1
|
Scanlon H, Latchford G, Allsop M. 'So being here is. . . I feel like I'm being a social worker again, at the hospice': Using interpretative phenomenological analysis to explore social workers' experiences of hospice work. Palliat Med 2024; 38:320-330. [PMID: 38372027 PMCID: PMC10955780 DOI: 10.1177/02692163231220163] [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] [Indexed: 02/20/2024]
Abstract
BACKGROUND Social workers have a significant role in hospices working with clients who are facing death but there is limited detailed understanding of the emotional impact of this work on social workers. Research has highlighted that those involved in hospice work find the work both a struggle (e.g. because of heightened emotions) and rewarding (noting that end-of-life care can feel like a privilege). AIM To explore UK hospice social workers' emotional experiences of work and how this influences their practice. DESIGN Semi-structured interviews were conducted with hospice social workers. Interviews were transcribed and transcripts were analysed using Interpretative Phenomenological Analysis. SETTING/PARTICIPANTS Eight social workers from different hospices in the UK. RESULTS Five overlapping superordinate themes emerged: making a difference to clients and families ('the difference made'), the emotional impact of working in hospices ('dealing with people's emotions, and death, and dying, it's serious stuff'), the relational context of this type of work ('awareness of affinity to connect'), the ways in which coping is facilitated in hospices ('seen it coming') and a foundation theme, connection and disconnection to values ('(dis)connection to values'). CONCLUSIONS The results offer an exploration of social workers' experiences of their work in hospices; how adept they were at coping and how they prepared for and made sense of the often emotionally-laden experiences encountered. Their experience of the rewards and meaning derived from their work offers important findings for clinical practice. Further research is suggested to explore a multitude of healthcare professionals' perspectives across country settings using Interpretative Phenomenological Analysis.
Collapse
Affiliation(s)
- Hayley Scanlon
- Leeds Teaching Hospitals NHS Trust, St James’ University Hospital, Leeds, UK
| | | | | |
Collapse
|
2
|
Allerby K, Goulding A, Ali L, Waern M. Increasing person-centeredness in psychosis inpatient care: staff experiences from the Person-Centered Psychosis Care (PCPC) project. BMC Health Serv Res 2022; 22:596. [PMID: 35505358 PMCID: PMC9066767 DOI: 10.1186/s12913-022-08008-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background Interventions to increase person-centeredness in hospital care for persons with psychotic illness are needed. Changing care delivery is however a complex venture, requiring staff to reconsider their mindsets and ways of working. A multidisciplinary educational intervention for hospital staff at four wards was launched to increase person-centeredness in the care of patients with schizophrenia and similar psychoses. This study aims to explore staff experiences of working to increase person-centeredness. Methods A heterogenic sample of staff (n = 23) from all participating wards were recruited for six focus group interviews. Semi-structured questions covered staff perceptions of person-centered care and the process of increasing person-centeredness. Transcribed data was analyzed using thematic analysis according to Braun and Clarke. Results Staff viewed person-centered care as an approach rather than a method. They described central aspects of person-centered care, such as recognizing the patient as a capable person who can participate in her/his care. Statements further showed how these core features were put into practice. Changes related to the intervention were presented in terms of evolving patient and staff roles, improved contact with patients, more flexible care routines, and a more positive ward climate. Neither psychotic symptoms nor involuntary status were considered barriers for person-centered care, but organizational factors beyond staff control seemed to impact on implementation. Conclusions After implementation, participants displayed good understanding of the core concepts of person-centered care in both thinking and action. They attributed several improvements in the care milieu to an increased level of person-centeredness. Psychotic behavior and involuntary treatment did not present major barriers to person-centered care. Findings suggest person-centered care is feasible in the psychosis inpatient setting and could improve quality of care. Trial registration The study is part of a larger study evaluating the intervention Person-Centered Psychosis Care (PCPC). It was registered retrospectively at clinicaltrials.gov, identifier NCT03182283.
Collapse
Affiliation(s)
- K Allerby
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345, Gothenburg, Sweden. .,Region Västra Götaland, Psychosis Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden. .,Institute of Health Care Sciences, Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530, Gothenburg, Sweden.
| | - A Goulding
- Region Västra Götaland, Psychosis Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden
| | - L Ali
- Institute of Health Care Sciences, Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530, Gothenburg, Sweden.,Region Västra Götaland, Psychiatry Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden
| | - M Waern
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345, Gothenburg, Sweden.,Region Västra Götaland, Psychosis Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden.,Institute of Health Care Sciences, Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530, Gothenburg, Sweden
| |
Collapse
|