Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-24T20:13:07.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Association between level of exposure to death and dying and professional quality of life among palliative care workers

Published online by Cambridge University Press:  23 June 2017

Tali Samson  and
Pesach Shvartzman
Tali Samson*
Affiliation:
Pain and Palliative Care Unit, Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Pesach Shvartzman
Affiliation:
Pain and Palliative Care Unit, Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Clalit Health Services for the Southern District, Beer-Sheva, Israel
*
Address correspondence and reprint requests to: Tali Samson, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva 84105, Israel. E-Mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Exposure to the death and dying of others is an anxiety-provoking condition that can contribute to psychological stress. However, the results of empirical studies that evaluated work-related outcomes among physicians and nurses with repeated exposure to dying patients are not consistent.

Objective:

Our aim was to evaluate whether a high level of exposure to death and dying (LED) can increase the risk for poor professional quality of life (ProQoL) in most healthcare workers, but it can also improve ProQoL in a subset of healthcare workers with specific characteristics.

Method:

We employed a cross-sectional survey designed to better understand the role of LED as a predictor of ProQoL among healthcare workers.

Setting and Participants:

Comparison of physicians and nurses with high LED (home-based palliative care units) with a matched group of physicians and nurses with low LED (primary care units) and evaluation of possible interaction effects among LED, death anxiety (DA), and engagement as predictors of ProQoL.

Results:

The final sample included 110 questionnaires from the high-LED group (response rate = 39%) and 131 from the low-LED (response rate = 24%) group. Workers with high LED reported an increased level of compassion satisfaction (CS) and low to moderate levels of burnout (BU) and secondary traumatic stress (STS), with no significant differences with respect to other healthcare providers. Although levels of CS, STS, and BU did not differ between groups, a univariate MANOVA revealed that the interaction effect of LED × Engagement reduced levels of CS and that the interaction effect of LED × DA increased STS among workers with high LED.

Significance of results:

LED was significantly correlated with ProQoL among healthcare workers with high LED due to the reported interaction effect. These findings imply, for the first time, that there is a possible correlation between engagement and the risk for poor ProQoL among workers with high LED. Further research is essential to gain a better understanding of this issue.

Keywords

Palliative careProfessional quality of lifeDeath exposureEngagementDeath anxiety
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Special Issue 4: Topics in Bereavement , August 2018 , pp. 442 - 451
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Abendroth, M. & Flannery, J. (2006). Predicting the risk of compassion fatigue: A study of hospice nurses. Journal of Hospice & Palliative Nursing, 8(6), 346–356.Google Scholar
Ablett, J.R. & Jones, R.S. (2007). Resilience and well-being in palliative care staff: A qualitative study of hospice nurses' experience of work. Psycho-Oncology, 16(8), 733–740.Google Scholar
Anderson, W.G., Williams, J.E., Bost, J.E., et al. (2008). Exposure to death is associated with positive attitudes and higher knowledge about end-of-life care in graduating medical students. Journal of Palliative Medicine, 11(9), 1227–1233.Google Scholar
Braun, M., Gordon, D. & Uziely, B. (2010). Associations between oncology nurses' attitudes toward death and caring for dying patients. Oncology Nursing Forum, 37(1), E43–E49.Google Scholar
Carmel, S. (2001). Fear of death and fear of dying: Structure and sociometric features of the measures [in Hebrew]. Gerontology, 28(3–4), 133–154.Google Scholar
Carmel, S. & Mutran, E. (1997). Wishes regarding the use of life-sustaining treatments among elderly persons in Israel: An explanatory model. Social Science & Medicine, 45(11), 1715–1727.Google Scholar
Chan, A.O., Chan, Y.H., Chuang, K.P., et al. (2015). Addressing physician quality of life: Understanding the relationship between burnout, work engagement, compassion fatigue and satisfaction. Journal of Hospital Administration, 4(6), 46–55.Google Scholar
Cho, Y.I., Johnson, T.P. & Vangeest, J.B. (2013). Enhancing surveys of health care professionals: A meta-analysis of techniques to improve response. Evaluation & the Health Professions, 36(3), 382–407.Google Scholar
Cohen, N. & Carmel, S. (2004). Changes in Fear of Death of Cancer Patients from Diagnosis till Death. Doctoral dissertation. Beer-Sheva, Israel: Ben-Gurion University.Google Scholar
Currow, D.C., Wheeler, J.L. & Glare, P.A. (2009). A framework for generalizability in palliative care. Journal of Pain & Symptom Management, 37(3), 373–386.Google Scholar
Deihl, L.M. (2009). The Relevance of the Supervisory Working Alliance to Burnout and Vigor among Residential Frontline Staff. Doctoral dissertation. Albany: State University of New York.Google Scholar
Depaola, S.J., Griffin, M., Young, J.R., et al. (2003). Death anxiety and attitudes toward the elderly among older adults: The role of gender and ethnicity. Death Studies, 27(4), 335–354.Google Scholar
Edwards, P., Roberts, I., Clarke, M., et al. (2002). Increasing response rates to postal questionnaires: Systematic review. BMJ (Clinical Research ed.), 325(7361), 444.Google Scholar
Figley, C.R. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. London: Psychology Press.Google Scholar
Hill, A., Roberts, J., Ewings, P., et al. (1997). Non-response bias in a lifestyle survey. Journal of Public Health Medicine, 19(2), 203–207.Google Scholar
Hoelter, J.W. & Hoelter, J.A. (1981). On the interrelationships among exposure to death and dying, fear of death, and anxiety. Omega, 11(3), 241–254.Google Scholar
Hooper, C., Craig, J., Janvrin, D.R., et al. (2010). Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36(5), 420–427.Google Scholar
Horesh, D. (2016). The reconstruction of criterion A in DSM–5: Is it a true incorporation of secondary traumatization into the PTSD diagnosis? Journal of Loss and Trauma, 21(5), 345–349.Google Scholar
Kaur, H. & Dutta, M. (2014). Death anxiety in females with and without exposure to death and dying: Differential dimensions. Sri Lanka Journal of Social Sciences, 37(1–2), 33–39.Google Scholar
Koo, K., Zeng, L., Zhang, L., et al. (2013). Comparison and literature review of occupational stress in a palliative radiotherapy clinic's interprofessional team, the radiation therapists, and the nurses at an academic cancer center. Journal of Medical Imaging and Radiation Sciences, 44(1), 14–22.Google Scholar
Linley, P.A. & Joseph, S. (2005). Positive and negative changes following occupational death exposure. Journal of Traumatic Stress, 18(6), 751–758.Google Scholar
Littman-Ovadia, H. (2013). Psychometric properties of the Hebrew version of the Utrecht Work Engagement Scale (UWES–9). European Journal of Psychological Assessment, 29(1), 58–63.Google Scholar
Mallett, K., Price, J.H., Jurs, S.G., et al. (1991). Relationships among burnout, death anxiety, and social support in hospice and critical care nurses. Psychological Reports, 68(3c), 1347–1359.Google Scholar
Mason, V.M., Leslie, G., Clark, K., et al. (2014). Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: A pilot study. Dimensions of Critical Care Nursing, 33(4), 215–225.Google Scholar
McFarland, D.C., Malone, A.K. & Roth, A. (2016). Acute empathy decline among resident physician trainees on a hematology–oncology ward: An exploratory analysis of house staff empathy, distress, and patient death exposure. Psycho-Oncology, 26(5), 698–703.Google Scholar
Neimeyer, R.A. (1998). Death anxiety research: The state of the art. Omega, 36(2), 97–120.Google Scholar
Pereira, S.M., Fonseca, A.M. & Carvalho, A.S. (2011). Burnout in palliative care: A systematic review. Nursing Ethics, 18(3), 317–326.Google Scholar
Peters, L., Cant, R., Sellick, K., et al. (2012). Is work stress in palliative care nurses a cause for concern? A literature review. International Journal of Palliative Nursing, 18(11), 561–567.Google Scholar
Peters, L., Cant, R., Payne, S., et al. (2013a). Emergency and palliative care nurses' levels of anxiety about death and coping with death: A questionnaire survey. Australasian Emergency Nursing Journal, 16(4), 152–159.Google Scholar
Peters, L., Cant, R., Payne, S., et al. (2013b). How death anxiety impacts nurses' caring for patients at the end of life: A review of literature. The Open Nursing Journal, 7, 14–21.Google Scholar
Pietrantoni, L. & Prati, G. (2008). Resilience among first responders. African Health Sciences, 8(Suppl. 1), S14–S20.Google Scholar
Quinn-Lee, L., Olson-McBride, L. & Unterberger, A. (2014). Burnout and death anxiety in hospice social workers. Journal of Social Work in End-of-Life & Palliative Care, 10(3), 219–239.Google Scholar
Ramirez, A.J., Graham, J., Richards, M.A., et al. (1996). Mental health of hospital consultants: The effects of stress and satisfaction at work. Lancet, 347(9003), 724–728.Google Scholar
Robinson, P.J. & Wood, K. (1984). Fear of death and physical illness: A personal construct approach. Death Education, 7(2–3), 213–228.Google Scholar
Samson, T., Iecovich, E. & Shvartzman, P. (2016). Psychometric characteristics of the Hebrew version of the Professional Quality-of-Life Scale. Journal of Pain and Symptom Management, 52(4), 575–581.Google Scholar
Sanso, N., Galiana, L., Oliver, A., et al. (2015). Palliative care professionals' inner life: Exploring the relationships among awareness, self-care, and compassion satisfaction and fatigue, burnout, and coping with death. Journal of Pain and Symptom Management, 50(2), 200–207.Google Scholar
Schaufeli, W.B. & Bakker, A.B. (2003). Utrecht Work Engagement Scale: Preliminary Manual. Utrecht, Netherlands: Occupational Health Psychology Unit, Utrecht University. Available from https://www.beanmanaged.com/doc/pdf/arnoldbakker/articles/articles_arnold_bakker_87.pdf.Google Scholar
Schaufeli, W.B. & Salanova, M. (2014). Burnout, boredom and engagement at the workplace. In People at Work: An Introduction to Contemporary Work Psychology, pp. 293–320. London: Wiley-Blackwell.Google Scholar
Schaufeli, W.B., Salanova, M., González-Romá, V., et al. (2002). The measurement of engagement and burnout: A two sample confirmatory factor analytic approach. Journal of Happiness Studies, 3(1), 71–92.Google Scholar
Shirom, A. (2003). Job-related burnout: A review. In Handbook of Occupational Health Psychology. Quick, J.C. & Tetrick, L.E. (eds.), pp. 245–264. Washington, DC: American Psychological Association.Google Scholar
Shirom, A. & Melamed, S. (2006). A comparison of the construct validity of two burnout measures in two groups of professionals. International Journal of Stress Management, 13(2), 176–200.Google Scholar
Slocum-Gori, S., Hemsworth, D., Chan, W.W., et al. (2013). Understanding compassion satisfaction, compassion fatigue and burnout: A survey of the hospice palliative care workforce. Palliative Medicine, 27(2), 172–178.Google Scholar
Stamm, B.H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the compassion satisfaction and fatigue test. In Treating Compassion Fatigue. Figley, C.R. (ed.), pp. 107–119. New York: Brunner-Routledge.Google Scholar
Stamm, B.H. (2005). The ProQoL Manual. Pocatello: Idaho State University and Sidran Press. Available from http://www.compassionfatigue.org/pages/ProQOLManualOct05.pdf.Google Scholar
Stamm, B.H. (2010). The Concise ProQoL Manual, 2nd ed. Pocatello, ID: ProQoL.org. Available from http://www.proqol.org/uploads/ProQoL_Concise_2ndEd_12-2010.pdf.Google Scholar
Tedeschi, R.G. & Calhoun, L.G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18.Google Scholar
Whitebird, R.R., Asche, S.E., Thompson, G.L., et al. (2013). Stress, burnout, compassion fatigue, and mental health in hospice workers in Minnesota. Journal of Palliative Medicine, 16(12), 1534–1539.Google Scholar
Zeidner, M., Hadar, D., Matthews, G., et al. (2013). Personal factors related to compassion fatigue in health professionals. Anxiety, Stress, & Coping, 26(6), 595–609.Google Scholar