Experiences of staff providing specialist palliative care during COVID-19: a multiple qualitative case study
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Abstract
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.
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Staff caring for people with an advanced progressive illness are at risk of stress, distress and burnout.
“Staff caring for people with an advanced progressive illness are at risk of stress, distress and burnout.”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [18]
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Self-citation
- Authors
- Bradshaw, A., Dunleavy, L., Garner, I., Preston, N., Bajwah, S., Cripps, R., Fraser, L. K., Maddocks, M., Hocaoglu, M., Murtagh, F. E., Oluyase, A. O., Sleeman, K. E., Higginson, I. J., & Walshe, C.
- Affiliations
- King's College London (GB)
- Lancaster University (GB)
- University of York (GB)
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, SE5 9PJ, UK
- University of Hull (GB)
- Corresponding author
- Bradshaw, Andy
- ORCID
- Venue
- Journal of the Royal Society of Medicine
- Publisher
- SAGE Publications
- Published
- 2022-02-08
- Volume
- 115
- Issue
- 6
- Pages
- 220-230
- ISSN
- 0141-0768 (ISSN-L)
- 1758-1095
- PMC
- PMC9158238
- OpenAlex
- W4226033045
- Cited by
- 51
- References
- 56
- Citations by year
- 2026: 1 · 2025: 11 · 2024: 20 · 2023: 15 · 2022: 4
- FWCI
- 14.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of the Royal Society of Medicine (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lancaster EPrints (Lancaster University) (acceptedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Funders
- South London and Maudsley NHS Foundation Trust
- King's College Hospital NHS Foundation Trust
- National Institute for Health and Care Research (CDF-2017-10-009, PDF-2011-04-048, CL-2010-17-009, CDF-2018-11-ST2-002, CS-2015-15-005, NF-SI-0611-10209, NIHR201354)
- Department of Health and Social Care
- King's College London
- Medical Research Council (CS-2015-15-005, MR/V012908/1)
- National Institute for Health Research Applied Research Collaboration South London
- Topics
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- specialist palliative care, COVID-19 pandemic, moral distress, burnout, workplace mental health, organizational support, healthcare workers' experiences
- MeSH terms
- COVID-19, Health Personnel, Humans, Palliative Care, Qualitative Research, Pandemics
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