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

Published online by Cambridge University Press:  02 March 2021

Tania Pastrana
Affiliation:
International Association for Hospice and Palliative Care, Houston, TX Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
Liliana De Lima*
Affiliation:
International Association for Hospice and Palliative Care, Houston, TX
Katherine Pettus
Affiliation:
International Association for Hospice and Palliative Care, Houston, TX
Alison Ramsey
Affiliation:
International Association for Hospice and Palliative Care, Houston, TX
Genevieve Napier
Affiliation:
International Association for Hospice and Palliative Care, Houston, TX
Roberto Wenk
Affiliation:
International Association for Hospice and Palliative Care, Houston, TX Fundacion FEMEBA, Buenos Aires, Argentina
Lukas Radbruch
Affiliation:
International Association for Hospice and Palliative Care, Houston, TX University Hospital of Bonn, Helios Hospital Bonn/Rhein-Sieg, Bonn, Germany
*
Author for correspondence: Liliana De Lima, International Association for Hospice and Palliative Care, 5535 Memorial Drive, Suite F – 509, Houston, TX 77007-8023, USA. E-mail: [email protected]

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.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

REFERENCES

Arya, A, Buchman, S, Gagnon, B, et al. (2020) Pandemic palliative care: Beyond ventilators and saving lives. Canadian Medical Association Journal 192(15), E400E404. doi:10.1503/cmaj.200465.CrossRefGoogle ScholarPubMed
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3(2), 77101. doi:10.1191/1478088706qp063oa.CrossRefGoogle Scholar
Broadband Commission for Sustainable Development (2019) State of Broadband Report 2019. Broadband as a Foundation for Sustainable Development. International Telecommunication Union and United Nations Educational, Scientific and Cultural Organization. Available at: https://www.itu.int/dms_pub/itu-s/opb/pol/S-POL-BROADBAND.20-2019-PDF-E.pdf.Google Scholar
Clark, D, Baur, N, Clelland, D, et al. (2020) Mapping levels of palliative care development in 198 countries: The situation in 2017. Journal of Pain and Symptom Management 59(4), 794807.e4. doi:10.1016/j.jpainsymman.2019.11.009.CrossRefGoogle ScholarPubMed
Gómez-Batiste, X, Connor, S, Murray, S, et al. (2017) Principles, definitions and concepts. In Gomez-Batiste, X & Connor, S (eds.), Building Integrated Palliative Care Programs and Services. Barcelona: Liberdúplex, pp. 4560.Google Scholar
Hawley, P (2017) Barriers to access to palliative care. Palliative Care 10, 16. doi:10.1177/1178224216688887.Google ScholarPubMed
Hovenga, EJ, Hovel, J, Klotz, J, et al. (1998) Infrastructure for reaching disadvantaged consumers: Telecommunications in rural and remote nursing in Australia. Journal of the American Medical Informatics Association: JAMIA 5(3), 269275. doi:10.1136/jamia.1998.0050269.CrossRefGoogle ScholarPubMed
International Narcotics Control Board, World Health Organization, and United Nations Office on Drugs and Crime (2020) INCB, WHO and UNODC statement on access to internationally controlled medicines during COVID-19 pandemic. Available at: https://www.incb.org/incb/en/news/news_2020/incb-who-and-unodc-statement-on-access-to-internationally-controlled-medicines-during-covid-19-pandemic.html (accessed 12 September 2020).Google Scholar
Kates, J, Gerolamo, A and Pogorzelska-Maziarz, M (2020) The impact of COVID-19 on the hospice and palliative care workforce. Public Health Nursing. Epub ahead of print. doi:10.1111/phn.12827.Google ScholarPubMed
Lapolla, P, Mingoli, A and Lee, R (2020) Deaths from COVID-19 in healthcare workers in Italy — What can we learn? Infection Control and Hospital Epidemiology, 12. doi:10.1017/ice.2020.241.Google ScholarPubMed
Larochelle, MR (2020) “Is It Safe for Me to Go to Work?” Risk stratification for workers during the COVID-19 pandemic. New England Journal of Medicine 383(5), e28. doi:10.1056/NEJMp2013413.CrossRefGoogle ScholarPubMed
Maital, S and Barzani, E (2020) The Global Economic Impact of COVID-19: A Summary of Research. Samuel Neaman Institute for National Policy Research. Available at: https://www.neaman.org.il/EN/The-Global-Economic-Impact-of-COVID-19-A-Summary-of-Research (accessed 21 January 2021).Google Scholar
Monaghesh, E and Hajizadeh, A (2020) The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health 20(1), 1193. doi:10.1186/s12889-020-09301-4.CrossRefGoogle ScholarPubMed
Murphy, E, Dingwall, R, Greatbatch, D, et al. (1998) Qualitative research methods in health technology assessment: A review of the literature. Health Technology Assessment 2(16), iiiix, 1–274.CrossRefGoogle ScholarPubMed
O'Cathain, A and Thomas, KJ (2004) “Any other comments?” Open questions on questionnaires — A bane or a bonus to research? BMC Medical Research Methodology 4(1), 25. doi:10.1186/1471-2288-4-25.CrossRefGoogle ScholarPubMed
Pappa, S, Ntella, V, Giannakas, T, et al. (2020) Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity 88, 901907. doi:10.1016/j.bbi.2020.05.026.CrossRefGoogle ScholarPubMed
Pastrana, T, Junger, S, Ostgathe, C, et al. (2008) A matter of definition — Key elements identified in a discourse analysis of definitions of palliative care. Palliative Medicine 22(3), 222232. doi:10.1177/0269216308089803.CrossRefGoogle Scholar
Pessin, H, Fenn, N, Hendriksen, E, et al. (2015) Existential distress among healthcare providers caring for patients at the end of life. Current Opinion in Supportive and Palliative Care 9(1), 7786. doi:10.1097/spc.0000000000000116.CrossRefGoogle ScholarPubMed
Pettus, K, Cleary, JF, de Lima, L, et al. (2020) Availability of internationally controlled essential medicines in the COVID-19 pandemic. Journal of Pain and Symptom Management 60(2), e48e51. doi:10.1016/j.jpainsymman.2020.04.153.CrossRefGoogle ScholarPubMed
Plessis, Ed (2016) Presence as a personal project in palliative care: Transcending personality. Nursing and Palliative Care 2(1), 12. doi:10.15761/NPC.1000137.Google Scholar
Radbruch, L, De Lima, L, Knaul, F, et al. (2020a) Redefining palliative care — A new consensus-based definition. Journal of Pain and Symptom Management 60(4), 754764. doi:10.1016/j.jpainsymman.2020.04.027.CrossRefGoogle Scholar
Radbruch, L, Knaul, FM, de Lima, L, et al. (2020b) The key role of palliative care in response to the COVID-19 tsunami of suffering. Lancet 395(10235), 14671469. doi:10.1016/S0140-6736(20)30964-8.CrossRefGoogle Scholar
Steckler, A, McLeroy, KR, Goodman, RM, et al. (1992) Toward integrating qualitative and quantitative methods: An introduction. Health Education Quarterly 19(1), 18. doi:10.1177/109019819201900101.CrossRefGoogle ScholarPubMed
Wolff, D, Nee, S, Hickey, NS, et al. (2020) Risk factors for COVID-19 severity and fatality: A structured literature review. Infection 114. doi:10.1007/s15010-020-01509-1.Google ScholarPubMed
World Health Organization (2020) WHO Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ (accessed 22 January 2021).Google Scholar
Wu, Y, Wang, J, Luo, C, et al. (2020) A comparison of burnout frequency among oncology physicians and nurses working on the frontline and usual wards during the COVID-19 epidemic in Wuhan, China. Journal of Pain and Symptom Management 60(1), e60e65. doi:10.1016/j.jpainsymman.2020.04.008.CrossRefGoogle ScholarPubMed