Underneath the White Coat: Risk and Protective Factors for Palliative Care Providers in Their Daily Work

J Hosp Palliat Nurs. 2020 Apr;22(2):108-114. doi: 10.1097/NJH.0000000000000623.

Abstract

Palliative care practice is associated with risk factors linked to end-of-life, chronicity, personal, interpersonal, and work characteristics, as well as with protective factors, but how these are perceived by the health care providers themselves is not clear. This article aims to elaborate a theoretical framework explaining the risk and protective factors for palliative care providers in their daily practice. Nineteen providers (16 nurses, 3 physicians) working in a palliative care unit of a clinical-research institute in Northern Italy were interviewed. A Grounded Theory qualitative approach guided the data collection and analysis. From the interviews, 28 codes, subsequently organized into 11 interconnected categories, emerged. They described both stressors (emotion management regarding death/dying, conflicts, communication and relationship with patients/caregivers, discrepancies between patients' and caregivers' needs, communication of poor diagnosis/prognosis, decision making about treatment, and real-life and work interference) and protective factors (social support, positive approach and value of past experience, recognized value of/passion toward professional work, work-family balance). Experiencing these elements as positive or negative depends on the professionals' point of view, as well as their past and present experience.Understanding what dealing with life-limiting illnesses means may suggest tailored interventions to improve professionals' well-being by fostering the protective elements and combatting the risk factors.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Female
  • Grounded Theory
  • Health Personnel / psychology*
  • Humans
  • Interviews as Topic / methods
  • Italy
  • Male
  • Middle Aged
  • Palliative Care / methods
  • Palliative Care / psychology*
  • Palliative Care / standards
  • Protective Factors*
  • Qualitative Research
  • Social Support