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Open accessJournal ArticleDOI: 10.1017/S1478951521000298

The impact of COVID-19 on palliative care workers across the world: A qualitative analysis of responses to open-ended questions.

02 Mar 2021-Palliative & Supportive Care (Cambridge University Press)-Vol. 19, Iss: 2, pp 187-192
Abstract: Objective With over two million deaths and almost 100 million confirmed cases, the COVID-19 pandemic has caused a “tsunami of suffering.” Health care workers, including palliative care workers, have been severely impacted. This study explores how the COVID-19 pandemic has impacted palliative care workers around the world and describes the coping strategies they have adopted to face their specific situation. Method We conducted a qualitative analysis of written, unstructured comments provided by respondents to a survey of IAHPC members between May and June 2020. Free text was exported to MAX QDA, and a thematic analysis was performed by reading the comments and developing a coding frame. Results Seventy-seven palliative care workers from 41 countries submitted at least one written comment, resulting in a data corpus of 10,694 words and a total of 374 coded comments. Eight main themes are emerged from the analysis: palliative care development, workforce impact, work reorganization, palliative care reconceptualization, economic and financial impacts, increased risk, emotional impact, and coping strategies. Significance of results The pandemic has had a huge impact on palliative care workers including their ability to work and their financial status. It has generated increased workloads and placed them in vulnerable positions that affect their emotional well-being, resulting in distress and burnout. Counseling and support networks provide important resilience-building buffers. Coping strategies such as team and family support are important factors in workers’ capacity to adapt and respond. The pandemic is changing the concept and praxis of palliative care. Government officials, academia, providers, and affected populations need to work together to develop, and implement steps to ensure palliative care integration into response preparedness plans so as not to leave anyone behind, including health workers.

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Topics: Palliative care (74%), Health care (58%), Thematic analysis (53%) ... read more

6 results found

Open accessJournal ArticleDOI: 10.1177/02692163211028065
Sarah Nestor1, Colm O' Tuathaigh2, Tony O' Brien2, Tony O' Brien1  +1 moreInstitutions (3)
Abstract: Background:In the pre-COVID-19 era, healthcare professionals experienced stress and burnout. The international literature confirms that COVID-19 placed significant additional burdens on healthcare ...

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Topics: Palliative care (63%), Health care (55%), End-of-life care (54%) ... read more

1 Citations

Open accessDOI: 10.12688/AMRCOPENRES.13035.1
18 Nov 2021-
Abstract: Background Palliative care workers commonly experience workplace stress and distress. General stressors include unmanageable workloads and staff shortages. Stressors specific to palliative care include regular exposure to death, loss and grief. The COVID pandemic exacerbated exhaustion and burnout across the healthcare system, including for those providing palliative care. Evidence based psychological support interventions, tailored to the needs and context of palliative care workers, are needed. Acceptance and Commitment Therapy (ACT) is an established form of cognitive behavioural therapy which uses behavioural psychology, values, acceptance, and mindfulness techniques to improve mental health and wellbeing. ACT is effective in improving workplace wellbeing in many occupational settings. Our study examines the acceptability and feasibility of an online ACT-based intervention to improve mental health and wellbeing in staff caring for people with an advanced progressive illness. Methods A single-arm feasibility trial. We will seek to recruit 30 participants to take part in an 8- week online ACT-based intervention, consisting of three synchronous facilitated group sessions and five asynchronous self-directed learning modules. We will use convergent mixed methods to evaluate the feasibility of the intervention. Quantitative feasibility outcomes will include participant recruitment and retention rates, alongside completion rates of measures assessing stress, quality of life, wellbeing, and psychological flexibility. Focus groups and interviews will explore participant perspectives on the intervention. We will run a stakeholder workshop to further refine the intervention and identify outcomes for use in a future evaluation. Results We will describe participant perspectives on intervention acceptability, format, content, and perceived impact alongside rates of intervention recruitment, retention, and outcome measure completion. Conclusion We will show whether a brief, online ACT intervention is acceptable to, and feasible for palliative care workers. Findings will be used to further refine the intervention and provide essential information on outcome assessment prior to a full-scale evaluation.

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Open accessJournal ArticleDOI: 10.1101/2021.11.17.21266437
Andy Bradshaw1, Lesley Dunleavy2, Ian Garner2, Nancy Preston2  +10 moreInstitutions (4)
20 Nov 2021-medRxiv
Abstract: ObjectivesTo explore the experiences of, and impact on, staff working in palliative care during the COVID-19 pandemic. DesignQualitative multiple case study using semi-structured interviews between November 2020 and April 2021 as part of the CovPall study. Data were analysed using thematic framework analysis. SettingOrganisations providing specialist palliative services in any setting. ParticipantsStaff working in specialist palliative care, purposefully sampled by the criteria of role, care setting and COVID-19 experience. Main outcome measuresExperiences of working in palliative care during the COVID-19 pandemic. ResultsFive cases and 24 participants were recruited (n=12 nurses, 4 clinical managers, 4 doctors, 2 senior managers, 1 healthcare assistant, 1 allied healthcare professional). Central themes demonstrate how infection control constraints prohibited and diluted participants ability to provide care that reflected their core values, resulting in experiences of moral distress. Despite organisational, team, and individual support strategies, continually managing these constraints led to a crescendo effect in which the impacts of moral distress accumulated over time, sometimes leading to burnout. Solidarity with colleagues and making a valued contribution provided moral comfort for some. ConclusionsThis study provides a unique insight into why and how healthcare staff have experienced moral distress during the pandemic, and how organisations have responded. Despite their experience of dealing with death and dying, the mental health and well-being of palliative care staff was affected by the pandemic. Organisational, structural, and policy changes are urgently required to mitigate and manage these impacts.

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Topics: Palliative care (70%), Health care (56%)

Open accessJournal ArticleDOI: 10.3390/MEDICINA57090924
Paul T. P. Wong1, Timothy Yu2Institutions (2)
Abstract: The COVID-19 pandemic has exposed the inadequacies of the current healthcare system and needs a paradigm change to one that is holistic and community based, illustrated by the healing wheel. The present paper proposes that existential positive psychology (PP 2.0) represents a promising approach to meet the rising needs in palliative care. This framework has a twofold emphasis on (a) how to transcend and transform suffering as the foundation for wellbeing and (b) how to cultivate our spiritual and existential capabilities to achieve personal growth and flourishing. We propose that these objectives can be achieved simultaneously through dialectical palliative counselling, as illustrated by Wong's integrative meaning therapy and the Conceptual Model of CALM Therapy in palliative care. We then outline the treatment objectives and the intervention strategies of IMT in providing palliative counselling for palliative care and hospice patients. Based on our review of recent literature, as well as our own research and practice, we discover that existential suffering in general and at the last stage of life in particular is indeed the foundation for healing and wellbeing as hypothesized by PP 2.0. We can also conclude that best palliative care is holistic-in addition to cultivating the inner spiritual resources of patients, it needs to be supported by the family, staff, and community, as symbolized by the healing wheel.

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Topics: Palliative care (71%)


21 results found

Journal ArticleDOI: 10.1191/1478088706QP063OA
Virginia Braun1, Victoria Clarke2Institutions (2)
Abstract: Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.

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77,018 Citations

Open accessJournal ArticleDOI: 10.3310/HTA2160
Abstract: ed summaries and general concepts can be formulated, which may, upon further investigation, be found to be germane to a wider variety of settings. Case studies, therefore are not necessarily restricted

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Topics: Health technology (53%)

1,218 Citations

Open accessJournal ArticleDOI: 10.1016/J.BBI.2020.05.026
Abstract: Background COVID-19 pandemic has the potential to significantly affect the mental health of healthcare workers (HCWs), who stand in the frontline of this crisis. It is, therefore, an immediate priority to monitor rates of mood, sleep and other mental health issues in order to understand mediating factors and inform tailored interventions. The aim of this review is to synthesize and analyze existing evidence on the prevalence of depression, anxiety and insomnia among HCWs during the Covid-19 outbreak. Methods A systematic search of literature databases was conducted up to April 17th, 2020. Two reviewers independently assessed full-text articles according to predefined criteria. Risk of bias for each individual study was assessed and data pooled using random-effects meta-analyses to estimate the prevalence of specific mental health problems. The review protocol is registered in PROSPERO and is available online. Findings Thirteen studies were included in the analysis with a combined total of 33,062 participants. Anxiety was assessed in 12 studies, with a pooled prevalence of 23·2% and depression in 10 studies, with a prevalence rate of 22·8%. A subgroup analysis revealed gender and occupational differences with female HCPs and nurses exhibiting higher rates of affective symptoms compared to male and medical staff respectively. Finally, insomnia prevalence was estimated at 38·9% across 5 studies. Interpretation Early evidence suggests that a considerable proportion of HCWs experience mood and sleep disturbances during this outbreak, stressing the need to establish ways to mitigate mental health risks and adjust interventions under pandemic conditions.

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Topics: Psychological intervention (56%), Mental health (55%), Mood (53%) ... read more

1,137 Citations

Journal ArticleDOI: 10.1177/109019819201900101
Abstract: Both the qualitative and quantitative paradigms have weaknesses which, to a certain extent, are compensated for by the strengths of the other. As indicated in this article, the strengths of quantitative methods are that they produce factual, reliable outcome data that are usually generalizable to some larger population. The strengths of qualitative methods are that they generate rich, detailed, valid process data that usually leave the study participants' perspectives in tact. This article discusses how qualitative and quantitative methods can be combined and it introduces the articles included in this issue.

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Topics: Population (52%), Qualitative research (50%)

698 Citations

Open accessJournal ArticleDOI: 10.1186/1471-2288-4-25
Alicia O’Cathain1, Kate Thomas1Institutions (1)
Abstract: The habitual "any other comments" general open question at the end of structured questionnaires has the potential to increase response rates, elaborate responses to closed questions, and allow respondents to identify new issues not captured in the closed questions. However, we believe that many researchers have collected such data and failed to analyse or present it. General open questions at the end of structured questionnaires can present a problem because of their uncomfortable status of being strictly neither qualitative nor quantitative data, the consequent lack of clarity around how to analyse and report them, and the time and expertise needed to do so. We suggest that the value of these questions can be optimised if researchers start with a clear understanding of the type of data they wish to generate from such a question, and employ an appropriate strategy when designing the study. The intention can be to generate depth data or 'stories' from purposively defined groups of respondents for qualitative analysis, or to produce quantifiable data, representative of the population sampled, as a 'safety net' to identify issues which might complement the closed questions. We encourage researchers to consider developing a more strategic use of general open questions at the end of structured questionnaires. This may optimise the quality of the data and the analysis, reduce dilemmas regarding whether and how to analyse such data, and result in a more ethical approach to making best use of the data which respondents kindly provide.

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Topics: Population (51%)

400 Citations

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