexed: 02/17/2024] Open
Abstract
The act of caring for people in pain, shortness of breath, and imminent death on a daily basis can intensify difficult situations for health professionals. However, difficult situations are rarely discussed in the services and in the professional training process. This study aimed to analyze difficult situations and feelings that emerge from healthcare. This is a phenomenological and qualitative study based on 30 difficult situations of health professionals who work exclusively in palliative oncological care. The interviews were conducted from August to February 2020. The results show that the main difficulties were motivated by identification (when the professional recognizes similarities in the patient they are caring for), a bad death (with suffering), caring for young patients, the death of a mother with a small child, and when there was a divergence between what the professional proposed and the patient's choice. There was a relationship between types of difficult situations and professional category. The professionals expressed both unpleasant feelings (sadness, impotence, anguish, fear) and pleasant feelings (compassion, gratitude). The results show that the concealment of the dying process throughout the societies' development turned it into a taboo, causing distress even in those who work in palliative care. They also show an important subjective dimension of care, usually neglected, which generates suffering, but also resignification. To properly provide care, health professionals must find meaning in the work, made possible by the modification of the their internal mindset via experience, which generates transformation, new meaning, and knowledge from praxis.
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Affiliation(s)
| | - Claudia Brito
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Chen C, Chen J. Subjective rather than objective patient death experiences link with physicians' and nurses' professional quality of life. BMC Nurs 2024; 23:41. [PMID: 38221624 PMCID: PMC10789078 DOI: 10.1186/s12912-024-01724-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/07/2024] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Patient deaths are impactful events for professional caregivers in both their professional and personal lives. The present study aims to explore how both subjective and objective patient death experiences are related to various aspects of professional quality of life (ProQOL) among physicians and nurses. METHODS Secondary analyses of cross-sectional data were conducted, and 306 Chinese physicians and nurses whose most recent patient death experience was more than one month prior were included. Objective and subjective patient death experiences were measured based on the number of past patient deaths and the Accumulated Global Changes (AGC) subscale of the Professional Bereavement Scale, respectively. ProQOL was measured with the Professional Quality of Life Scale. Regressions were run following bivariate analyses. RESULTS The number of past patient deaths was not significantly linked with any of the three ProQOL scores in either the bivariate analyses or regressions. Meanwhile, higher AGC scores were associated with higher burnout, secondary traumatic stress, and compassion satisfaction scores after participants' age, occupation (physician/nurse), department, work experience, job commitment, and sense of mission were controlled. CONCLUSION Subjective rather than objective past patient death experiences link significantly with all three aspects of physicians' and nurses' ProQOL. The more professional caregivers think that they have been changed by all past patient deaths in their career, the more they experience burnout and secondary traumatic stress, but, the more satisfied they are with their job and the helping itself.
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Affiliation(s)
- Chuqian Chen
- Department of Medical Humanities, School of Humanities, Southeast University, Tower B, Humanities Building, Jiulonghu Campus, 211189, Nanjing, China.
| | - Jieling Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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He S, Zhao H, Wang H, Chen F, Lv T, Li L, Zhang H. The mediating effects of attitude toward death and meaning of life on the relationship between perception of death and coping with death competence among Chinese nurses: a cross-sectional study. BMC Nurs 2023; 22:87. [PMID: 36997960 PMCID: PMC10060942 DOI: 10.1186/s12912-023-01245-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/11/2023] [Indexed: 03/31/2023] Open
Abstract
Abstract
Background
It is important to understand how the perception of death affects the competence to cope with death.
Objectives
To explore whether the perception of death has an indirect effect on competence to cope with death through the mediation of attitude toward death and meaning of life.
Methods
A total of 786 nurses from Hunan Province, China, selected by random sampling method and asked to complete an online electronic questionnaire between October and November 2021 were included in the study.
Results
The nurses’ scored 125.39 ± 23.88 on the competence to cope with death. There was a positive correlation among perception of death, competence to cope with death, the meaning of life, and attitude toward death. There were three mediating pathways: the separate mediating effect of natural acceptance and meaning of life, and the chain mediating effect of natural acceptance and meaning of life.
Conclusion
The nurses’ competence to cope with death was moderate. Perception of death could indirectly and positively predict nurses’ competence to cope with death by enhancing natural acceptance or sense of meaning in life. In addition, perception of death could improve natural acceptance and then enhance the sense of meaning in life to positively predict nurses’ competence to cope with death.
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Hahn S, Butler EA, Ogle K. "We are Human too.": The Challenges of Being an End-of-Life Doula. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231160900. [PMID: 36876361 DOI: 10.1177/00302228231160900] [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: 03/07/2023]
Abstract
End-of-life (EOL) doulas are emerging professionals who provide an intimate approach to the death process by focusing on the psychological, social, spiritual, and emotional needs of dying individuals. EOL doula work is stressful; it exposes individuals to recurring stressors such as suffering and grief. Trained professionals are needed to help advocate for the dying individual and their families. Despite the growing literature on EOL doulas, information regarding the challenges of being an EOL doula is underrepresented in the literature. This paper is one of the first to address this concept. Twelve in-depth, semi-structured interviews regarding the EOL doula experience were conducted as a part of a larger exploratory study. Three overarching themes emerged from the larger project: motivations to become an EOL doula, roles of an EOL doula, and challenges of an EOL doula. In this article, only challenges of EOL are discussed, along with subsequent subordinate themes.
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Affiliation(s)
- Sarah Hahn
- School of Social and Behavioral Sciences, Mercy College, Dobbs Ferry, NY, USA
| | - Emily A Butler
- Department of Psychology, Mercy College, Dobbs Ferry, NY, USA
| | - Kimberly Ogle
- A Pathway Home: Grief Support Services and End of Life Preparation, Oxford, OH, USA
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Lv T, Li L, Wang H, Zhao H, Chen F, He X, Zhang H. Relationship between Death Coping and Death Cognition and Meaning in Life among Nurses: A Cross-Sectional Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231158911. [PMID: 36803151 DOI: 10.1177/00302228231158911] [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: 02/22/2023]
Abstract
To explore nurses' ability to cope with death and its relationship with death cognition and meaning in life in the context of Chinese traditional culture. 1146 nurses from six tertiary hospitals were recruited. Participants completed the Coping with Death Scale, the Meaning in Life Questionnaire, and the self-made Death Cognition Questionnaire. Multiple regression analysis revealed that the search for meaning, the understanding of "good death", receiving education related to life-and-death, cultural aspect, the presence of meaning, and the number of patient deaths experienced in career explained 20.3% of the variance in the ability to cope with death. Lacking a correct understanding of death, nurses are not sufficiently prepared to deal with death and their ability to cope with death is influenced by the unique cognition of death and the sense of the meaning in life in the context of Chinese traditional culture.
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Affiliation(s)
- Tingting Lv
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Lezhi Li
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Huiping Wang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Hong Zhao
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Fengzhi Chen
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiachan He
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Huilin Zhang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
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Davis A, Repar P, Wilson M, De Luca E, Doutrich D, Thanasilp S. Transforming Nurse Self-Care Through Integration of Spirituality: Lessons From an International Collaboration in Palliative Care. J Transcult Nurs 2023; 34:91-99. [PMID: 36408564 DOI: 10.1177/10436596221134814] [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] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION With growing evidence of compassion fatigue and burnout in health care, it is time for a deeper look at the vital practice of self-care among professionals providing palliative care. The purpose of this study was to provide insights into ways empowerment, caring for self, environment, and building relationships impact well-being among palliative care professionals. METHODS Interpretative descriptive methods framed focus group interviews, conducted during a conference on palliative care integrative health practices held in Thailand. An interprofessional research team used inductive reasoning processes to analyze the interviews. RESULTS Three themes emerged from the four focus groups (N = 22): Buddhist Beliefs and Practices, Community-mindedness, and Empowerment. Aspects of spirituality were consistently woven into self-care practices. DISCUSSION Findings suggest that self-care can be reimagined to include highly personal and unique expressions of spirituality. Health care communities are called to integrate ritual in culturally congruent ways, thus supporting health care professionals to find new sources of meaning, enrichment, and empowerment.
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Roche N, Darzins S, Oakman J, Stuckey R. Worker Experiences of the Work Health and Safety Impacts of Exposure to Dying and Death in Clinical Settings: A Qualitative Scoping Review. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221117902. [PMID: 36476137 DOI: 10.1177/00302228221117902] [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: 12/22/2023]
Abstract
Workers employed in clinical healthcare settings often encounter dying and death of patients as a part of their role. This scoping review aimed to explore the physical and psychosocial OHS impacts on health workers exposed to death within their occupational role and their inherent coping strategies. Six electronic databases PsycINFO (Ovid), Medline (Ovid), AMED (EBSCO), CINAHL (EBSCO), and Proquest Social Sciences were searched for peer reviewed research articles published between March 1971 and April 2022. PRISMA-ScR guidelines were followed. Three authors independently assessed articles for inclusion. Fifty-three studies with focus settings in hospitals, hospice, general practice and residential care were identified. Five main themes were developed and organized using and ergonomic systems approach: Cultural Environment, Workplace, Job Demands, Impacts and Coping. The findings demonstrate that caring for dying patients, the dead and their families in clinical settings impacts workers emotionally, physically, behaviorally and spiritually.
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Affiliation(s)
- Natalie Roche
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Susan Darzins
- School of Allied Health, Australian Catholic University, Melbourne, VIC, Australia
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Rwth Stuckey
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
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Chan WCH, Yu CTK, Kwok DKS, Wan JKM. Prevalence and factors associated with demoralization in palliative care patients: A cross-sectional study from Hong Kong. Palliat Support Care 2022:1-9. [PMID: 36052852 DOI: 10.1017/s1478951522001171] [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: 11/07/2022]
Abstract
OBJECTIVES Although demoralization is common among palliative care patients, it has not yet been examined empirically in the Hong Kong Chinese context. This study aims to examine (1) the prevalence of demoralization among community-dwelling palliative care patients in Hong Kong; (2) the percentage of palliative care patients who are demoralized but not depressed and vice versa; and (3) the association of socio-demographic factors, particularly family support, with demoralization. METHOD A cross-sectional study targeting community-living palliative care patients in Hong Kong was conducted. A total of 54 patients were recruited by a local hospice and interviewed for completing a questionnaire which included measures of demoralization, depression, perceived family support, and demographic information. RESULTS The prevalence of demoralization was 64.8%. Although there was overlap between demoralization and depression (52.8% meeting the criteria of both), 7.5% of depressed patients were not demoralized, and 13.2% of demoralized patients were not depressed. Participants who were not single and had more depressive symptoms and less family support had a significantly higher demoralization level. SIGNIFICANCE OF RESULTS This is the first study which reports the prevalence of demoralization in Hong Kong. Demoralization was found common in community-living palliative care patients receiving medical social work services in Hong Kong. This study provides evidence of the importance of differentiating the constructs between demoralization and depression. It also provides an implication that those who are married, more depressed, and have the least family support could be the most vulnerable group at risk of demoralization. We recommend that early assessment of demoralization among palliative care patients be considered.
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Affiliation(s)
- Wallace Chi Ho Chan
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Clare Tsz Kiu Yu
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Denis Ka Shaw Kwok
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
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11
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Finotto S, Artioli G, Bodecchi S, Mainini C, Pedroni C, Di Leo S, Ghirotto L, Hayter M, Tanzi S. “Challenging Professional Boundaries”: A Grounded Theory Study of Health Professionals’ First Experiences of End-of-Life Care in Hospital. OMEGA-JOURNAL OF DEATH AND DYING 2022; 85:753-771. [DOI: 10.1177/0030222820954957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Little is known about health professionals first experiences of End-of-Life care in hospital. This study aims to understand the psycho-social process that occurs when hospital-based health professionals engage in caring for a dying patient for the first time. We conducted a Grounded Theory study, with 19 health professionals. Challenging professional boundaries is the core category which explains the overall process. The theoretical model we conceptualized evidenced three phases: 1) building a relationship between patient/family and professionals, 2) the disrupting impact and 3) the reaction phase. Our analysis highlighted the initial strong impact of this experience, which brought professionals to perceive emotional suffering and feelings of inadequacy. The new aspect our grounded theory revealed is that all the categories are pertinent to all the professionals involved, therefore they explain important aspects of interprofessional collaboration in End-of-Life care.
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Affiliation(s)
| | | | | | | | | | | | | | - Mark Hayter
- Faculty of Health Sciences, University of Hull, UK
| | - Silvia Tanzi
- Faculty of Health Sciences, University of Hull, UK
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12
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Sapeta P, Centeno C, Belar A, Arantzamendi M. Adaptation and continuous learning: integrative review of coping strategies of palliative care professionals. Palliat Med 2022; 36:15-29. [PMID: 34554042 PMCID: PMC8793319 DOI: 10.1177/02692163211047149] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Coping is essential to manage palliative care professionals' challenges. The focus has been on the effects of coping mechanism; however, little is known about coping itself in palliative care. AIM To synthesise evidence of coping strategies in palliative care professionals, and how different strategies play roles over time. DESIGN Systematically conducted integrative review. DATA SOURCES PubMed; CINAHL; Medline; PsycINFO and B-ON were searched (1996-2021) combining 'coping' AND 'palliative care'. A predefined data extraction sheet was developed to report data. Two researchers performed constant comparative analysis using Nvivo®. RESULTS Thirty-one studies were included. Four main strategies with recurrent reference to time were found: (a) proactive coping, involving activities to achieve self-confidence and control situations and emotions; (b) self-care based coping, including self-protection and self-awareness activities, with behavioural disconnection; (c) self-transformation coping, involving activities to accept limits; and (d) encountering deep professional meaning, is a coping mechanism based on meaning, frequently considering the deepest meaning of work. The dynamic and influencing factors were training, team interaction, professional motivation and family. They were usually protective factors, though sometimes they represented risk factors. The emotional burden associated with healthcare and systemic stressors were always risk factors. An explanatory model describes a complex and dynamic process, in which everyday strategies and more introspective strategies are combined. CONCLUSIONS The model showed a process of adaptation and learning to persevere in palliative care. It changes over time under factors and strategies, and evolves in a personal and professional transformation, parallel to the working life. It would be worth assessing coping in healthcare professionals who chose to leave palliative care and to investigate the reasons they did so and their coping mechanisms.
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Affiliation(s)
- Paula Sapeta
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - Carlos Centeno
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
- Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Alazne Belar
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
| | - María Arantzamendi
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
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Personal and Emotional Factors of Nursing Professionals Related to Coping with End-of-Life Care: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189515. [PMID: 34574439 PMCID: PMC8465186 DOI: 10.3390/ijerph18189515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 02/03/2023]
Abstract
The death of a patient can be a traumatic event, causing emotional and psychological distress in professional nurses and potentially hampering the quality of their care. Optimal self-perceived coping with death involves valuing these difficult situations as challenges and actively coping with work-related stress during the care of the dying patient. Thus, the aim of this study was to assess Spanish nurses’ self-perceived competence with patient death and investigate its relationship with their personality traits, anxiety and fear of death. A cross-sectional study based on a web-based survey was conducted. A sample of 534 Spanish nurses provided socio-demographic information and answered validated questionnaires. Most participants perceived their coping with death as optimal. Men and nurses older than 31 years coped better with death. Professionals with an optimal self-perception showed significantly lower scores on all personality dimensions evaluated, while a higher level of the anxiety trait predicted worse coping. Although with medium explanatory power, psychoticism, anxiety, and fear of death were the main predictors of the development of optimal coping with death among Spanish nurses. These characteristics together with information from the work environment and evidence-based practice could help to develop better routines and contexts of care for nurses working in end-of-life care.
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Melekis K, Weisse CS, Phillips E. Engaging Future Healthcare Professionals as Caregivers to Hospice Patients in Comfort Care Homes. OMEGA-JOURNAL OF DEATH AND DYING 2021; 87:632-648. [PMID: 34154456 DOI: 10.1177/00302228211026197] [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: 11/17/2022]
Abstract
Most people wish to die at home yet significant barriers exist in accessing care in one's home, especially for individuals with caregiver and/or housing instability. Across the U.S., residential homes for the dying are opening to address gaps in end-of-life care by recruiting community members to serve as caregivers to hospice patients during their final days. This paper describes a blended-experiential training program, informed by both an evidence-based educational framework and transformative learning theory, that trains undergraduate students to serve as surrogate family members to hospice patients in residential care homes. This study analyzed data from a sample of undergraduate students (n = 35) who participated in an 8-week program. Applying Kirkpatrick's evaluation model, study results indicate the program provided essential knowledge and skills in end-of-life care, benefiting both student learning outcomes and resident care.
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Affiliation(s)
- Kelly Melekis
- Social Work Department, Skidmore College, Saratoga Springs, New York, United States
| | - Carol S Weisse
- Psychology Department, Union College, Schenectady, New York, United States
| | - Emma Phillips
- Social Work Department, Skidmore College, Saratoga Springs, New York, United States
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15
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Fu R, Lin JLL, Jiang J, Zhou T, Pan J, Coyte PC. "Not Just Anybody Can Do It": A Qualitative Study of the Lived Experience of Inpatient Palliative Care Professionals in China's Mainland. Palliat Med Rep 2021; 2:104-112. [PMID: 34223510 PMCID: PMC8241397 DOI: 10.1089/pmr.2021.0014] [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] [Accepted: 03/29/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Over the past 5 years, China has invested substantially in palliative care programs to meet the rising demand for such services. In China's mainland, most palliative care programs are embedded within an established hospital unit, but a small subset of providers practice exclusively in a stand-alone inpatient palliative care department. Objective: To explore the lived experience of professionals at an independently operating palliative care hospital department in China's mainland. Design: We used purposive sampling to select palliative care physicians and nurses. Semistructured in-depth interviews were conducted in person. Thematic analysis was used to elicit key themes that pertained to participants' lived experience. Setting/Subjects: Ten palliative care physicians and seven nurses at the palliative medicine department in the West China Fourth Hospital of Sichuan University in Chengdu, Sichuan Province, participated in the interviews. Results: Three themes related to participants' lived experience were (1) interactions with patients and families (e.g., frequent encounters with death, communication difficulties, witnessing family struggles, and developing mutually trusting relationships); (2) factors influencing their work life (e.g., supportive working environment, unmet training needs, policy restrictions, and lack of public awareness); and (3) perceived nature of work (e.g., complex and demanding, underappreciation, encroachment of work stress into personal life, deriving accomplishment from work, and personal growth). Conclusion: This study helps fill the void in the palliative care literature regarding the lived experience of inpatient palliative care professionals in China's mainland. Our findings revealed factors influencing the well-being of palliative care professionals that are meaningful to policymakers.
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Affiliation(s)
- Rui Fu
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jia Lu Lilian Lin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jianjun Jiang
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tingting Zhou
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Assessment of professional bereavement: The development and validation of the Professional Bereavement Scale. Palliat Support Care 2021; 20:4-14. [PMID: 33729116 DOI: 10.1017/s1478951521000250] [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: 11/05/2022]
Abstract
OBJECTIVES To develop and validate Professional Bereavement Scale (PBS), a specific measurement tool for professional bereavement experiences. METHODS An online cross-sectional survey collected data from 563 physicians and nurses from urban hospitals in Mainland China. Item consistency analysis, component factor analysis, exploratory factor analysis, and confirmatory factor analysis were run to develop and validate the scale. Correlational analysis was conducted to evaluate the psychometric property of the scale. RESULTS Two subscales of the PBS were developed: the 17-item Short-term Bereavement Reactions Subscale (PBS-SBR) and the 15-item Accumulated Global Changes Subscale (PBS-AGC). Four factors, namely, frustration and trauma, guilt, grief, and being moved, are involved in PBS-SBR. Five factors are involved in PBS-AGC, which are new insights, more acceptance of limitations, more death-related anxiety, less influenced by patient deaths, and better coping with patient deaths. Both subscales have good content validity, construct validity, and criterion validity, as well as satisfactory internal consistency and split-half reliability. SIGNIFICANCE OF RESULTS PBS is a specific assessment tool for professional bereavement which is clearly defined, comprehensive, rigorously tested, and generalizable to different professional caregivers from various departments. Unveiled constructs illustrate that professional bereavement experiences contain a professional dimension in addition to a personal dimension both in an event-specific and a global perspective, which distinguishes them from familial bereavement experiences.
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17
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Affiliation(s)
- Wendy Hamood
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia
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Arantzamendi M, Sapeta P, Collette N, Sesma AB, Pérez-Solero MTT, Echarri FI, Centeno C. Insight and Inner Peace in Palliative Care Professionals after an Art Therapy Workshop Focused on Personal Self-Care: A Preliminary Experience. Palliat Med Rep 2021; 2:34-39. [PMID: 34223501 PMCID: PMC8241372 DOI: 10.1089/pmr.2020.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 11/12/2022] Open
Abstract
Background: Emotional exhaustion is a problem many palliative care (PC) professionals face during their activity. Art therapy is emotionally beneficial for palliative patients who experience suffering, but its impact on professionals' experience of suffering has not been researched. Objective: To examine the immediate reactions of professionals after an art therapy workshop focused on personal self-care, also considering previously used coping strategies. Design: A four-hour art therapy workshop was designed including a generic qualitative study of participants. Participants were PC professionals and their reactions were examined using an ad hoc questionnaire with open-ended questions. Descriptive analysis of quantitative variables and thematic analysis of open-ended questions were conducted. Results: Seventeen professionals participated voluntarily. They rated the workshop positively, using words such as "calm" and "relaxation" to express the effects of the workshop, which they considered therapeutic and a source of self-awareness. For some, it allowed them to release emotions; for others, it enabled introspection and opened up a more elaborated emotional response. They thought artistic expression would be useful for their colleagues, or even for their own personal development. In the workshop, professionals opened up and explained how they face intense moments on a day-to-day basis: how they approach the situation, or how they try to control their surroundings; how they disconnect/distance themselves; and how they consider circumstances as a learning process and source of self-nurturing. Participants described art therapy as calming, healing the most intense feelings, and feeding the soul. Conclusion: Professionals reacted immediately with enthusiasm to art therapy, positively assessing its effects. Some attributed effects are in line with daily strategies of connecting with one's inner self. Others are about promoting self-awareness and inner peace, while providing healing opportunities. Art therapy may play a role in self-care for the PC professional, and should be researched further. Research Ethics Committee of the Universidad de Navarra approved the study (Number: 2019.167).
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Affiliation(s)
- María Arantzamendi
- Instituto Cultura y Sociedad (ICS), Universidad de Navarra, Grupo ATLANTES, Pamplona, España.,IdisNA-Instituto de Investigación Sanitaria de Navarra, Pamplona, España
| | - Paula Sapeta
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - Nadia Collette
- Unidad de Cuidados Paliativos, Hospital Santa Creu i Sant Pau, Barcelona, España
| | | | | | | | - Carlos Centeno
- Instituto Cultura y Sociedad (ICS), Universidad de Navarra, Grupo ATLANTES, Pamplona, España.,IdisNA-Instituto de Investigación Sanitaria de Navarra, Pamplona, España.,Departamento de Medicina Paliativa, Clínica Universidad de Navarra, Pamplona, España
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McCallum KJ, Walthall H, Aveyard H. Self-care while undertaking qualitative nursing research. Nurse Res 2020; 28:e1741. [PMID: 33029992 DOI: 10.7748/nr.2020.e1741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Nursing research is usually carried out by registered nurses with some experience of practice. However, nurses may find that the role of the nurse researcher is very different from that of the practising clinical nurse and has its own challenges. AIM To explore the differences between the two roles and offer some guidance to nurses carrying out qualitative research, particularly research into sensitive topics. DISCUSSION Nurses need to be aware of various issues that could affect their ability to carry out nursing research and be emotionally traumatic. CONCLUSION There is a general need for greater awareness about the potential risks of carrying out qualitative research into sensitive topics. IMPLICATIONS FOR PRACTICE Nurse researchers must consider self-care when planning a research project, assessing their role, personality, background, personal experiences and stress triggers, and ensuring peer and supervisory support, reflection and a healthy lifestyle.
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Affiliation(s)
- Kay Joanne McCallum
- Oxford Brookes University, Oxford, England; Debra Jackson, professor, University of Technology Sydney, Ultimo, Australia
| | - Helen Walthall
- nursing prof doc, Oxford Brookes University, Oxford, England
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20
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Choo Hwee P, Hwee Sing K, Yong Hwang MK, Hum Yin Mei A. A Qualitative Study on the Experiences and Reflections of Junior Doctors During a Palliative Care Rotation: Perceptions of Challenges and Lessons Learnt. J Pain Symptom Manage 2020; 60:549-558.e1. [PMID: 32276094 DOI: 10.1016/j.jpainsymman.2020.03.038] [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: 12/17/2019] [Revised: 03/21/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022]
Abstract
CONTEXT Doctors caring for patients with life-limiting illness are often exposed to emotional distress. OBJECTIVES We aimed to explore the experiences and perceptions of junior doctors working full time in a palliative care rotation. We examined the lessons junior doctors learnt in managing their emotions as they face patients' death on a daily basis. METHODS We conducted a qualitative study with seven focus group discussions involving 21 junior doctors (medical officers and residents). Data were analyzed using qualitative thematic analysis to identify the themes related to the perceived challenges of these junior doctors and how they managed the struggles. Interviews were conducted with junior doctors who spent at least two months in a palliative care unit in a tertiary hospital or an inpatient hospice. RESULTS Junior doctors caring for dying patients in a palliative care rotation faced internal conflicts. Conflicting feelings arose because of differing expectations from their preconceived notions of their roles as doctors. Two main themes of internal struggles were professional distancing and emotional detachment as well as prognostic uncertainty and when to withhold and withdraw medical treatments. Coping strategies that helped included mentoring and role modeling provided by palliative care physicians, reframing their care experiences and reflection to find meaning in their work. CONCLUSION A palliative care rotation exposes junior doctors to emotionally overwhelming experiences. With proper guidance, this exposure is useful in teaching junior doctors important coping strategies, allowing learning to occur at a deeper level.
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Affiliation(s)
- Poi Choo Hwee
- Palliative Medicine Department, Tan Tock Seng Hospital, Singapore and Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore.
| | - Khoo Hwee Sing
- Health Outcomes and Medical Education Research (HOMER), National Healthcare Group, Singapore, Singapore
| | - Mervyn Koh Yong Hwang
- Palliative Medicine Department, Tan Tock Seng Hospital, Singapore and Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore
| | - Allyn Hum Yin Mei
- Palliative Medicine Department, Tan Tock Seng Hospital, Singapore and Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore
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Chan WCH, Tin AF, Yu TK. Professional quality of life, depression, and meaning in life among helping professionals: The moderating role of self-competence in death work. DEATH STUDIES 2020; 46:958-968. [PMID: 32687432 DOI: 10.1080/07481187.2020.1793431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We examined the moderating role of self-competence in death work, and the relationships of professional quality of life with personal well-being and self-competence in death work. Two hundred helping professionals (mean age = 40.43, 85.5% female) completed a questionnaire. Better professional quality of life (i.e., a higher level of compassion satisfaction and lower levels of burnout and secondary traumatic stress) was associated with better personal well-being and self-competence in death work. Self-competence in death work moderated the negative impact of a lower level of compassion satisfaction on depression. Implications on self-care of helping professionals doing death work are discussed.
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Affiliation(s)
| | - Agnes Fong Tin
- Center on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Tsz Kiu Yu
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
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22
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Chan WCH, Chan SO, Wong ALY, Ng PKL. Understanding family involvement in body donation in Hong Kong: A qualitative study of registered donors and bereaved family members. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:270-278. [PMID: 31566842 DOI: 10.1111/hsc.12861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/18/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
Encouraging the public to donate their bodies after death is crucial for anatomy teaching in medical education. In Hong Kong, success may be affected if family members override the registered donors' wish after death, and thus the role of family in body donation is worth more attention. This study aims to examine how family is involved in the process of body donation. A qualitative study was conducted in Hong Kong. Registered donors and bereaved family members were recruited from a body donation scheme organised by a medical school. In-depth interviews were done and thematic analysis was conducted. Five themes were found: (a) decision-making: individual versus family; (b) family conflicts: avoidance versus confrontation; (c) trust in family members: discuss versus do not discuss; (d) family members' struggles in implementation; (e) informed end-of-life planning. Findings revealed that donors may not necessarily discuss their decisions about body donation with family members directly. Instead, it was found that family was involved in the body donation process in different ways and to different extents. For example, donors considered family members' views about body donation, but they chose not to involve them in the discussions if they expected objections, in order to avoid conflicts. Bereaved family members considered understanding family members' body donation decisions prior to death important, and they shared the implications of body donation for funeral arrangements and the grieving process. Findings help to understand the role of the family in body donation, especially in the Hong Kong Chinese context, and may give insights into how the body donation scheme could be enhanced to facilitate better communication between registered donors and family members as well as to support bereaved family members in implementing the decision to donate.
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Affiliation(s)
- Wallace Chi Ho Chan
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Sun On Chan
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Pasu Kwai Lun Ng
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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23
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Galiana L, Oliver A, De Simone G, Linzitto JP, Benito E, Sansó N. A Brief Measure for the Assessment of Competence in Coping With Death: The Coping With Death Scale Short Version. J Pain Symptom Manage 2019; 57:209-215. [PMID: 30447381 DOI: 10.1016/j.jpainsymman.2018.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022]
Abstract
CONTEXT The coping with death competence is of great importance for palliative care professionals, who face daily exposure to death. It can keep them from suffering compassion fatigue and burnout, thus enhancing the quality of the care provided. Despite its relevance, there are only two measures of professionals' ability to cope with death. Specifically, the Coping with Death Scale (CDS) has repeatedly shown psychometric problems with some of its items. OBJECTIVE The aim of this study was to develop and validate a short version of the CDS. METHODS Nine items from the original CDS were chosen for the short version. Two cross-sectional surveys were conducted in Spanish (N = 385) and Argentinian (N = 273) palliative care professionals. The CDS and the Professional Quality of Life Scale were used in this study. Statistical analyses included two confirmatory factor analyses (CFAs), followed by a standard measurement invariance routine. Reliability estimates and evidence of validity based on relations with other measures were also gathered. RESULTS CFA models had excellent fit in both the Spanish (χ2(27) = 107.043, P < 0.001; Comparative Fit Index [CFI] = 0.978; Tucker-Lewis Index [TLI] = 0.970; Root Mean Square Error of Approximation [RMSEA] = 0.093 [0.075, 0.112]; Standardized Root Mean Square Residual = 0.030) and Argentinian (χ2(27) = 102.982, P < 0.001; CFI = 0.963; TLI = 0.950; RMSEA = 0.106 [0.085, 0.128]) samples. A standard measurement invariance routine was carried out. The most parsimonious model (χ2(117) = 191.738, P < 0.001; CFI = 0.987; TLI = 0.992; RMSEA = 0.046 [0.034, 0.058]; Standardized Root Mean Square Residual = 0.043) offered evidence of invariance across countries, with no latent mean differences. Evidence of reliability and evidence of validity based on relations with other measures were also appropriate. CONCLUSION Results indicated the psychometric boundaries of the short version of the CDS.
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Affiliation(s)
- Laura Galiana
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Amparo Oliver
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | | | | | - Enric Benito
- Department of Health Sciences, University Francisco de Vitoria, Madrid, Spain
| | - Noemí Sansó
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain.
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24
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Autocompetencia para el trabajo en final de vida. Versión española de la Self-Competence in Death Work Scale. ENFERMERIA CLINICA 2019; 29:3-9. [DOI: 10.1016/j.enfcli.2018.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 08/25/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022]
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25
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Chen C, Chow AYM, Tang S. Professional caregivers' bereavement after patients' deaths: A scoping review of quantitative studies. DEATH STUDIES 2018; 43:500-508. [PMID: 30265838 DOI: 10.1080/07481187.2018.1488775] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 04/19/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
We conducted a scoping review of quantitative studies on professional caregivers' bereavement after patients' deaths following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found 12 studies involving 1317 professional caregivers that met inclusion criteria. Professional caregivers commonly had moderate, and sometimes long-term, bereavement reactions after patients' death. The evidence of factors affecting profession grief is inconclusive. Previous researchers extensively used the framework of understanding familial bereavement for analyzing the professional caregivers' bereavement, which we found to be inadequate. We call for a clear definition of professional bereavement and the development of a specific measurement tool.
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Affiliation(s)
- Chuqian Chen
- Department of Social Work and Social Administration, The University of Hong Kong , Pokfulam , Hong Kong SAR , China
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong , Pokfulam , Hong Kong SAR , China
| | - Suqin Tang
- Department of Social Work and Social Administration, The University of Hong Kong , Pokfulam , Hong Kong SAR , China
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26
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Chen C, Chow AYM, Tang S. Bereavement process of professional caregivers after deaths of their patients: A meta-ethnographic synthesis of qualitative studies and an integrated model. Int J Nurs Stud 2018; 88:104-113. [PMID: 30227279 DOI: 10.1016/j.ijnurstu.2018.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 08/10/2018] [Accepted: 08/23/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Professional caregivers bereave after patients' deaths. Such bereavement can exert considerable influences on huge numbers of professional caregivers and their clients. No study, however, has synthesized scattered evidence on the core process of such bereavement, and no corresponding model exists. AIM To systematically review and synthesize the experience of bereavement after patients' deaths, and in particular, its core process, in professional caregivers' own descriptions in existing literature, and to propose an integrated model on that basis. DESIGN A review was conducted following Enhancing Transparency in Reporting the Synthesis of Qualitative Research Statement (ENTREQ). DATA SOURCE CINAHL Plus, PubMed, PsycINFO, Scopus, Embase, and Web of Science were searched in April 2018 with keywords as combinations of "professional caregiver" and "bereavement". References of eligible studies from pre-planned searches were manually screened. REVIEW METHODS Full-text and English-written qualitative studies published in peer-reviewed journals in or after 1980 were included. Their qualities were assessed by two of the authors independently. Meta-ethnography was employed to synthesize findings from previous studies. RESULTS Twenty-three studies met the inclusion criteria, the majority conducted in Western and developed regions of the world. Three core concepts were identified in the core professional bereavement process: (1) perceived nature of patients' deaths; (2) bereavement reactions; (3) accumulated changes. Each concept consists of both a personal dimension and a professional dimension. Risk and protective factors and coping methods were unveiled to influence the core process. An integrated, process-oriented and multi-dimensional model was proposed on the basis of these findings. CONCLUSIONS Patients' deaths are significant events for professional caregivers, and they bring both personal and professional, both temporal and long-lasting impacts. Professional bereavement is distinctive from familial bereavement and deserves serious attention for its own sake. Attention, acknowledgment, and in-time support must be given to professional caregivers when they encounter patients' deaths.
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Affiliation(s)
- Chuqian Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Suqin Tang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
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27
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Chan WCH, Wong KLY, Leung MMM, Lin MKY. Perceived challenges in pediatric palliative care among doctors and nurses in Hong Kong. DEATH STUDIES 2018; 43:372-380. [PMID: 30015574 DOI: 10.1080/07481187.2018.1478912] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/05/2018] [Accepted: 04/08/2018] [Indexed: 06/08/2023]
Abstract
This study aims to examine perceived challenges, including knowledge, skills, self, and work environment, of professionals in providing pediatric palliative care (PPC) in Hong Kong and the differences in perceived challenges between groups. A total of 680 pediatric doctors and nurses participated in the survey. They tended to perceive the provision of PPC as difficult and considered "advanced skills" (those dealing with death-related issues) challenging. Findings indicate that nurses, professionals who are less experienced, do not have children, and have not received palliative care training perceived a higher level of challenges in providing PPC. Implications for training and support are discussed.
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Affiliation(s)
- Wallace Chi Ho Chan
- a Department of Social Work , The Chinese University of Hong Kong , Hong Kong
| | - Karen Lok Yi Wong
- a Department of Social Work , The Chinese University of Hong Kong , Hong Kong
| | - M M M Leung
- b Department of Pediatric and Adolescent Medicine , United Christian Hospital , Hong Kong
| | - M K Y Lin
- c Children's Cancer Foundation , Hong Kong
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Cheung JTK, Au DWH, Chan WCH, Chan JHY, Ng K, Woo J. Self-competence in death work among health and social care workers: a region-wide survey in Hong Kong. BMC Palliat Care 2018; 17:65. [PMID: 29678168 PMCID: PMC5909221 DOI: 10.1186/s12904-018-0317-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 04/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND According to the Quality of Death Index, Hong Kong is lagging behind many other Western and Asian countries in the category of palliative and healthcare. To ensure the provision of high-quality palliative care, it is important to explore the self-competence of health and social care workers in coping with death work including palliative care. This region-wide study aims to assess the level of self-competence with a validated Self-Competence in Death Work Scale (SC-DWS) and examine its correlates. METHODS The SC-DWS was administered to a cross-sectional convenience sample of health and social care workers across eight healthcare institutions between January and October 2016. Total scores for the 16-item SC-DWS and its Existential and Emotional subscales were calculated. We then examined sociodemographic variables (e.g., age, profession, place of employment) in relation to the total and subscale scores using multiple linear regression. Coding was conducted on responses to a final open-ended question asking about the personal views of the workers towards their self-competence in death work. RESULT We collected data from 885 health and social care workers. Mean score of the SC-DWS was 60.16 (range: 16 - 80), while its Existential and Emotional subscales scored 37.90 (range: 10 - 50) and 14.46 (range: 4 - 20) respectively. Four categories of personal view towards self-competence in death work including (1) personal resources; (2) existential challenges and coping; (3) emotional challenges and coping; and (4) personal recommendations on improving self-competence were identified. In multivariate analyses, workers aged 50 or above, divorced, working in Hospice A, Rehabilitation Hospital B (where a quality improvement initiative in end-of-life care was implemented) and Acute Hospital B (a Christian institution with strong caring culture) and with personal bereavement experience had significantly higher scores, whereas nurses scored significantly lower than less-educated personal care assistants. CONCLUSION There is still room for improvement in self-competence in death work among health and social care workers, particularly the young, nurses and those working in acute hospitals. Future initiatives should involve identifying barriers in individual healthcare institutions. Training of the provision of palliative care is necessary.
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Affiliation(s)
- Johnny T K Cheung
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Doreen W H Au
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wallace C H Chan
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jenny H Y Chan
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kenway Ng
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jean Woo
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
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30
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Alconero-Camarero AR, Sarabia-Cobo CM, González-Gómez S, Ibáñez-Rementería I, Lavín-Alconero L, Sarabia-Cobo AB. Nursing students' emotional intelligence, coping styles and learning satisfaction in clinically simulated palliative care scenarios: An observational study. NURSE EDUCATION TODAY 2018; 61:94-100. [PMID: 29195213 DOI: 10.1016/j.nedt.2017.11.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 10/09/2017] [Accepted: 11/06/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Emotional intelligence is highly relevant in palliative care training, considering the coping styles used by nursing students. Clinical simulation provides the opportunity to evaluate these variables in a realistic and natural context. OBJECTIVES To analyze the possible relation between emotional intelligence, coping styles and satisfaction with one's own self-learning in nursing students participating in simulated scenarios related to palliative care at the end of life. METHODS A descriptive, observational and correlational study of students in their second year of nursing at a Spanish University during the 2015/2016 academic year. Three variables were measured: emotional intelligence (Trait Meta-Mood Scale-24), coping styles (the Questionnaire for Dealing with Stress) and satisfaction with students' own learning (Student Satisfaction and Self-Confidence in Learning Scale, Spanish version CSLS-Sv). RESULTS In total, 74 students participated in this study (ME: 20.3years). An association was found between satisfaction with learning, according to the EI attention subscale (in which the highest scores were registered) and two specific coping styles (FSP, with high scores and open emotional expression). CONCLUSIONS Emotional intelligence and coping styles are desirable qualities in students, especially as they have a relevant role in satisfaction with one's own learning. Nonetheless, in part, these results depend on the characteristics of the educational activities designed, which is especially relevant in simulation applied to palliative care.
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Chan WCH, Tin AF, Wong KLY. Effectiveness of an experiential workshop for enhancing helping professionals' self-competence in death work in Hong Kong: a randomised controlled trial. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1070-1079. [PMID: 27868259 DOI: 10.1111/hsc.12407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
Helping professionals require self-competence in coping with the existential and emotional challenges of death work. Previous training often focused on knowledge and skills rather than on this competence. This study aimed to examine the effectiveness of a 3-day workshop in Hong Kong to enhance helping professionals' self-competence in death work. A randomised controlled trial was conducted to examine the effects of the training between January and May 2014. Targeted participants were helping professionals who had been doing death work for at least 6 months. The 112 participants were openly recruited from hospitals and NGOs and were assigned to an intervention group or a waitlist control group. Data were collected at pre-intervention and post-intervention. Primary outcome was self-competence in death work. All participants were grouped for analysing the changes in outcomes at pre-intervention, post-intervention and 3-month follow-up. Participants in the intervention group experienced a significant increase in the total score of the Self-competence in Death Work Scale (SC-DWS) and in scores of the Existential and Emotional subscales of SC-DWS. The positive effects of training on self-competence in death work were maintained at the 3-month follow-up. This study provides evidence of the effectiveness of training in enhancing helping professionals' self-competence in death work. Further research is required to examine the long-term effects of training.
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Affiliation(s)
| | - Agnes Fong Tin
- Center on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Karen Lok Yi Wong
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
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Kruse A. [The special requirements of old age in terms of dying]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 60:18-25. [PMID: 27882392 DOI: 10.1007/s00103-016-2481-x] [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] [Indexed: 11/29/2022]
Abstract
It is expected that the rising average life expectancy will leave ever more people with chronic progressive diseases of the body and brain. This then means not only having to deal with increasingly longer periods of care, but also possibly distinct neurocognitive disorders in the years prior to death and dying. The aim of this study is to report epidemiological data on the causes of death, as well as on the places of death. In addition, the attitudes and behaviour towards death and dying, as well as the different places of death will be discussed. Expecting support in the process of dying, as well as factors that have a more conducive effect on the internal processing of dying, are mentioned. At the same time, the attitudes and behaviours in respect of the accompaniment of dying people, which can be seen in the staff in clinical inpatient facilities, are addressed. Personal intense grappling with dying and death actually has a positive effect on these behaviours and attitudes. Finally, the contribution turns to the question of to what extent the theory of compression of morbidity may be perceived as valid, especially in view of the rising average life expectancy. It is emphasised that chronic diseases, even when no functional loss is present, place not only great demands on the patient, but also on the care system and financial resources. Furthermore, it is demonstrated that frailty can often cause mental disorders. Specific requirements with a view to the care of people with dementia are given.
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Affiliation(s)
- Andreas Kruse
- Institut für Gerontologie, Universität Heidelberg, Bergheimer Straße 20, 69115, Heidelberg, Deutschland.
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