부산대학교 도서관

Systematic Review: Background: Work stress can impact on palliative care and hospice healthcare professionals (HCPs) well-being. Elevated and prolonged periods of work stress can lead to burnout. Research has struggled to capture the prevalence of burnout and it has been reported that hospice HCPs present with less symptoms of burnout than palliative care HCPs working in other healthcare settings. Research has not yet provided an explanation for these findings. The current review aimed to identify and synthesise qualitative research to explore the strategies hospice HCPs use to promote adaptation in response to work stress. Methods: A systematic search strategy was applied to four databases (PsycINFO, Web of Science, MEDLINE and CINAHL). The review findings were analysed using Thomas and Harden's approach to thematic synthesis and the confidence in the review findings was assessed using GRADE CERQual. Results: Ten studies were included in the synthesis and analysis led to the development of four analytical themes: the sanctity of the hospice, regaining agency, the journey to self-care and the identification of meaning and purpose. Conclusions: The review demonstrates that hospice HCPs have identified strategies that they use in response to work stress that develop with personal and professional experience in hospice care. The hospice setting is influential for HCPs adaptation to work stress as it promotes the development of psychological safety amongst staff. The findings highlight the importance of the participant to researcher relationship during data collection and that staff support should be provided by individuals who understand hospice care. The findings highlight that hospice HCPs could benefit from organisations allowing for the co-production of organisational support. Empirical Study: Background: Palliative care HCPs are regularly exposed to emotionally challenging situations, such as patient suffering and death. These sources of stress can impact on the psychological well-being of staff. Research has struggled to capture what mitigates the work stress experienced by palliative care HCPs. The need for palliative care is predicted to increase, making it vital to support the palliative care workforce. Psychological flexibility, self-compassion and team climate have been identified as moderators of stress in other populations, however limited research has explored these in relation to work stress in palliative care staff. Methods: The current study aimed to gain insight into the levels and sources of work stress in palliative care HCPs and whether levels of work stress differed between occupational groups. The study used a cross sectional design to also explore the potential relationships between psychological flexibility, self-compassion and team climate with work stress in this population. Results: In total, 46 responses were analysed. Most respondents were staff nurses (48%), with 96% of respondents working in inpatient hospice settings. Almost half of the respondents had been working in palliative care for over five years (49%). Key sources of stress reported were organisational factors and HCPs perception that palliative care had become more medicalised in recent years. Self-compassion, collective ownership of goals and team collaboration were related to work stress in palliative care HCPs. Conclusions: Research has demonstrated the challenges of capturing what promotes and maintains staff well-being within this unique population. In consideration of support for palliative care HCPs, this could involve the promotion of self-compassion, as well as team-based approaches, to promote HCPs management of work stress. An area for future research would be the development of a quantitative measure to capture sources of work stress, specific to palliative care HCPs.