RT Journal Article
SR Electronic
T1 Burnout in Palliative Care - Difficult Cases: Qualitative Study
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP bmjspcare-2021-003347
DO 10.1136/bmjspcare-2021-003347
A1 Mervyn Yong Hwang Koh
A1 Marysol Dalisay Gallardo
A1 Hwee Sing Khoo
A1 Allyn Hum
YR 2022
UL http://spcare.bmj.com/content/early/2022/04/14/bmjspcare-2021-003347.abstract
AB Objectives Burnout is common among palliative care clinicians, occurring as a result of emotions experienced in caring for challenging patients or families. Awareness of these scenarios helps clinicians and teams appropriately manage their own emotions and prevent burnout. We studied challenging clinical situations and the emotions encountered by experienced palliative care clinicians which could potentially contribute to burnout.Methods A qualitative study was conducted using semistructured interviews with purposive sampling of 18 palliative care clinicians—5 doctors, 10 nurses and 3 social workers who worked in various palliative care settings (hospital palliative care team, home hospice and inpatient hospice). The interviews were recorded verbatim, transcribed and analysed using a thematic analysis approach.Results The mean age of the interviewees was 52 years old and the mean number of years practising palliative care was 15.7 years (ranging from 10 to 25 years). The following clinical situations were reported by our respondents as particularly challenging, potentially leading to burnout: (1) abusive patients and families, (2) ‘bad deaths’, (3) death of young patients, (4) complex cases, and (5) having multiple deaths or difficult cases at any one time. Emotions encountered in the course of care of these cases included: (1) feeling overwhelmed, (2) having a sense of helplessness and failure, as well as (3) a sense of injustice.Conclusion The challenging cases we described evoke strong emotional reactions from palliative care clinicians that need to be adequately addressed to prevent burnout.All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.