18 - The concept of debriefing and its application to staff dealing with life-threatening illnesses such as cancer, AIDS and other conditions

Summary

EDITORIAL COMMENTS

The ubiquity of the conceptualization of debriefing as an appropriate intervention to deal with ‘stress’ has meant that it is now frequently applied in health care settings to deal with emergency health workers' experience and also that of other workers perceived to work in stressful settings such as with terminally ill patients as well as more widely.

This detailed review examines the types of stressor experienced by health care workers, and their relationship to burnout and other work-related stress is considered. Critical incident stress debriefing as a model in such contexts is critically reviewed, although Turner and Kelly note that there is no empirical research validating its use for health care staff in these settings.

Of particular value, and applicable to many other worker and stress situations is the detailed review of factors that need to be considered as sources of stress. These include factors relating to the situation of the patient and the illness, for example type of illness, stage of lifecycle, suVering and other clinical problems, and patient characteristics. Factors relating to the individual worker include maturity and past experience, personality style, interpersonal relationships, expectations, requirement for emotional support, education and training experiences of staff, pre-existing psychological vulnerability and morbidity, and protective factors. External factors include administrative issues, team membership, and volunteer status. Sociocultural factors include personal and social attitudes to death and dying and cultural requirements for these.