Adaptation and continuous learning: integrative review of coping strategies of palliative care professionals

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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Delirium Rate and Risk Factors in Palliative Care Outpatients and Caregiver Coping Strategies

10.22371/07.2014.010 ◽

2014 ◽

Author(s):

◽

Sarah Deur Livermore

Keyword(s):

Risk Factors ◽

Palliative Care ◽

Coping Strategies ◽

Caregiver Coping

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Assessing the Unique Experiences and Needs of Muslim Oncology Patients Receiving Palliative and End-of-Life Care: An Integrative Review

Journal of Palliative Care ◽

10.1177/0825859718800496 ◽

2018 ◽

Vol 34 (1) ◽

pp. 52-61 ◽

Cited By ~ 2

Author(s):

Carolina Gustafson ◽

Mark Lazenby

Keyword(s):

Palliative Care ◽

End Of Life ◽

End Of Life Care ◽

Care Delivery ◽

Data Extraction ◽

Integrative Review ◽

Life Care ◽

Oncology Patients ◽

Care Models ◽

Patient Care Delivery

The objective of this review was to detail the experiences of Muslim oncology patients receiving palliative and end-of-life care and identify where gaps in the providing of culturally aware care occur. We also sought to examine ways in which providers could be better educated on the needs of Muslim patients at the end-of-life and identify barriers Muslims faced when being treated with hospice and palliative care models developed for non-Muslim populations. We conducted a search in April 2018 in the National Library of Medicine and CINAHL databases using the search terms “palliative care,” “Muslim,” and “cancer.” Included were articles with focuses on adult Muslims with palliative and end-of-life care experiences. We then followed the PRISMA guidelines for an integrative review and used a data extraction matrix to identify 20 papers that met the inclusion criteria of the review. We identified four major themes patient experiences, patient care delivery suggestions, Muslim provider experiences, and definitions of death, present in all 20 papers of the review. Each of the included papers was categorized based on the dominant theme in the paper. This review ultimately found that the care provided to Muslim patients is subpar for the standard of culturally competent care and that the needs of Muslim patients at the end-of-life, as well as the needs of their families, are not being met. Moving forward further research on this topic is needed with a particular focus on examining the experiences of terminally ill Muslim patients receiving treatment in non-Muslim majority settings.

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Team Well-being and Resilience Practices in Hospice and Palliative Care

International Journal of Whole Person Care ◽

10.26443/ijwpc.v7i1.226 ◽

2020 ◽

Vol 7 (1) ◽

pp. 33

Author(s):

Glen Isamu Komatsu

Keyword(s):

Palliative Care ◽

Organizational Support ◽

Success Factors ◽

Well Being ◽

Palliative Care Team ◽

Care Team ◽

Self Awareness ◽

Team Members ◽

Reflection Process ◽

Over Time

High functioning, resilient teams do not happen by chance. Teams, similar to individuals, need to be educated, nurtured and formed over time, by a consistent vision and process. With proper team formation, the compassionate care of patients, families and colleagues can be developed, modeled and reinforced. Self-compassion is another focus to help caregivers cope with the stresses of the work and mitigate against burnout. The primary intervention which will be discussed is a regularly scheduled reflection process, e.g. 30 minutes weekly or 90 minutes monthly, with a pediatric hospice team, an inpatient palliative care team and an outpatient palliative care team. The reflection process incorporates mindful meditation, journaling, listening exercises, individual and group reflection to encourage and practice self-awareness, self-reflection, greater emotional intelligence and leadership skills. Specific tools employed include the Search Inside Yourself © Program, books by various authors, selected music, videos and personal journals. Qualitative feedback from team members, patient, family and colleague satisfaction scores has been positive. Buy-in from all team members, initially, was difficult, but over time, all team members have recognized the value of the process and have incorporated the exercises not only in their work, but in their personal lives and other roles/jobs. Other key success factors are organizational support for time for this process and individual champions to develop and lead the reflective process. The workshop will include a demonstration of exercises used in team reflections with learner participation.

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Adaptive and maladaptive coping strategies among patients with advanced cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e24129 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e24129-e24129

Author(s):

Rony Dev ◽

Akhila Sunkepally Reddy ◽

Joseph Anthony Arthur ◽

Ali Haider ◽

Ishwaria Mohan Subbiah ◽

...

Keyword(s):

Risk Factors ◽

Palliative Care ◽

Substance Use ◽

Coping Strategies ◽

Advanced Cancer ◽

Male Gender ◽

Adaptive Coping ◽

Post Secondary Education ◽

Maladaptive Coping ◽

Post Secondary

e24129 Background: Few studies have examined the coping mechanisms among patients with advanced cancer seen by palliative care. The objective of the study was to evaluate coping strategies in advanced cancer patients and identity risk factors for maladaptive coping. Methods: The authors conducted a secondary analysis of a cross-sectional survey on chemical coping. We prospectively enrolled patients with advanced cancer from a Supportive Care Clinic and documented the patient demographics, symptom expression (Edmonton Symptom Assessment System), Zubrod performance status, substance use history including tobacco, and coping strategies (the Brief COPE Questionnaire). Univariate and multivariate analyses were performed to identify risk factors for the use of maladaptive coping strategies. Results: Among 399 patients, the most common malignancies were gastrointestinal (21%) and breast (19%). Cancer patients frequently incorporated adaptive coping strategies including acceptance (86.7%), emotional support (79.9%), religion (69.4%), active coping (62.4%), instrumental support (48.4%), positive reframing (48.6%), planning (49.6%), and infrequently, humor (18.5%). Common maladaptive strategies included self-distraction (36.6%) and venting (14.5%), while self-blame (6.3%), denial (4.5%), behavioral disengagement (1.8%), and substance use (1.0%) were infrequently reported. On univariate analysis, venting was significantly associated with anxiety and depression, female gender, and tobacco use; and self-distraction was significantly associated with younger age, gender, depression, dyspnea, and a post-secondary education (P<0.05 for all). On multivariate analysis, male gender (OR -1.22, p<0.0001) and smoking (non-smoker vs everyday OR -1.9, P=0.008 ) remained significant for maladaptive venting; and age (HR -0.026, p=0.005), male gender (OR -0.65, p=0.004), dyspnea (OR -0.12, p=0.01) and post-secondary education (OR 0.596, p=0.022) remained significant for self-distraction. Conclusions: The vast majority of patients with advanced cancer seen by palliative care reported using adaptive coping strategies. We identified subgroup of patients who may be more likely to use maladapative coping strategies and may benefit from further psychological support.

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An integrative review to identify how nurses practicing in inpatient specialist palliative care units uphold the values of nursing

BMC Palliative Care ◽

10.1186/s12904-021-00810-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sue Moran ◽

Maria Bailey ◽

Owen Doody

Keyword(s):

Palliative Care ◽

Data Extraction ◽

Integrative Review ◽

Specialist Palliative Care ◽

The Future ◽

Nursing Values ◽

Palliative Care Units ◽

Being There ◽

The Impact

Abstract Background Caring for individuals and their families with a life-limiting, symptomatic illness and those who are dying has long been an integral role of palliative care nurses. Yet, over the last two decades, the specialty of palliative care has undergone significant changes in technology and medical treatments which have altered both the disease trajectory and the delivery of palliative care. To date, there is little evidence as to the impact of these medical and nursing advancements on the role of nurses working in palliative care and how in clinical practice these nurses continue to uphold their nursing values and the philosophy of palliative care. Methods An integrative review was conducted searching seven academic databases from the time period of January 2010 – December 2019 for studies identifying research relating to the role of the palliative care nurse working in specialist palliative care units and hospices. Research articles identified were screened against the inclusion criteria. Data extraction was completed on all included studies and the Crowe Critical Appraisal Tool was utilized to appraise the methodological quality and thematic analysis was performed guided by Braun and Clarke’s framework. The review was conducted and reported in lines with PRISMA guidelines. Results The search yielded 22,828 articles of which 7 were included for appraisal and review. Four themes were identified: (1) enhancing patient-centred care (2) being there (3) exposure to suffering and death (4) nursing values seen but not heard. The findings highlight that while palliative care nurses do not articulate their nurse values, their actions and behaviors evident within the literature demonstrate care, compassion, and commitment. Conclusion These findings suggest that there is a need for nurses working in specialist palliative care units to articulate, document, and audit how they incorporate the values of nursing into their practice. This is pivotal not only for the future of palliative nursing within hospice and specialist palliative care units but also to the future of palliative care itself. To make visible the values of nursing further practice-based education and research is required.

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