Rights statement: The final, definitive version of this article has been published in the Journal, Journal of the Royal Society of Medicine, 115 (6), 2022, © SAGE Publications Ltd, 2022 by SAGE Publications Ltd at the Royal Society of Medicine page: https://journals.sagepub.com/home/SPP on SAGE Journals Online: http://journals.sagepub.com/
Accepted author manuscript, 567 KB, PDF document
Available under license: CC BY: Creative Commons Attribution 4.0 International License
Final published version
Licence: CC BY: Creative Commons Attribution 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Experiences of staff providing specialist palliative care during COVID-19: A multiple qualitative case study
AU - Bradshaw, A
AU - Dunleavy, Lesley
AU - Garner, Ian
AU - Preston, Nancy
AU - Bajwah, Sabrina
AU - Cripps, Rachel
AU - Fraser, Lorna
AU - Maddocks, Matthew
AU - Hocaoglu, Mevhibe
AU - Murtagh, F.E.M.
AU - Oluyase, Adejoke
AU - Sleeman, K.E.
AU - Higginson, I. J.
AU - Walshe, Catherine
N1 - The final, definitive version of this article has been published in the Journal, Journal of the Royal Society of Medicine, 115 (6), 2022, © SAGE Publications Ltd, 2022 by SAGE Publications Ltd at the Royal Society of Medicine page: https://journals.sagepub.com/home/SPP on SAGE Journals Online: http://journals.sagepub.com/
PY - 2022/6/30
Y1 - 2022/6/30
N2 - Summary Objective To explore the experiences of, and impact on, staff working in palliative care during the COVID-19 pandemic. Design Qualitative multiple case study using semi-structured interviews between November 2020 and April 2021 as part of the CovPall study. Data were analysed using thematic framework analysis. Setting Organisations providing specialist palliative services in any setting. Participants Staff working in specialist palliative care, purposefully sampled by the criteria of role, care setting and COVID-19 experience. Main outcome measures Experiences of working in palliative care during the COVID-19 pandemic. Results Five cases and 24 participants were recruited (n = 12 nurses, 4 clinical managers, 4 doctors, 2 senior managers, 1 healthcare assistant, 1 allied healthcare professional). Central themes demonstrate how infection control constraints prohibited and diluted participants’ ability to provide care that reflected their core values, resulting in experiences of moral distress. Despite organisational, team and individual support strategies, continually managing these constraints led to a ‘crescendo effect’ in which the impacts of moral distress accumulated over time, sometimes leading to burnout. Solidarity with colleagues and making a valued contribution provided ‘moral comfort’ for some. Conclusions This study provides a unique insight into why and how healthcare staff have experienced moral distress during the pandemic, and how organisations have responded. Despite their experience of dealing with death and dying, the mental health and well-being of palliative care staff was affected by the pandemic. Organisational, structural and policy changes are urgently required to mitigate and manage these impacts.
AB - Summary Objective To explore the experiences of, and impact on, staff working in palliative care during the COVID-19 pandemic. Design Qualitative multiple case study using semi-structured interviews between November 2020 and April 2021 as part of the CovPall study. Data were analysed using thematic framework analysis. Setting Organisations providing specialist palliative services in any setting. Participants Staff working in specialist palliative care, purposefully sampled by the criteria of role, care setting and COVID-19 experience. Main outcome measures Experiences of working in palliative care during the COVID-19 pandemic. Results Five cases and 24 participants were recruited (n = 12 nurses, 4 clinical managers, 4 doctors, 2 senior managers, 1 healthcare assistant, 1 allied healthcare professional). Central themes demonstrate how infection control constraints prohibited and diluted participants’ ability to provide care that reflected their core values, resulting in experiences of moral distress. Despite organisational, team and individual support strategies, continually managing these constraints led to a ‘crescendo effect’ in which the impacts of moral distress accumulated over time, sometimes leading to burnout. Solidarity with colleagues and making a valued contribution provided ‘moral comfort’ for some. Conclusions This study provides a unique insight into why and how healthcare staff have experienced moral distress during the pandemic, and how organisations have responded. Despite their experience of dealing with death and dying, the mental health and well-being of palliative care staff was affected by the pandemic. Organisational, structural and policy changes are urgently required to mitigate and manage these impacts.
KW - Qualitative research
KW - palliative care
KW - hospice
U2 - 10.1177/01410768221077366
DO - 10.1177/01410768221077366
M3 - Journal article
VL - 115
SP - 220
EP - 230
JO - Journal of the Royal Society of Medicine
JF - Journal of the Royal Society of Medicine
SN - 0141-0768
IS - 6
ER -