Burnout and Resilience After a Decade in Palliative Care: What Survivors Have to Teach Us. A Qualitative Study of Palliative Care Clinicians With More Than 10 Years of Experience

ContextBurnout is common among palliative care clinicians (PCCs). Resilience helps to reduce burnout, compassion fatigue, and is associated with longevity in palliative care.ObjectivesWe aimed to study PCCs who have remained in the field for longer than 10 years to deepen our understanding on their views on burnout and resilience.MethodsWe conducted a qualitative study using semistructured interviews and purposive sampling on 18 PCCs – five doctors, 10 nurses, and three social workers who worked in various palliative care settings (hospital palliative care team, home hospice, and inpatient hospice). The mean age of the interviewees was 52 years, and the mean number of years practicing palliative care was 15.7 years (range 10–25). The interviews were recorded verbatim, transcribed, and analyzed using a grounded theory approach.ResultsFour major themes emerged from our analysis – struggling, changing mindset, adapting, and resilience. Intervening conditions, such as self-awareness, reflection, and evolution, were also important factors. The core phenomenon of our study was that of transformational growth – a process that PCCs have to go through before they achieve resilience. We also further classified resilience into both personal and collective resilience.ConclusionOur findings highlight the evolving process of transformational growth that PCCs must repeatedly undergo as they strive toward sustained resilience and longevity. It also stresses the importance of taking individual and collective responsibility toward building a culture of personal and team resilience.     

Resilience: a concept analysis

TOPIC: Concept analysis of resilience. PURPOSE: To analyze the concept of resilience and provide a definition of resilience that is contextually independent of specific age-related groups or populations. SOURCES: Published literature. CONCLUSIONS: Resilience is being increasingly studied in innovative ways among diverse populations. The broadly accepted definition of the term, however, has evolved through literature related specifically to children and adolescents. This concept analysis can provide a fundamental definition of resilience that is derived from the evolution of the term but broadly supports contemporary applications. Resilience researchers can apply this definition when exploring the possibility of resilience-based interventions.     

先天性巨结肠患儿家庭抗逆力现状及影响因素分析

目的 了解先天性巨结肠患儿家庭抗逆力现状及影响因素.方法 选择2020年7月-2021年7月我院住院治疗的118例先天性巨结肠患儿主要照顾者为研究对象,采用先天性巨结肠患儿及主要照顾者一般资料量表、家庭弹性评定量表、照顾负担量表及领悟社会支持量表进行横断面调查.结果 先天性巨结肠患儿主要照顾者家庭弹性评定量表(FRAS...     

心理韧性10年文献回顾及其对心理护理的启示

目的通过回顾国内近十年来的相关文献,对心理韧性的发展现状进行文献计量学分析,提出今后护理实践的努力方向。方法以"心理韧性"、"心理弹性"、"心理复原力"、"韧性"、"弹性"、"复原力"和"Resilience"分别作为主题词和关键词,在中国知网(China National Knowledge Infrastructure,CNKI)中,检索2003-2012年的相关文献,并对文献的数量以及研究的对象、方法和内容进行分析。结果有关心理韧性的文献逐年增多,研究方法以描述性研究和综述类文章较多,研究对象多集中于大学生、青少年这类年轻的群体中,研究内容以综合性研究和相关性研究居多。结论心理韧性的研究越来越引起国内研究者的关注,但是研究方法单一,研究对象分布不均衡,研究内容较局限,在心理护理领域中的应用还需做出进一步的努力。     

临床护士心理弹性的现状研究

目的了解临床护士心理弹性现状,分析心理弹性的主要影响因素,为科学管理提供依据。方法采用整群分层抽样的方法,选取600名临床护士进行心理弹性调查,并分析其影响因素。结果临床护士心理弹性整体状况及其各维度均处于中等水平。多元线性回归分析显示,心理弹性的主要影响因素是年龄、工龄、学历、婚姻状况、科室、医院等级(P0.01)。结论临床护士心理弹性处于中等水平,护理管理者应有针对性地对其进行培训,以提高其心理弹性。     

血液透析室护士心理韧性及其影响因素分析

目的调查血液透析室护士心理韧性现状,分析其影响因素,为增强血液透析室护士心理韧性提供依据。方法采用心理韧性量表对120名血液透析室护士进行问卷调查。结果血液透析室护士心理韧性总体水平较高,学历、从事血液透析年限和职称是其影响因素。结论针对血液透析室护士心理韧性的影响因素,制订相应的干预措施,提高护士的心理韧性从而提高其工作能力。     

Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S.

ContextMany clinical disciplines report high rates of burnout, which leads to low quality of care. Palliative care clinicians routinely manage patients with significant suffering, aiming to improve quality of life. As a major role of palliative care clinicians involves educating patients and caregivers regarding identifying priorities and balancing stress, we wondered how clinician self-management of burnout matches against the emotionally exhaustive nature of the work.ObjectivesWe sought to understand the prevalence and predictors of burnout using a discipline-wide survey.MethodsWe asked American Academy of Hospice and Palliative Medicine clinician members to complete an electronic survey querying demographic factors, job responsibilities, and the Maslach Burnout Inventory. We performed univariate and multivariable regression analyses to identify predictors of high rates of burnout.ResultsWe received 1357 responses (response rate 30%). Overall, we observed a burnout rate of 38.7%, with higher rates reported by nonphysician clinicians. Most burnout stemmed from emotional exhaustion, with depersonalization comprising a minor portion. Factors associated with higher odds of burnout include nonphysician clinical roles, working in smaller organizations, working longer hours, being younger than 50 years of age, and working weekends. We did not observe different rates between palliative care clinicians and hospice clinicians. Higher rated self-management activities to mitigate burnout include participating in interpersonal relationships and taking vacations.ConclusionBurnout is a major issue facing the palliative care clinician workforce. Strategies at the discipline-wide and individual levels are needed to sustain the delivery of responsive, available, high-quality palliative care for all patients with serious illness.     

Overcoming: a concept analysis

BACKGROUND. Nurses often work with individuals and populations striving to improve or maintain the quality of their lives. Many, struggling from complex health and social problems, are challenged to surmount barriers to achieve this goal. The growing number of homeless families in the United States represent one such cohort. AIMS. To develop an operational definition of overcoming and explicate its meaning, attributes, and characteristics as it relates to homeless families. METHODS. Using the concept analysis method described by Walker and Avant, along with an extensive literature review, and sample cases pertaining to family homelessness, we delineated the defining attributes, antecedents, consequences, and empirical referents of the concept, overcoming. CONCLUSION. The results of this concept analysis, particularly the relationship of overcoming to family homelessness, provide guidance for further conceptualization and empirical testing, as well as for clinical practice.     

护理人员心理弹性与风险感知水平关系研究

目的探讨心理弹性对护理人员风险感知水平的影响,为护理人员有效规避职业风险,提高执业安全提供科学指导。方法采用心理弹性量表和护理人员风险感知问卷对西安市某三级甲等医院525名临床护理工作人员进行调查。结果护理人员心理弹性整体处于中等偏下水平,3个维度得分由高到低依次为力量、坚韧和乐观;护理人员风险感知处于中等偏上水平,排名前3位的维度分别是职业暴露风险、身体功能风险和人身安全风险;心理弹性总分和各维度与风险感知各维度呈负相关(P0.01),力量和韧性可有效预测护理人员风险感知水平(P0.01)。结论护理人员心理弹性对风险感知水平具有较大的影响,良好的心理弹性可有效降低其风险感知水平。     

脑卒中主要照顾者心理弹性及影响因素研究

目的探讨脑卒中患者主要照顾者心理弹性现状,并分析其影响因素。方法采用一般资料问卷和心理弹性量表对220名住院脑卒中患者主要照顾者进行问卷调查。结果脑卒中患者主要照顾者心理弹性得分为(69.96±13.69)分,处于中等水平;主要照顾者的性别、年龄、照顾时间和压力是主要照顾者心理弹性的影响因素(P<0.01或P<0.05)。结论脑卒中患者主要照顾者心理弹性水平有待提高,护理人员应针对影响因素给予主要照顾者个体化的干预措施,促进主要照顾者积极应对,提高主要照顾者的心理弹性,使其更好地照顾患者,提高生活质量。     

An exploratory study of resilience and job satisfaction among psychiatric nurses working in inpatient units

The present exploratory study was designed to examine the relationship between resilience and job satisfaction in psychiatric nurses working in inpatient units in a large, urban medical centre. The long range goal was to understand the dimensions of job satisfaction in this inpatient environment in order to implement nurse retention programmes specifically targeted toward teaching nurses skills in developing resilience. The nurses (n = 32) reported a high level of resilience and high job satisfaction. The job satisfaction subscale of professional status had the highest mean rating among these nurses, and the physician-nurse interaction subscale had the lowest mean score. Implications for future practice and research are addressed.     

Correlates of Recent Suicide Attempts in a Triethnic Group of Adolescents

Purpose: To describe recent self-reported suicide attempts in a triethnic group of adolescents, to analyze differences in the correlates of attempts by ethnicity and gender, and to explore theoretical correlates of recent suicide attempts using a resilience framework.
Methods: Quantitative data were collected from 10,059 students in 7th, 9th, and 11th grades in Connecticut in 1996. Secondary analysis was done to compare respondents of African American, Hispanic Latino, and Caucasian ethnicities. Data were analyzed using bivariate and multivariate procedures. Logistic regression was used to identify the best set of explanatory variables for recent suicide attempts.
Results: The percentage of suicide attempts was significantly higher among Hispanic Latina girls (19.3%) than in any other ethnic-gender group. Significant relationships were found between recent suicide attempts and (a) family history of suicide attempt, (b) friend's history of suicide attempt, (c) history of sexual abuse, (d) history of physical abuse, and (e) environmental stress. The significant set of explanatory variables for recent suicide attempts for the three ethnic groups combined were stress, internalizing and externalizing behaviors, physical and sexual abuse, family and friend attempted suicide, social connectedness, and religious influence.
Conclusions: Findings support use of a resilience model for suicide attempts among three ethnic groups. The finding of a significantly higher percentage of recent suicide attempts by Hispanic girls compared to girls in other ethnic-gender groups warrants further investigation along with development and testing of culturally sensitive preventive interventions.     

中老年人的复原力与成功老化

介绍了复原力、成功老化的概念以及复原力与成功老化的关系。提出在中老年人群中复原力正向性影响成功老化;成功老化可增强复原力。建议在中老年人群中进行更多的研究,以验证复原力与成功老化的关系。