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The experiences, coping mechanisms, and impact of death and dying on palliative medicine specialists

Published online by Cambridge University Press:  11 June 2013

Sofia C. Zambrano ,
Anna Chur-Hansen  and
Gregory B. Crawford
Sofia C. Zambrano*
Affiliation:
School of Medicine, Discipline of Psychiatry, The University of Adelaide, Adelaide, Australia School of Medicine, Discipline of Medicine, The University of Adelaide, Adelaide, Australia
Anna Chur-Hansen
Affiliation:
School of Medicine, Discipline of Psychiatry, The University of Adelaide, Adelaide, Australia
Gregory B. Crawford
Affiliation:
School of Medicine, Discipline of Medicine, The University of Adelaide, Adelaide, Australia Mary Potter Hospice, Adelaide, Australia
*
Address correspondence and reprint requests to: Sofia C Zambrano, Discipline of Psychiatry, The University of Adelaide, Eleanor Harrald Building, Adelaide, SA, 5005, Australia. E-mail: sofia.zambranoramos@adelaide.edu.au
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Abstract

Objectives:

Research on the experiences, coping mechanisms, and impact of death and dying on the lives of palliative medicine specialists is limited. Most research focuses on the multidisciplinary team or on nurses who work with the dying. Fewer studies consider medical professionals trained in palliative medicine. This study aimed to explore the experiences, coping mechanisms, and impact of death and dying on palliative medicine specialists when dealing with their patients at the end of life.

Methods:

A qualitative research approach guided the study, one-on-one interview data were analyzed thematically. A purposeful sampling technique was employed for participant recruitment. Seven palliative medicine specialists practicing in one city participated in open-ended, in-depth interviews.

Results:

The analysis of participants' accounts identified three distinct themes. These were Being with the dying, Being affected by death, and dying and Adjusting to the impact of death and dying.

Significance of results:

This study further contributes to the understanding of the impact of death and dying on professionals who care for dying patients and their families. Despite the stressors and the potential for burnout and compassion fatigue, these participants employed strategies that enhanced meaning-making and emphasized the rewards of their work. However, the consequences of work stressors cannot be underestimated in the practice of palliative care.

Keywords

Palliative medicine physicianspsychological adjustmentlife experiencesend of life care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 4 , August 2014 , pp. 309 - 316
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Arroll, B. & Falloon, K. (2007). Should doctors go to patients' funerals? British Medical Journal, 334, 1322.Google Scholar
Berger, J.T., Rosner, F., Potash, J., et al. (2000). Communication in caring for terminally ill patients. Journal of Palliative Medicine, 3, 69–73.Google Scholar
Boston, P.H. & Mount, B.M. (2006). The caregiver's perspective on existential and spiritual distress in palliative care. Journal of Pain and Symptom Management, 32, 13–26.Google Scholar
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.Google Scholar
Casarett, D.J., Spence, C., Haskins, M., et al. (2011). One big happy family? Interdisciplinary variation in job satisfaction among hospice providers. Journal of Palliative Medicine, 14, 913–917.Google Scholar
Clark, D. (2007). From margins to centre: A review of the history of palliative care in cancer. The Lancet Oncology, 8, 430–438.Google Scholar
Currier, J.M., Holland, J.M. & Neimeyer, R.A. (2008). Making sense of loss: a content analysis of end-of-life practitioners' therapeutic approaches. Omega, 57, 121–141.Google Scholar
Dunwoodie, D.A. & Auret, K. (2007). Psychological morbidity and burnout in palliative care doctors in Western Australia. Internal Medicine Journal, 37, 693–698.Google Scholar
Fallowfield, L.J., Jenkins, V.A. & Beveridge, H.A. (2002). Truth may hurt but deceit hurts more: Communication in palliative care. Palliative Medicine, 16, 297–303.Google Scholar
Firth, P. (2011). Clinical Supervision and Reflective Practice in Palliative Care: Luxury or necessity? In Caregiver stress and staff support in illness, dying and bereavement, Rezenbrink, I. (Ed.). New York: Oxford University Press, 1–22.Google Scholar
Kaldjian, L.C., Curtis, A.E., Shinkunas, L.A., et al. (2008). Goals of care toward the end of life: A structured literature review. The American Journal of Hospice & Palliative Care, 25, 501–511.Google Scholar
Kearney, M.K., Weininger, R.B., Vachon, M.L., et al. (2009). Self-care of physicians caring for patients at the end of life: “Being connected … a key to my survival.” Journal of the American Medical Association, 301, 1155–1164.Google Scholar
Lindqvist, O., Tishelman, C., Hagelin, et al. (2012). Complexity in Non-Pharmacological Caregiving Activities at the End of Life: An International Qualitative Study. PLoS Medicine, 9, e1001173.Google Scholar
Malterud, K., Fredriksen, L. & Gjerde, M.H. (2009). When doctors experience their vulnerability as beneficial for the patients: A focus-group study from general practice. Scandinavian Journal of Primary Health Care, 27, 85–90.Google Scholar
Malterud, K. & Hollnagel, H. (2005). The doctor who cried: A qualitative study about the doctor's vulnerability. Annals of Family Medicine, 3, 348–352.Google Scholar
Maslach, C. & Leiter, M.P. (2008). Early predictors of job burnout and engagement. The Journal of Applied Psychology, 93, 498–512.Google Scholar
Maslach, C., Schaufeli, W.B. & Leiter, M.P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.Google Scholar
Palliative Care Australia. (2003). Palliative Care Service Provision in Australia: A Planning Guide. Canberra: Palliative Care Australia.Google Scholar
Penderell, A. & Brazil, K. (2010). The spirit of palliative practice: A qualitative inquiry into the spiritual journey of palliative care physicians. Palliative & Supportive Care, 8, 415–420.Google Scholar
QSR International. (2008). NVivo 8 [Computer Software] (2008 ed.). Doncaster, Australia: QSR International.Google Scholar
Rokach, A. (2005). Caring for those who care for the dying: coping with the demands on palliative care workers. Palliative & Supportive Care, 3, 325–332.Google Scholar
Seale, C. (2010). The role of doctors' religious faith and ethnicity in taking ethically controversial decisions during end-of-life care. Journal of Medical Ethics, 36, 677–682.Google Scholar
Serwint, J.R., Rutherford, L.E. & Hutton, N. (2006). Personal and professional experiences of pediatric residents concerning death. Journal of Palliative Medicine, 9, 70–81.Google Scholar
Sinclair, S. (2011). Impact of death and dying on the personal lives and practices of palliative and hospice care professionals. Canadian Medical Association Journal, 183, 180–187.Google Scholar
Sinclair, S., Pereira, J. & Raffin, S. (2006). A thematic review of the spirituality literature within palliative care. Journal of Palliative Medicine, 9, 464–479.Google Scholar
Slocum-Gori, S., Hemsworth, D., Chan, W. W., et al. (2011). Understanding compassion satisfaction, compassion fatigue and burnout: A survey of the hospice palliative care workforce. Palliative Medicine, http://www.ncbi.nlm.nih.gov/pubmed/22179596 (Accessed on 10 July 2014).Google Scholar
Swetz, K.M., Harrington, S.E., Matsuyama, R.K., et al. (2009). Strategies for avoiding burnout in hospice and palliative medicine: Peer advice for physicians on achieving longevity and fulfillment. Journal of Palliative Medicine, 12, 773–777.Google Scholar
Vachon, M.L. (2011). Four decades of selected research in hospice/palliative care: have the stressors changed. In Caregiver stress and staff support in illness, dying and bereavement, Rezenbrink, I. (ed.). New York: Oxford University Press, 1–22.Google Scholar
Webster, J. & Kristjanson, L.J. (2002). But isn't it depressing? The vitality of palliative care. Journal of Palliative Care, 18, 15–24.Google Scholar
Yedidia, M.J. (2007). Transforming doctor-patient relationships to promote patient-centered care: lessons from palliative care. Journal of Pain and Symptom Management, 33, 40–57.Google Scholar