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Clayton M, Marczak M. Palliative care nurses' experiences of stress, anxiety, and burnout: A thematic synthesis. Palliat Support Care 2023; 21:498-514. [PMID: 35706143 DOI: 10.1017/s147895152200058x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This systematic literature review aimed to critically appraise empirical evidence investigating palliative care (PC) nurses' experiences of stress, anxiety, and burnout. METHODS Six databases (PsycINFO, MEDLINE, Scopus, CINAHL, PubMed, and Web of Science) covering literature within psychology, medicine and healthcare, and social sciences were searched from inception until December 2020. Studies were eligible if they included qualitative literature reporting on experiences of nurses working in a PC setting of stress, anxiety, or burnout, and were published in English. Eighteen studies satisfied the review's inclusion criteria and were considered relevant to the review aims. Critical appraisal was undertaken using the Critical Appraisal Skills Programme Qualitative Checklist. RESULTS Thematic synthesis identified three main themes: When work becomes personal, The burden on mind and body, and Finding meaning and connection. The findings suggested that stress, anxiety, and burnout are deeply personal feelings experienced by nurses both on an emotional and physical level. Additionally, PC nurses' experiences can differ in meaning and strength depending on their relationships with patients, patients' families, and colleagues. SIGNIFICANCE OF THE RESULTS The synthesis highlighted that PC nurses' experiences are complex, encompassing clinical and organizational challenges, and the personal impact their work has on them. Having a greater understanding of the factors that contribute to PC nurses' experiences may help in PC nurses' core training and continuing professional education, as well as the provision of effective supervision and staff support.
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Affiliation(s)
- Malcolm Clayton
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Department of Psychology, University of Warwick, Coventry, UK
| | - Magda Marczak
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Rexand-Galais F, Urban T, Vollot P, Hureaux J, Maillard B. [Feminization of the patient in thoracic oncology and experiences of caregivers: An exploratory study]. Rev Mal Respir 2020; 37:123-133. [PMID: 32044195 DOI: 10.1016/j.rmr.2019.11.652] [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: 12/21/2018] [Accepted: 11/03/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The epidemiology of lung cancer is evolving and caregivers need to address an emerging demographic, women, sometimes presenting at a young age. The effect of this ongoing change on thoracic oncology services and on the nursing population (registered nurses and auxiliary nurses) has not been evaluated. METHODS A quantitative analysis can help to control the biases that may have an impact on nursing staff identification with female patients. A categorical and automated qualitative study (Tropes software) of speech productions related to "difficult situations" was carried out. RESULTS Four contexts activating critical situations were identified: disagreement and conflict in care, a constraining situation of care, an overflow situation, particularly related to increased suffering of the patient and a feeling of being isolated in care delivery. Regarding the management of female patients, after the impact of disagreements in management, the feeling of care being constrained in the presence of a female patient with whom caregivers identify themselves is more significant than with regard to male patients. CONCLUSION Support within the care team is essential, but not sufficient. Only a practice-based training context involving peers outside the team seems to help address the most impactful situations.
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Affiliation(s)
- F Rexand-Galais
- Département psychologie, université d'Angers, Angers, France; GIP cancéropôle Grand-Ouest, réseau SHS (Angers), maison de la recherche Germaine-Tillion, Angers, France.
| | - T Urban
- Service de pneumologie, pôle Hippocrate, CHU, Angers, France; MINT, UNIV Angers, Inserm 1066, CNRS 6021, université Bretagne Loire, Angers, France
| | - P Vollot
- Direction générale, Centre hospitalier, Cholet
| | - J Hureaux
- Service de pneumologie, pôle Hippocrate, CHU, Angers, France; MINT, UNIV Angers, Inserm 1066, CNRS 6021, université Bretagne Loire, Angers, France
| | - B Maillard
- Centre fédératif douleur, soins de support, éthique clinique, CHU, Nantes, France
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Parola V, Coelho A, Romero ÁA, Peiró RP, Blanco-Blanco J, Apóstolo J, Gea-Sánchez M. The construction of the health professional in palliative care contexts: a scoping review on caring for the person at the end of life. Porto Biomed J 2018; 3:e10. [PMID: 31595242 PMCID: PMC6726306 DOI: 10.1016/j.pbj.0000000000000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/04/2018] [Indexed: 11/29/2022] Open
Abstract
Aim The aim of the study was to map of the literature on the elements contributing to the construction of the health care professional in the context of palliative care. Methods Scoping review based on Arksey and O'Malley framework. PubMed, Embase, CINAHL, Scopus databases, and gray literature were the sources searched (2005-2015), completed by reference searching, hand searching, and expert consultations. Primary studies focusing on different professionals working in palliative care units or hospice centers were eligible for inclusion. Results From a total of 3632 articles, 22 met the inclusion criteria. The content of the studies was described and classified in 5 elements: (i) construction and application of the concept of care; (ii) psychosocial effects that the daily care produces; (iii) working conditions that influence the caregiving provided; (iv) knowledge mobilized in the provision of care; and (v) strategies adopted by health care professionals to build relationships. Data about nurses, physicians, and psychologists were found, but no data were found about social workers. Gaps identified in the publications were as follows: relationship competencies and strategies adopted; the real needs from educational programs; and the view of other professionals. Conclusions Key elements identified in the concept of the construction of the health care professional should be addressed in future interventions: prevention of emotional exhaustion, depersonalization, and achievement of a greater personal accomplishment. In addition, none of the articles retrieved offered the different perspectives of all the disciplines in a multidisciplinary team.
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Affiliation(s)
- Vitor Parola
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto.,Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
| | - Adriana Coelho
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto.,Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
| | - Álvaro A Romero
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - Roland P Peiró
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - Joan Blanco-Blanco
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - João Apóstolo
- Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
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Oliveira I, Fothergill-Bourbonnais F, McPherson C, Vanderspank-Wright B. Battling a Tangled Web: The Lived Experience of Nurses Providing End-of-Life Care on an Acute Medical Unit. Res Theory Nurs Pract 2018; 30:353-378. [PMID: 28304263 DOI: 10.1891/1541-6577.30.4.353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Meeting the heath care needs of patients at the end of life is becoming more complex. In Canada, most patients with life-limiting illness will die in hospitals, many on medical units. Yet, few studies have qualitatively investigated end-of-life care (EOLC) in this context, or from the perspectives of nurses providing EOLC. The purpose of this study was to seek to understand the lived experience of nurses on a medical unit providing EOLC to patients. Interpretive phenomenology guided the method and analysis. Individual face-to-face interviews were conducted with 10 nurses from 2 hospital medical units. The underlying essence of these nurses' experiences was that of "battling a tangled web." Battling a tangled web represented their struggles in attempting to provide EOLC in an environment that was not always conducive to it. Seven themes were generated from the analysis: caring in complexity, caught in a tangled web, bearing witness to suffering, weaving a way to get there: struggling through the process, creating comfort for the patient, working through the dying process with the family, and finding a way through the web. The findings contribute to an understanding of the experiences of nurses in providing EOLC on a medical unit including perceived facilitators and barriers.
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Österlind J, Prahl C, Westin L, Strang S, Bergh I, Henoch I, Hammarlund K, Ek K. Nursing students' perceptions of caring for dying people, after one year in nursing school. NURSE EDUCATION TODAY 2016; 41:12-16. [PMID: 27138476 DOI: 10.1016/j.nedt.2016.03.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 02/20/2016] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
AIM To describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden. METHODS Interviews (n=17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions. RESULTS The analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives. CONCLUSION Nursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening.
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Affiliation(s)
- Jane Österlind
- Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden; Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden.
| | - Charlotte Prahl
- Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden; Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden
| | - Lars Westin
- University of Skövde, The School of Health and Education, Sweden
| | - Susann Strang
- Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences, Sweden; Angered Hospital, Sweden
| | - Ingrid Bergh
- University of Skövde, The School of Health and Education, Sweden
| | - Ingela Henoch
- Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden; Angered Hospital, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Kina Hammarlund
- University of Skövde, The School of Health and Education, Sweden
| | - Kristina Ek
- University of Skövde, The School of Health and Education, Sweden
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Henoch I, Carlander I, Holm M, James I, Kenne Sarenmalm E, Lundh Hagelin C, Lind S, Sandgren A, Öhlén J. Palliative Care Research - A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 2012. Scand J Caring Sci 2015; 30:5-25. [DOI: 10.1111/scs.12253] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 05/06/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Ingela Henoch
- Institute of Health and Care Sciences; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC); University of Gothenburg; Gothenburg Sweden
| | - Ida Carlander
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
- Medical Management Center; Department of Learning, Informatics, Management and Ethics; Karolinska Institutet; Stockholm Sweden
| | - Maja Holm
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
- Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Inger James
- School of Health and Medical Sciences; Örebro University; Örebro Sweden
| | - Elisabeth Kenne Sarenmalm
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
- Research and Development Centre; Skaraborg Hospital; Skövde Sweden
| | - Carina Lundh Hagelin
- Medical Management Center; Department of Learning, Informatics, Management and Ethics; Karolinska Institutet; Stockholm Sweden
- Sophiahemmet University; Stockholm Sweden
- Research and Development Unit in Palliative care; Stockholms Sjukhem Foundation; Stockholm Sweden
| | - Susanne Lind
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
- Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Anna Sandgren
- School of Health Sciences; Jönköping University; Jönköping Sweden
- Center for Collaborative Palliative Care; Department of Health and Caring Sciences; Linneaus University; Kalmar/Växjö Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC); University of Gothenburg; Gothenburg Sweden
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
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Laporte P, Vonarx N. Les infirmières et la mort au quotidien : souffrances et enjeux. ACTA ACUST UNITED AC 2015. [DOI: 10.3917/inka.154.0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Authentic and congruent leadership providing excellent work environment in palliative care. Leadersh Health Serv (Bradf Engl) 2011. [DOI: 10.1108/17511871111125701] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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